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10 December 2020 | Story Gcina Mtengwane and Andiswa Khumalo | Photo Scott sa ha Molefe (Scott Photography)
Gcina Mtengwane and Andiswa Khumalo
Gcina Mtengwane and Andiswa Khumalo believe economic vulnerability of women is a cause and a propellant of gender-based violence.

Gender-based violence can be understood as violence that is perpetuated as a result of normative role expectations associated with gender, power, and culture. It takes different forms. The most common forms are physical, emotional, psychological, verbal, domestic and socio-economic violence, to mention a few.

It is a profound, widespread, and pressing matter in South Africa and beyond its borders. In its entirety, gender-based violence is a threat to the economy, society, and humanity, as it creates emotional, social, and economic unrest that prohibits the growth and success of individuals, families, communities, and society as a whole. More than 30% of women in South Africa suffer from gender-based violence in the form of harassment, rape, femicide or domestic violence. Although women and young girls are the worst affected by gender-based violence, the term and act apply to both genders, including men and young boys.

Economic vulnerability of women

Notwithstanding the fact that gender-based violence happens to both genders, it is worth noting that women are the worst affected. There is a myriad of reasons for this. This article puts its focus on the economic vulnerability of women as both a cause and a propellant of gender-based violence. What we argue here is that there are structural socio-economic differentials that create and perpetuate the vulnerability of women to gender-based violence. We further posit that unless these vulnerabilities are addressed, gender-based violence will be a persistent problem for generations to come.

Our starting point is that women in South Africa generally have a higher unemployment rate than men. Additional to this, women struggle to ascertain livelihoods outside employment. This means that even in cases where women are employed, they will earn less than men. Furthermore, women also struggle to succeed in entrepreneurship. This can be associated with the ‘unpaid normative duties’ of child-rearing and household maintenance. This makes them vulnerable to abuse, as they cannot exercise their independent social and economic existence outside the confines and control of the male partner. It is worth noting that black African women are the most vulnerable, with an unemployment rate of more than 30%.

More worrying is that more than four out of every ten young females (15-34) are not in employment, education, or training (NEET). This further exacerbates the vulnerability context across all ages. Females consistently record a higher headcount; however, they remain behind in social, political, economic, and cultural matters. To amplify this, Statistics SA (2020) reports that 39,2% of female-headed households in South Africa do not have an employed member of the household.

Another point of concern is that there is a ‘social class and income link’ associated with gender-based violence. Gender-based violence is more prevalent among less-educated women than those with secondary education or higher. Additional to this, wealth/income is a key factor in the prevalence of gender-based violence. To that end, Statistics SA (2020) reported that the prevalence of physical and sexual violence decreased with the wealth quintile. In other words, the higher the wealth/income, the lower the prevalence of gender-based violence.

Overcoming economic vulnerability

Over and above all of this, the bigger question is, ‘how do we overcome the economic vulnerability that subjects poor women to gender-based violence?’ Here are a few contemplations:
1) Empowerment of women and economic justice. It may be good to take more deliberate and decisive action to capacitate women to a point where they are able to support their own livelihoods outside of economic dependence on a male.
2) Unlearning the outdated gender roles. Research suggests that more and more women are exiting the ‘nurturing and child-rearing’ role. This is because of the rising cost of living. Technology has made paid work less labour intensive. This then eliminates physical traits as a requirement for high-paying employment opportunities.
3) Socio-cultural re-engineering. This speaks to unlearning outdated cultural norms and dictates. While noting that every society, ethnic group, and culture has gender role expectations, these can also change over time. Perhaps now is the time for those expectations to change. If its existence is tantamount to abuse and even death, then certainly we need to unlearn the toxic and outdated and learn the forward-looking and solidarity-inducing doctrine.
4) Women as spearheads in women’s issues to inform legislation, policy, and practice. As the adage goes, ‘one is the master of your own condition’. This means that a person’s awareness of her/his condition allows them to be better suited to make the best inputs to liberate herself and those in like conditions.  

A lot more than what we suggest can be done to uplift women from the economic vulnerability that subjects them to gender-based violence in the household and elsewhere. We do not hold a monopoly on gender-based violence and the solutions therein. Our only hope is to spark a conversation that will contribute to feasible real-life solutions to one of our biggest and far-reaching challenges as a nation – gender-based violence and its socio-economic roots.

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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