The Northern Cape Department of Health is based in a refurbished Victorian home in central Kimberley. Inside, sitting at a boardroom table, health MEC Mase Manopole is speaking softly. Occasionally her voice rises, to stress a point.
It’s a sweltering day and the air-conditioning is off. “I don’t like aircon,” she smiles, shrugging. “Normally I switch it on for guests, but I forgot. Sorry.”
On lentils and keeping fit
Somehow we start the interview not with corruption or the shortage of healthcare workers, but by discussing dietary choices. The MEC claims she hasn’t eaten red meat in 25 years, saying lentils are a far healthier source of protein. “Lentils, it’s cheap and can last you so long,” she says. “I have a lot of different recipes, I mean you can even make patties.
“I am educating people, here in the department too. I ask the government officials, ‘What is on your plate?’ The protein, the carbohydrates, the vitamins and minerals. Even the premier (Dr Zamani Saul) stopped eating red meat six weeks ago. When we’re eating somewhere he will say: ‘Come, sit next to me. I need the encouragement from you, you are my partner on this journey’.”
Leaning back in her seat, she laughs. To keep fit, Manopole sways to Zumba-dancing videos in her living room, two to three times a week. “I love aerobics,” she says. “Especially Zumba, it’s a Spanish kind of dancing. There’s a yoga studio here in Kimberley too which I intend to join.”
The MEC’s immediate plans include launching an annual aerobics competition within the provincial health department. “We will have aerobics clubs throughout the province,” she says. “A healthy lifestyle campaign, to help officials deal with stress. We will use parking lots at government buildings for aerobic classes, you know, with sound.” Asked for his response to this, Manopole’s media spokesperson, Lebogang Majaha, only wipes his brow and grins.
Ripples of hope
Manopole took office as MEC on May 29 last year. She was appointed by the Northern Cape Premier Dr Zamani Saul, whose inaugural speech on the same day sent ripples of hope through South Africa’s largest and most sparsely populated province. “I commit here that I will be an activist premier, who will always be amongst the people,” said Saul at the time. “I will spent less time absorbed in the comforts of the office. My biggest reward will be the happiness of the people of the Northern Cape, and particularly the poor and downtrodden.”
Soon dubbed ‘the people’s premier’, Saul put his words into action, scrapping expenses like blue-light brigades and framed portraits of government officials in public buildings. Indeed, at the health department’s reception, there are no framed photographs of Manopole.
Speaking inside the boardroom, she nods: “I’m okay with this. It is useless to have portraits of officials up everywhere, but they never leave the building. I go out all the time. To visit hospitals and clinics around the province, meeting with people face to face. And people do recognise me. I mean, in Kuruman I was at a shop buying fruit when this woman came up to me and said: ‘MEC, I need this and this.’ So, we discussed her problem.”
Manopole points out how, just the day before our interview, she addressed staff at health facilities in Upington and Kenhardt, some 400 kilometres away from Kimberley. A lively Facebook page chronicles her official visits criss-crossing the province, along with statements on topics ranging from the coronavirus to community wheelchair handovers. On the Facebook page, people comment and criticise, publicly airing their gripes.
For official trips Manopole hits the road in an Audi Q7, and occasionally in her own Toyota RAV4. “The Q7 was the car we found here,” she says. “We didn’t buy any new cars, it was bought by the previous administration. Sometimes I go with my personal car, I have a RAV4.”
The Northern Cape is 372 889 square kilometres in size, slightly larger than Germany. Last year Statistics South Africa estimated the province’s population at 1,26 million people. Presently its health department has 222 ambulances – that is one ambulance for every 1700 square kilometres, or one ambulance for every 5 675 people.“ The province is so big, reaching people is a challenge,” says Manopole. “We have to be creative in this, the special vastness of our province.”
Vast rural expanses
The Northern Cape’s key health challenges go hand in hand. Vast rural expanses, grinding poverty, plus resource and staff shortages. Manopole also inherited a department shadowed in allegations of corruption and misuse of state resources – an overstretched health system mired in low morale.
A pivotal problem is South African doctors and specialists being reluctant to work in these far-flung corners, and even in the province’s main cities like Kimberley and Upington. For example: the Northern Cape does not have a single full-time obstetrician and gynaecology specialist in its public sector. However, a health department employee who specialises in obstetrics and gynaecology practises at the Robert Mangaliso Sobukwe Hospital in Kimberley part-time.
While they are trying to recruit a suitable full-time specialist, there are challenges. Manople notes “a shrinking pool of obstetrician and gynaecology specialists in the public space, and the fact that most health professionals prefer to practice in South Africa’s larger cities.” She says some of the gaps are being filled by foreign doctors, notably from the Democratic Republic of Congo.
“Yes in many peripheral areas of the province we have foreign doctors,” she says. “They were already in South Africa, where they applied for the positions. I mean, anyone can apply to stay here in our province. Some of them have said they love the Northern Cape, and they won’t move to any other place in South Africa.” But what about the language barrier? Manopole claims minimal language barriers exist between foreign doctors and patients – who, in the Northern Cape, are predominantly Afrikaans-speaking. She says English is used as a medium, and should a misunderstanding arise, Afrikaans staff members help to translate.
Retired healthcare workers invited to return
In July last year, in a bid to bolster the province’s health workforce in a cost-effective manner, Manopole extended a call to retired and unemployed health practitioners to consider working for the state again. “We are recruiting those who are still strong and able to work as session workers,” she says. Session workers are staff on part time contracts, who work shifts. “It is cheaper than employing, for example, full time nurses, because of their cost to company packages. We can appoint three session nurses for the price of one full time nurse. So we have three bodies in a facility for the cost of one. I mean, yesterday in Upington, the hospital’s operational manager said to me, ‘MEC, thank you for bringing in those two session nurses, they’ve made a huge difference.’ These are creative solutions within the constraints of the department’s fiscal situation.”
Modestly she adds: “It’s not just me who came up with the idea, we all brainstorm together.” Expounding on the fiscal situation, Manopole sighs, saying that the department’s budget of R4,1 billion does not stretch nearly far enough. On the other hand, critics have pointed out how millions of tax rands allocated to the health department have, over the years, disappeared into thin air. Or more accurately, into cunning pockets.
“No really, R4.1 billion is not a lot. I can give you a break down,” says Manopole. “This is for goods and services, for salaries, for medical technologies. The X-rays, mammograms, those are expensive. Maintaining buildings, upgrading them. I mean, aeromedical ambulances, airplanes, we use them per request only when there is a really, really serious emergency, because we want to manage the budget.”
Funding remains an enduring headache. Commenting on the De Aar hospital, which has been vandalised with a TB ward still not open, Manopole says: “Yes I am aware of it – that it is not open. This I will present next week as well. We need funding to make this hospital operational.”
‘A statue of corruption’
Emblematic of the province’s corruption woes is the infamous Northern Cape Mental Health Hospital, which opened in Kimberley last year. Construction on the hospital dragged on for thirteen years, with costs ballooning from R290 million to nearly R2 billion as the half-built shell stood ghostly and derelict a few kilometres outside town. At the hospital’s launch on September 30, Saul described it as a “statue of corruption”.Manopole relays how a Hawks probe into corruption at the Mental Health Hospital is nearly done.
“The Hawks appraised me that the investigation is nearing completion,” she says. “So soon we will know. If people in this department are found to have contravened the law the Hawks will be able to act on it, handing the cases to the prosecutors who will proceed. If wrongdoers are identified, there will be steps.”
Manopole pauses, crossing slender fingers on the table in front of her. “So, I know there are lots of allegations of corruption,” she adds. “Several cases that deal with this department are currently with the Hawks. And even with the Zondo Commission (of inquiry into allegations of State Capture). We are cooperating. The Hawks called me. They said to me, early last year they weren’t getting the cooperation required for their investigation. But now that has changed. I conferred with my management and said: ‘You must cooperate with the Hawks, let them do the interviews they need, and so on’. We are putting measures in place to deal with corruption.”
The situation around the head of the health department (HoD), Dr Steve Jonkers, remains murky. Jonkers’ appointment to health in 2017 sparked incredulity from opposition parties given pending corruption and fraud charges against him, stemming from his tenure as HoD at the provincial Department of Transport. Manopole shakes her head and gestures. “Jonkers is not in this building,” she says. “He’s in the building next door. When all of that happened he was at the Department of Transport.” Furthermore, she points out that she was not responsible for his appointment and that this falls under the jurisdiction of the premier.
Inspired to serve
Manopole was born in 1971, the fifth of six children, to a teacher mother and entrepreneurial father, who owned a shop and a butchery. She grew up in Warrenton, 70 kilometres north of Kimberley, on the N12 to Johannesburg. Born into an activist family, her own political convictions only took shape later. But from an early age, she was inspired to serve.
“So, my sister and my little brother were activists. I remember a time when the apartheid police came to harass us, looking for some or other documents at our home. Back then I didn’t understand what was happening. I think my own passion to serve started with my dad,” she says. “He was a community leader in Warrenton, where he ran social programmes. For example, at a point there were retrenchments and he was feeding fifty families for six months, giving them packages with basic groceries and so on.
"He also used to have livestock. So while these families were recuperating from the retrenchments, every second month he would slaughter a cow and give them the meat.” After school she started studying purchasing and marketing management at the University of Technology in Bloemfontein. But she dropped out to help with her father’s business back home. In 1996, Manopole married and moved to Kimberley, where she landed her first job at Statistics South Africa. Her marriage floundered in 2005, but it gave her two boys: Tokgamo (23) now registered to study at the AFDA film school in Cape Town and Itumeleng (17) enrolled at Blue Hills College, a Seventh Day Adventist boarding school in Midrand.
In 2007, she completed a Higher Certificate in Economic Development at the University of the Western Cape. Her career was picking up speed.Manopole went on to serve on the provincial leadership of the Young Communist League of South Africa; as provincial treasurer of the National Education Health and Allied Workers’ Union (NEHAWU); and as provincial chairperson of the Congress of South African Trade Unions (COSATU). In 2014, she took office as a Member of Parliament for the African National Congress (ANC), and in 2017 she joined the Northern Cape Legislature.
Being a mother
How does a divorced mother of two find time to build a political career? “Their father was always involved,” says Manopole. “But I would not have been able to do this without my support structure. My mum, she now lives in Kimberley, and my sister in Bloemfontein.” She recalls practically rearing her sons in board rooms and at conference centres around the province.
“The last one, he was two-and-a-half years old at the time of the separation and my career was getting busy,” she says. “He used to attend meetings with me. He would go to conferences with me, for two or three days. So, even though I had to work at the conferences during the day, in the evening, I’d save time to spend with him.” Being a mother has shaped her perspective and priorities. “You know, my youngest, I nearly lost him when he was eight months old,” she says. “Both of them are asthmatic and he was not responding to oxygen. Maybe because of this personal experience it is such a priority to me that maternity wards must be well resourced and efficiently run.”
On December 25, she visited maternity wards at Kimberley’s Galeshewe Day hospital and Robert Mangaliso Sobukwe hospital as part of the department’s ‘Programme to Welcome New Born Babies on Christmas Day’. The visit is recorded on the department’s Facebook page, along with the hashtag #MerryChristmasToAllTheMothers. “MEC Manopole expressed her delight that all 21 new born babies in the province are well,” reads the social media entry. “She also educated mothers on the importance and benefits of breastfeeding.”
Breastfeeding is close to Manopole’s heart. “My eldest child I breastfed for about one year and eight months,” she says. “My mum had to stop me and say “That’s enough. This boy is going to talk now!” Unfortunately the youngest one couldn’t proceed that long. I think maybe it was all the work I had to do. But I used to put my breast milk in the freezer for him and then the nanny would warm it. And I’ve seen the results in both their immune systems. Apart from asthma, they have no illnesses.”
Meanwhile, Manopole has completed a string of academic qualifications. This month she will register for a Masters degree in health administration at the University of Johannesburg. “I like UJ (the University of Johannesburg) because it is more Africa-orientated,” she says. “My degree will focus on how to develop health governance in rural areas, specifically on our continent. So it will be the Northern Cape challenge – the South African challenge – within the larger context of the African continent.”
When Manopole hangs up her thinking hat, plenty of heart remains. “To be an activist, you must have a passion to serve,” she says. “An inner voice that makes you want to create change, in whatever your area of responsibility in a community. So those are the things that have driven me to be me – to make an impact. I am hoping for activists to move this country forward, regardless of race and gender. If we get together to break those barriers, we will have a better country.”
*This article was produced by Spotlight – Health journalism in the public interest.
Image credit: Emile Hendricks, Spotlight