Healthcare During Apartheid
Beginning in the late 1940s, black Africans living in South Africa became targeted by the government and were subjected to exploitative laws based on the color of their skin. They made up 80% of the population at the time (Scrubb). Africans were forced to relocate and live in primarily rural areas that were separate from white South Africans, called Bantustans (Scrubb). The South African government let each Bantustan take control over its own healthcare, which allowed for the government to escape responsibility for how they were run. Without government regulation, healthcare in Bantustans was very poor and sanitary guidelines were often ignored (Scrubb). Blacks who lived in urban areas were allowed to access better healthcare, if only to prevent the spread of disease to whites living in the same area.
Huge healthcare disparities existed; there was one physician for every 330 whites, as compared to one physician for 91,000 blacks (Scrubb). Clinics in rural areas were understaffed and overcrowded and workers in these clinics tended to be undertrained. Many who worked in public healthcare moved to private healthcare to work in better conditions and receive better pay, leaving those in Bantustans with little access to acceptable healthcare (Scrubb). HIV entered South Africa in 1982 and was present mainly in homosexual circles (Scrubb). By 1990 the rate of HIV infection in heterosexuals had surpassed homosexuals and infection rates had drastically increased (Scrubb). During the fall of apartheid, the government did not have the means to combat rising infection rates.
After the fall of apartheid, there was hope for a fight against the HIV epidemic and access to better healthcare (Johnson, 108). The African National Congress (ANC) was elected through democratic means in 1994 (Johnson, 108). They won by an overwhelming majority due in part to their platform that every individual had a right to health, and it was the responsibility of the government to provide that opportunity (Mbali, 5). Before the ANC’s election, NGOs, researchers, and health workers worked with anti-apartheid factions to try to stem the epidemic (Johnson, 109). It was hoped that a democratic new government would cooperate to better fight the virus and provide relief to those already living with it. Little the government did to slow the spread of HIV was effective for the next decade. The prevalence rates rose from 2.2% in 1992 to 26.5% in 2002, which made South Africa the country with the fastest growing HIV infection rates in the world. It did not help that at a time when infection rates could have potentially been curbed (1990-1995), there was no effective government or health department well established enough to effectively do so (Mgoba, 1171).
South Africa’s wealth had little to do with the ineffectiveness of its HIV prevention programs. South Africa is relatively wealthy when compared to other African...