Documentary Photographer & Journalist Anna Tervahartiala is the Edge of Humanity Magazine contributor of this documentary photography. From her project “Where Laughter Turns To Tears“. To see Anna’s gallery of projects click on any image.
A man sits on a stretched bed and cries. The nurse had just finished dressing a wound on his head. When asked about the accuracy of the statistics, a doctor working in the casualty was quick to note that the statistics are far from the truth. As the hospital of Katutura suffers from a lack of manpower, the staff has to prioritize treating the patients over counting them.
Where Laughter Turns to Tears tells a story of the Casualty Ward of Katutura State Hospital in the capital of Windhoek, Namibia. Katutura is a neighborhood created in the beginning of the 1960’s after the forced removal of the black population from the old location, an area segregated for black residents of the city. In Herero language, Katutura stands for “The place where people do not want to live.”
A man flinches as a nurse stitches a wound on the top of his head. A nurse working in the dressing room said that she might stitch up to 50 patients, during a night shift on a month-end weekend. Fights and accidents keep the staff of the ward busy through the night.
Approximately 60 percent of the population of Windhoek lives in Katutura. Katutura Hospital is the sole public casualty ward open 24/7 in the whole of Namibia.
A surgeon visits the casualty ward on a Friday evening. According to the staff of the casualty, most of the cases treated during month-end weekends are not of natural causes, but cases related to alcohol abuse.
Even though accidents and illness do not look at the time of day, the casualty is a reflection of life. “Bloodbath”, “mayhem”, “war zone”, are words used by the personnel of the hospital to describe the scene they work in as the month comes to a end. Month-ends are the time when people start receiving their salaries and have money in their pockets. When celebrations end, work at the hospital begins. This is the way it has been for years. According to the nurses and doctors on duty, the situation has only gotten worse.
The scar behind the left ear of this young man is a reminder of a previous visit to the hospital. This time this man was brought to Katutura Hospital after he had been cut with a machete. According to a WHO report from 2011, Namibia has the fifth highest alcohol consumption on the continent of Africa. The reasons behind alcohol abuse and violence are not self-explanatory. Some of the reasons seem to be linked with unemployment and poverty as well as the rapid growth of the city of Windhoek. In 2014, both the unemployment as well as the national poverty rates of Namibia was 28 percent.
In statistics numbering the trauma cases treated during weekend night shifts from January to June 2015, the highest number of cases on a single weekend stood at 529. Out of six months, four had their busiest weekend nights after the first half of the month. During night shifts there are usually 2-4 doctors and 8-9 nurses on duty.
A young doctor examines the x-ray of a man whose forehead has been fractured. The man said that he had been hit on the head in a bar, but he had arrived to the hospital hours after the incident. According to the doctor, one of the biggest issues faced at the casualty ward of the Katutura State Hospital is the violent and disrespectful behavior of patients. The staff of the hospital do not feel safe while doing weekend night shifts as a noticeable number of patients come to the hospital due to violence. “If the people fight outside, they will also fight inside,” a doctor working at the casualty said.
CPR room of the casualty ward. Dopamine is used in CPR for increasing cardiac output.
A man sleeps in the area for patients who are not in the need for immediate care.
Man wounded by a stone thrown at him. The nurse doing the stitches worked swiftly. When she heard that the man had been driving, her expression tightened. The man was visibly drunk.
The cleaner of the casualty ward cleans blood from the floor of the inspection area. Namibia suffers an ongoing lack of medical professionals.
“When I notice that I have a night shift on a month-end weekend, I come to work mentally prepared. I know that it will be a busy night,” Nurse Malioh Phares says. Phares has worked at the Katutura State Hospital for four years.
Inspection area of the of the casualty ward of the Katutura State Hospital when night starts turning into morning.