Vuyo Mvoko
JANE HLONGWANE (28), her face exuberant with the satisfaction of pregnancy, smiled as she was asked how she felt now that she and her unborn child could take advantage of free medical care from the government.
“Happy, really happy …” she said, in search of better words to describe her pleasure.
Two years ago she couldn’t pay a R74 pre-delivery fee and had to leave the hospital without her first child’s birth certificate. Nor could she afford pre-natal classes. She still cannot believe how fortunate she was not to have had complications during the birth.
The government this year approved a R500-million budget for free health service during 1994/95 for pregnant women and children under the age of six. One of the “presidential lead projects” announced last month was the approval of a R25-million clinic building programme.
For Rebecca Ngobeni, though, the thrill she expressed over “the greatest news mothers ever heard this year” brought back a memory too painful to contemplate.
Her neighbour’s son would be alive today, she said, if the state had been taking care of the pregnant poor and their children. He died of malnutrition, bronchitis and related sicknesses shortly after birth.
During pregnancy the child’s mother went to neither hospital nor clinic because, Ngobeni said, “she came from one of the poorest illiterate families in the neighbourhood and could not afford to buy food or attend pre-natal classes”.
Ngobeni’s own one-year-old child was “very fortunate” because she had been working and therefore could afford to take care of herself during pregnancy and of the child after birth.
Before the introduction of the scheme, she had to pay R40 at the local Katlehong-based Natalspruit Hospital and is happy that now she can use the money to take care of the child’s other needs.
Welcome as it is, the programme has major problems. One of these is a shortage of medicines.
Ngobeni complains that the hospital often substitutes other medicine for medicines that have been prescribed. Conceded sister Ndlovu (not her real name): “It still happens a lot that doctors’ prescriptions are not available.”
For reasons nurses say they do not understand, the dispensary at the hospital closes at 15h30, often before all the children have received attention. Nurses said they try to persuade mothers to bring their children very early in the mornings to avoid such disappointments, but acknowledge that this is no guarantee of success.
On the day before our visit, even “early bird” mothers were among the many who left the hospital very late in the afternoon. Some of them had not yet been unattended to and many were told to come back and collect medication the following day as the dispensary had closed.
There had been no fewer than 250 children that day, and only five of the usual nine doctors were in attendance.
Access to free health care is hampered by the overcrowding. Even mothers like those from the dirt-poor informal settlement areas of Phola Park, Zonkizizwe and Moleleki Extension 2 manage to pay for public transport to the hospital, at a cost of R5,40. Parents bring their children to the hospital for free treatment of even minor ailments, for satellite “well baby” clinics in the area only offer immunisation and vaccination. First aid, nowadays, is now neglected by some mothers, according to nurses. They say even minor cuts that could be treated with an antiseptic and a clean piece of cloth are brought to the crowded hospital.
The same applies to diarrhoea cases. In some cases the problem can be solved by the mother stopping feeding and preparing a certain recommended rehydration mixture for the child. Overcrowding can result in seriously ill children being neglected as their mothers, bored by the waiting, hardly observe changes in the child’s condition.
* Repeated attempts to obtain comment from hospital officials were unsuccessful.