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08 October 2020 | Story Motsaathebe Serekoane | Photo Supplied

We need to acknowledge that inherent in opening up spaces that were previously reserved for exclusive inhabitation and use is problematic in the contestation for place and symbolic public representation. Broadening the heritage landscape allows us an opportunity to bridge the existing gaps in the heritage space, in particular, askew representation through monuments and declared sites.

The country’s 2030 Developmental Plan requires South Africa to continuously reflect on progress made since the dawn of democracy in 1994. The scope is big; my focus here is on the heritage landscape. I do not want to create an impression that this matter exists in isolation, the intersectional engagement is imminent. The conversation on heritage is vast. My summary of all I have read and heard is that at stake in South Africa, with the historical legacy of segregation policies, is the competing notion of space, conflicting and often-competing ideological notion of commemoration or memorialisation, and the lack of shared collective memory and meaning of public representation. Effectively we don’t know what to do with our historical text and footprints. 

“A community is divided when their perception of the same thing is divided” …Steve Biko

Three questions 

This is a challenge for the notion of inclusion (aka social cohesion) and a threat to preservation and conservation of the country’s heritage resources material. It is equally important that I bring to your attention related conversations with a position that asserts that forfeiting the past for the sake of the future is perhaps an overly simplistic way of conceptualising and describing how society moves beyond conflict or pain. The argument for imagining inclusive spaces necessitates a paradigm shift in our thinking. The literature argues for a move from multiculturalism to interculturalism because of cross-cultural overlaps, interaction, and negotiation. The interculturalism approach goes beyond opportunities and respect for existing cultural differences, to the pluralist transformation of public space, civic culture, and institutions. In line with this view, reconfiguration of public spaces towards inclusive ends would have to emphasise the politics of recognition and negotiation of difference. So where does this leave us? There are no easy answers. As the country embarks on the process of auditing and spatial identity transformation I put forward the following three questions:
• Whose conception of the past should prevail in the public realm?
• Whose conception of the present should prevail in the current realm for the future?
• How do we balance the old and the new so that we do not dump history?

Sustainable change will require consultation and participation

Advancing change affords interested and affected communities to develop an awareness of layered complexities of our history and intersectional voices (some louder than others), and promotes the practices of collaboration and capacity-building with community members to advance sustainable change. Sustainable change will require, in line with the democratic principles, that the review process acknowledges consultation and participation. Ideally, the audit and review process should be designed to encourage conversation, reflection, and social analysis. The transformation of spatial social milieu should assume collective ownership and management of space founded on the permanent and temporary participation of the 'interested and affected parties', with their multiple, varied, and even contradictory political interests. In the review of the current symbolic landscape for inclusion, the spatial identity transformation must be negotiated. It must be developed from a focal point that understands the interrelationship between space and spatial inscription through the form of street names, symbols, and public art. 

I can’t pre-empt the end of the process, the process should inform the outcome. Should it be that some of the statues are to be “repositioned and relocated”, as also stated in the president's speech, this should not be equated to dumping history/historical dumping. Reposition and relocation are plausible alternative arguments in the spatial reconfiguration discourse. If it is done well it should contribute to the educational programme of the country. It should also be kept in mind that memorabilia are protected by the National Heritage Resources Act (NHRA) No 25 1999. Subsequently, the audit and review will require a nuanced approach guided by the NHRA (including relevant legislation) and leaning towards a process-oriented, person-based approach to allow for agency/agility and new possibilities (cf. SONA pronouncement of imagining the New City). Imminent is a guiding or reference document that draws lessons from review processes demonstrated by, among others, the University of Free State’s review and ultimately relocation of the president MT Steyn statue to the War Museum. I believe the South African Heritage Resources Authority and its Provincial Heritage Resources Authority should guide the process. 

Heritage serves a social and economic function

Just as a footnote, it is prudent that we remind ourselves that heritage, in addition to many things, serves a social and economic function. Although I acknowledge the views that some of the symbols in the public spaces trigger painful memories of the past, losing those will rob the country of its rich narrative that, in line with NHRA, is to be bequeathed to the next generation, but also that can boost the country’s economy through heritage cultural tourism footprints. 

Ultimately, “Our heritage is unique and precious and it cannot be renewed. It helps us to define our cultural identity and therefore lies at the heart of our spiritual well-being and has the power to build our nation. It has the potential to affirm our diverse cultures and in so doing, shape our national character” …NHRA, No. 25 1999

Opinion article by Motsaathebe Serekoane, Lecturer: Anthropology at the UFS.


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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