Suspected Covid-19 patients were routinely left for hours in an open tent, in sub-zero temperatures, outside a South African hospital during the mid-winter peak of the pandemic, leading to "many" people dying of suspected hypothermia.
"It was freezing in that tent. As soon as night falls it's horrible, you can see the patients declining. Hypothermia is one of the major causes of death here. Especially in that tent," said a doctor at Sebokeng Hospital. "We're tired and sad and fearful for our patients. I ask myself how many people need to die unnecessarily for there to be an adequate investigation," she said.
The marquee-sized tent was erected in the car park and used by the hospital as a makeshift triage and waiting room - over the course of several cold and hectic weeks in July, with elderly patients collapsing after being left for two days or more without sanitation, food or proper heating. The doctor said sick people were forced to crowd around three small electric heaters that frequently broke.
"We don't have drugs. No ventilator equipment. There was PPE lying all over the place, waiting to infect more people," said the doctor, who complained that a number of medical staff had caught the virus as a result of the conditions.
Leaked messages have revealed that the decision to use tents provoked an angry backlash from experts in the provincial health department. Medical advisers urged management not to use the tents, precisely because of the risk to patients.
The revelations have emerged as South Africa's government has acknowledged and condemned widespread corruption and mismanagement during its response to the pandemic. The pandemic has also exposed deep institutional weaknesses, including a widespread culture of corruption and apparent nepotism, and the dangers of a system of "cadre deployment" that has seen key departments led by allegedly incompetent political appointees from the governing African National Congress (ANC).
President Cyril Ramaphosa has angrily condemned the corruption, citing examples of price hikes of 900%, and lashing out at "hyenas" seeking to profit from disaster.
A number of senior officials and ministers have been criticised for instances where their relatives have secured large contracts from government. The South African authorities say they are now investigating government departments over irregularities in coronavirus-related tenders worth 5bn rand ($290m; £220m).
Staff had repeatedly complained about conditions, and inquired about how special Covid-19 relief funds were being disbursed.
"We haven't seen that money. I do know management is aware of our struggles. We've tried multiple times as doctors and nurses to try to ask management where the money is being allocated," the doctor said. "Are we going to get more staff, more resources? And we don't really get answers, and that is devastating for us."
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