Separate Public Hospital Units: This Is Not Reform, It’s ‘Class Apartheid’

The The Announcement by president Netumbo Nandi-Ndaitwah that senior government officials must start using public hospitals was, at face value, bold and commendable.

It signaled a willingness – at least in principle – for those in power to share the same healthcare system as ordinary citizens.

It could have been a turning point, a symbolic bridge between leaders and senior officials and the realities ordinary citizens face.

What is emerging instead is a troubling contradiction: a policy framed as improvement and equality has devolved into separation.

There are many ways to describe this: healthcare apartheid; VIP care; public neglect; a nation in one hospital, divided by status; equal on paper, apart in practice; a fast track for the powerful, a waiting room for the rest. The list goes on.

Creating exclusive hospital units for senior government officials fundamentally undermines the spirit of the directive.

While citizens queue for hours, sit on worn benches, and navigate understaffed wards, a parallel system is being built – faster, better resourced, and reserved.

The message it sends is: equality is being performed, not practiced.

This is where the phrase “equal but separate” becomes painfully relevant.

HISTORY AND HIERARCHY

Let’s be clear: the issue is not that hospitals are being upgraded. That is long overdue.

The issue is the speed and selectivity of these upgrades.

When facilities designated for officials are improved “at the speed of light”, while ordinary wards remain stagnant, it is difficult to justify.

It suggests that efficiency is possible but that it is only prioritised when the beneficiaries are powerful and privileged senior government officials.

For the average citizen, improvements remain a distant promise, always deferred, always delayed.

This raises an uncomfortable but necessary question: if rapid transformation can happen for a few, why not for all? The answer, it seems, lies not in capacity but in the political.

That is precisely what makes this situation troubling. It exposes a gap not just in infrastructure, but in empathy and sensitivity.

Healthcare is not a luxury, it is a fundamental right.

And rights, by definition, should not be tiered.

When access to quality care depends on one’s political status, we are no longer dealing with a public health system but the emergence of a class-based structure that mirrors the inequalities we struggled to dismantle during the liberation war.

APARTHEID AND ACCOUNTABILITY

To call this a modern-day form of apartheid may sound provocative, but it is not without basis.

t its core, apartheid was about separation justified by difference.

It created systems where one group received superior services because of who they were.

While the context here is different, the underlying logic is unsettling.

A hospital that treats patients differently based on their governmental or political standing is not just inefficient, it’s unjust.

Defenders of this approach might argue that such units are necessary for security, logistical reasons and revenue generation; that senior officials require a certain level of privacy or protection.

While these concerns are not entirely unfounded, they should not come at the cost of equity.

Security measures can be implemented without creating separate systems of care.

When separation becomes the default solution, we risk normalising inequality.

Moreover, perception matters. Even if the intention behind these ‘exclusive units’ is benign, the optics are damaging.
Citizens are not blind to disparities around them.

They see the new equipment, the faster service, the cleaner spaces; they notice who has access to them.

This breeds resentment, erodes trust, and deepens the divide between the public and those in power.

“Shared hospitals, divided care.” That is the reality we are drifting towards.

MISSING THE BOAT

If the aim of the directive was to improve public healthcare, the approach must be re-evaluated.

True reform does not isolate excellence, it distributes it.

It ensures that every patient, regardless of status, walks into a facility adequately equipped, properly staffed and efficiently run.
It does not create islands of quality in a sea of neglect.

There is also a missed opportunity here. Imagine if senior officials were required to use the same facilities, under the same conditions, as everyone else.

The pressure to improve would be immediate and undeniable. Waiting times would shrink.

Resources would be allocated more fairly.

Accountability would no longer be abstract, it would be personal.

That is the kind of transformation that policies like this should aim for.
Instead, we see a dilution of intent.

A powerful idea is being softened into something far less impactful.

The directive risks becoming a hollow exercise rather than a genuine effort at reform.

“Equality cannot live in separate rooms.” It is a simple truth but one that carries profound implications.

‘MIND THE GAP’

If Namibia is serious about building a fair and inclusive healthcare system, it must resist the temptation to create shortcuts for a few.

Progress should be measured by how consistently all citizens receive dignified care.

Anything less is not reform, it can be seen as rebranding inequality.

The question “is this fair at all?” answers itself. Fairness is not just about policy declarations, it is about lived experiences.

As long as that experience remains unequal, no amount of rhetoric can bridge the gap.

In the end, the legitimacy of any public system rests on trust. And trust cannot thrive where there is visible, institutionalised disparity.

A hospital should be a place of healing, not a reflection of social hierarchy.

If we allow “equal but separate” to take root in our healthcare system, we risk normalising a dangerous precedent, one where inequality is not only accepted, but designed.

For me, that is a future worth resisting.

• Ndumba Kamwanyah is a public policy expert (PhD) focusing on the interplay of social welfare policy, development and democracy. He is also a certified mediator with a master’s in conflict studies.

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