Gastro outbreak hits Cape Town

Medical specialists warn that the outbreak is a shock marker of an underlying socio-economic crisis in the city

Red Cross Children's hospital is threatening to close its doors as it buckles under the strain of a severe outbreak of diarrhoeal disease that is threatening the lives of thousands of Cape Town children.

And as other hospitals battle to contain the overflow of children so sick they need to be admitted for lifesaving treatment medical specialists warn that the outbreak is a shock marker of an underlying socio-economic crisis in the city.

In the previous 24 hours, from 7am on Wednesday, 25 children were admitted to Red Cross with diarrhoeal disease, but that excludes the slightly lower number who are rehydrated and then discharged.

"Our facilities cater for 40 inpatients but in the past couple of weeks we've been overwhelmed, with as many as 60 children in the ward at any one time," said Dr Ralph Diedericks, head of medical emergency services at Red Cross.

Tygerberg hospital, which picks up the overflow from Red Cross, is equally feeling the strain.

A source, who did not wish to be named, said there were 34 children in the emergency unit on Thursday night, but they were still short of 14 beds.

The specialists agree that the annual outbreak, which co-incides with the year's hottest months, is getting worse a concern they say is linked directly to lack of proper housing, inadequate water supply and undernourished children.

The Tygerberg hospital source said last year's outbreak was the worst he'd seen but this year it was even worse.

Diedericks confirmed this view, saying Red Cross data showed that the number of children with diarrhoeal disease was already up 18 percent on last year.

The number of children with diarrhoeal disease was already up 18 percent on last year

"The bottom line is that the people responsible for housing and infrastructure are not able to keep up (with the demand) and the problem is surfacing in health problems, like the outbreak of diarrhoeal disease among the children," the Tygerberg source said.

Diedericks said the affected children were extremely disadvantaged, living with poor sanitation and water supplies, all compounded by malnutrition and added illnesses like HIV and Aids.

"As many as 60 percent of the children we see are underweight for their age," he said.

Red Cross has been so overwhelmed in the past fortnight that Diedericks said they had been asking for the hospital to be closed.

"Of course the hospital never really closes, but the only way we can cope is to divert emergency cases to other hospitals like Tygerberg," he explained.

The annual diarrhoeal outbreak runs for several months, with February and March the peak months.

However, Diedericks said it could extend well into April.

In spite of a significant amount of work being done in conjunction with senior health management in the province to increase resources in a bid to address the crisis, Diedericks said they were still overwhelmed this year.

An oral rehydration "corner", where mildly dehydrated babies and children were treated to avoid hospital admission, was also under severe strain.

In some cases children were so severely dehydrated by the time they arrived at the hospital that they had to be put into the intensive care or high care units immediately.

Red Cross managed to discharge only five or 10 children daily, but were admitting around 25. "So we're starting off with wards that are 150 percent full and it's proving quite a challenge to find space for everyone who needs attention," Diedericks warned.

Registrars were under pressure every minute of their shifts as they tried to stabilise, accurately diagnose and then ensure children received the correct level of care all while making certain they did not miss any other medical problems affecting the patients.
- Cape Argus