Cape Town - Growing up on a wine farm in Klapmuts, Minnie van Wyk, 60, depended on a mobile clinic that came to the farm once a week to provide health services to farm workers and their children.
If anyone in her family got sick in between, they had to walk or hitchhike to clinics in Paarl or Stellenbosch, both about 15km away.
While she now lives in a RDP house, the former farm worker says accessing health care remains a challenge after 20 years of democracy.
While her home is just a stone’s throw away from Klapmuts Clinic, the only health facility in the region, she says the poor service makes it difficult to appreciate.The clinic is overcrowded and sometimes runs out of medicine.
“There’s no doubt that my life is much better than it was before democracy,” Van Wyk said. “I have a house, and there’s a school right next door, but I’m not so sure if health services have improved much in Klapmuts over the past 20 years. Our clinic is small and overcrowded. If you go early you must be prepared to sit there the whole day. I’m not sure if that’s better than the mobile services I depended on as a little girl.”
In its election manifesto, the DA – the governing party in the Western Cape – promises accessible, affordable and high quality health care to every citizen. The party also advocates that medication be available to all who need it, and proposes a holistic approach that promotes wellness to prevent diseases, rather than the curative model of health care.
The party manifesto says chronic medication should be collected from pharmacies, making collection more convenient and less time-consuming.
The drawcard for the ANC for the next five years is its flagship universal health programme, the National Health Insurance (NHI).
This would be publicly funded and administered, and promises citizens comprehensive health cover and quality health services irrespective of their socio-economic status.
NHI would see expansion and strengthening of free primary health programmes, improved management at public hospitals, and reduced costs of private health care.
While the Western Cape has received high scores for better health outcomes thanother provinces, Van Wyk said promises of timeous response times by ambulances and an adequate supply of medication hadn’t materialised.
“Maybe it’s yet to happen... who knows?” she said.
Theresa van Schalkwyk took her 18-year-old daughter to the clinic. She was about to miscarry but was told there was nothing wrong with her and sent home.
“A few days later we were back at the clinic. An ambulance was called in the morning, but by the time it came to the clinic after 3pm to transfer her to Stellenbosch Hospital, my daughter had already lost the baby,” Van Schalkwyk said.
For Johnny Pietersen, a farm worker at a nearby wine farm in Joostenbergvlakte, accessing health services was even more of a struggle.
He could access a mobile clinic once a month. If he got ill in between, he had to travel to Klapmuts Clinic about 5km from the farm.
“After hours he had to either wait for an ambulance that took an average of four hours, or hire private transport to Stellenbosch at R150 one way.
While he would vote on May 7, Pietersen was not sure if there had been any change in health provision.
“I wouldn’t say the health service has improved for many farm workers in the area in the past 20 years. Everything is far from us. Even the ambulances are reluctant to come to the farms – they say it’s difficult to find addresses.
“When you go to the clinic it’s always so full that sometimes you come back home without getting help,” he said.
Pietersen said bureaucratic processes that forced residents to use public health clinics to get referrals to provincial hospitals made life difficult.
“GPs aren’t allowed to write us referral letters, you must go to the clinic if you want a letter. It’s like the government is forcing people to use the system whether it works or not,” he said.
Meanwhile in Delft, only 35km outside Cape Town, residents say while they have a good package of health services, including a 24-hour emergency unit, maternity section and ARV unit, they still face
overcrowding and bottlenecks at clinics.
Sheila Oliver, 55, of Belhar, said although the Delft community health centre had been expanded in recent years, long queues discouraged many from using the clinic.
She sees no point in voting as “I haven’t seen any improvement in my life after democracy.
“If I’m sick I’d rather go to a private doctor than come here.
“Arriving at 4am or 9am makes no difference because you still wait the whole day. The clinic is always overflowing and chaotic, it doesn’t look like there’s enough staff.”
Muziwamandla Majiyezi of Delft complained of overworked staff, saying he“almost died inside the clinic” after nurses failed to attend to him, despite a referral letter from a private doctor that recommended “emergency care” due to his unstable blood sugar.
“Staff have no time to attend to emergencies. After waiting eight hours I had to go home without getting help. I kept drinking lots of water to bring down the sugar, but I felt so sick,” he said.
Majiyezi received care only the following day.
While he would vote next month, he remained unsatisfied with many promises that politicians made, and had one message for the party that would govern the province.
“Make health accessible to every citizen, and it must be of high quality, as you promised,” Majiyezi said. “We don’t want to be served by overworked staff, as that results in poor service delivery to citizens.”