Cullinan follow up
||19 October 2008 07:00
Devi Sankaree Govender
|Show: ||Carte Blanche|
Devi Sankaree Govender (Carte Blanche presenter): "Last year we visited this facility, the Cullinan Care and Rehabilitation Centre. We brought you images of patient neglect, staff shortages, and cases of abuse that will forever remain in our minds."
At this government-run facility for the intellectually and physically disabled on the outskirts of Pretoria, we uncovered staff sleeping on the job, seeping wounds, patients eating off the floor and allegations of sexual abuse.
[Carte Blanche April 2007] Patient: "And does aunty remember how he said I must masturbate? I didn't want to do it (again), but he insisted."
Worst of all was the discovery of prison-like cages, in which patients were locked for extended periods of time - sometimes with nothing more than a steel bed frame and a piece of torn foam for comfort, while urine and faeces were seen on the walls, floor and ceiling. We spoke to former employees.
[Carte Blanche April 2007] Margaret Niemand (Former employee): "Nobody cares, nothing, nothing. Those children are so neglected."
[Carte Blanche April 2007] Amelia Grobler (Physiotherapist): Amelia: "... her eye was physically removed."
[Carte Blanche April 2007] Ruda Landman (Carte Blanche presenter): "From a ... from a?"
Amelia: "No, the eye was taken out of the head."
We also heard from extremely concerned parents.
[Carte Blanche April 2007] Chadine Christians (Allistair's mother): "...and when they came around the corner I burst into tears."
Chadine's son Alastair had a bump on his forehead, his eyes were blue and swollen and he had bite marks on his arms and back.
Andrew Christians (Allistair's father): "Then I asked: What happened here?' Nobody could tell me, but I was not surprised because nobody ever knew anything."
Chadine: "Allistair's my child, not my animal. I wouldn't even treat my animal like that."
Devi: "The Department of Health has now invited us back to see the changes they have made since our investigation."
In September this year we joined new acting CEO of the centre, Jabu Ncgobo, for a tour of the facility. He was brought in by the department as a change agent in October last year to rapidly bring about long-overdue and sustainable interventions at the centre
The state of bathrooms has visibly improved. This ward for adults has also undergone a total make-over.
Devi: "What was it like before?"
Jabu Ncgobo (Acting CEO - Cullinan Care Centre): "It has changed..."
Devi: "Yes, it's been quite radical."
Patients no longer lie around in the corridors and cleaners are clearly on hand. The daily menu is also a priority. This board at the nursing station now allocates nurses and cleaners to specific wards every day of the month. And, over 100 patients attend occupational therapy every day.
While visiting this ward, we came across one of the patients who we repeatedly found in the cages when we did our expose last year.
Devi: "Are you fine?"
The cages in which he once found himself are no more.
Devi: "When we were last here this was where we found patients locked in cages. The cages are gone, the patients have been removed and this entire ward is being refurbished."
Devi: "Explain to us what happened. Did the cages come down almost immediately?"
Jabu: "They went away immediately after the expose."
Aletta Masigo (Nursing services manager): "The patients were not supposed to be in that ward in the first place."
Devi: "So when you saw the footage of patients being caged, that was a shock for you?"
Aletta: "Cages have been there for quite a long time, but we were unable to lock them."
But lock them, they did. This nurse was disciplined after our story and is still employed at Cullinan.
Jabu: "There aren't any reasons for me to be worried because she is performing like all other personnel in the institution. She has realised the error she made."
The Centre now has in-house medical care and a full-time physician. After our show, 21 care workers were brought in while permanent nursing positions were filled.
Devi: "What was this clinic like before?"
Jabu: "There wasn't a clinic."
More nurses and in-house medical staff: all of these initiatives have changed the face of Cullinan. However, no one expected that this new clinic would be the scene of a double tragedy over the Easter weekend. On Easter Sunday, two patients - 45-year-old Dawie Marais and 24-year-old Dewald Riekert - both died in unclear circumstances, while in the same courtyard a short distance apart.
It's alleged that they both choked on fish, but details are sketchy. Nearly six months later the autopsy report is outstanding and their families have, therefore, little closure.
Dawie's sister Sanna Berning cannot come to terms with his sudden death after more than 20 years at the centre.
Sanna Berning (Dawie Marais' sister): "I just want to know the truth."
Dewald's father Ben Riekert and step-mother Magda haven't come to terms with their loss either. Dewald was at Cullinan for 16 years.
Ben Riekert (Dewald's father): "Inside I am fuming."
Magda Riekert (Dewald's step-mother): "If we do get some answers it will give us a bit of peace of mind."
Ben: "I totally believe its neglect."
The police are waiting for blood results from the Department of Health's Forensic Pathology unit to complete the autopsy. Without it, the Department of Health refuses to elaborate on what happened. All they'll say is that there was no negligence and the centre is buying another resuscitation machine. But what about Cullinan's own internal investigation?
Devi: "Two patients died on the same day. Something went wrong and we just don't know what it is?"
Jabu: "We had patients in the courtyard. There were nurses supervising them. And it was during that period that they noticed that one of the patients, Mr Marais, was struggling to breath, as if there was something here [touches throat]. They immediately rushed him to the clinic."
The official story says that paramedics, based at Cullinan, immediately dealt with Dawie.
Jabu: "While they working with Mr Marais, the same nurses in the courtyard also noticed that Mr Riekert was also struggling in the same way as Mr Marais with breathing and they also rushed him into the clinic and he was taken to Pretoria Academic."
The department insisted that they sent the families a clinical report on the 4th of July. This both families deny. After conducting our interviews Carte Blanche was surprised to receive an email from the department, expecting us to tell the families to be at Cullinan the following morning to collect a clinical report and statements. Surprisingly, they were given staff reports that completely contradicted Jabu's version of events. Two of the nurses' statements indicated that it was in fact Dewald who was found first, and then Dawie shortly thereafter. This explains Sanna's statement about her brother Dawie:
Sanna: "They told me that he choked on the fish and when they got to him they couldn't help him because they were busy with the other person."
Other details have added to the confusion.
Ben: "The paramedic said to us that he was told he choked, but he also couldn't get anything from his throat."
Magda: "The doctor could see that there was something in Dewald's lungs."
Sanna: "Then I asked them what happened? She said to me, Your brother was naughty, he stole fish and then choked.'"
But Jabu says it's impossible for patients to steal food as a security guard is posted at the kitchen. Cullinan maintains there was enough personnel, but we know that a nurse in that ward did not come to work that day.
Ben: "We were told that his lifespan wouldn't be more than mid-teens. So we expected trouble but the way he died is not him."
Sanna: "The life he had here I wouldn't wish for anyone and where he is now he is happy. He's not suffering there. He doesn't have all the hurt."
Ben: "If his death would just make it safer for the other people that's there, then his death wasn't for nothing. He's my son - he was very close to me ... very, very, very close me."
We asked the Department of Health's Johanna More for clarity.
Devi: "If the autopsy report comes back and says, They both choked,' - then?"
Johanne More (Chief Director - Dept of Health): "If its food then we'll check who was feeding the patients. But if it was something else also under whose watch was this patient and then I think that will assist us. But currently I can't speculate to say it could have been A or B."
While the families wait for answers Jabu insists Cullinan has improved following our expose. The department has fast-tracked a brand new policy to take people out of institutions and place them in community-run homes. As a result, Cullinan's patient numbers have halved making nurses' jobs more manageable.
Devi: "The days of putting all physically and intellectually challenged individuals into institutions are over. Government is now talking about reintegration into communities in partnership with privately run suburban homes like this one."
Occupational Therapist and former Cullinan employee Linda Krause, runs three Qumi homes in the area. They started when the Department of Health called her last year and asked if she would consider opening a community run home to take in people released from Cullinan. Two-thirds of her 35 residents come from the centre. The homes are funded by donations and patients' government grants. There is a strong emphasis on Occupational Therapy and interaction.
Linda Krause (Qumi Homes): "I believe all of them should be released from Cullinan. Not because there's such a lot wrong with Cullinan, but because it's not the right type of situation for the intellectually disabled."
Devi: "Is this an example thought of a situation where government was right? If we move people to the communities it would be better for them?"
Linda: "I believe it absolutely. I am absolutely in favour of that move."
The only difficulty Qumi faces is funding the R2400 needed monthly, per resident. The local community supports them significantly.
Linda: "Every month we sit and we look at each other and say, This is a miracle,' because there is no way that this place could have started and remained open for a year with [the] money that we have on our books or that we get in on a regular basis."
For the patients who remain at Cullinan and those who now live in community run homes, life has changed immeasurably. It seems a far cry from what long-term institutionalisation offered them in the past.
IMPORTANT DISCLAIMER:While every attempt has been made to ensure this transcript or summary is accurate, Carte Blanche or its agents cannot be held liable for any claims arising out of inaccuracies caused by human error or electronic fault. This transcript was typed from a transcription recording unit and not from an original script, so due to the possibility of mishearing and the difficulty, in some cases, of identifying individual speakers, errors cannot be ruled out.