Where a Hospital Has No Doctors The South African Constitution promises access to health care services. Nevertheless, many South Africans do not receive adequate care — or any care at all. Patients in the town of Warrenton find their hospital staffed with doctors only 14 days each month.
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Where a Hospital Has No Doctors

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Where a Hospital Has No Doctors

Where a Hospital Has No Doctors

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It's MORNING EDITION from NPR News. I'm Steve Inskeep.

Think of the decades the U.S. has spent trying to fix its race relations, and you have some idea of South Africa's challenge.

Americans started as many discussions as they ended when they ended legal segregation. Now compare that struggle to South Africa's 14 years since ending apartheid. All this week, we've been exploring South Africa at a crossroads. NPR's Charlayne Hunter-Gault is our guide, and in a minute, she'll take us to an emergency room. She's in our studios after completing the series. Welcome back.


INSKEEP: Why were you doing this now, looking at South Africa now?

HUNTER-GAULT: Well, Steve, it is a crossroads moment. You know, in South Africa, the party is elected in the elections, and then the party chooses the president. And up to now, they've both been the same person. The president of the party was the president of the country.

Now you have a split. The president of the party is not the president of the country.

INSKEEP: There's also been a few years since the first black president, Nelson Mandela, has left the stage, and there must be questions about whether the promise of that moment has been fulfilled.

HUNTER-GAULT: Well yeah, because Nelson Mandela was an icon to the world, and he raised the expectation that South Africa was a miracle nation, it was going to have people getting along. And I think that was important to ease the country from one system of oppression into the multiracial democracy that South Africa is today. But as one person from the Human Rights Commission, Jody Kollapen, told me, he said, you know, in a way, it created an expectation that couldn't possibly be met.

INSKEEP: And let me ask about one aspect of that because this week you've told us about South Africa's education and underlying problems there. You've talked about crime and corruption and underlying problems there. And it raises this question: Did South Africa have a situation where there were white officials who, whatever their prejudices, may have known their business, and they've been replaced by a whole new group of people who may not know their business as well, who have to learn it?

HUNTER-GAULT: Well, that is a problem. When the African National Congress took over, there was an eagerness to make up for past discrimination. So there's been a rush to bring blacks into every system that the government has, and a lot of whites have been pushed out or, you know, left on their own. And somehow there's growing recognition that there needs to be some balance struck between keeping people with experience while you train the next generation of people from the black majority to take over.

INSKEEP: Well, let's see how that story plays out when it comes to health care, our subject for today, and where are you going to take us, Charlayne?

HUNTER-GAULT: Well you know, no matter where you go in South Africa, there's a horror story about public health. And I went to a small, agricultural town in the Northern Cape, and I found chaos.

Ms. ELNA JOHNSON: There was no doctor.

HUNTER-GAULT: No doctors at the hospital when Elna Johnson's friend Ricardo Myburgh went there complaining of chest pains. The nurses dismissed him, telling to go to a local, 24-hour shop for over-the-counter medicine for gas. The man, in his early 40s, died soon after.

Doctors at the hospital work only for the first 14 days of the month due to budgetary constraints. One of them told me people have died as a result.

Ms. ANNA BERGER(ph): Our children was poisoned yesterday.

HUNTER-GAULT: Anna Berger was beside herself after three members of her family and four of the staff at their car dealership drank morning coffee they soon realized had been poisoned. Tommy Berger(ph) told me:

Mr. TOMMY BERGER (Hospital Patient, South Africa): I was vomiting. I was seeing stars and stuff, and all the jitters in my legs. And my wife passed out.

HUNTER-GAULT: They called Warrenton Hospital for an ambulance, but, Berger recalled:

Mr. TOMMY BERGER: No ambulance available.

HUNTER-GAULT: The Berger family recovered from their ordeal, but the story didn't turn out so well for Yvonne Thyse, who gave birth prematurely at the Warrenton Hospital.

Ms. YVONNE THYSE (Hospital Patient, Warrenton Hospital, South Africa): They just showed me that it's a boy but didn't give him to me so I can hold him. They just take him away and say, he's dead. I was broken.

HUNTER-GAULT: But some two hours later, as the family was preparing to bury the baby, named Tiny Gift, a nurse who'd just come on duty realized the baby, in fact, was not dead. After hearing all these stories, I went to the hospital.

Is the person in charge available?

Unidentified Woman: No.

HUNTER-GAULT: Some time later, Mary Thuntsi, director of the District Health Services for the regional office, denied there'd been any deaths at the hospital due to the absence of doctors. She also said that two doctors had been offered an arrangement to work on a rotating basis so that the latter half of the month would be covered. But, she said, they declined.

At the same time, she said the Myburgh heart case and baby Gift were under investigation.

Warrenton's district counselor, Hans Versage, says local officials like him realize there's a serious problem.

Mr. HANS VERSAGE (District Health Office, Warrenton, South Africa): There's no one who can run the hospital proper, to be here and to look after the patients and the staff here. For us, it's a disaster, and it is a crisis.

HUNTER-GAULT: Dr. Francois Venter, head of the South Africa HIV Clinicians Society, says the Warrenton Hospital crisis is a symptom of the larger public health crisis in the country. He said South Africa's infant mortality rates, its TB cure rates and its mother-to-child HIV prevention rates were appalling for a middle-income country.

Dr. FRANCOIS VENTER (South Africa HIV Clinicians Society): Our new TB rate is the second-highest in the world, which is, you know, when you look at how much money we spend on TB compared to countries around us, such as Zimbabwe or Mozambique or Namibia even, we're vastly worse off than them. It just seems ridiculous.

HUNTER-GAULT: Health care is listed in South Africa's constitution as a human right. Yet human-rights chairman Jody Kollapen says that right for the poor is being violated.

Mr. JODY KOLLAPEN (Director, Human Rights Commission, South Africa): The concern of the Human Rights Commission is that in the area of health, as in many other areas, we are forced reducing rights to commodities that people can afford these in accordance with their resources.

So if you seek justice, then the quality of justice you get will not depend on the quality of your humanity, but it will depend on the quality of the resources you have.

HUNTER-GAULT: Critics like Kollapen and Dr. Venter argue the major problem is lack of leadership at the top. The ruling African National Congress, which gives policy direction to the government, acknowledges there are serious problems within the health sector. But ANC spokesperson Jesse Duarte argues many good people are doing good things for the country's public-health sector and that they're working against formidable odds.

Ms. JESSE DUARTE (Spokesperson, African National Congress): One doesn't want to throw the baby away with the bath water because you've got people there who've now experienced the dark side of administering a huge health-care crisis. We inherited one. Remember that South Africans coming out of apartheid would have many illnesses caused by just poverty. And the illnesses of poverty are still there.

HUNTER-GAULT: Dr. Francois Venter says until there's a more rational approach and stronger leadership at all levels…

Dr. VENTER: We're just plugging dikes - left, left, right and center.

HUNTER-GAULT: While the poor get sicker and sicker.

INSKEEP: NPR's Charlayne Hunter-Gault is in our studios, briefly back from Johannesburg, where she's based and from which she's been bringing us this series on South Africa at a crossroads. The conversation continues this week, and Charlayne, where do we go next?

HUNTER-GAULT: Well, we look at the economy and the challenges where you have a skill shortage that affects every sector of the society.

INSKEEP: Even in this very rich nation.

HUNTER-GAULT: In this rich nation, you still have two nations. You have a wealthy nation of mostly white, a few black millionaires and billionaires and people on the rise. But you also have the majority still black, poor and uneducated. And so you have an economy that's moving in one direction, and you don't have the people educated to step into jobs that are needed to fuel this economy.

INSKEEP: And we end with?

HUNTER-GAULT: Leadership, and that's why South Africa's at a crossroads. You have a president of the party, a president of the country - two different people with different views on issues - and the president of the party has also been charged with corruption. His trial is later this year. And that's why people are so uncertain, because there is an uncertain political landscape with so many pressing problems that need to be addressed.

INSKEEP: NPR's Charlayne Hunter-Gault, thanks very much.

HUNTER-GAULT: Thank you.

INSKEEP: And you can hear other stories in our series on South Africa at NPR.org.

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