!am Di — Residents of !AM Di, a remote village in the Tsumkwe constituency of the Otjozondjupa region, face a healthcare dilemma due to an acute shortage of ambulances.
The lack of a reliable transport system to health centres has forced families into heart-wrenching situations, sometimes transporting sick relatives and family members themselves, or tragically retrieving the bodies of deceased family members from distant roadsides after they succumb to illnesses.
During a recent visit to the area by New Era, the quietness and isolation of !AM Di struck the crew upon arrival.
There was no sound pollution from vehicles, industry or other sources.
Only the morning chirping of birds filled the air.
Being in the village and surrounded by shrubs felt like the place had been frozen in time.
As the crew stepped out of the vehicle, the villagers curiously gathered around the headman's fire to hear what news the visitors had brought.
Here, a sense of unity and respect was evident in their assembly.
Life in this place is simple. With no shebeens or other distractions, !AM Di is a place untouched by modern developments. Residents live close to nature, content with having wild animals as neighbours.
People here sleep in traditional homes made of grass and dry twigs.
When New Era arrived in the isolated area at around 08h30, village headman Sao Lui was waiting by the fire as his wife assisted their 28-year-old daughter, IIuce Sao, with delivering a difficult home birth. IIuce had been suffering from complications for over a week, yet daily calls to the local clinic for an ambulance went unanswered.
A mother of three, IIuce was fighting for her life to deliver her fourth child after experiencing complications for more than a week.
With no medical support available, her mother and aunt stepped in, ultimately assisting her through a successful delivery witnessed by this publication.
IIuce finally delivered a baby boy, though she remained weak after the ordeal due to significant blood loss. When asked about her condition, she replied: "I am in pain. I am in deep pain."
The two elder women called the birth a fragile success, considering the lack of medical assistance.
"We alerted the clinic from the first day she started experiencing complications, and requested an ambulance every day," said headman Sao.
"But my wife and our neighbour ended up helping her instead," he added.
Deadly
The headman then recounted another painful ordeal which had occurred earlier. He said the officials from a contracted undertaker's office abandoned the body of a young family member who had died at a hospital in Grootfontein, leaving it on the roadside, more than 20 kilometres from the village.
"We don't understand what happened with the two officials who were supposed to bring the deceased home. We were here, prepared to welcome our loved one and pay our last respects, only for one of the young men to get a call, instructing us to go over 20 kilometres down the road to collect the body," he continued.
Visibly emotional, he stated: "We were shocked. We couldn't believe it, and thought the boy was joking about something so serious. A young relative rushed there, and it was true the body had been left there, and the undertaker's vehicle had already gone. We had to call the Nyae Nyae Conservancy for help. We have no donkey, bicycle or car in the whole village. We had no choice but to carry the body home with our own hands."
Conservancy
Nigel Swaartbooi, a senior officer with the Nyae Nyae Conservancy, confirmed the incident.
"We responded as quickly as we could. The undertaker called to ask about the condition of the road, and I informed her that the road required an off-road vehicle. She, however, had come with a small car and left the body on the roadside before driving off," he added.
Tsumkwe constituency councillor Johannes Hausiku confirmed the incident, but clarified that it had taken place last year, leading to the termination of the undertaker's contract.
The councillor said he took the matter up when he learnt about it, and action was taken against the undertaker.
"The undertaker had left two bodies on the roadside after attempting the trip in a small car. This inhumane act led to the contract being terminated. It was unacceptable," he stressed.
Hausiku said the San people fall under the department of marginalised communities, who get assistant from the government for such services.
"When they lose loved ones, they are assisted by the government through a contracted tender system.
But what happened here was inhumane, and it highlighted the serious flaws in our transport and service systems", he observed.
Transport
Otjozondjupa regional health director Timoteus Gebhard confirmed that transport shortages are not unique to Tsumkwe, but a widespread challenge across the region.
He stated that this shortage has persisted in part due to a budget freeze which previously prevented the health directorate from purchasing new vehicles.
Gebhard noted that the restriction was temporarily lifted during the Covid-19 pandemic in 2020, allowing the region to purchase an ambulance, which was assigned to Tsumkwe.
"During 2020, we bought new vehicles when the freeze (moratorium) was lifted. An ambulance was sent to Tsumkwe Clinic to cover the vast area from Gam to Grootfontein, But the roads here are extremely rough, and vehicles always break down," he added.
"The vehicle, bought in 2020, is already in a poor condition. You wouldn't believe it was purchased only four years ago, as the harsh terrain has taken a severe toll on it."
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
The region's newest ambulance is a 2014 model, further underscoring the scarcity and condition of the fleet.
"Our vehicles are old and overused, and we simply don't have enough. I cannot deny that emergencies outside the clinic often go unattended to due to the unavailability of transport," Gebhard acknowledged.
He emphasised that under regular circumstances, maternal emergencies would be prioritised. "If transport is available, we would attend to these cases immediately," he said.
However, he symphasised that most of the San communities in the region culturally preferred to give birth in the bushes, and only during complications do they go to hospital.
"Those people, in most cases, prefer to give birth in the bush. But, unfortunately, this one couldn't get help. I wish I could know how she is doing now, and whether she managed to go to the hospital," he added.
Gebhard urged residents with private vehicles to help transport patients in emergencies. "For those who can assist, we encourage them to step in, especially in urgent cases where there is no other option. This assistance is vital given the current crisis," he contionued.
Recently, it was reported that the drought-stricken Otjozondjupa residents, especially those situated in remote areas, are yet to benefit from the government's drought relief food roll-out programme as the region has only one truck to distribute the food.
