Wednesday, January 9, 2008

2008. Apartheid Addington Hospital & Town Hill, 1989, O Maritzburg Certified

Durban's Addington Hospital started Fraser doing Occupational Therapy (OT) at St. Giles, constructing cardboard boxes, to get his clawed right hand working. Fraser was still confused. His memory was bad. OT was slave-labour, as Fraser wasn't being paid.

After twenty months at Addington, without consulting me, Addington sent Fraser to a Durban Mental Health halfway house near Windermere Road, halfway from home to hell. Fraser existed with other mental health citizens amongst carer professionals. The idea was that Fraser would be swiftly rehabilitated into normal city living. The idea was insane. Despite Dr. Luiz's neuropsychological assessment, Addington had made Fraser madder, due to Neuroleptic Malignant Syndrome and the wheelchair fall.

Daily, Fraser was expected to find his way kays across town back to Addington for OT slave-labour, and afterwards back to Windermere Road. Fraser either bussed or shambled to Addington. He became fit. I thought Dr. Luiz was mad expecting crippled Fraser to daily commute or shamble across Durbs CBD or beachfront to Addington OT, then back to Windermere Road.

One Friday night, Fraser wasn't at the halfway house. "Where's Fraser?" I asked a daft citizen.

"Back at Addington. He got pissed at Wagon Wheels Hotel. Cracked his nut!"

A white social worker said, "Patients like Fraser often fail rehab." She didn't know how Fraser got booze money. I thought Dr. Luiz sending Fraser miles away to a halfway house to fail was round the bend: lacking insight and judgement. Addington had set up Fraser for a fall.

Again, Fraser lay abed in Addington, concussed, his bloody face stitched. Again!

Dr. Luiz sent a message through a nurse saying, "Fraser failed rehabilitation. Durban Mental Health doesn't want Fraser anymore." Dr. Luiz, doctors, nurses, physiotherapists, social workers and OT therapists avoided me.

As I was living hundreds of kays away in Koffiefontein, I made two separate appointments to see Durban Mental Health's chief. I twice sat for hours outside his muggy Esplanade office. The prick avoided me - twice. He was too scared and / or contemptuous to see me, and only answered my letters when I appealed to his common humanity. I was learning that apartheid mental health, psychology, psychiatric and medical clowns didn't give a shit about a patient's family.

After Fraser recovered again, he stayed in Addington doing OT. Matron again grumbled, "Bed space!"

Unused to dealing with a brain-damaged brother, I didn't realize Dr. Luiz was aiming to kick Fraser's arse.

In my fantasies, the following consultation should've happened:

Dr Luiz: "Fraser's rehabilitation has failed, as Fraser lacks insight, having poor judgement in daily activities. He would be a danger to himself and others, due to his drinking, by causing motor accidents."

Me: "But Fraser was brain-damaged by a sugarcane truck."

Dr. Luiz: "Fraser has failed to make significant progress, having permanent brain malfunction."

Me: "But Fraser got Neuroleptic Malignant Syndrome due to neuroleptics."

Dr. Luiz: "The Addington team believes Fraser should rehabilitate by working in a sheltered environment, under observation."

Me: "So you're blaming the patient - Fraser will be a president's patient?"

Dr. Luiz: "Yes"

At that stage, I was unsure what a president's patient entailed, but the pattern of bullshit, avoidance, contempt, manipulation of me as patient's family, by apartheid medical and mental health staff, would continue for many years. I gradually got the above info from Addington, as it was a state hospital, which couldn't stop nor control my visiting Fraser, and because staff couldn't avoid my presence, and because I nagged hospital staff / mental health personally and by letters.

Addington professionals never consulted me once they'd decided to certify Fraser. They did what they liked, backed up by the 1973 Mental Health Act, just sneakily shifting Fraser to Town Hill Hospital, Pietermaritzburg, without consulting me, nor asking Fraser's nor my consent. I subsequently found out that all it took to certify someone was a letter / statement from one or two doctors, and a magistrate to certify the "patient."

Considering States-of-Terror and black-on-black slaughter in SA, certifying brain damaged, clawed and crippled Fraser a danger to himself and others was risible. Given their "danger" reasoning, doctors and magistrates should've certified many more South Africans, but they had their own agendas, ignoring necklacings, murderous carjackings and "political" killings in cities, townships, puppet homelands and rural areas.

While mad apartheid crumbled, during the 20 months Fraser convalesced at Addington there were Zulu nurse-aides at Addington, but no non-white patients.

Why was Fraser certified if he was brain-damaged? Addington professionals never explained. They did what they liked, with the full force of the law behind them, jabbering about Fraser's substance abuse (pissed once); inappropriate behaviour (walking instead of bussing to OT); transfer process; rehabilitation; management; sheltered employment.

They didn't mention Town Hill's "rehabilitation" would involve:

- Powerless Fraser being confined to a fenced, guarded Maritzburg madhouse, and Fraser having to ask carers' permission whenever he wanted to walk in Maritzburg;

-Lining up with other bored, certified patients several times daily, receiving toxic drugs popped by nurses into Fraser's mouth;

- Sedation: zombie citizens, sitting around, staring into space, or at old magazines, or TV;

- Drug side-symptoms, like obesity or low white-blood-cell count;

- Doing mindless OT like sorting screws (no pay, slave-labour for outside contractors);

- Wearing grubby old clothes and old shoes;

- No privacy: sleeping 2-4 men in sparsely furnished male hostel rooms;

- Smelly fellow patients, and shared ablutions;

- Unstimulating, boring, sheltered environment (just trees to talk to);

- Apartheid from normal people, interactions and social activities;

- No sex, no normal social interactions, or relationships;

- Iatrogenic illnesses, like meningitis and skin infections;

- Punishment detention in closed wards, seclusion room and forensic ward (euphemism for prison), for doing normal things like looking at children, or walking in town;

- Infantilization, disempowerment and alienation;

- Dehumanizing labels like "mentally disabled" or "intellectually disabled."

Shortly after Fraser's admittance to Town Hill madhouse, a social worker exasperated Fraser's curator bonis by advising, "Fraser's far too high-powered to be at Town Hill. You must move Fraser as soon as possible!" After I wrote to Town Hill's superintendent, the social worker denied her advice, defensively recommending, "Fraser must stay at Town Hill a long time!" Fraser's curator became frustrated, as Town Hill wouldn't supply information he needed to find decent placement for Fraser. I began to have a dim view of social workers and slimy, maggoty carers.

Besides care and treatment, Town Hill vacillated between gaoling Fraser for months in closed wards and the forensic security block, or trying to get rid of Fraser by placement elsewhere in KwaZulu-Natal or other provinces. Social workers took Fraser to interviews at placement places, and Fraser rejected places simply because he didn't like discipline and structure restricting his liberty. He liked freedom. For a while Fraser mind-fixed about working at Durban Saint Giles, where he could come and go as he liked, which was unacceptable to everyone except Fraser. Carers expected Fraser to be infantilized and separated from normal people.

Another NGO said, "Fraser is not suitable for this hostel, simply because our policy [exploitation] is that residents must work on a daily basis [slave labour without pay] which Fraser is not prepared to do." Fraser wasn't that brain damaged to see he would be exploited by greedy businesses as cheap labour, doing boring, repetitive tasks for ever. (Yet carers insisted Fraser had no judgement nor insight). Funny how Fraser being "a danger to himself and others" was ignored when his free labour was required.

Reasons why NGOs rejected Fraser; or why the curator and I rejected placement:

- No vacancies;
- Long waiting list - years. (Often small NGO hostels and / or workshops);
- Trial period;
- Increasing monthly levies;
- Patients more handicapped than Fraser, like cerebral palsied and wheelchair patients;
- Fraser's net assets wouldn't qualify Fraser for state subsidized homes. Thanks to Fraser's curator's investment expertise, Fraser had too much invested money, stopping him being state placed. Fraser had to be a pauper for state placement;
- Various Durban nursing homes: Charges varied according to amount of nursing care. GST would be added in most cases. Tariffs could increase.

Thus Fraser and I were trapped in a continuous nightmare of medical and madhouse staff, lawyers, and state and NGO placement staff, all with their own agendas, hiding behind the Mental Health Act 1973, and ultimately hiding behind patients, and when things went wrong, blaming the patient and family. But I still had to discover that arrogance and meanness on my donkey wagon ride over many years.

Durban Headways, a head injuries support group, said this about head injuries:

" * The head injured person is a changed person - he may have paralysis, loss of memory, sight, speech, and a change of personality. Demands on carers are enormous.
* Adjustments needed are progressive, as improvements can take place over several years. [True, with Fraser].
* Carer and patient can become socially isolated." Deliberate Town Hill madhouse policy.

Soweto unrest: Teenager Stompie Moeketsi Sepei was murdered in mysterious circumstances. Some whispered Winnie Mandela was involved. She denied it at later trials. Even Archbishop Tutu's post-apartheid Truth and Reconciliation Commission hearing of Winnie Mandela battled to find the truth about Stompie's murder.

Fraser's curator and I playing Pig Dog visited Addington's accountant, who charged Fraser little for his long stay at Addington Hospital.

Conscience? Expedience? New SA looming? Post-apartheid, during the New Millenium, Addington became an Aids hospital where poor Zulus went to die. Families had to bring food and shit paper for patients, or patients went without. For years, Fraser would complain about Addington's Dr. Luiz certifying Fraser to Town Hill.

Copyright Mark JS Esslemont.

See South Africa's Mental Health Act 1973.


Mark JS Esslemont said...

Email from an old school friend:

"...I didn't know that your brother had had that tragic accident. I'm shocked at what I skimmed thru on your website. My daughter qualified as a clinical psychologist... and did her community training at Pmb where she went to the various mental institutions. If there is anything you think my daughter or myself can do please contact me. I really mean that. These last 20 years must have been so tough for you and your family..."

Mark JS Esslemont said...

Email from another old school friend living in USA:

"I think I know why your bro Fraser's face is so familiar. I used to go to St. Giles for years to exercise with Sports Slade during my lunch hour. I used to see all the disabled individuals there doing their menial labour tasks."