By Inhlase Reporter
“Hot dog E10, E10 hot dog!” “E1 Banana, banana E1!”
Vendors shouting out to customers at the market square in downtown Manzini, no, not quite, this is at the Raleigh Fitkin Memorial (RFM) Hospital early in the day. Staffers take time around the tea break to sell snacks, including fruits and sweets to scores of patients who are normally either sprawled on the ground in front of the Outpatient Department or are crammed on the benches in various sections of the country’s busiest referral hospital.
The crowd provides a very reliable market for the hospital employees who bring their goods to sell during working hours. Most of them are in pain and cannot walk to the tuckshop adjacent the operations theatre a few tens of metres from the hospital main entrance, if they need a snack. Alternatively, if patients need a bite, they must go to the main gate which is home to vendors selling a variety of goods and edibles.
Inhlase Centre for Investigative Journalism spent eight weeks visiting the hospital at a time when eSwatini had run out of life-saving drugs where it discovered that the main routine for nurses and support staff is doing business with patients who come to idle about in anticipation of service which is not there because of shortage of medicines. Nurses use this quality time making money.
But the hospital says it has a way of dealing with such a situation. Dr Bitchong who stood in for the Chief Executive Officer said staff members ‘on duty’ were not expected to do anything other than their duty. “Failure to respect this goes against our policy and is handled accordingly.”
A sickly man on June 30 lay shaking on the ground covered with a rug while he lay lamely at the garden area in front of the Prevention of Mother to Child Transmission (PTMTCT) section which doubles up as the gynaecology section. Staffers walked past as he writhed in pain while other patients went about their business, least concerned. The other patients commented in hushed tones though that the staffers were so heartless as to ignore a sick man but were keen to sell hot dogs.
“To us they see customers, buyers for their foodstuffs and not patients who need their attention,” says a heavily pregnant mother swinging her waist to put to position her bulging belly.
Business is booming at RFM, given the large number of patients who come from all the four regions of the country to this hospital because of its strategic positioning. It is at the centre of the four regions of the country and a gateway to any region. Manzini is the economic hub of eSwatini.
Some patients arrive in the twilight hours of every working day so that they can be attended to in time to report for work the next day. They arrive around 5 o’clock in the morning to queue and by the time the hospital staff arrive they have already formed large crowds outside the various sections of the hospital. These are perfect captives for the marauding pastors who pounce around this time to catch the helpless patients by switching to a sorrowful hymn accompanied by a befitting verse from the Bible bearing the unwelcome possibilities of eternal roasting in hell.
These pastors or, gospel peddlers, conduct a short sermon and quickly collect money from the patients in exchange for blessings. These sermons are strategically designed to be short in order for the one pastor to give way for another to take over and also get a share of the offerings.
June 28 was rather unusual in that a pint-sized pastor appeared from nowhere and burst with a verse from the Book of Joshua. It would seem that he is a regular around the Card Room arena because most of the patients appeared not to mind the strong stench of alcohol from his mouth. Seeing that no one was interested in his preaching, more especially because he appeared extremely hung over, he disappeared before he could even either start a hymn or close with a prayer, as per tradition among Christians.
“We are a faith-based institution and allowing the word of God to be shared at our institution is in line with our Mission. We also respect the rights of our clients who will freely chose to give something after listening to the word of God guided by their belief,” says Dr Bitchong.
Furthermore, he acknowledged that the hospital was faced with shortage of drugs and medical supplies making it difficult to continue routine operations at the theatre.
“We try, however, to procure essential drugs and medical supplies to ensure that emergency procedures are provided. The shortage of drugs and medical supplies indeed create a challenging work environment for staff,” says the doctor.
Staff members are, however, extremely demotivated despite the high moral and religious standards of the institution belonging to the Church of the Nazarene. They allege that the hospital deducts loan repayments but does not remit it to the financial houses such as Eswatini Development Finance Corporation (FINCORP). As a result, they spend most of the time making money to supplement their livelihoods because they can no longer obtain loans from financial houses such as micro-lenders.
“Due to the fact that we occasionally experienced some delays in receiving our budgeted subvention, we shared our challenges to the financial institutions that you cited in your questionnaire and negotiated a grace period and took a commitment to settle any interest that may result from the delay,” explains Dr Bitchong.
According to Worldata.info, primary healthcare is relatively free in eSwatini but its poor quality doesn’t meet the needs of the people. EmaSwati have access to government-subsidized health services yet most people still need to pay out-of-pocket for these services. As much as 41.7 percent of citizens also opt to pay for private healthcare instead.
As eSwatini healthcare service has collapsed, the RFM Hospital has become a paradise for the hustlers who peddle an assortment of items.