Rehana Rossouw
Although touted as a model for primary health care in many parts of the world, the Alexandra Clinic is dying for lack of support in South Africa.
For more than six decades the clinic has served its underpriveleged community, now numbering about 300 000, caring for up to 500 patients a day. This week the clinic announced it will have to cut services within the next two months if no funding is found.
It is one of hundreds of non-governmental organisations (NGOs) scaling down operations or facing closure as foreign funders redirect their support to Reconstruction and Development Programme (RDP)
The Alexandra Clinic was fortunate: of its R13-million annual budget, R9-million was secured from foreign donors. The deficit of R4-million was promised by the Guateng MEC for health, but has not yet been
Like thousands of other NGOs, the Alexandra Clinic is pinning its hopes on a task force set up by the recently-launched NGO Coalition and the RDP office to establish a National Development Agency which will provide a mechanism for funding to flow to development agencies. The task force will present its findings before the end of the year.
This week, the RDP office pledged R50-million to launch the agency and negotiations have begun with the European Union to allocate R75-million. Local funders – – Kagiso Trust and the Independent Development Trust (IDT) — will also contribute resources.
In a memorandum to the government in June, a consortium of 24 NGOs said immediate funding was required by many of the most worthwhile development projects if they were to survive at all.
They expressed concern at the lack of clarity in government policy over the role of NGOs in development work and the mixed messages emanating from the government which had the effect of putting on hold grantmaking decisions by foreign and domestic funders.
The memorandum also asked the government to examine the lack of capacity in provinces which led to delays and non-delivery of funding where NGOs were involved in contractual relations with them.
This toenadering by NGOs to the government is viewed as the last hope for the sector.
The Development Resources Centre (DRC), which is dedicated to strengthening the capacity of the NGO sector, believes that the time has come for NGOs to become market related or to die.
DRC executive director Gavin Andersson said in order to survive, NGOs would have to do development work in communities under contracts signed with the government.
“Like any other market-related project, NGOs will have to tender for projects and grants for overhead expenses would have to come from the ‘one-stop-shop’ National Development Agency,” Andersson said.
Andersson predicted that some NGOs would not survive the transition and would die, particularly those which served poorer communities which were unable to assist
IDT chief executive Professor Merlyn Mehl said if NGOs vanished from the scene, the hopes of delivering on the RDP would be put back for many years.
In the latest edition of the IDT’s journal Leading Edge, Mehl argued: “Even areas traditionally regarded as the preserve of the state, such as school building, have been taken over by NGO structures which have demonstrated admirable efficiency plus capacity to deliver on scale and at low cost.
“It would be short-sighted indeed to let this capacity of civil society vanish at the time when it is most crucially needed in the history of our country.”
Toe the pro-choice line, says ANC leadership
Officially the ANC’s position on abortion is pro- choice.
But not all members agree, writes Marion Edmunds
The leadership of the African National Congress is pulling out all the stops to whip the party back into line on its pro-choice stand on abortion.
Well-placed sources say that Tuesday’s ANC-alliance media conference at party headquarters was specifically to remind members that the ANC had a pro-choice stand, and that a vote of conscience — where MPs would not be subject to the dictates of the whip but could vote as individuals — on abortion legislation would not be tolerated.
There is a growing fear inside (and outside) the ANC that conservative and religious MP’s might start to push for a vote of conscience on abortion legislation when it comes before Parliament, instead of voting according to the official pro-choice party line. This fear, felt keenly by the pro-choice lobby inside the party, is matched by the growing sense of unease amongst those ANC members who are uncomfortable with the idea of abortion-on-demand because of strongly held religious and ethical beliefs.
There is evidence that a great deal of soul-searching has been going on in the party in recent months. Sources say that there is much informal debate on the matter between party members — around dinner tables, behind closed doors. There is a determination by some to keep the party discussions out of the public eye.
Since the tabling of the abortion report last week by Dr Abe Nkomo’s Ad-hoc Parliamentary Committee on Abortion and Sterlisation, tension about views on abortion has increased.
As an indication of the strong feeling, a highly respected ANC MP this week asked to withdraw comments he had made to the Mail & Guardian on the handling of the abortion issue until after the matter was discussed in the ANC parliamentary caucus.
Originally this matter was deemed too sensitive to be discussed internally before the local government elections. Earlier this month, the caucus chair, Baleka Kgositsile, said that the matter could “easily erupt” and that it was not in the interests of the party to deal with it until next year.
Since the tabling of the Nkomo report, the matter has been put down for discussion, possibly for next week.
Kgositsile said that rumours that a group of conservatively minded ANC members were trying to influence ANC Cabinet ministers to allow a vote of conscience on abortion legislation were a
But members of the Reproductive Rights Alliance (RRA) – – a loose group of NGOs involved in women’s issues and health care — are worried that a traditional, conservative and religious lobby has been working quietly on senior ANC members and even Cabinet members to push for a vote of conscience.
A representative of the RRA, Michelle O’Sullivan, said this week that many South Africans had voted for the ANC on the basis of its position on abortion and that it could not now renege on that position by allowing party members to vote on the legislation according to their conscience.
One of the NGOs in the alliance, the Women’s Health Project, called this week for the ANC “not to be intimidated by so-called moralists who are not in touch with women’s real health needs”.
Nkomo, the head of the committee which investigated the abortion legislation, has appealed to members of the RRA to intensify their lobbying to ensure that ANC cabinet ministers stick to the ANC policy position.
A male source in the ANC, who wished to remain anonymous, confirmed that the issue was a ‘political hot potato” within the party and that there were differing opinions. He said that the women in the ANC had pushed a certain position on the matter, which had become policy, but that they had not neccessarily convinced the traditionalists of the wisdom of that position.
One of the few ANC MPs who was prepared to speak openly to the M&G was Dr Ram Saloojee. He said that he was sympathetic to the women’s lobby, but said that as president of the Islamic Council of South Africa, his religion would not allow him to vote for the total liberalisation of the abortion law. He said that he would prefer the ANC to allow a vote of conscience on abortion legislation. He has the support of a number of other Muslim ANC MPs.
Kgositsile, however, says a vote of conscience is unacceptable because ANC MPs were elected to Parliament through proportional representation on a party list, and thus must take a party line.
Father Smangaliso Mkhatshwa, an ANC MP and a Catholic, said this week that he believed that the majority of South Africans do oppose abortion. He said that he was distressed that the debate on abortion had degenerated into mud-slinging between pro-lifers and pro-choicers. He said that the debate was missing a middle ground which took all elements into account — economic, social, political as well as moral.
He acknowledged that there were many ANC members who did not support the liberalisation of abortion.
Its is ironic that the men in the ANC tend to be more outspoken on abortion than the women. ANC veteran Adelaide Tambo refused to be drawn on the matter when asked.
She said: “My point of view is affected by my religious belief but I have a sensitivity towards the will of the people and I wouldn’t like to comment further.”
Contrast this to the responses of the Deputy Minister of Environmental Affairs, Bantu Holomisa, who said, just before Women’s Day: “Personally I think women should have the last say on the matter.”
It is urgent that the ANC debate the matter as it affects the Bill of Rights in the final Constitution. While this does not boil down to putting a “right to abortion” in the Bill of Rights, it does demand that certain choices are made by the ANC before October.
On abortion, the ANC is caught between a rock and a hard place. It is sensitive to the powerful pro-choice women’s lobby — but it will also have to respond to the attitudes of its more conservative members and the constituency beyond.
Meanwhile, a well-placed Inkatha source said it was likely that Inkatha would change what was considered a pro-choice stand on abortion, as there was such a strong pro-life feeling within the party.
The source said that he was under the impression that many of the IFP women were pro-choice but that they were too frightened to speak up about their views in front of the men.
Cabinet battle lies ahead
Marion Edmunds
The head of the Parliamentary Ad-hoc Committee on Abortion and Sterilisation, ANC MP Dr Abe Nkomo, has predicted a tough battle in Cabinet over his report, which recommends abortion on demand up to 14 weeks.
Should the report be adopted by Cabinet, corresponding legislation will be drawn up and piloted through Parliament by the Health Portfolio Committee. This will involve further extensive public consultation and open debate.
The Report on Abortion and Sterilisation has proposed new legislation for abortion, making it possible for women and girls to have abortions on request to up to 14 weeks, and, under certain conditions, up to 24 weeks. Such conditions would be worked out between the woman and her health worker, and could include the economic and social situation of the woman.
The report recommends that it not be neccessary for a woman to get the consent of her partner, and that girls under 16 need not tell their parents, although it would be advisable.
It is also suggested that a range of health workers be trained to conduct abortions and that resources be improved to give women access to abortions, especially in areas where there are few doctors. Yet the report recommends that doctors or health workers who feel that they cannot conduct abortions for ethical reasons can refer cases elsewhere.
The report also suggests that statistics on abortion be collected. Nkomo highlights in the report the difficulty of getting accurate and scientific information on abortion in South Africa, partly because of the past law forbidding abortion on demand and because of the stigma attached to abortions
The report recommends that a great deal of red tape, present in the 1975 Act, be scrapped.
In the report, Nkomo says that the recommendations were drawn up after the committee received 452 submissions. He said that it was unfortunate that the majority of the submissions were from well-resourced white people and that there were considerably fewer representations from black and poor people.
Nkomo said that he was suprised that opposition parties were trying to make mileage out of the debate.