Zanempilo

Community Health
Care Centre

Zanempilo Community Health Care Centre

(ZCHC), infamously known as the "Biko
Clinic", was the first primary health care
centre initiative outside of the public
sector in South Africa.[1] It is located in
Zinyoka Village, near King William's Town
in the Eastern Cape. The clinic was
established as one of the Black
Community Programmes (BCPs)
spearheaded by Steve Biko and Mamphela
Ramphele.

Purpose
"Zanempilo" meaning "bringing health" in
isiXhosa, operated from 1974 to 1977 and
aimed to improve the physical health of
the community, assist with economic
growth and restore a sense of dignity for
black people. It took an holistic approach
to treating health problems in the
community by considering the
environment and living conditions of the
patients. The Black Consciousness
Movement became active from the 1960s
to the 1970s after the ANC and PAC were
banned by the South African government.
The South African Students Movement,
SASO had limitations as a student
movement therefore, the Black
Consciousness Movement created a
numerous political and community
organisations like the Zanempilo
Community Health Care Centre in order to
expand the movement.[2] At the time,
residents in the Ciskei region experienced
the negative effects of the migrant labour
system, state neglect, decreasing
agricultural sustainability (as many young
skilled men had left to work in the mines),
inadequate health services and an influx of
people due to forced removals.[3]

Zinyoka Community
The village of Zinyoka in the Ciskei
experienced all of these challenges with
rural health clinics scattered
approximately 20 kilometres apart. These
clinics lacked medical supplies and staff
members. Grey Hospital in King William's
Town was mostly used for white patients.
The hospitals that allowed black people
were the Mission Hospital, Mt Coke
Mission Hospital and St Matthews Mission
which were far away and poorly resourced.
The Zanempilo Community Health Care
Centre mainly served people from the
surrounding rural areas. These were
mostly women who were either domestic
workers or relied on their husbands' wages
from mining. Research and statistics done
be ZCHCC staff found that the "average"
Zinyoka family consisted of an average of
6 people. Each family earned an income of
R5-R10 per week and the families
consisted mostly of women and children.
Most of the men were over the age of 50
(as younger men were at work). [4]
 A village in the Ciskei near King
William's Town

Funding
The startup funding came from Angela
Mai, a German citizen born in South Africa,
who approached the BCP with between
R20 000 - R30 000.[5] The South African
Council of Churches (SACC) assisted in
running costs. The clinic opened in
January 1975.[6]
Staff
Mamphela Ramphele is a qualified
medical practitioner who worked at Mt
Coke hospital and joined Zanempilo as
the head medical officer. Dr. Ramphele
was permanently on duty for the first
year of the project and earned a salary
of R600 per month.[7] Ramphele was
restricted to Tzaneen in 1977 which
forced her to end her tenure at
Zanempilo.
Steve Biko was the regional director of
the BCP. After his expulsion from
medical school, the government
restricted Biko to King William's Town in
the hopes of ending his influence.
However, Biko joined the BCP and
directed his political activity there. The
government was unaware for quite
some time that the BCPs were
associated with the Black
Consciousness Movement. Biko often
came to Zanempilo to avoid police
surveillance and frequently held
meetings with members of the ANC and
PAC. Students from Fort Hare spent
their holidays assisting at Zanempilo.
Nontombeko Moletsane was one of the
2 nursing staff sisters that Ramphele
recruited from Mt Coke hospital.
Beauty Nongauza was one of the 2
nursing sisters that Ramphele recruited
from Mt Coke Hospital.
Dr Siyolo Solombela joined the clinic
after completing his internship duties at
Livingstone Hospital in Port Elizabeth.
Stanley Roji was the watchman of the
clinic and reported police disguising
themselves as sick patients in order to
spy on the political activists in the clinic.
Mziwoxolo Ndzengu was the resident
ambulance driver from Ginsberg.
Mr Flask was the local builder who
rushed to have the clinic completed by
the end of 1974. He also built the staff
 house where Ramphele lived for the
reasonable cost of R4000.[8]

Facilities
The health care centre was built on the
land of an Anglican church. The ZCHCC
provided:

an outpatient section for minor and

major ailments
a maternity section with an antenatal
clinic, labour ward, nursery and lie-in
ward for mothers after delivery
a panel van which functioned as an
ambulance and a mobile clinic to
access further distances
These services were available 24 hours a
daty, 7 days a week and throughout the
year. The facility expanded and was fully
equipped with beds, flushing toilets,
electricity and clean water, amenities that
many of the residents of Zinyoka were
unaccustomed to.[9] Zanempilo not only
functioned as a health facility, but also as
a political meeting point, training ground
for activists, community centre to discuss
problems and place of events and
celebrations.[10] The facility had many
visitors ranging from neighbouring
villagers, political activists, businessmen,
philanthropists, international visitors and
the security police.
Projects
Nontombeko Moletsane initiated a bulk
grocery buying scheme. Child mortality
decreased after the nutrition of the
community improved. She also started a
leather factory which provided many of the
women with income.

Resistance
The headman and chief in Zinyoka, Sidoko
Sijama, under the chief of Tshatshu, was
against the operations of the clinic. Many
of the members of the Ciskei government
were afraid that this clinic would cause
conflict with the authorities. A rival clinic
was built but it did not succeed. Other
attempts to end the operations of the
clinic included withholding the operating
licence and not allowing the clinic access
to free immunisations for children.

Closure
Two weeks after the death of Steve Biko,
on the 17 October 1977, all black
consciousness organisations including the
BCPs were banned. Two days after this
ban, authorities confiscated all the assets
of the clinic. They also destroyed the
leather work factory and placed the
Zanempilo clinic under government
control. Additionally, all clinic programmes
were cancelled, it no longer offered 24
hour care, it was not open on weekends, it
lost supplies and no longer provided
ambulatory services.[11]

Legacy
The success of the ZCHCC led to the
initiation of a similar project at the South
coast of Natal called Sonempilo meaning
"Eye of Health" however, the banning of
black consciousness organisations led to
the closure of this facility in 1977. During
Mamphela Ramphele's time in Tzaneen,
she created the Isutheng Community
Health Programme which empowered
women through growing vegetable
gardens and other economically
empowering activities.[12] The Biko
Heritage Trail which runs from Port
Elizabeth to King William's Town, it
includes Niko's home in Ginsenberg
township, Biko Bridge in East London and
the Zanempilo Clinic.[13][14] Currently, the
"Biko Clinic" is functioning and in need of
repairs. It serves 800 people per month in
a community of 3500.[15]

See also
Africana womanism
Black Power
 Black Power Revolution
Black Surrealism
Négritude
Steve Biko Foundation

External links
The BCM in South African literature (http
s://web.archive.org/web/200605240418
18/http://www.nigeriansinamerica.com/
articles/26/1/The-Black-Consciousness-
Movement-in-South-African-Literature)
Interview with Mamphela Ramphele (htt
ps://www.pbs.org/newshour/bb/africa/
april97/ramph_4-21.html)
The relevance of Black Consciousness
today (http://stiffkitten.wordpress.com/
2010/04/17/the-relevance-of-black-cons
ciousness-today) , 2010
Black Consciousness in Dialogue: Steve
Biko, Richard Turner and the ‘Durban
Moment’ in South Africa, 1970 – 1974 (h
ttps://web.archive.org/web/201204062
31439/http://www.gold.ac.uk/media/wo
rking%20paper_Ian%20Macqueen.pdf) ,
Ian McQueen, SOAS, 2009
Columbia University research page on
the BCM. (http://socialjustice.ccnmtl.col
umbia.edu/index.php/Biko's_Legacy)
Bikoism or Mbekism? Thesis on Biko's
Black Consciousness in contemporary
South Africa (https://web.archive.org/w
eb/20110719131144/http://rudar.ruc.d
k/bitstream/1800/2630/1/Bikoism%20o
r%20Mbekism%20%28thesis%29.pdf)
Black Consciousness in South Africa (ht
tps://web.archive.org/web/2007063001
2128/http://www.ukzn.ac.za/ccs/files/g
ibson.%20final%20edit.pdf) , by Nigel
Gibson
New introduction to Biko's I Write What I
Like (http://abahlali.org/node/3039) , by
Lewis Gordon, 2007
 Steve Biko: The Black Consciousness
Movement (https://www.google.com/cu
lturalinstitute/#!exhibit:exhibitId=AQp2i2
l5)

References
1. Leslie Hadfield. Biko, Black Consciousness
and "the System" eZinyoka. South African
Historical Journal Volume 62, 2010-Issue 1
2. http://www.sahistory.org.za/topic/black-
community-programmes-bcp Archived (htt
ps://web.archive.org/web/2017111823570
5/http://www.sahistory.org.za/topic/black-c
ommunity-programmes-bcp) 2017-11-18
at the Wayback Machine Accessed 5
December 2017
3. M.Ramphele. Across Boundaries: The
Journey of a South African Woman Leader.
Feminist Press at CUNY, 1999 of 97.
4. Leslie Hadfield. Biko, Black Consciousness
and "the System" eZinyoka. South African
Historical Journal Volume 62, 2010-Issue 1
5. Leslie Hadfield. Biko, Black Consciousness
and "the System" eZinyoka. South African
Historical Journal Volume 62, 2010-Issue 1
6. M.Ramphele. A Passion for Freedom: My
Life. I.B:Tauris, 30 Sep 2014 PG 132-135.
7. M.Ramphele. Across Boundaries: The
Journey of a South African Woman Leader.
Feminist Press at CUNY, 1999 of 97.
 8. M.Ramphele. Across Boundaries: The
Journey of a South African Woman Leader.
Feminist Press at CUNY, 1999 of 97.
9. Leslie Hadfield. Biko, Black Consciousness
and "the System" eZinyoka. South African
Historical Journal Volume 62, 2010-Issue 1
10. http://www.sahistory.org.za/topic/black-
community-programmes-bcp Archived (htt
ps://web.archive.org/web/2017111823570
5/http://www.sahistory.org.za/topic/black-c
ommunity-programmes-bcp) 2017-11-18
at the Wayback Machine Accessed 5
December 2017
11. Leslie Hadfield. Biko, Black Consciousness
and "the System" eZinyoka. South African
Historical Journal Volume 62, 2010-Issue 1
12. http://www.sahistory.org.za/topic/black-
community-programmes-bcp Archived (htt
ps://web.archive.org/web/2017111823570
5/http://www.sahistory.org.za/topic/black-c
ommunity-programmes-bcp) 2017-11-18
at the Wayback Machine Accessed 5
December 2017
13. "Steve Biko Centre aims to inspire" (https://
www.brandsouthafrica.com/south-africa-fa
st-facts/history-facts/biko-centre-031212) .
Brand South Africa. 4 December 2012.
Retrieved 2 March 2023.
 14. http://www.sbf.org.za/home/index.php/ste
ve-biko-heritage-trail-sites/ Archived (http
s://web.archive.org/web/2017120904403
4/http://www.sbf.org.za/home/index.php/s
teve-biko-heritage-trail-sites/) 2017-12-09
at the Wayback Machine Accessed 9
December 2017
15. https://m.news24.com/SouthAfrica/News/
biko-clinic-in-dire-need-of-renovation-
20170916 Archived (https://web.archive.or
g/web/20171117091034/https://m.news2
4.com//SouthAfrica/News/biko-clinic-in-dir
e-need-of-renovation-20170916) 2017-11-
17 at the Wayback Machine Accessed 4
December 2017

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