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23 September 2020 | Story Prof Theodore Petrus | Photo Supplied
Prof Theodore Petrus is Associate Professor of Anthropology at the University of the Free State.

As we as a South African nation prepare to celebrate Heritage Day on 24 September, and as we reflect on our heritage during Heritage Month, what stands out clearly is that this year’s heritage celebrations will be somewhat … different. It will not be like previous celebrations because as a country, we – along with our fellow continental and global citizens – have experienced what can be described as one of the greatest health, social, and economic challenges that we as a species have ever faced. The repercussions and impact of the COVID-19 pandemic will be felt for some time to come. And it is this realisation that may cast a little damper on our celebrations during this #Heritage Month.

But what can our shared heritage as South Africans teach us about who we are as a people, and how can this knowledge help us to adapt to and overcome the long-term challenges wrought not only by the pandemic, but also by the many other challenges facing us? 

Heritage Day is a celebration of our cultural heritage and diversity as a nation. It presents us with an opportunity to reflect on our individual and collective heritage. It is also an opportunity for us to take stock of the cultural and other resources that enable and empower us to take ownership of what we want to be as a nation, as a country, as a people. 
So, in view of the questions raised earlier, here are some ideas on what I think our shared heritage can teach us:

1. The heritage of where we come from

Inasmuch as our past is a painful one – a past that still has lingering effects decades after the transition to a democratic dispensation – it still plays a fundamental role in shaping who we are now, and who we want to become.
Colonialism and apartheid sought to suppress our indigenous cultures and traditions, and had a negative impact on our psyche, self-confidence, and dignity as indigenous and African people. But one positive that came from this, is that if it was not for our shared heritage of colonialism and apartheid, we probably would not have become the nation we needed to become to bring it to an end.  

Instead of destroying symbols of that painful past, we need to shift our perspective to re-interpret those symbols in a new way. The power of cultural symbols lies in their meanings. Symbolic anthropologist Victor Turner spoke about the ‘multivocality of symbols’, meaning that we can ascribe whatever meanings to our cultural symbols we choose. Let us reflect on how we can change the current meanings we ascribe to our cultural symbols that reflect an awareness of how the heritage of where we come from does not keep us trapped in negative and painful meanings of these symbols, but instead inspire us to create new positive meanings.

2. The heritage of where we are now

After 1994, we began the process of creating a new contemporary heritage as a nation struggling to free itself of the burden of a painful past. And while it was difficult, we have made significant strides. Yes, we do still face challenges rooted in the past: institutional and structural violence; race and diversity-related issues; intercultural and intergroup conflicts; crime and violence against men, women, and children; corruption at various levels of governance; and others. We are also faced with ‘newer’ challenges as a country that is part of the globalised world. Poverty, inequality, unemployment, slow economic growth, and ailing infrastructure are all contemporary problems, some of them rooted in the past, others the product of the contemporary context. 

What can we learn from our shared heritage of where we are now that can help us to overcome these contemporary challenges? We need to remind ourselves of what we are capable of as a nation. We have ended an oppressive regime, not once but twice. And, with all of the challenges, problems, and obstacles, we are still here.

3. The heritage of where we are going

This might sound strange, because heritage usually refers to the past and present. Rarely do we speak of heritage in a future-oriented context. However, as a nation, given our past and given our present, where we come from and where we are now determines where we are going. 

As South Africans, we need to ask the question: where do we want to go? Are we heading in that direction? If not, how do we change course so that we do go in the right direction? I have no simple answer. But what I can suggest is that it should start with critical self-reflection, both individually and collectively. We also need to ask ourselves what legacy we want to leave for future generations. Do we want them to still be struggling with the same problems and challenges that we are dealing with right now? Or do we want to leave them a legacy of a nation that stood up to its challenges, took ownership of them, and found a way to overcome them?

A globally devastating pandemic. A painful past. A present wrought with seemingly insurmountable obstacles. As a South African, as a child of the soil, I know that as a nation we can overcome, and we can emerge better and stronger. That is our heritage. The heritage of hope.

 

Opinion article by Prof Theodore Petrus, Department of Anthropology, University of the Free State 

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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