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MEC opens new clinics in Tabankulu and Maluti
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Speeches and Media Releases
 Health

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 EASTERN CAPE PROVINCIAL GOVERNMENT

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

TO MARK THE OPENING OF THE NEW CLINICS IN TABANKULU AND MALUTI

14-15 SEPTEMBER 2000



INTRODUCTION

I am very much honoured to grace this event, which is a milestone in the development history of this community. What is more pleasing is 
the fact that our strategic objective of bringing better life to all is beginning to bear fruits.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 advocated the betterment of life for all 
with particular emphasis on rural development. 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 not just another milestone in the delivery of health care service but also a long-term goal of 
transforming the health care service so that we can achieve a sustainable health care toady and tomorrow. The construction itself 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.

PRIMARY HEALTH CARE

Ladies and Gentlemen: allow me to take this opportunity and share with you the governments policy on the delivery of health service. On 
coming to office the new government took a conscious decision of moving away from the old practice of promoting secondary health care as 
the best method of bringing health service to the people. Having noted that our people travelled long distances to the hospitals and some 
die on the way or some were admitted for minor illnesses, the government decided to embark on Primary 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 specialized.

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 governments 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 the Independent Development Trust is also involved in the electrification of our rural clinics. There are also other companies 
like Goldfields, which are making their resources available to us.

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 reorientation of 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 enemys 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.

HIV/AIDS

HIV/AIDS is not only the worlds greatest killer disease and a threat to humanity, but also a unique disease. What makes it unique and 
problematic is the following-:

(a)It is incurable  there is still no cure for HIV/AIDS, but it can be controlled.

(b)It is an infection by virus. Unlike other diseases, which are spread by other organisms like malaria wherein the spread would be 
prevented by killing mosquitoes, human beings spread it and you cannot kill people with a view to control it.

(c)HIV/AIDS, except in few cases is transmitted through sexual intercourse. Sex is still a taboo to talk about in public.

(d)Males are the most transmitters of HIV. On the other hand women are prone to be carriers hence there is a high percentage of women 
infected with HIV. The situation is also exacerbated by the status of women. It is an undeniable fact that no female has power  financial 
or otherwise. They depend on males for their livelihood.

(e)The virus attacks the immune system that is the main protector against antibodies. However, poverty kills the immune system. The rate of 
transmission in poverty-stricken areas is faster than other areas.

(f)It thrives well when there are other diseases like TB.

OTHER FACTORS THAT AFFECT THE SPREAD OF HIV/AIDS

* High rate of illiteracy amongst our people. The majority of our people especially in rural areas have had no access to education; hence 
they cannot be able to interpret the information available to them. We need to empower the people so that they can have access to 
information that is vital to their survival.

* Migrant Labour System. This is one of the major problems facing our country at present. The fact that women in rural areas are the most 
affected indicates that males who come from the mines and other industries carry the virus with them.

* The gender inequalities in education, employment, wages compounded by poor access to reproductive information makes women prone to being 
the worse affected than males. In many instances women find themselves being victims of the deteriorating economic situation when they are 
forced to use desperate measures to survive. There have been reports in some institutions of higher learning that female students have 
resorted to selling sex so as to pay for their fees.

* Our cultural inclinations sometimes create a conducive environment for the spread of HIV/AIDS. Though this might be controversial it must 
be mentioned that polygamy in certain situations could result in many people getting infected with the virus. This equally applies to those 
who still believe that to prove manhood is to have as many women as possible. Talking about sexual activity in many communities is a taboo. 
This is a barrier we must overcome. It is a painful departure from the practices that the older generation, but it is a necessity. Gone are 
the days when parents wouldnt talk to their children about sexual activities. Equally important is how we manage our prestigious custom 
i.e. traditional circumcision. There are people who still do not believe that the transmission could occur during the process. If the 
custom has to be preserved we should make use of sterile instruments. Parents must take responsibility of ensuring that their children are 
safe when they are going to the school.

* Stigmatisation. As long as we continue to put a stigma on people infected with the virus we will not be able to control the disease. 
People living with HIV/AIDS are human being too. They do not need to be discriminated against. Under the circumstances voluntary testing is 
not possible because of the fear that people infected with the HIV will be discriminated against.

* That the collapse of immune systems in our people who live mostly in our poor parts of the province convinces us that there is a need to 
look beyond issues of treatment and containment.There is a vicious cycle that we have to explore. The inequities that exist in these parts 
of the world indicate to us that those living in poverty-stricken areas are more likely to have their immune systems destroyed. Perhaps the 
scientists will have to tell us why the link

HIV/AIDS AS A CHALLENGE TO SUSTAINABLE DEVELOPMENT

The rate of infection affects the socio-economic development negatively. A large amount of household income is spent on health care for 
adults and children, who are ill because they are HIV positive, have AIDS or AIDS related diseases. The household capacity to sustain 
itself is significantly reduced as members infected become economically inept. Many African families are stretched to the limit, as they 
have to accommodate children whose parents have died of AIDS.

HIV/AIDS poses a threat to investment in Eastern Cape as well as the rest of the country. Companies form abroad are sceptical of investing 
is a country where social responsibility exceeds the returns on investment. As is the case now, since HIV/AIDS affects mostly the 
economically active population group, this means a large amount of money will be used on training and replacement of personnel. Above all 
the rate of absenteeism due to sick leaves.

Of particular concern is the strain that is going to exact in our limited Health Budget. The economic situation in our province has led to 
80% of the people depending on public health sector meaning that the management of HIV/AIDS in the Province will deplete our Health Budget. 
The Health Budget is also affected in a sense that a large percentage of HIV infected people are prone to opportunistic diseases like TB. 
Most of them are admitted to our hospitals and they stay in some cases longer than 30 days.

The fight against HIV/AIDS calls upon all of us to act in unity. We call upon:-

1.Religious community to strengthen its resolve to increase public awareness.
 2.Organised labour to educate its members about the consequences increasing infections.
 3.Business community and organised labour to continue to find solutions that will contribute to investments.
 4.It is also imperative to change the attitudes of males so as to change their social behaviour, which is a main contributor to increasing 
infection.
 5.Women must be empowered so that they can play an active role in the economy thereby reducing high level of dependency on men.

The worlds biggest killer and the greatest cause of ill health and suffering across the globe, including South Africa, is extreme poverty. 
While we continue with the sustained public awareness encouraging safe sex and the use of condoms, there must be a better-focussed 
programme targeted at the reduction and elimination of poverty and the improvement of nutritional standards of our people.

MC, having said all this I must talk about nurses. They are the backbone of healthcare service delivery. In many instances they are 
neglected and forgotten. Unfortunately because of the neglect most of them become so demoralized, most of them have left the country for 
greener pastures in other countries despite the fact we have invested a lot of money in them to render services in their country.

We have observed this trend and I must say, naturally as a doctor when you make diagnosis the next step is to manage that diagnosis and 
give a prognosis. I must say to you, the present Government is doing all it can to improve the conditions of nurses especially those in 
rural areas.

The idea of having nurses provided with incentives is to counter the perception that being in the rural clinics means a punishment. As a 
Department or a Government we can try to ensure equitable allocate resources but if our Human Resource not is committed and prepared to do 
something for the poor and rural we still remain with the same status of health in the Eastern Cape.So Im on my knees ladies and gentleman 
requesting these qualified nurses to commit themselves to uplifting the standard in what ever way to help the poor and the rural not by 
giving the money but being of service to those who need your services, those are voiceless who have been neglected by the past government. 
The Union, the National Party, the Transkei and the Military Governments have all neglected those that are poor hence health status still 
remains what it is today.

Mphathi theko ndivumele ndithi kuluntu lwalapha, eliziko lempilo ayilolika rhulumente phaya eBisho okanye uGoqwana. Lelenu. Ukuba nifuna 
lingasebenzi nini abazakuchaphazeleka ayingoGoqwana okanye uStofile. Xa ndithetha ngoluhlobo ndithi yiphatheni kakuhle, ningavumeli 
izihange ibesisigqubu sazo esi. Yikhuseleni ngokwenu. Okwesibini kufuneka kubekho abantu abazakuncedisa apha. Abo Bantu basuka kwalapha 
kuni. Ukuba bazakuvuzwa kanjani, ixhomekeke kuni. Urhulumente akanamali yokuqesha. Ukuba sithe safaka abantu abasuka kwezinye iindawo ze 
nazi ukuba nagbantu ababekwe ngenxa yokuba kuncitshiswe abasebenzi kwelinye iziko lempilo.

Xa ndiqukumbela ndifuna ukuthi, inkqubela phambili ayikokwakha amaziko empilo kuzo zonke iindawo. Impilo youluntu ixhomekeke nakwezinye 
izinto ezibalulekileyo ezinje ngamanzi ahambayo, izindlu zangasese, umbane, imfundo, njalo-njalo. Apha ehlabathini kukho amazwe aphambili 
kakhulu ngekqubela ingakumbi kwezempilo kodwa izinga lezigulo lingaphezulu kwelifanelekileyo. Kukho amazwe ahluphekileyo kodwa abantu 
baphilile. Lento isibonisa ukuba eyona nto ibalulekileyo kukufundisa uluntu ngezempilo. Uluntu ngokwalo lunoxanduva lokuba lwenze ngcono 
indawo eliphila kuyo. Ukuba asiyikhathalele impilo yethu ndingatsho ndiqiniseke ukuba sizakugula sife ekhona amaziko empilo.

Thank you,

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