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03 December 2020 | Story Andre Damons
The final webinar of the UFS Thought-Leader Series, presented in collaboration with Vrye Weekblad as part of the Vrystaat Literature Festival’s online initiative, VrySpraak-digitaal took place on Wednesday (2 December). Dr Max du Preez, Editor: Vrye Weekblad (top left) was the facilitator with Ms Magda Wierzycka, Chief Executive Officer: Sygnia Group (top right), Zingiswa Losi, President of the Congress of South African Trade Unions (bottom left) and Prof Ivan Turok, SARChI Research Chair in City-Region Economies at the UFS and Executive Director: Human Sciences Research Council (HSRC), as the other two panelists.

The South African government must ensure that the COVID-19 vaccine is free of charge and that the most vulnerable and exposed in the country receive it first. South Africa cannot afford for anyone not to be immunised.

This is according to Zingiswa Losi, President of the Congress of South African Trade Unions (Cosatu), who was a panellist on Wednesday 2 December at the final webinar of the UFS Thought-Leader Series, presented in collaboration with Vrye Weekblad as part of the Vrystaat Literature Festival’s online initiative, VrySpraak-digitaal. Magda Wierzycka, Chief Executive Officer: Sygnia Group, and Prof Ivan Turok, SARChI Research Chair in City-Region Economies at the UFS and Executive Director: Human Sciences Research Council (HSRC), were the other two panellists.

Progress gives hope

Losi said the news on the health front is hopeful because of the good progress that has been made with regard to developing vaccines for COVID-19. The progress that has been made with the economy also gives her hope.

 “As South Africa we cannot afford to undertake another mass lockdown; our economy, we believe, cannot cope with it. There is not enough available in the UIF or social security to cushion workers any longer. We would face the danger of public rejection if we were to go back to a lockdown.”

According to Losi if the government wants to rebuild the state, it needs to address its internal demons. Says Losi: “It cannot allow corruption and wasteful expenditure to continue to consume 10% of the budget. Bail-outs for state-owned entities are not sustainable. The government also needs to show the necessary will to arrest those who steal, and seize their assets.

“And we are saying the ANC must deal with its demons of corruption, factionalism, and mismanagement of the state. It cannot expect to continue to lead, while it itself is limping. Nor can it continue to take workers’ loyalty for granted. We are looking forward to all of us to be playing a pivotal role in shaping society not only 2021, but in fact in the future of our country,” concluded Losi.

No knight with solutions

Wierzycka says when you look at South Africa and other countries you need to recognise that this crisis is not like the global financial crisis. “This crisis has hit every single country in the world, which basically means that no-one is coming to our help. We are on our own. There is no white knight that's going to arrive with some solution.

“This is where it is so essential that we have some kind of economic policy certainty and political certainty, because the only way that we are going to manage our way through this is to attract foreign investment and job-creating,” said Wierzycka.

Investment in infrastructure is needed as it is the only realistic tool for mass job-creation. Tax breaks and incentives and funding to would-be entrepreneurs or small businesses should be encouraged, said Wierzycka, because those small businesses tend to employ five or 10 people, but these people effectively support 30 to 40 families.

“If it were up to me right now, I would call together the brightest minds in South Africa in a think-tank, completely apolitical, who would sit around a boardroom table designing strategies to get us out of this crisis because no-one is coming to help us.”

Leaders should be held accountable

Prof Turok said looking forward he hopes the local elections will see real choices offered to the electorate, a genuine democratic contest between ideas, different philosophies and different outlooks and different ways of addressing challenges.

“I hope these elections will give us a clear outcome, the civic leaders, I think that's really important. We want our leadership to be held accountable. We want our leadership to stand up and be clear as to what they stand for and be accountable to ordinary people. We want and need a national government to recognise the special important, special claim subsidy as crucibles of progress of social mobility,” said Prof Turok.

He also talked about urbanisation in Africa, saying the continent is the fastest urbanising continent in the world and that a billion more people will be living in cities in 30 years’ time.

According to Prof Turok, we must make sure that South Africa makes a contribution to this. “And that we ensure that this process, this transformation, is a productive one and creates jobs and livelihoods, rather than shantytowns. We've got to see cities as economic drivers. You've got to build on the opportunities of density, of social diversity around the world as critical elements of productivity of investment of innovation, and of economic dynamism.”

African cities, like Johannesburg, and Lagos in Nigeria, should collaborate on joint projects, share expertise to transfer skills, to support each other and to overcome the xenophobia we face in South Africa.

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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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