As a cleaner at the emergency casualty ward at Charlotte Maxeke Academic Hospital in Johannesburg, Sakhile Masombuka has seen a lot of blood and suffering. He chatted to Spotlight about his work.
Sakhile Masombuka started working as a cleaner at the emergency casualty ward at the Charlotte Maxeke Academic Hospital in Johannesburg in June last year.
“I remember my first night, it was hell,” said the 32-year old from Tsakane in Ekurhuleni.
“It was my first time to see people injured like that, a lot of blood coming out everywhere (from their bodies). There were patients with multiple stab wounds and a lot of gunshot wounds.
“People were crying, the first patient who came in was screaming for help, he had a gunshot wound, blood was coming out, another one was quiet. People were (on the verge of) dying – in fact, one person died that night,” he recalled.
But that night in the casualty ward wasn’t the first time for Masombuka to see a dead body.
“I’ve worked in the administration office of a mortuary, so I have sometimes seen dead bodies. Still,” he said, “it’s sad seeing dead bodies in the hospital, especially since the doctors fight hard to keep them alive.”
Masombuka said he had to toughen up quickly to be able to do the job.
‘Toughen up quickly’
Masombuka realised that he had to toughen up quickly.
“It was not easy for me (after what I had seen), but I had to learn to adjust while doing the work – I just told myself that I was placed here for a reason, I had a job to do,” he said.
“That was a Thursday night, I had started working from 8pm, I worked through the night and I finished the next day. It was not easy to leave the place because it was busy. When my shift was almost done, someone came in with multiple stab wounds. I had to wait for the doctors to finish with that patient (before I could leave).”
Another busy night was New Year’s Eve.
“After midnight it started getting hectic. I saw a patient who came in after his three fingers were cut by a firecracker. It was so bad his three fingers were removed.”
Other images from the emergency casualty ward also linger in Masombuka’s mind.
“One night someone got stabbed on [sic] the neck, it looked gruesome. He had lost a lot of blood. It was bad. Another patient who was badly injured was in a car accident, all over his legs were open and raw.”
Masombuka also spoke of the night he had to remove a patient’s faeces (for the first time) from the floor.
“The patient was not feeling okay, he just relieved himself on the floor,” he said.
He told Spotlight that the busiest nights were on weekends, holidays and during the week when there was a local soccer match like when Kaizer Chiefs were playing.
“Most of the people coming here are drunk, most of them are males. When they talk, you can hear they were at a game, they were watching the soccer, a lot of them are wearing clothes of the matches they have been to.”
Masombuka said the job taught him to be more cautious when it comes to your life.
What casualty cleaners do
According to Lungiswa Mvumvu, Communications Officer at Charlotte Maxeke Academic Hospital, cleaning at a hospital differs a lot from what a normal cleaner does.
“It is nothing like cleaning your home… Cleaners have to, for example, learn what are the right chemicals to use because there are infections coming in. They have to understand what chemicals to use for what incident.
“They have to be sure not to hurt themselves.”
Mvumvu said that to start working as a cleaner at a hospital, you have to understand the demand of the job.
The blood smells when it gets dry, this is why I have to work quickly so that it doesn’t get dry.
“You might have to work 24/7, you might get called in to come to work at any time. You might be called to work at a different area. We need the people to understand the commitment.”
Mvumvu explained that Masombuka is trained to clean the emergency, ICU, trauma and theatre wards. “Every minute there needs to be a cleaner because you have patients coming in with injuries, people vomit, there’s blood on the floor, nurses are running around…”
Masombuka said he had three months’ intensive training when he started working.
“I only worked a day shift for a week while training, then had to work night shift from there.”
His tasks include removing blood from the floor, cleaning the floors, scrubbing, cleaning the walls and doing high dusting.
He said he had gotten used to the blood spillage and cleaning of the blood on the floors but still recalls the smell.
“The blood smells when it gets dry, this is why I have to work quickly so that it doesn’t get dry – to prevent the smell. When it does get dry and smelly, I can use something like a multi-purpose cleaner to kill the bad smell,” he explained.
But Masombuka said he wished cleaners could get a “danger allowance”.
“In the private sector, I know cleaners get paid a minimum of R3 500, at government departments we get paid from R7 500. I wish it was more like starting from R10 000. The hospital is a hectic place to work in. It would also be nice if cleaners could get danger allowance as a benefit.”
Through the training Masombuka had to learn the different resources he had to make use of.
For example, he uses different mops for different things.
“There’s mops for the toilets, mops for the blood, mops for infected areas. Also, there are different types of waste, general waste goes into the black or see-through plastic, the red box is for human waste – anything that comes out of the mouth or body goes into that red box.”
He also learned about what detergents to use, how to clean certain areas and how often to do these tasks. “The linen needs to be removed daily.”
Masombuka said he always has to wear protective clothes and a mask because you don’t know the patients coming in.
“They might have different diseases.”
Another thing he learned was that he is, under no circumstances, allowed to give any patient water.
“If a patient asks me, I have to tell the nurses – the nurses takes care of the patients in that way.”
He explains that the hospital also has an infection control team that comes in on a regular basis.
The infection control team then advises Masombuka on what measures should be put in place especially if there is an infected area.
I’m doing it for my community. I’ve wanted to do community work and working for the health department is part of my vision.
Respecting life more
Masombuka said it is important for him to be there whenever a new patient comes into the emergency ward.
“When they come in, they come in with blood. I must be there to remove the blood quickly, so that it doesn’t get dry. It can leave permanent marks if the blood dries on the floor.”
Sometimes though, he is on a lunch break or he is helping another cleaner in a nearby ward.
“I came back once and there was already a patient here, on his way to theatre. I had to move fast to clean up the blood.”
Some days he takes a half an hour break instead of an hour.
He says he sometimes has his break at the entrance of the ward, to keep an eye on whether a new patient comes in or not.
From Friday to Sunday he gets assistance because those are normally busy days.
“When the place is full of patients, there’s a lot of noise and there is a lot of blood. It becomes a bit chaotic, you have to ask them to move to the side … some patients are impatient though, and some people fight.”
Masombuka said it is no longer hard for him to see bad things (like the injured people).
Although there is counselling available for staff, he has not gone for it.
“I have become hard. When people (at my home) get hurt, I’m not bothered because I’ve seen worse.”
But he has his off days when things get a bit much. “Sometimes I do feel like I need relief, that I need to do something different to work with because this place is so traumatic. Then I think I should go outside or sometimes I wish that I could work in the administration offices of the hospital instead.”
According to Masombuka, he has learned to respect life more.
“There is a lot of things happening out there (in the communities). I’ve learned that one should be more cautious when it comes to your life. People have been killed because they were trying to be heroes. And alcohol is not good – I see a lot of drunk people coming in here.”
Masombuka said he has not gotten sick yet since working at the hospital last year.
Every three months he must go for tests – for HIV, high blood sugar and so on.
Doing it for the community
“The nurses and the doctors are very supportive and they respect me,” said Masombuka.
“If a doctor undermines me or what I’m doing, I don’t take it personally. I’m here to do a job.”
Masombuka has a diploma in financial management and he is currently studying part time for his LLB. He said many people don’t understand why he is working as a cleaner yet he has a qualification.
“I’m doing it for my community. I’ve wanted to do community work and working for the health department is part of my vision. I’m hoping that Charlotte Maxeke Academic Hospital becomes the best hospital.”
#WhatItsLike: This article is part of Spotlight’s #WhatItsLike series – in which we ask cleaners, doctors, facility managers, and many others in the public healthcare system what it is like to do the important work they do.
- This article was produced by Spotlight – health journalism in the public interest