“Did you know? Chris Hani Baragwanath hospital is the largest hospital in the southern hemisphere.”
This little fact featured in the wrappers of iconic South African chewing gum brand Chappies for years. But lately, institutions have been claiming it is the “third largest hospital in the world”.
“The Chris Hani Baragwanath hospital is the 3rd largest hospital in the world, occupying around 173 acres (0.7km²) with approximately 3,200 beds and about 6,760 staff members. The facilities are housed in 429 buildings with a total surface area of 233,795 m².”
Why the hospital’s size was a talking point
Chris Hani Baragwanath began its life as a military hospital, serving British troops in the Second World War. Its name was derived from Cornishman John Albert Baragwanath.
After 1948, and the establishment of apartheid, the hospital found itself in the centre of a black township, Soweto, and became a civilian hospital for black patients.
Historian Dr Simonne Horwitz read for a Ph.D. on the pre-1994 history of Chris Hani Baragwanath which was subsequently published as Baragwanath Hospital, Soweto.
She told Africa Check that a lot of the initial stress on the hospital’s size came from the minority National Party government which wanted to show that it looked after black people in the country. This was part of efforts to portray its policy of separate development as viable, despite strong international criticism.
“The apartheid government used Bara as its showpiece… Some of the original discussion was [about] how big it was,” Horwitz said.
A Guinness world record in 1997
After the advent of democracy in 1994, struggle stalwart Chris Hani’s name was coupled to that of Baragwanath and in 1997, the hospital was renamed Chris Hani Baragwanath hospital.
It was also in that year that the hospital submitted an application to the Guinness Book of Records to be recognised as the largest hospital in the world, hospital spokesman Nkosiyethu Mazibuko confirmed to Africa Check.
“We still record the Chris Hani Baragwanath hospital as the largest hospital in the world by number of beds, [with 3,294],” Guinness World Records PR Manager Doug Male told Africa Check.
He said that records are either initiated in-house or, as was the case with Chris Hani Baragwanath, an organisation applies for the record. If it is an application for a record, their researchers will check that the record claim is true.
Male said that the records were checked annually, but “sometimes things fall through the cracks”, such as Chris Hani Baragwanath’s status as the largest hospital in the world.
So it still the biggest?
Chris Hani Baragwanath considers two hospitals larger than itself: the West China Hospital and the Chang Gung Memorial Hospital, Mazibuko told Africa Check.
The West China Hospital, which is affiliated with Sichuan University in the city of Chengdu, is said to have 4,300 beds. The Chang Gung Memorial Hospital claims to have 9,000 beds, but according to its website it consists of not one hospital but a collection of hospitals dotted around the island of Taiwan.
Africa Check asked the World Health Organisation, World Bank and the Organisation for Economic Co-operation and Development (OECD) for information on hospital sizes.
OECD media co-ordinator Anna Biernat and the World Bank’s data centre said that they did not have this information and only collected hospital-bed data on a national level. The World Health Organisation South Africa’s communications associate Greer van Zyl told Africa Check that the organisation did not keep a ranking or list of hospitals by bed numbers.
Using our trusty friend Google we then methodically searched for the largest hospitals on each continent.
Hospitals such Ahmedabad Civil Hospital in India (“more than 2,000 beds”) and Hospital das Clinicas with the University of Sao Paulo Medical School (with its 2,200 beds) trail behind the Soweto-based hospital. The United States also has a number of large hospitals, such as New York-Presbyterian (2,328 staffed beds) and Florida Hospital Orlando (2,247 beds), but doesn’t nearly reach the number of beds Chris Hani Baragwanath is claimed to have.
We did find one hospital that is bigger: the Clinical Centre of Serbia. Fellow fact-checking organisation Istinomer in Belgrade checked with public relations official, Aleksandra Beric, who said the hospital has 3,470 beds available.
Are all Bara’s beds still available?
Chris Hani Baragwanath hospital is not as big as it used to be. Staffing problems, maintenance issues and ward renovations mean that it has fewer hospital beds available than before.
In 2011, it was announced by health minister Aaron Motsoaledi that the hospital would be downscaled to 1,200 beds, in line with international standards. It was reported last year that emergency patients were being referred to other hospitals because of renovations at Chris Hani Baragwanath’s emergency unit. In January, medical casualty was still closed.
The hospital’s Mazibuko told Africa Check that no wards had been closed but that some were being renovated. He said that this process was almost completed.
“The bed occupancy is 3,400 [with] 2,888 usable,” he said.
Size isn’t everything
Bigger is also not necessarily better. A serious concern with a hospital as large as Chris Hani Baragwanath, which has grown haphazardly for the last 70 years, is that “it is so expensive to maintain”, said Prof Stephen Hendricks, a public health specialist in South Africa.
“When Bara was built it was much smaller than it is now and they have just been adding on sections,” Hendricks said. The wiring, plumbing and engineering techniques range in age and efficiency, making maintenance expensive.
“There are discussions at high levels to decentralise Bara into three possible hospitals, which will be more in line with the vision of the National Health Insurance. That is more accessible. Soweto has 4 to 5 million people and they all come to Bara,” he told Africa Check.
Conclusion: Chris Hani Baragwanath hospital is no longer the third largest in the world
Chris Hani Baragwanath hospital is huge and still holds the Guinness World Record for the largest hospital on earth with 3,294 beds. However, the people at Guinness need to update their books.
Due to maintenance work and renovations Chris Hani Baragwanath currently only has 2,888 beds available, a spokesman told Africa Check.
By the hospital’s own standards two other hospitals have overtaken it in size: the Chang Gung Memorial Hospital (9,000 beds), a conglomeration of institutions, and the West China Hospital (4,300 beds). Africa Check was able to locate a third, the Clinical Centre of Serbia that has 3,470 beds.
Although Chris Hani Baragwanath hospital may have fallen out of the top three it needs to consider whether it would like to keep up with the competition: bigger hospitals mean more expensive maintenance and increased bureaucracy.
Do you know of a larger hospital in the world? Tweet us @AfricaCheck or email us at firstname.lastname@example.org.
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