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14 March 2019 | Story Opinion Article by Prof Francis Petersen | Photo Sonia Small
Prof Francis Petersen
Prof Francis Petersen, Rector and Vice-Chancellor of the UFS.

2019 is the year of the national general elections in South Africa – 8 May is when South Africans will have an opportunity to vote and to impact change, hopefully for the better.  But the beginning of 2019 saw the resurfacing of student protests, mainly driven by issues of registration, challenges associated with the National Student Financial Aid Scheme (NSFAS), student accommodation, safety of students (off-campus), insourcing, and various other issues influenced by local institutional context.
  
Challenges for university vice-chancellors

Our Constitution promotes protest, but emphasises the peaceful nature thereof, and that it should not infringe on the rights of others or damage property.  However, the protests experienced by the majority of higher-education institutions in South Africa in 2019 was exactly the opposite – disruption of classes, intimidation and victimisation, disrespect and often destruction of property.  A notion or approach of almost entitlement, even if the university management was willing to engage and was constantly open to assess ways and means to resolve these issues.  The drive for these protests was short-term gains, totally divorced from the long-term implications on the institution’s welfare.  This puts the university management under enormous pressure, sometimes feeling exposed and alone in ensuring that the institution remains sustainable – financially, as well as from an infrastructure and human resource perspective.

There is no doubt that the upcoming elections are used for political lobbying, tactical manoeuvring, and undermining to demonstrate political muscle – all playing out on our university campuses and to be managed by university vice-chancellors (VCs) and their executives.

Are universities not the pillars of knowledge in society, the providers of human capital and new knowledge to ‘lubricate’ our economy, the delivery of the next generation of professionals who will shape how our society, or a new South African citizenship should look like?  If this is the case, who are protecting our universities, who is standing with our VCs and university executives to ensure that our universities remain the beacon of hope for generations to come?  What is expected of VCs and university management in situations where there is a continual push for more, and if the response is not positive or immediate, protests, and in most instances violent and criminal behaviour. My personal view is not to securitise or militarise our campuses, but to resolve these issues through continuous engagement – but what if protests becomes violent and criminal?  What if disruptions challenge or threaten students, staff, infrastructure, and the academic project?  Student leaders seem to have forgotten the engagement with university leadership through a principle of ‘give and take’, always balancing short-term wins with the long-term sustainability and growth of the university.

Although universities often have their own internal disciplinary processes, these are slow, and the transgressors are often repeat offenders.  The sanctions are also in many cases restorative – which I believe it should, but to what end?

Help needed to ensure sustainability of universities 

We have seen how weak leadership, corrupt practices, and inadequate government funding have had a detrimental effect on the overall state of universities in the rest of the continent.  This has led to the outflow of excellent academics from the continent to elsewhere on the globe – a loss for the university and the continent!  Universities, although resilient, are also fragile as a system.  The protests associated with the #Rhodes and #FeesMustFall movements, together with the continued protests in 2019, run the risk of putting South African universities on a similar trajectory.  A fragile university system, when broken, will take decades to be restored.

Therefore, if universities are important institutions for society and the country, should there not be more concerted efforts from government and society to ensure that our universities remain strong and competitive? Although I do not offer a specific solution per se, should government, together with university leadership, staff, and students not be more vocal, thinking of a mechanism to curb and/or disallow immediate disruptions and the breakdown of infrastructure, and show visible support to university leadership in an effort to continue the academic project?  Our universities are performing extremely well against global counterparts, keeping in mind the current (and the past 10 years) South African economic growth and investment constraints with respect to infrastructure, research, and high-level scientific equipment – even a more critical argument to protect these national assets.

Academic project remains crucial

I am not for a moment belittling the issues raised by students and student leaderships – in fact, most, if not all of these issues, are legitimate.  I can understand the frustrations of the students – the slow pace of transformation, social integration, and often the lack of urgency in executing agreed decisions within the higher-education sector.  However, I am questioning the type of reaction or action exhibited by the students if, for similar legitimate reasons (through proper engagements), student demands cannot be completely met by university leaders.

In the final analysis, South Africa needs strong universities which are competitive – the country needs appropriate skills to enable and support the economy.  Also, universities need to listen to the student voice – deal with their concerns in a fair and socially-just manner; but as a sector with all its stakeholders, we need to ultimately respect the academic project and the infrastructure (physical and human) which support it.  We cannot afford party-political dynamics to ‘abuse’ the university campus in a way that can destroy the fibre of our higher-education system.  This will be catastrophic for South Africa, and I believe for the continent.

I call on government, voices in society, fellow students, student leadership, and staff to support university management openly, pro-actively and firmly, so that our universities remain places of intellectual engagement and discovery, places where different views are respected and heard, and by ‘jealously guarding’ the institutions as ‘country resources’, responding to all stakeholders’ concerns in a fair and just manner.

It is only then that universities ‘regain’ their rightful place in society, educating the next generation of scholars and professionals, advancing new knowledge, and purposefully disseminate and apply these to society – contributing to ‘lubricating the economy’ and to the betterment of the quality of life of our people! 




News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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