Question NW2146 to the Minister of Health

Reply:

Background to the reply: 

A hospital that has the deliveries of 56 babies at a time, would generally require a minimum of approximately 25 Midwives at a particular time to ensure maximum coverage. This means that these midwives would have to take care of the 56 newborn babies, while also continuing to monitor the new arrival and those mothers who are in the active stage of labour. In this situation these nurses must ensure that the mothers and their newborn babies receive quality clinical care which would not result in unnecessary litigations. At this hospital, the picture derived from the letter that was received from MEC about this incident, it means that this was the reality at the time. The nurses, like all workers, are at times faced with acute shortage of resources, because of the sudden (unexpected rise in service demands) and at times these sudden increases outstrip the actual resource envelope. The nurses at this time were faced with the hard choice of either leaving the babies on unrestrained on the beds, with a risk of them falling or creating safe mechanism of keeping them safe and unharmed/unhurt).  

1.. The Minister of Health stated during the interview about this incident that the unfortunate incident of placing the newborn babies in the cardboard boxes instead of cribs is unacceptable and apologised to the families of the newborn babies. The position of the department, which is in line with standard clinical practice, is that not all the newborns delivered will require incubators. Incubators are used in situations where the new-born baby is sick and requires supportive machine or continuous oxygen for survival. Healthy new-born babies may require crip/ basinet, not a permanent arrangement but, as a backup support in case the mother is unwell to take care of the baby, need to take a bath or go to the toilet. In general, where both the mother and the baby are well, babies are safe to be kept on the mothers’ chest in what is called Kangaroo Mother Care (KMC).  

2. The Provincial Department of Health instituted the investigation on the matter and the details will be made available when the report has been finalised. 

3. Contingency plans are in place in all hospitals; however, contingency plans are developed based on the average delivery rates per facility.  The department has a plan in place for the procurement of essential equipment in all the hospitals, however there are times where the sudden increase in the number of patients such as admissions cannot be preplanned. The contingency measures in place include the enforcement of the referral system, which ensures that a hospital that cannot manage the situation for various reasons, including the lack of capacity such as equipment, human resources etc, such a hospital can refer the patients to the next facility which has capacity. The report from the province indicated that Mahikeng Hospital had a capacity of 16 incubators and 31 cribs and on the night in question, which is enough for the normal day to day management of the workload. The report from the province further indicates that on the day in question, 56 babies were delivered, thus outstripping the available capacity. This means that 47 babies had been placed in accordance with proper prescribed procedures, leaving the nurses to place 09 babies in cardboard boxes. It is reported that four babies were placed in card boxes and others were placed two babies in each crib.  

END.