Thirty-year-old Sthembile Mkhize from KwaNyuswa in KwaZulu-Natal says she is afraid to return to her local clinic after she was told to leave the facility during the night while waiting for an ambulance to take her to hospital.  Mkhize says she arrived at the 24-hour Halley Stott Clinic with her boyfriend at around 3pm on 10 September after experiencing abdominal pain, vomiting, diarrhoea and severe weakness. Mkhize says she was taken to the high care unit where healthcare workers placed her on a drip and inserted a urinary catheter. She says nurses informed her that an ambulance had been called to transfer her to St Mary’s Hospital.  Mkhize and her boyfriend, Nkululeko, say they waited for several hours but the ambulance did not arrive. At about 8pm Mkhize says she told the night-shift nurse that she was tired of waiting and the nurse asked her to wait until 10pm.  According to Mkhize the ambulance had still not arrived by 1am.  She says after repeatedly asking how much longer they would have to wait for the ambulance, the same nurse asked her to sign a form. Her catheter was then removed and she was told to leave the health facility.  Mkhize says she did not have enough time to read the document and was not given a copy. She believes she was asked to sign a release form stating that she had refused treatment.  Mkhize and Nkululeko say they spent the rest of the night outside the clinic waiting for daylight before they were able to take a taxi home.  Afraid to return Mkhize posted about the experience on social media shortly after being asked to leave the clinic. She says clinic management contacted her the following day to apologise for the incident.  According to Mkhize, management told her there were not enough ambulances in the area and that the nurse should not have told her to leave the clinic. Health-e News has not independently confirmed what was signed during her treatment at Halley Stott Clinic. Following the phone call, Mkhize returned to the clinic on the same day. An ambulance was called again, and this time it arrived and transferred her to St Mary’s Hospital for follow-up care.  According to Mkhize she was diagnosed with an intestinal parasite, received treatment and was discharged from St Mary’s Hospital later that night.  Mkhize says she has been told to return to Halley Stott Clinic on 14 November for further follow-up care, but she is now afraid to return and says she would prefer to get follow-up care from a different clinic.  “I am afraid to go back, what I have experienced that day has left me afraid to seek healthcare at my clinic,” she says. “Even after I was called by the management I could see that the staff and some healthcare workers who knew about my story were talking behind my back.” “How can I go back there again?” “I am afraid of my local clinic and I don’t want anything to do with it,” she says. According to Mkhize, management at Halley Stott Clinic promised to assist her with a referral letter for follow-up care at another facility, but nothing has happened since.  Ambulance shortages under scrutiny Mkhize’s experience comes amid ongoing concerns about ambulance shortages and response times in KwaZulu-Natal.  Last month the provincial legislature conducted oversight visits to EMS bases across the province. Preliminary findings from the visits showed that ambulance and staff shortages and slow response times remained concerns. As of 21 May, only 248 of the province’s 448 ambulances were operational. In March, the KwaZulu-Natal Legislature’s Standing Committee on Public Accounts (SCOPA) identified an acute lack of ambulances. The committee said chronic delays in repairing state vehicles were contributing to the challenges faced by the province’s emergency services fleet management.  KZN Department of Health Health-e News sent questions to the KwaZulu-Natal Department of Health twice last month. The department did not respond to our queries, but Mkhize says she and Nkululeko were contacted on 25 September and asked to attend a meeting at the clinic.  Mkhize says when they said they could not afford transport, they were told someone would collect them the following day, but nobody arrived and she has received no further communication. Mkhize says she wants to know what measures the hospital will take to prevent this from happening to other patients in the future.  “I know I am not the only one who has been treated like this in this clinic.”  The department had also not responded to Health-e News’ follow-up questions by the time of publication.  Author Sandile Mbili Sandile Mbili is an award-winning freelance health journalist and radio drama scriptwriter based in KwaZulu-Natal. He has contributed to Health-e News since 2016 and is an Africa Health Communications Fellowship fellow through Fraycollege. He has written and produced more than 10 radio dramas and won two MTN Radio Awards. View all posts

Indoda Wednesday, an initiative adopted by the City of Johannesburg Health District in April last year, is bringing together men and boys to talk about violence, mental health and other social issues. More than 1,000 men have been reached in Johannesburg’s Region G alone. For 67-year-old Elias Jim from Lawley, the gatherings have become part of a much longer journey away from violence. Elias says for decades, anger has shaped how he responded to conflict. Raised in a home where violence was directed at his mother, Jim says he absorbed the behaviour he witnessed and eventually became violent himself.  “I was absorbing the violence from my father.” Jim says he was nicknamed ‘Khalambazo’, meaning axe.  “My father was abusive and feared by everyone in the house, including my mother. He would beat my mother in front of us,” Elias says. When Jim got married, the abuse extended to his wife.  “At 22 I married my first wife and we had a child. We were married for only 4 years. My abusive traits started to show. I oppressed my wife, I never allowed her to contribute in any decision-making. I wanted her to be just a trophy and be controlled.”  In 1983, Jim married again, and had his second child.  “In this marriage I became worse. I was a monster to my wife. She would shake when she spoke to me, that’s how much she feared me,” he says. “My second wife was my punching bag, I oppressed her even more [than my first wife].”  In 1992, Jim was arrested for gang-related violence and spent 24 years in prison before his release in 2016. A journey that started in prison Jim’s journey to change started behind bars.  He says several fights in prison led to introspection. He asked for psychosocial support from prison social workers and attended anger management classes. He says he also participated in other programmes that were offered in prison, including conflict resolution, substance abuse, gender abuse and relapse prevention.  “I changed in jail, I had no choice, I was tired of violence and fighting. It was becoming a heavy burden to carry,” he says.  “I became a facilitator in prison and held group sessions with men, and started to advocate for more mind renewal programmes for our inmates. I was no longer violent, I was helping inmates who were struggling to cope with prison life.” Jim says when he was released from prison in 2016, he continued to mentor other men. In April this year, he joined the Ennerdale/Lawley Indoda Wednesday group after other men saw the work he was doing with boys and men in his community.  “Every Wednesday we gather boys and men to discuss their daily challenges, issues around gender-based and community violence, mental health and how they can positively contribute in their communities,” he says. “Although my rehabilitation started in jail, the work I do with Indoda Wednesday helps me to heal further. Men need safer spaces to talk without fear and stigma.” Another man finds support One of the men who says the gatherings helped him is 42-year-old Orange Farm resident Lerato Magongwa. Magongwa joined Indoda Wednesday in 2022 after a series of setbacks. He lost his job and his relationship and was later hijacked and kidnapped in Johannesburg. He says he became depressed and suicidal and later suffered a stroke. “Finally I had someone who was willing to listen to my story.” “Finally I was among people who cared about me and didn’t make me feel judged,” he says. Magongwa says he gradually began to recover and is no longer suicidal or ashamed. He now facilitates Father A Nation’s Champions for Change programme, where men discuss their challenges, including gender-based violence, and are referred for additional support where needed. A safe space for men and boys The City of Johannesburg Health District says the initiative followed a Men’s Parliament meeting where men resolved that they needed private and safe spaces to discuss issues affecting them. Men and teenage boys can attend the gatherings, which take place in settings including community halls and churches. Discussions include gender-based violence, substance use, mental health, traditional initiation schools and skills development. The City says the gatherings also encourage men to use health services including HIV testing, TB screening, prostate cancer services and mental health referrals. Health services linked to the programme have also been taken to taxi ranks, including Bara, Bree and MTN taxi ranks, on alternating Wednesdays. Connecting men to healthcare The Indoda Wednesday programme also refers men to healthcare facilities who need help with mental health and drug rehabilitation. The City says community health centres that form part of the initiative include Itireleng in Soweto, Discoverers in Florida, River Park in Alexandra, Chiawelo in Soweto and Stretford in Orange Farm. The Mpathy Rhiza clinic in Orange Farm provides free healthcare services including HIV testing, TB screening and prostate cancer services, with a particular focus on men on Wednesdays.  The Gauteng Department of Health has welcomed the initiative. Department spokesperson Steve Mabona says it runs a separate Men’s Health Forum for its male employees.  Mabona says the programme provides spaces where men can discuss mental health, stress, relationships, financial challenges and substance use. Mabona says men who need additional support can access counselling and trauma debriefing or be referred to psychologists, social workers, mental health and substance-use services. October is Mental Health Awareness month in South Africa with World Mental Health Day marked on 10 October.  Author Lerato Kodisang Lerato Kodisang is a journalist with experience engaging communities through civil society and local platforms at district and provincial level. She is passionate about health and people-centred reporting that centres lived experiences and gives voice to issues that matter to communities. View all posts

A year after the City of Johannesburg announced a R150-million project to rehabilitate the decommissioned Kya Sands landfill, residents living nearby say recurring waste fires and smoke from illegal dumping continue to affect their daily lives, with some reporting breathing problems. The Kya Sands landfill site, decommissioned more than 15 years ago after reaching capacity, borders a densely populated informal settlement, several middle class residential suburbs and an industrial manufacturing hub.  The City previously estimated that deteriorating air quality associated with the fires was affecting about 80,000 residents in and around Fourways, Cedar Lakes and Bloubosrand. Smoke affecting residents “I cough every single day. It recently woke me up at 3 o’clock in the morning, because I couldn’t breathe, and I started coughing immediately,” says 60-year-old Deborah Ball, who moved into an estate in Craigavon in August last year. She said she did not have asthma before moving to the area but developed bronchial problems during winter. When the burning becomes intense, she said she immediately notices a difference in her breathing. Ball says the smoke sometimes has an acrid smell, which she believes comes from materials such as tyres, rubber or chemicals being burned. “It’s really bad, like a horrible toxic smell that you can’t breathe.” ” I’ve had to start using an inhaler pump, because my chest closes now.” Illegal dumping continues Ward 98 councillor Davon Steenkamp says a boundary wall is being built as part of the City’s R150-million rehabilitation project, but trucks are still dumping waste on nearby private properties, where he says it is set alight to make space for the next load. “There have been a lot of residents complaining about respiratory problems. Even myself, when I drive through there or go into that area, it affects my sinuses, so I know very well what some of the repercussions are.” “It is also very sad for the people living in the informal settlements nearby because, unlike the people in the surrounding areas outside the settlement, they cannot afford to get air purifiers. They constantly have to close their doors, and it is also difficult for the children who are living there,” said Steenkamp. “The informal settlement residents cannot really do anything about this. The illegal dumpers are part of a syndicate that makes millions of rands a month, and they come there with weapons, so it is a dangerous situation.” The issue of organised crime syndicates, known locally as “waste-lords”, operating unchecked in the area has been widely reported, but despite the proposed rehabilitation project, hundreds of trucks are reportedly still accessing several illegal dumping sites for a fee. Chairperson of the police forum, Lizzy Mabena, believes measures should be taken to address abandoned land and initiatives explored to establish if the City can take over these properties, as many of them have accumulated significant municipal debt. “The City seems to be failing to hold large companies accountable, there are allegations that some are illegally dumping at the site, with others reportedly contracted by the City itself,” says Mabena. City says rehabilitation is underway The City of Johannesburg’s Environment and Infrastructure Services Department (EISD) admits the Kya Sands landfill, which ceased operations in 2010, has become a hotspot for illegal dumping and related environmental challenges.  In a statement MMC for Environment and Infrastructure Services, Jack Sekwaila, said recurring waste fires were contributing to deteriorating air quality in Fourways, Cedar Lakes and Bloubosrand. Sekwaila says measures to curb illegal dumping have been strengthened, and interventions to extinguish and prevent recurring fires are actively underway. EISD Executive Director Dr Tebogo Modiba described the project as a long-term intervention aimed at permanently securing the site, preventing illegal activities and providing a long-term waste management solution for the area. The City said approximately 98,000 tonnes of illegally dumped waste had been removed, while security personnel had been deployed at the site. It said eight local SMMEs had been subcontracted for plant hire and other services, with 37 community members employed on the project. The City also said air quality monitoring systems were completed in January 2026. For Deborah, however, the impact remains immediate. “We really are not living in a very healthy environment right now.” Author Gerald Masuku Ditiro Gerald Masuku is a senior multimedia and digital journalist with experience across print, digital, social media, and magazine publications. I am passionate about multimedia storytelling, and have covered diverse beats. View all posts

Seventy-five percent of girl learners surveyed in I_Menstruate Movement’s Bleeding in Silence: Barriers to Menstrual Hygiene Among School Girls in South Africa research reported distress at menarche, their first menstruation. This finding highlights an often-overlooked dimension of menstrual health: the emotional impact of navigating menstruation without adequate information, resources and support.  As we commemorated World Mental Health Day on 10 October and the International Day of the Girl Child on 11 October, I_Menstruate Movement is calling for urgent action to address the systemic barriers that undermine girls’ dignity, mental wellbeing, safety and right to education. The Movement is marking these commemorations in Maseru, Lesotho, through participation in the 29th Ordinary Session of the Civil Society Organisations Forum, the 48th Ordinary Session of the African Committee of Experts on the Rights and Welfare of the Child (ACERWC), and a side event on Utilising the ACERWC Mechanisms for Universal Child WASH and Menstrual Hygiene, hosted by the Centre for Human Rights based at the University of Pretoria. Our participation brings the lived experiences of children in South African schools into continental conversations on children’s rights and accountability. It reinforces a central message of our work: menstrual health cannot be separated from mental wellbeing, education, safety, dignity and equality.  Menstrual health is more than access to products When girls lack menstrual products, clean water, safe toilets and accurate information, menstruation can become a source of anxiety, shame and exclusion. Stigma and fear of embarrassment can make it difficult for children to ask for help, participate confidently at school or manage menstruation with dignity. Menstruation itself is not a mental health problem. However, the conditions surrounding it, including stigma, inadequate facilities and a lack of support, can contribute to emotional distress. Governments must therefore treat menstrual health as an essential part of protecting children’s physical and mental wellbeing, rather than leaving girls to navigate these challenges alone.  Girls must help shape the solutions At I_Menstruate Movement, we challenge these systemic barriers through participatory research, child-led advocacy, education and movement-building. Our Menstrual Health Equity Bill, developed through a child-led process with school-going members, demonstrates that children can identify policy failures and help shape the legislative protections needed to address them. We believe girls must not only be heard when policies are developed; they must have meaningful opportunities to shape solutions, influence public investment and hold decision-makers accountable.  From commitments to action We call on governments across South Africa and Africa to invest in safe and accessible school WASH facilities, reliable access to menstrual products, age-appropriate menstrual health education and supportive environments where children can speak openly without fear or stigma. These commitments must be backed by adequate budgets, clear responsibilities and mechanisms to monitor implementation. Continental platforms such as the ACERWC provide important opportunities for civil society to bring evidence of children’s lived experiences into regional accountability processes and press governments to fulfil their obligations. Children, especially girls, must be part of these processes, not simply the subjects of policies designed by adults. As we mark these two important days, our message is clear: girls should not have to endure shame, distress or exclusion because they menstruate. Menstrual dignity is a matter of children’s rights, and those rights must be protected, resourced and fulfilled. We must stop asking girls to adapt to systems that fail them and start changing those systems.  Author Tracey Malawana Tracey Malawana is the founder and Executive Director of I_Menstruate Movement. View all posts http://imenstruate.org/ Founder and Executive Director

In April 2023, the National Department of Health published Draft Regulation R3337, proposing changes to the way foodstuffs are labelled and advertised in South Africa, including the introduction of prominent front-of-pack warning labels on certain products high in sugar, sodium and saturated fat. More than three years later, South Africans are still waiting for these regulations to reach the finish line. Three years is a considerable period in public policy, particularly when the policy in question concerns a preventable contributor to the country’s growing burden of non-communicable disease. During this time, the evidence supporting clearer food labelling has continued to grow internationally, while South Africa’s proposed regulations have remained caught in a lengthy process of consultation and negotiation. The country now needs to move from deliberation to implementation. We have been debating this for long enough The case for front-of-pack warning labels did not begin with the publication of R3337. South African researchers have spent years examining how consumers understand nutrition information, which warning-label designs are most effective and how such measures could work within the South African food environment. The proposed system has therefore emerged from a substantial body of local research, public consultation and policy development rather than being an intervention introduced without consideration of its potential consequences. There is also considerable international experience to draw upon. Countries including Chile, Mexico and Argentina have introduced front-of-pack warning labels, while the World Health Organization has recognised interpretive front-of-pack labelling as an important policy measure for helping consumers identify products with excessive amounts of nutrients of concern. Evidence from countries that have implemented these systems indicates that warning labels can improve consumers’ understanding of the nutritional quality of products and can create incentives for manufacturers to reformulate products to avoid receiving warnings. South Africa should continue to consider legitimate questions about how the regulations will operate in practice. However, after years of research, consultation and policy development, the central issue should now be how the regulations can be implemented effectively rather than whether the country should continue debating the principle of clearer food labelling. NEDLAC must help decisions move forward This is where the current process involving the National Economic Development and Labour Council (NEDLAC) becomes particularly important. NEDLAC has an important constitutional and institutional role in South Africa’s system of social dialogue, bringing together government, organised business, organised labour and community constituencies to consider policies with significant socio-economic implications. Meaningful engagement with affected stakeholders is an important part of good policymaking, particularly where regulation may have economic and commercial consequences. However, consultation is ultimately intended to improve decision-making. It should not become a mechanism through which decisions are indefinitely postponed. NEDLAC’s own protocol for the tabling of matters recognises the importance of concluding its processes within a reasonable period. The protocol indicates that, unless a matter is exceptionally complex, the NEDLAC process should ordinarily be completed within six months. This does not mean that complex policy questions can or should be rushed. It does, however, establish an important principle, in that social dialogue should have a reasonable endpoint. R3337 has already been under consideration for substantially longer than that period since its publication in 2023. If the regulations are now before NEDLAC, this process should be used to address outstanding issues and enable government to make a final decision. It should not become another stage at which an already lengthy policy process is allowed to drift without resolution. Delay has consequences for public health The consequences of delay should also be considered in the context of South Africa’s health burden. The country faces high levels of obesity, hypertension, diabetes and other non-communicable diseases, with unhealthy diets contributing to this burden. Government therefore has a legitimate public health interest in creating a food environment in which consumers can more easily understand the products available to them and in which manufacturers have incentives to improve the nutritional quality of those products. Front-of-pack warning labels are not a solution to every problem within the food system, and they should not be presented as one. They are, however, one evidence-based measure within a broader package of interventions aimed at improving diets and reducing exposure to unhealthy food environments. The argument that consumers can simply consult the existing nutrition information on the back of a package also overlooks the purpose of interpretive labelling. Consumers make purchasing decisions quickly, often while navigating a large number of products and competing marketing messages. Nutrition information that requires considerable time or nutritional knowledge to interpret does not provide the same form of information as a clear warning displayed prominently on the front of a package. Public policy has a role in ensuring that important information is accessible at the point where decisions are made. Government must now make a decision The responsibility for bringing R3337 through its final stages ultimately rests with government. Legitimate concerns raised by business and other stakeholders should be considered, but consultation must ultimately lead to a decision. After three years of research, public engagement and policy deliberation, South Africans should not be left waiting indefinitely while the regulations move through one procedural stage after another. A public countdown is now calling on the Minister of Health to approve R3337 by 10 December 2026. This deadline provides a clear opportunity for government to demonstrate that evidence-based public health policy can move from consultation to implementation. NEDLAC has an important role in facilitating social dialogue, but it should not become a place where health resolutions go to die. South Africans have waited three years for stronger protection from an unhealthy food environment. The evidence has been considered. The stakeholders have been heard. Now government must act. Authors Zukiswa Zimela Zukiswa Zimela is Communications Manager at the Healthy Living Alliance (HEALA), a coalition of civil society organisations advocating for equitable access to affordable, nutritious food in South Africa. View all posts https://heala.org/ Communications Manager Darshen Naidoo Darshen Naidoo is a Public Health Law and Policy researcher at PRICELESS SA at the South African Medical Research