JOHANNESBURG, South Africa -- The white minority government announced plans Wednesday to tackle the complex issue of segregated health care, directing a cautious desegregation of whites-only hospitals and a 'fair division' of the health budget to redress racial imbalances.
Faced with startling disparities in health care statistics for South African blacks and whites, National Health and Population Minister Rina Venter told Parliament the government intended to launch 'an orderly reconstruction of health services.'
Among the statistics cited by Venter: infant mortality among 1,000 live births varies from 9.3 for whites to 60.6 for blacks; life expectancy of 71 years for whites and 62 for blacks and 5.5 percent of blacks qualifying for medical aid and medical benefit schemes against 68.8 percent of whites;
'This problem can only be addressed by a fair division of funds,' Venter said, noting a special emphasis would be placed on primary health care through building low-cost community health centers.
'With full open-heartedness and honesty, we must take the health interest of the total population as our most important direction,' she said.
Opposition lawmakers and health workers reacted skeptically. Democratic Party legislator Mike Ellis said the move appeared promising but he called for clarity on an 'orderly' transition.
'Does it mean that hosptials won't be truly open to all, or that they may accept patients from all race groups but wards remain segregated?' he asked.
'You must excuse us if we do not believe you when you say apartheid is dead,' said Miley Richards, a member of the 'colored,' or mixed race chamber of the segregated Parliament.
'We have been on the receiving end of apartheid for so long that only when we witness the cremation of apartheid will be believe that it is really dead,' Richards said.
The announcement coincides with government debate on the gamut of the ruling National Party's apartheid laws implemented since it took power in 1948 and President Frederik de Klerk's program to negotiate a political settlement to South Africa's racial conflict.
Last August, anti-apartheid activists staged a nationwide campaign of civil disobedience against apartheid laws, making hospitals the first target and sending scores of blacks into white-administered hospitals to seek medical care.
The pioneer of the heart transplant, South Africa has the most sophisticated hospitals on the African continent and the capacity to provide high-quality health care. At the same time, it failed to expand facilities at the community level. Last year, 300 children died of measles -- deaths Venter described as 'totally unnecessary.'
Moreover, apartheid legislation coupled with the lack of attention to hospital expansion in black areas has triggered an acute shortage of hospital facilities for blacks while whites-only hospitals stand half-empty.
'It is a fact that while a lot of our hospitals are overcrowded with bed occupancy rates of more than 100 percent, there are other hospitals which are totally underutilized,' Venter told Parliament.
Assuming the population needs three beds per 1,000 people, whites have a surplus of 11,700 beds and blacks a shortage of 7,000 beds, she said.
'In order to correct this matter the government has decided that the available capacity of beds in all hospitals must be accessible to all persons and that a model for the management thereof in an orderly fashion be designed,' she said.
Venter told a news conference earlier the 240 hospitals under the ministry would be open to all races and that she expected 44 whites-only hospitals under separate administration would follow suit.
Precise details of the desegregation plan remained unclear, however, and raised the possibility of continued segregation under the guise of 'personal preference.' Venter also did not address segregated private hospitals.
'The health of people is a very personal matter. The state therefore carries the responsibility to ensure that all programs for the provision of health services must have a high degree of acceptibility.
'Enough space must exists for pers preference of religious practices, culture apporaches and communication means,' Venter said.
Venter dismissed as 'oversimplification' charges that inequities in South Africa's health care system are wholly due to a complex organization that effectively has created eight separate health ministries -- one in each of the four nominally independent black homelands and one for each racial group.