'In a queue to die': South Africa nurses work in fear and exhaustion

Nthabeleng, a 28-year-old nurse on the front line of South Africa's Covid pandemic, is exhausted and afraid. 

Each day, she begins her shift haunted by the dread of contracting coronavirus and dying, leaving behind a five-year-old daughter. She finishes it numb with fatigue, but the fear has remained.

Every week, a "colleague dies" somewhere, said Nthabeleng, who works in a rural clinic in northern Limpopo province.

That morning, two nurses had died at another clinic in the same province, she said.

"We are also in the queue of dying -- we are just waiting for our day," she said, her voice shrouded in despondency.

Nthabeleng's name, like those of other healthworkers in this report, has been changed due to a media blackout on reporting from hospitals.

Africa's worst-infected country may be over the peak of a deadly second wave of coronavirus, but a surge in patient numbers in recent weeks has left nurses drained.

At least 1.46 million infections have been recorded in South Africa, which accounts for 41 percent of the continent's total cases. Of these, 45,000 have died.

A new, more contagious variant of the virus, has fuelled the spread, and the pressure on hospitals is the worst in the country's living memory.

Compared to most African countries, South Africa's health care system is well off, yet workers say they have battled to cope.

Gruelling 12-hour-long shifts, calming panicky patients and shuttling between infected and non-infected patients are all part of Nthabeleng routine at the small clinic where only three nurses work.

"It's like a supermarket approach -- you do everything," she said by phone as she nervously related her daily routine.

The fear of coronavirus transmitting the virus between patients and catching it herself, runs deep. 

Relief is on the horizon.

Earlier this week, South Africa took delivery of its first coronavirus vaccines -- a million doses of the Oxford-AstraZeneca formula, which arrived from India.

But it will not be until mid-February before the country's immunisation campaign begins, and it will take many months before the population of 58 million is shielded.

'Clandestine' death count

In the interim, "the situation is very bad," said a 27-year-old male nurse. "The rate of testing positive among nurses is high."

"Some recover and some die," he said. "I have lost a colleague recently who worked at a neighbouring clinic."

Over 35,100 medical workers had contracted the virus in South Africa's public sector by October last year, according to health minister Zweli Mkhize, with more than 400 of them dying.

New figures are not available, and unions are in any case sceptical.

National Education, Health Allied Workers Union (NEHAWU) spokesman Khaya Xaba described the numbers of workers infected and dying as "clandestine".

Vacancies left by nurses who die are not being speedily filled, exacerbating the workload for those who have survived, according to another union.

"Those who have died have not been replaced and nurses that are unemployed remain very much unemployed," Lerato Mthunzi, president of the Young Nurses Indaba Trade Union, told AFP.

The government says it appointed more than 14,232 extra nursing staff between March and October last year.

Despite the exhaustion, many nurses vow to soldier on at the front line.

Nthabeleng, in the meanwhile, says she has moved out of her home and into a nurses' hostel to protect her young child and pensioner grandmother from infection.