Human Rights Violation Hearings — Cape Town — 1997-06-10

NEIL MYBURGH: I was just one of a team that have grown to a size of about 35 people of the Mpiliswane Saca Clinic in Crossroads, a Clinic that ran from 1980 until its demise in 1986.
 My particular job there was to run the dental section and as co-chair of the Clinic Committee, whatever I say now really has to be taken as one small piece of the jig-saw puzzle that is being assembled here and I hope it accurately reflects what the other staff of the Clinic and those we worked with, experienced at the time.
 I will briefly take you through some of the background of what we saw to be the role of the Clinic.  As I rethought through this process, it became very clear that our experience here, might be equally relevant in the discussion around the abuses of the medical profession which will be heard in about a week's time and so the information could be equally well presented there.
 I however will take you through what we saw as the role of the Clinic and particularly our experiences in 1985 and then the May, June period of 1986 which led up to the closure of the Saca Clinic and the occupation of the Clinic by the South African Defence Force at that time.
 Dr Bletcher will follow up with far more medically specific information and some of the cases which we dealt with.
 The Saca Clinic was a project that was a combined effort of the community and Christian activists.  It grew and developed and it attempted to respond to the real needs, the health needs of the community, but it soon became clear that it was more than just a health care delivery system and it became surrounded by a range of activities from childrens' art sessions, nutrition centre, advice office, UCT student legal resource sessions, social welfare services, community worker training, sewing, bookkeeping, typing, printing, educare developments and numerous other activities that came to complement the medical and dental services.
 Both in practise and in theory the clinic became a community based and community governed project.  It was significant in how it developed into the conflict period.
 Final responsibility for policy and decision making was in the hands of a clinic committee elected annually at an AGM of clinic patients.
 In an ear of political and social oppression it is no surprise that both the Crossroads community and the Saca Clinic itself, came to be seen as a "political" and potent symbols of resistance to the apartheid government of the day.
 Retrospectively one can also see that it had evolved into more than just a clinical service and it became a comprehensive community development enterprise.  And an innovative model for community health and development.
 The Crossroads community like many others, was not supposed to exist, it was illegal.  It therefor did not need to be supplied with basic services such as sanitation, water and health care etc.  In fact the health authorities of Cape Town were involved in successive attempts to get rid of Crossroads by classifying the area as a health hazard to Cape Town.  You can read the Argus of 23 May 1984 if you want to see one of the accounts.
 Medical and administrative people responsible for those efforts, have never been challenged to apologise or atone for this.  The Divisional Council of the Cape repeatedly closed the doors of its clinics when the slightest rumour of unrest filtered in from the townships.
 Having no relationship with the community, it rendered them useless in these circumstances and they were unable to take on their responsibility for health care provision.
 Their failure to remove sewerage buckets and refuse at such times, were among the real health risks and discomforts they imposed upon this community.   The Cape Provincial Administration likewise refused to acknowledge the need for day hospital or primary care facilities.  Only later when the Saca clinic was established, did they agree to subsidise a small portion of the salary bill.
 It was in response to this officially determined neglect that the Saca Clinic actually came into existence.  Supported by a determined community and in the face of tremendous odds, it became a source of nurture and development.
 Conflict with the State took various forms.  Perhaps the most noticeable was the 1985 shootings in February of that year.  The rumoured arrival of a relocation squad of about 600 men in Khayelitsha circulated the community on the weekends round about the 16th, 17th of February and people decided to stay home on the Monday.
 This let to direct and immediate confrontation with the police and we were very soon seeing numerous injuries from buckshot, rubber bullets and shot ammunition.  Some of the statistics will be presented to you by Dr Bletcher.
 Until that time, demolition and construction of blanket shelters, plastics and other shacks and tear smoke were the normal form of State aggression in the area.
 Sadly this also was seasonal, especially in winter.  On Monday the 18th of February, people stayed home.  The confrontation with the police led to the injury of hundreds of people, many of whom we treated.
 Staff were cut off for two days and many slept at the clinic overnight.  The whole area was cut off.
 Some recurring images of that time that I still have, I remember dealing with patient Mda who I had cared for during the afternoon.  He was really in pain and we had to give him Pethidine.  In the early hours of Tuesday morning, his family returned his body to us, to confirm his death.
 Some buck shot had penetrated deep inside him and caused damage no one had been able to see.  I recall dodging policemen firing wildly on my way across Klipfontein Road to the N2 and the SOS intercom number 18 to meet the Metro ambulance service personnel who delivered the Pethidine.
 They were not willing to come in to deliver the emergency supplies to us or to collect patients and internal community taxi service had to take this on, at even greater risk for the drivers.
 Perhaps the worst memory of all was that of returning to the clinic to find staff in tears and the rest mopping up the sea of blood lost by the first of our patients to die there
 The massive blood loss from his bullet riddled groin had been too much despite a huge effort from the clinic's medical staff.
 This was also the beginning of a cycle of violence.  The first deaths were followed by funerals which were banned gatherings which led to further confrontation and the cycle of fortnightly funerals and deaths followed us right through 1985.
 Sadly these experiences were to reoccur again and again.  And while we became a good team at coping with these, we never came to terms with the deaths and injury and left its mark.  We also had to seek supplies because we were not a wealthy clinic by any means.
 We tried to get them from Groote Schuur, additional drip sets and emergency equipment and from the Metro emergency services, but they refused.
 The only help was from the superintendent from the Guguletu day hospital who did us where he could.  It also generated another problem - while severely injured patients had to be transported to tertiary hospitals such as Groote Schuur and Tygerberg, they woke up under police guard at Tygerberg and at Groote Schuur, their names had been underlined in red on the records.
 Fortunately the Red Cross led to the SAP guards being withdrawn, but neither institution has ever acknowledged this bridge of medical ethics and it had serious repercussions for us later that year.
 When conflict broke out again in 1985, in July and August, October, patients who arrived at our clinic with severe injuries, refused to be referred for care at these institutions.  In stead we had to set up an in patient service for which we were not well equipped and it was from ideal care for these patients.
 Added to this were the difficulties of the regular SAP and SADF raids, cordons, road blocks, house to house searches.  There was one serious attempt to seize patient records and no warrants to search the premises or to seize the records was ever provided.
 It clearly was an ongoing attempt at intimidation more than anything else.  I was charged with being in a Black area without a permit.  I was chased by the SADF and SAP personnel on at least four occasions.  These experiences are not unique.
 Other staff had the same.  The conflict with the Executive Committee at Crossroads, later known as the "witdoeke" and headed by Johnson Ngxobongwana was represented on our clinic committee and we had a collaborative relationship but reactionary political agenda started to become visible in early 1986.
 This increase in conflict led to the seizure of the clinic keys by the Executive Committee on Monday, 5th of May.  Staff and patients were locked out. 
 Complaints that we were too political, that the staff was rude was never substantiated.  In fact a recent survey of patients at the time, had indicated none of these complaints and a very high level  of satisfaction of the clinic's services.
 After a week of exhausting negotiations an agreement was in fact reached with the clinic Committee, signed by four members of the Executive, including Prince Gobingca, Cede Nzungu, one name I cannot read at this stage and Sam Ndima and co-signed by the clinic Committee.
 In short guaranteed safe access for staff and clinic access to all members of the Crossroads community.  Sadly within two weeks of this, the real conflict on the satellite squatter areas on the western edge of Crossroads, broke out on the 17th of May.  In fact that is less than a week after this document was signed.
 Clinic staff continued to work at the clinic, but found themselves in "witdoek" territory.  And were unable to actually treat half the community who normally were the clients of the clinic.  
 Clearly access was not free and equal and clearly the safety of the staff was now beginning to be threatened.  The staff was divided into three teams and they began to work at other sites, including Site B, Khayelitsha, at the Zwolani Centre in Nyanga and continuing at the Old Crossroads clinic.
 Less than one month later, on the 9th of June, the same occurred at KTC, and you've heard Mr Kahanovitz speak of that.  I was personally witness to the SAP caspers escorting hoards of armed "witdoek" vigilantes from near the old Administration Board offices and the Nyanga/Crossroads border, down Klipfontein Road, passed the cemetery to where they entered KTC across Millers Road.
 On the same day our ambulance was beaten with sticks at "witdoek" road blocks and direct threats on the lives of staff was made.  The threats on the safety of the staff was our main reason and our decision to close the clinic on that day.  It was a temporary decision while we weighed up the circumstances.