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27 April 2021 | Story Prof Sethulego Matebesi | Photo Sonia Small
Prof Matabesi
Prof Sethulego Matebesi is a Senior Lecturer and Academic Head of the Department of Sociology at the University of the Free State.

This year’s Freedom Day marks an important milestone in the history of South Africa. It will be 27 years since the first non-racial elections were held in the country, a figure that equals the number of years Nelson Mandela spent in prison.

If equating Mandela with the freedom we enjoy today is not already disingenuous enough, we sunk even lower by assuming that we are close to achieving the civil liberties he embodied. You do not have to go further than read the daily media headlines to understand the extent of the onslaught on the pillars of democracy. That this onslaught comes from political leaders is one of the main reasons why most South Africans are disillusioned with politics, democracy and social issues.

Anarchy wreaking havoc in weak societies

Sociology taught me about the relevance of institutions to a social structure: they control human conduct by setting up predefined behaviour patterns. For example, throughout history anarchy has wreaked havoc in settings where organisations are weak, fragmented, and the citizenry is inactive. Similarly, while peace, unity, and the preservation and the restoration of human dignity are the hallmarks of Freedom Day celebrations, we have become a nation increasingly influenced by symbolic politics and the politics of offence.

It would be hard to find a better example of a significant threat to the pillars of democracy than the widespread onslaught on the judiciary. At the heart of the broader political, legal, and moral issues confronting SA today is how the right of all to equal respect and equal protection under the law has been compromised. Casting doubt about the independence of the judiciary conceals the motivations that most endanger the principles of freedom and equality.

My stance is not aimed at muting the expression of unpopular opinions – a basic tenet of democracy. However, we need to be mindful of events that have and will become powerfully symbolic in altering the nation’s social fabric.

Freedom under attack by populist politics

Any societal change requires some form of flexibility. No doubt, the first decade of democracy was accompanied by hope and the euphoria of the Rainbow Nation. This period demonstrated how different racial groups could live together in harmony, play together, and attend the same school without being required to forsake values they hold dear. This period was punctured by notions of active citizenship and the promotion of democratic cooperation that is based on the acceptance of universal human rights and the rule of law and values of diversity.

While millions of people elsewhere in the world have been forced to flee hunger, war, terrorism, and emboldened autocrats in their countries of birth, the euphoric wave of the Mandela years has, unwittingly and dramatically, worn off during the past decade in South Africa. This turn of events is linked to populist politics that seriously compromise democratic institutions in the country.

In my opinion, there are no heroes in situations like these.

In a country characterised by rampant corruption, violent crime, gender-based violence, human trafficking, racial intolerance, and teenage drug abuse, are politicians the only ones to be blamed for the threats to democracy?

Conquering immorality and safeguarding our freedom

Despite all the challenges we face as a country, we remain a remarkably resilient nation, as is widely acknowledged. This resilience is echoed by how we have navigated our way around a highly divisive and intolerant society to embrace and celebrate our rich and vibrant cultural heritage.

Nevertheless, we have become complacent. We have been vocal against any narrative aimed at restricting our legal, religious, human, civil, economic and political rights. Yet, partly due to our collective inaction, we have failed to use the means to provide a compelling counter-narrative of resistance to the manipulation of state institutions and broader immorality permeating society. This inaction affects the lives and livelihoods of millions of those who do not have the organisational capacity and means to advocate for the causes that affect them.

Let us use this year’s historic Freedom Day celebrations to demonstrate our firm resolve to protect the critical pillars of democracy from further exploitation. This kind of collective responsibility is what South Africa has always been about. Only when our government at all levels, the private sector, and concerned citizens across the country begin a critical partnership and commitment to maintain our democratic institutions and processes that our past losses as a nation become gains and defeats become triumphs.

* Prof Sethulego Matebesi works on all current affairs such as political and social issues. More specifically, he focuses on social movements and protests, community-mining company conflict, and local municipal governance.

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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