(Names have been anonymised in this article to protect the doctor, not the officials. They know who they are.)
Once upon a time and not so long ago our politicians and senior public servants cared about the lives of other people. They cared about the loss of life. They took personal risks to prevent it. They went to prison. They went to exile. They risked their own security and comfort.
That was once-upon-a-time.
That was history.
The loss of ethics, urgency and empathy is at the heart of our national malaise. We no longer care about lives, other than our own. In that spirit let me tell you a story of something that happened in the week we all celebrated Nelson Mandela’s 100th birthday.
Thursday 19 July 2018. Out of the blue, at precisely 13.15 I received a message from a doctor I do not know at a hospital in XXX. It read:
“I am a XXXX at XXXX. I have that awful situation where I have a baby who needs ICU care and there are no beds in the state hospitals. That state does not buy out beds…”
Nine minutes later, fighting my own sense of resignation, I responded and quickly found out that the baby was critically ill and “looking worse by the minute”. The doctor said she was “trying to do a desperate call round to hospitals on my cell” but that none of them had pediatric ICU beds available.
SECTION27 is an organisation that uses the law to protect and advance human rights: this includes human life. The Constitution says “no one may be refused emergency medical treatment” and that we must always act in “the best interests of the child”. But faced with a premature baby with respiratory distress the law was useless. Even an urgent court application to compel the Provincial government to open up an ICU bed would have taken hours. That would have been too late for Baby A.
She would have been dead Baby A, like other neonates that die every year because of deficiencies in the public health system.
I have an advantage. I know many senior officials in the Department of Health and also have many of their phone numbers. So I started my own round of phone calls. In my head somewhere I could hear the promise politicians had made during the Life Esidimeni Arbitration about “never again” and being “always available” on their cellphones.
First I tried the MEC for Health in XXX Province. His phone was answered by his assistant. I explained the purpose of my call and begged him to put me through to the MEC. He declined. The MEC was, he said, “in a meeting for at least another hour”.
He said I should call the Head of Ministry, Mr XYZ and gave me his number. I called. No answer. Instead I got one of those phone-generated “Sorry, I can’t talk right now”. I replied:
“It’s very urgent. Mark Heywood from SECTION27. I was advised to call you. It concerns a critically ill baby at XXXX. No ICU bed. Please call me Mr XYZ.”
But Mr XYZ’s probably doubles up as an ANC office bearer. It was a weekend of high drama in that Province’s intra-ANC politics. His meeting too was far too important for that. He replied with a message:
“Please call Mrs ABC the district manager to assist arranging the bed, I will also send her an SMS now.”
The clock was ticking. I sent another message to the MEC’s phone:
“I am trying to call you about a life and death matter. Was referred to your head of Ministry. He is not answering the phone.”
But medical doctor MEC’s meeting was too important by far for matters of life and death. He didn’t respond. Meetings trump the Hippocratic Oath if you are a politician.
That was the last I didn’t hear from him.
So I called ABC fighting a strong sense of déjà vu about the type of response I would encounter. At least she answered the phone. But I was right. She was mostly concerned about following protocol.
“Had the doctor spoken to the medical manager?” she asked. “Had the doctor spoken to the CEO?”
I explained that I didn’t know; the minutes were passing by and the baby was critically ill. I promised Mrs ABC that I would call the doctor and ask her. That was the end of Mrs ABC. A little later I sent her an SMS answering her questions: “The doctor has spoken to the medical manager and CEO. Don’t have authority.” But that didn’t generate a response.
Maybe she too had a meeting.
Feeling the doctor’s desperation, having hit a literal soon-to-be really dead, dead end, I tried another strategy. I called one of the CEOs of a major medical aid scheme. It was 13.31. Initially his phone too generated a “Can I Call you later?”
“It’s urgent. I’m trying to see if I can get help getting a bed for a prem baby in XXX. XXXX hospital has no ICU bed. Desperate doctor trying to get help.”
He called me back within a minute.
I had asked the doctor if there were any private hospitals nearby. She said there were. So I asked him if he would ask a CEO of a private hospital group whether he would arrange to transport the baby to a nearby hospital and admit the baby there. For free. He agreed to ask. A few minutes after that the private hospital group CEO called. I told him what little I knew about the baby and the doctor and gave him the doctor’s number.
The next I heard from him was at 2.13pm:
“Hi, we will accept the baby and are just finding a bed and a pediatrician and will organize ICU ambo transfer.”
Two hours later the baby had been transferred, incubated and was out of danger. A little life had been saved. Two parents had been spared an agony that I know from personal experience. It lasts a life time. The doctor was soon being asked questions by her higher ups and asked to explain why she had sought outside help. Now there was a sense of urgency! It seems the department’s lethargy doesn’t extend to paper-work and protecting your own skin.
This all took place a day after we celebrated Madiba’s 100th birthday. Doctor DoGood lived his legacy. But what of those party apparatchiks and deployees who claim to act in his name? The less said the better, for their inaction would disturb Madiba’s peaceful soul.
And what is the moral of the story?
It is that the weakest among us suffer from the “who cares?” attitude of the post-Mandela politician, and it is the vulnerable who need health care who seem most frequently to be their victims.
It was not long ago that Mosebenzi Zwane, before he became more infamous, needed a patient to be kicked out of an ICU bed at Dihlabeng hospital in the Free State so that his relative could be put in the same bed.
It was only six months ago that Justice Dikgang Moseneke called the Gauteng government “delinquent” for their treatment of the Life Esidimeni victims and found its officials guilty of “torture” as well as “cruel, inhuman and degrading treatment.”
But, who cares? Nobody has been punished. Zwane’s still an MP. Despite appearing before the ANC’s Integrity Commission former Health MEC, Qedani Mahlangu, continues to enjoy the high life of a senior member of her political party.
Who cares? Baby A lives because of the choice of one good doctor to go out of her way to save his life. But that is not the end of the story because many other children continue to be at risk. One of the last messages I received that day read:
“The baby is just the tip of the iceberg. Cubicle one. We have three ICU and three High Care babies with 2 nurses. Should be 5-6. Cubicle 2. 8 HC babies 2 nurses. Should be 4. A packed low care …”
But hey, who cares?
If you are a politician or public servant please ask yourself a question: do you?