Last Sunday, when Victor Holland died at the age of 77 he joined a generation of political activists who can proudly say that in the years of our democracy they never turned their backs on the values and principles that sustained them as they fought apartheid. Although less well known, Victor Holland stands alongside the likes of Charlotte Maxeke, Steve Biko, Neil Aggett and Florence and Fabian Ribeiro, Frayne Mathijs and David Sanders – remarkable individuals who stood up for health as a human right, and did so by maintaining exemplary professional dignity, ethics and integrity.

Victor Holland was born and grew up in Coronationville, designated a “coloured” suburb by the apartheid government. He was one of nine children. That part of the West Rand has always been a hotbed of politics. On one side of Coronationville was the Western Native Township, for years separated by palisade fencing, until it’s African residents were moved to Meadowlands (Soweto) and it became modern day Westbury. On the other was Sophiatown, until it was bulldozed and its residents moved to make way for Triomf (now Westdene).

Victor’s younger brother Errol, who was born on the same date five years later, followed in his footsteps (literally). Errol’s own life is one of colour and commitment and he has become a distinguished haematologist and veteran health activist. According to Errol “ever since his high school days Victor had been determined to become a doctor”.

But the apartheid ideologues meant that fulfilling that dream was never going to be easy. The Hollands lived only a few kilometres from Wits University but, according to Errol, a direct passage into medical school there was thwarted by the “perverse collaboration of the Wits Medical School and the apartheid governance establishment”. In those deranged days, black candidates had to apply for a permit to attend a “white” university. The first time he applied, Victor was accepted by Wits, “which had him bursting with joy” but his application for “permission” was rejected by the apartheid government. A year later, he received his permit, but then — “to his utter disappointment” – Wits rejected his application.

Fifty years later you can still imagine that disappointment. However people with a calling to be doctors don’t give up easily.

Because of being rejected by Wits Victor first had to complete a BSc degree at the Bellville College (now the University of the Western Cape), the institute of higher learning where “Coloured people” were designated to study.

After that, in 1963, he was accepted at the University of Natal (now Nelson Mandela School of Medicine), then a racially segregated campus, where black people were “permitted” to study medicine. Ironically, this medical school created a generation of politically aware world-class doctors, some of whom continue to play a leading role in health. Its alumni include the likes of Jerry Coovadia, Zweli and May Mkhize, Ralph Mgijima, Aaron Motsoaledi, Salim and Quarraisha Abdool Karim – to name but a few.

After university Victor completed his internship at the then Coronation (now Rahima Moosa Mother and Child) Hospital. Following a stint in Paediatrics at the Baragwanath Hospital in the early 1970s, he commenced training towards his specialist qualification in Internal Medicine with the Colleges of Medicine of South Africa. As brother Errol attests, this too was a time of political and medical trauma, as doctors tended to the wounded of the 1976 Soweto and other uprisings.

As a physician, Victor Holland spent many decades as a head of one of the General Medicine wards, initially at Coronation Hospital and then at the Helen Joseph (originally JG Strijdom) Hospital. He also developed a specialisation in Gastroenterology.

Here too he worked alongside one of the legends of South African medicine, Dr Yosuf “Joe” Veriava. The relationship with Veraiva was to last a lifetime. In an interview this week Veriava recalled several aspects of Victor Holland’s life.

Firstly, despite those like FW de Klerk who would have us forget the million daily insults of “petty apartheid” , Victor’s life was an example of how apartheid blocked and demeaned the lives of black people at every turn. It was a struggle for a black person to become a doctor; then segregation in medical practice meant lower wages, worse conditions and no opportunities to specialise even if you were working in a designated black hospital like Bara. It meant a different set of patients, with diseases of poverty and oppression.

Victor lived and internalised all this.

However, Veriava commented repeatedly on his “silence” and quiet political commitment to equality. He says, Victor wasn’t outwardly a political activist; “he never went out and made a big racket like I did”; he was not politically “ostentatious” – but “he always supported us, was deeply moral, conscientious and committed to service.” It was also clear that Victor never found himself on the wrong side of struggles for the right to health.

What became clear as I listened to Joe Veriava was that from the early 1960s onwards, Victor channeled all his energy into acquiring the skills to specialise as a Gastroenterologist (again despite obstacles) to become a world-class doctor for poor people. He sought to provide the “best care under difficult circumstances”. Even after he was recognised as one of the best specialists in Internal Medicine in the country, and after far more lucrative opportunities opened up in the private medical sector, he stayed at his post.

According to both Errol and Joe Veriava it was in the Medical Outpatients service, with it’s massive load of patients with chronic disorders, particularly Diabetes and Hypertension, that Dr Victor Holland made his lasting contribution. Here he was a “silent” (the word crops up again) team leader, mentoring “a lot of registrars and interns, leading by example, as a good doctor with sound ethical values”.

Errol recalls how “Victor’s gentle, respectful and mindful care of this largely aged patient population is legend, and people from all walks of life had only the greatest praise for his professionalism”. His reputation meant he was often called upon to care for high profile patients; in one case, travelling to Pretoria Central Prison to care for Dmitri Tsafendas, the assassin of the “grand” architect of apartheid, Prime Minister Hendrik Verwoerd.

Coronation Hospital serviced a wide catchment area stretching from the surrounding Coloured townships to as far as Lenasia, Eldorado Park, Benoni and beyond. Here, Veriava recalls Victor’s role in the amalgamation of the racially segregated JG Strijdom (white) and Coronation (Coloured and Indian) hospitals, after doctors refused a request by the apartheid government that doctors at Coronation provide specialist services to the hospital one kilometer down the road (petty apartheid again, FW), in return for 26 of the beds at JG Strijdom.

He also recalls Holland’s refusal to implement a ‘red sticker system’ whereby Coronation was not allowed to admit and treat African patients (identified by the red stickers on their files), but rather discharge them to the care of a black hospital.

“We just decided not to abide.”

Finally, Victor Holland always believed in public medicine and that access to health care services should be a right, as it now is in section 27 of our Constitution. Given his dedication to the public service, he shunned many opportunities on offer to engage in money-making private practice and when he retired around 2012/13 it was still as a public servant.

As we prepare for the medical emergency that the Covid-19 pandemic is about to land, and as we witness the crisis that has been caused by underinvestment in public health, the privatisation of medicine and its resultant inequality, this is the lesson and legacy of his life we should take to heart.

Victor Holland died knowing that the struggle for equal health was far from over; it’s on our shoulders to see it to the finish. Sadly, because of SARS-CoV-2 there will be no public memorial at this stage. So let this article’s attempt to capture the spirit of a “People’s Doctor” be our call to arms and a reminder of the values and ethics we should carry into this battle and beyond. DM/MC