In March 2015, the South African Human Rights Commission held a hearing on Emergency Medical Services in the Eastern Cape. The Commission’s interest in Eastern Cape emergency medical services emerged from a complaint submitted to the Commission by the community of Xhora Mouth, a group of around 2000 people living on the coast of the former Transkei in four villages.

While the evidence heard at the hearing demonstrated the complete absence of emergency medical services in the area, what was also clear was that it is not only a lack of access to services in an emergency that characterises this community but in fact a lack of access to even primary health care services.

A mobile clinic visits the community once a month to provide chronic medication to registered patients. A health point run and largely funded by local organisation, the Bulungula Incubator, is operated by Community Health Workers and tests blood pressure and blood sugar but can do little more. If a community member needs so much as a painkiller or a HIV test, she has to travel to the clinic. And this journey is arduous.

SECTION27 made the two-hour journey to Nkanya Clinic, the local clinic of the Xhora Mouth community, which provides nothing resembling easy access to primary health care services. A two-hour walk over hills and across a river is strenuous for a healthy person and must be near impossible for someone desperately in need of health care services. Sometimes, when a family member is too ill to walk, she will be pushed in a wheelbarrow all the way to the clinic. In rainy weather, the terrain becomes slippery and muddy, the trenches in the path deepening and the river widening, making a long journey even more treacherous.

In what follows we trace the steps of a person in need of primary health care services from Xhora Mouth to Nkanya Clinic.