It’s the worst thing to happen – to anyone.
We meet Natasha Sibanda in Johannesburg’s bustling Central Business District. On the street, the cantankerous crowd has a life of its own, their colorful clothes distinct in the morning light as they move in unison like shoals of fish.
Adjacent to this street is a tiny one-bedroom apartment the size of a matchbox and in grimy grey.
As we enter, a pall of gloom. Sibanda, only 22, lost her husband Samuel four weeks ago in Zimbabwe, his country of birth. Their only son is a year old.
“My husband was 25 years old&#8230; We were in Zimbabwe visiting family when he suddenly fell ill. We went to the hospital where they gave us a list of all the items they needed in order to help him. We had to buy all of them [with] cash at a pharmacy before they could treat him,” she says, as a lone tear rolls down her cheek.
The items totaled a bill of $300, which they didn’t have. Her sister, working in South Africa, promised to send the money the following day.
“I pleaded with the hospital to help him while we looked for the money because we both lived in Zimbabwe and had no jobs but they said his condition wasn’t serious and we had to come back when we have money because the hospital didn’t have any of the medicines needed.”
Heartbroken and worried, Sibanda took her husband home.
The night was going to be long.
At about 2AM, Samuel started vomiting. She took him back to the hospital where he was declared dead on arrival.
“I’m still not sure what killed him but I’m hurting because doctors wanted to help him but couldn’t because they didn’t have medicines and now he is dead and my son has no father,” sobs Sibanda.
Her story is only one of many painful parallels in some of Africa’s developing economies with poor – and crippling – healthcare systems.
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“You don’t want to fall ill in Zimbabwe. It’s like a backyard garage where you bring all your car parts for your vehicle to be fixed. If you have no cash, you can’t be treated,” says Mthokozisi Khuphe, a former government nurse.
Khuphe worked for government for eight years before moving to the private sector and then migrating to work in Namibia.
“When I started, there was already a crisis. I remember there was a big strike and a lot of people resigned. We, the new junior staff, had to work on everything even though we were just starting out. I would have 120 to 150 patients in a day [who] I had to help by myself,” says Khuphe.
He says Zimbabwe’s healthcare system was and still is putting patients’ lives at risk.
“Many patients lost their lives. I remember sometimes there would be no syringes, and needles were in shortage. We would reuse them repeatedly on the same patient when in fact you are supposed to use one and dispose it off immediately&#8230; There was even a time the whole hospital had one ventilator&#8230; As a nurse, it is difficult to know what can help the patient but you don’t have the equipment and the patient dies.”
Zimbabwe is not alone. Africa’s public healthcare sector is in the intensive care unit.
Although the situation is not as terrible as in Zimbabwe, the World Bank and World Health Organisation issued a report on universal healthcare in the world in December, where South Africa received a score of 70 out of 100 for Universal Health Coverage. (The National Health Service (NHS) in the United Kingdom (UK) scored 90.)
The report stated that the poor quality of healthcare in the public sector was concerning.
Jasson Urbach, a director of the Free Market Foundation and head of its Health Policy Unit says the situation is dire. There are pervasive problems with the quality of healthcare in the public sector.
“The healthcare system is a sea of mediocrity in the government-run healthcare sector, punctuated by islands of excellence in the private healthcare sector. Currently all political will is aimed at implementing National Health Insurance (NHI) [free health for all] and nothing is being done to address the current issues of pervasive poor quality in the public sector,” he says.
According to Urbach, the NHS in the UK employs 1.3 million people to service 55 million UK residents, yet the entire South African civil service employs 1.3 million people.
“To think that South Africa can run a government administered Universal Health Coverage system such as the National Health Service is unrealistic.”
He says the poor quality of services in the public sector is the single greatest challenge in South African healthcare.
“If the quality is not addressed, 70 percent of public facilities will not qualify to contract with the NHI, if it gets implemented, which will collapse service provision in the healthcare system altogether. Poor quality is not the result of shortages of funding; it is the result of poor management,” he says.
It is true.
According to inspection records published by the Office of Health Standards Compliance, a government agency in South Africa, hospitals and clinics in the government’s flagship NHI pilot program are failing to improve any faster than those in the rest of the country.
<a href="http://www.forbesafrica.com/uncategorized/2018/04/03/death-denial-fear-listeriosis-cost-south-africa/" target="_blank" rel="noopener">READ MORE: Death, Denial And Fear: What Listeriosis Cost South Africa</a>
Among the 1,427 facilities inspected, only 89 scored a pass mark of 70% or more. Facilities fell short on matters ranging from the availability of medicines to infection control.
“As an example, there are contracts with cleaning services in place in all public facilities, or cleaners are employed. If a facility is not considered clean, that is a management failure. Poor systems and processes lead to undue delays in treatment. Incompetent political managers at the provincial level, leads to incompetent appointments at hospital levels, which leads to failure of the system,” says Urbach.
Patients in South Africa’s public hospitals are dejected.
Results cited in the General Household Survey 2015 suggest healthcare received from the private sector is significantly preferred to that from the public sector, and states that users of private healthcare facilities seem to be more satisfied with those facilities than users of public healthcare facilities, across all provinces.
“Whereas 97.7 percent of users were satisfied with private facilities (91.9 percent were very satisfied), only 81.1 percent of users of public healthcare facilities were somewhat satisfied or very satisfied. Only 57.6 percent of individuals that used public healthcare facilities were very satisfied,” states the report.
According to Urbach, another problem is that the government does not have the same incentives as the private sector. It partly explains why there are poor healthcare outcomes in the public sector.
Dr Matthew Adams, a surgeon at one of the big public hospitals in South Africa, agrees with Urbach.
“Private hospitals pay two to three times more than government and they have better working conditions compared to us&#8230; essential machine breakdown and fixing them is delayed, and tenders to supply certain things are given to people who can’t deliver on time which always sets us back,” he says.
That’s not all.
Adams says hospitals are understaffed and they have to work long hours and there is misadministration by hospital management.
“[The] department says there is no more money for new doctors but not enough monitoring is done on how much is spent per patient and measures aren’t taken to see how we can save the hospital money&#8230; Hospitals are actually set up in a hierarchy, so that the first place a patient goes to is a clinic before a hospital for day-to-day assistance, but because of low quality, patients overlook lower level health centers to go to hospitals and doctors see cases they are not supposed to see adding to doctor frustration,” he says.
Frustration leads to doctors leaving the public sector for the private sector, or leaving the country altogether.
“The last time I saw statistics [about the number of doctors leaving] was in 2005 when the Health Professions Council of South Africa reported that despite the fact that medical schools produced approximately 19,500 graduates between 1990 and 2005, their records show only 9,304 new registrations during this period. This implies that a significant number of individuals, after graduating, instead of practising in South Africa, are leaving the country,” says Urbach.
Among the common reasons cited for the mass exodus of skilled healthcare personnel from the public sector are poor salaries, high workloads, poor work environments and few opportunities for advancement.
According to Liz Still, who compiles the annual Health Care in South Africa publication, the public sector does not have enough posts available to employ South Africa’s health professionals. For example, over the period 2002-2010, approximately 11,700 doctors graduated but only 4,403 posts were created in the public sector. In the field of dentistry, there were 2,140 graduates but only 248 public posts were concurrently created.
These conditions impact the quality of care.
According to various reports, last year, South Africa’s Health Minister, Aaron Motsoaledi, said more than 5‚500 medical negligence claims have been made against the health department since 2014. The number of claims grows every year. There were 1‚562 claims made in 2014/15‚ 1‚732 in 2015/16 and 1‚934 in 2016/17.
And it hurts the tax payer.
The department paid R391.32 million ($32.4 million) in medico-legal claims in 2014/15 alone and a whopping R730.87 million ($60.6 million) in 2015/16.
It is so bad that in 2016/17‚ the total value of claims rose to R1.2 billion ($99.5 million)‚ with Gauteng&#8217;s 521 claims accounting for almost half of this at R566 million ($47 million).
Romany Sutherland, an attorney at LLA INC. Law, says the majority of these cases are due to obstetric damages.
“These are children who suffer brain injury as a result of complications during birth&#8230; South Africa has a 10 percent higher cerebral palsy rate than anywhere in the world and we don’t know why this might be&#8230; To me, as an attorney, it comes down to perhaps people not being trained properly. Nurses are not involving the obstetricians soon enough,” she says.
Cerebral palsy cases cost the government about R17 million ($1.4 million) on average per case.
“Each province deals with the issues differently. I’m in the Western Cape and here; we try and negotiate or mediate these cases as soon as possible so that reasonable pay-outs are made without undue delay. I believe the best way to go with the negligence cases is to take the initiative to open discussion with your opponent,” says Sutherland.
The problem is, some health departments don’t have any decision-makers who have settlement authority. It means all negligence cases have to go before a judge in the court of law before the department can pay out. It takes longer and costs the state more money.
“The litigation process is extremely expensive. The amounts you see reported in the media don’t include costs. It is a big worry because I haven’t gone to court in nine years because I like to negotiate cases and come to reasonable settlement and the Gauteng government doesn’t allow for that to happen,” she says.
According to Sutherland, some costs to take the case through trial can be four times the amount of settlement.
The amount of money that attorneys stand to make on such cases has caused a boom in the medical negligence industry.
“There are attorneys who are touting for clients and some even paying midwives up to R30,000 ($2,500) for a file. There are also some frivolous cases where the negligence did not cause damages&#8230; yet they carry on&#8230; If such cases are settled, it is not the touting attorney’s fault but the department that is not defending those cases properly,” she says.
The rise in lawsuits is also causing medical insurance for obstetricians to rise.
“An obstetrician is currently paying R1 million ($82,830) in insurance. I think the price has gone up by approximately R100,000 ($8,283) if not more every year for the past couple of years&#8230; This is also cause for some medical students to not consider this field because insurance is just too expensive.”
Back in Johannesburg, as we part with Sibanda, she tells us she wants to go back to school to study public healthcare administration so she can help the very hospitals that didn’t give her husband timely treatment. She wants to save lives.
If only government authorities sitting in their airconditioned offices and seeking treatment in plush private hospitals knew her pain and predicament.

Operating theatre in a cardiac surgery ward. Anesthetics.

Would You Seek Medical Care In Africa’s Public Sector?

Instead of saving lives in hospital, 27-year-old Sherwin Prim, who spent 10 years qualifying as a doctor at the University of the Witwatersrand, is in jobless limbo.
This is Prim&#8217;s depressing lot since he finished his internship on April 30 in Cape Town. The Department of Health (DOH) told him there was a delay over the allocation of posts in community service and internship positions, the next stage in his career.
&#8220;Fortunately, my mom has taken me in and I still have my car,&#8221; he says.
Every day Prim hopes for a post before his life savings run out – a reality unimaginable when he moved down from Johannesburg to take up a bright future as an intern two years ago at the Tygerberg Hospital.
&#8220;I can&#8217;t practice as a doctor at the moment. It is illegal. It would be against our professional regulations… I can only do so once I have completed my community service,&#8221; says Prim.
The rules say doctors need to intern for two years, after graduation, plus complete a year of community service to be allowed to operate within the law. According to the DOH, posts open in two cycles. Once at the beginning of the year, to accommodate those who have qualified in the standard period, and in mid-year for those who qualify later.
<div id="attachment_33206" style="width: 310px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-33206" class="wp-image-33206 size-medium" src="https://www.forbesafrica.com/wp-content/uploads/2017/08/Sherwin-1-e1503343147389-300x248.jpg" alt="" width="300" height="248" />Dr Sherwin Prim. (Photo supplied)</div>
Prim hoped in vain for the second cycle, which would have meant a starting date of May 1.
&#8220;I have been waiting for the last three months without a salary. It is a serious administrative issue.
<div class="mceTemp"></div>
Doctors are being misinformed, they are not being allocated to positions.&#8221;
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It means Prim went from an average internship salary of R380,000 ($28,400) to moving back home to Johannesburg with his mother. These days all he can do is part-time work as a tutor at the university where he graduated.
&#8220;I have been doing some casual work through the university, invigilating and facilitating clinical skills with med students in the meantime. But most of this has been once or twice a week. I am not allowed to work more than 23 hours a month. It’s nowhere near my salary as an intern and works out to just R200 ($15) per hour.&#8221;
Prim isn&#8217;t alone. Other medical staff have found themselves scraping by as waiters in Spur, call center agents and estate agents.
Doctor Naira Langenbach works as a stand-in secretary in Johannesburg.
&#8220;The worst part is the unknown. The worst part is that you sit there and ask ‘when are they going to call me?’ I say to myself ‘just breathe, its fine, it&#8217;s going to be alright’,&#8221; says Langenbach.
&#8220;[At the reception desk] I try not to tell people I am a doctor, because I get very indignant, very quickly. I just want to be done with this. As soon as I am given my post I am going to go do my year of community service and then my degree will be worth something. I&#8217;ll probably do an MBA or maybe biomedical engineering. I am not going to do this anymore.&#8221;
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It is worse for Langenbach because she was born in Amsterdam, Netherlands. Despite being educated in South Africa since she was nine years old, she feels she is pushed to the back of the queue.
<div id="attachment_33230" style="width: 235px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-33230" class="wp-image-33230 size-medium" src="https://www.forbesafrica.com/wp-content/uploads/2017/08/Naira-Langenbach-225x300.jpg" alt="" width="225" height="300" />Dr Naira Langenbach (Photo supplied)</div>
&#8220;What bugs me most about this is my degree is the same. It&#8217;s not that I have a dodgy degree. My degree is the same as the people from my year; exactly the same, 100 percent.&#8221;
It isn&#8217;t the first time she has had to work as a secretary either. When Langenbach graduated from university in 2015, she was forced to scrape for work for five-and-a-half months before her international work permit was issued.
&#8220;Last time [I was working for] one of my lecturers, I was helping them out with their accounts. That’s what I ended up doing. It&#8217;s not a good use of my skills. Now I&#8217;m back [where I started].&#8221;
It took a year for Langenbach to get word of a community service post, and when it came she missed it.
&#8220;On Saturday, because I am an orthodox Jew, my phone was off. On Monday morning I get a snotty email saying you didn&#8217;t pick up the phone and you will have to start work on the first of January 2018,&#8221; she says.
Langenbach tracked the caller down but was too late – her post had been given to someone else. The man on the phone promised to resolve the matter. Two days later, on July 11, Langenbach received an email saying she was awarded a post for a hospital in Mpumalanga; she didn&#8217;t even apply for it.
&#8220;I might have been allocated a spot, but I don&#8217;t trust it. There have been a lot of hoax emails going around and I can&#8217;t get hold of anybody to confirm it. I have no proof, no contract, no letter, no nothing.&#8221;
&#8220;I&#8217;m broken. I&#8217;m so defeated. Even when I tried to call Mpumalanga they hang up the phone after three rings.&#8221;
&#8220;You reach a point where you accept [the delay] and say okay I&#8217;m going to [give up], if I start work I start work. But in the meanwhile I think &#8216;am going to become a specimen cutter for Lancet?&#8217; The same week that you resign your hopes, the same week, the national department says they are going to open up applications. This hope that you tucked away is suddenly the size of three houses. Then they crush your hope. And you are back to asking ‘am I doing this again?’&#8221; says Langenbach.
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Zahid Badroodien, a doctor and chairperson of the Junior Doctor Association of South Africa (JUDASA), says four South African community service doctors, 20 international community service doctors,  139 South African interns and 63 international interns remain unlikely to receive any employment this year because of insufficient posts.
<div id="attachment_33231" style="width: 430px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-33231" class=" wp-image-33231" src="https://www.forbesafrica.com/wp-content/uploads/2017/08/Zahid-Badroodien_JC-5-e1503483209160-300x200.jpg" alt="" width="420" height="280" />Dr Zahid Badroodien (Photo by Jay Caboz)</div>
Badroodien works at the Site C Youth Centre in Khayelitsha, a township 30 kilometers south east of Cape Town, where he sees the cost of the shortage of doctors.
&#8220;This facility sees 200 people a day and we turn people away. We have three or four doctors here depending on the day. We need more people to come into the system.&#8221;
&#8220;As a community service doctor, who works in a clinic on an ordinary day, I am here from 8AM to 4PM every day. My call [at the hospital in Khayelitsha] then starts at 5PM and finishes at 7AM. I am then back at the clinic at 7AM until 12PM. Then I go home. Then I come back the next day and it starts all over again,&#8221; says Badroodien.
This dispute is just one of many complaints by junior doctors about an online system that came in August last year. The system places around 1,200 interns and 400 community service doctors a year.
&#8220;There have been many excuses as to what the problems are. Initially we were told there were technical difficulties with the online application system. Subsequent to that we were told the difficulties were with internship posts, specifically that there weren&#8217;t enough internship posts for the number of applicants that were applying,&#8221; says Prim.
In November, JUDASA cried foul that 307 (of about 1,700) medical students applying for internship had either not been placed or were placed inappropriately.  This included neglecting special circumstances because of a computer glitch which overlooked whether a student is married, pregnant or an owner of property.
The issue dates back to November 2015, when doctors got fed up with the manual paper application system that would regularly lose applications, says Badroodien.
&#8220;What I gauged at that stage was the [DOH] didn&#8217;t really understand the extent to which this impacts doctors&#8217; personal lives, but also the people they needed to serve, the clinics where doctors needed to serve,&#8221; he says.
Beneath the surface there is also an internal battle between the DOH and provinces for the control of posts and placements. Provincial departments, that run the hospitals, make the final call. This means the DOH cannot guarantee whether a province accepts the doctor, once the posts are issued.
The process of acceptance can cause months of delay. Letters of employment are issued by the DOH according to vacancies supplied by provinces. The doctors then have to be interviewed by provinces and then issue contracts, which is the guarantee of employment. Then doctors must travel back to Pretoria to submit the contract of employment, along with the DOH&#8217;s letter of acceptance, to the Health Professions Council of South Africa (HPCSA).
&#8220;There is a lot of bias that comes in. When I was employed as an intern I was approached by a hospital to come and work for them, before I had even applied. That to me is problematic … We all have South African degrees, we all are South Africans, how are you choosing who is better placed for your hospital,&#8221; says Badroodien.
The DOH tells a different story. Aaron Motsoaledi, the Minister of Health, refutes claims that the system has been delayed and has denied the freezing of posts.
He claims that doctors are at fault, turning down positions.
“There are those who were placed in January and they declined those placements, saying they’d rather wait for the next cycle because they are not going to a certain hospital which is too rural or whatever. Others give religious reasons while others quote illness,” says Motsoaledi.
In a statement in January, Motsoaledi also addressed the concerns of JUDASA concerning the freezing of posts.
&#8220;Since the beginning of the year, we have been inundated with media queries about doctors and pharmacists who could not get employment in the public service because the government allegedly failed to place them into posts, or alternatively failed to create posts.&#8221;
&#8220;Despite trying very hard, the department is not always in a position to accommodate all the needs.&#8221;
South Africa needs every doctor it can get; a rising concern is when hospitals are forced to limit posts due to budget cuts.
In a 2016 announcement Motsoaledi said: &#8220;We want to put it on record that there are no medical posts frozen in this country. If there is freezing of posts by government departments, they have nothing to do with medical doctors as posts in the health sector are exempted. The country needs doctors to work in health facilities and therefore there is no way we can put moratorium on medical posts.&#8221;
Although the minister has denied there was a lack of posts, the DOH’s director-general, Malebona Precious Matsoso, told a parliamentary standing committee in March the DOH could not afford to hire the doctors they needed.
In Matsoso&#8217;s presentation she said the healthcare system had 45,733 vacant posts, and 351,925 filled posts. The vacancy number included frozen posts. The situation is so bad that two state-of-the-art buildings in the Free State cannot be opened because there are no health workers.
At the clinic in Khayelitsha, reality hits home. Badroodien says patients come as early as 4AM to queue and, due to the lack of doctors in other provinces, patients will travel more than 600 kilometers for treatment.
&#8220;When a patient from the Eastern Cape comes to our clinic with a broken neck to be seen by a doctor here, you need to say that is unacceptable,&#8221; says Badroodien.
&#8220;The national health department now finds itself at a tenuous junction: Find the money to open posts for medical interns or risk leaving dozens of graduates essentially unemployable,&#8221; says Badroodien.
South Africa’s dwindling economy and recent ratings downgrades could topple the country’s already fragile public health systems, experts have warned. So the next time you are sitting in the hospital and asking where the doctors are, they could be waiting on tables, answering phones or sitting at home.
<h2>Understaffed, Undersupplied, Unhappy</h2>
A 2015 study by research group Econex shows the extent of the health crisis. South Africa had 60 doctors per 100,000 citizens in 2013, while the world average was 152 doctors per 100,000 citizens.
The South African Medical Journal (SAMJ) in June released a report from 2,225 doctors that revealed the most significant reason doctors gave for leaving the public sector was dissatisfaction with working conditions.
The survey showed 60.73% of public sector doctors said the state of supplies was inadequate. Just over 66% of public sector doctors were concerned about the lack of equipment and infrastructure compared to 20.41% in the private sector. Around 38% of doctors in the public sector said hygiene and management was not of a good standard. In the private sector this was only 5.37%.
The report, conducted by the Colleges of Medicine of South Africa (CMSA) that included South African Medical Association (SAMA) members, found further underlying reasons for doctors leaving: immigration, better opportunities in private practice as well as being unable to apply for posts as they were frozen.

The Waste Of Doctors Waiting On Tables And Answering Phones

For two months, his eyes, like big saucers, stared at the ceiling, lost somewhere between the living and the dead. The little boy lay listless in his hospital bed in Nairobi, Kenya. A sheet clung to his tiny frame, but it couldn’t hide the scars from the third-degree burns beneath and traces of the violence wreaked on this young life. Into this shattered existence came a ball of paper and string called Chico.
“He couldn’t talk, but Chico raised his arm and talked to him. He clung to Chico’s hand and for the first time in two months, he smiled,” says puppeteer Daniela Hadasy.
Chico is a larger-than-life puppet dog. In the hands of the puppet master, the dog with the cheeky smile has bounced his way into the hearts of sick and injured children in hospital wards across Ethiopia and Kenya.
“The idea is to draw out the emotion from the children so they can deal with their terrible traumas. When it’s a puppet talking to them and not an adult, they feel more free to talk openly. Yes, I’m sitting there and pulling the strings, but it’s the puppet who’s sharing his problems and telling the children how he feels, especially when things are bad. And because he’s telling his story, the children feel safe to tell theirs.”
The art of puppetry is nothing new. History records puppets in ancient Egypt more than 4,000 years ago. In rural Africa, puppets still flourish, but in the cities they are losing out to books and television. “Children everywhere connect with puppets, but in Africa, the puppets immediately become a part of them. It’s the right tool for children there, especially in the slums where most of them have so much anger inside and don’t even have a toy to play with,” says Hadasy, who comes from Tel Aviv, Israel.
Hadasy was seven when she discovered her talent for mimicking voices without moving her lips.
“I used to talk to myself all the time and although I instinctively understood it was normal for children to do this, it scared me that I could use my voice without moving any part of my body. For many years, I kept it
a secret.”
If you look carefully, you can see Hadasy’s stomach moving. Sometimes, there’s a faint quiver on her lips. But most times, she sits perfectly still and lets the puppet create its magic. She holds a conversation with him, alternating between her voice and the one she’s given him. In a typical session, she starts off chatting about everyday things to build the confidence of the child.
“The puppet talks like a child and thinks like a child and so a friendship grows between them. Then, when the child trusts the puppet, we can begin to chat about really traumatic things. I’ve heard everything. Children confess to being raped, abused, to having terrible things done to them. Some of them are so lost and no one has been able to reach inside them.&#8221;
Puppets create a space of safety through which children can express their deepest fears. Follow-up sessions are done with teachers and nursing staff so the therapy is long-term.
“If, for example, medical examinations were done with puppets, it would be so much easier for children. In many of the hospitals, there’s not enough space for the parents to stay over and so children go through scary oncology treatment alone. Especially in the slums in Africa, children have been taught to hold their emotions inside, not to share them. They’re used to keeping quiet. Through the puppets, I help them express themselves, teaching them that if they have a problem, they need to talk about it because only then can someone hear them and
help them.”
Often, Hadasy gives the children small puppets of their own to keep.
“When a child holds a puppet, they feel it’s the puppet who’s doing the talking and so it’s easier for them to open up. They absolutely love their puppets; I’ve seen children take them with them to the toilet. He’s their friend because they really need him.”
She has traveled the world with her entourage of nine puppets, each with a name and a distinct personality. Taking care to create each puppet’s persona, Hadasy spends hours developing the puppet’s voice, giving it a family, making it a part of her and understanding which puppet is right for which children.
“I work in hospitals in Israel where there are a significant number of immigrant children from Ethiopia. One time a little girl asked me why I hadn’t created a black puppet. I felt so ashamed: How could I not have thought of it myself? So I gave birth to Lucia, a popular Ethiopian name in Israel. When I came back to the hospital, the girl was so excited. She said, ‘Oh, she’s like me, she looks like me. I’m so happy—she’s my friend.’”
The beauty of puppetry is that its language is universal and instinctively understood by children everywhere, even the dying child in Nairobi.
“The children in the hospital ward had gathered around his bed where Chico was hugging him, shouting enthusiastically as the puppet clasped the boy’s frail hand in his huge brown paw. We danced with him and we sang with him. I said to the nurse: ‘See that’s the point of puppetry—not just to talk but to dance and to sing and show that life is still beautiful despite the blackness inside.’”

Tag: Hospitals

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