Disappointing, totally unacceptable and shameful.
That was the sentiment from health minister Joe Phaahla after a health ombuds report found nurses at the Motherwell NU 11 Clinic in Gqeberha, Eastern Cape, turned away a teenage rape victim because they were afraid to touch her.
Zenizole Vena, 15, who was gang-raped, subsequently died at the Motherwell police station last September after having multiple seizures. She had been raped and held hostage for four days after being abducted on the way to school.
News of the teenager’s ordeal sparked outrage as her family asked why the clinic had referred her to the police rather than treating her.
Releasing the results of his investigation into the incident on Tuesday, health ombud Prof Taole Mokoena said after Vena arrived at the clinic after the sexual assault, two nurses not only failed to open a file for her but did not examine or even touch her.
“Instead, they instructed her to go to the police station because they believed that nurses do not touch rape victims to avoid tampering with the evidence,” said Taole. “Miss Vena’s social, psychological and physical state was never considered by the nurses,” he told journalists before handing the report to Phaahla.
The investigation found that despite Vena and an elderly escort who took her to the clinic not having transport, the nurses failed to arrange transport for them, a decision that saw the rape victim walk about 2km to the police station. Vena was on her way there when she had seizures that resulted in her wetting herself.
“A local taxi driver offered to take them to the police station as Miss Vena could no longer walk nor talk.”
Upon arrival at the police station about 8am, the two were not helped but were asked to wait at the charge office. When a police officer checked on Vena about 9.30am she was lying on the floor, dead. No first aid was given to her at the police station. The police opened an inquest docket after Vena was declared dead.
Taole’s probe sought to ascertain if Vena died as a result of neglect, was denied care at the clinic and whether clinic staff failed to refer her to the next level of care.
A complaint was lodged by DA shadow health minister Michéle Clarke in September 2022.
Based on oral and documentary evidence, Taole’s investigation found the clinic was negligent, and concluded that Vena “was not attended to in a manner that is consistent with the nature and severity of her condition”. Not only did the nurses refer her to the police station without a referral letter, they also failed to refer the patient to the next level of care, as required.
“It is quite disturbing that a basic human instinct to assist the person in distress, particularly a child, does not seem to have existed within the police station at Motherwell,” said Taole.
Receiving the report, Phaahla expressed shock at the attitude shown by the nurses who had taken an oath to look after the sick.
“I tend to see people in desperate situations. I don't think there is any excuse for the attitude ... where nurses say they are afraid to touch the patient because they think they will be tampering with evidence. That's totally unacceptable. It is incumbent on any person who has taken an oath of their profession to look after the sick. Once the person presents to a health facility, it is incumbent on the attending health professional to ascertain ... at least establish the basic facts.
“From our side, as a minister of health ... we take responsibility for this. We don't question the validity of the matters which are reported. I think we should feel ashamed and apologise to the family and the loved ones of Miss Vena for the kind of treatment meted out to her in our health facility,” said Phaahla.
Phaahla said his office would be working with the Eastern Cape health department to make sure the remedial actions and recommendations of the report were implemented.
Taole said despite an undertaking by the Eastern Cape department of health, no disciplinary action was taken against the nurses. The investigation noted other discrepancies at the clinic, including the fact that there was no proper sign-posting stating clinic hours or the services offered. It found that the clinic did not have fulltime doctors, had no 24-hour security and the security guards available during office hours were not well-equipped despite high crime levels in Motherwell.
Staff at the clinic indicated that they were not aware of sexual assault standard operating procedures. It was established that the infrastructure capacity of the clinic was unable to cope with the patient load and had only two consulting rooms. Patient privacy was “very compromised”.
The clinic experienced communication breakdowns, with no functional landline telephone, and the only cellphone was with nurse who had been on leave since last September.
Among a list of recommendations, Taole proposed that disciplinary action be taken against the nurses involved within one month of the report being handed over and that Eastern Cape premier Oscar Mabuyane should within six months ensure that the clinic was refurbished. Proper signage indicating opening hours should be put up, and security should be beefed up.
The head of department should within three months submit a security plan to protect patients and healthcare workers from risks and threats, and ensure that staff was capacitated to deal with security incidents and threats, including on weekends and holidays.
He recommended that the number of doctors be increased within three months of the report, and a district manager develop a realistic sexual assault policy within two months to co-ordinate processes between the health facility's other units such as family violence and child protection, and the police.
He called for the referral of the nurses to the SA Nursing Council for investigation into their professional misconduct. Taole recommended that a district manager arrange a meeting with Vena's family to explain the report and apologise to facilitate closure. Counselling should be arranged with the family within 30 days of the report.
Clarke welcomed the report and recommendations.
“We will ensure that these recommendation are followed through. In the new year we will do another oversight at the clinic to see what plans have been implemented.
“I think there is a lot more to be said that needs to be facilitated between the family and the Motherwell clinic for what happened to their daughter that day. In my view, they should ensure that the family is compensated adequately in terms of this issue,” said
Clarke.
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