Date: 18/01/2008
Source: KwaZulu-Natal Provincial Government
Title: SA: Ndebele: Black Summit address

When in 1994, Nelson Mandela was inaugurated as the first President of a free, democratic, non-racial, non-sexist South Africa, he inherited all the legacies of apartheid. His immediate concern was to turn what was an economic, social, political and cultural wasteland into a viable nation, on par with the rest of the world. The problem with colonialism and apartheid was that every aspect of life was defined in terms of race. There was a visible hierarchy of racial privileges which saw White South Africans have access to all amenities as well as health, education, housing so on, while Black South Africans received minimum support from government. Africans were at the bottom of this deprivation.

This distribution of resources saw blacks in general and Africans in particular, receiving the biggest slice of poverty. So in terms of where they lived, there was an under-supply of basic services such as water, electricity, roads, healthcare, education, sanitation and welfare. Population development was a pipe dream. Education systems to keep blacks as menial labourers for whites were put in place in 1953. It was called Bantu Education. It had no intellectual and scientific content. All learning was done through memorisation.

The major reason for our struggle for liberation was to turn this around and to create a new society guided by the universal concepts of human rights and equal access to resources, services and opportunities. Today this is work in progress in South Africa. It underlines all our planning and distribution of resources. There is a relationship between deprivation and poverty on the one hand and deteriorating health and disease on the other.

When HIV and AIDS emerged in South Africa in the 1980s it was treated as an intellectual health issue. This was more because it affected the poor and by definition blacks, the most. Similarly simple diseases such as tuberculosis (TB) and sexually transmitted infections (STIs) were all treated as poor academic medical issues, not related to the social conditions of the carriers.

The decision by the newly elected democratic government in South Africa in 1994 was to turn this around, more so because we were in government and had access to resources previously denied to us. In order to create an equal society, it was imperative that all our citizens access healthcare on an equal basis. When crafting the Bill of Rights, which is embedded in our Constitution, the founders of our democracy were mindful of the fact that political rights without transforming society through a sound socio-economic foundation would be unsustainable.

During the apartheid system sanitation relief for blacks was provided through the bucket system. The backlog was so huge that as back as 2003 there were some 13 605 households utilising the bucket sanitation system in our province (what is referred to here as a state). The last 100 buckets were eliminated in December 2007. All our clinics, except for only 65, have running water. Government runs the water and sanitation at clinics programme to correct this matter.

The province has 2 272 000 households. Of these, 1 740 786 are supplied with running water. Processes are underway to enlist assistance from our national government to secure additional funds for backlogs generated through our historic imbalances. Rural areas do pose huge problems. However, water purification plants are being installed to provide water to remote rural areas. Some 1 218 612 households are now supplied with sanitation.

This is low, especially in rural areas. Some 1 534 125 households are now supplied with electricity. Some 139 718 consumers receive free electricity while some 1 128 496 consumers receive free basic water services. It is important to factor these issues into the healthcare discussion because of the relationship between their absence and the poor quality of the health of the citizens. The fight against poverty must be accompanied by continuous improvement of the ability of the poor to access government services.

The services in the province of KwaZulu-Natal can be mirrored throughout the Republic of South Africa. One of the biggest challenges that we face in our country is illiteracy. Until government started with an interventionist literacy programme called the Masifundisane Campaign (let one teach one), almost 20% of the adult population in KwaZulu-Natal could not read and write. Now, being unable to read and write is one of the worst deprivations that a human being can suffer. It is a risky life-style. Indeed, it is as if one is living in total darkness.

As I indicated earlier HIV and AIDS, TB and STIs are the biggest healthcare issues facing South Africa today and indeed most of Africa and the so-called Third World. A comprehensive programme for the treatment of HIV and AIDS, TB and STIs has been developed and adopted. Its main thrust is community involvement. The programme includes a focus on mother-to-child transmission, a programme to assist victims of rape, voluntary counselling and testing as well as treatment of advanced TB streams. Some 80% of the public healthcare facilities have community-based governance structures.

Young people are key role-players in all these programmes. The transition to adulthood is a critical stage of human development during which young people leave childhood behind and take on new roles and responsibilities. The nature and quality of young people's future lives depends on how successfully they negotiate through this critical period.

Youth represent a large and growing demographic group globally. They face numerous challenges in becoming productive, healthy adults. Factors such as globalisation, improvements in technology, increased democratisation, shifts in age distribution, increasing numbers of girls enrolled in schools and universities, all determine how our youth deal with the world impact of them. Schools and tertiary institutions have globally become the places to interact with the youth. HIV and AIDS is the leading cause of death among the youth.

Mortality and morbidity related to pregnancy and childbirth (particularly in Sub-Saharan Africa where levels of early childbearing remain high) and as a direct consequence of unsafe abortions in most developing countries remains a significant risk to young women's health. Unprotected sex is one of the riskiest behaviour patterns of young people.

We are, therefore, mindful of the fact that health equality can be best achieved within the confines of a comprehensive life-improving package. Our model looks into a range of issues that affect the health of our citizens. The Regional Consultation Conferences held during 2007 in preparation for the second African-Caribbean Diaspora Summit made the following recommendations around healthcare to:

* launch a Global Africa Fund on AIDS for research and mobilisation of constituencies such as artists and sport personalities
* establish collaborative research and development projects in the following priority areas: health (with particular emphasis on HIV, malaria, TB, cholera and chronic lifestyle diseases) and pharmacology
* promote a community-based approach and primary healthcare to treat HIV and AIDS, including counselling and more government support to improve nutrition and good diet
* provide greater commitment to lobby governments of the North and private companies to refrain from poaching healthcare professionals from Africa and the Caribbean.

We plan to include these issues in our discussion panels during the 10th annual African Renaissance Conference to be held in May this year in Durban and we look forward to seeing you there.

I thank you!