Hospital ICUs are on life support

SA has just five ICU beds per 100 000 people, way below international averages. In some provinces the number is closer to one

- ANITA NKONKI and WENDY JASSON DA COSTA

DON'T hold your breath if you need an ICU bed; South Africa's intensive care system is buckling under severe strain.

Experts are sounding the alarm, warning that shortages of beds and trained staff could lead to preventable deaths.

The situation is dire: South Africa has just five ICU beds per 100000 people, far below the global average. In some provinces, the number is even lower.

Professor Fathima Paruk, head of Critical Care and Emergency Medicine at the University of Pretoria, says South Africa's ICU capacity lags far behind international standards. She revealed that while Germany averages 39 ICU beds per 100000 people, South Africa has just five, and these figures are based on pre-Covid-19 data. In some provinces, the number is closer to one.

"Hospitals will need more ICU beds as patients live longer," Paruk said. "Intensive care saves lives, but it requires trained staff, technology and resources that many hospitals simply don't have. The demand is growing faster than the system's ability to respond."

Because of this shortage, many critically ill patients are stabilised in peripheral hospitals before being transferred to facilities with ICU capacity. However, sometimes this happens too late. Experts say the result is unnecessary loss of life, especially among trauma, surgery and high-dependency patients.

"You can't run an ICU bed without nurses and doctors who are trained in critical care, and we are extremely short of them in both the public and private sectors," Paruk added. "Across the country, only 25% of our ICU nurses are trained in critical care."

But for health workers on the front-lines, the ICU crisis is only one symptom of a much deeper malaise. Hospitals nationwide are battling collapsing buildings, water shortages, power failures and severe understaffing, leaving many demoralised.