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06 May 2020 | Story Dr Ina Gouws | Photo Supplied
Dr Ina Gouws

The President of the Republic of South Africa made another address to the country on Thursday 23 April 2020, indicating that the country will enter a phased approach out of lockdown in the coming months. This announcement was met with positive feedback not only nationally, but internationally. It was clear that the President consulted with many experts and also with opposition parties, which indicated that an ‘all-hands-on-deck’ approach was followed across party lines and varied interests. The plan seemed rational, well thought through, and clear: 
 
Support for lockdown
The government’s lockdown and subsequent restrictions on movement, trade and industry held wide support until now. The argument that people’s lives are most important and that the prevention of the spread of COVID-19 infection must be a priority, was accepted as rational. Truth be told, this strategy was entirely reliant on public trust and cooperation, which the President did have at the start of the lockdown. So, when he announced that the country would enter Level 4 from 1 May 2020, there was a sense of relief that progress was being made and that sacrifices made by all of us (some much more than others), have yielded some positive results. 
However, there was also an almost immediate realisation that this approach would have to rely on state machinery, especially on provincial and local levels, which – before the lockdown – was ineffective, to say the least. State capacity had been gutted by widespread corruption, incompetence, and the inability or unwillingness to hold to account those who are guilty of mismanagement and corruption. Add to that the planned deployment of more than 70 000 South African National Defence Force (SANDF) troops in our midst, as well as very little detail on how the R50 billion relief fund will be applied, and most importantly, how oversight over the spending will work. 
Cynicism is good 
This cynicism is being criticised as being uncooperative and that South Africans should only be proud of how government has met the challenges of this pandemic thus far. It is true that in the context of the country’s reaction to the pandemic, this government has done much better than most across the globe. The larger context of governance realities in the country cannot be ignored though. 
I was reminded of certain elements of the value of cynicism in an article by JR Macey. The article was written in the context of USA politics, but there certainly are touch points with South African politics. He basically argues that cynicism is good, and that people should be more cynical when it comes to politicians, officials, lobby groups, etc. As people, we are looking for leadership and sound decision-making. We expect good governance from the government. As South Africans, we have been consistently disappointed with our government in this regard for decades now. When it became clear that this virus was spreading across the globe like wildfire, we naturally held our collective breath. How will a government that can hardly keep the lights on or provide safe drinking water and whose public healthcare system has all but collapsed, deal with this virus when it finally arrives? All valid questions. We were appeased when the President announced a planned lockdown not long after the first cases were reported. We were impressed with the leadership from the Minister of Health and the experts he surrounded himself with. Rightly so. The President announced that the SANDF would assist the police in enforcing lockdown rules, but that they should perform their duty with empathy and in a spirit of service to the country. South Africans were supposed to feel secure. 
Cynics raise questions
Yet, cynics raised questions about the fitness of the untrained SANDF to perform these duties and of the SAPS which, according to the latest crime statistics, all but lost ‘the war on crime’. Cynics raised questions about the ability of the public healthcare sector to use the time bought by the lockdown to ready itself for the inevitable rise in the numbers of infected South Africans who would need very specific healthcare, and to protect its healthcare workers. Cynics questioned the lack of data with which decisions are made and the reluctance to start planning for getting out of lockdown for the sake of the economy. These questions were met with accusations of being unpatriotic, tone-deaf, and choosing to save the economy over dying South Africans.
These questions became prevalent after the announcement of the phased approach on 23 April. Commentators, journalists, politicians across party lines, as well as ordinary citizens once again began to realise the validity of being cynical. There are many reports of brutality by the SANDF and SAPS, so there are understandably fears regarding the deployment of thousands more soldiers. The phased approach will rely heavily on local government machinery; so, how will the accountability for financial and performance management work when it continues to worsen in most municipalities.
It is good to be cynical; cynics are believed to be more vigilant, to question, and to expect answers. The problem is that cynics often do not get the answers and then stop participating. This is something we as South Africans cannot afford at a time when our freedoms are encroached upon. We need to be more vigilant than ever. Listen to the cynics. See if their questions are answered (not spun), because the expectations from government in the coming months are going to be immense and South Africans must make these expectations clear.
Opportunity 
Provinces and local governments must carefully discern what these measures mean for each region and communicate this clearly. The latter has been sorely lacking up to now where most provinces and local governments are concerned. Oversight on all levels of government should not only be allowed but welcomed. There is time and opportunity to address all these concerns to prevent chaos and confusion. Public trust and participation are essential for this process to succeed. All the good governance principles such as transparency, accountability, responsiveness, etc., are required to ensure the success of the implementation of any government process, just as it has always been. This is an opportunity to use an enormous crisis to put these principles at the center for a change. One lives in hope...

Dr Ina Gouws is Senior Lecturer: Programme: Governance and Political Transformation in the Faculty of the Humanities.

News Archive

Ethics at the heart of healthcare practice
2017-05-17

Description: Ethics at the heart of healthcare practice Tags: Ethics at the heart of healthcare practice

Prof Gert van Zyl during the launch of Health
Ethics for Healthcare Practitioners with
Prof Laetus Lategan at the Central
University of Technology.
Photo: Supplied

The Central University of Technology (CUT) in partnership with the University of the Free State (UFS) launched a newly published book: Health Ethics for Healthcare Practitioners that aims to raise awareness among healthcare practitioners and patients about various unethical challenges faced by healthcare services in both the private and public sectors.

Prof Laetus Lategan, Director of Research Development and Postgraduate Studies at CUT, and Prof Gert van Zyl, Dean of the UFS Faculty of Health Sciences, are the co-editors of the book intended to provide a moral guide to healthcare professionals when dealing with their patients. 

Holistic approach to healthcare practice

Their work places renewed emphasis on the importance of healthcare ethics. This is due to a diversifying range of healthcare services and the imminent collapse of the public healthcare service sector; most notably in developing countries. The authors particularly focus on how their findings can be integrated into real-life situations.  

The book looks at modern-day healthcare ethics and how they apply to both patients and healthcare practitioners including doctors, professional nurses and therapists. It is an elaborate reference book that will help healthcare practitioners to make informed decisions should they be faced with ethical dilemmas in their practices and assist them to gain a better understanding and devise solutions to problems faced by communities.

Academic journey and partnerships forged
Prof Van Zyl said the book had been a joyful journey of collaboration between the two universities, a journey of academic colleagues who become friends. He explained that they wanted to focus on creating new approaches to healthcare from an ethical perspective, to provide a guide and reference on ethics, not only to healthcare practitioners, but also to patients. “We hope this book will make a difference in healthcare delivery,” he concluded.

Prof Lategan said modern science needed to become more interdisciplinary, which would transcend the way science was conceived. “The essence of healthcare is to be of service to other people and have relationships with other people. I think it’s high time for us to start caring for one another, especially in the academic environment. If we are really looking after the health of other people, whether it is mental, spiritual or physical health, it starts with caring for other people.”

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