• Durban’s Addington Children’s Hospital was shut down by the apartheid government for providing care to child patients of all races.
• It is now well on its way from a ghostly ruin into a lifeline for a new generation thanks to visionaries like Professor Hoosen Coovadia.
• Spotlight spent time inside the historic KwaZulu-Natal Children’s Hospital with its striking artworks and wards named after birds.

An ornate, double-storey building with a bell-tower, sea-facing verandas and large sash windows for fresh air, Addington Children’s Hospital opened on Durban’s beachfront in 1931. The well-ventilated facility was designed for fighting respiratory illnesses such as tuberculosis (TB) in an era of “sanatorium treatment”. This was before the 1943 discovery of the antibiotic Streptomycin, which laid the foundation for modern TB medicine.

The Addington Children’s Hospital had 80 beds in five wards named after birds – Kingfisher, Heron, Jacana, Martin, and Loerie – and vivid artworks, including 52 stained-glass windows depicting fairy tales and sculptures by pioneering artist Mary Stainbank.

A former patient recounts: “I was born at the hospital in 1950 and spent time there in 1957 being treated for pneumonia... My bed was in line with the second window, and I remember so well looking out over Addington beach.” Some former nurses recall the hospital’s elaborate murals and mosaics, often somewhat “spooky” at night.

The facility is steeped in history. In the 1980s, during apartheid, the hospital, situated in a section of Durban’s beachfront then reserved for “whites-only”, treated children of all races. This defiance by healthcare staff prompted the ruling government of the time to shut it down in 1984.

Three decades of crumbling decay 

Afterwards, the hospital complex, consisting of seven structures spread across 3.5 acres (about the size of a South African cricket field), stood abandoned for nearly three decades. Beside the towering provincial Addington Hospital, which adhered to apartheid policy and thus remained operational (treating mostly adult patients), the specialised children’s facility became a forlorn sight: an array of crumbling heritage buildings.

Inside, water dripped through cracks and puddled on floors as shrubs pushed through gaps in the walls. Displaced people sought shelter in the derelict wards and dark corners, living next to children’s iron beds and rusting wheelchairs, amid shattered glass, tiles and washing basins.

In 2009, the renowned paediatrician Professor Hoosen Coovadia, who grew up in nearby Wills Road in the Warwick triangle, was one of a few local visionaries pushing for the hospital to be repaired. A year later, an internal Addington Hospital newsletter broke the news to healthcare staff.

The newsletter’s editor, Sue Meyer, wrote: “I am sure that you have seen something happening along the perimeter of the Children’s Hospital… It is a building that has seen much neglect and has basically begun to fall apart. But there is such good news, I just have to share it with everyone. The Children’s Hospital is getting a revamp!”

Revamp! A public-private partnership

In 2011, Coovadia, along with Dr Arthi Ramkissoon, registered the KwaZulu-Natal Children’s Hospital Trust. Effectively, they established a public-private partnership for renovating the hospital and re-establishing its services, in collaboration with the KwaZulu-Natal Department of Health. At the time, Ramkissoon said: “My vision is for children to have their physiotherapy and other therapy on the beach. I would like the wheelchairs and the beds to be wheeled out there, so I’m going to try to build some sort of ramp.”

On the provincial government’s side, then-MEC of health, Dr Sibongiseni Dhlomo, was credited with greasing the bureaucratic wheels to get the project off the ground. “Today, we pay tribute and say thank you to all the compatriots who have shared our dream and committed their time and resources to make the restoration and reconstruction of this facility a reality,” Dhlomo is quoted as saying in a 2013 prepared speech at the official launch of phase one of the hospital’s rebirth – the reopening of its outpatient wing.

Coovadia and Ramkissoon have since died, but the KwaZulu-Natal Children’s Hospital Trust continues their legacy as the hospital’s renovations continue.

Chief executive officer of the trust, Taryn Millar, says: “This project really was initiated through the efforts of two former trustees, Prof Jerry Coovadia and Dr Aarti Ramkissoon, both obviously very well known in the public health sector. They were the ones with the initial connections within the Department of Health to really push for this project to happen.”

Millar elaborates on the public-private partnership: “The trust is responsible for fundraising, renovation, building and equipping the facility. And then it’s handed over to the Department of Health, which staffs it and maintains it in perpetuity. I think sensible relationships and partnerships between the public and private sectors really are the way forward.”

Shift in focus from HIV to mental health 

Coovadia’s seminal work on HIV transmission (see Spotlight’s 2021 interview with him) inspired his original intention for the children’s hospital.

“Initial discussions around the hospital were that it would actually fill the gaps within HIV treatment. But obviously, as time goes by, needs change,” says Millar. She adds that today, the precinct’s main focus is on child and adolescent mental health and neurodevelopmental needs.

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On a sunny winter’s day, she takes Spotlight on a tour of the premises reached via Prince Street, which runs parallel to the palm-lined beach. The main hospital building’s entrance facade, with its ceramic sculpture depicting Jesus blessing a group of children, has been restored. Its terracotta roof is now retiled.

The foyer is bright white with a commemorative plaque to former Durban councillor Mary Siedle, who initially drove fundraising to build the hospital complex in the late 1920s. Further along, a ceramic plaque reads: “JML and Marie Baumann cot”, referring to John Michael Leonard and Marie Baumann, the founders of Bakers Biscuits on Durban’s West Street (makers of Marie biscuits), who were among those who sponsored a child’s hospital bed for £100 back in the day.

New beginnings

Inside the foyer are rows of red chairs. On one, a woman sits scrolling on her phone, waiting. It is plausible that her child is being treated at the renovated old outpatients building, which houses a Neurodevelopment Assessment Centre.

Millar relays that the centre has treated “well over 45 000 child patients since opening in 2013” for conditions including cerebral palsy, autism, cleft palate, and broader neurodevelopmental disorders. Here, mothers find support and respite in the hands of healthcare professionals who help them understand and care for their children with special needs. The centre’s multidisciplinary team consists of paediatric neurologists, occupational therapists, physiotherapists, speech therapists, dietitians, social workers and psychologists.

Inside the main hospital building, we cross fluorescent-lit corridors to the new Victor Daitz Paediatric Psychology Centre. Images of Kingfisher birds feature in the centre’s signage, a homage to the old hospital’s bird names. Millar points out rooms with educational toys, used for counselling and group therapy. Inside a boardroom, Millar and fellow board member of the trust, Kim MacIlwaine, spell out further details of the unfolding renovation.

Money and future plans 

They say another R500 million is necessary to finish the entire precinct. Among their pending plans is a 36-bed child and adolescent in-patient mental health unit. Reflecting on the need, Millar says: “Within KwaZulu-Natal, there are 4.3 million children of whom, it is said, 10% to 20% will develop some form of mental health or neurodevelopmental condition. And across the entire province, currently, there are only eight public-sector psychiatric beds available for adolescents. This is at Townhill Hospital, in Pietermaritzburg.”

MacIlwaine adds:

Other plans include a rehabilitation ward for neurological conditions, a palliative care ward, and an inclusive children’s playground with special swings, wheelchair-accessible sand and play zones, and “safe retreat” spaces like a make-believe igloo.

To date, the trust has collected over R200 million in donations.

“Durban is a very diverse community. And we’ve got this represented in our funders: the South African Muslim Charitable Trust, the Jewish-based Victor Daitz Foundation. The Hollywood Foundation (the charitable arm of Hollywoodbets), the Elton John AIDS Foundation...” says Millar.

A time-warp and a dream

Millar continues to show us around the main hospital building. Passing through a door, bizarrely, we step back in time, into a dusky, unrenovated wing with peeling paint and plaster. At the hospital complex, this contrast lends a surreal air. Old and new co-existing side-by-side, separated by mere brick walls.

An obituary for Coovadia published in the South African Journal of Science refers to his dream for the children’s hospital.

Leading South African infectious diseases epidemiologist Professor Quarraisha Abdool Karim wrote:

Today, Coovadia’s daughter, Dr Anuschka Coovadia, serves as board chairperson of the hospital’s trust, as his dream continues to take shape.

This article was first published by Spotlight – health journalism in the public interest. Sign up to the Spotlight newsletter.