Umtata, 8 December 2004
Minister of Health, Dr Manto Tshabalala-Msimang,
President Nelson Mandela,
Premier of the Eastern Cape, Nosimo Balindlela,
Their Majesties, the Kings of the Eastern Cape,
MEC for Health, Dr Bevan Goqwana,
Honourable MECs, MP's, MPL's, Mayors and Councillors,
Chief Executive Officer of the Nelson Mandela Academic Hospital, Rod Allen,
Distinguished Guests,
Comrades, Ladies and Gentlemen:
I would like to thank our Minister of Health, our Premier and the CEO of the Academic Hospital for the opportunity they have given me to participate in this important occasion of the opening of the Nelson Mandela Academic Hospital.
The first time I came to Umtata was in 1959. We were expelled from Lovedale High School in the same year and therefore I had to cross the Umbashe River from Edutywa to write my Matriculation examinations at St Johns, here in Umtata.
I tell you this short history to make the point that I have some familiarity with what this town and what the Transkei looked like in the past. As we project and pursue the vision of a better life for all, I believe that together with you, I have an idea of what Umtata and the Transkei should look like in future.
But because I know what Umtata and the Transkei were, and because I have an idea of what Umtata and the Transkei are today, I also know that the dreams you and I share about both these areas will take time to realise.
There are some in our country who like to pretend that it is possible to fulfil those dreams in a short time. Speaking in eloquent tongues, they tell the country the plain fabrication that miraculously, our own Rome can be built in a day.
They pretend that by now, ten years into our democracy, we should have cleaned out the dirt that accumulated during a long period of three-and-a-half centuries of colonialism and apartheid. Thus do the victims of misrule get transformed into the perpetrators of that misrule.
Accordingly, those that benefited from our oppression are very happy to make loud noises claiming that we are the cause of our poverty and underdevelopment. They say that when we refer to the legacy of colonialism and apartheid, we are merely making excuses for our failure to meet the legitimate expectations of the people.
Kodwa ke sisonke silapha siyazi ukuba akukho ibitheni ngosuku olunye. Nangwev' exhathisa ngomsimbithi, yaqal' ukuhamba ngokukhasa.
(But all of us here know that one day's work does not amount to much. Even the old man who now leans on a walking stick started to walk by crawling on his knees.)
To those who would like to pretend that they know better, and are entitled to claim that their maturity in years gives them the right to expect that democracy will cause manna to fall from the heavens, I will respond and say - ubododa abukhulelwa: ubudoda ngamava!
(Mere age does not amount to manhood: to be a man is to be wise.)
Abo banamava bathetha bathi, notywala besiNtu buyalindwa!
(The wise say that it takes time even to brew traditional beer!)
We have gathered here today to open a world-class hospital. There are many in the world who describe our transition from apartheid to democracy as a miracle.
If that is so, I would like to add that the existence of the Nelson Mandela Academic Hospital at Umtata, in the Transkei, is a miracle. Even more miraculous is the fact that the Transkei is home to the first Academic Hospital that democratic South Africa built during our first decade of liberation.
I would like to believe that what we have done together, to bring to life this outstanding health facility is a precursor of things that are yet to be.
When we built it we sought to make the statement that liberated South Africa is determined to break with a past that defined the Transkei and similar areas in our country and region as giant rural hospices.
These are the areas to which broken migrant workers returned to await their certain death.
These are the areas which imprisoned large rural populations, forcing them to try to eke out an impossible existence from soils that had been degraded and turned into barren waste by their transformation into what were called Native Reserves, and later Bantustans.
When we built this hospital, we sought to live up to the pledge we had made as a people, that we will do everything we can to meet the commitment to achieve the objective of health for all.
And so we must ask and answer the question - what is so special about this particular hospital!
This hospital will serve and help to address the health needs of 2.5 million people in this rural region that was formerly little more than a labour reservoir and a homeland of endemic ill health.
We expect that from a child from Misty Mount, a mother from Bomvana, to an indigent grandfather from Tsilitwa all can be referred to this hospital from over 20 clinics and health care facilities, and receive as close to their doorsteps as possible, the benefits of leading-edge, world-class medical technology and services.
Our strategic approach to delivering health care services has been developed holistically so that patients can first access a clinic such as the Mbekweni Community Health Centre or referral hospitals such as St Barnabas in Libode, St Patrick's in Bizana, St Lucy in Tsolo or even the Old Umtata General Hospital.
From there, if specialist medical care is needed, the patients will then be referred to the Nelson Mandela Academic Hospital. In the past, people from this region, who were in need of care provided by a tertiary hospital, had to travel to Bloemfontein or Durban.
This imposed a heavy burden on many of our people because of the cost and difficulty of travel. As a result, many people simply had to do without the necessary treatment, often with avoidable fatal consequences.
Among other things, this Academic Hospital will help us further to develop our capacity to access to tele-medicine, bringing the most modern information and communication technologies to this very rural part of our country.
The Nelson Mandela Academic Hospital is also a practical example of partnership among all spheres of government and civil society. In this regard, national government has worked together with the Eastern Cape provincial government, the O.R. Tambo District Municipality, the King Sabata Dalindyebo Local Municipality and the Walter Sisulu University of Science and Technology.
The construction of this hospital has also made it possible for 40% of its contractors to benefit under the government's black economic empowerment tender procedures.
Furthermore, this academic hospital will serve the practical training needs of the students and specialist graduates of the Walter Sisulu Medical School, (formerly the UNITRA Medical School).
In an era when we have seen a brain drain of health workers to the developed countries of the North, it is very heartening that the graduates of Walter Sisulu Medical School have shown unwavering commitment and dedication to the imperative to serve the masses of our rural masses.
We are inspired by the pioneering initiatives of the Faculty of Health and Sciences at the Walter Sisulu Medical School, which have implemented problem-based learning and community-based teaching programmes for 480 medical students to train and work in local communities.
The combination of such a progressive medical curriculum with a state-of-the-art hospital is unique. We must treasure this synergy of academia and actual practice. It should be the role model that we use to help us regenerate our villages, our towns, our provinces, our country and our continent. Indeed, this provides one of the many optimistic reasons why we confidently call the 21st the African Century.
Ten years ago, all this would have looked like an impossible dream. Then, Umtata was nothing more than a backwater of the apartheid system, the capital of the Transkei Bantustan where there were no decent medical facilities, while the medical facilities in Pretoria, Johannesburg, Cape Town, Durban and other medical institutions that served the white minority, were state-of-the-art establishments.
Because of disregard for the human dignity of black people, people from the Transkei and other areas had to cross provincial boundaries to get to overcrowded black academic hospitals such as King Edward in Durban.
Today we are happy that we are able to bring up-to-date health services closer to our people. As we celebrate our first decade of liberation, we are proud to say that this hospital is a shining beacon containing within its precinct our finest expertise in doctors, nurses and other medical and health care workers.
We should celebrate this property of the people by guarding and protecting what is a jewel in our health care system. We dare not allow it to fall victim to neglect, vandalism, corruption and theft of the basic things that make this an excellent and efficient hospital.
I am confident that hospital managers, nurses, doctors, specialists, interns, community service doctors and other health care workers, will all continue to perform in the manner that has always made health workers in our country such special and exemplary professionals.
At the same time, we need members of the community who sit on hospital boards to contribute to the success of this hospital even as they act on all legitimate complaints of patients, to ensure that our delivery of health care services is of the highest standard. Each and every one of us should develop a sense of ownership and custodianship of this hospital and indeed the entire health care system everywhere in our country.
The Nelson Mandela Academic Hospital cannot exist in isolation. It is part of the whole system of our public health facilities and support services. Any weakness in any of our facilities will threaten the quality of care that this hospital can provide.
As we know, government has embarked on a long-term plan called the Hospital Revitalisation Programme. Through this programme we have adopted a new integrated approach whereby we incorporate the latest, most effective and cost-effective health technology with organisational development.
Among others, there are 31 hospitals under this programme, of which 11 are brand new and the rest are being or will be upgraded, including the Old Umtata General Hospital.
As government we invest in infrastructure such as this project because we believe that as we fight poverty and strive to nurture the conditions conducive to the creation of work opportunities, we need at the same time, to stimulate the creativity and energy of our people to fight against the depressing marginalisation of many areas in our country, and the debilitating health circumstances which afflict them.
There are many others, apart from health care workers, such as contractors, caterers and cleaners, who will benefit from this institution. This speaks to the integrated impact of our development initiatives, a people-centred goal we must pursue.
The OR Tambo Municipality is second to the Nelson Mandela Metro as the most populous area in this province and perhaps the poorest. Accordingly, we have to make a special effort in areas such as this, so that our programmes of fighting poverty and underdevelopment have the desired effect.
This hospital project is part of the important programme of government focused on the 13 poorest rural nodes that fall under our Integrated and Sustainable Rural Development Programme.
Currently the Government is assessing this and other development programmes, including the Urban Renewal, Agricultural Support, Small and Medium Business and other initiatives, to ensure that we put in place the means and resources to ensure that these interventions actually succeed in their intention.
As government we have dedicated our Second Decade of Freedom to the effective implementation of our programmes, decisively to create jobs, push back the frontiers of poverty and expand access to a better life for all. That access to a better life for all must necessarily mean better health for all our people, among other things.
And by better health we mean better health. We mean access to good and adequate nutrition, clean water and sanitation, and healthy environmental conditions conducive to good hygiene and other conditions of life, free of pollution.
We mean the creation of socio-economic conditions leading to a radical reduction in drug and alcohol abuse, as well as crimes of violence against the person such as rape, abuse of women and children, assault and assault with intent to cause grievous bodily harm, and murder. We refer to the reduction of accidents on our roads, to reduce the rate of death from unnatural causes.
To achieve the goal of a better life for all, we are determined to develop an objective and scientific profile of the burden of disease in our country, properly to understand what causes illness and death among our people.
We are determined to make certain that the public health system responds in an accurate and timely manner to our actual health conditions, including the diseases of poverty, tuberculosis, water-borne illnesses, infant and maternal mortality, respiratory diseases, diabetes, sexually transferred infections, AIDS, cancers, mental disease and others.
We are determined to ensure that we construct a health infrastructure with a strong primary health care base, an equally formidable middle echelon and an excellent tertiary sector, as exemplified by this Academic Hospital. In all instances we aim to make certain that our health facilities have the necessary physical, technical and service infrastructure, personnel, drugs and medicines, and access roads, properly to discharge their responsibilities.
In this context, I must also reaffirm our determination further to improve general access to traditional African medicine and medical practice. We salute the Medical Research Council for the work it is doing in this regard, which will help us to catch up with such areas of the world as China, India and Latin America, as well as defeat the inferiority complex imposed on us by racism, colonialism and apartheid, based on the notion that indigenous African knowledge amounts to nothing more than barbaric superstition.
To achieve the goal of better health for all, we have to ensure that our people have access to affordable drugs, medicines and services. We do not, will not, agree that individual and corporate financial profit should take precedence over the lives of our people and the realisation of the goal of a better life for all.
At the same time, we will work to ensure that the private sector continues to function as a viable partner in our comprehensive national health system. In this regard I must reiterate what we have said before, that we have absolutely no intention to suppress or weaken the private health care providers, in all their sectors.
Nevertheless we cannot ignore the imperative that our first task is to serve the interests of the poor of our country. These, the millions that have consistently voted us into power, are subject to levels of morbidity and mortality that cannot be reduced through subservience to the dictates of a market economy in the provision of health care.
I am confident that we will continue to work together to meet all the challenges and opportunities presented by this Academic Hospital.
I am delighted and honoured to declare the Nelson Mandela Academic Hospital officially open, as well as wish all who work in it and the patients they will serve, good health and success in their work and the realisation of our common dream.
This day is one of celebration because this hospital represents a further expansion of the vistas of hope that freedom has brought all of us.
Sigide, sisine, ngoba okukwanda sikuvuyelayo namhlanje ngezamazik' wempilo kwaliwa ngabo bangabathakathi!
(Let us joint in a festival and dance, because the expansion of the health services we celebrate today is opposed only by those who dispense the witch's evil.)
Thank you.