Donald Trump and Motsoaledi’s Damascus moment

By PHAKAMISA MAYABA

Emerging from flunkable stints in both the embattled departments of home affairs and health in a vegetative state, one never have thought anything worth paying attention to would ever escape the lips of Dr Aaron Motsoaledi. Seen as the paragon of a non-performing minister, his medical qualification may have spared him the usual accusations of being just another useless, unqualified deployee.

But following a report by the Health Ombud and Office of Health Standard and Compliance (OSHC) requested by Motsoaledi himself, the minister’s recent utterings have caught us unawares, leaving one wondering if he isn’t experiencing something reminiscent of a Matthews Phosa ‘Damascus moment’ whilst at the same time granting validity to the sentiments of the chattering classes. The cognoscenti have long maintained that government departments are straitjacketed in red tape, and navigating one’s way around it is an exhausting process with dire potential consequences, particularly for the multitudes who depend solely on the public service.

Former President Thabo Mbeki knows all too well that dragging one’s feet, especially on matters of health, is a ticking time bomb. It could mean blood on one’s hands. Lots of it, and it’s often too late to say sorry as millions die on your watch and your political enemies gleefully scurry to use it against you when they feel you’ve overstayed your welcome at Mahlamba Ndlopfu.

Like Phosa, perhaps Motsoaledi, who sprang into action following former 702 and Cape Talk broadcaster Tom London’s indicting viral video about his stay at Johannesburg’s Helen Joseph Hospital last year by instructing the Health Ombud to investigate the matter, has finally seen the light.

The jackboot of bureaucracy is antithetical to progress, and flies in the face of necessity and pragmatism. It’s counterintuitive to government’s own commitments to – inter alia – rebuild infrastructure, and stands in the way of all efforts aimed at staving off what is clearly a country where all manner of dilapidation and disgruntlement are waiting to happen.

Tom London’s video that exposed the sad state of affairs at Helen Joseph Hospital. Video: YouTube.

In said video, London complains about the appalling state of the facility — from broken toilets to general infrastructural decay and an impersonal staff who lack a sense of agency. Uncharacteristic of the archetypal political principal, browbeaten to tow the party line, Motsoaledi’s reaction thereto was so left of field as to be (prematurely) commendable.

He could’ve pulled a Qedani Mahlangu, former MEC for Gauteng Department of Health, who testified before the Life Esidimeni arbitration hearings where some 144 mentally ill patients had died in the hands of what would mostly later be revealed to be unfit NGOs. Experts had warned against the so-called ‘Marathon Project’ – moving those patients into the care of said NGOs. Sadly, those warnings fell on deaf ears, and in due course we had a crisis on our hands. Bear that word in mind: crisis!

For most of her testimony, Mahlangu seemed set on saving her own skin, showed little remorse, and was in perpetual deflective or denial mode. But the findings of former Deputy Chief Justice Dikgang Moseneke – bless his heart –were unforgiving. Of Mahlangu, he said she was ‘aware of the full risks of implementing the Marathon Project. She ignored and indeed brushed aside the warnings at many levels that death might ensue and it did. Her overall conduct was irrational, inexplicable, highly reckless and led to the death of at least 144 mental health care users.’

But back to Helen Joseph. According to Health-E News, ‘The Gauteng Department of Infrastructure is the implementing agency of the department’s infrastructure developments. At the moment the hospital CEOs do not have powers to fix anything in their facilities.’

But Motsoaledi wasn’t going to save anyone’s hide. ‘The lack of delegation is an issue,’ Health-e News quotes him as saying. ‘You can’t manage a hospital from an office in town. That’s why the NHI Act says, especially academic hospitals, must be autonomous. The CEO and the board must be able to do anything, including procurement.’

‘There is a department called DID (Department of Infrastructure),’ he continued, ‘I don’t even want to hear that name. It causes me problems. I once exploded when I was visiting Chris Hani Baragwanath Hospital and I found that globes were not working. I asked the CEO how on earth can this happen, and he said no minister, I don’t have delegations, anything to do with infrastructure is delegated to DID.’

But Motsoaledi’s most exemplary comment was this: ‘After the video by London, Gauteng Health announced that they were going to rush to the hospital, but I said the appropriate structure to investigate the allegations is the ombudsman and OHSC. Because when you investigate yourself, you will leave the ugly parts aside. And I said Gauteng Health can’t investigate itself.’

That was the part that elicited my knee-jerk appreciation until I thought, wait a minute, how many hearings and commissions of inquiry have we lived through post democracy that have actually seen those fingered for malfeasance being held criminally accountable? Don’t worry … I’ll wait.

In light of the issues facing Helen Joseph in general and the entire public health sector in particular, US president Donald Trump’s cessation of all Pepfar (the President’s Emergency Plan for AIDS Relief) funding to South Africa last month doesn’t appear to have been given the attention it so urgently deserves. A staggering 84 per cent of South Africans rely on a public health sector that is, amongst others, famously underfunded and overcrowded. We have the lowest doctor-patient ratio of 0,9 per 1,000 when compared to other BRICS countries. Infectious diseases like TB remain problematic, responsible for some 54 000 deaths in 2022.

What do such statistics hold for a country with at least 7.8 million people living with HIV? And why does there seem to be little alarm when researches predict that some 601 000 people will die from AIDS-related deaths, and 501 000 more be infected, as a result of Pepfar withdrawal in the next ten years?

The grim tales are writ large across the country’s public health facilities, but perhaps the one that has slipped under the radar is the rampant corruption that lurks freely in the sector. Even more than Trump’s regrettable executive order, this is the one area that will probably be responsible for much of the catastrophe that potentially lies ahead. As the Covid-19 pandemic so crassly demonstrated, a health crisis is fertile ground for the flourishing of all manner of corruption. Whether it was the lay-by frontline worker selling off food parcels meant for the poor, the slew of unscrupulous PPE tenders, or the massive Digital Vibes looting, in the panic and chaos of a crisis, the plunderers have a field day. The ongoing narrative, however, has been overly fixated on Trump – the presidential candidate that the leftist press has warned against.

Given South Africa’s unwavering stance on the Israel-Palestine conflict, it is doubtful that any diplomatic overtures will twist Trump’s arm. His recent kicking out of the South African ambassador to the US, Ebrahim Rasool, coupled with his knee-jerk statements on white Afrikaners suggest that the Donald has it seriously in for Mzansi, and he doesn’t seem at all bothered that a few hundred thousand previous Pepfar beneficiaries might perish as a result. His intention is to teach us a severe lesson: what the MAGA boss says, goes. But perhaps the lesson that may have landed unintentionally is that in uncertain geopolitical climes, self-sufficiency is a bulwark against indignity.

The country that is capable of looking after its own, fighting its own wars and prospers alongside allies who show mutual respect is the God-ordained pursuit which all nations owe to their citizenry. As the Trump and JD Vance versus Zelensky spat so succinctly showed; being the underdog is only adorable in sport or in the movies. In geopolitical power battles, it leaves you looking like a bum, pretty much like the image of our leaders running to the West, cap in hand, to grovel for charity. How demeaning it must be; the one president is fully behind your war effort, the next administration is demanding a comeuppance, sommer telling you to dress properly next time.

Whatever our leaders might tell us about having their act together in the face of the severed aid, reality says it might be an early winter for those affected by HIV/AIDS. As it is, the health sector is facing serious financial impediments, and no amount of political grandstanding will make up for an estimated loss of R3.7 billion in free money this year alone.

Although it is no skin off the teeth of a certain class where HIV is no longer the menace of the Mbeki denialism years, one hopes that government will meet the issue before the bodies start piling up. It is all good and well for Motsoaledi – and his counterparts for that matter – to rope in independent bodies to investigate their respective departments. But if there was ever any justice in the world, it would be to see some of them playing cards with the 26s in prison. Few things would be such an effective lesson to others that when you steal from the sick, a lot of innocent people die.

FEATURED IMAGE: Health Minister Aaron Motsoaledi … ‘Damascus moment’ about Helen Joseph Hospital. Image: GCIS on Flickr.

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This is an edited version of an article that first appeared on Phakamisa Mayaba’s website, eParkeni. Used with permission.