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20 August 2020 | Story Dr Nadine Lake | Photo Supplied
Dr Nadine Lake is a lecturer and Programme Director of the Gender Studies programme in the Centre for Gender and Africa Studies

The transition to democracy in South Africa has been characterised by an uphill battle towards equality. Inequalities shaped by race, gender, and class politics have been amplified since the outbreak of COVID-19. While South Africans initially thought they might be spared the devastation wrought by the virus, it is now certain that nobody is immune, regardless of race, class, age, gender, or social location. In an unprecedented manner, South Africans have become accustomed to hearing from government through President Cyril Ramaphosa’s state addresses on COVID-19 and its spread throughout the country. Although the initial national addresses were regarded as a panacea for some in a time of uncertainty, they are increasingly considered ignorant of broader human rights and the future of the populace. The South African situation is different from those struggling with the pandemic in the Global North, because of structural inequalities that have exacerbated an already precarious outlook on the economic and social stability of the country.

Gender-based violence needs immediate attention

In addition to recently emphasising a zero-tolerance attitude towards corruption in South Africa, President Ramaphosa surprised the nation when he emphasised that our country is dealing with two pandemics. First, COVID-19 has laid bare the slow pace of economic transformation and a crumbling health infrastructure. Second, gender-based violence has emerged as something that needs immediate attention. While it is true that gender-based violence has been and remains a burning issue in the country, it is important to identify the paradox that exists between the liberal agenda couched in the language of women’s rights on the one hand, and the blind eye turned towards slow economic transformation and high unemployment on the other. This emphasis on a liberal political agenda during a time of crisis is not new and has formed part of what we have come to know as political pinkwashing in Western democracies. Pinkwashing has been defined as a practice whereby states seek to create a more positive image of their nation, government, and human rights record, among other things, by speaking about and promoting LGBT rights (Lind, 2014, p. 602). While the African National Congress (ANC) may not be ready to fly the rainbow flag, it is worth noting the tensions between human rights and women’s rights, which have become part of political discourse, or more accurately, politicking. 

GBV and rape culture part of the social fabric

South Africa is reported as the country with the highest rape statistics in the world. In 2018/2019, the South African Police Services reported 52 420 cases of sexual offences. Non-profit organisations such as the One in Nine Campaign, however, highlight that only one in nine women report a sexual offence, and therefore a realistic estimate is likely much higher than the recorded statistics. Furthermore, according to a survey conducted by the South African Medical Research Council, one in four South African men have admitted to committing rape. These statistics demonstrate that gender-based violence and rape culture form part of the social fabric and that women are disproportionately affected by violence. In the first week of the South African lockdown, more than 87 000 cases of gender-based violence complaints were reported. One of the rape cases that received prominent media attention during the first phase of the lockdown, was that of a police officer who raped his wife. The Minister of Police, Bheki Cele, quickly gained the reputation of a rape apologist when he stated that the man who raped his wife was her husband and not the police, because he was not in a police uniform, and the rape did not happen at the police station. This absurd response reinforces common rape myths and reduces the seriousness of sexual offences. Although opposition political parties such as the Democratic Alliance (DA) have called for the removal of Minister Cele, who was deemed unfit for office, these calls have fallen on deaf ears. The message conveyed is that men in positions of authority are exempt from punishment and speak and act with impunity when it comes to sexual violence. 

#MeToo

Gender-based violence and rape is not specific to South Africa. The normative position of violence against women is widespread and deeply entrenched in institutions, cultures, and traditions worldwide. Movements such as #MeToo, which emerged in 2017 as an outcry against sexual violence and abuse, gained rapid momentum and started to see the prosecution of sexual predators such as Harvey Weinstein and Jeffrey Epstein in the United States. The global solidarity against sexual abuse shown by women on social media has shown that relentless pressure on patriarchal systems forces accountability, and refuses men permission to perpetrate violence against women with impunity.

As we reflect on Women’s Month 2020 in South Africa, it is necessary to observe a moment of silence to victims of sexual abuse and femicide. We pay respect to Fezekile Khuzwayo, Uyinene Mrwetyana, Tshegofatso Pule, Naledi Phangindawo, Nompumelelo Tshaka, Nomfazi Gabada, Nwabisa Mgwandela, Altecia Kortjie, and Lindelwa Peni, and the many other women who have suffered misogynistic violence. Women’s Month provides us with the opportunity to take hands and speak out against the micro-aggressions and brutal acts of gender-based violence that should not form part of what we define as a truly democratic South Africa. 

Opinion article by Dr Nadine Lake, lecturer and Programme Director of the Gender Studies programme in the Centre for Gender and Africa Studies, University of the Free State


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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