Bunkers, tunnels & other finds: Why Charlotte Maxeke Hospital is still closed

JOHANNESBURG - While it is no secret that most of the country’s infrastructure is still stuck in time, the April fire at the Charlotte Maxeke Academic Hospital has brought to the fore complex and deep challenges regarding compliance with building regulations and occupational health and safety.

Gauteng MEC for Infrastructure Development Tasneem Motara told Eyewitness News in an interview this week that “if we were to really comply with the letter of the law, all our hospitals should be condemned”.

A myriad of factors led Motara to this conclusion, however, this does not mean the hospitals are not structurally sound or that they could collapse at any given moment.

In the case of Charlotte Maxeke Hospital, she said the reason there were delays in reopening the critical facility - much to the frustration of the province’s residents as it is among the largest in Gauteng - were rooted in its failure to meet existing requirements of the Building Regulations Act and occupational health and safety laws.

The City of Johannesburg, which is the custodian of the implementation of the regulations, has sent the provincial government back to the drawing board since its mop-up operations after the fire came short of its standards and demanded that it should comply before the hospital can be declared legal for full occupation.

“So, what we thought would be a straightforward process, meaning we would just get our structural engineers to confirm what we could see at the naked eye and submit that structural report to the hospital and say, based on the structural integrity of the building, you can access eight-and-a-half sections of the building out of 10. And the rest we would be able to deal with from a short to medium term to make it structurally sound for you to reoccupy that one-and-a-half section, became complex,” said Motara.

She added that since the hospital was 100% evacuated during the fire, a decision she commends the management for, they now need the local authority - the City of Joburg - to give them permission to reoccupy.

Charlotte Maxeke Hospital, like many others across the country, was built by the apartheid regime in the 1960s and did not have to comply with the recent regulations.

Motara used the hospital’s evacuation procedure as an example of the many hurdles they would have to overcome before the city signed off on the building.

“A building needs an evacuation area that not only takes you out of an affected area of the building, takes you to an assembly point, but also allows you to exit the entire vicinity of the building. Now, Charlotte doesn’t have that at all. It’s got assembly points, but the assembly points don’t allow you to exit the vicinity completely. So, in the event of a disaster, you would be able to get out, assemble at the assembly point, but practically you would have to go through that area [inside the hospital] again to exit the building. That is just the way it was designed,” she said.

Motara said even as they continued with the improvements, it became clear that they would not be able to create an evacuation system envisaged by the City’s regulations and other laws, simply because of the way the building was designed.

What they would do, however, was to retrofit the compliance to meet the standards.

“We are retrofitting the compliance to say if you have an assembly point, it must be so many metres away from the exit. But for all intents and purposes, if the building would collapse and you needed to get people out you would have to evacuate them through air because you wouldn’t be able to re-access the building. It would become practically impossible,” she explained.

NO TIMELINES

Motara also told Eyewitness News that it would be folly to predict when the Charlotte Maxeke Hospital would return to full service, given the complexities and unpredictability of the construction work under way.

The hospital has been operating partially, with the newly built COVID-19 ward as the only unit receiving inpatients. The oncology unit that was built in recent years has also been reopened. It provides outpatient services to cancer patients who are receiving treatment at the hospital.

Although some of Motara’s colleagues and Gauteng Premier David Makhura made several repeated assurances to the public that the hospital would be reopened shortly after the fire, reality has proven otherwise.

Motara provided clarity on the question of when the hospital would re-open.

“It is a tedious, long process. It is complicated but it is a very necessary thing for us to do because we had been chasing compliance as the state in all our facilities and not meeting the standards. We have continued to make the argument that our buildings may be structurally sound, but there are very definite aspects of compliance that we are not meeting, and if those are not met, we are actually just occupying a building illegally”, said Motara.

The Gauteng government also needs to procure a minimum of 1,540 fire doors for the hospital, a task that has been difficult.

“There are fire doors at the hospital but they do not meet the current standards. So, we had them tested, they are one-hour fire-rated [it can resist a standardised fire for one hour]. What the municipality is looking for now is two-hour fire rating, meaning the door can be ablaze for two hours without being destroyed”.

But, such doors aren’t found on hardware store shelves.

"Each of these are purpose-made. They are not a shelf item. You have to measure each opening and then they fabricate it, and they fabricate it with aluminum, steel. And then there is the fitting that goes on the inside of it. I am told it takes anywhere between six to 12 days to manufacture a door."

The 12 days could be extended though, given the COVID-19 pandemic and other disruptions - such as the July violence that affected the delivery of goods and other supplies.

Motara, who has worked in construction for a long time, cited such incidents as the reasons behind her reluctance to predict when the work at Charlotte Maxeke Hospital could be completed. After all, the decision would lay with the City of Johannesburg, which could at any given point turn them back to make other adjustments as and when it was deemed necessary.

Currently, the construction work at the hospital is at phase two out of three. Phase one included the reopening of the oncology unit and other areas.

Motara explained their request to open wards and floors as and when they were complete was turned down by the City.

INCOMPLETE BUILDING PLANS

Another factor that delayed the reopening of the hospital was the absence of complete building plans for the facility.

The problem is widespread across state-owned buildings as the apartheid regime did not register building plans with necessary authorities.

As a result, Motara said they have been making interesting discoveries across the province as they renovated and rebuilt some schools and hospitals, among other infrastructure.

"At Dr George Mukhari [Hospital], when they were digging for the foundation, they found bunkers. Those bunkers are not on any building plans. Nobody knows about them, we are not sure what to do with them, not sure whether we should destroy them. We don’t know where it leads to. Contractors were even afraid to go in because they were worried about what they would find."

And the unusual discoveries have been many.

“We even find that with a lot of our inner-city schools. There is a school we are doing refurbishment on. There are things underneath, it’s a whole structure underneath the school, and we are not sure whether we must update the plans and include it. We are not sure how far it goes to and to what extent you can go underneath - what does it do, where does it lead to, and all of that,” she said.

The apartheid regime declared all state buildings national key points, hiding its plans from the public and its leaders continued to take them with when they departed office after the emergence of the democratic dispensation during the 1994 transition.

At Charlotte Maxeke Hospital, which is over 60-years-old, Motara said to meet the compliance specifications of the City, they’ve had to reconstruct the plans.

“We didn’t have the building plans. What we then had to do is 3D scan the building because the building plans must be accurate in terms of all your walls, all your structures, all your services. Where are the electrical pipes, water pipes, the gas lines, all of that,” she explained.

Work at the hospital will likely continue for months to come as the Gauteng government chases its mandatory target to ensure it is compliant with current legislation that regulates occupational health and safety.

Other hospitals in the province have been buckling under pressure as patients who would have ordinarily visited Charlotte Maxeke Hospital for consultations and other services have no option but to go elsewhere.

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