Bandile Masuku has become an “insomniac”.
The Gauteng health MEC wakes up at 4am to read, a task he likes to get out of the way early, so he can “squeeze in” family time before starting his official work day. He goes to bed “very late”.
On Wednesday, the number of confirmed Covid-19 cases in Gauteng surpassed 42 000. Days before, Health Minister Zweli Mkhize warned that within the coming days Gauteng would “emerge with the highest Covid-19 numbers”.
The surge in infections was expected. But after months of the province being out of the spotlight, new Covid-19 cases now seem to be coming thick and fast.
Talking to the Mail & Guardian on Wednesday — in between a frenzy of hospital visits and meetings — Masuku appears calm. After wrapping up another interview, members of his team anxiously swoop in. The MEC has to adjust his schedule for this interview, but he doesn’t seem to be in any rush.
In a locked-down world in which media largely conduct interviews through digital platforms, face-to-face meetings are increasingly rare.
Masuku sits at the far end of a table in a courtyard at the Edcon Retail Academy in Ormonde, Johannesburg, where the Gauteng health department moved its offices to be closer to the mega-quarantine facility at the Nasrec Expo Centre. He takes off his mask and places it on the chair next to him.
Masuku’s coolness doesn’t seem to match the enormity of his job.
Gauteng has the largest health system in the country. When Masuku was appointed in 2019, the department was still haunted by its most public failures. The revelations of the Life Esidimeni tragedy — which resulted in at least 144 mental health patients losing their lives after being placed in state facilities and nongovernmental organisations that were found to be unlicensed — were followed by allegations of rampant corruption in the Gauteng health department.
Shortly after Masuku was sworn in, the department was swept up into another scandal when a video showing 76-year-old patient Martha Marais handcuffed to a bench at Mamelodi hospital, northeast of Pretoria, went viral on social media.
Asked about whether he had any second thoughts about taking on the task, Masuku pauses before letting out a heavy breath: “Yes. Because sometimes you feel inadequately prepared. The only thing there was, was the promise that I would do everything to the best of my ability.”
The department is still struggling, the MEC concedes. “I would be fooling myself, by saying we have made all the changes we need to make,” he says, leaning forward in his chair.
“It will take some time for those changes to come around. We need to be doing basic things correctly … Those are ongoing things. But health in Gauteng is a very resilient department.”
One of the main tasks Masuku set for himself when he was appointed was to boost morale among the workers keeping the battered healthcare infrastructure going.
By last Friday, 709 of the province’s public healthcare workers had tested positive for Covid-19.
Masuku began his career in the province’s healthcare system. He worked at Johannesburg’s Charlotte Maxeke academic hospital and Chris Hani Baragwanath hospital, and Pholosong hospital in Tsakane before heading the obstetrics and gynaecology unit at the Thelle Mogoerane regional hospital in Vosloorus.
This experience, he says, makes him “empathetic” to the daily struggles of healthcare workers.
Gauteng’s response to the pandemic has been buoyed by its army of community healthcare workers, who have long battled for better pay and to be made permanent by the department. In June, Masuku said 8 500 of these workers — who are at the front line of bringing services to the province’s densely populated townships — would become employees of the department at the beginning of July.
The department has “started to turn a corner” when it comes to boosting morale, Masuku says, “but we still have to do more. Now we are dealing with anxiety. We are dealing with fear. And it requires a whole lot of effort.”
In the wake of this anxiety, Masuku believes it is his job to stay composed. “It is a scary task. But one thing that I have learnt through my medical training is that you don’t panic,” he says.
“The first rule: don’t panic. Even when you are faced with the most difficult and scary situations … I have already faced life and death situations. I have lost patients. But the point is to stay calm and to do what is expected.”
One activity that helps him to stay calm is “reading a lot”. “That prepares you so you don’t base your decisions on emotions or feelings,” he says. “It must be about science. It must be about logic.”
It is because of his reading that he has floated the idea of intermittent lockdowns in Gauteng, an option he spoke about at a media briefing on Monday.
Last month, the World Health Organisation urged Pakistan to implement intermittent lockdowns to counter a relentless surge in new coronavirus infections in the South Asian country. A similar strategy was used to contain the Ebola epidemic in Sierra Leone.
Masuku says the current trajectory of Covid-19 infections in Gauteng is more or less in line with the province’s modelling.
“It might be off by 2 000 infections or so, but otherwise it has been quite accurate. We knew that we would go through June without much of a problem in terms of bed capacity. But when we approach August, we will experience a lot of pressure.”
The pressure that will inevitably come with the August peak will be helped by the field hospitals the department is setting up, he says. “That is a stop-gap measure that will ensure we don’t get to the point where a patient doesn’t have a bed.”
But, Masuku says, the department “is no longer talking about preparations”.
“We are talking about dealing with the situation as it comes and changing our response as we move forward. Things have changed. We have moved from a very simple response to a very complex, multifaceted response.”
Masuku says his life is now “almost at its most intense”. Beneath his outward calmness and measured words, he still has many worries.
Exhaling even more deeply now, he says: “My biggest fear is losing a lot of lives [that] we could have saved. I don’t want it to end badly. There will be lives lost. But we should be able to save those lives that can be saved … That is my biggest fear — getting to a point where we should have been able to help, but we are in a space where we can’t do anything.”