Concern has been raised over a Bredasdorp man being discharged from Tygerberg Hospital in Bellville, Cape Town, where he underwent five major operations, owing to lack of running water and other inadequate facilities in the informal settlement he lives in, which are essential in wound care.

The hospital allegedly planned to discharge Jaco Wastie back to Bredasdorp despite his critical condition. His weight had dropped to 45 kg due to severe illness, and on his arrival at Tygerberg doctors diagnosed him with a cancer on the lip, which had been growing over two years. His chances of survival were minimal.

“The doctor said he has a very slim chance for recovery,” Vicky Snyman, who has supported Wastie since his admission at the hospital, told Hermanus Times.

Multiple operations later and and an anticipated slow but steady recovery the hospital had allegedly begun moves to discharge him without the authorisation of a social worker and a discharge letter. This raised concerns.

An open letter circulated by a group of people supporting Wastie said he would be returning to an environment far from conducive to his recovery and where the availability of suitable after-care was seriously in doubt.

Wastie, who was a homeless man before admission, reportedly underwent a combined 65 hours in five separate surgeries and operations. One was 21 hours long.

Procedures included tissue necrosis and the emergency removal of tissue, followed by a procedure involving a chest flap to the chin to maintain blood flow.

“He dropped to 45kg. Stitches came loose. Pain beyond words,” read the letter from concerned supporters.

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Since 12 August Wastie has been and is still recovering from extensive reconstructive surgery.

“Weighing 45 kg I lifted my broken body out of bed and started tasting different foods again,” he said.

On 21 October Wastie was allegedly told to “pack his bags and a taxi would be organised,” according to Tess Riekert of the Lephalale Farming Community Support Group. “Everyone was in a terrible state when we heard this.”

Allegedly no step-down facility was prepared for him and no social worker went to see him, despite weeks of attempts to reach out.

“For weeks [Wastie] and [Snyman] have been asking for the social worker to see Wastie,” said Riekert in correspondence with the Hermanus Times. “We actually feel Jaco’s case should have been dealt with by the social worker from the very onset. Now we are told all step down facilities are full […]?”

“The staff work under tremendous pressure, however there seems to have been a failure in communication.

“We feel the ball was dropped and [Wastie] should not have to suffer the consequences. How can the social worker possibly okay him to go back to informal settlement to a place with no clean facilities?”

“Must I go home like this, with stitches still in?” Wastie himself asked. “Who will look after my wounds at the squatter camp?”

The department responds

In response to concerns the Western Cape Department of Health and Wellness said discharge planning takes into account patients’ medical needs and the circumstances that could affect their recovery.

“Where additional support is required, health-care teams work with social workers, transitional care facilities and other partners, including the Department of Social Development, to explore appropriate arrangements,” said Esethu Madlwabinga, communication officer at the department.

He said the department’s support could include assistance with ongoing care, follow-up appointments and access to available support services.

It acknowledged that access to suitable accommodation, basic hygiene and a supportive environment could significantly affect recovery, particularly for vulnerable patients.

However, the department declined to comment on Wastie’s individual circumstances, citing patient privacy and dignity.

“While we understand the public interest in this matter we have a responsibility to protect every patient’s privacy and dignity,” Madlwabinga said. “We are therefore unable to discuss an individual’s medical care, personal circumstances or discharge arrangements.”

The department did not directly confirm whether Wastie had been discharged, whether his discharge had been postponed or what arrangements had been made for his recovery.

Search for safe accommodation

The group says it has contacted various facilities in an effort to secure suitable step-down care, but was told that available facilities were full.

Although he has reportedly made progress and can now eat soft foods he still requires further jaw reconstruction and must take care while recovering.

The supporters say the Bredasdorp settlement has no running water, limited sanitation facilities and no nearby clinic, raising concerns about his ability to manage wound care in those conditions.

However, a temporary place has since been independently found for Jaco, although, it reportedly still presents its own challenges.

Supporters are now attempting to raise funds for safe accommodation near the hospital, high-protein soft foods and transport to help Wastie continue his recovery.

The department reiterated its commitment to person-centred care and said concerns about how patients are treated are taken seriously.

It encouraged patients and their families to raise concerns directly with the hospital so they can be addressed.

“The department remains committed to working with our partners to support continuity of care,” Madlwabinga said.

However, the department’s response did not clarify his current discharge status nor confirm whether suitable accommodation had been secured.

All claims made by Wastie and his supporters had not been independently verified nor had the department addressed the specific allegations or provide a timeline of social-work involvement.