On Whose Health Matters?

One afternoon, while in transit after a long day at work, I pondered a topic around health but struggled with how to preface it as a reflective passage on my time with the sand people. Suddenly, as I was wrestling with ideas, I noticed a young lady two seats in front of me falling into a seizure, lying lifeless on her peers. The ensuing chaos saw people trying to assist as best they could, but little of substance could be done. In my desperation, I turned to ChatGPT for advice—how audaciously idiotic of me! Meanwhile, a man who had been ranting about Christian spiritedness on the bus touched her and spoke the word of God. Miraculously, she made a sound, but it yielded no substantial result. It was a minutiae effort, a small comfort amid a greater crisis.

For some time, I was riddled with puzzlement, although my emotions had fallen scarce. Common among the sand people is the tendency to feel concerned without taking action. After the incident, the commuters grappled with the best course of action. They shouted to the driver to reroute to a nearby clinic, but the dim signs aboard declared, "Board at your own health and safety risk." How tragic it is to realize that the bus driver is obligated not to deviate from the route under any circumstances, as dictated by some unyielding policy. I can only imagine the horror if commuters were to witness someone losing their life on board—what charges could be brought against the company? Administrative negligence? Does the company adhere to health and safety protocols within transport regulations? Could this matter be taken seriously?

This incident starkly highlighted for me the state of public care for those commuting with chronic medical conditions and occupationally challenging disabilities. Their experiences of using public transport are rife with discrimination and prejudice. Ironically, just two stops after the incident, a paramedic, identifiable by his uniform, disembarked. This was someone who could have advised us on how to assist the young girl medically! How absurd that a public health professional in a public space could be unable to assist a fellow citizen. It is humiliating to realize that our public healthcare system in South Africa is so deficient, so desensitized, that even our professionals are unable to provide assistance in such dire situations. But who can blame them? Most public health professionals flee from the squalor they were reared in, finding it undesirable, and in most cases, justifiably so, due to the neglect by state departments and the intolerance of innovation and change by their superiors in positions of authority.

Setting this aside, we must ask: Who is entitled to a healthy life in the city? Do the sand people have any say in it? Are they included? By what standards and norms? Within that population, who has the means and power to secure their lives with safety nets, insurance, and possibly bodily integrity? Few, if any, from the sandy landscapes. The sand people only receive the crumbs left from the schemes of others. They may be assured some form of healthcare that allows them to live but they remain food insecure, they want to work but struggle to meet their basic necessities; they socially ostracized but they are required to be sane in the city? To me, this alludes to the profound loss of bodily integrity and the elusive assurance of a sustainable healthy life among the sand people.

Indeed, there are serious public health asymmetries that structurally create disparities amongst populations, and I put it to you that for the sand people to be emancipated from this crisis, the value-use of the body in terms of its structure and integrity, must be reconciled in the city. As I end, this narrative underscores the pressing need for systemic change and highlights the broader issues of accessibility, equity, and compassion in our public health system. The incident relayed here is just part of a microcosm of larger societal challenge that require urgent and collective actions to ensure that everyone, regardless of their socioeconomic status or physical condition, has the right to a safe and healthy life - as enshrined in the Constitution.