A Journey to the Source: Reporters in South Africa Learn How and Where to Find People Behind the Stories

Jul 242012

Stretching across a broad expanse of wilderness along South Africa’s Eastern Cape, the Transkei is the region set aside for the Xhosa people by the old apartheid regime, ostensibly as an experiment in black self-governance. It is also the birthplace of some of South Africa’s greatest freedom fighters, among them Nelson Mandela, Walter Sisulu and Thabo Mbeki.

The Transkei has a proud history born out of poverty and neglect against which the people still struggle. With few industries in the rural areas, it remains one of South Africa’s poorest provinces.

I set out on a five-day journey with two young reporters and a camerawoman who are used to meeting the daily demands of the South African Broadcast Corporation’s television news and radio shows. As a Knight International Journalism Fellow, I have been working with SABC reporters to improve health reporting, including multimedia, and this was a great opportunity for some hands-on training. Often the starting point for a typical news story is a government briefing, an organization’s angry complaint – in this instance, from the unpaid members of the South African Medical Association – or, as I often find, a listener who views the SABC News phone number as a hotline to get an overwhelmed government moving. I want them to try something new, to invest time into listening to people tell their stories.

Since January, provincial governments already over budget had been struggling to make it to the end of the financial year with the expectation that new funds would ease a bit of the pressure. That was not to be. The fiscal year ended in April. In June, with winter settling in, SABC News television reporter Nomawethu Swandle; her trusty sidekick, camera woman Nomleh Diko; and radio reporter Unathi Binqose were still filing reports on doctors and nurses on strike, and a hiring freeze in the provincial health system.

For months, I’d urged them long distance from Johannesburg to tackle these stories from the ground up. This trip was an opportunity to work along side them, and push beyond the sound bites.

The itinerary I drew up took us right back to Madwaleni Hospital in Xhora, where Swandle had visited months ago. She relays with excitement a sound bite from a vexed patient, “You can come here carrying a sick person in a wheel barrel, and you’ll leave here with that person still sick in a wheel barrel.” I suggested to Swandle that that certainly was snappy but hardly revealing. Ask the next person to tell you the story behind the sound bite, I suggested.

So it was then that she found the young woman who came to the hospital at daybreak in a small truck with her baby and her mother, who was weak and breathless from tuberculosis. When the truck dropped them off, she carried them, one at a time, on her back to the hospital corridors. They waited in line to see a doctor, and then hours more, for the truck that brought them to be filled with other patients before the young woman could lift her mother back onto the floor of the truck. They said they would probably reach home by late evening when the arduous trek with mother and baby would be made from the roadway to the homestead in the hills of the Transkei.

Most of the patients express gratitude, and indeed the hospital is clean, nurses and doctors bustling from one examining room to the next, generally attending patients with a kind consideration despite the overwhelming demand.

The hospital’s administrator describes a scenario in which one burned out doctor after another, three European, one American, are resigning. Visas had expired, living conditions are poor and they don’t have enough tools, experience or supervision to meet the challenges they face. By July, the hospital could be down to two doctors unless reinforcements are sent in.

The reporters stand agog in a 28-bed ward shared by nurses who work, cook, sleep and bathe in shifts. Here they store food on the floor in open boxes they sarcastically call their “kitchen cabinets,” and block out the sun with uniforms hung on a line that stretches across the windows.

We’re told there are plans in the distant future for a $500-million renovation of Madwaleni Hospital, but nowhere is there any indication of new facilities for the nurses.

At the end of three days, upon my insistence, Diko, Nomleh and I sat, from 6 o’clock until midnight for a promised interview with the provincial health minister who bailed because he had an early plane to catch the next day. Instead, as is usually the case, it was the minister’s spokesperson who acknowledged the direness of the situation that has arisen when doctors and nurses don’t show up because the department has failed to meet payrolls.

In reality, a lot of it is due to bureaucratic bungling, papers that haven’t been filled out, in an arcane process which appears intentionally designed to delay the outflow of meager funds as much as anything.

Conditions in some of the Eastern Cape’s city hospitals are just as chaotic, but recover more quickly, establishing a semblance of order. Hospitals remain overburdened, however, because as bad as things are, they are a last resort when clinics can’t see patients because missing nurses aren’t replaced when they retire and doctors visit only once a week.

The reporters will continue to report to audiences on the “substandard conditions and accommodations” at hospitals and clinics in the Eastern Cape and other provinces. But after days of traipsing across the countryside, wandering through hospitals and clinics, seeing an ambulance rusting in a parking lot, observing scores of patients sitting quietly, they will know what a health system in near collapse really feels like.