Mobilising for Health Equity and a People’s NHI!

A Health Equity public meeting was hosted by the People’s Health Movement South Africa (PHM-SA) on 9 June 2018 at Community House, Salt River, Cape Town. The meeting was attended by about 120 health and human rights activists and community members. A range of critical health equity issues were addressed by speakers from PHM-SA, the Treatment Action Campaign (TAC) and the Rural Health Advocacy Project (RHAP).

Nowhi Mdayi (PHM-SA Steering Committee member) opened the meeting and called on health activists to unite to ensure health services for people in our communities!

Tinashe Njanji (PHM-SA Coordinator) spoke on health struggles in South Africa 40 years after the Alma Ata Declaration of 1978.

The People’s Health Movement’s alternative health analysis, Global Health Watch 5, was launched at the public meeting and copies of the book were available. David Sanders (PHM-SA Steering Committee member) gave an overview of the publication and spoke about global inequalities in health. Globally, eight men have the same income as 3,5 billion people. Similarly, in South Africa, 10% of the population have the same income as the other 90% – this is a problem for health, because health is about income, food, housing. To mobilise for global health equity, activists from 80-90 countries will participate in PHM Global’s Fourth People’s Health Assembly in Bangladesh in November 2018.

Karessa Govender of the Rural Health Advocacy Project (RHAP) spoke about Health Workers as Change Agents and Patient Advocates. She emphasised the need to change the negative framing of advocacy, and to reframe advocacy as a core competence and responsibility of all healthcare workers, which must be part of undergraduate health sciences curricula for all healthcare professionals: “Being able to effectively advocate should be as routine as drawing blood for a nurse or doctor”.

Masindi Zibaya (PHM-SA Steering Committee member) described how healthcare workers suffer because of lack of resources, supplies and equipment. During discussions, participants were interested in steps that can be taken to create awareness in communities about the need to make health advocacy part of the work of healthcare workers as well as of communities themselves.

Soundz of the South kept the meeting space vibrant and full of fire with their songs and poetry calling everyone to Join the Struggle for Health for All!

Peter Benjamin (PHM-SA Deputy Secretary) inspired us with a vision of Mobile Mobilisation for Health for All by launching PHM-SA’s new health advocacy mobilisation tool, BAVUSE! He pointed out that most people have cell phones today and that there are in fact now more cell phones than people in the world! The question is how can we use this for political mobilisation and for increasing people’s voice about health issues – discussing, organising and bringing change?

Even the most basic cell phone can do voice, SMS and USSD, and we can use this for mobilisation. PHM-SA had sent out one million Please Call Me ads the previous day – asking people to join the People’s NHI Campaign on BAVUSE! They could join free by dialling the code *134*1994*333#. More than 600 people had joined the campaign by the time of the meeting. This new BAVUSE! tool can be used to find people throughout the country and to get organised and mobilised around health issues in different provinces and areas.

Noma Rangana of Treatment Action Campaign (TAC) addressed the multiple challenges at healthcare facilities, the reasons for these challenges, how all this relates to the National Health Insurance (NHI), and the role of civil society in ensuring that government provides access to quality healthcare services for all. Treatment is not readily available in healthcare facilities because there are not enough nurses, patients wait for hours, and nurses do not have time to explain to patients how to use the medication or what its side effects are. There are infrastructure problems, not enough qualified healthcare workers, and facilities are too small for the communities they serve. Treatment Action Campaign did an infection control survey of 254 facilities and only 14 clinics met the quality standards. All this shows there is a great need for health systems strengthening.

The National Health Insurance (NHI) prescribes the number of doctors, nurses and the services a healthcare facility must provide. The NHI was started long ago, but today there is still no change. People in NHI pilot districts often do not even know they are in an NHI district – the service has not changed since the launch of the NHI in their areas. Where did the money go? Government has the power to ensure that the NHI provides access to quality healthcare services for all. There are many players in civil society – it is time for civil society to do something!

Anneleen de Keukelaere (PHM-SA Associate Coordinator) explained how BAVUSE! can support mobilisation for a People’s NHI. The plan is to use this tool to gain support from people across the country in the coming months. Once people sign up using the free dial code *134*1994*333#, we can communicate with them and mobilise for a People’s NHI in different provinces. A People’s NHI is based on the principles of universality and social solidarity.

Currently, government is planning a 5-tiered NHI system that undermines universality, social solidarity and social justice, because it will again fund healthcare in different ways for different sections of the population, e.g. the unemployed, public sector workers, and people working for big companies. This will perpetuate inequity and is against the fundamental principles of the NHI. To return to these principles and obtain a People’s NHI that ensures good, equitable healthcare for all, we need to mobilise! An NHI information brochure was distributed at the meeting.

Masindi Zibaya explained how she is using BAVUSE! with her cell phone to mobilise around health issues in the community: Information must flourish! Health for All Now – not tomorrow, NOW!

Elroy Paulus (PHM-SA Deputy Chair) closed the meeting by capturing the main points of the contributions and discussions, and emphasising the importance of thinking global, acting local.

See also the press release, “PHM-SA Demands Health Equity For All Now!” and another article covering the public meeting that was published in GroundUp, “Activists Launch Cell Phone Campaign For Better Health System”.