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Speech at the opening of a clinic in Qumbu
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Speeches and Media Releases
 Health

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EASTERN CAPE PROVINCIAL GOVERNMENT

SPEECH DELIVERED BY THE M.E.C. FOR HEALTH DR BM GOQWANA

TO MARK THE OPENING OF THE NEW CLINIC IN QUMBU

ON THE 10 DECEMBER 1999

I am very much honoured to grace this event which is a milestone in the development history of this community. I am also particularly 
pleased because when we engaged ourselves in the struggle for social development many people saw us as social outcasts, people who deserve 
to be thrown away, people who do not deserve humane treatment. Today I am pleased to say it is the very same people who are now in 
government who have initiated this project. Had we stood aloof, this dream would not have been realised. Had we been cowards, our people 
would not have been free. As much as we rejoice the construction of this clinic we should not forget those who sacrificed their lives so 
that your dream society can come true.

The construction of this clinic area is another mile stone in the history of development of this community. This is long overdue. It is an 
indication of how the former homeland rulers valued the life of the people in rural areas. To them you did not deserve this. Your 
government under the leadership of the African National Congress has made an unwavering commitment to deliver essential services to all the 
people of our country with particular emphasis to the rural communities.

In South Africa we were given an impression that the only way to deliver health service is through secondary health care. The construction 
of clinics in these areas marks the fundamental shift from this philosophy. Our emphasis is on Primary Health Care. This means that we 
shall do away with the notion that the hospitals are the places to go to when suffering from general illnesses. All general functions will 
be rendered at the local clinics with the nurses being the backbone of the services.

We envisage this process by ensuring that through training and orientation the nurses can investigate the cause of illnesses, analyse the 
extent of the problem and even prescribe treatment necessary where required. Some may argue that the nurse may never be able to replace the 
function of the doctor. This is not the intention.

What we are doing is simply to empower our nurses to a level where they can be equated with the general practice in the health service. In 
extreme cases, of course, patients can always be referred to bigger and more advanced institutions.

The most important aspect about primary health care system is that it is cheaper to implement, more accessible and affordable. With the 
shortage of doctors this also means that the services rendered by the doctors are going to be more focused or even specialised.

Our philosophy of Primary Health Care can never be functional unless the very buildings we keep on erecting are fully equipped and 
accessible. Water, electricity, roads and communication infrastructure, staffing and all the necessary equipment is a basic condition for 
the functioning of these clinics. There are many clinics in this region which do not have electricity, or water and some are not 
accessible. As a result of this most of our programmes have not met the required standards.

As part of the government’s efforts to ensure that such essentials are available we have brought in all the relevant stakeholders. We are 
busy negotiating with the Department of Public Works and also Water Affairs so that water and roads are in good order. Apart from this 
initiative we have also been approached by the Independent Development Trust. They are giving us money so that our rural clinics can be 
electrified. There are also are companies like Goldfields who are making their resources available to us.

Ladies and Gentlemen, let me make something clear. When it was said the people from where the project is situated should be considered 
first when job opportunities come, it was not a mistake. Given the conditions in the Province at this stage it is impossible to employ new 
people. What the government is doing is to identify qualified personnel from other areas to come and man these facilities.

This is reflected by a number of cases of measles, typhoid, shigella and other preventable diseases. These cases are most prevalent in 
North-Eastern part of the province.

There is still a high occurrence of TB with figures as high as 311/100 000. The most unfortunate situation is that nearly 50% of these 
cases are HIV positive. These are only recorded cases. The figures could be high is accurate data can be collected.

Rheumatic heart disease is still prevalent. While efforts are being made to ensure that we reach all children for immunisation, to date we 
are still at 54% which is far below than the World Health Organisation standards.

The diseases I am talking about are not prevalent in most of the province but here in the former Transkei. The challenge to us is to ensure 
that the inequalities which exist within this province are eliminated. It is imperative to ensure that per capita expenditure in this area 
is brought to the same level as other regions.

The realities out there are, to say the least, most astonishing. As an example, if one looks at the Health priorities of the metropolitan 
areas of the East London and PE, the concerns are with highly specialised equipment such as CT scanners being switched off, etc. within the 
very same province, Bambisana in Lusikisiki or Greenville in Bizana the concern is with providing electricity of the hospital or the 
building of the out patient department which is non-existent. Currently the Health Department is receiving a lot of negative coverage not 
because we are sitting down and doing nothing, but, that when resources are distributed equally those who have been privileged are feeling 
the pinch. They are trying all the tricks to discredit this government. I want to assure you that as long as I am still heading this 
department I will make sure that those areas that were neglected before receive priority in resource distribution.

Allow me Master of Ceremonies to touch one important aspect in health service delivery. Like other provinces, the Eastern Cape government 
inherited three different administrations which were not only politically antagonistic to each other, but also had totally different 
cultures. That cultural identification has continued to exist despite attempts to inculcate new ethos. The situation has been worsened by 
the fact that one of the administration had within itself not only racial segregated service delivery institutions ,but also fragmented and 
duplicated services. The Eastern Cape Department of Health falls within this ambit.

The reality of the situation is that when we said we are transforming we only focussed on transforming the departments at national level 
and concentrating on reorientating the attitudes of the whites. Little did we realise that there are people especially those from the 
homeland administration need to be transformed. We find ourselves in a situation where we have a problem with our own brothers and sisters. 
The most unfortunate situation is that in the course of their activities they tend to consciously or unconsciously do the enemy’s job. The 
challenge is upon us to ensure that we do not resist change. Change is painful in the beginning but the fruits are enormous.

When we engaged ourselves in the struggle we did not mean that when freedom is attained we are going to enrich ourselves. What we see some 
of our comrades doing today is not what was supposed to be happening. Some are so corrupt to such an extent that they have no consideration 
of the people suffering. The rural and the poor are robbed on daily basis by people claiming to be representing their interests. As 
President Thabo Mbeki has pledged, such practices will be put under strict spot light. We are not going to leave any stone untouched. In 
fact we do not have untouchables.

Master of Ceremonies, on this day I want to put a challenge to the youth, especially the young and promising and also those who seem to 
lose hope. I was born in this area. I grew up here. The conditions at the time were far worse than they are today. It was a remote area 
with no communication and roads infrastructure. Today I am a qualified physician and a specialist in the field. During that time nobody 
thought there would ever be a specialist from this area, but here am I today. I wanted to serve my people. It so happen that what I have 
been doing in the past years was not enough. I had to sacrifice all the niceties of being a Physician to head this department. It is a 
sacrifice because what I am getting is far less than when I was doing my private practice. I felt that it is better to suffer than let your 
own people suffer. The message I want to pass today is simple, "let us not lose hope, there is always a light at the end of the tunnel. You 
must not allow your unfortunate circumstances to determine your future".



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