Abegail Fleurs’s soup kitchen in Extension 10, Rhini, Grahamstown, Makana. The residents of Extension 10, one of the most recent housing developments in the area, have little access to EMS and other basic services. Photo supplied.
16 October 2015
Earlier this month, Health-e reported the difficulties of accessing ambulances in rural Eastern Cape. Here we report on how difficult it is to get an ambulance in a township as close as five kilometres from the nearest hospital.
Located on the windswept plain on the north-westernmost outskirts of Grahamstown, Extension 10, part of the Mayfield RDP housing project, boasts 1,200 colourful houses. Although most residents agree that the houses provide far more comfort and protection than the shacks they previously inhabited, people have been unhappy since they moved-in about two years ago.
“We have been chucked-away here in Extension 10,” says Abegail Fleurs. “The girl across the street was in labour, so I called the ambulance at 7:15pm. Promises, promises, promises. By 8:45pm, I called again. But when I said that I’m in Extension 10, the person told me straight that the ambulances don’t come to us. We ended up having to scramble to pay R60 to hire a car to get her to the hospital.”
“If you call the ambulance they won’t come; the same with the police. If we have problems in [Extension] 10, we need to walk to the corner shops in Extension 9 and wait for them [Emergency Medical Services and South African Police Service] to come so that we can show them,” says Catherine Gysman.
Home to a collection of people from various informal settlements in Grahamstown, the development managed by the defunct Makana Municipality was awarded a Govan Mbeki award for the best integrated residential development programme by the provincial human settlements department, despite allegations that not all beneficiaries received their homes legitimately.
“They say part of the reason they don’t come in here is because the roads are so bad, and the streets have no names, but the rubbish truck comes every week to collect the bags,” says Gysman. “It’s not only that, but when we need to go out at night, there are no streetlights so it’s too dangerous to walk.”
“Living up here means you wait too long for everything, if it even comes at all. We have been forgotten by our councillors who never come up here, so what must we do for help?”
Fleurs is unemployed. The family survives on child grant money and her husband’s piecework. But Fleurs always tries to have at least R5 airtime. “With the Blackberry I always have data so I post on Facebook, and usually I make a plan to have airtime so that if something happens people can come to me so that I can phone.”
Research done by the South African Human Rights Commission on the state of the Eastern Cape’s Emergency Medical Services (EMS) released earlier this month, found that the province is currently about 200 EMS vehicles short of national targets. (Health-e has reported extensively on this problem.) Plagued by poor management and chronic budget shortfalls, the repercussions often affect those who can afford it the least.
However, issues faced by Eastern Cape EMS (EC EMS) are not only related to poor management and a lack of adequate infrastructure. “It’s about the attitudes and perception of the emergency personnel. The new ambulance men, the new generation don’t share similar values. The problem is that internal issues are not being addressed when it comes to the service itself,” says Goodwill Featherstone.
An ex-ambulance man and EMS station manager, Featherstone is now manager of the Jabez Aids Health Centre. Three rooms and a minibus are used by the NGO’s community care workers to administer crucial HIV/Aids treatment and support to an existing database of residents of the larger Joza township area.
Jabez Aids Health Centre, Extension 9, Rhini, Grahamstown. Managed by Goodwill Featherstone the three rooms and a minibus are used by the NGO’s community care workers to administer crucial HIV/Aids treatment and support to an existing database of residents of the larger Joza Township area. Photo: Hancu Louw.
Featherstone took early retirement from the EC EMS after 25 years of service. “I couldn’t take the strain any longer. After the 1994 election, I think we reached a stalemate; funds were not enough to run the ambulance service. It was the time the taxis were coming in, they were overturning all over the Eastern Cape … It was heavy man.”
Featherstone says he has heard of the problems in Extension 10. “The problem I think is that the EMS personnel don’t know the area, so they ask for an escort to wait at a landmark to guide them to the case.”
Featherstone is wary to place the blame squarely on the Department of Health, suggesting that health care problems are as much about those who deliver service as those who rely on the service . “The problems aren’t only with the [emergency personnel], our people don’t always know what an emergency is … so it’s also about educating the people who live in our communities,” he says.
But in many cases the situation is urgent. “My husband had been suffering from cancer for many years, and it was getting to a point where he was permanently bedridden. One evening, he became very sick and we needed to get him to Settlers [local hospital] soon. I came to Fleurs’s house to make a call to the ambulance, although we know that if they come it will be only after a long time,” says Alta Barman.
Unsure the ambulance would come, Barman started asking around in the hope that someone might have petrol and a vehicle to transport them the five kilometres to the hospital.
“Usually what we do is ask them [EMS] to meet someone on the corner by those shops there,” she says, pointing to a couple of spaza shops about a kilometre away. “No one could take us and it was too late to get a taxi, so I had to wait in the darkness for more than an hour before the ambulance came.”
EMS staff were either restricted or unwilling to speak to the media. They said they needed the consent of a supervisor. After numerous attempts to contact representatives from the Eastern Cape Department of Health, the last communications received was from Sizwe Kupelo, departmental spokesperson: “I will establish facts before responding to these questions.”
Featherstone says, “People are out of touch; in Bhisho their fingers aren’t on the pulse. They don’t know the politics of the EMS … We just don’t have somebody who has balls that can stand up and take charge for EMS with the legislators in Bhisho to tell them what the realities are on the ground.”