100% increase in gunshot victims at Groote Schuur Hospital in last 8 years

Mary Bruce had been hanging up her laundry in her backyard when she heard a gunshot. She ducked and tried to run for cover.

“The second bullet got me,” she recalled. “I fell down. I couldn’t move.”

The gunman continued to shoot as she lay on her property in Hanover Park last month. She had to drag her leg as she crawled to find shelter under a bakkie.

“I thank the Lord for my life today. I could have been gone. I laid there for 10 minutes and nobody knew I had been shot,” she said tearfully.

Bruce is lucky to have her leg – medical staff at Groote Schuur Hospital in Cape Town had feared she would lose it after being hit in the femoral artery, one of the major arteries in the body.

The number of patients admitted for gunshot wounds at the world-renowned institution has increased by more than 100% in the past eight years.

According to the provincial health department, the trauma centre had previously attended to an average of 37 gunshot victims per month. It now sees an average of 73.

The hospital’s trauma unit, under the leadership of trauma surgeon Professor Andrew Nicol, currently maintains a survival rate equivalent to a Level One trauma centre in the US.

This, he said, was due to enormous efforts by his team of surgeons, nurses and theatre staff.

Bruce, who has worked with children at risk since she lost her son to gang-related violence, praised the service she received after her admission.

“If it wasn’t for Groote Schuur, I wouldn’t have a leg today,” she said at a press conference on Thursday.

At Tygerberg Hospital, the other major trauma centre in the province, the numbers are even more dire. Since the beginning of the year, an average of 107 gunshot victims are treated per month.

Emergency centres are operating at more than 100% capacity most of the time.

In 2008, emergency centres at district and regional hospitals in the city collectively saw 186 425 emergency cases.

In 2018, this number stood at 382 132.

In recent years, there has also been a 17% increase in the caseload at Forensic Pathology Services. During 2018, 4 170 of the 11 930 admissions were as a result of unnatural deaths.

Of these, 2 029 – almost half – were deaths due to gunshot wounds.

Since January, 5 840 bodies were admitted, with 1 993 being deaths through violence which required post mortems. Of these, 1 100 were as a result of gunshots and 893 were a result of stabbings.

Ambulance response times have also been affected by the increase in violence as they require police escorts in areas where staff have previously been attacked. According to the department, only 27% of priority one calls could be reached in under 15 minutes during the last financial year.

Currently, only 12% of these calls could be reached within the targeted times.

Dr Beth Engelbrecht, the head of the health department in the province, said their teams’ safety takes first priority.

“But our staff has PTSD (post-traumatic stress disorder). When they get into the [vehicle] to go into an area where they have been attacked before, we get a sense that they can’t cope,” she said.

The direct result of violent crime is that patients who have non-life threatening conditions have to make way for the emergency cases and are forced to wait longer for medical care, especially over weekends.

Forensic pathologists also face an increased workload, resulting in a delay in bodies being released to loved ones for burial.

Health MEC Nomafrench Mbombo said the provincial health budget “goes to crime”.

“We are now on battleground medicine,” she said.

And matters are not expected to improve any time soon as budget cuts meant that there was not enough money to increase the province’s staff complement.

When hospitals run out of beds and have to find alternative places to treat the patient, the department is told “shame on you for treating people in the passage”, she said.

“But it’s how things are,” she admitted.

According to the department, the significant increase in the number of patients admitted to hospitals and morgues as a result of gunshot injuries results in the whole health system facing the brunt of this burden – from primary care to hospitals and forensic pathology services.

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