Compassion Key for Ekuhlengeni Psychiatric Hospital’s Unsung Healthcare Heroes

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Nearly 500 patients are under the special care of a small multidisciplinary team of allied healthcare professionals working at Ekuhlengeni psychiatric hospital in Umbogintwini near the South Coast of Durban.

The team’s passion involves them constantly conceptualising innovative ways to ensure that the long-stay of vulnerable patients is pleasant and that their basic human rights are not compromised in any way.

This is according to Ekuhlengeni’s Acting CEO Mr Mzwandile Zondo, a site-trained nurse who has served KwaZulu-Natal’s Department of Health (KZN DoH) at various levels and within various healthcare institutions, who addressed UKZN’s College of Health Sciences Public Relations team during a site visit.

Said Zondo: “The facility provides care to mental health care users (MHCUs) suffering from chronic mental illness and who cannot be accommodated within the community due to being a danger to themselves and the community.”

Zondo said society was ignorant to a large extent about mental health issues, with many people erroneously believing that MHCUs had little or nothing to contribute. UKZN medial alumnus, law enthusiast and a medical officer at the facility, Dr Zakhele Khumalo, agreed with Zondo.

Khumalo said what impressed him about the hospital was its intersection of medicine, law, religion and family law - without which MHCUs in some cases would end up in orphanages, asylums, old age homes and even prison. “We are governed by the law in how we take care of the MHCUs. It is vital to keep in mind that work takes place within a human rights environment,” he added.

Zondo said they realised that what they do as a multidisciplinary team is not merely a job but rather a calling, which required collective decision-making under DoH guidelines. He said several factors influenced why it was often difficult to re-integrate the facility’s MHCUs into society. “We have patients who come from decent families whose members prefer to visit only occasionally and/or take MHCUs out on ‘leave of absence’ dates and then back to the hospital. It’s sad, but on the upside this process also helps us monitor whether a patient is dischargeable.”

The only specialist psychiatrist at the facility, UKZN alumnus Dr Michelle Daniels, said she was currently lobbying for much-needed psycho-social rehabilitation and palliative care in psychiatry. “Palliative care in psychiatry, also known as palliative psychiatry, focuses on improving the quality of life for individuals with severe and persistent mental illnesses (SPMIs) who are facing life-limiting conditions. It shifts the focus from solely trying to cure the mental illness to managing symptoms, addressing psychosocial needs, and promoting overall wellbeing. This approach is particularly relevant for individuals with SPMIs where curative treatments may be limited or ineffective,” she said.

Ms Silindile Dlamini is responsible for planning, monitoring and evaluation at the facility. A DoH-trained nurse who went on to specialise in Nursing Psychiatry and aspired to pursue her Master’s in Public Health at UKZN, Dlamini said there was a need to shift interventions from focusing on the global north and instead adapt best practices suitable to the local context, which she said was riddled with a variety of socio-cultural and socio-economic challenges. Family neglect made it difficult to monitor and evaluate patient progress.

Said Dlamini: “We need to put more effort into the schooling system, which is where the country’s youth get exposed to drugs and other negative influences - a key influence to the increasing number of younger MHCUs at the facility.”

UKZN-trained social workers at the hospital Mrs Vanessa Reddhi and Ms Ntokozo Zaca are a link between MHCUs and their families. They agreed with Dlamini, saying what made them passionate about their work was helping to improve the quality of life of MHCUs.

“It’s so rewarding to trace a patient’s family,” said Zaca. “A good day is not only when MHCUs receive visits and day-passes, it is even more rewarding when a family agrees to an MHCU being discharged from the facility to their home. The feeling of being acknowledged that your work makes a difference is incredible,” she said.

Mr Devadren Moodley, Ekuhlengeni’s Pharmacy Manager, is supported by Mrs Siveshni Subroyan and Mr William Maphanga - all of whom trained at UKZN and with Moodley also having obtained a BSc in Physiology at the former University of Durban Westville. They said they enjoyed serving the community and ensuring that MHCUs have a constant supply of necessary medication. Their dedication is inspired by examples such as male nurse, Mr Zabo Cele, who joined the facility 18 years ago as a qualified nurse and went on to pursue an Advanced Diploma in Psychiatry and Management at UKZN.

Occupational Therapist (OT), Ms Avania Naidoo said her desire to work at Ekuhlengeni was ignited during her undergraduate degree when she and her peers did a UKZN’s rotational block at the facility. “I enjoy working in the mental health field. I find it quite intriguing. I love the people I work with because they are a vulnerable population so it is so rewarding to make positive changes in their lives.”

Ekuhlengeni’s Chief Physiotherapist Dr Marilyn Hooblaul said she was thrilled to have just completed her PhD, which focused on developing a framework for the inclusion of mental health content into the physiotherapy curriculum at UKZN. Hooblaul works with Mrs Preshni Govindasamy, a UKZN second-year master’s physiotherapy candidate who joined Ekuhlengeni in 2021. She said they worked very closely with the multidisciplinary team to find effective solutions for the facility. “Every day we learn from each other and everything that we collaborate on is underscored by a common purpose.”

Milestones achieved over the years include: group exercise programmes; individual strength training programmes; a walking club for MHCUs at their facility; Move for Mental Health annual event; outreach to a school for autistic learners, Colours of Bliss, and the KwaMakhuta Clinic as well as a centre from where wheelchairs are provided for people in the community in the south of Durban.

The visit also included tours of the facility’s multidisciplinary areas, the lush-green garden and the carwash operation.

•    CEO Zondo confirmed that Ekuhlengeni accepts donations but there are standard DoH policies and procedures that must be adhered to.

Words and photograph: Lunga Memela