Dr Nkosazana Zuma, Minister of Health, in The Mark Gevisser Profile
There’s a lesson Nkosazana Zuma learnt from the African National Congress training manuals when she was an operative that she continues to apply, now that she is in Cabinet: “If you sell your people out by giving in to the enemy, the enemy will respect you even less for it.”
The commonsensical health minister chooses to recount this particular struggle homily when asked what she has read, in her life, that has influenced her most: it says much about both her down-home intellect and her current state of embattlement. She accepts, of course, that the enemies she has to deal with in her current job are of an entirely different order to those she confronted when she was working underground, out of Swaziland, for the ANC. Sometimes, though, she feels that the “enemies of transformation” she has to fight now are “more difficult to deal with” than those she encountered during the liberation struggle.
She reminds me of a middle-aged Staffordshire bull terrier or two I have known. She is stolid and doughty, thickset and lowslung, unfashionable but powerful; wilful and driven; self-contained, diffident, and sometimes downright crabby; possessed of an astonishing economy of motion (she sat through a three- hour interview with barely an eye-flicker) that masks an equally astonishing capacity for action: she kicks, as they say, ass.
Her image is that of a country doctor you would both trust and fear: prematurely matronlike (she is only in her mid-forties) with a bonnet of unstyled grey curls framing her features, she is given to sensible two- pieces and low-heeled pumps.
Phlegmatic and undemonstrative by nature, she does not reveal any agony at the fact that her carefully maintained image of dependability has been scorched by the Sarafina 2 fiasco. On the streets she has become a figure of parody: the taxi-drivers laugh about Sarafina 4 and Sarafina 5; the cartoonists fashion her unlikely frame as a Broadway chorus girl chucking dollars about the stage of her profligacy; even her fellow parliamentarians joke about Sarafina 2 on public platforms.
There is no doubt, though, that she has been deeply hurt by the affair. If this was her first major political test, she failed. Not because the whole thing was her brainchild and she still insists that, “I stand by the principle of an Aids musical like this”, or because she finds no problem with the inadequate and unsavvy way that the project uses drama to effect behaviour change. Not because of the poverty of the play’s message; not even because the justification for spending so much on the project was that Mbongeni Ngema apparently has the power to pull black people back into township theatres, and the day I went — last Saturday afternoon — there were no more than 80 souls in the thousand-seater Eyethu Cinema.
No: she failed because, rather than acknowledging that there might have been irregularities and instituting an immediate inquiry, she rushed, hackishly, to the defence of a department that seems to have acted indefensibly; and then demanded of the ANC that it rush, as hackishly, to her own defence. Of the several canards she pulled out of her hat, the most ill-advised was the race card (her critics were whities who just wanted to pull black people down): it has been effectively trumped, not only by The Star’s political editor Kaizer Nyatsumba’s condemnatory column last week, but also by the anger and derision of many ordinary black men and women.
Sitting in her home on the Groote Schuur Estate last week, she did allow herself self- reflection on the issue: “I looked seriously at my intentions; I genuinely believe I’ve done nothing wrong.”
What about her department? She answers by speaking generally rather than specifically: “If, in any matter, I don’t see any deliberate wrongdoing or bad intention or sabotage from the people in my department, I should not leave them in the cold. It doesn’t mean I am saying they did everything right, but if someone was trying to make an honest day’s work and they made a mistake, I’m not saying the mistake should not be pointed out …” Lift the haze of obfuscatory double negatives, and one thing becomes clear: Nkosazana Zuma has realised that she needs to distance herself, even if slightly, from the actions of her department.
Her comportment over the last few weeks notwithstanding, she strikes one as a person of immense integrity. She has always been, says one senior health professional who knows her well and is deeply dismayed by the Sarafina 2 mess, “on the side of the angels; deeply committed to health reform and bringing the right of health care to ordinary people.”
A senior comrade from exile describes her as “refreshing; very simple and uncomplicated and frank; open, honest and direct”. Another colleague notes her “capacity for hard work” and her “genuineness” as “legendary” within the ANC. The source adds, though, that “when the situation calls for it, she can be tough and difficult, and can get very stubborn indeed”.
From very humble Natal midlands beginnings — – the oldest of eight children of a Catholic rural primary school-teacher — she got to the University of Natal’s non-European medical school in 1972, just as Steve Biko was leaving. She became a vice-president of the South African Students’ Organisation, but left it — and her studies — to join up with the ANC abroad, because “being proud of what you are and asserting yourself is a great start, but it doesn’t liberate the country — – you need a bit more than that.”
She finished her degree in Britain and, as a good medic to the movement, she came to the attention of ailing older men like Oliver Tambo and Harry Gwala, as well as the younger and healthier Thabo Mbeki. She met and married Jacob Zuma; committed her life to the struggle. She was one of the first batch to return to the country, and played a major role in re-establishing the ANC in the tense southern Natal region. Friends say that she fully expected the ANC to win the province, and was readying herself for a career as its MEC for health.
Then Nelson Mandela called her to Pretoria. It was unexpected and difficult: her children, the youngest of whom is six, remain in Durban. Nkosazana Zuma is extremely uncomfortable talking about her personal life: all she will say about the fact that she is not the only wife of Jacob Zuma, is that “I am his only legal one”. There is something dislocated and lonely about her current existence.
Despite her paranoia about the media —“I’ve never received good press; everything I touch is attacked” — she has developed a sturdy reputation as a minister, perhaps for the very reason she got into trouble over Sarafina 2: she stubbornly stands her ground, and insists on action. This publication alone has twice awarded her eight out of 10 in its annual Cabinet review.
What has been the greatest achievement of her tenure? “Undoubtedly, the free health care for children under six that President Mandela announced after his election … the fact that it was done in the first 100 days was a real highlight, because if it hadn’t been done then, so many quetions would have been asked that it would never have happened.”
The logic reveals, perfectly, the “shoot now and fight the fires later” approach that she shares with her increasingly controversial director -general, Olive Shisana. And that is the basis of most of the criticism the two women receive from their colleagues in public health.
Despite the fact that there has been more reforming movement in this sector than almost anywhere else, there have also been a string of ill-fated and ill-conceived plans, the latest of which is Shisana’s pet project, the National Health Information System; a hi-tech fantasy that would have all South Africans carrying smart cards with their entire medical histories on them, and the most sophisticated centralised database in the world. “It’s a brilliant end-point for 10 or 15 years’ time,” says one highly placed critic. “For now, though, how about electrifying the clinics and training the nurses in basic diagnostic skills?” So outlandish is the project that the European Union has withdrawn its funding for the first phase.
Then there is the troubled National Health Insurance plan, which finds itself once more on the rack after having been sent back from Cabinet a few weeks ago. Zuma does some damage control by saying that, “I’m not committed to health insurance. The most important thing is to bring free health care to the people: if we can do it through taxation, then that’s preferable.”
The latest dazzle-’em announcement is that there will be free primary health care in clinics for all South Africans starting April 1. “It’s absurd,” says one provincial director. “The homework hasn’t been done. There’s no attention to detail. It’s all quite meaningless.” Zuma probably knows this: once more, though, her strategy is to commit her sector to reform, and deal with the problems it creates later. It’s the combat mode of progress: advance now, count casualties later.
Several health professionals note that there is a pattern to all the schemes she has introduced, ranging from those mentioned above, through the import of Cuban doctors, down to Sarafina 2. They say there should be more substantive process; that complex reforms are often implemented in a scattershot manner, with little consultation and nowhere near an adequate level of planning and research or pilot programming.
There are, nonetheless, some exceptionally good reforms coming out of the health department: the new district system, for example, and innovative new plans for hospital management. Whatever her problems, one thing is invaluable about Nkosazana Zuma: she is both a steely activist and a committed professional in the field of her portfolio. If you have any doubts about the latter, ask her about what it’s like to watch a child under your care die unneccessarily due to lack of facilities.
At the end of our time together, I ask Dr Zuma — who was chair, before she became minister, of the committee that drafted South Africa’s exemplary Aids policy — why she has chosen to be so high-profile about anti-tobacco legislation and yet so silent on Aids.
She disputes the premise of my question strenuously: she speaks much more about Aids than she does about smoking; it’s just that “everyone thinks about me every time they have a cigarette, because of the warnings on the packets and the ads”.
I josh that she should institute a campaign of similar intensity promoting condoms — then people would think about her every time they have sex too. She lets loose a deep ripple of laughter; her face opening into the broadest of grins. In one of the most difficult weeks of her life, I am afforded a brief glimpse of her teeth — and her humanity.