Drastic increase in gunshot victims putting strain on Cape’s major hospitals

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Cape Town - The drastic increase in gunshot victims clogging up emergency trauma centres at Cape Town’s major hospitals has left little room for other trauma victims. Revealing the true extent of violent crime in the province, Health MEC Nomafrench Mbombo said there had been a 100% increase in patients presenting with gunshot wounds at the Groote Schuur Hospital over the past eight years. Uncovered figures by the trauma surveillance study showed that the Western Cape Trauma Centre previously attended on average to 37 gunshot victims a month. Mbombo said that number was now a monthly average of 73 cases, “while Tygerberg Hospital has since the beginning of 2019 treated on average a staggering 107 gunshot victims per month”. Mbombo said gunshots were treated at other hospitals as well but Groote Schuur and Tygerberg were the two major trauma centres.

Mbombo said in the 2018/19 financial year, 80.76% of violence-related deaths occurred in the metro health district, with Khayelitsha (318), Parow (242) and Delft (239) as the top three suburbs, “hence the enormous pressure Tygerberg Hospital was experiencing because it is the specialised hospital for these areas”.

“Our emergency centres are operating at more than 100% capacity most of the time. In 2008, our emergency centres at our district and regional hospitals in the metro collectively received 186 425 emergency visits, compared with 382 132 visits in 2018,” Mbombo said.

She said It was not only the hospitals that were placed under pressure by attending to the increasing number of gunshot victims. “Over the last few years, we have also seen a 17% increase in the case-load at our Forensic Pathology Service (FPS).”

She said the FPS recorded 11 930 admissions last year with 4 170 being unnatural deaths. “Of these, 2 029 (48.6%) were deaths due to gunshot wounds.”

Mbombo said since January, FPS recorded 5 840 admissions, with 1 993 being deaths through violence and requiring post-mortems, 1 100 were deaths by gunshot and 893 stabbings.

She said another trend was the increase in the number of patients arriving with multiple wounds.

“Managing patients with multiple gunshot injuries is a complex matter which is why the head of the Trauma Centre at Groote Schuur Hospital, Professor Andrew Nicol and his team have had to come up with new techniques to assist them.”

Nicol said special surgical techniques were developed to deal with the severely injured patient called “Damage control surgery”.

He said the concept was to conduct abbreviated surgery by using plastic shunts, staples and tubes to stop the bleeding and to transfer the unstable patient to ICU as rapidly as possible.

“The patient is stabilised in the ICU and returns to the operating room 24 hours later for the definitive repair of their injuries. This has been a major advance in trauma care and is allowing the trauma centre at Groote Schuur to have a comparable survival rate for these injuries to a Level 1 trauma centre in the US,” Nicol said.

Senior researcher: justice and violence prevention at the Institute for Security Studies (ISS), Dr Andrew Faull, said Cape Town was among the most violent cities in the world.

“In 2017/18 its murder rate was 69 per 100 000 residents compared with the national average of 36 and a global average of 6.1”. Faull said since November last year, more than 2 300 people were murdered in the Western Cape, most in specific parts of the Cape Flats.”

He said amid such bloodshed, “the notion that streets saturated in armed men would bring order was intuitively appealing but intuitions are often wrong”.

“It is often suggested that the bulk of Cape Town’s violence is gang-related, but is this true?” He said in 2017/18 the police couldn’t determine a motive for 38% of murders.

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