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Public health in SA: Crying out for help, but who is listening?

By Louise Carmody

I was one of over a hundred people who gathered last week in the University of the Free State auditorium, as communities shared their experiences with an independent panel of three commissioners. Treatment Action Campaign and Section 27 convened the panel to investigate the real situation of public health care services in the province.

Listening to brave testimonies of personal pain and loss, I was deeply saddened that so many of the problems described are well known and yet people’s voices go unheard by government.

Each emotional story wove together into a powerful tapestry which illustrated systematic failures of the public health care system. Families losing loved ones, too many people sick and dying for lack of accessible, acceptable and quality health care services. Mothers and babies at risk due to the shortage of ambulances, health care workers and equipment, and traumatic experiences at health facilities driving people away from health care services.

But this was not new to me. Amnesty International documented similar concerns in a 2014 report.

Commissioners Bishop Paul Verryn, Thembeka Gwagwa and Thokozile Madonko listened carefully. They heard a grieving mother’s pain as she told of the death of her baby because she was unable to give birth in the hospital. About a brother’s unanswered requests for a post mortem report for his 21-year-old brother, who died having been misdiagnosed and mistreated by doctors. Elderly patients spoke of their difficulty to get to clinics in time to get a place in the queue, then waiting hours to see the one — over-worked — nurse available. About a young woman whose friend was stabbed in a tavern and bled to death in a casualty waiting room chair.

It is clear that the systems which are supposed to be protecting people, the health, police, education, transport and social development services are failing.

The picture of how South Africa treats its mothers and babies was proclaimed a “national emergency”, with the reality on the ground a far cry from the official commitments made to reduce maternal and new-born deaths.

‘Medical apartheid’
For individuals coping with multiple challenges and discrimination, such as adolescents living with HIV, and women living in poverty, there are often additional difficulties accessing the specific services they need. The problems can become more profound when the services require particular sensitivity to rights, such as sexual, reproductive and HIV services.

The plight of health care workers, especially for those working in rural areas, was highlighted by Dr Pillay from the Rural Health Advocacy Project. She linked the stress of understaffing, lack of medicines and equipment to a loss of morale and sensitivity of some doctors and nurses. Dr Pillay warned that the impact of insufficient financial and human resources for health were depriving poor people of their rights, and akin to “medical apartheid”.

Public spaces, such as these, where people can respectfully share experiences and seek answers, are essential. The integrity of the hearing contrasted with so many of the avoidable hardships described, which were caused or made far worse because patients were not listened to by service providers. Worse, many people highlighted they fear intimidation if they speak out. The Stop Stockouts report highlighted the sharp decrease in the number of health facilities in the Free State that were reporting to them, suggesting health care workers are unable to report stock outs.

Amnesty International has made recommendations to the government of South Africa that they ensure that all branches of government are involved in the response to maternal mortality, HIV and gender-based discrimination, and develop programmes to promote safe pregnancies and deliveries, including by addressing the social and economic challenges women and girls face accessing early antenatal care. Because all departments are responsible, from health to transport.

At the event, a heartbroken mother spoke of her traumatic loss of her baby, because of the long wait for an ambulance. When the ambulance finally arrived, the paramedics fixed an oxygen mask over her baby’s small face. Tragically, the ambulance struggled over pot holes on the poor road to the hospital and, unnoticed, the mask came loose on the way. The baby died a few days later.

This story is all too common.

It is vital that local, provincial and national governments start listening to the communities they serve. I hope they respect the findings of this People’s Commission of Inquiry and commit to an integrated response to delivering the basic services they have promised to the people of South Africa.

Louise Carmody is a Thematic Researcher with Amnesty International, International Secretariat Southern Africa regional office where her work focuses on Maternal Health and Sexual, Reproductive Rights


  • Amnesty International is a non-governmental organisation focused on human rights, with over seven million members and supporters around the world. The Southern African regional office of the International Secretariat is based in Johannesburg, South Africa. Twitter: @AmnestySARO


  1. Paul Bluewater Paul Bluewater 14 July 2015

    …no-one is listening.

  2. Alan Watkins Alan Watkins 14 July 2015

    I am repeatedly puzzled why this does not translate into ANC losses at the voting booth. Over the past 20 years there have been so many similar large scale tragedies that affect a small circle of people around the dead and the mistreated, lets assume 6 (but its probably a lot more) are affected and hopping mad when

    – someone suffers and/or dies in the state health system
    – someone suffers or dies or whose life is needlessly shortened because of the state’s attitude to HIV/AIDS
    – someone suffers due to poor policing and unsympathetic police reaction to murders, rapes etc
    – someone protesting suffers at hands of public order police, not just at the Marikana scale, but at the lower generally non-lethal scale – remember there are thousands of riots and protests each year
    – someone suffers on housing, water supply, electricity supply etc etc because of inept national and local government
    – poor education that fails millions of children, ensuring that they will never be able to get out of the poverty trap
    etc etc etc.

    All of the above should be amplified when those suffering and hopping mad people hear of corruption that takes money out of projects that should be easing their plight, and when they see the national leaders driving around in big German cars, living in big houses e.g. Nkandla, hear of the millions spend on jet travel and other luxuries for the political elite. Really, ANC leaders have proven to be so inept and so corrupt and so heartless towards poor people while feathering their own nests, that just about ALL support should by now have been driven away. This driving away of support should not be because of big national issues but only because of the bad DIRECT and PERSONAL experiences of people in millions of cases, and the knock on effect of those around them.

    Do the maths and there should be millions of people who hold the ANC responsible and who should NEVER on pain of death vote for the ANC again. Where are these people?

  3. frans van erk frans van erk 14 July 2015

    Of course no-one of the Great Entitled ones will listen, NEVER, UNLESS THEY ARE REMOVED AND PROSECUTED OR DEATH.

  4. Bad Moon Bad Moon 15 July 2015

    The anc government don’t care, come election time they just once again come with false promises and buying the votes by means of food parcels, free taxi services, providing you vote anc. What I can’t understand is that the voters can’t see thru this racket, are they so short sighted?

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