By Dr MASIMBA MAVAZA | On the 13th of December 2023 the thick cloud of death enveloped Cape Town. It left a cruel hand on a lovely young family. It took with it one of the most finest people on earth. The cruel angel of death shadowed and escaped with Arthur Midzi.
When the news of his death came in the early morning of Tuesday I experienced shock and feelings of unreality and disconnection. There was intense sadness, which was overwhelming. It gave me extreme anxiety, which was both general and at nothing specific.
When someone dies, particularly someone you were close to, it can be devastating and overwhelming. Bereavement affects us all, but everyone will cope with it differently and experience different feelings.
The death of Arthur has not sunk yet. It still looks like I am in a dream which I will wake up from very soon.
My eyes become heavy and my mind just went blank. Indeed Arthur is gone and indeed dead.
Grief affects people in different ways. There’s no particular way you should be feeling, or length of time it will take for you to start to feel more like yourself again. But in this case I will never be myself again.
My feelings became chaotic and it is very hard to pin down exactly how I am feeling. Intense feelings are very frightening,
I felt anger and irritation. At the moment I am feeling a sense of hopelessness and depression
I have a completely irrational fear of going to bed in case I fell asleep and didn’t wake up. A sudden death does have odd effects.
Arthur died in a hospital having been admitted just for a day.
I might want to like feel there’s no point seeking help because it won’t bring Arthur back. I feel very powerless.
What hurts me most is the fact that Arthur would have survived in any other hospital if he was not Zimbabwean. More so he would have survived if he was South African.
The rights of non-nationals to access the health care system is a complex matter and has been a major topical point in South Africa. There is a well documented health xenophobia in South Africa. This was sparked by Limpopo Health MEC Dr Phophi Ramathuba’s remarks about immigrants. In a video, Dr Ramathuba was seen lambasting a Zimbabwean woman who was in a hospital bed seeking medical treatment. She told the woman that foreign nationals are killing her health system and they must go
back to their countries of origin for medical treatment. Health or medical xenophobia is a term used to describe negative
attitudes and practices of healthcare providers towards foreign nationals based on their national origin. This results in the medical maltreatment of the person seeking health care services.
The situation is real Zimbabweans who seek treatment in South Africa are treated badly. Arthur was caught up in this xenophobic conspiracy. The Soutj African politicians do always publicly castigate foreign nationals. The hate against foreigners is ordained by several
Ministers and it manifest itself in South African hospitals.
Arthur suffered extreme high blood pressure which can be desrcrines as Hypertension: this elevated blood pressure which caused tiny arteries to burst inside the brain. Normal pressure is 120/80 mm Hg. Blood thinners: drugs such as coumadin, heparin, and warfarin used to prevent clots in heart and stroke conditions. Arthur was not given any of the thinking medivatoon. The moment they discovered that Arthur was a foreigner the doctors signed him off to death.
There have been many instances of health xenophobia in clinics and community health centres. Members of Operation Dudula have been turning away immigrant patients from the Jeppe Clinic in Johannesburg and harassed immigrants outside several clinics including Hillbrow and Kalafong in Tshwane. It was reported that members of Operation Dudula demanded that all foreigners leave the clinics and that only South Africans could receive treatment, with some people being assaulted by members of the group. Immigrants suffering from chronic illnesses such as HIV, diabetes and high blood pressure are unable to access medication crucial to their well-being since Dudula started gatekeeping at the clinics. It is important to note that Dudula’s actions are tantamount to criminal and illegal conduct but nothing was done.
The hatred towards foreigners was now implanted in the hearts of service providers. The mood of the nurses changes once they see a foreigner in hospital.
These nurses do not know that health care crisis in South Africa is not caused by foreign nationals; they are scapegoated for the failures of the state to address the health care crisis by the people who fail to hold the relevant parties – ministers and directors general – accountable. There is a misconception that it is caused by foreign nationals. The march against foreigners in Soutj Africa caught up with Arthur and he died in the hands of those who are sworn to heal the sick regardless of their nationality. A foreigner is a human being and the treatment foreigners get in hospitals is appalling.
Treating people badly based on their nationality is inhuman, illegal and unfair. It diminishes their human dignity. What is the position of the law on this matter? The right to access health care services is a basic human right guaranteed by the Constitution. Section 27 of the Constitution states that all people in South Africa, regardless of status or nationality, have the right to have access to health care services and that no one may be refused emergency medical treatment.
The National Health Act confirms that all people in South Africa can access primary health care at clinics and community health centres.
Foreigners in South Africa have the same right to access health care as South African citizens, as set out in the Constitution. The Minister of Health must publicly condemn the actions of these xenophobic nurses and uphold the Constitution and the domestic and international legal obligations which ensure the right to health for all.
The nurses and doctors could have saved Autthur if only he was South African. He should have been given blood thinners: drugs such as coumadin, heparin, and warfarin used to prevent clots in heart and stroke conditions may have saved Arthur.
Arthur suffered bleeding disorders: hemophilia, sickle cell anemia, DIC, thrombocytopenia.
Tumors: highly vascular tumors such as angiomas and metastatic tumors can bleed into the brain tissue.
When a person is brought to the emergency room with a suspected brain hemorrhage, doctors will learn as much about his or her symptoms, current and previous medical problems, medications, and family history. The person’s condition is assessed quickly. Diagnostic tests will help determine the source of the bleeding.
Computed Tomography (CT) scan is a noninvasive X-ray to review the anatomical structures within the brain and to detect any bleeding. CT angiography involves the injection of contrast into the blood stream to view arteries of the brain. There is
Treatment for his condition, this includes lifesaving measures, symptom relief, and complication prevention. Once the cause and location of the bleeding is identified, medical or surgical treatment is performed to stop the bleeding, remove the clot, and relieve the pressure on the brain. If left alone the brain will eventually absorb the clot within a couple of weeks – however the damage to the brain caused by ICP and blood toxins may be irreversible.
Generally, patients with small hemorrhages (<10 cm3) and minimal deficits are treated medically. Patients with cerebellar hemorrhages (>3 cm3) who are deteriorating or who have brainstem compression and hydrocephalus are treated surgically to remove the hematoma as soon as possible. Patients with large lobar hemorrhages (50 cm3) who are deteriorating usually undergo surgical removal of the hematoma.
Medical treatment
The patient will stay in the stroke unit or intensive care unit (ICU) for close monitoring and care. Arthur was suppposed to be given blood thinners, reversal drugs will be given to restore clotting factors. His Blood pressure was supposed to manage or to decrease the risk of more bleeding yet provide enough blood flow (perfusion) to the brain. Controlling intracranial pressure is a factor in large bleeds. A device called an ICP monitor was supposed be placed directly into the ventricles or within the brain to measure pressure.
Removing cerebrospinal fluid (CSF) from the ventricles helps control pressure. A ventricular catheter (VP shunt) may be placed to drain CSF fluid and allow room for the hematoma to expand without damaging the brain.
Hyperventilation also helps control ICP. In this case coma was supposed to be induced with drugs to bring down ICP.
If Arthur was not a foreigner a
Surgical treatment would have been applied.
The goal of surgery was to remove as much of the blood clot as possible and stop the source of bleeding if it is from an identifiable cause such as an AVM or tumor. Depending on the location of the clot either a craniotomy or a stereotactic aspiration may be performed.
The staff at the hospital as in many South African hospitals did not care for Arthur.
The bedside ethics were clearly flouted as Arthur was drooping with no care insight.
The South African nurses are becoming vigilantes and use their official capacity to eliminate foreigners by less caring for them.
It will be a relief to see All health care facilities (clinics, community health centres and hospitals) ensuring that all staff, medical and nonmedical, recognise the right to health for all, as well as that all migrants, refugees and asylum seekers regardless of their documentation status have the same access to health care services as South Africans.
It is important to remember that united we stand, divided we fall, in the true spirit of Pan-Africanism.
Relying on the experiences of migrant patients, research on migration and health in South Africa has documented a particular concern with public health care providers as indiscriminately practicing ‘medical xenophobia’. There is more complexity, ambivalence, and a range of possible experiences of non-nationals in South Africa’s public health care system.
Many Zimbabweans have died in South African hospitals simply because they are foreigners.
When I remember Arthur I see the unfairness of the South African medical Xenophobic behaviour. Arthur represents many Zimbabweans who die in the hospitals when they could have been treated.
My tears are not yet dry my heart is bleeding. How many more bodies are we to count.
Arthur sleeps with his fathers but the gap he has left nobody can fill it.
The world will never be the same without Arthur. But for how long shall we allow such inhuman and xenophobic rhetoric continue. Why should we look at the demonic treatment Zimbabweans are being treated in the Republic. To Arthur I can only say Fare thee well my son. When the trumpet sounds behold we will be risen again. Till Jesus comes again sleep well Mhofu💤 God will not be silent for a long time. It is well with my soul. To Mandy and Family find in your heart time to understand God knows how to comfort and he will comfort you.