Nontando Guwa asks if our democracy is still democratic

The dismissal of Deputy Health Minister Nozizwe Madlala-Routledge has evidently seen a momentary shift in the public discourse. Her dismissal was followed by the suspensions of Dr Nared Pandey, the head of clinical services at the East London Hospital Complex (ELHC), and Dr Nokuzola Ntshona, deputy manager of ELHC and medical superintendent at Cecilia Makiwane Hospital (CMH).

Recent reports by the Daily Dispatch revealed that Dr Ntshona had earlier written to President Thabo Mbeki accusing Health Minister Manto Tshabalala-Msimang of turning a blind eye to the Frere crisis. Additionally, a report by Dr Gerald Boom, head of paediatrics at Frere Hospital, had stated that 200 babies were dying at Frere every month due to bacterial infections and another 200 at CMH. Upon an impromptu visit on July 13, Madlala-Routledge described the situation as a “national crisis”.

In an interview, staff at Frere revealed that during Tshabalala-Msimang’s visit to Frere, medical equipment, designer chairs, curtains, beddings and even pot plants were removed from Bhisho Hospital and CMH and taken to Frere. Curtains and blankets were changed and lilac and pink duvets and curtains were brought in to impress the minister. Staff confirmed that what Madlala-Routledge saw at Frere Hospital the Friday when she visited was the true condition of the hospital, and that what Tshabalala-Msimang saw was a window-dressed Frere. Following this, Tshabalala-Msimang rejected claims that babies were dying due to equipment shortages at Frere.

In view of all this, it is not clear what a frustrated Dr Ntshona and her colleagues were expected to do when the Health minister clearly failed to see the real problem. Perhaps of greater concern is the possibility that infants continue to die while politicians continue to cover for each other and the problem is turned into an ugly web of recriminations instead of offering a clear solution to the problem at Frere.

For the residents of East London, Mdantsane and the surrounding areas being serviced by the ELHC, the suspension of these doctors – who in many ways were viewed as “good Samaritans” who refused to keep quiet over the crisis, but were willing to sacrifice their jobs in an effort to get the government, particularly the Health Ministry, to respond – is seen as a mockery of the country’s democracy.

Seemingly, the ANC government is adamantly refusing to effectively respond to the plight of a section of its core constituency. In effect, it is exposing itself to ridicule from its opponents and a simmering anger among its supporters in the region.

It has now become a trend in the ANC-led government that in light of corruption and service-delivery crises, whoever blows the whistle on government gets “booted out”.  While the Constitution of South Africa provides the legal space for citizens to engage, the political reality is increasingly being marked by defensiveness from government and intolerance of dissent.

On Dr Ntshona’s suspension, the South African Medical Association (SAMA) issued a statement that “Ntshona acted within her ethical and moral obligation when she exposed the situation at the complex by confirming that babies were dying for avoidable ailments and there was therefore no reason for her suspension”.

The Freedom of Expression Institute has clearly pointed out that a trend to shut down critical voices in the public health sector is now firmly established. There is a growing concern over the clear intolerance the ANC government is displaying against people blowing the whistle on poor service delivery. This sadly takes place against a backdrop of repeated protests and violent unrest over poor service delivery in South Africa.

The dismissal of Madlala-Routledge only serves to affirm the allegations of deep political divisions within the ANC, especially as it prepares for its December national conference in Limpopo.

As the politics of the day get messier and murkier, it is the ordinary and mostly poor citizens of South Africa who are bearing the brunt. In the midst of all the current political bickering, one can only hope that the legal space provided for in the Constitutional framework of the country will remain “open”.

It is important to ask what the core tenet of our democracy is and examine whether the ANC-led government still has the best interests of the poor citizens of the country at heart, or if it has been caught up in today’s politics so much that it has forgotten its mandate.

No matter what is said in mitigation, even if only half of what was reported to be happening at Frere and CMH is true, it represents a serious failure of the public health system and a serious failure by government to provide health services to poor people. It is important for the powers that be to realise that wherever there is smoke, there is probably fire.

The Local Government Transformer Oct/Nov 2007