Mandela’s Dream in the Eastern Cape

Nelson Mandela, our beloved Madiba, is no longer with us, but his eldest grandson, Chief Nkosi Zwelivelile Mandela, is still very much alive and showing inspiring leadership in the Eastern Cape Province of South Africa. Chief Mandela has requested Health Promotion South Africa (HPSA) Trust to create its first Health Information Centre outside the Western Cape at the new Nelson Mandela clinic in Mvezo. A small rural village on the tranquil banks of the Mbashe River, Mvezo is the place where President Mandela was born, near Qunu where he grew up. Situated in the heart of the former Transkei homeland, this area lacks adequate healthcare facilities and has a history of neglected basic health education.


The health challenges in this area relate to the lack of infrastructure in general. With few roads, there is greater isolation and more difficulty to get to health facilities, if they are available. Typically, a hospital needs to care for 10 to 15 villages, which means long distances for people to get there; too long in the case of emergencies. Clinics are situated to accommodate two to three villages, but there are no full-time nurses at all clinics (they come from the nearest hospital). The Mvezo clinic has nurses visiting once in two weeks, and in between there are no services available at the clinic. With Health Promoters, the people will have the opportunity to do a lot more for themselves.


The rural health system is not well developed yet, similar to the education system and other infrastructures. For example, in some areas there is now pumped water from underground with little or no monitored purification. The same water is untested for direct drinking from the source, but people drink it anyway. In places that do not have access to this water, rivers are still the main source – and they are no longer clean; their quality is also untested, yet they still serve as the main source for drinking water. As the population grows, health issues emerge such as skin problems and (infant) diarrhoea. Aqua purification tablets could have been a partial solution, as an alternative to boiling, if they were available. In rural areas there are also plenty of domestic and wild animals freely roaming around, contaminating water resources, and leading to a greater danger of transference of disease from animals to people. When a health (or life) threatening event occurs, there are normally no experts around to ask for assistance. Trained Health Promoters would be the best immediate first point of contact to rural people.


The Eastern Cape is one of the very lovely parts of South Africa. It is peaceful and has a beautiful flowing landscape. The vast rural areas, far away from city life, make it attractive to the steadily growing numbers of inhabitants. But the isolation has its costs to people’s health as the cost of infrastructure development is high, and the pace of progress is slow. People feel they are voiceless and powerless. HPSA can help to ease this burden by providing trained Health Promoters to support the people in between visits of the over-worked nurses and doctors. Western Cape already benefits greatly from HPSA services. The next big priority for HPSA expansion is the Eastern Cape, where the ripple effects will be large and the dream of Mandela can yet become a reality.

Author: Jeff Balch

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