A large children's hospital in Durban, South Africa, is being rebuilt two decades after it closed owing to apartheid. It opened in 1931 as a facility for all races, but racial tensions in the 1980s forced its closure.
Now with Durban and the surrounding province of KwaZulu-Natal extremely hard hit by AIDS and tuberculosis, local leaders are hopeful they can begin reopening the hospital early in 2013.
If the rehabilitation project is successful, it could restore one woman's dream from almost a century ago of having a multiracial hospital in Durban by the sea.
While child mortality rates almost everywhere else in the world have been falling, this part of South Africa has seen the rate rise. At some maternity clinics in the region, 50 percent of pregnant women are testing positive for HIV.
"HIV contributes to almost 50 to 60 percent of deaths in children under the age of 5 [in South Africa]," Mohern Archary, a pediatrician at the King Edward VIII Hospital in Durban, says.
This is why Arthi Ramkissoon, a public health director at the University of the Witwatersrand, is pushing to restore the boarded-up Children's Hospital in Durban.
"Children are a neglected part of the health system," she says, and a hospital dedicated exclusively to the needs of kids could help reduce the province's rising infant mortality.
The Durban Children's Hospital was the first facility in all of Africa dedicated exclusively to kids. It was built in 1928 by then-Durban Mayor Mary Siedle, who wanted to take a child of color for medical treatment but could not find a place.
The hospital had a mandate to serve kids of all races, but it sat on a prime, beachfront lot in a white neighborhood. Amid rising tension about the hospital attracting nonwhites into a white neighborhood, the apartheid regime shut it down in the 1980s.
Now the hospital's seven buildings have fallen into deep disrepair. Windows are shattered. Roofs have collapsed, and pigeons have taken up residence in the gutters.
Ramkissoon, who works with KwaZulu-Natal Children's Hospital Trust, is still trying to raise money to restore six of the seven buildings on the 3 1/2-acre site. The first building to be rebuilt is expected to open early in 2013. It will house a center for HIV-positive teenagers.
The focus of the new children's hospital, she says, will be broader than just HIV. There will be general pediatric medicine, psychological services and inpatient wards.
Ramkissoon hopes to take full advantage of the facility's prime location next to the Indian Ocean. "My vision is for children to have physical therapy on the beach," she says. "I'd like the wheelchairs and beds to be wheeled out there. I'm going to try to have a ramp or something out to the sand."
STEVE INSKEEP, HOST:
Let's go next to South Africa, to the city of Durban, where efforts are underway to rebuild a historic children's hospital that was shut down in the later days of white minority rule in South Africa. This hospital originally opened in 1931 with a mandate to serve children of all races, but it was hard to keep it open during apartheid times because of its location. It was sitting on a prime beachfront lot in a white neighborhood. Now, with local hospitals strained by the AIDS epidemic, city leaders are trying to reopen the children's facility. NPR's Jason Beaubien reports.
JASON BEAUBIEN, BYLINE: The Durban Children's Hospital was designed in the 1920s with stately porches and huge windows facing the Indian Ocean. But now the porches are crumbling, the glass is shattered, and red clay tiles of the roof have slipped out of place or fallen away completely.
ARTHI RAMKISSOON: And down here you can see original stained glass from the 1920s, which was put in at child height.
BEAUBIEN: Arthi Ramkissoon with the KwaZulu Natal Children's Hospital Trust is one of the people pushing to restore this institution to its former glory.
RAMKISSOON: There's one more here which is a bit damaged. We'll have to fix that.
BEAUBIEN: This project is more than just the restoration of a cool old building. It's a project entwined with apartheid, the historical inequities of South Africa, and AIDS.
RAMKISSOON: This was formerly known as the Addington Children's Hospital, built in 1928 by a woman who wanted to take a child of color for medical treatment and could not find a place.
BEAUBIEN: That woman was Mary Siedle, a white philanthropist from a prominent mercantile family. In the 1980s, amidst rising tension over the hospital attracting non-whites in to a white neighborhood, the apartheid regime shut down the Durban Children's Hospital. If the rehabilitation project is successful, it could restore one woman's dream from almost a century ago of having a multi-racial hospital in Durban by the sea.
Now, as South Africa grapples with AIDS instead of apartheid, this province has the highest rate of HIV in the country. At some maternity clinics in KwaZulu Natal, nearly half the women are HIV positive. AIDS has put significant new strains on the public health care system in South Africa and Ramkissoon says the medical needs of young people have often been pushed to the back burner.
RAMKISSOON: We have a population who almost half of which are under 24 years of age. We also have an increasing under five mortality. So together with the burden of HIV, children are a neglected part of the health system.
BEAUBIEN: On the other side of town, Dr. Mohern Archary a pediatric infectious disease specialist at the King Edward the Eighth Hospital, says HIV is also affecting kids directly.
DR. MOHERN ARCHARY: HIV contributes to almost 50 to 60 percent of deaths in children under the age of five.
BEAUBIEN: That's across all of South Africa, and he says the problem is even worse here in KwaZulu Natal. The new provincially-run hospital won't focus exclusively on HIV, but also offer general medicine as well as psychological and social services for children. That's the goal, anyway. Arthi Ramkissoon is still trying to raise money to restore the other six buildings on the three-and-a-half-acre site.
(SOUNDBITE OF CONSTRUCTION WORK)
BEAUBIEN: Amidst the bustle of construction workers working in one corner of the compound, Ramkissoon says she can already picture the finished ocean front hospital.
RAMKISSOON: We are going to have rehabilitation here as well as everything else, and my vision is for children to have their physiotherapy and other therapy on the beach. I would like the wheelchairs and the beds to be wheeled out there, so I'm going to try and have some sort of ramp or other access to the sand.
BEAUBIEN: The first building on the complex is scheduled to re-open early next year. It will house a center for HIV positive teenagers who've been on AIDS treatment since birth. Jason Beaubien, NPR News. Transcript provided by NPR, Copyright NPR.