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19 May 2020 | Story Cornelius Hagenmeier and Prof Colin Chasi | Photo Supplied
Cornelius Hagenmeier.

Africa is defined by colonial borders, within which states attempt to build viable systems. Universities are a significant part of the national innovation systems that seek to change the socio-economic and other fortunes of the many poor and marginalised Africans. As Africa approaches the celebrations on the occasion of the 57th anniversary of the founding of the Organisation of African Unity (OAU), the COVID-19 crisis reveals – if we are willing to see it – that there is a need to focus much attention on intra-Africa internationalisation programmes for African higher education.

Because national socio-economic and health systems are often inadequate, Covid-19 protects unprecedented human and social suffering for many on the continent. To try and stave off this harm throughout the continent, borders have been closed and economies have been stifled. Except for the ‘repatriation’ of citizens, international travel has become all but impossible. Africans have, as never before, been bound to colonial boundaries, which are preserved according to a principle called uti-possidetis. This principle was reluctantly ratified by members of the Organisation of African Union (OAU) in July 1964. This ratification was reluctant, because leaders recognised that African boundaries were arbitrarily and chaotically imposed in the scramble for Africa. These borders were not developed by internal historical processes. In consequence, they divide kith from kin, limiting trade and commerce across the continent. Nevertheless, leaders adopted the uti-possidetis principle for fear that allowing the contestation of these borders would likely yield territorial wars that would bring heightened misery without end. 

State power in Africa today is exercised within postcolonial borders that continue to be weak and porous. It is also exercised by states that are themselves generally weak. These states take their health-promoting actions to neighbourhoods that often have inadequate socio-economic and health systems for combating COVID-19. They entrap us in compartments that produce lives that are short and brutish.  We would do well to ask how we can decolonise our borders in ways that set us free to change socio-economic fortunes.

Within the confining arrangements of state power, the health threat of the COVID-19 pandemic has been met with almost every African country adopting stringent health precautions, often resulting in sudden, sharp economic declines. With this, the livelihoods of millions are in jeopardy. African higher education has not escaped the resultant challenges.
The higher education sector is struggling to adapt. To be sure, in many ways, it is producing mighty work. Many books and journals will write about how systems moved significant aspects of teaching and learning online, often with great success, sometimes with great frustrations. At the same time, Africans rightly expect higher education systems to contribute to finding immediate responses to the pandemic threat. In many cases, universities are assisting by researching the coronavirus genome, developing effective and cost-efficient necessities such as personal protective equipment and ventilators; or by researching effective vaccines, medication, and public-health interventions. However, it is difficult to find excellent examples of how these steps are changing national narratives, particularly those that bind us to colonial miseries.

The African Union (AU), which is the successor to the OAU, is trying to build multilateral efforts. It has developed an ‘Africa Joint Continental Strategy for COVID-19 Outbreak’ and established an ‘Africa Taskforce for Coronavirus’. These efforts seek to foster collaboration between multilateral stakeholders. For the African Union recognises that to adequately address the crises occasioned by COVID-19, it is necessary that member states, African Union agencies, the World Health Organization and other partners work synergistically to avoid duplication and to maximise efficiencies, given that resources are extremely constrained. 

A central tenet of the OAU is African solidarity. Member states have undertaken to coordinate and intensify their cooperation and efforts to achieve a better life for the people of Africa. It is encouraging that the AU’s Chairperson, President Cyril Ramaphosa, refers to pan-Africanist ideas when he calls for the ‘strengthening of the bonds of solidarity that exist between us as Africans’ (24 April 2020). Ideas of African togetherness, underpinned by the philosophy of ubuntu, must inspire African solidarity. They are more relevant than ever before. 

It is vital that we think, beyond this COVID-19 crisis, of how long-run coordination of African higher education institutions in Africa must produce continent-wide systems of innovation that take us out of perpetual poverty, disease, and unnecessary deaths.

African higher education is struggling to define its place in the rapidly changing realities of the continent. Many institutions are driven to merely concentrate on how they will survive, or on how sprouting areas of excellence will make it through adverse financial conditions that emerge. 

Africa is at a critical juncture. How we make it through COVID-19 and what we learn from doing so, will determine whether Africa unites as we shape the post-COVID-19 future.

Prof Colin Chasi. (Photo: Anja Aucamp.) 

Periods of great strife, devastation, and hardship are opportunities for radical renewal and quantum leaps in development. But we must have the courage to take those opportunities. If we have the courage to unleash our universities in the kinds of continent-changing work that is needed, the fortunes of African countries are, after all,  tied together (no matter what colonial boundaries and divisions may say). 

The decisions that will be made during and in the wake of the pandemic will determine whether the crisis and its aftermath will allow the continent to focus on becoming a prospering, united world power, or whether national egoism (tied to colonial histories) will prevail and hinder sustainable development. 

How African higher education evolves in the post-pandemic world will largely depend on whether universities will be able to embrace the interconnectedness and interdependency of Africa’s social and economic realities. African higher education systems must escape the temptation to respond to immediate challenges in isolation. These times should teach us that when your neighbour catches the flu, your home economy suffers too. However, where people should observe social distancing to overcome the flu, economies must reach across borders if they are to flourish in markets large enough to truly impart value to ideas, services, and goods.

Higher education should serve African people by advancing social transformation and development through collaboration in skills development and research. Through intra-African partnerships and collaborations, African universities can make significant contributions to finding responses to the peculiar public health and medical challenges of emerging African societies and shaping a prosperous and unified post-pandemic Africa.

Many African higher education institutions excel in specific fields. The quality of programmes and research is not uniform throughout institutions. We need to lead the world in recognising each other’s strengths to produce intensified collaboration in capacity development and research. In doing this work, higher education will go far beyond repeating and mimicking colonial patterns, or if you wish, it will go beyond colonial boundaries. It will be a key driver in finding responses to the cross-cutting challenges that need to be resolved to fulfil the aspirations of Africa’s Agenda 2063. Indeed, by leveraging the complementary strengths of its higher education institutions, the continental higher education system could become a critical force shaping a positive post-COVID-19 African reality. Pan-Africanism in higher education should not be limited to isolated initiatives such as the development of the Pan-African University, but should establish a framework for sustained continental academic collaboration.  

As African universities prepare to contribute to the celebrations for the 57th anniversary of the OAU, they should consider how they can strengthen intra-African collaboration to achieve the pan-African vision of ‘an integrated, prosperous and peaceful Africa, driven by its own citizens, representing a dynamic force in the international arena’ (AU vision statement). 

Fortunately, there are excellent points of departure. Laudable programmes such as the Association of African Universities staff exchange programme already exist, yet much of the intra-African higher education collaboration is still financed by foreign donors. The African Union, African governments, and the African higher education sector influence the structure of those programmes through consultation, and consequently minimise the risk of them responding to the international perceptions of African needs rather than real African needs. This should be strengthened, not least through committing equity to the formulation of joint programmes. 

For the brave new world in which we must make space for our children to thrive, brave new African frameworks for collaboration should be developed. Energy must be invested in removing obstacles to African higher education collaboration. Some of the things that need to be done are well known. Practical measures could include strengthening the harmonisation of African higher education accreditation and quality assurance mechanisms, establishing an African credit recognition and transfer system, and fast-tracking the harmonisation of African higher education programmes. The celebration of 2020 Africa Day should encourage African higher education to work towards devising a strategy for strengthening collaboration, which would assist the continent in shaping a positive post-COVID-19 African reality. If this can be achieved, African universities could emerge as genuine agents of achieving solidarity and development in post-pandemic Africa, and thus realising the ideals of the OAU.

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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