A Great Public Health Humanitarian – Nelson Mandela

With the recent passing of Nelson Mandela, it is a good time to discuss how influential a single leader can be regarding the health and development of a country.  Mandela passed away December 5 at the age of 95 from complications of a lung infection.  He has had an immense impact on the lives of many South Africans through his political and humanitarian efforts and his work in ending the apartheid.  He is considered South Africa’s symbol of freedom with his struggle against racial oppression.  He was imprisoned for 27 years due to his strong political will and was convicted of conspiracy to overthrow the government.  He was released from prison in 1990 after an international effort lobbied for his release.  He was later elected South Africa’s first black president where he formed a government of national unity in an effort to defuse racial tension in the country.  He also was successful in creating a new constitution and created the Truth and Reconciliation Commission that investigated past human rights abuses.  His administration introduced measures to encourage land reform, combat poverty, and expand healthcare services.  After his presidency he focused on causes such as human rights, world peace, the fight against AIDS, rural development and school construction.

It is reported that four out of five South Africans depend on the public health care system that Mandela championed.  Free healthcare was introduced in 1994 for children under six and pregnant women.  This was extended to all people using primary level public sector health services in 1996.  Although this was a great accomplishment, access to healthcare services still remains vastly unequal between blacks and whites. 

One of his legacies that he leaves behind in South Africa is a special train that has helped bridge the health care gap in the country.  Mandela was instrumental in the development of a train called Phelophepa (meaning good, clean health) that cuts through South Africa’s countryside.  It runs nine months throughout the year and delivers low-cost medical care to the rural poor.  The train treats 1,500 patients a week on average.  The poor health of individuals in rural South Africa under apartheid was due to lack of access to health services.  There was only one doctor for every 40,000 black South Africans.  The numbers have since improved to 1 in 4,000.  This service is affordable to the population because it is mainly run by volunteers.  Student doctors live on the train and provided the services.  A second train has since been launched in 2012 that now allows doctors to reach 100,000 people a year. 

Throughout this course and our class discussions, we often mentioned the marginalized individuals and the disparities that they face.  I found this “healthcare train service” system that South Africa has implemented a great effort in trying to reduce those disparities and allowing more opportunities to access of health services for the rural poor.  This is a creative and innovate solution that I feel could be implemented in countries similar to South Africa.  I have not heard of such a service offered anywhere in the world and would love to see if such benefits would be gained in other areas of public health services.

CBS News.  Nelson Mandela’s Legacy:  Train of Hope Bridges Health Care Divide in South Africa.  December 6, 2013.

Nelson Mandela Foundation.  The Life and Times of Nelson Mandela.  http://www.nelsonmandela.org/content/page/biography.