When South Africa was still governed by the racist apartheid system, laws that separated and targeted each race made life nightmarish for anyone who wasn’t white. Being of Indian origin, my family sat somewhere on the middle rungs of the social structure, with white people at the top and black people at the bottom of the socioeconomic ladder. Schools, neighborhoods, beaches, public toilets — everything was segregated, and the resources funneled into each of these areas was minimal for black citizens. Health care was no exception.
My aunt was a nurse and a midwife under apartheid, and although she is now over 70 and claims that her “forgettery” has overtaken her memory, some of the horrors witnessed under that brutal regime cannot be wiped clean from her mind.
Nonwhite nurses (black, Indian, and colored ladies) had to train and work in nonwhite hospitals. They were not allowed to treat white patients, and the only contact Auntie had with white nurses was when they came to nonwhite hospitals to supervise. As far as salary went, the white nurses at the white hospitals got 50 rands per month, the Indian nurses got 10 rands, and the black African nurses got a grand total of 4 rands. Salaries improved somewhat after they graduated. But the conditions under which nonwhite patients were treated was appalling.
After hearing my aunt’s stories, I am ashamed at the lame thoughts I had after my own baby was born, like lamenting the fact that the lactation consultant didn’t have the time to show me the proper technique for the “football hold” method of breastfeeding. In contrast, my aunt once heard another nurse walk into the maternity ward and instruct all the new mothers to feed their babies with these words: “OK, cows, time to produce milk!”
Auntie recalls how she saw all the new babies being bathed, one after the other, in the same dirty bathwater. She would see overwhelmed mothers on her rounds, and when she returned later in the day, she’d sometimes find only an abandoned baby. Auntie worked with a heavy heart when she was assigned to take care of these children. Their bassinets were crowded in a small, windowless room. She was so busy preparing formulas, changing diapers, and bottle-feeding that there was little time to hold and cuddle them.
Many rural women only came to the hospital in desperation after hours of trying to deliver naturally. Some of them would walk for miles and miles to get to the hospital and would be totally exhausted when they arrived. Because hospitals for black people were so ill-equipped, they didn’t have ambulances, and people used wheelbarrows to get their loved ones medical care when they couldn’t walk. Auntie recalls that “women often came with their traditionally painted faces and were embarrassed that the sheets were getting stained with the ochre-colored washable paint. I think we were pretty good in reassuring them it was OK.”
The delivery room was huge. Beds for vaginal deliveries were lined up against one wall, beds for women with high-risk cardiac problems were in the center, and beds for women with preeclampsia — which is very high-risk — were against the opposite wall. Women with preeclampsia were separated by a curtain as they were sedated. There were no screens between any of the other women. They delivered in full view of one another.
The post-delivery room was also always packed to capacity. This included mattresses on the floor. Nurses and patients could barely walk between the beds. Sometimes two or more babies were delivered in rapid succession. A nurse would have to tie the umbilical cord and place the baby on the mother’s chest, with a sticker with the mom’s name on the baby’s back and a band with the same info on the mom’s arm, before attending to the next delivery in the same row of beds. Umbilical cords were cut only after the delivery of the placenta, but this also helped to prevent a mix-up of babies.