The number of gunshot wound patients at Groote Schuur Hospital has doubled in the past eight years, and surgeons are having to do “damage control surgery” to keep up.
Surgeons have had to rethink their treatment of severely injured patients, Professor Andrew Nicol, the head of Groote Schuur’s trauma centre, told a briefing there last week.
“We perform rapid, short surgeries to essentially stop the bleeding, control any contamination and get the patient into ICU.”
They now have, on average, 73 gunshot-wound patients a month, compared to 36 eight years ago. And the surgeries are more complex.
“Over the years, we predominately dealt with single-gunshot patients, but now we are seeing multiple-gunshot patients.”
Professor Nicol spoke about a 52-year-old robbery victim who came in with 37 gunshots and a 23-year-old robbery victim who had 17 gunshots.
Surgeons are now using plastic shunts, staples and tubes to help stop the bleeding.
“After 24 hours, once the patient has been stabilised they are taken back into theatre to complete their surgery.”
Professor Nicol said the hospital’s survival rate was on par with that of a Level 1 trauma centre in America.
Mary Bruce, from Hanover Park, was shot in the knee when she was caught in gang crossfire while hanging washing last month. She lay in her backyard for about 10 minutes before someone found her.
The bullet shattered in her knee, and she had to have several operations at Groote Schuur.
“I thank the Lord for my life today and the doctors, nurses and staff at Groote Schuur – if it wasn’t for them I wouldn’t have a leg today,” said an emotional Ms Bruce.
“I am scared for my life everyday. Like it’s raining here today, that’s how the bullets are on the Cape Flats.”
Health MEC Nomafrench Mbombo said injuries from violence were one of the biggest contributors to the province’s quadruple burden of disease, which placed the health system under pressure.
“The health system has seen a significant increase in the number of patients being admitted to hospitals to morgues due to gunshot injuries. The whole system faces the brunt of the burden – from primary care, to our hospitals and our forensic pathology services,” she said.
Innocent people, such as Ms Bruce, were being caught in the crossfire, Dr Mbombo said, and patients with non-life threatening conditions had to make way for those with gunshot and stab wounds. The services of forensic pathologists were also under strain.
Dr Beth Engelbrecht, head of the provincial health department, said one could not “cost” the cost of violence.
She said 65% of murders took place between Friday 5pm and Monday 4am, putting massive pressure on services over the weekend.
The high case load due to violence forced the department to shift funds away from other areas, she said.