His skin was charred and peeling; his blistered flesh burning constantly. When he could muster some energy, the 14 year old boy screamed in agony. Mostly, though, he had only enough strength to moan in quiet desperation, and to blink away the ever-present tears that filled his large brown eyes.
“He was burnt in a hut fire. He had significant burns, about 40 percent burns, and he was lying in the hospital getting dressings every day, and just slowly wasting away; the hospital diet is not always rich in protein and nutrients,” recalled Dr. Liz Gatley, at Zithulele Hospital in South Africa’s Eastern Cape province.
As days became months, hope for her young patient faded. “He was dying. He just got thinner and thinner and more anemic,” the rural health specialist said.
But Gatley wasn’t prepared to surrender another life to the harsh conditions under which the people of Oliver Tambo District, one of the country’s most isolated and poorest areas, live.
“I decided to start investing in a high-protein diet for him,” she said. The hospital couldn’t afford meat for patients, so the physician bought it herself. For six weeks, three times a week, she cooked meat and fed it to the ailing burn victim.
“He survived, in the end. I couldn’t believe it. He stayed well enough to be able to be transferred to another hospital for a skin graft, which is what he really needed,” Gatley said.
She recently saw the boy for the first time in six months. “He walked through the hospital door the one day. I couldn’t believe it; he looked really chubby, actually. I saw his scar; it was nicely healed and he was absolutely fine. It was amazing,” she told VOA, laughing.
Gatley’s story is further proof of a remarkable transformation that’s happened at Zithulele Hospital. Five years ago, said community health worker Ncedisa Paul, the facility was “very far away” from being a place of compassion and the “oasis of hope” she now describes it as.
“The place was terrible. There were only two doctors to serve this community of 130,000 people. People said things like, ‘You go into Zithulele alive; you come out dead,’” Paul commented.
She added that the hospital frequently ran out of the antiretroviral (ARV) medication needed to keep HIV-infected patients alive. “Many people died,” said Paul. “The graveyards here are full of bodies.”
Senior nurse Thembeka Gaushe remembered the hospital as an “uncaring kind of place.” She acknowledged, “The doctors and nurses were just under so much pressure, and the conditions were just so bad here, that we stopped caring for our patients.”
Zithulele remains assailed by serious challenges. It sometimes runs out of basic medical materials, such as antibiotics, needles, oxygen and surgical gloves. Yet it has achieved successes unprecedented in South Africa’s crumbling public health sector
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The hospital has drastically reduced what was one of the highest infant death rates in the country, and has put more than 2,700 HIV-positive patients on ARVs. While other state health facilities buckle under severe staff shortages, the hospital has no vacant posts. It employs 10 doctors – all specialists in rural medicine. Many public hospitals across South Africa don’t have a single doctor.
Ben Gaunt, Zithulele’s dynamic chief physician, has been a major driver of positive change at the institution. “In 2005, when I first came here, we didn’t have anything,” he said.
But Gaunt did have a dream – to give the impoverished, unemployed people of Oliver Tambo District, where one in three people is HIV-positive, Tuberculosis (TB) is rife and children die of preventable illnesses such as diarrhea and pneumonia, access to the best possible medical care.
The hospital’s turnaround began with a “simple” but firm decision by Gaunt to employ only people who were passionate about rural health and saving the lives of the poorest of the poor.
“Public health is all about numbers and filling posts and that kind of bureaucratic stuff, and it’s wrong,” he insisted. “It shouldn’t be about quantity of health workers, it should be about quality – appointing the right people for the right jobs.”
To achieve this, Gaunt refused to advertise posts in newspapers, which remains the standard way that the government offers public health jobs. Instead, he personally “head-hunted” staff.
“Through personal networks, we found people who were keen on rural health. Headhunting is a far more effective way of finding quality people,” he maintained.