‘The infrastructure can’t cope’: South African healthcare workers struggle to deal with third wave
Dr Angelique Coetzee is a GP in the South African capital Pretoria, where she has run a family clinic for the past 33 years.
But she has never known anything like COVID-19.
She said: “If you have never been in such a situation, you can’t imagine what it is like. We’ve been dealing with 30 or 40 positive cases every day. The pressure is extreme.
“If you look at a country like Australia where they have a few cases, well I would see their national caseload in a couple of days. Can you imagine?”
When we first spoke in June, Dr Coetzee seemed on the verge of tears.
She said: “If I speak to you now, that means someone with COVID will not been seen – and there is no point trying to message. I don’t have time to answer.”
Dr Angelique Coetzee is a GP in the South African capital Pretoria
South Africa has found itself in the grips of a Delta variant-driven “third wave” of infection.
The caseload has been brutal, outstripping the first two waves by a factor of three.
The country’s acting health minister says this surge has now peaked in the province of Gauteng, where the cities of Pretoria and Johannesburg are situated but Dr Coetzee says her personal and professional burden has barely changed.
She said: “We have been seeing fewer patients on a daily basis this week but the weather is colder and COVID-19 patients are turning up with pneumonia so we are seeing sicker patients than we have been during the last three or four weeks.”
South Africa’s beleaguered public-run health system has struggled to cope with wave after wave of the virus.
Lacking sufficient beds and qualified staff, city hospitals used casualty departments as holding centres where patients wait for space to free up – sometimes for days.
South Africa’s healthcare system has been struggling with staff shortages during the pandemic
“This is the third wave we have experienced, comes less than six months (after the second) and the infrastructure can’t cope,” said Dr Coetzee.
“Most patients need oxygen and I try to admit them to hospital but because of (capacity) problems I have had to treat them at home. We have been waiting for 24 to 48 hours before we could get them cylinders, dealing with the stress of trying to manage patients without oxygen with the knowledge that if we don’t make a plan they are going to die. All this while the surgery is full, full, full. It is so very stressful.”
The extreme working patterns and the mental pressures that come with it have been felt in unexpected ways.
“I have had colleagues who have had motor vehicle accidents. One was so tired after work that he drove his car into a tree,” she said.
“The second one was hit at a crossroads – and a lady doctor reversed into a garage door because she had forgotten to open it. The most bizarre things that happen in a short space of time but it shows you the pressure they are under.”
Community groups have been running ad-hoc clinics in South Africa during the pandemic
Dr Coetzee has been operating on the very edge within a healthcare system that was been put under severe strain.
There are no support workers or home visits or specialist consultations for most people in South Africa.
Instead, GP’s like Dr Coetzee try to do it all.
“You become distant after a while but you try to carry on and on. I think that is the only way to survive it,” she said.
Yanga Booi is a 32-year-old nurse working at the intensive care unit at Thelle Mogoerane Regional Hospital in Vosloorus, on the outskirts of Johannesburg.
He says the hospital is poorly equipped and the staff have been insufficiently prepared during the pandemic.
He said: “The health system in South Africa did a complete spin when the pandemic hit our shores. We were put in the spotlight and given this false sense of heroism, but it wasn’t the right sort of attention because when we went to work, the hospital was in a worse state that than it was before.
“We were ill-prepared from the beginning, and we are still not prepared.”
The third wave has come as rioting and looting has taken place across the country
The hospital in Vosloorus provides beds and treatment but Booi says COVID testing at the facility is not reliable and patients are not properly isolated.
“We cannot be sure who has COVID because we get so many false negatives. It’s like we wait for people to get sick or drop dead, then look into the COVID thing,” he said.
“I remember admitting a patient who was negative on admission and so we didn’t isolate him. A few days later he died and we found out that he was positive.
“It’s a sad situation because the hospital does not have an isolated ICU ward for COVID patients. It’s a general ICU with isolation rooms and we admit COVID patients to it – some people have it and others don’t. We cannot be sure.”
Mr Booi says dozens of his colleagues have paid a terrible price over the course of three separate waves of infection in South Africa.
He said: “It is unfortunate that we have had to watch our colleagues dying from this… countless members of staff have gone, it’s not just nurses, it’s the doctors, it’s the clerks, it’s the porters.”
The 32-year old, who took up the profession when he was offered a government bursary, says he was “deeply afraid” when the pandemic arrived.
Yet 17 months later he has noticed a change in himself and others.
Yanga Booi said the country was ill-prepared for the pandemic
He said: “The loss of life has caused us to grow a thick skin, just like when we came into the profession. Our first experiences with death were terrifying but then we got accustomed to people dying and that is what has happened with COVID.
“We are used to the virus we know it is here to stay and we must find ways to keep going.”
Dr Shabir Mahdi is dean of the faculty of health sciences at Witwatersrand University in Johannesburg and is a source of expertise and fearless criticism in a country that has struggled in all aspects of its pandemic response.
Dr Mahdi says the ferocity of South Africa’s third wave of infection came as a “huge surprise”.
He said: “The current resurgence far exceeds what we have experienced either in the first or second wave in the number of documented cases. In fact, the numbers of new cases diagnosed on a daily basis is three times what it was at the time of the peak of the first and second wave.”
Dr Shabir Mahdi said the third wave in the country came as a ‘huge surprise’
However, this eminent viriologist is unsparing in his criticism of the government’s response.
While the magnitude of the Delta-fuelled third instalment could not have been predicted, he says health officials knew another wave was coming at the beginning of South Africa’s winter season.
He said: “In a province like Gauteng where 25% of the population live, our hospitals are completely overwhelmed but at the same time, we have beds that are literally vacant in the same hospitals and we can’t actually use those beds because some official in some government department forgot that you actually need to have health care workers available to actually staff those beds.”
Volodymyr Zelenskyy has called on Ukraine’s partners to make sure Russia doesn’t “deceive” them over a ceasefire.
After breakthrough talks between Ukrainian and US officials in Saudi Arabia, Kyiv said it was ready to accept a proposed 30-day ceasefire with Russia.
But his nightly address on Wednesday evening, a day after the Jeddah summit, President Zelenskyy said, “we must move toward peace” – but issued a warning to allies.
“The key factor is our partners’ ability to ensure Russia’s readiness not to deceive but to genuinely end the war,” the Ukrainian leader said. “Because right now, Russian strikes have not stopped.”
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The focus has now switched to Vladimir Putin’s response to the proposed ceasefire. President Trump said the US had received “some positive messages” adding: “We have people going to Russia right now”.
However, he warned Moscow: “In a financial sense, yeah we could do things very bad for Russia, would be devastating for Russia.”
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Will Russia go for ceasefire deal?
European defence ministers, meeting in Paris, said now was the time for Moscow to show it was serious about ending the war.
UK Defence Secretary John Healey was among those attending, and had a direct message for Russia’s president: “I say to president Putin, over to you, you want to talk, prove it.”
Mr Healey called on Russia to accept the ceasefire and end the war, adding, “the pressure is now on Putin”.
For his part, President Putin has been playing to his domestic audience with a visit to Kursk, where Russian troops finally seem to be gaining the upper hand against Ukrainian forces who seized territory in the Russian region last year.
The Russian line is approaching Sumy from Kursk Oblast
Dressed in camouflage, the Russian president called for his forces to defeat the enemy and completely liberate Kursk, in remarks reported by the Interfax news agency.
He also said enemy troops captured in the region will be treated as terrorists, as Russia’s chief of the general staff told Mr Putin that Ukrainian forces in the region are surrounded.
World
Pakistan: Hostages killed after separatist militants hijack train carrying hundreds of passengers
Hostages have been killed after separatist militants hijacked a train carrying hundreds of passengers in Pakistan, authorities have said.
The Pakistan military (ISPR) said 21 hostages were killed, as well as four security force soldiers, on the train that was carrying more than 400 people.
Earlier on Wednesday, the Baloch Liberation Army (BLA) claimed responsibility for the attack and said they had killed 50 people.
A Pakistani government spokesman described the attack as “an act of terrorism,” and passengers who had been freed described how gunfire was “coming from everywhere”.
ISPR director general Ahmed Sharif Chaudhry added in a statement: “Today we freed a large number of people, including women and children. The final operation was carried out with great care.”
A soldier stands guard next to a rescue train after the hijack by separatist militants. Pic: Reuters
The train was hijacked on Tuesday as it entered a tunnel in Bolan, a district in the southwestern province of Balochistan.
The Jaffar Express was packed with 440 people, including women and children, Mr Chaudhry told local broadcaster Dunya TV.
He added that “militants were in touch with their handlers and masterminds in Afghanistan via satellite phones” during the incident.
Passengers rescued by security forces from the hijacked train. Pic: AP
The train was on a 1,000-mile journey from Quetta to the city of Peshawar.
Militants blew up the railway tracks before firing at the train, killing the driver and trapping it inside a tunnel at Mashkaf.
Security forces exchanged gunfire with the militants who were wearing vests loaded with explosives.
The train was hijacked as it entered a tunnel in Bolan, Pakistan
‘God saved us’
Noor Muhammad, who was travelling with his wife, said: “First, they hit the engine with an RPG (rocket-propelled grenade).
“After that, gunfire started and explosions were heard, RPGs were used. God saved us.
“They made us get off (the train) and told us to get down or they would shoot. We got down and then they said ‘leave’.”
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Officials said a large number of the hostages had been rescued. Pic: AP
Bashir Yousaf, who was with his family, said: “Everyone was crying and passengers were shouting, everyone was lying on the floor trying to save their lives.
“The sound of gunfire was coming from everywhere, then they (insurgents) told us to get down.
“After getting off we were told not to look back. I just kept walking without looking back to save my family’s lives.”
A soldier keeps watch near to the scene of the hijacked train. Pic: AP
Mr Chaudhry added to Dunya TV that security forces “first took out some of the militants and then began clearing compartment by compartment killing the militants”.
He said the total number of militants was 33, and added that no passenger was hurt or killed during rescue operations.
However, he added that before “the final clearance,” 21 people were killed by the militants. Four Frontier Corps soldiers were also killed.
“Perpetrators will be hunted down and will be brought to justice,” he said. “This incident of the Jaffar Express changes the rules of the game.”
Soldiers and police have been deployed at sites close to the hijacking. Pic AP
Earlier in the day, Pakistan’s Prime Minister Shehbaz Sharif condemned the attack and said security officials were “repelling” the militants, while interior minister Mohsin Naqvi called the attackers “enemies” of the country.
The BLA – designated a terrorist organisation by the UK – had demanded the release of Baloch political prisoners, activists, and missing persons within 48 hours.
It had threatened to start executing the hostages if the government did not fulfil its demands.
The group often targets infrastructure and security forces in Balochistan but has also struck in other areas, including the southern port city Karachi and the strategic port of Gwadar on the Arabian Sea.
World
Pakistan: Hostages killed after separatist militants hijack train carrying hundreds of passengers
Hostages have been killed after separatist militants hijacked a train carrying hundreds of passengers in Pakistan, authorities have said.
The Baloch Liberation Army (BLA) claimed responsibility for the attack and said they had killed 50 people on the train that was carrying more than 400.
Government officials have not confirmed how many hostages have been killed. Sarfraz Bugti, the chief minister in Balochistan province, said “we people have also been martyred, but we will share details later”.
More than 50 militants have been killed and the insurgent attack has now ended after a day-long stand-off, according to officials.
A soldier stands guard next to a rescue train after the hijack by separatist militants. Pic: Reuters
Security officials told the Associated Press news agency that more than 300 hostages had been rescued.
Pakistan’s junior interior minister Talal Chaudhry said 70 to 80 attackers had hijacked the train.
A Pakistani government spokesman described the attack as “an act of terrorism”.
Passengers who have been freed described how gunfire was “coming from everywhere”.
Passengers rescued by security forces from the hijacked train. Pic: AP
The train was hijacked on Tuesday as it entered a tunnel in Bolan, a district in the southwestern province of Balochistan.
The Jaffar Express was packed with 425 people, including women and children.
The train was on a 1,000-mile journey from Quetta to the city of Peshawar.
Militants blew up the railway tracks before firing at the train, killing the driver and trapping it inside a tunnel at Mashkaf.
Security forces exchanged gunfire with the militants who were wearing vests loaded with explosives.
The train was hijacked as it entered a tunnel in Bolan, Pakistan
Officials said a large number of the hostages had been rescued. Pic: AP
Noor Muhammad, who was travelling with his wife, said: “First, they hit the engine with an RPG (rocket-propelled grenade).
“After that, gunfire started and explosions were heard, RPGs were used. God saved us. They made us get off (the train) and told us to get down or they would shoot. We got down and then they said ‘leave’.”
Read more from Sky News:
Arrested captain of crashed ship is Russian national
Children under eight ‘should avoid drinking slushies’
Bashir Yousaf, who was with his family, said: “Everyone was crying and passengers were shouting, everyone was lying on the floor trying to save their lives.
“The sound of gunfire was coming from everywhere, then they (insurgents) told us to get down.
“After getting off we were told not to look back. I just kept walking without looking back to save my family’s lives.”
A soldier keeps watch near to the scene of the hijacked train. Pic: AP
Soldiers and police have been deployed at sites close to the hijacking. Pic AP
Pakistan’s Prime Minister Shehbaz Sharif condemned the attack and said security officials were “repelling” the militants, while interior minister Mohsin Naqvi called the attackers “enemies” of Pakistan.
The BLA had demanded the release of Baloch political prisoners, activists, and missing persons within 48 hours.
It had threatened to start executing the hostages if the government did not fulfil its demands.
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