When public healthcare actually works

In the beginning

AFTER I left a major TV station to focus on freelance writing, there were consequences, such as my medical aid expiring.

I had to choose what I could afford to pay monthly: a multitude of subscriptions to online publications I needed for my work, or medical insurance. In theory, one can claim everything back from the taxman; however, the reality is an article on its own.

I chose a hospital plan, swallowed my pride, and, like millions of other South Africans, went to a community clinic for chronic medication.

Mine is in Green Point, in the Old City Hospital Complex in Portswood Road, just behind New Somerset Hospital. Ten years ago, when I registered, those who arrived early were helped first. It was a somewhat interesting experience to stand in line at 5am in the cold, fog, rain or wind.

There were people who had arrived at 4.30am, and by the time the clinic opened at 7am the line was already long. I was surrounded by people from all walks of life, except the affluent and well-off. My type of people.

People in wheelchairs were unloaded from ancient, battered cars by family. The engines coughed and clouds of black smoke exploded from exhaust pipes.

The group included women with crying, sickly babies, elderly men and women who stood there coughing, drug addicts and homeless people. There were domestic workers and people who had probably worked all their lives in factories or dingy offices and couldn't get by on their pensions.

The first time, I looked at everyone and thought: these are the invisible ones. People no one really wants to acknowledge. You don't find them in a private doctor's office. Also not in an expensive hospital with air conditioning and a view.

You find them here, at 5am in the dark.

From bitter pills to healthy pills

Come with me on my journey. In the beginning, they gave you a number at the front door. Then you walked to rows of wooden benches where you sat until they called your number.

The floors were shiny and smelt of disinfectant. Cleaners emptied bins; people in uniforms hurried past; there was a sense of healing in the air.

I went there on the first day with my identity document. My number was called and I went to counter one. They asked me a few questions, wrote down my contact details and opened a file for me. After that, I had to sit down again.

A nurse called my name shortly afterwards. I went into a room where my blood sugar was tested, I was weighed, and I had to provide a urine sample. It was when they took my blood pressure that the nurse's eyes widened. I was immediately sent to another room and asked to lie down.

A doctor came in and warned me that my blood pressure was extremely high. After being there for a while, I was taken to her office.

I didn't even know I had high blood pressure. She asked me a few questions, placed a stethoscope on my heart, checked my pulse and told me how to lower my blood pressure.

Medication was prescribed. Then I had blood tests to check the functioning of my liver and kidneys, and measure cholesterol levels.

I went directly to the waiting room at the pharmacy. Here, it was just as neat. I placed my file on the counter and waited. Within minutes, my name was called again and I received my pills.

A month later, I had to return. The doctor informed me about my good blood test results and checked my blood pressure again; it was considerably lower this time.

From then on, everything worked out even better.

Health all around

An appointment with the doctor is scheduled for every six months, and you must adhere to it. The system has changed so that nobody has to wait outside at 5am any more.

You collect your medication every two months, also at a set time. During the lockdown, they delivered it to your home.

In the time I've been going to this clinic, my blood pressure has stabilised, I have no cholesterol issues, and my mental health medication ensures I get an early start and am able to work.

Although there are still moderate mood swings, I'm no longer lying motionless and paralysed in a dark depression. My life is productive; my health is well managed; I'm on track.

During my last visit, the nurse cautioned me that I am severely overweight and need to make an appointment with the clinic dietitian.

This success story isn't just mine; it's also the story of many other people I talk to there.

Over the years, I've come to know the staff and realise how hard they work, but especially how they treat homeless people with compassion. Nobody is looked down upon. Whether this is the case at other public clinics, I don't know; my plan is to visit Langa or Nyanga  and see for myself.

The dramatis personae

A visit to this clinic is never a waste of time. It's the interesting people who sometimes make you feel as if you're stuck in a movie.

The other day, I had to wait for my six-month prescription renewal. I sat in the pharmacy's waiting room.

A baby was crying in the background. There was a woman of a certain age with a British accent who always loudly says to the pharmacist, “Thank you kindly, young man, it's all jolly good, your service, Bob's your uncle." If you close your eyes, she sounds just like Maggie Smith.

I found myself sitting across from a woman with a crutch. “Noooo," she says, her foot hurts, and she doesn't know why. “And I drink my borrie every evening so I don't get cancer. I saw it on YouTube."

She worked at Stikland Hospital for years, then had a heart attack while driving. Today, she was here for her foot; thanks to the pills she was getting, her heart was fine. Her name was called, Venetia, and she waved and limped into the examination room.

Then there's the queen who's always impeccably dressed in a type of skirt that hangs over a trouser suit. She wears a turban and has two gold teeth.

The other day, she sat next to a man who looked like a stereotypical boer: moustache, two-tone shirt, khaki shorts and field boots. These two sat closely together and chatted like old friends. Only here, where everyone is equal, I thought, nowhere else.

Another woman being called “auntie" is dressed all in pink. Pink Crocs, headscarf, sweater and skirt. Her face looks proud. Yet, if your eye becomes a camera lens and you zoom in and look past the pink, you see her hands: aged and worn, with thick veins; the skin fragile and terra-cotta brown. Hands that know hard, hard work; silent, defenceless hands that carry a lifetime's history in their wrinkled palms.

Quick facts

Annette Neethling has been the operations manager of Green Point Community Health Clinic for seven years.

She answers a few questions:

When was the centre established?

This facility opened in March 2000.

How many patients do you assist each month?

We see an average of 2,962 patients.

What specific services does the centre provide?

• Chronic care
• Acute care
• Mental health services
• Family planning
• Basic antenatal care services
• Antiretroviral therapy (ART)
• Baby clinic
• Eye tests

What challenges do you face?

We have many patients who live outside our district. Often, these patients do not provide their correct home address.

In addition, our homeless patients do not always have fixed addresses. This is a challenge because we are unable to locate our patients to provide information or feedback on test results or services they have received.

We want to encourage our patients to provide the correct address where possible. We will not turn any client away since it is their right to access healthcare where they choose, but we request that our clients fulfil the responsibility of providing the correct details, including contact numbers, so that we can fulfil our role in ensuring that every patient has access to the best possible healthcare services.

What do the statistics say?

According to Statista:

As of 2022, 15.8% of South Africans were members of medical schemes, a slight decrease from the 16% recorded in the previous year. Considering the total population during the review period, this means approximately 9.7 million people can afford private medical care.

This leaves approximately 52 million people dependent on public healthcare, constituting 84.2%. When membership figures are compared across population groups, coverage by medical schemes was significantly higher among whites (71.9%), followed by Indians/Asians (48.7%), coloureds (18.2%), and black Africans (9.7%).

Take a moment to let the final percentage sink in.

♦ VWB ♦

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