I stick my head out of my consulting room into the corridor. Chair line the walls and they are occupied by Desmond Tutu’s rainbow people: Indian, Zulu, Chinese, White – all are represented.
“Who’s next?”
A little old lady who look, for all the world, like my granny totters to her feet and, stick in hand, creaks slowly into my room. I show her to a chair and pick up her notes. I flick through them pretending to read – but the reality is I am stunned.
My year working in South Africa has so far been a year of rural Africa. The catchment area of our hospital included a town with a small white community but we never saw them. Almost without exception they would have had private health cover and I suspect many would have chosen death over Hlabisa Hospital if it came down to it. Pietermartizburg is however a small city and in the apartheid era had three hospitals: a black hospital (in the township of Edendale) and white hospital (Grey’s) and one for all the rest (Northdale). Grey’s was opened in 1985 and even now its wide corridors, pristine halls, large wards and quiet emergency department contrast starkly with Edendale’s overflowing halls, grimy floors, long queues, and privacy-less wards.
The little old lady and I chat amiably. She has mild heart failure and I cannot entirely work out why she is here – this is the Medical Outpatient Clinic and serves as a referral service for the difficult or complicated patients the district and rural hospitals cannot manage.
Greys from the air - taken on the way back from outreach visit
“Well, Mrs Smith,” I conclude, “you are doing very well and your medication is just right. I don’t think we need to see you here again. I will write a letter to your local clinic and they can continue to give you your medication.”
Her face suddenly tightens.
“Do I have to? Really? Can’t I get my medication from here at Grey’s?”
“I’m afraid that this clinic is for complicated patients and once we get you better then we refer you back. If there are any problems we can see you again here.”
Her eyes fill with tears.
“Don’t make me go to the clinic doctor. You have to wait so long and I am so weak. I hate it at the clinic. Can’t you let me get my tablets here.” Her knuckles have whitened as she grips her walking stick anxiously.
“Is the clinic so bad?”
“It is terrible doctor. And my husband is so ill. We came from Zimbabwe 15 years ago and we lost everything. Our pension, our house and everything. We have no insurance, nothing. Don’t make me.”
I happened to visit her local clinic the other day. It isn’t great. Queues are long and organisation chaotic. But I suspect what really troubles her is that it located in a previously coloured area. The changes the country has seen in the last 14 years have probably been faster than a 88 year old lady can handle.
She looks at me plaintively.
I am a coward. I am only here for a week. This isn’t my battle.
“Well we need to see you in 3 months for a blood test anyway so you can get your medication here til then but after that you must prepare yourself for using your clinic.”
“Oh – thank you doctor.”
I scribble her prescription and she totters out drying her eyes.
I sit in the empty room guiltily for a few minutes.
What would I have done had she been Zulu?
Did I treat her differently because she looked like my granny? Or to put it baldly – because she was white?
Comments
I found your blog while browsing through some SA blog authors.
I won’t lie, I have read your entire blog over the last week. I have found it so interesting and funny. Love your stories of the sisters and nurses and all your experiences at Hlabisa. I have spent some time teaching in rural areas and townships in SA and can relate to some of the situations you have been in.
I love how you have written without arrogance, as many visitors to our country do, but with complete humility and how you seem to have embraced your many sticky situations without complaining. I can tell that SA has touched your heart, not surprisingly.
I found this last post quite thought provoking. I think at the end of the day it comes down to expectations, and the fact is that some white South Africans expect to be given what they want, especially the older ones who went through Apartheid. It is almost guaranteed that a person of another race would not be so bold as to give such a request, or may not even think of asking more from someone who is helping them. I don’t know the answer. I can sadly see my gran asking you the same question though. It is sad that there is such a huge difference between public and private healthcare. Then again, there is the same difference between public and private schooling here too...that distinct and unfair difference encompasses almost everything.
I shall stop writing this essay of a comment now!
Thank you for everything you have done this last year and for all the lives of people you have touched,changed and healed. I know your life and your view on life will not be the same
Michelle.