IZINDABA

Ivan Toms – a selfless model of social conscience

Izindaba that the notifiable disease had factors included viral respiratory tract caused his death. Toms’ successor as infection, being in a smoky environment City Health Director, Ivan Bromfield and/or smoking, and some immune (acting), called a media conference the deficiencies. next day to request anyone who had been in close and prolonged contact Struck down by long odds with Toms to consider preventive Bromfield said there were 74 cases of medication and to be on the lookout for meningococcal meningitis in symptoms such as sudden fever, intense last year of which 8 were fatal, and that headaches, nausea, vomiting, stiff neck in 95% of cases there was no identifiable or a pink rash. source of infection. The disease was most often caused by a common He speculated that Toms had bacterium lying dormant in the nasal gone home, ‘felt a bit groggy, passages. taken a headache pill and lain The diminutive 54-year-old UCT down’. Overnight, the rapidly graduate’s fierce sense of justice and ensuing brain swelling could strength of character kept him at the have caused confusion, with centre of social justice issues for his Toms lapsing into a coma some entire professional career. He pioneered while before death. primary health care in Cape Town’s strife-torn townships, initiated the End Conscription Campaign, crusaded for Toms was in excellent physical gay rights and was at the centre of condition, having recently completed finding innovative responses to the the Argus/Pick ‘n Pay cycle tour, but HIV/TB pandemic. Toms risked life experts confirmed that the contagious and limb at the SA Christian Leadership disease can develop rapidly, causing Assembly (SACLA) clinic in Crossroads headaches, sleepiness, coma and where he regularly confronted police death within 8 - 12 hours. Dr Andrew and soldiers hunting down Crossroads Whitelaw, a senior specialist in the and Guguletu township residents they One of ’s most dedicated department of microbiology at Groote had shot during violent confrontations modern-day doctor activists and Cape Schuur Hospital, said it was generally in the 1980s. Town’s Health Director, Ivan Toms, died accepted that a person could go from suddenly of meningococcal meningitis asymptomatic to critically ill in even at his Mowbray home, on 24 March, His sudden death stunned less than this time. Toms not calling evoking shocked tributes from all friends and professional for help would be consistent with quarters. colleagues, prompting an his last having been seen socially the Toms’ body was found on his bed outpouring of accolades from (Sunday) evening before his death. He all sectors of a society he had by police at about 09h00, the Tuesday speculated that Toms had gone home, after the Easter long weekend, after so selflessly and passionately ‘felt a bit groggy, taken a headache served. worried city council executive managers pill and lain down’. Overnight, the asked them to check his home when he rapidly ensuing brain swelling could I was among several who would 338 failed to attend an important meeting. have caused confusion, with Toms dodge Casspirs, teargas canisters, Professor Lorna Martin, head of UCT’s lapsing into a coma some while before buckshot and petrol bombs to meet forensic medicine and toxicology and death. Infectious disease expert Graeme Toms at the clinic for a daily count a friend of Toms, helped colleague Dr Meintjes confirmed that confusion was of fatalities and injuries that would Linda Liebenberg conduct the post one of the common manifestations of feature prominently on the Cape Times mortem on his body and confirmed to the disease. Whitelaw said predisposing front page the next day. His setting up

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of the clinic and fearless, outspoken he had so selflessly and passionately services in Cape Town, his province and treatment of the township ‘comrades’ served. nationally’. among the 60 000 residents for whom he Archbishop said he was initially the only doctor for nearly ‘thanked God for having known’ Toms ‘He could easily have lived a 4 years, quickly earned him ‘enemy’ and described him as ‘a prime example life of privilege and comfort status in the state security hierarchy. of Ubuntu’. ‘He was utterly selfless. but opted instead to reflect on The SADF seized control of the clinic Knowing him makes one feel proud.’ the realities of the country and in 1986 during the infamous security A ‘terrifically shocked’ Justice Edwin to take a bold stand against the force backed ‘Witdoeke’ attack on Cameron (who was Toms’ trial lawyer) injustices he witnessed.' Crossroads and razing of the KTC said he last saw him at the finish line of squatter camp, leading to a community the Argus/Pick ‘n Pay cycle race where boycott of its services. Having earlier they joked about their good health and ‘He was passionate about the been conscripted into the army as a compared finishing times (Toms’ time advancement of the public health non-combatant doctor in was 4.5 hours). service in general, and in particular (1978), Toms’ experience of the police of services to address the HIV/AIDS and army brutality in Crossroads led epidemic – his passing will be sorely him to refuse an obligatory 1-month felt for a very long time.’ Joint work SADF camp call-up to the Namibian by the TAC, City Health, the Provincial border soon after the clinic takeover. Health Department and Médecins sans This defiance, in July 1987, gave the Frontières as partners on TB increased authorities the excuse they needed the cure rate from 53% to 68%. With and he was charged and tried under Toms at the helm, City Health was compulsory conscription legislation. also pivotal in increasing the number In his celebrated trial, during which of Western Cape antiretroviral roll- his sexual orientation was gratuitously out sites, once again leading the way questioned, he was jailed for 21 months, nationally. of which he served 9, in Pollsmoor Zackie Achmat, TAC Deputy Prison. He was both sexually molested General-Secretary who first met Toms and raped during his incarceration. in 1982, described him as ‘an energetic, humorous and dedicated activist. Jailing judge praised Toms Anti- activists will mourn his In sentencing, the judge described premature death.’ Toms as the antithesis of a criminal Toms was awarded the Order of the and bemoaned the law that forced his Baobab in Bronze for his ‘outstanding jailing, adding, ‘jails are there for people contribution to the struggle against who are a menace to society – you are apartheid and sexual discrimination’. not a menace to society … in fact you In the citation he was described by the are just the opposite, you have always Presidency as ‘a remarkable individual been an asset to society in the services who has always had the courage of his you have rendered’. convictions. He could easily have lived In 1991 Toms became the national co- a life of privilege and comfort but opted ordinator of the National Progressive instead to reflect on the realities of the Primary Healthcare Network Cape Town Mayor said country and to take a bold stand against and 2 years later Director of the Toms led his department to exceed the injustices he witnessed.’ Students’ Health and Welfare Centres its own targets for reducing the city’s He is survived by his brother in Organisation (SHAWCO) – an NGO HIV/AIDS and TB infection rates, Australia. 340 linked to UCT that became a model achieving the best successes in the for primary health care delivery in country. Long-time friend and fellow Cape Town’s townships. His sudden activist, Dr John Frankish of the Western Chris Bateman death stunned friends and professional Cape’s Global HIV Fund, said that over colleagues, prompting an outpouring of 20 years ‘Ivan made a sustained and accolades from all sectors of a society significant contribution to public health

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