Madiba's dream comes true

Thursday, July 3, 2014

Even when he couldn’t remember most things, the one thing that the late former President Nelson Mandela constantly asked was: “Where are we with the children’s hospital?”

And as the icon’s health continued to deteriorate in recent years, he continuously conveyed his wish for South Africa to have a state-of-the-art children’s hospital that would pay attention to the health needs of children in Southern Africa. SAnews recently caught up with Nelson Mandela Children’s Fund CEO Sibongile Mkhabela.  

Just as the world prepares to celebrate Madiba’s birthday on 18 July, six months after his death, the hospital's Trust has announced that construction has finally begun and the hospital was expected to be completed in the first quarter of 2016. Group Five had won the contract to construct the Nelson Mandela Children's Hospital in Parktown, Johannesburg.

There could not have been a better birthday gift for the man who loved children dearly and had given up part of his salary as President to a fund he had set up to help needy children across South Africa.

On schedule for 2016

“We are very excited. This has been tata’s passion. His last activity with us was dedicating a site in which the hospital will be built. We have now broken ground. It’s exciting. We are starting and we are on schedule to open our doors in 2016,” says Mkhabela. 

As seen in his many interviews throughout his presidency, children were very close to Mandela’s heart. When he spoke about children, it was a father talking more than a distinguished President. He had not seen children for 27 years when he was finally released from prison in the early 1990s. He was not there to bury his teenage son who died in the late 60s. He was also absent when his daughters grew up, and the youngest of them Zinzi was only allowed to see her father when she turned 16.

“It was a personal thing for him. His time with children was something he felt was taken away from him for a very long time. So when he established the Children’s Fund, he talked about his vision for the children of this country.

“He felt if we built a society where children are puzzled by warmth and love, we’ve got it wrong. He created an organisation that would ensure that the children are treated the way they should be treated. He then wanted to ensure their health is taken care of - hence the idea of the children’s hospital.”

There are only four children’s hospitals in the entire African continent and for an economy of its size; Mkhabela says it’s always been “baffling” that South Africa has only one dedicated child health institution  - that being the Red Cross War Memorial Children’s Hospital in Cape Town. 

Canada for instance, a country with a population of less than 20 million has 19 hospitals for children and in the United States the number is believed to be close to double that.

The Nelson Mandela hospital is expected to employ around 150 doctors and 451 paediatric nursing professionals.

Explains Mkhabela: “It’s a Southern African hospital. It is important that we work in the children’s hospital as a Mandela legacy. His  view was for any country or continent to be strong, it has to have its own knowledge base and having children cared for is one thing but building up on how we treat them when they sick is very important.”

Currently, the biggest issue in the agenda of the United Nations concerning children is that greater care be taken to ensure that they survive the first 1000 days of their lives. South Africa is among five countries that are least performing when it comes to child maternal survival. The paediatric healthcare system is behind all documented health-related Millennium Development Goals to reduce child mortality. The creation of a tertiary and quaternary paediatric facility is in line with the national Health Department’s ‘modernisation of tertiary services’ plan.

Road to fund-raising was no easy feat

Mkhabela says the establishment of the Nelson Mandela Children’s Hospital will further assist the government by freeing much needed funding required for primary and secondary healthcare.

“We had to be thorough in our research leading up to the establishment of this institution. From the time he dedicated the site, we spent a lot of time in building a business case making sure that all partners are on board. We had to have the national department of health on board because we will be providing tertiary services that are under their ministry.”

But it hasn’t been an easy journey for fundraisers. Initially, the project was estimated to cost around R1 billion. That figure was scaled down to around R750 million after specialists from healthcare group Medi-clinic revisited all the plans and architectural drawings for the project. Mkhabela says simply asking for money from international donors to build the hospital was not working and fundraisers had to change their strategy.

“We spent months negotiating and convincing. The response we got from funders in the US was that South Africa is a strong economy. They could not understand why we would go so far to get money for a children’s hospital. They have so many children’s hospitals, as many as the schools.

“We had to change our strategy and say South Africa has to raise 50 per cent of the money before we go back to them. So, we were no longer going outside to get funding; we were going there to ask for partnership because Mandela is not only a South Africa icon; he is a world icon….. therefore we said we are giving people an opportunity to participate in building a legacy.”

The plan proved to have worked.  More than R570 million has been raised and of that amount, R100 million came from Melinda and Bill Gates Foundation founded by the US computer software billionaire.

But, it’s also worth noting that a number of funding commitments were also made at Mandela’s passing in December last year, by those who wanted to make sure that his wish for the hospital was fulfilled. The Children’s Fund, as a charity, donated R50 million. The City of Johannesburg has offered to do the gardens at the hospital and Mkhabela says that will knock off a good R20 million off the budget.

“It’s those kinds of gifts that are helping us move. We have been receiving a lot of support from all walks of life - even children themselves - have been donating towards the project,” she says.

What do children stand to gain?  

But how different is a children’s hospital from other healthcare facilities?

“A children’s hospital is such an important place. Children who go there are extremely sick. In South Africa we don’t do dialysis for children. We don’t even know the number of children with kidney failure,” says Mkhabela.

At any given time, Johannesburg alone would have about 100 children awaiting heart surgery and by the time they go ahead of the queue they are already too sick and the chances of survival are already slim. The reason for this is that there are not enough ICU beds for children. 

Mkhabela says Baragwanath hospital in Soweto, as huge as it is, has less than 30 ICU beds for children.

“When they are very sick, they are mixed together with the adults and as you can imagine a scenario where a child is sick and is in the vicinity of adults who are sick and struggling with machines and ventilators and as an eight-year-old, for example, you have to wake up to this. It is not good for the child.

“In a children’s hospital, you build with an understanding that when an eight- year -old is admitted, there is a family accommodation for the dads and moms who are accompanying the child. It’s part of the healing process that the child is surrounded by care givers from home all the time.”  

She says the Nelson Mandela Children’s Hospital has begun recruiting nurses who are receiving training ahead of the 2016 operations.  The nurses will be part of the opening during the first quarter of 2016.

Mandela family behind project

The Mandela family itself has continued to throw its weight behind the project.

Widow Graça Machel and Mandela’s daughter Zenani and grand-daughter Ndileka all sit on the hospital’s trust which is chaired by Machel. The latter was recently quoted as saying she was inspired by her late husband’s rich legacy that promotes justice, compassion, and solidarity.

“Children were very dear to Madiba and his last wish was to build the Nelson Mandela Children's Hospital. This is my dream too - and I wish it can be realised in my life time.

More about the hospital

  • Construction will include a family resource centre, a sibling activity centre and a day care centre
  • Accommodation for out-of-town family members will be provided to ensure support for paediatric patients on long stays.
  • A majority of single bed wards are included in the design to ensure privacy and specialised care
  • Recreation and areas for relaxation are included in the design for parents and family members.
  • Intimidating large medical equipment will be downplayed with colourful, cheerful décor to ease patients’ anxiety while being treated.
  • A learning centre will also be built so that school-aged children can stay current with their studies while hospitalised.  


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