‘The infrastructure can’t cope’: South African healthcare workers struggle to deal with third wave

Published

4 years ago

July 25, 2021

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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.”

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.

“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.”

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 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.

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.”

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.”

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Children ‘eating out of piles of garbage’ as Gaza aid trickles in

Published

10 hours ago

July 29, 2025

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Children 'eating out of piles of garbage' as Gaza aid trickles in

“Children are eating out of piles of garbage” – that was the answer from UNICEF’s Salim Oweis when I asked if aid was now getting to those who need it.

The phone call was intended for background to try to get a clearer idea of the latest aid distribution in Gaza, but it’s a conversation I won’t forget.

“Parents are crushing whatever they can into water, most likely unclean water, because there is no infant milk or formula. The reports are horrific,” says Salim.

“Our colleagues are struggling to find enough food for themselves.”

Latest: Trump tells Sky he’s trying to get Gaza ‘straightened out’

It’s been three days since Israel announced humanitarian pauses to allow aid to get to starving people in Gaza but it’s not yet being felt on the ground.

I’m told more aid trucks have entered Kerem Shalom – the border crossing between Gaza and Israel – but that’s only the first stage of the journey.

The aid then needs to be collected and brought inside the Gaza Strip, then taken to partners on the ground for distribution.

It’s a lengthy process, and it needs to be accelerated with urgency.

So far, lorries carrying famine preventative supplies have been collected – that’s high-energy biscuits, food for children between six months and two years, infant formula, vaccines and nappies.

Therapeutic food, which has a peanut butter like consistency, and is aimed to treat malnutrition has arrived at Kerem Shalom but there’s no confirmation yet on whether it’s made it in.

I had not heard of therapeutic food before. I’ve since learnt it is high in energy and micronutrients and won’t treat the complications of malnutrition, but will get a child out of the danger zone.

There is an ongoing issue of desperate people attempting to loot these lorries as they enter Gaza.

“The more aid that goes in, the more the looting will decrease because people will trust that there is now food coming back in,” says Salim.

But the amount getting in is still a fraction of what is needed.

The situation is so desperate, not everyone can wait until tomorrow for help. People are now dying everyday in Gaza due to hunger.

There is no time for wrangling over detail. Food is needed in mass quantities immediately. We have had warnings for months that Gaza was on the brink of famine. It’s now here.

For those working to help the most vulnerable and innocent in Gaza, it feels extremely personal.

“The rest of the world has failed the children and the civilians of Gaza,” says Salim.

“The world is numb and leaders of the world are apparently deaf.”

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Mile after mile of grey rubble – the view from a plane dropping aid to Gaza

Published

1 day ago

July 29, 2025

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Mile after mile of grey rubble - the view from a plane dropping aid to Gaza

We are on our way to Gaza with the Jordanian military.

The aircraft is hot and noisy and as we get closer, the atmosphere gets more tense. Aircrew gesture with their hands to tell us how many minutes there are to go. Fifteen. Six. One.

The Jordanian military C-130 flies out over the sea before banking and heading inland for Gaza. The parachutes, attached to the top of each of the eight pallets, are prepared for the drop.

As land approaches, I look down. The ground is modern and built up – we’re still over southern Israel.

Then a few short minutes later, it’s clear we’ve crossed Gaza’s border.

The ground turns grey, the shapes of buildings disappear, there are no cars, no people.

You can see the outline of communities and villages that are now flattened. Mile after mile of grey rubble.

This mission by the Royal Jordanian Air Force is one of the first aid drop flights since Israel announced they could resume. It is carrying eight tonnes of food and baby formula.

Foreign nations know this is a deeply flawed way of delivering aid – road convoys are far more effective and can carry far more – but the Jordanian flight crew say the need in Gaza is so urgent, it’s simply an attempt to do something.

When the aircraft ramp opens, the aid is pushed out and it’s gone in seconds.

The parachutes seem peaceful as they open and their fall slows. But dropping food from the sky is a dangerous and undignified way to feed people.

On the ground it’s chaos.

Our colleagues in Gaza say the fighting for food has become lethal – gangs are now punching and stabbing people to reach it first. Most critically, it’s not getting to the weakest. To those who really need it.

One man becomes emotional as he describes racing to find food and leaving with nothing.

“I came only for my son,” he says. “I wouldn’t come here if it was just for me. When you have a child, they need bread.”

He’s an engineer in normal times and seems in disbelief that his life has come to this. “The aid comes from the sky and we have to run after it. I’ve never had to do this in my life.”

It is hoped Israel’s humanitarian pauses in fighting will rapidly increase food distribution by road but it’s very unclear how that is going.

Hospitals in Gaza have reported another 14 deaths from starvation in the last 24 hours, the Gaza health ministry said on Monday.

Airstrikes killed another at least 78 Palestinians across Gaza on Monday, local health officials said.

We cannot verify these numbers because Israel has not allowed international journalists access to Gaza.

And Monday’s flight came with strict media conditions.

We were told the Israeli side had warned that any shots of Gaza filmed from the air could result in these aid flights being cancelled.

But Israel’s tight grip has not stopped the images from Gaza getting out, horrifying people around the world.

The question now is what more the international community will do about it.

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Israeli human rights organisations accuse country of genocide

Published

1 day ago

July 28, 2025

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Israeli human rights organisations accuse country of genocide

Two Israeli human rights organisations have said the country is committing genocide against Palestinians in Gaza.

In reports published on Monday, B’Tselem and Physicians for Human Rights (PHR) said Israel was carrying out “coordinated, deliberate action to destroy Palestinian society in the Gaza Strip”.

The two groups are the first major voices within Israeli society to make such accusations against the state during nearly 22 months of war against Hamas.

Israel has vehemently denied claims of genocide. David Mencer, a spokesperson for the government, called the allegation by the rights groups “baseless”.

He said: “There is no intent, (which is) key for the charge of genocide… it simply doesn’t make sense for a country to send in 1.9 million tonnes of aid, most of that being food, if there is an intent of genocide.”

B’Tselem director Yuli Novak called for urgent action, saying: “What we see is a clear, intentional attack on civilians in order to destroy a group.”

The organisation’s report “is one we never imagined we would have to write,” Ms Novak said. “The people of Gaza have been displaced, bombed, and starved, left completely stripped of their humanity and rights.”

PHR said Israel’s military campaign shows evidence of a “deliberate and systemic dismantling of Gaza’s health and life-sustaining systems”.

Both organisations said Israel’s Western allies were enabling the genocidal campaign, and shared responsibility for suffering in Gaza.

“It couldn’t happen without the support of the Western world,” Ms Novak said. “Any leader that is not doing whatever they can to stop it is part of this horror.”

Hamas said the reports by the two groups were a “clear and unambiguous testimony from within Israeli society itself regarding the grave crimes perpetrated by the occupation regime against our people”.

Dire humanitarian conditions

Since Israel launched its offensive in Gaza following the deadly Hamas attack on 7 October 2023, nearly 60,000 people – mostly civilians – have been killed, according to Gaza health officials.

Much of the infrastructure has been destroyed, and nearly the whole population of more than two million has been displaced.

An increasing number of people in Gaza are also dying from starvation and malnutrition, according to Gaza health authorities.

On Monday, the Gaza health ministry reported that at least 14 people had died from starvation and malnutrition in the past 24 hours, raising the total number of hunger-related deaths during the war to 147.

Among the victims were 88 children, with most of the deaths occurring in recent weeks.

UN agencies say the territory is running out of food for its people and accuse Israel of not allowing enough aid deliveries to the enclave. Israel denies those claims.

Israeli Prime Minister Benjamin Netanyahu on Sunday said “there is no starvation in Gaza” and vowed to fight on against Hamas.

US President Donald Trump said on Monday that many in Gaza are facing starvation and implied that Israel could take further steps to improve humanitarian access.

Israel has repeatedly said its actions in Gaza are in self-defence, placing full responsibility for civilian casualties on Hamas. It cites the militant group’s refusal to release hostages, surrender, or stop operating within civilian areas – allegations that Hamas denies.