Violence strains health services

Dr Andrew Nicol, head of Groote Schuur Hospitals trauma centre, speaks about the complications of treating a gunshot victim.

More than one out of every five of the province’s 30 000 ambulance cases during the festive season was a victim of a shooting, a stabbing, an accident or other violence or physical injury.

And in almost a third of those trauma-related cases, a gun, a knife or some other weapon was to blame.

It costs R22 000 to R25 000 to treat someone with a gunshot wound.

Health MEC Dr Nomafrench Mbombo presented these facts at a press conference at Groote Schuur on Tuesday to show just how much of strain violence placed on the province’s already stretched health services.

From December 15 to December 15, to January 15, provincial Emergency Medical Services (EMS) took more 30 000 patients to hospital, according to Dr Mbombo.

“Of these cases, 23%, which totals 8 069, were as a result of patients sustaining injuries, which range from violent trauma, such as stabbings and gunshots to physical and interpersonal violence as well as accidental injury,” said Dr Mbombo.

Of the 8 069 cases, the top-three causes for the use of the EMS were assault with a weapon, (2 894 cases), physical assault (956 cases) and accidental injury (864 cases).

Dr Shaheem de Vries, the province’s EMS director, said the service had done 14 000 inter-facility patient transfers.

“Of these, 1 481 relate to all forms of injuries whereas a staggering 1 131 cases were as a direct result of violence,” said Dr De Vries.

Professor Lorna Martin, head of the forensic medicine and toxicology division at UCT, said the province’s morgues had registered 11 000 unnatural deaths last year.

“A majority of them are in the metros; there are over 8 000 cases of unnatural deaths,” said Professor Martin.

There are over 4 400 cases at Tygerberg mortuary and 4 037 cases at the Salt River mortuary.

Professor Martin said violence and injury placed an increasing burden on pathology services, EMS and trauma units.

Dr Mbombo said patients with severe trauma injuries like gunshot wounds often took priority in the trauma room triage system, meaning patients with less serious injuries waited longer to be seen.

Dr Andrew Nicol, head of Groote Schuur’s trauma centre, shared a case study of a 16-year-old gunshot victim, explaining what a bullet can do to vital organs.

Dr Mbombo said it was important to retain specialists so they could pass on their skills.

Rising violence in communities, she added, put more trauma victims in the hospitals and, ultimately, led to longer waiting times for other patients.

“Whenever people ask us why the long wait in hospitals, they need to ask themselves what is contributing to the wait.”