Community activism: A tale of three Eastern Cape clinics
The residents of Lusikisiki in the Eastern Cape are poised to celebrate the opening of a brand new temporary clinic. Plans for a day hospital are also underway. But many other clinics in the province are falling apart – and it is patients who are paying the price of neglect.
The Lusikisiki clinic
The village clinic in Lusikisiki is an example of how civil society activism can help to bring about progress and change. Residents protested because their clinic facilities consisted of just two tents and a rickety park home. Even the pit toilets were unfit for human use.
Attempts to engage the provincial MEC of Health, Sicelo Gqobana, had failed. So the Treatment Action Campaign (TAC) asked SECTION27 for help with exploring litigation options. Papers requesting a response from the MEC and the National Minister of Health were filed by TAC with SECTION27’s support.
After Dr Aaron Motsoaledi, the Minister of Health, had been briefed by SECTION27, an official team was dispatched to Lusikisiki. Within days, a temporary structure had been erected and plans for a day hospital were presented. A new, temporary clinic will be opening soon.
The residents of Lusikisiki are looking forward to having decent health facilities. But many other Eastern Cape villages still have to make do with substandard health facilities.
The Pilani clinic
To reach the Pilani Clinic from Mthatha, a town in the Nyandeni area, requires a two-hour drive along potholed roads. The clinic, in the OR Tambo District Municipality, is one of South Africa’s pilot sites for a new National Health Insurance scheme.
But the clinic has no electricity and an unreliable water supply. Three rondavels serve as consulting rooms, and the waiting areas inside are too small. The gas supply for the fridge in which the clinic’s drugs are kept is erratic. Pit latrines near the clinic block frequently.
Only one professional nurse works at the clinic which serves an area in which 150,000 people live. Prior to 2006, when the nurse agreed to work there, the clinic had been closed for years.
Patients are often sent home when the nurse and her assistant don’t reach the end of the waiting lists. Drug and vaccine stock-outs are frequent.
The Hamburg clinic
Hamburg Clinic, located between Port Alfred and East London, is in the Amathole District and operates in a building which has partially collapsed. Despite the fact that the building is unsafe for patients and staff, it continues to be used.
Staff have reported their concerns about the condition of the building to the district health authorities. A site visit, however, led the health authorities to conclude that only minor renovations were needed. Further deterioration has occurred since the delegation visited. “The clinic is … in danger of collapsing,” says a staff member.
Out of sight, out of mind
Many remote clinics are in bad condition. As one activist commented, it is a case of the facilities being “out of sight, out of mind”. Had it not been for the work of the people in Lusikisiki, the clinic may have remained forgotten. We need further committed activism to ensure that the progress made in Lusikisiki is repeated in towns such as Hamburg and Pilani, and across the Eastern Cape.
Activism alone is not enough however. The Eastern Cape Department of Health needs to maintain and improve clinics without being prompted by activists who draw attention to these failings. The Department needs to develop a comprehensive understanding of what health facilities are available, what state they are in, and what the healthcare needs are in the communities it serves. Without this, the provincial Department of Health will not be able to deliver services effectively.
[/box]Anso Thom is joint editor of the NSP Review and a former journalist at Health-e News.