The South African context of a faulty public healthcare system, apartheid spatial planning and class and race divides breeds a strange state of being. Either we endure suffering silently, escaping into another world in order to survive the torment, or we advocate for ourselves and others. Both of these methods form from a sense of helplessness and self-preservation — it is a case of do or die.
My experiences of the public healthcare system as a young girl in the townships forced me into advocacy early in my teens because I watched healthcare providers disregard and mistreat people who they deemed guilty of causing their own suffering. I watched nurses separate patients into categories: people with HIV or Aids and the others.
They would make no secret about the reason for the discrimination; they would stand in front of the crowd and almost gleefully remark that the right section was for “Aids patients”.
The stocky, middle-aged passive aggressive nurse would go on to let the crowd know that these patients needed to see the two doctors available to them to help with their Aids. They disclosed people’s medical information if they thought it was due to immoral behaviour.
That’s just how it was — no one said anything besides murmuring about how rude the nurses were. The group on the right would look at the floor; I imagine they must have wanted the ground to open up and swallow them in that moment.
I would cringe at the audacity until I just couldn’t control myself and would loudly ask the nurses why they felt the need to humiliate people and disclose their medical history. I demanded to know why they singled out certain patients and if they realised that they were doing more harm than good because who would want to get tested or come in for check-ups and medication if they knew they would face abuse?
The passive aggressive nurse had turned and scowled at me, and her colleague, whose voice sounded like she had been born with a built-in megaphone, started to remind me about who was in charge. The room suddenly came to a hush; you could hear the sound of people holding their breaths and I could feel their eyes on me. This is why no one ever says anything: because saying something means that you would become the target of abuse.
The nurse shouted at me about how I shouldn’t tell her how to do her job. I looked at her and asked, “Oh, so, your job description includes discrimination and abuse?”
She continued to scream about something before storming off, but I had zoned out. Advocating for yourself and others in the public healthcare system is important. In my experience, it is the difference between life and death, holding healthcare workers responsible for abuses of power and overall accessibility.
For some bizarre reason, the public healthcare system can breed a particular type of abuse of power and lack of accountability. This is because of myriad factors: vulnerable people tend to keep their heads down; people don’t feel empowered to demand service delivery; the fear of retaliation when we do complain; poverty and class means “beggars can’t be choosers”; a lack of education and language barriers play a role because how do you complain to authorities via email if reading and writing in English is not a skill you have?
How do you articulate an issue when you don’t feel confident enough to do so in a language different to your mother tongue? It doesn’t help that most of the senior staff and people in positions of power are white people. Even if they happened to not be racists, the power dynamics are skewed so we don’t feel open to raising an issue.
We have a major issue regarding human rights in South Africa. Most vulnerable people are not explicitly taught about our rights — we don’t expect to be treated with basic respect and dignity. You can’t really advocate for your human rights and demand that they are met if you don’t know they exist. History hasn’t done a very good job of showing vulnerable people that their lives matter.
I used to resent my mother because I felt she didn’t care about me and refused to stand up for me even when she would admit the treatment I received was subpar and racist. I couldn’t understand how my mother could sit on those old benches, in a waiting room with broken windows and dirty floors, at 5am; how she could articulate how awful it was and yet not do anything about it.
I would fight back my tears, swallow the lump in my throat, and bury my face in a book wondering: “Does she not love me? Why is she okay with putting me through this?”
My mom looked worn out, exhausted and cold — she would dress warmly, and keep the hood of her coat on, and cover herself in a big, navy-blue knitted shawl. She had to get up at 4am to get ready and get us to the hospital, where we would wait for several hours before getting me home and then go to work. She would have to work late for several evenings to make up for the half day she took off for the hospital; my mom needed to appease her bloated, perpetually red-faced tyrant of a boss.
Hot Water is published by Jacana Media.