17 August 2002
National Women's Day is a day to commemorate women's struggle for change, to celebrate the progress, which has been made towards improvement of quality of life of women. It is the day for reaffirming our commitment to the work towards the liberation of women.
It is heartening that National Women 's Day has been and continues to be marked throughout South Africa by many organizations and groups. One of such special occasions was the burial of Sara Baartman, whose life reflects the sad history of all kind of oppression that African women were subjected to.
As we celebrate the National Women 's Day, we acknowledge that we still have a long way to go to achieve full emancipation of women from the hardships they have experience because of their race, gender and social class.
Rural women had the most difficulty in accessing education, health and other basic services. Where there was no running water, they were the ones who had to walk long distance to fetch water from the river for use by the whole household. They were the ones who had to go into the bushes and collect woods for families with no electricity. They literary kept the fire burning and kept families together while many rural men were in urban areas. Some women still face these challenges in their everyday life. Unfortunately, this major contribution made by women and rural women in particular has never been and is still not being valued or appreciated.
Migration is another major factor that has exposed women to several challenges including HIV and AIDS. Single sex hostels broke down the families and indirectly encouraged men to have "urban partners" while occasionally returning to their families and wives in the rural areas. Of course, this led to a spread of disease and sexually transmitted infections including HIV.
Sexual violence against women and girls and rape are issues that remain a challenge in our society. Poverty and poor living conditions have added to women's vulnerability to violence and increased risk of contracting sexually transmitted infections. The physical trauma of violence and sexual assault have left scars and unimaginable emotional damage on many women.
But I have some concerns that I would like us to address here and in other forums. These are matters that can assist in further interrogating the issues raised in a memorandum I received earlier today from the Association for Community and Rural Advancement.
We need to ask whether: "Are things getting better for rural women in South Africa, or are they getting worse, or are they staying the same?"
If things are getting worse, as a patriotic citizen of this country I ask why are they getting worse and what is it that I as an individual and part of a collective can do to address them?
If they are getting better, another question arises as to whether are they getting better fast enough for women who have been subjected to oppression for hundreds of years?
You, the rural women of Kgalagadi District are the only people who can answer these questions as you see them from this part of South Africa. All I can do is to reflect, briefly, on what I see happening in South Africa as a whole.
As a society we are all battling to come to terms with high level of violence and to deal with it. We know that the brutality of the previous regime, and the violence used against our people, has seriously affected all of us including our children.
The other major factor is that, although we still have a long way to go, our criminal justice system is improving. This has increased the reporting of cases because our people know that there is now more possibility of seeing justice being done.
The recent example is the arrest and successful prosecution of the man charged with raping Baby Tshepang in this province. As South Africans, we all welcomed the maximum sentence of life imprisonment that was imposed on David Potse after being found guilty of this barbaric crime against our children. This is a clear indication of advances we can make against crime through commitment and cooperation between a community and law enforcement agencies.
Other things have improved for women in SA, including for rural women, but we still have a long way to go in reaching our targets.
Free health care for pregnant women and for children under 6 years, was a major achievement. In many communities, the poorest women who in the past had not come nor brought their children to a clinic, started to visit health facilities. Women started to book earlier at antenatal clinics and therefore, increasing the chances of safe pregnancy and delivery.
There is still more to be done, and much effort now must be focused on improving the quality of care provided in those free services. As we move forward, we need not forget the period just seven years behind us. The days when women had to pay to attend clinics, and had to pay for a safe delivery.
In addition to making primary health care free (first for women and children, and later for everyone), the government also set about building new clinics and expanding or upgrading old ones. More than 500 new clinics were built, mostly in rural areas, and more than 2500 existing clinics were expanded, upgraded or received new equipment.
Again, much more still needs to be done to ensure that every clinic is fully equipped and is well maintained. We have started doing this through the Hospital Revitalization Programme - where we seek simultaneously to improve physical infrastructure, facility management and quality of care. The number of hospitals in the programme will increase to 36 a year from now. Sites are selected largely on the basis of achieving maximum impact and we have included some remote and resource-poor hospitals in our test batch.
The confidential enquiry into maternal deaths is something that has received less publicity, but is very important. Every nurse and doctor is now required by law to tell the provincial health department if they know of any woman who has died within 6 weeks of being pregnant. Any member of the public is also invited to report any such death. It does not matter if 2 or more people report the same death.
Once such a death is reported, there is a confidential enquiry into all the circumstances. The purpose of the enquiry is not to find the scapegoat. The objective is to establish if anything could have been done to prevent that death, and then to recommend steps that will help to prevent any future death that could be avoided.
We still have unacceptable level of women who still die after childbirth, particularly in rural areas. But we have improved a lot since this system of reporting and investigating the causes of maternal deaths was put in place. It is guiding our interventions and has definitely helped to improve the situation.
One of the most common causes of maternal deaths has, for many years, been infection after back street abortions. There are still problems with how some hospitals and some health workers are implementing the Choice on Termination of Pregnancy Act. The extreme example is the reported case of abuse of Termination of Pregnancy patients in one of the hospitals in Mpumalanga (Philadelphia) and we acted swiftly to rectify the problem.
The act is in place and it is effectively addressing the challenge of back street abortions. At Chris Hani Baragwanath Hospital, for instance, significantly fewer women are coming in with infection following abortion compared to a period prior to the implementation of this Act.
We need to encourage our women to utilise family planning services in order to prevent unwanted pregnancies and when they decide to get pregnant, to use the free antenatal care services available.
Other areas where there have been major improvements, though more still needs to be done, include the area of immunization. In the spirit of lestema, we need to go out to our community and encourage women to bring their children to the health facilities for full immunization. Full immunization protects our children from many disease including tuberculosis, polio, haemophilus influenzae type b, Perturssis (otherwise known as whooping cough). Health workers will be able to tell you at your clinic as to when you need to bring your child for different immunization injections and oral drops until the last immunization at the age of five.
During this year of Voluntarism, we have a duty to go out to lend a helping hand to those in need of care and support and women constitute a large portion of this group. Let us help children in need of care and many of those people who qualify to receive some social support from government to access their grants. These efforts, coupled with poverty eradication projects funded by government and various partners can assist us in alleviating poverty and improve the status of many poor women. We need not forget that poverty and gender inequality are the main factors that make women to be more exposed to many infectious diseases.
Services to protect women from cervical and breast cancer are available free of charge. However, what is crucial is for all of us go out and alert women to the dangers of these diseases. We have to advise them on what steps to take prevent and identify the symptoms of these diseases as early as possible for them to be managed. And our local clinics and hospitals will be able to assist in these campaigns
The most obvious improvement in the quality of life in rural areas has been bringing electricity into people's homes. Since 1994 more than 2 million households have been connected to the electricity grid. This has changed the lives of more than 10 million people, most of them in rural areas.
Clean, piped water supplies have also improved and have reached more than 7 million people since 1994. Again, most of these people are in rural areas. In addition, more than 1 million houses have been built since 1994, and a significant proportion of them benefit people from the rural areas.
Within the health sector, the most dramatic improvement for mothers has been the virtual elimination of measles. All grandmothers and the older mothers will remember that measles used to kill thousands of our children. And even when it did not kill our children, measles gave them terrible diarrhoea, malnutrition, and even blindness.
Today, measles has virtually gone. It started to disappear in about 1997 and by 2000 it was virtually gone. We have to remain vigilant, and that is why I have urged you to ensure that every child in your community is immunized against measles and other diseases. Mothers should never again have to live in terror of their child dying of measles or getting polio.
In conclusion, I must tell you that many of our advances as the health sector are dependent on health workers and professional that will have to work with our communities on the ground to tackle various challenges facing our people.
Together with Health MECs, we have realized that if there is major threat to our overall health effort, it is the continued outward migration of key health professionals, particularly nurses, and the vast urban-rural inequity in their deployment in the country. We have therefore instructed the Director-General for Health to work with the private sector, nursing organizations, trade unions and other relevant bodies to conclude a clear framework for attracting and retaining nurses.
My intention is to present and debate this framework in our regular meeting with the MECs within the next two months. .
I know that conditions for rural women are still difficult and that we still have a long way to go to achieve a truly healthy society. BUT I also know that we have made significant progress along what we have always known would be a long and difficult road.
As government we believe that true liberation comes with socio-economic and gender emancipation. And unless we can push back the frontiers of poverty, most of the democratic advances that have been made will be in vain.
Let us stand together and assist each other in achieving our goal of a better life for all.
Issued by Department of Health