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23 September 2020 | Story Nombulelo Shange | Photo Supplied
Nombulelo Shange is a Lecturer in the Department of Sociology.

Heritage Day is almost here; it’s time to celebrate all the ‘fluffy’, less threatening to whiteness parts of African culture, braai, and sample weird and wonderful traditional food we’ve never tried before. For one day, we go to work in beautiful colourful traditional attires, put on cultural dance and singing performances, and share it on social media. We will have dialogues on ubuntu and how we should use it to ‘turn the other cheek’ and ignore structural oppression in an attempt to save the failed rainbow nation. What will be missing, and what is always missing, is serious discourse on how side-lined indigenous knowledge can and should be used to address poverty, developmental and ecological challenges, our struggling health-care system, and many other modern and historical challenges that South Africa is faced with. 

Decolonising knowledge systems

#FeesMustFall protests in 2015 and 2016 briefly brought the issue of decolonising knowledge systems and, well … everything to the fore. But since the end of the FMF protests, these discussions have been confined to the university space and are not being heard in other important spaces such as workplaces, churches, healthcare structures, schools, etc. Even within universities, students have the sense that their decolonial agenda has been hijacked and turned into a PR activity that pushes reform and minimal systematic change instead of revolution and a total dismantling. And so, indigenous knowledge ends up being manipulated and moulded to fit the Western context rather than being the foundation of the curriculum. 

The COVID-19 global pandemic has forced us into a precarious space, where we have to rethink almost everything about life, our work environment, how we use technology, how we socialise and interact with each other, how we run schools, how we show caring, and so much more. We have an opportunity here to rethink how we can use this disruption and those that will come in future to advance our cultural and traditional medical practices. So much of Western/modern medicine is already based on the cultural appropriation of African knowledge systems, which we as Africans at times look down upon. The appropriation of African ideas is a manipulation that involves stealing African ideas, presenting them as Western, while convincing Africans that the same practices are inferior. One example of this is the story of Onesimus, the African slave who cured smallpox.

Onesimus’ role in curing smallpox

Onesimus lived during the smallpox pandemic of the early 1700s, which claimed 30% of the lives of those infected. Onesimus was sold to Cotton Mather, a New England minister and author. During the pandemic, Onesimus advised Mather that smallpox was preventable. Onesimus shared the details of a common surgical procedure, which helped to prevent smallpox and many other contagious illnesses in Africa. The procedure involved making an incision on a patient’s arm and exposing them to a small amount of the disease to allow the body to build immunity to the disease in a controlled environment while still under the care of the healthcare provider. In the case of smallpox, it was a small amount of pus from an infected person that was rubbed on the incision of the patient being immunised. Mather then ran human trials on slaves and found this vaccine to be successful. The slaves who formed part of his trials were less likely to contract smallpox, and those who did were more likely to recover.

Just like most important black contributions in history, Onesimus’ role was written from the history books, and the credit was given to Mather. Eventually, scientists researched and explored this method, and their discoveries led to modern-day vaccination medicine and technology that saves millions of lives every year. This and other violent historical erasures has contributed to the systemic racist ways in which we undermine African indigenous knowledge and always opt for Western solutions to health challenges, even in instances where the African solution might be cheaper, more accessible, and more effective. 

Traditional healers possess a wealth of knowledge

Fast forward more than 300 years to 2020, the COVID-19 outbreak and global lockdown. Countries such as China, Russia, the UK, and many others involved in trying to develop a vaccine for the Coronavirus are still exploring similar methodologies to what Onesimus shared with Mather to fight the spread of smallpox. Locally, traditional healers are frustrated because they are being left out of interventions to tackle the spread of the Coronavirus. In an interview with Sunday Independent, traditional healer Zama Ndebele expressed his disappointment over government’s lack of engagement with traditional healers. Ndebele added that their collaboration in creating a cure or vaccine would be useful and that they possess a wealth of knowledge about different herbs and their uses. Traditional healers are still interested in collaboration despite running the risk of experiencing erasure and exclusion from historical and scientific records, in a similar way to how Onesimus’s contribution was undermined.

Often when the discussion around mainstreaming African knowledge systems comes up, some worry that the quality of knowledge will be weakened. But French philosopher Michael Foucault, whose contributions have been instrumental in feminist and revolutionary discourse, reminds us that knowledge is about power. Foucault says even scientific knowledge is socially constructed. Those who dominate use their power to present their cultural ideas as the only objective scientific truth. 

Prioritise and value own knowledge systems

One positive reflection we should gain from the current global pandemic is that we should prioritise and value our own knowledge systems. We need to do better in investing in our cultural identity and indigenous knowledge. We need to ensure that it can be used as more than just gimmicks to attract Western tourists who expect us to ‘perform Africanness’ for their entertainment. African knowledge systems should be built into the way knowledge is produced, the way we run our healthcare systems, how we build new technologies. We can learn a lot from Asian countries such as South Korea who have done this successfully in many social structures, but more noticeably, in their healthcare systems that surpass even some of the best Western healthcare systems. Doing this can also potentially restore black identity and create a sense of pride as we start to see our practices represented in the mainstream and being labelled as important scientific contributions instead of an alternative. This reclaiming can drive us to juxtapose our knowledge systems with other cultures in ways that uplift and advance humanity. With ecological degradation looming and unknown public health crises lurking in our future, African knowledge systems that often encourage sustainability have the potential to save our lives in various ways.

Opinion article by Nombulelo Shange, Lecturer in the Department of Sociology, University of the Free State

 

Watch short video below:

 


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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