Opinionista Andrew Ihsaan Gasnolar 7 January 2021

Our loved ones are shipwrecked in a chaotic healthcare system that has been stretched too far

Each day we are battered by the Covid-19 second wave sweeping over the country, threatening our national wellbeing and economy, and the livelihoods of millions of vulnerable South Africans. A crowning indignity is a dysfunctional public healthcare system that compounds the anguish of those who must rely on it to save the lives of their loved ones.

After a brutal, demoralising and exhausting 2020, 2021 finally arrived. However, South Africa was confronted by a new Covid-19 tsunami; a tsunami driven by a new strain, 501Y.V2, and by the inaction, complacency and incompetence of our public representatives and governments.

Field hospitals were shuttered. The photo opportunities from the first coronavirus wave were long forgotten and the public healthcare system was even more fragile, even more stretched, and not fully prepared for this inevitable moment.

Instead, we are confronted by the failures of South Africans to adhere to mitigation measures adopted during various stages of lockdown. And confronted by the inability of South Africa’s government to meet the demands of the day.

We are unable to effectively manage a healthcare system that is in desperate need of coordination and project management — as well as funding, supplies and medical professionals.

My attempts — and those of others in my family — to engage with the provincial Joint Operating Committee left us bewildered and confused. We instead opted for calling private hospitals ourselves, calling in favours, relying on our personal networks in the hope that we could find the best possible public healthcare solution for our loved one because the system was just not up to it. This is the reality thousands of South Africans are being forced to wrestle with each day.

We are confronted in this second wave with the possibility that all the months of preparing might have been squandered. The missteps of South Africa’s “new dawn have been replicated across the country’s political system, resulting in this second wave nearly crippling our healthcare facilities, clinics and hospitals.

Medical professionals are no longer able to make choices, but rather are being forced to accept inevitable outcomes due to a health system that is overwhelmed. Each day, people continue to die, in part because there are no adequate facilities, resources or available medical professionals available. Each day, we are confronted by a second wave across the country that not only threatens the health system and a fragile economy, but also the livelihoods of millions of vulnerable South Africans.

It is one thing being aware of the impact of Covid-19 and another being confronted personally by the onslaught of the health crisis on lives and communities across our country.

The system failures are bitter reminders of a squandered, lost decade. Theft and malfeasance have crippled our ability to meet the needs of our country. South Africa’s government – national, provincial and local – has failed to deal with the human cost of the global pandemic. Families across the country are distraught, panicked, worried and exhausted — not only because they are struggling with the health and socioeconomic costs of Covid-19, but also because they are often alone in this battle.

Interacting with South Africa’s healthcare system is debilitating, disheartening and, in many instances, leaves families fractured. Each interaction I have had with our public healthcare system has reminded me of cruel fluorescent lights in those old, dated government buildings with dark corridors.

These buildings are not filled with compassion and dignity, but rather reflect the desperation of a system chronically under-resourced with, generally, committed but overstretched medical professionals. The sad truth, though, is that there are some officials in healthcare facilities who are callous, uncaring and, in some cases, malicious and negligent. A more suitable role for them would perhaps be in a gulag or, more appropriately, a correctional facility.

Each time I have interacted with our public healthcare system, I have been left heartbroken and disillusioned.

This is the South Africa of many millions. The second wave reminds us of it and how fractures and malfeasance have crippled public service — but, even worse, how they are stealing the livelihoods and ending the lives of far too many.

As a young child, I was subjected to those cold fluorescent lights, accompanied by a mechanical hum, as a nurse examined my body to document the abuse and violence committed on me. At no point did a social worker appear, or a medical doctor. A file sits somewhere in that archaic system, with my name, bruises, fractures and indignity of treatment documented.

My next interaction with the system was in the labyrinth of Tygerberg Hospital 20 years ago. Getting lost in the corridors there became a familiar experience, as we tried to abide by the stringent visitor policy when we went to see my grandfather. We walked through corridors riddled with forgotten and discarded equipment, with the ever-present fluorescent light and hum. Many days were spent watching over my grandfather, including when he was given the wrong medication and almost died.

This is a reality far too many South Africans are confronted with each day as our public representatives fail to confront the challenges of our times.

These are not the tales of a healthcare system I thought would be repeated in our current dispensation. But the truth is thousands of us are having to battle for our loved ones shipwrecked in a chaotic system that has been stretched too far.

This week I was reminded how this very public healthcare system sent my grandmother home almost 15 years ago — essentially to die because, as far as the local clinic was concerned, she had reached the end of her lifespan. We opted to use the private healthcare system that so few can afford and were able to ensure grandmother lived comfortably and happily with her family for many more years.

This is the South Africa of many millions. The second wave reminds us of it and how fractures and malfeasance have crippled public service — but, even worse, how they are stealing the livelihoods and ending the lives of far too many.

Our healthcare system is often accessed through local community clinics; clinics that require a queuing process that often starts before sunrise and has patients returning home at dusk hoping that the medication they have been given was worth the wait and the indignity of dealing with disinterested staff and suffocating red tape.

My late grandparents were forced in part by the realities of apartheid to navigate this system. At the dawn of democracy, we, like many other millions, hoped things would get better. This week, as I walked through Tygerberg, I was reminded how much those corridors have remained unchanged. The facility has remained the same — but this time the Covid-19 tsunami is blowing.

We are not allowed to visit our family members when they are admitted into the public healthcare system. Often they leave our homes in an ambulance, or are dropped off and wheeled away behind glass doors, through gates and into darkened corridors. Our access to them is dependent very much on our means. Are we able to access data? Are we able to fight the system when we want to bring our loved ones’ essential items? And are we able to endure the indignity at every turn while hoping they’ll pull through.

This past Sunday, I met a family at Tygerberg who were trying to drop off essential items for a loved one during visiting hours. The family had endured the difficulty of travelling via a broken public transport system, carrying a Sunday lunch made especially for their mother. Children and grandchildren were praying she would pull through. Instead of a seamless drop-off process, that family, and many others waiting outside, were confronted by obstinate security officers who informed them their mission was impossible.

Why such a lack of human feeling during a humanitarian crisis?

In the early hours of Thursday morning, my family lost a brother, and I lost my uncle within seven days of his Covid-19-positive pathology report. That report has spiralled into a rushed ambulance ride to the closest government clinic, then — due to an overflow of patients and demand — to Tygerberg Hospital, with its incessant hum and fluorescent lighting at every turn.

Riedewaan was compassionate, he was committed to social justice and deeply saddened to see how every fibre of South Africa has been twisted to further perpetuate inequality, poverty and unemployment.

Riedewaan, like many thousands of others, was unable to engage with his family, restricted in his movements, highly contagious and heavily dependent on the public healthcare system.

It is a system that was unable to provide the assurance his family needed, that continues to be pressured and on which so many of us continue to rely on in the hope that lives can be saved. DM

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