South Africa-Social Welfare Health Care Services

Data as of May 1996

Until 1990 apartheid was practiced in most hospitals, to varying degrees. Some admitted patients of one racial group only, and others designated operating rooms and special care facilities for patients of certain racial groups. This practice often led to expensive and redundant services and organizations, and, at times, unnecessary neglect. A few medical personnel, nonetheless, ignored apartheid-related restrictions, especially in emergency rooms and public clinics. By the early 1990s, deliberate racial distinctions were beginning to disappear from hospital care in general. Health care services continued to reflect the status of the communities in which they were found, however; wealthier people had easier access to health care and generally received better care.

South Africa's health care facilities include hospitals, day hospitals, community health care centers, and clinics. In 1995 about 25,600 doctors as well as 24,500 supplementary health professionals, 160,000 nurses and nurses' auxiliaries, and more than 5,100 dentists and dental specialists were registered with the South African Medical and Dental Council (SAMDC) and the South African Nursing Council. In the early 1990s, only about 1,500 doctors, nationwide, were black. Wealthy white areas averaged one doctor per 1,200 people; the poorest black homelands, one doctor for 13,000 people.

Seven universities have medical schools, and six provide dental training. Nurses are trained at several universities, hospitals, and nursing schools. More than 300 hospitals are managed entirely or in part by provincial governments, and 255 hospitals are privately operated. There are an estimated 108,000 hospital beds nationwide, and almost 24,800 beds in psychiatric hospitals.

The South African Red Cross renders emergency, health, and community services, and operates ambulance services, senior citizens' homes, and air rescue services across the nation, but primarily in urban areas. Some areas also have twenty-four-hour-a-day poison control centers, child-assistance phone services, rape crisis centers, and suicide prevention programs.

One of the interim government's highest priorities in the mid-1990s is the prevention of childhood death and disease through nationwide immunization programs. The incidence of tetanus, measles, malaria, and other communicable diseases is high, especially in the former African homelands. For this reason, one of President Nelson Mandela's first actions after assuming office in May 1994 was to implement a program of free health care for children under the age of six. By early 1996, officials estimated that at least 75 percent of all infants had been immunized against polio and measles.

Malnutrition and starvation also occur in a few, especially rural, areas. These problems are being addressed through other elements of the government's RDP of the 1990s (see Postapartheid Reconstruction, ch. 3). Minister of Health Nkosazana Zuma noted in December 1994 that only 20 percent of South Africans have any form of health insurance. The government plans to institute a program of free universal primary health care, but health officials estimated in early 1996 that it might take ten years to implement the plan fully.

Social Welfare

Data as of May 1996