by Reggie Yates
Travelling all the way to South Africa in making the Knife Crime ER film, where I was confronted with similar issues of violence but on a whole other level, forced me into an uncomfortable corner. I’d go on to face the actuality that everything I saw might have happened to me, but the toughest question I’d have to ask myself was, why didn’t it?
I was back in Cape Town and the beauty of the city was still able to catch me off guard; Table Mountain still had that magic about it every time it caught my eye. The picture-perfect views, sunsets and beaches led me to make the classic embarrassing Brit abroad statement … ‘I reckon I could live here’.
But South Africa had an impressive gift of slapping me with a reality check whenever I found myself getting too comfortable. The beauty of Cape Town had my attention for all of five minutes before I was reminded that I was in the country’s murder capital. Twelve miles from the city centre sits Khayelitsha, one of the biggest townships occupying a sizable chunk of the Cape Flats. Partially illegal, the predominantly residential township continues to grow, housing millions.
It was my first time driving into the township and I hadn’t even realised we were in. My limited experience told me townships were essentially shantytowns. I was expecting rows and rows of badly built walls and corrugated iron roofs. I was quickly corrected as Khayelitsha was not only huge, but it might as well have been a city in its own right. Street lamps lit the route and the perfectly paved roads made getting to our destination a lot easier than I’d expected. Excited to see how people lived while being slightly embarrassed of my naivety, I arrived in this chunk of Cape Town I didn’t know, but was desperate to experience.
It was payday weekend and it was buzzing. I was twelve miles from the centre of the city but the streets here were just as busy. Music seemed to come from every passing car and kids wouldn’t take no for an answer washing windscreens at traffic lights. The night had just begun and the taverns were opening. Khayelitsha was clearly a place full of life, but how could somewhere so vibrant carry such a reputation for violence?
My first port of call was the newly built hospital situated right in the heart of the township. At the time of filming, the shiny new facility was only a year old but already had one of the busiest emergency centres in Cape Town.
As a kid I’d spent much more time than any child would ever choose to in a hospital as my mother worked in one. The Whittington Hospital in Archway was and still is an impressive group of buildings overlooking the whole of London. When I was around five or six, my mother worked as a medical secretary in one of the taller buildings. I ended up spending some of my half-term and Easter breaks with mum at work because, well, why would you pay for childcare when there was a fully functioning children’s ward? I’d hang out with kids dealing with all manner of conditions, but all I saw was new friends to play with and an endless stream of toys. I’d go on to have health issues of my own as a child, but I’d never dealt with anything that made hospitals a scary place for me.
Walking into this hospital felt strangely familiar. I was on the other side of the planet, but the smell and feeling was instantly recognisable. It was just like being back at work with Mum, even if outside the building was another kind of life entirely.
It was a Saturday night and beyond the colossal car park, you could hear the parties just getting started. Music was in the air and steadily getting louder from the streets of Harare, the nearest residential block just beyond the hospital. Known as one of the most notorious parts of the township, the whistling and cackles coming from the bars and clubs sounded like undeniable fun.
Unfortunately, given its proximity, once those bars and clubs had closed for the night, their tipsy patrons would hang out in the street. Any violence would see their night end right where I was stood. In the hospital.
Over the next few days, I was set to shadow the junior doctors. Being in a hospital I was totally good with, but I hadn’t really thought about just how much I’d see in the presence of the medical staff.
Welcome to Khayelitsha
The weekend shift staff change was under way and it was busy in the emergency room. There was already someone being stitched up after a fight and another man who’d lost a leg. The staff were from all over the world and predominantly young with a hunger to learn.
I met Lauren, one of the junior doctors who was beginning her shift, and so full of smiles you wouldn’t think she was surrounded by blood and bandages. Totally in her element, Lauren grabbed a clear plastic bag and handed me a foot severed at the calf muscle. I stared in a panicked awe as Lauren pulled and twisted the limb exposing tendons and bone talking me through the intricacies of anatomy. She was fascinated and excited from a medical standpoint; I was trying my best not to throw up.
Lauren went on to explain that the inebriated patient had stumbled onto the train tracks and not got away quickly enough as the fast train approached. She described it as a traumatic amputation; all I could think about was the poor bloke arriving at the hospital holding his severed foot.
This was my first two minutes in the ward and Lauren happily chewed gum, describing what I’d just seen as a typical start to the weekend. This was apparently the calm before the storm. The drunken man would wake without a foot, but thanks to the junior doctors he’d be alive.
Lauren worked every patient in the room alongside Amy and François. Buzzing from bed to bed, they were just getting started but had a fantastic shorthand and rhythm. All under the age of thirty, it was all they could do to cope with the frequency and extremity of cases coming through the door.
Amy saw to a young man who’d just come in. She marked a diagram indicating the various wounds he’d received across his entire body from being attacked with a panga blade (a type of machete). The thick and heavy blade had left the back of his skull soft, and Amy injected his scalp and tended to the three-inch gash on the back of his head. Totally nonchalant about the severity of the case, Amy had seen this before and assured me I’d see lots more that very same night. She wasn’t wrong.
‘Welcome to Khayelitsha’ was her dry closer before being called away to help with another patient. I’d been introduced to new parts of the world in so many ways over the years, but for victims of knife crime to act as a fitting introduction was a chilling first.
The shift continued and it wasn’t long before the floodgates opened. Quickly, young men covered in stab wounds filled every bed and were queued up side by side in the hallway. The stench of blood began to fill every corridor managing to overpower that strong chemical hospital smell.
A man with bright pink blood pouring from his head sat slumped in a wheelchair while an older man clutched at his chest in pain. It was so much to take in. I was taken aback at how the group of young doctors buzzed from case to case while I watched, totally overwhelmed. In a typical weekend, the emergency ward would see over 100 patients; 90 per cent of those cases would be stab victims. Blunt force trauma was another cause of young men coming through the door and the numbers were astounding. One of the most common causes of death for young men under the age of twenty-five from Khayelitsha is violent crime.
After an hour of blood, stitches and pain-fuelled moans, the room felt less like an emergency ward and increasingly like a chop shop. People were being wheeled in, repaired and rolled out, with a similar case filling their spot as soon as they’d gone. It was incredible to watch but completely understandable given the circumstances. These doctors had to work fast as their speed, or lack thereof, could affect a life for good.
Relax, Booti
At twenty-six, François was an incredibly assured doctor who jumped from patient to patient. Filling the bed in front of him lay a man with internal bleeding in need of immediate treatment. Wiping his sweat away with his elbow, he called me over to help him with a chest drain.
I jumped at the opportunity to help and shrugged off my bomber jacket, throwing on an apron and gloves. I was on camera doing what I always do, and getting stuck in here felt like the best way to
bond with the doctors. I figured helping might just stop me from being an annoying, question-asking obstacle and even make me useful.
We were in a hospital surrounded by people in need of serious medical attention and I had absolutely no right to administer any medical help, but François felt differently. I was worried my involvement would create another foot-in-a-bag situation or worse. Given no choice in the matter, I was holding the terrified patient’s arms and desperately trying to keep him still while François made a small incision between his ribs. ‘Relax, Booti’ was said repeatedly in an effort to calm the patient down. Booti, meaning brother, would become a term of endearment I’d hear repeatedly over the next few hours.
Aggressively working the cut open with a steel tool, François needed to drain the chest cavity of blood or air that had built up around the lungs because of the stabbing. Blood trickled out of the new opening and a loud sharp hiss of air spat its way from the gap between the man’s ribs. Acting quickly, François snatched up a tube and inserted it into the gap to prevent a lung collapse.
Stood with my eyes impossibly wide, I couldn’t believe what was happening right in front of me and totally forgot about my role of holding helper, instantly becoming a gawping idiot. My mouth was wide open but I wasn’t even close to my soundman Joe in the race for stupidest facial expression. Joe held a huge boom mic above the entire procedure and every squelch and spit was in loud stereo sound booming into his ears from the huge pair of headphones he had to wear.
Joe looked like he was going to be sick as I decided to focus on the doctor who was making light work of what might have been the scariest thing I’d ever witnessed. François explained that the way he’d gone about the procedure, was neither the best or his preference. It was an unfortunate necessity due to the time pressure of saving the man and being able to get to the next in-need patient. My squirming wasn’t helpful, but the incredibly polite doctor found time to thank me before rushing off to save another life only two beds away.
As the night went on, the stream of injured men was constant and the cause hardly varied. Frustratingly, it was one stab victim followed by another. A knife wound, regardless of its severity, is an awful thing to witness but, after the first few hours of the weekend night shift, those reporting a single stab injury, I began to consider lucky. Many victims had multiple cuts and wounds and, more often than not, huge gashes on the head.
Pulled from a car covered in blood, Lukanio was wheeled into the trauma room. Mugged and stabbed on his way home from a tavern, the 21-year-old didn’t look good. Quickly tended to by the pack of international doctors, he was being helped but with the amount he was wailing you’d never think it.
He’ll survive … to come back next week
At the time we were filming in South Africa, UK statistics recorded around seventy-seven stabbings countrywide in a week. In Khayelitsha, that number would usually be matched if not beaten in a single weekend.
The phrase ‘Relax Booti’ calmly uttered by François earlier would continue to be said for the rest of the shift, but in the case of Junior Doctor Nicole, it would be shouted. Taking no prisoners, Nicole was broad, stern and an incredible presence in the ward. She didn’t suffer fools gladly, and abruptly explained that most of the knife fights arose out of drunken disputes over women.
Sewing up bright red bloody head wounds, Nicole explained that the scalp bleeds a lot more than most other places in the body so an injury can usually look a lot worse than it actually is. I wasn’t desensitised to the blood just yet, but as the night wore on I became so used to seeing bleeding men doubled over drunk I had to check myself. I hated the constant thread in every story being poverty, the release of alcohol-fuelled partying and the inevitable violence as a result.
Nicole had seen it all before – as recently as the previous weekend to be exact – and was in a strange place of acceptance. Working on her patient’s prescription, Nicole looked up to watch the man lying unconscious with a head ridded with lumps. ‘He’ll survive … to come back next week.’
The night continued, as did the flow of drunken stab victims. One doctor described the combined smell of blood and alcohol as unbearable and I understood his position. It wasn’t an easy environment to be in the middle of and I’d only spent a few hours there. For the junior doctors, this was school and term was far from over.
One of the senior consultants, Dr Henny, arrived to oversee the work of the young team. I followed him into a curtained-off cubicle where he explained the young man lying on his side had been stabbed in the head and his skull might have been fractured in the process.
He injected the man’s scalp and began to stitch the wound while talking me through his process of assessment. With no time to waste and lacking specialised, sophisticated medical machinery, he slipped his little finger into the second and bigger gash on the man’s head. Sliding it under the skin and rubbing the bone was the quickest and most effective way to rule out an underlying skull fracture.
The man was conscious but pain free due to local anaesthetic. Dr Henny grabbed my hand and launched my finger beneath the skin, guiding it up and down the smooth skull bone. The thickness of the skin was strange and heavy while the skull bone felt like the perfectly smooth stone to skim across water that I’d spend ages searching for at the beach.
It was fascinating but a first I won’t be repeating anytime soon. If you catch me fingering some random bloke’s skull, pull me aside and have a word. Thanks.
The nine-to-five for these doctors was doing everything in their power to tend to whatever came through the door. They were doing amazing work but they were literally just doing their job. The truth was that the medical staff in Khayelitsha Hospital were the most positive part of a crime cycle. Every young stab victim they patched up was half expected to make a return visit in the not too distant future.
The emergency ward was only one side of the story; what was causing so many young men to end up as victims of shockingly similar knife attacks? I saw so many casualties on my first night that I wanted to see where they were coming from, so the next day I headed into the township.
In Khayelitsha, the scars of a troubled history were everywhere. Built in the late eighties, the township was situated on the fringes of Cape Town during Apartheid. Twenty years on, the place was alive and home to millions. Signs of regeneration were visible as small pockets of houses built to a high standard stood proudly side-by-side. That being said, there was still a 61 per cent unemployment rate and many of the township’s residents were still bound by poverty.
I hopped in a local taxi and was ferried around by Zuka. Filling his seat and then some, the mountain of a man pointed out the skinny alley ways that criminals would flee down after altercations. Muggers could hide between buildings and pounce whenever they saw fit, making the atmosphere shift dramatically as soon as night fell. A breeding ground for violence, the living conditions seen in the majority of the township that was home for so many was also the perfect place for a career in crime.
Speaking to Lukanio who I met in the hospital, it was clear that his brutal mugging not only left him covered in stab wounds but also hungry for revenge. Describing the police as inactive, Lukanio explained that many people would take justice into their own hands. He stressed that drugs and alcohol usually lay at the root of any violence.
He’s gonna kill our children
While talking on camera to a small group of teenagers, I had no idea I was about to be given a first-hand experience in the effects of substance abuse.
A car roared its way towards us and a small group of children playing in the road. Wild and clearly out of it, the drunk driver was pulled from his car by the quickly forming mob. Local men and women surrounded his car pulling and dragging the man in different directions. The keys from his car were confiscated and what was about to happen to the inebriated driver looked like it was going to be anything but positive.
An angry man screamed, ‘He’s gonna kill our children,’ as things became s
uddenly more menacing. I feared the mob might take matters into their own hands, exerting what was commonly known as Community Justice.
In an environment where an underfunded police force struggles to get to corners of the sprawling townships across the country, over the years the communities themselves have increasingly become police, judge and jury. Lukanio explained that had the man hit a child or injured someone, the mob might decide to punish him there and then using the most extreme version of force imaginable.
That level of extreme punishment would be the case for his attacker, causing Lukanio to keep his stabbing quiet and manage it without any help from the police or community. One such punishment used in community violence was known as necklacing. The guilty party would be trapped in a stack of tyres, have petrol poured over them and then set alight.
In the twelve months leading up to my arrival in Khayelitsha, there were nine incidents of necklacing. Thankfully community justice doesn’t always lead to death. Back at the hospital, the night shift had seen four men turn up accompanied by the police. Stripped naked and beaten, their punishment was humiliation, hammering home the fact that the township was home to so many, but also a world operating within its own brutal rules.
On the night shift, I joined paramedics Ata and Ricardo. The minute a call came in, we dashed for the ambulance and I was made to sit up front with Ata. I did a terrible job of hiding my excitement, as a flashback to a fire station school trip caused immediate regression. The day I wore that fireman’s hat and got lifted into the driver’s seat of the shiny red truck was happening all over again, only this time it was probably for the best I didn’t press all the buttons or pull at every switch.
En route to a call, the sirens wailed as Ata ripped through the streets. Ricardo sat on the patient bed flipping through a battered book of maps trying to figure out where we were going. There was a new sat nav that hadn’t yet been completely installed, leaving Ricardo and Ata no option but to go old school.
