As a health professional and health manager, it is understandable that most of what I write about is health related. But I am also a citizen of this country and live some of the realities that South Africans experience, albeit not fully experiencing what my less fortunate fellow South Africans experience. For this reason I reflect here, accepting that I am a privileged citizen of this country, on the general state in which South Africans find themselves.
Whilst the abolition of apartheid removed discrimination on the basis of race, we are still a country divided along racial lines between those who have and those who have not. South Africans are bombarded on a daily basis by reports of failing sewerage plants and areas without a reliable water supply, often affecting to a greater degree those less privileged. Sewerage disposal and water are the primary responsibility of those at municipal level. Recently on Human Rights Day, linked to the tragic events at Sharpeville on 21st March 1960, I was struck by the disconnect between government and reality when in a speech delivered in the Northern Cape it was stated that municipalities were not serving communities in the manner that they should. This from the leader of the political party that governs, bar a few, most of the municipalities across the country.
We have witnessed the spectacle of major metros in South Africa paralysed by in-fighting within coalitions formed after the 2021 local government elections. It seems that those in the privileged position of being elected officials feel little for the rights of the people that they purport to serve but are rather self serving in their desire to remain in power.
Worse still some schools remain without waterborne sewerage and learners are forced to utilise pit latrines with the inherent risk that results. I can recall on numerous occasions from 1994 until the present day undertakings from politicians across the country that pit latrines would become a thing of the past. It is 2023, almost three decades later, and they apparently remain a reality at some rural schools.
Much has been written about the failure of the State entity, Eskom, to ensure a constant supply of electricity to the citizens of South Africa. It has reached a stage where we are expected to be grateful when the level of power outages are only at Stage 1 or 2 and not higher stages. The Minister of Electricity, a few weeks into his new position visiting power stations, is reported to have said that sabotage, fraud and corruption are not the causes of the challenges at Eskom, that the problems can be resolved in 18 months and the country can be reassured that “load shedding” would not exceed Stage 6 during the coming winter!. This despite a weight of evidence provided by energy experts and not least the recently resigned CEO to the contrary . Let us not forget that the current President, then Deputy President, headed a “war room” in 2014 to address electricity supply following the initial signs of problems at Eskom when power supply to the country faltered in 2007 for the first time. And yet now it can be resolved in 18 months!
Roads across the country are deteriorating and in various areas local residents have started initiatives to repair potholes themselves. In a recent media opinion piece, people were encouraged to extend this initiative indicating that methods to repair potholes are available from the internet! I have in the past year traveled through towns in the North-West province, and the capital of the Free State province, Bloemfontein, and experienced roads where the road surface has deteriorated such an extent that it would probably make sense to remove the black top entirely.
I have written before about the importance of refuse removal and the fact that in many areas refuse is not collected regularly if at all. In a visit to Bloemfontein last year I witnessed oozing black plastic refuse bags stacked on pavements which had clearly not be removed for some time. Talking to people in Bloemfontein, they indicated that in certain areas, residents have engaged private contractors to remove refuse on a regular basis which the local municipality is unable to do.
Understanding the massive challenge that government faces to provide adequate housing for the majority of South Africans, the fact that informal settlements have burgeoned across the country is testimony that this is a failure of government to ensure that citizens live in a safe environment. The regularity of fires in informal settlements in which lives have been lost and in most cases those involved lose all their meagre possessions emphasises the dire situation that prevails. I have walked in the past through various informal settlements and the close proximity of the structures is an affront to the dignity, privacy and safety of those living there. I recall the initial fervour with which so-called RDP or “matchbox” houses were erected, but clearly whatever progress was made it has been insufficient.
Much is blamed on the COVID-19 pandemic but in reality the challenges facing South Africa were there before the advent of the pandemic. Unemployment was at disastrously high levels prior to the pandemic highlighted by the fact that of around 60 million South Africans, only around 7 million are registered as taxpayers while only around 5 million (8%) actually shoulder the personal tax burden which is the largest contributor to what SARS collects annually. Job creation summits held by government have promised increased employment opportunities, but the reality is that the perilous state of the country mitigates against the establishment of new private sector undertakings that will increase employment.
I will not elaborate on the issues of safety and security as reflected by the inability of the State to ensure that citizens are safe on the streets where they live and in their homes. The frequency of violent crime, often affecting the most vulnerable groups such as women and children, only serves to emphasise this fact.
South Africa has a Constitution that guarantees citizens of various basic rights including the access to healthcare which I will not address here. I acknowledge that contrary to what some may say, there has been significant progress in South Africa since 1994 with the abolition of the policy of apartheid and all that went with it. That if nothing else this restored the human dignity of the majority of South Africans. Services previously limited to a minority of the population are now delivered, albeit imperfectly, to the majority. However despite this, from what I have outlined briefly above, it is clear that the basic rights of citizens, are infringed on a daily basis. Yet faced with this reality, government retreats into processes and rhetoric.
We have just experienced a failed attempt to shut down the country by a political party. Whilst many of the issues raised by their leaders are valid, the concept of a “national shut down” to address a country that is already shut down at various levels is fallacious. There is indeed a need for citizens to say enough is enough but the route to do so should rather be through healthy political debate, social activism and not populist demagoguery. I am not making the case for any political party but anger and frustration should be expressed at the ballot box. This is the inherent value of a democracy and what is indeed enshrined in our Constitution. Thereafter, rather than being powers unto themselves, those who are elected must be held accountable but importantly hold themselves accountable. That is the essence of a true democracy.
Health services, as with other basic services, must be accessible to all the people of South Africa. However, without water, electricity, water born sewerage, roads, refuse removal, adequate shelter, personal safety and gainful employment this is not possible. It is time as a country to say; “Enough is enough!”
