Boat ride to check on the baby: Eastern Cape’s maternal healthcare crisis [Video]

Pregnant women in the Eastern Cape face unimaginable challenges in accessing antenatal care and maternity services.

Many travel long distances, often in labour, to reach healthcare facilities, only to find overcrowding, understaffing, and inadequate resources.

Woman rides boat, walks across forests to access prenatal care

One such victim of the province’s inadequate provision of basic natal care is the landlord of agriculturalist and maternal healthcare activist Hombakazi Mercy Nqandeka, living in Nqileni Village, Bulungula.

Nqandeka took to social media to share the dire conditions of accessing healthcare in the village she currently resides in.

The video depicts the monthly checkup process that her landlady, who is heavily pregnant, goes through before she can receive the help that she needs at a village 6km away.

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Nqandeni, who is currently enrolled at Stellenbosch for a PhD in Health Sciences focusing on Indigenous Knowledge Systems, told The Citizen she would always hear the expecting 40-year-old talk about having to cross a river to get to the healthcare facility.

She added that she was shocked at what the pregnant woman had to go through every month.

“I realised how far behind we are in South Africa in terms of health. What really bothers me is that there is a clinic here that was built by a local organization Bulungula Incubator.

Nqandeka recently accompanied her landlady to the clinic and witnessed firsthand the treacherous journey many women endure to receive medical care. The video depicts the lady walking to the village river, in order to get to the other side. They get on the deteriorating boat, rowed by another woman, to get to the other side.

Watch: Bulungula lady travels approximately 14km to receive basic natal care

@mercynqandeka A glimpse of what pregnant women go through to get their monthly checkups#SAMA28 #fypシ #mzansitiktok #departmentofhealthsouthafrica ♬ original sound – Mercy H Nqandeka

They walk through forests and eventually reach the tar road before having to walk through the village to reach the clinic.

According to Nqandeka, this journey takes approximately 14km to and fro their place of residence and the healthcare facility.

The conditions women endure while travelling to healthcare facilities are treacherous, with many walking for hours or relying on unreliable transportation.

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Although the local clinic is gradually growing, it still does not have adequate facilities to cover all the residents’ health needs.

“They are slowly getting there but it’s so slow. I think natal care is one of the important things that we just can’t be slow about. This is a woman who has to cross a very shaky, unstable boat,” said Nqandeka.

Challenges faced to reach proper healthcare

Nqandeka highlighted the challenges faced by boat crossers. She said the boat was very old and was donated to the village a long time ago.

The surfaces that the boat docked on caused concerns and safety hazards as they are not solid and often get muddy.

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“The walking is like 14km to and fro. There’s also passing through little forests, little rivers — it’s just not very ideal, especially for a [pregnant] woman. She does it though [and] she normally walks alone all the way to the main gravel road where she joins in [the other village] and continues to walk to the clinic.”

Moreover, Nqandeka said the long waiting hours at the clinic just added to the already mounted challenges.

Other modes of transportation are not easily accessible with one having to walk approximately 2 to 3 kilometers to get to the village’s main road.

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“There’s no road that leads to the main road where someone can take a taxi. Taxis stop there phezulu elalini (in the upper part of the village) and people have to walk down to the river,” she said.

A call for midwife incorporation into natal care

Nqandeka believes incorporating indigenous midwifery into natal healthcare is the future.

“This indigenous midwife has sort of been sidelined and some of them have been absorbed into community health workers,” she said.

Moreover, Nqandeka acknowledged the “thin line” between helping someone as a midwife and violating a law.

Midwives could play a crucial role in alleviating the strain on the healthcare system, but they require training and support to handle complex deliveries and emergencies.

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The Health Sciences student said while there are several complications related to inadequate healthcare access in the community, people just suffer in silence.

She said despite the dire need, initiatives to address the shortage of healthcare facilities and professionals in the Eastern Cape are scarce.

Community-based programs like outreach services offer some relief, but more comprehensive solutions are needed.

“They [clinics] are understaffed, doctors are doing what they can but they really cannot match up the numbers. For example, our district hospital here serves so many villages; I don’t know how many people. The reality is that they can’t meet demand, so it’s a matter of looking into our capacity and how we can expand that, how do we ensure that the clinics are working [and] have what they need,” she explained.

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Village midwife’s aid

In situations where a pregnant woman might be far away from a health facility in time for labour, she often has to consult a midwife in the village.

Nqandeka says the midwife in Nqileni has helped a lot of people give birth for decades with “many men and women who have passed through her hands”.

She added that while the woman assisted a lot of people it was usually under critical situations.

Healthcare professionals advise expectant mothers living far from facilities to seek care as early as possible, but managing high-risk pregnancies in these conditions is extremely challenging.

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Funding for healthcare infrastructure, training, and staffing in underserved regions like the Eastern Cape remains insufficient.

As the government struggles to explain the disparity in healthcare access between urban and rural areas, tangible actions to bridge this gap are long overdue.

The Citizen reached out to the Eastern Cape health department, the response will be updated once received.