Saving lives amid harsh realities
Onandjokwe medical staff are excelling amid a shortage of basic items such as beds and ablution facilities, and a morale-destroying wait for a new maternity ward to be completed.
Staff at the Onandjokwe Lutheran Hospital maternity unit last year saved the lives of 88 women who experienced complications during childbirth.
Out of 7 101 births recorded at the hospital last year, there was only one maternal mortality, and according to health ministry executive director Ben Nangombe this compares well with the best hospitals in the world.
All this was achieved despite a shortage of basic items such as beds and ablution facilities.
The head of the maternity ward, Dr Nsangamay Tshimanga, says the hospital successfully handled 88 high-risk deliveries last year.
These women arrived at the hospital in critical condition but thanks to the dedication and hard of the medical staff, death was prevented, Tshimanga said.
“The only death that was recorded out of 7 101 births was of a mother who was known to have high blood pressure. She was stable during pregnancy, delivery and post-delivery. She was sent home with a follow-up date. Unfortunately she did not show up for the follow-up as she came in three weeks later in a critical condition and died in our ICU.” Tshimanga said despite poor hospital conditions, the medical staff did wonders to save lives. The hospital has a severe staff shortage which means that one doctor attends to 3 185 patients while a nurse attends to 642 patients. The World Health Organisation (WHO) recommends a ratio of one doctor per 1 837 and one nurse per 297 patients.
The hospital's maternity section offers antenatal care, a labour ward, postnatal care and neonatal care. “The situation in the maternity ward here at Onandjokwe demonstrates how not to run a health facility. Despite the difficulties, let us get the basics right. Let us acknowledge our shortcomings and address them. It is the only way we can move forward. I commend the staff at Onandjokwe for the good work they are doing despite the challenging environment,” said Nangombe.
He said that the maternity section was created as part of the ministry's approved structure of critical posts during December 2019 with the additional staff of one chief registered nurse, 20 registered nurses and two enrolled nurses. Although not an ideal situation, these numbers were determined considering the financial constraints. He added that 50 nurses - 32 registered and 18 enrolled - worked in the maternity ward. “These 32 registered nurses are divided into 20 for day shift and 10 for night shift and one registered midwife on each shift. Whereas enrolled nurses are divided into 10 for day shift and eight for night shift. These numbers can be lower when nurses are on leave or attending workshops,” Nangombe said. The hospitals acting medical superintendent, Dr Siraji Saad Rwehumbiza, said many of the staff are so loyal that they regard the hospital as their home. “People here regard the hospital as home and treat everyone as family and that is why they do everything with passion and dedication to save their community. We receive patients from all over the north coming to deliver at our unit,” Rwehumbiza said.
Critical condition exposed
When the government took over Onandjokwe hospital in 2015, it undertook the construction of a new maternity ward due to the high demand for services - a project that has yet to be completed, despite patients facing difficult conditions due to the ageing, small ward. Following the circulation of a video exposing the sorry state of the maternity ward, the health ministry was quick to respond, promising the rapid completion of the new ward, which has been under construction for the past five years. Health minister Kalumbi Shangula, who was attending a funeral in the north, had to change his programme to join Nangombe to address the situation of overcrowding and a plague of cats at the hospital.
The health ministry said it approached the Central Procurement Board of Namibia in September 2019 for a determination on the contract with the contractor responsible for the maternity ward construction. They are still waiting for a procurement board resolution. Amupolo Building Construction was appointed in 2015 to construct a new N$59 million antenatal and postnatal maternity ward, which was expected to be completed in August 2016.
During a media briefing recently, Nangombe said the delay in the completion of the maternity ward is worrying.
“Our expectant mothers face difficult conditions. There is a shortage of basic items such as beds and mattresses; patients are accommodated in corridors and other inappropriate spaces with limited access to ablution facilities,” Nangombe said.
“The delay not only robs our people of quality healthcare, but it is bad for the morale of our health workers,” he said. The new project is a 150-bed ward which includes antenatal care, post-natal care, an operating theatre, a delivery section, a baby unit and administration components. Nangombe said the project has been delayed due to the technical and financial capacity of the contractor. Of the N$59 million, only N$22 million has been paid to the contractor for work completed.
'We did nothing wrong'
Amupolo Building Construction owner Erasmus Amupolo said during an earlier interview with Namibian Sun that they were already preparing the roofing when the works ministry's building inspectors ordered them to stop, as they were unhappy with the floor work. “We did nothing wrong. Everything was done according to the building plan that was presented to us. We are now waiting for the way forward from the works ministry, but it is a must that the floor work has to be redone and that is now going to be extra work. We do not know who will cater for it,” Amupolo added at the time.
ILENI NANDJATO
Out of 7 101 births recorded at the hospital last year, there was only one maternal mortality, and according to health ministry executive director Ben Nangombe this compares well with the best hospitals in the world.
All this was achieved despite a shortage of basic items such as beds and ablution facilities.
The head of the maternity ward, Dr Nsangamay Tshimanga, says the hospital successfully handled 88 high-risk deliveries last year.
These women arrived at the hospital in critical condition but thanks to the dedication and hard of the medical staff, death was prevented, Tshimanga said.
“The only death that was recorded out of 7 101 births was of a mother who was known to have high blood pressure. She was stable during pregnancy, delivery and post-delivery. She was sent home with a follow-up date. Unfortunately she did not show up for the follow-up as she came in three weeks later in a critical condition and died in our ICU.” Tshimanga said despite poor hospital conditions, the medical staff did wonders to save lives. The hospital has a severe staff shortage which means that one doctor attends to 3 185 patients while a nurse attends to 642 patients. The World Health Organisation (WHO) recommends a ratio of one doctor per 1 837 and one nurse per 297 patients.
The hospital's maternity section offers antenatal care, a labour ward, postnatal care and neonatal care. “The situation in the maternity ward here at Onandjokwe demonstrates how not to run a health facility. Despite the difficulties, let us get the basics right. Let us acknowledge our shortcomings and address them. It is the only way we can move forward. I commend the staff at Onandjokwe for the good work they are doing despite the challenging environment,” said Nangombe.
He said that the maternity section was created as part of the ministry's approved structure of critical posts during December 2019 with the additional staff of one chief registered nurse, 20 registered nurses and two enrolled nurses. Although not an ideal situation, these numbers were determined considering the financial constraints. He added that 50 nurses - 32 registered and 18 enrolled - worked in the maternity ward. “These 32 registered nurses are divided into 20 for day shift and 10 for night shift and one registered midwife on each shift. Whereas enrolled nurses are divided into 10 for day shift and eight for night shift. These numbers can be lower when nurses are on leave or attending workshops,” Nangombe said. The hospitals acting medical superintendent, Dr Siraji Saad Rwehumbiza, said many of the staff are so loyal that they regard the hospital as their home. “People here regard the hospital as home and treat everyone as family and that is why they do everything with passion and dedication to save their community. We receive patients from all over the north coming to deliver at our unit,” Rwehumbiza said.
Critical condition exposed
When the government took over Onandjokwe hospital in 2015, it undertook the construction of a new maternity ward due to the high demand for services - a project that has yet to be completed, despite patients facing difficult conditions due to the ageing, small ward. Following the circulation of a video exposing the sorry state of the maternity ward, the health ministry was quick to respond, promising the rapid completion of the new ward, which has been under construction for the past five years. Health minister Kalumbi Shangula, who was attending a funeral in the north, had to change his programme to join Nangombe to address the situation of overcrowding and a plague of cats at the hospital.
The health ministry said it approached the Central Procurement Board of Namibia in September 2019 for a determination on the contract with the contractor responsible for the maternity ward construction. They are still waiting for a procurement board resolution. Amupolo Building Construction was appointed in 2015 to construct a new N$59 million antenatal and postnatal maternity ward, which was expected to be completed in August 2016.
During a media briefing recently, Nangombe said the delay in the completion of the maternity ward is worrying.
“Our expectant mothers face difficult conditions. There is a shortage of basic items such as beds and mattresses; patients are accommodated in corridors and other inappropriate spaces with limited access to ablution facilities,” Nangombe said.
“The delay not only robs our people of quality healthcare, but it is bad for the morale of our health workers,” he said. The new project is a 150-bed ward which includes antenatal care, post-natal care, an operating theatre, a delivery section, a baby unit and administration components. Nangombe said the project has been delayed due to the technical and financial capacity of the contractor. Of the N$59 million, only N$22 million has been paid to the contractor for work completed.
'We did nothing wrong'
Amupolo Building Construction owner Erasmus Amupolo said during an earlier interview with Namibian Sun that they were already preparing the roofing when the works ministry's building inspectors ordered them to stop, as they were unhappy with the floor work. “We did nothing wrong. Everything was done according to the building plan that was presented to us. We are now waiting for the way forward from the works ministry, but it is a must that the floor work has to be redone and that is now going to be extra work. We do not know who will cater for it,” Amupolo added at the time.
ILENI NANDJATO
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