Hospital cleaners in a failing health care system

Bea is a cleaning lady. She has been working in a hospital in Budapest for four years. She does not wish to share exactly which one. She is scared for her job – and with good reason. She feels that the stories she tells, the stories she, herself is terrified of, might jeopardize her job.

A corpse lay in the toilet of a Budapest hospital for five days, before it was found by hospital personnel. The media was immediately trying to find out who was responsible and was demanding for a comprehensive health care reform. A few days passed and a similar tragedy took place in a hospital in the city of Győr. What we are talking about is a generalized structural problem, which is complicated and comprises of several aspects, but one that requires an immediate resolution.

Because nobody can be left to die in the toilet of a hospital without being noticed for days. But unfortunately it happened. Twice.

The only government official who addressed this issue was Zoltán Ónodi-Szűcs, the secretary of state for health care. According to him however, it is not the system that should be blamed. He thinks that the problem is that there are toilets in which people can get stuck. In a bold statement, he also tried to put the responsibility on the hospital’s cleaning firm, claiming that there might have been problems with supervision that triggered the tragedy. The words of the secretary of state contained only one relevant point: he drew attention to the fact that there are more workers in a hospital than just doctors and nurses. There are others whose working conditions are also far from ideal. Unfortunately, nowadays the only occasion when the auxiliary personnel of hospitals are in the news is when they are made to be scapegoats in a failing system. So let us talk about them.

Bea is not working in either of the two hospitals in which the recent tragedies took place. “It could happen at any moment in our hospital as well. We might notice it faster, but I am not even sure about that,” she says. When I ask her about who should be held accountable after such an event, she shrugs her shoulders.

“I would look for people to blame. Because there would be many. But I can give an explanation for all of them. The doorman cannot remember every person who enters the hospital in order to count whether everybody who is supposed to leave has done so at the end of the day. The doctors have no idea who the patient is: they just know their medical sheet, they check that, and do not really have time to see who lies in the bed and who does not. The nurses are on their feet for their entire shifts, they know the patients, but have almost no time, and might think that the patient was transferred during somebody else’s shift. And there are the cleaners. Why didn’t they go into the toilet? Why didn’t they find the patient? Why didn’t they clean properly?” At this point her enumeration turns bitter. According to Bea, a lot of people cannot even imagine how much work a hospital cleaner does. This is difficult, physical labor without end: if the floors are clean, nobody notices, but if not, everybody blames her.

“Don’t get me wrong, I am not telling you this to make you feel sorry for me. This is my job, and sometimes I am very proud of the fact that I work in a hospital. It is a big thing for me, as I only finished elementary school. But it is not an easy job, and it is nothing like in the television series where everything shines, and everybody smiles.” A hospital cleaner sweats for eight hours a day (plus the overtime which is sometimes paid, sometimes not). Early in the morning, during the night, on holidays – this is a job that is required on every day of the year and every hour of the day. The wages are, however, humiliating: around 80 thousand forints (roughly 250 euros) per month, which is barely above the minimum wage. This is the amount a cleaner works her fingers to the bone for, and we haven’t even mentioned the psychological burden yet.

“What I haven’t seen in terms of losing one’s human dignity, does not really exist. Torn stiches, vomit, blood, faeces. Dying people, dead people. I am running though the hallways, wiping what I see, and ten minutes later, everything is how it was. I clean the toilet ten times, but even if I had seven lives, it would still not be enough. I don’t want to over-explain, because it is useless. But sometimes I have nightmares about the things that happened that day. I have no idea how others cope with it as for me it is very difficult.”

Why does she do it, then? Why does not she return to the school where she used to work?

“Do not think for a second that I am a saint, none of us are. People will sneak a thousand (one thousand forint – the eds.) into my pocket when they want me to take them out for a walk or to get them a cigarette. Or if they need me to bring clean sheets, or to pop out to the shop for some decent food. For a time I did not accept anything, because what did I know about what one is allowed to eat with, let’s say, an amputated leg. But then that feeling passed and also my salary needs to be supplemented, and I would not get this extra money while working in a school.”
This is why Bea thinks that we should not look for individual scapegoats, but we should focus on making our hospitals into decent, livable places. Places in which no doctor, nurse, cleaner or doorman is overworked or exhausted, and where everybody is provided with adequate working conditions. And last but not least, they are given decent wages accompanied with the respect that they deserve.

“I work with chemicals and medicines, which is no small responsibility, even if I am just a cleaner. When they hired me, they told me in ten minutes what rules I should follow. I wipe the floor, clean the tiles, these are the main duties, but let’s face it, I work among patients, and if I want to be honest, I am not sure I respect every rule while I go about my work. Of course, there are regulations: I must not touch the medical instruments, but just today a patient asked me to fix his leaky infusion. He wanted to put his arm in a more comfortable position, and I helped him. Now, what rule did I break? And should I have left him there with his arm twisted?”

Nowadays, a hospital cleaner is hired with no previous experience and no special qualifications. Hospitals are looking for cleaning personnel on every day of the year. “I do not claim that anybody could do this for an entire lifetime. Many quit quickly, when they realize what the job actually entails. You need stomach and strength. Without them you’d better not start” – summarizes Bea. And after that she runs home, the next day she starts her shift at four in the morning. She says that if she gets lucky nothing special will happen the next day. “But something always happens…”