Mdantsane, 5 April 2002
Honourable President,
MEC's,
Heads of Health,
all nurses present here today,
distinguished guests,
sponsors,
ladies and gentlemen.
My special welcome to the nephew and niece of the late Cecilia Makiwane amongst us today.
Today is a special day in the history of nursing in this country. A day that the Department and the Ministry of Health put aside to express sincere gratitude to those who form the backbone of our health system. This is the day that we will always use to show that we care about our most valued human asset, nurses. It is a day to pay tribute and salute the dedicated nurses who have been making a real contribution with commitment and dedication to the health system in our country for many decades. This was done under conditions that are often far from easy.
Allow me to pay a special tribute to the fallen heroes of the nursing profession in the line of duty, one of them being Cecilia Makiwane. A brief resume of Cecilia Makiwane is as follows:
Cecilia Makiwane was born in 1880 at MacFarlane Mission in the District of Victoria East, six miles from Alice. Her father , Rev Elijah Makiwane was born in 1850 at Sheshegu location, Victoria East. He was educated at Ncera and Healdtown, a renowned institution of leaders.
In 1877 Rev Makiwane married Miss Maggie Majiza of Burnshill, an old pupil of Lovedale who was an assistant teacher at Girls' School of Lovedale. Between them they had three children; Daisy, born in 1878 and first black woman to matriculate with mathematics as a subject; Cecilia born in 1880 was second child and Ashton, born 1882, was the only son and last born to Maggie. She later died in 1883.
Rev Makiwane later married Miss Mtywaku of Peelton by whom he had:
Cecil Makiwane, who settled at Tsolo in the Transkei,
Tennyson Makiwane, who settled in Umtata
Thandiswa Makiwane married the famous Dr DDT Jabavu
After many years of practice at Victoria Hospital in Lovedale, she got sickly. Cecelia had been under much strain physically and emotionally. This was understandable for she was a pioneer embarking on an unheard of career for an African woman. The strain took its toll on her health. Lovedale granted her long sick leave. She joined her sister, Mrs Majombozi, and later she died in Thaba-Nchu, where she was buried.
A statue of Cecilia Makiwane was put up in Victoria Hospital in Alice. The unveiling was attend by two thousand nurses whose way she pioneered. They came from all parts of Southern Africa to be present in this historic occasion so that they could return to tell thousands of their colleagues who were unable to attend.
Cecilia Makiwane Hospital in Mdantsane which is an establishment of 1450 beds, was named after Cecilia Makiwane as an honour for her role as a noble pioneer. Nurses hold a day of Prayer around the 7th January to commemorate and celebrate State Registration of black professional nurses.
Professional nurse training was established by the year 1900 having been started by Henrietta Stockdale in 1877 in Kimberley for whites. No black candidates were admitted to training institutions.
The year 1900 is regarded as the beginning of education and training of the black nurses in South Africa. It is about this time that the first black nurses were professionally trained to become professional nurses.
If you would recall there were Cape and Natal colonies and Transvaal and Orange Free State republics.
During the nineteenth century European Countries sent missionaries to establish mission stations in Africa. Usually mission stations consisted of a church building, school and sometimes a hospital, which led to the provision of education facilities and provision of health care. Victoria Hospital was founded way back in 1898 as part of the Lovedale mission.
The aim was to treat the sick and train young black male assistants and young women as nurses. Although the hospital was closed during part of the Anglo Boer war it reopened during 1902. Training of nurses at Victoria Hospital was part of the missionary campaign to restore mankind's social and physical health. In 1903, the first 3 year nursing course started with 2 young black students namely Mina Colani and Cecilia Makiwane. Cecilia proceeded to take up the Colonial Medical Council exam in 1907 and became the First Black Nurse in Africa to be a professional nurse.
Although this idea was conceived about two years ago it has not been possible due to financial constraints and some pressing health issues that needed some funding. We approached several private sector organisations for financial assistance and to our greatest joy and jubilation we were given a generous sponsorship by Discovery Health.
As you are well aware April has been declared a health month with a slogan 'Health in Action' - A month of mobilisation. The emphasis is poverty relief and nutrition some of the activities to be done include hearing from women whether they were receiving quality health care and what issues they wanted to have addressed.
The focus is also on improving health care in South Africa and without the involvement and active participation of nurses our efforts are going to be all in vain.
This occasion today forms part of the campaign of the Department of Health to celebrate the work of nurses, health workers including lay health workers and volunteers. We should be saluting the pioneers of the home-based care movement, supporters of TB programmes including educators, counsellors and activists in HIV/AIDS promotion and care.
Health workers including nurses all over the world are facing difficult challenges created by worsening socio-economic conditions and the impact of emerging and re-emerging diseases. We also ask the nurses to provide more, high quality health services with fewer resources. At the same time, the knowledge and skills needed to perform effectively in your different fields continue to grow and change rapidly. Health care institutions and their managers are also confronted with these realities. The challenge is to continue to improve the quality of care we are providing and to create a supportive environment for better service to be provided.
Through your dedication and commitment, we have made a significant progress in addressing issues of accessibility and equity and bringing hope to our citizenry. We all have a reason to collectively and individually, feel proud of ourselves for participating in reshaping service delivery in our country. In years to come, our successors will be referring to us as pioneers of a health system in a democratic era. This has been a historic challenge for all of us.
The best can only be achieved if the environment is conducive to change and reinforces new behaviour. Change in performance is complex and is often not easily accomplished.
We have passed through what could have been the worst period of transforming our health system. Indeed as South Africans we are now among those at the forefront of change not just in our country and the Region, but the world. Resources are not enough and will continue to be scarce. But we have managed to do a number of things with those limited resources.
As we debate the issues around working conditions and specifically salaries for health workers including nurses, we need not to forget where we are coming from. We need to remember major improvements that have been brought about by this government including opportunities for career development and promotion that were not available to health workers from historically disadvantaged communities.
If we broaden our view and look at how salaries have increased between 1995 and 2000 we will be able to appreciate efforts that have been made in this area using the very scarce resources we have. By 2000, most of the salaries had increased to almost double the amount they were in 1995. For sure, these salaries cannot be more competitive than those paid Britain, Canada or Saudi Arabia, but the changes that have happened over the past seven years reflect our commitment to improving working conditions.
Let me hasten to add that we remain firmly committed to improving on the current situation within the limitation of resources available to us. We strongly believe that a lot more still needs to be done in this regard. One of the major challenges in improving the quality of care mainly in the rural areas is the difficulty we face in maintaining sufficient staffing levels and staff turnover. Many people with skills do not like to work in the rural areas and this causes difficulty in recruiting and keeping staff in these areas where public health services are most needed.
However, we have made many efforts to address this problem. Firstly, we recruited doctors from Cuba to assist while we seek permanent ways to achieve our goal of an equitable and quality health care in both urban and rural areas of this country. We have introduced community service that gives our young health professionals an opportunity to work and gain experience in working with communities that desperately need their services.
We have extended community service to cover seven other professions in the health sector including clinical psychologists, dieticians, environmental health officers, physiotherapists, radiographers, speech and hearing therapists as well as occupational therapists. Community service among these professionals will be phased in from 2003 with professional nurses coming in as the last group in 2007, or earlier.
The meeting between the provincial Health MEC's and myself (Minmec) has also instructed the officials in the Department of Health to look at the possibility of having a comprehensive package of incentives that can attract people to work in the rural areas. There are financial and other non-monetary incentives including the improvement of working and living conditions for our health workers in the rural areas that will be investigated and a set of proposals is to be tabled for our consideration within the near future.
We are taking all these measures to ensure that we improve the quality of care that we are providing to our people. Funding for HIV/AIDS programmes will increase over the next three years. Some of this money will go directly to the provinces to strengthen areas that are most affected by the impact of HIV/AIDS in our hospitals and clinics. Managers at service level know where the pressure is greatest and they will decide whether to spend this on drug supplies, laboratory services or recruitment of nursing staff or doctors. We will be elaborating on this sometime soon and giving more details on the amount of money to be spent on specific programmes. In whatever way these funds are utilised, I must assure you that the allocation of this money will in some way ease the burden that HIV/AIDS is adding on your daily work activities. We are celebrating with all statutory councils including the South African Nursing Council and all training institutions to make sure that graduates are able to deal with patients with HIV/AIDS including counselling, care and treatment, TB and Cholera, and Malaria.
The key objectives to improve quality of care include:
These are duties that require a lot of courage. They require spiritual strength and willingness to serve your people with dedication. We must be driven by a desire to see our hard work translating into healthy lives.
I want to congratulate all the provincial winners and some of the runners up present today. I also want to congratulate the National winner and runners up in advance of the official announcement tonight.
Lets enjoy ourselves tonight. This is only the beginning of good things to come. When I looked at some of the good work that have been done by the winners, I was really touched by their level of commitment to the service of humanity, at times under very difficult situations. I have just asked myself how many of these unsung heroes and heroines have passed by unnoticed.
For a person to go that extra mile in service delivery it takes a very special person with an outstanding attitude and altruism.
CONCLUSION
I would once more like to congratulate you on your success, and in closing I wish to quote from Charles Swindoll, who states
… 'The longer I live the more I realise the impact of attitude on life. Attitude to me is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think, say, or do. It is more important than appearances, fitedness or skill. It will make or break a company … a church … a home.
The remarkable thing is we have a choice everyday regarding the attitude we will embrace for that day. We cannot change our past … we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string that we have, and that is our attitude … And I am convinced that life is 10% what happens to me and so it is with you … we are in charge of our attitudes.'
Let us be positive in our attitudes, and we shall be positive and successful in our work.
I THANK YOU LADIES AND GENTLEMEN