Speech notes by Celeste Barker, MPL, Health budget vote debate — 23 July 2014

Honourable Madam Speaker, colleagues and distinguished guests.

Thank you for this opportunity. What I will say is divided into 3 parts. The first includes some issues which I invite you to think about, the second outlines three recent case studies and the third is a comparison and a proposed solution.

So let’s begin with a trip into the fairly recent past. Those of us who attended the Truth and Reconciliation Commission (TRC) Human Rights Violation Hearings in the then Centenary Hall (now Nangoza Jebe Hall) in PE are pretty likely to remember a man with the surname Niewoudt  and a young freedom fighter with the surname Mtimkulu.

Simphiwe Mtimkulu was poisoned by Niewoudt before being discharged. He was sent home to die and his mother testified to how his hair had fallen out from the poison administered by Niewoudt. She was incredibly dignified and brave when she spoke.  Umama Mtimkulu outlived Simphiwe and died this year just before the election.

After attending her memorial service my breath was taken away when I heard how she died.

Apparently she had Asthma or a chest problem and she died without dignity on the pavement while waiting for an ambulance to take her to hospital!

No one should die like that – least of all a brave woman whose son died for freedom!

The first case study is located in the NMBM, in the Livingston Hospital.  A sick old man was transported after a 5 hour wait from Kouga to Livingston. When he arrived at the hospital he was seated next to a woman who was miscarrying in a chair and screaming in pain. After a long waits he was attended to and eventually moved into a male ward. The miscarrying patient bled onto the floor near the old man’s feet. The bloody mess was left on the waiting room floor overnight.

His wife, who has nursing experience, was scared to leave his bedside because there were over 40 patients in the ward and only 2 nurses on duty. She went home and came back the next day to find her husband tied to the bed so tightly that his ankles were bruised.  He and the man next to him were wet and smelled like urine as did the ward and the linen.

Livingstone Hospital is a health risk. It reeks of urine in the lobby. The air in the car park is cleaner. Passages, lifts and the reception area are unsanitary and basic health care is neglected.

I claim this because of what I saw and photographed. Not one bed in my lines of vision had hospital linen on it and not a single bedside table had a jug or glass of water on it. This means that patients’ relatives and friends must collect and wash linen for the hospital. It also means that only those who have a support system will have clean, dry linen on their beds and that incontinent patients will lie in wet beds.

Because of the apparent lack of linen the old man’s wife and a friend drive up and down daily to take fresh linen to Livingstone. The old lady makes his bed, changes his wet sheets, washes and shaves her husband and tries to feed him. He is often so drugged that he cannot open his eyes or talk.  Staff members say that he is difficult and that is why he was tied up. Heaven only knows the reasons why he was tied up so tightly that his ankles were bruised.

He, and the others in the ward, do not have their incontinence pads changed regularly. He got frustrated because he wanted to go to the bathroom. There is no wheelchair in the ward and although his wife offered to help a nurse accompany him to the bathroom, her offer was declined and no alternative such as a bedpan was offered.

The gentleman in the bed opposite has had a stroke.  His children also change and wash his linen daily. They bring food to the hospital, feed him and stay there until he falls asleep.

The basics of hygiene, cleanliness and health care are lacking. There are balls of fluff that are stuck to the ceiling. The emergency buttons above the beds are either taped down or broken and the supply of hot water is erratic. The bedsteads are filthy and the windows are so dirty that one cannot see through the glass. It appears as though ink has been thrown at them.

A used drip lay in the wash basin and I picked up a blood spattered cotton-wool ball on the floor next to a bed. Even the ceiling had blood marks on it and patients report that rats run in the ward at night!

Kwanele Nyani! Enough is enough!

This cannot carry on! Every single person in the province has the right to decent health care and dignity.

The second case study is of a District Hospital which admitted a patient with kidney stones at night and sent him packing in the morning. He was verbally abused and told to leave. Staff shouted at him and declared that there was nothing wrong with him and he was not in pain.

In this instance the man’s family had to bundle him into a car and drive 5 hours to St George’s Hospital in the NMBM where the kidney stones were identified and removed.

Another very controversial and sensitive case is that of the 500 plus initiates who have died from botched circumcisions over the last eight years in our province. Reports in the Daily Dispatch suggest that the young boys who died or have been severely damaged were largely under age or attended by under qualified surgeons.

We cannot sweep this under the carpet because it is a sensitive issue; 500 deaths over an eight year period averages out to 63 deaths a year. Who knows what youthful talent and leadership potential has been lost unnecessarily this way.

For this reason we support women’s rights to speak and be heard in this matter. This includes the rights of mothers and grandmothers as well as the resolution adopted by Imbumba Yamakhosikazi Akomkhulu (IYA) on 11 July 2014.

IYA is a women’s forum of queens and traditional leaders led by Western Pondoland Quee,n Madosini Ndamase, Chairperson, Nkosikazi Nosandi Mhlauli, Eastern Pondoland Queen, Masibuza Sigcau and AbaThembu Queen, Nokwanda Dalindyebo.

The IYA resolved to support the proposed introduction of Medical Male Circumcision (MMC) and have been criticized for doing so. Again we say that we uphold the constitution and support every citizen’s constitutional right to equality and freedom of speech. Particularly as this issue has a track record of death and disfigurement.

The beauty of life in a democratic state is that we have the power to turn wrongs into rights.

I therefore appeal to this house to consider the cases described in this speech and the possible solutions.

The International First Year Experience (FYE) Conferences began  because universities recognize that first experiences at  culturally “foreign”   institutions can be alienating and dehumanizing,  especially for first generation students. Dehumanization and alienation cause increased failure, dropout and withdrawal rates. Universities lose income and credibility as institutional reputations are threatened when students’ success rates decline.

Much the same paradigm appears to operate in our public health system. It is the product of binaries of superiority and inferiority and the legacy of apartheid. It is also the product of the last 15 years of provincial management. It won’t go away even if we hide it and protect information with labels like “confidential” or give exclusive reading rights based on coloured paper.

This is our responsibility now. It shows in the packed buses of pregnant women who flee this province to give birth in the Western Cape because infant and maternal mortality rates are lower there than they are here; hospitals in the Western Cape are cleaner and safer.   Staff morale is low for reasons including the culture shock and/or the dehumanization of being labelled a “human resource” not a person (what happened to Ubuntu?) and for many patients isibhedlele is a lonely, overwhelming and frightening experience. Hence, if staff are not supported or institutions are understaffed neither group – like overwhelmed first year students – copes or does the job properly.

I thank you.