The Western Cape is bleeding, and so are its health workers. 

High levels of violence and the severity of some of the injuries they deal with are driving health workers to their sick beds, according to the head of trauma at Groote Schuur Hospital in Cape Town.

Prof Andrew Nicol told a media briefing on Thursday that many emergency workers were being booked off with burnout and post-traumatic stress disorder.

At Groote Schuur, the province’s second-biggest hospital, the number of patients with gunshot injuries had doubled in the past eight years from 36 cases a month to 73, he said. The biggest hospital, Tygerberg, treats another 107.

Nicol said the intensity of trauma had also shifted from single-shot wounds to multiple shots. A 52-year-old woman who was shot 37 times during a house robbery was saved, he said.

"The numbers have increased but the complexity has changed. The heart-wrenching cases that we have to endure on a daily basis is something to behold," said Nicol.

"It does cause damage, especially to our young doctors who are exposed to this massive level of violence and who work on weekends often with intoxicated patients. It’s taking a toll on them."

The head of health in the Western Cape, Dr Beth Engelbrecht, said ambulance staff were  particularly badly affected by post-traumatic stress disorder due to the violence aimed at them.

"The impact of violence on staff who have to manage complex trauma, see and experience violence day in and day out and face a never-ending wave of illness, pain and injury, is massive," she said.

Over the last three years, at least 100 EMS staff had taken time off due to post-traumatic stress disorder, and the number was probably higher because staff did not always disclose the reason for their sick leave.

Violence had also had a devastating effect on ambulance response times. Over the last two years, the number of "priority one" calls attended to within 15 minutes had fallen from 65% to 12% because crews had to wait for police escorts before entering dangerous "red zones".

"This is a direct result of when an area is unsafe and our EMS crews cannot enter on their own," said Engelbrecht.

"Violence affects all sectors of society but health carries a massive burden. The emotional, economic, and long-term impact on communities cannot be quantified."

Nicol said almost 90% of gunshot patients are male, more than half are unemployed and one in five are linked to gangs.

Health MEC Nomafrench Mbombo said the level of violence meant important surgeries for cancer and orthopaedic patients ended up being delayed.

"We are competing with resources, and end up robbing Paul to pay Pauline," she said.

"Communities are often upset with our facilities when they see patients treated in corridors and some are sleeping on the floor.

"But, given the level of violence and dwindling funding, we are often left with no choice as we have to treat everyone that walks through the health system. It would be unconstitutional to turn anybody away."