A day care centre for small children

During the apartheid era, health, education and policing were severely neglected in black residential areas. Urban townships like Alexandra fared better than the rural regions, but the legacy of decades of neglect remains.

One of the first pledges of President Nelson Mandela’s democratic gorvernment in 1994 was to provide free primary health care to all of South Africa’s citizens. Eight years later, the health system is buckling under the demand.

Christine Mahlalela’s husband Phillip has tuberculosis. He goes to the nearby Alexandra Clinic to get the free tablets he needs to keep the disease in check.

When it comes to her children, Christine prefers to pay for private health care.

“If they get sick, and it’s serious, I rush them to a specialist doctor. I will pay whatever it costs. I had pneumonia and my boss took me to a private clinic. If I had gone to Alexandra Clinic I would be dead by now because they haven’t got staff, and they don’t have the drugs.”

There is no public treatment policy for the millions of South Africans living with HIV and Aids.

Christine says the primary schools in Alexandra are good, but her older children travel further afield to get a sound secondary schooling.

When it comes to the police service, she is scathing.

“Crime is our number one problem here in Alexandra” she says. “And if you call the police, they’ll ask you first ‘Is anyone dead there?’ If you say ‘no’, they won’t come immediately. And they are so corrupt.”

'Lighthouses of Knowledge' offer internet access

Curitiba, Brazil

Healthcare and education are free, but demand is high and supply limited. City planners have tried to decentralise services and locate them near bus terminals.

“My husband and I go to free colleges - we couldn’t afford private education,” Tatyane said.

There are free schools all over the city, but some do not have enough places for local children, who then have to travel to other schools.

Patients sometimes have to wait hours at health clinics. But Tatyane has been to her local hospital when she has needed treatment. Cases are prioritised according to need, and, in her experience, waiting times have been between 40 minutes and one hour.

About 40 “Lighthouses of Knowledge”, offering library services and internet access, have been built around the city. Tatyane’s friends use these, although she has access to such facilities at her college.

The city administration has offices in low-income areas, in developments called Citizenship Streets, where they offer activities such as painting and drama classes.