MANANA STICKS TO HER GUNS
By Justin Arenstein
Mail & Guardian (South Africa) 11 Feb. 2002
Tacit approval isn't enough for Mpumalanga. The province will not provide
nevirapine or any other anti-retroviral drugs to HIV-positive women until it
receives direct orders to do so from the government
Outspoken provincial MEC for Health Sibongile Manana is on record saying
that all anti-retrovirals are "poison" and a plot to undermine the African
National Congress government. She's sticking to her guns, despite growing
consensus that nevirapine could save the lives of thousands of mothers and
their newborn children.
"Nothing is proven yet. We're sticking to our policy of only providing
nevirapine at two rural pilot clinics in the province and will not extend
the service anywhere else until we get orders to do otherwise or until the
trials are completed in December," said provincial health department
spokesperson Dumisani Mlangeni.
"I can say, however, that we are finding it difficult to run the trials. Our
rural people are simply not used to having to register for medication,
undergo counselling and come in repeatedly for treatments. We're having a
very slow uptake in the trials."
Provincial statistics indicate that only 407 women have registered for
treatment at Shongwe hospital in Mpumalanga's HIV/Aids epicentre of Nkomazi,
while 641 women have registered at Evander hospital on the Highveld.
This is despite Mpumalanga's status as South Africa's second-worst HIV/Aids
hotspot, with an estimated 20 people dying every day in Nkomazi alone.
Mlangeni believes that additional transport costs for patients have
influenced the number of women registering. He refuses to comment on whether
Mpumalanga's documented antagonism towards anti-retroviral campaigners has
"That's a tricky question and not one that I can answer alone. We'll just
have to wait for our trials to run their full course," he said.
Manana's persecution of everyone from rural hospice volunteers to veteran
hospital superintendents who support the use of anti-retroviral drugs has
earned her a reputation as Mpumalanga's own Nurse Ratched.
Like the dictatorial character in Ken Keasey's book One Flew Over The
Cuckoo's Nest, Manana is accused of ignoring the plight of patients in
favour of rigid adherence to bureaucratic dogma.
Terrified hospital staff, who watched as Manana systematically axed veteran
doctors for giving anti-retroviral drugs to rape survivors, only dare refer
to her as the "Big Nurse" in whispers.
Her track record as a highly qualified homeland nurse during the 1980s
smoothed her way into provincial politics, securing her a backbench seat in
Mpumalanga's legislature on the ANC ticket in 1994.
Never high profile, Manana quietly chaired the legislature's standing
committee on health until she was appointed ANC caucus chairperson and then
Her skills as a no-nonsense enforcer won her a seat in Premier Ndaweni
Mahlangu's hardline cabinet in 1999, and have helped her implement often