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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

UFS cardiologists and surgeons give children a beating heart
2015-04-23

Photo: René-Jean van der Berg

A team from the University of the Free State School for Medicine work daily unremittingly to save the lives of young children who have been born with heart defects by carrying out highly specialised interventions and operations on them. These operations, which are nowadays performed more and more frequently by cardiologists from the UFS School of Medicine, place the UFS on a similar footing to world-class cardiology and cardio-thoracic units.

One of the children is seven-month-old Montsheng Ketso who recently underwent a major heart operation to keep the left ventricle of her heart going artificially.

Montsheng was born with a rare, serious defect of the coronary artery, preventing the left ventricle from receiving enough blood to pump to the rest of the body.

This means that the heart muscle can suffer damage because these children essentially experience a heart attack at a very young age.

In a healthy heart, the left ventricle receives oxygenated blood from the left atrium. Then the left ventricle pumps this oxygen-rich blood to the aorta whence it flows to the rest of the body. The heart muscle normally receives blood supply from the oxygenated aorta blood, which in this case cannot happen.

Photo: René-Jean van der Berg

“She was very ill. I thought my baby was going to die,” says Mrs Bonizele Ketso, Montsheng’s mother.

She says that Montsheng became sick early in February, and she thought initially it was a tight chest or a cold. After a doctor examined and treated her baby, Montsheng still remained constantly ill, so the doctor referred her to Prof Stephen Brown, paediatric cardiologist at the UFS and attached to Universitas Hospital.

Here, Prof Brown immediately got his skilled team together as quickly as possible to diagnose the condition in order to operate on Montsheng.

During the operation, the blood flow was restored, but since Montsheng’s heart muscle was seriously damaged, the heart was unable to contract at the end of the operation. Then she was coupled to a heart-lung machine to allow the heart to rest and give the heart muscle chance to recover. The entire team of technologists and the dedicated anaesthetist, Dr Edwin Turton, kept a vigil day and night for several days.

Prof Francis Smit, chief specialist at the UFS Department of Cardiothoracic Surgery, explains that without this operation Montsheng would not have been able to celebrate her first birthday.

“After the surgery, these children can reach adulthood without further operations. Within two to three months after the operation, she will have a normal active life, although for about six months she will still use medication. Thereafter, she will be tiptop and shortly learn to crawl and walk.”

Mrs Ketso is looking forward enormously to seeing her daughter stand up and take her first steps. A dream which she thought would never come true.    

“Write there that I really love these doctors.”

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