Health-e News: The power struggles behind the TAC split in Free State

While the Treatment Action Campaign (TAC) has led a vocal campaign against the collapsing services in the Free State, targeting Health MEC, Benny Malakoane, TAC itself has been weakened by a split led by its own former provincial chairperson, Sello Mokhalipi. The split comes at the very time when serious financial woes have led to TAC cutting back on its provincial offices and retrenching staff.

Divisions came to a head a cold winter’s day in July 2015, when 117 community health workers and activists charged with attending an illegal gathering appeared to stand trial at Bloemfontein Magistrate Court. Outside the court, the slightly built Mokhalipi stood with 23 of those charged community wearing T-shirt with the words “HIV negative” emblazoned on them. Across from them, like a mirror image, were TAC activists wearing the iconic “HIV positive” shirts that Mokhaliphi had worn for almost 10 years. On that day, Mokhaliphi persuaded 23 of the 117 community health workers who had been charged to accept a controversial deal with the province: they would plead guilty, agree to never participate in an “illegal gathering” again and get their jobs back. In doing so, they became the Positive Action Campaign’s newest members and earned the wrath of those in the TAC, who were left asking whether they had been bought off. Although his new T-shirts bear an eerie resemblance to his old one, Mokhalipi says it sends a different message: “We are the Positive Action Campaign and our vision is to end Aids by 2030,” he says. “Our aim is also to get the HIV-negative people to join the struggle.”

But Mokhalipi was still wearing his TAC T-shirt when he blew the whistle on deteriorating conditions in the Free State health system in 2013. As TAC Free State chairperson, Mokhaliphi was instrumental in TAC’s campaign to improve health service delivery in the province, which led TAC to call for the sacking of the influential Health MEC, Dr Benny Malakoane. When the campaign began, Mokhalipi had been working for the Department of Health’s provincial AIDS council, seconded by TAC to the secretariat to represent people living with HIV. But Mokhaliphi has since become the leading actor in a complex drama in which he plays a charismatic character whose story is marked by sacrifice, persecution and betrayal.

His former TAC comrades describe him as charming, but with a leadership style that paces him squarely – and often singularly – in the spotlight: “Although he is great at standing for people’s rights and accountability, his authoritarian leadership made it difficult for people to work freely and express themselves,” says one TAC member.

Through TAC, Mokhaliphi worked with civil society to release a report on medicine shortages in the province. He says he knew that, in doing so, he had crossed a line and might be made to pay for it.

“I knew from this report that I was going to be threatened and the Department would plan to silence me,” he says, and he was right. After the report went public, Mokhalipi’s office was raided and his computer was seized by men who variously identified themselves as Hawks, police and Health Department officials. A sustained campaign of persecution began.

Mokhaliphi’s fears escalated after he and more than 100 activists and community health workers participated in a night vigil outside the Department of Health’s Bloemfontein headquarters in July 2014.

“We couldn’t sit anymore and wait for [Health MEC] Benny [Malakoane] to gamble with people’s life,” he says. “We had to stand up and fight.” That night, 117 community health workers were arrested and charged.

According to Mokhaliphi, he received a number of threatening phone calls telling him that TAC must stop calling for Malakoane to be fired. When four cars allegedly followed him after a radio interview, Mokhaliphi says he received another call. “Leave the country,” said the caller. “I lived a life of running,” says Mokhaliphi, who fled the province with his family.

The Free State Department of Health has denied allegations that Mokhaliphi was ever intimidated or threatened, according to Mail & Guardian reports. In October 2014, Mokhaliphi stopped running and returned home to a very different life. He had been fired from his position at the provincial aids council and alleges that TAC promises to fund his legal fight to get the job back never materialised. He also claims that the international human rights organisation, Amnesty International, gave funds to TAC to assist him during this time but that he was disappointed with the support he received and couldn’t continue with TAC. He then decided to form the PAC but maintains that the new organisation is not a reaction to the past two hard years, but the continuation of a project he began when he was first diagnosed with HIV in 2007.

“I was volunteering as a counsellor then at the Pelonomi hospital and it upset me that people were not getting their treatment,” he remembers. “I couldn’t sit and watch,” he adds. “I went straight to management, and I represented the patients and voiced out our concerns. From then on and with other volunteer councillors at the hospital, I formed a group that would fight stigma in the province,” says Mokhaliphi, who adds his initial decision to join TAC was a practical one

“We were a small fish in the HIV struggle,” he says. “We strategically wanted to be a TAC Free State branch as TAC would equip us with the treatment literacy and advocacy tools.” The PAC now operates in 35 branches across Free State townships, according to Mokhaliphi.

While TAC General Secretary Anele Yawa says he welcomes the PAC as a new player in the struggle for access to better health care services in Free State, he worries that the young organisation was born out of bitterness. According to Yawa, TAC did everything it could to pool both financial and legal resources to ferry Mokhalipi’s safely out of the province following threats. Yawa also says that the money from Amnesty International was given to Mokhalipi as a monthly stipend while Mokhalipi was on the run. But something else had happened when Mokhalipi returned to the Free State. Former provincial AIDS council colleagues had tipped off TAC to allegedly corrupt deals made by Mokhalipi during his time at the council.

“As TAC, we decided to launch our own internal investigation and informed Mokhalipi, who then resigned,” says Yawa, adding that Mokhalipi later spread rumours about TAC leadership targeting him. Mokhalipi denies the allegations.

Even before the court appearance, the ANC in the Free State had made it clear that it would not tolerate any campaign aimed at undermining its leadership. The ANC Youth League organised a march calling for the deregistration of TAC because it had dared to call for the resignation of the health MEC. This made it a political party not a non-governmental organisation, according to the youth league. Things were getting very uncomfortable for TAC members. But on the court day, when the 23 community health workers accepted the deal, the split was cast in stone. “It was here that TAC felt Mokhalipi’s betrayal,” Yawa says. “The very same man behind the night vigil was now misleading the very same community healthcare workers.”

In many ways, the drama of Mokhalipi’s split from the TAC mirrors South Africa’s political scene, where personality and ideology clashes give birth to new parties. But the possible involvement of anti-TAC elements in government, and the ANC playing a role in encouraging the split cannot be ruled out.

According to University of Johannesburg researcher and sociologist, Trevor Ngwane, splits frequently happen within social movements when differences in politics and leadership cause tension. These tensions can lead to members feeling as if they no longer fit in, according to Ngwane.

Ngwane said the decision by Mokhalipi to start a new organisation so similar to his previous affiliation shows a type of “I can do it alone” thinking that “often comes with opportunistic agendas”.

“Often these splits create competition in campaigns and can often weaken the cause of action,” Ngwane said. He added that, by playing into individual aspirations, the Department of Health could also divide and rule.

While the TAC has been successful in combining grassroots outreach programmes with the legal activism, it is not clear how the PAC plans to distinguish itself. It is also unclear where the funding for the running of the organisations although Mokhalipi says he relies on membership donations and income from his part time work. For now, PAC believes that South Africa needs to intensify its HIV preventative strategies and says that our biggest battle is with the quality of HIV counselling people receive while testing. In contrast, the TAC wants to fix the Free State public health system and intensify its campaign to get the MEC fired. DM

Photo: Thousands of South Africans protest in support of the Treatment Action Campaign (TAC) global call to action on tuberculosis and HIV/Aids in Cape Town, South Africa 08 November 2007. EPA/NIC BOTHMA.