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13 July 2021 | Story Sanet Madonsela | Photo Supplied
Sanet Madonsela is a double cum laude graduate currently finalising her master’s degree in Governance and Political Transformation. She was recently appointed as the Projects and Events Coordinator for the International Association for Political Science Students (IAPSS) and is a member of the South African Association of Political Science (SAAPS) Emerging Scholars Committee.

Opinion article by Sanet Madonsela, master’s student in Governance and Political Transformation, Department of Political Studies and Governance, University of the Free State,


In December 2018, the streets of Eswatini were filled with billboards proclaiming ‘Fifty years of peace, stability, and progress’ as the country celebrated its independence. While the king and a few others were in a celebratory mood, a large portion of the population was not. The reality was that 63% of the population lived below the poverty line, 28% were unemployed, while 200 000 people were dependent on global food aid to survive. The country has banned political parties since 1973 and has been criticised for the unhealthy working conditions of its sugar industry, poverty wages, and violent suppression. Over the years, the polygamous King Mswati III banned divorce and revealing apparel, while increasing the number of traditional rituals, of which the Umhlanga (the Reed Dance) is the most popular. During this ritual, young women perform for the court, some of whom would catch the king’s eye. It is worth noting that Mswati III owns 60% of the country’s land, in addition to shares in the country’s major luxury hotels, real estate, transport, mining, brewery, sugar, and dairy products. He lives in ostentatious luxury with his 15 wives. His personal wealth is estimated at R2,8 billion. This is in stark contrast to the R30 per day that 60% of the population live on daily. 

Calls for the abolishment of the monarchy

The current conflagration in the kingdom follows the death of a 25-year-old law student who was allegedly killed by the police. This unrest increased and eventually resulted in calls for the abolishment of the monarchy and replacing it with a democratic system of government. It is alleged that 60 people have been killed by members of the Royal Swazi Police Service and the Umbutfo Eswatini Defence Force, while billions of rand in damages have been inflicted during the current vicious crackdown. There are also allegations that journalists and pro-democracy activists are being tortured and abducted in the country. The current wave of repression is not new to Eswatini, as journalists, trade unionists, and other activists have been subjected to persistent repression under Mswati III. Under his rule, freedom of speech, assembly, and association have been limited, while dissidents have been arrested, tortured, and imprisoned. In an effort to quell the uprising, the government has engaged in further violent repression while at the same time shutting down the internet. The latter was deemed to be important, since Swazi activists would make use of social media to call attention to human rights violations, as well as using it to mobilise and co-ordinate their actions.  In all of this, the Southern African Development Community (SADC) and South Africa have remained silent. The internet shutdown was confirmed by the South African telecommunications giant MTN, stating that it had received a directive from the country’s Communications Commission. While this explanation might suffice, it is not that simple. Mswatini III is the largest independent shareholder of MTN Eswatini, and his eldest daughter, Sikhanyiso Dlamini, was appointed as one of the company’s local board of directors in 2012. To complicate matters, the late Prime Minister, Ambrose Mandvulo, was the former chief executive officer of MTN Eswatini. MTN and the royal family are firmly entwined while the impoverished Swazis languish under the yoke of oppression.  

SADC is unable to intervene

The SADC is unfortunately unable to intervene, given its own internal challenges – and one might even say – unwillingness. Years ago, the African Union’s standby arrangements tasked the SADC with creating a 3 000-strong rapid intervention force. It is safe to say that it did not do so and has been unable to intervene during the numerous previous crises in Eswatini, the dispute over the Okavango River between Botswana and Namibia, during the long ongoing tragedy in Zimbabwe, and the terrorist violence in northern Mozambique. Instead, they have been issuing statements. Their inaction in terms of Eswatini is hardly surprising. The SADC as an institution reflects the concerns of the political elite in their respective countries instead of Southern Africa’s beleaguered citizens, and as such, inaction and protecting the political elites in these countries is their want. The political opposition and civil society in Swaziland’s call for a more robust intervention has been met with a deafening silence. While a fact-finding mission has been sent, the nature of the crisis demands far more strident action from the regional body, which is simply not forthcoming.

It is worth stating that Southern Africa has failed to learn an obvious lesson regarding conflict. It is much safer, cheaper, and more effective to resolve small conflicts before they gain momentum. The lower-level protests in Eswatini should have been resolved before it turned into riots, damaging government buildings, shops, banks, and vehicles. The damage is estimated at R3 million. This crisis is now spiralling out of control. The common dominator in the country’s history of unrest is the lack of democracy. Instead of operating a multi-party system, the country insists on remaining an absolute monarchy – not a constitutional one. Pro-democracy activists in the country have vowed to intensify demonstrations until democratic reforms take place and all opposition parties are unbanned. 

South Africa has the ability to assist Eswatini

On a more positive note, South Africa has the ability to assist Eswatini in order to get out of its morass. It can intervene in the country, given its economic leverage that ranges from business to trade interests. Moreover, the intertwined marital ties between the Zulu and Swazi monarchies could assist with a Track 2 diplomacy to push the feudal kingdom to embrace a constitutional monarchy. Feudal despotism has no place in the 21st century.

For corporates such as MTN, there needs to be an understanding that putting profits above people is a sure recipe for further political instability, which will ironically undermine profits. In other words, short-term gains and medium- to long-term pains. What is desperately needed, is a new social contract in the kingdom that brings together the Royal House, the political opposition, and civil society, as well as the corporate sector. South Africa has a vested interest in securing such an outcome, as there is a strong likelihood that refugees will cross the border into South Africa should the conflict dynamics escalate. This is exactly what happened when Pretoria chose to pursue a policy of ‘quiet diplomacy’, in effect ignoring the crisis in Mugabe’s Zimbabwe, which resulted in millions of its citizens seeking refuge in South Africa. 

South Africa needs to act, and act urgently – together with its fellow partners in the SADC – to ensure that Swaziland does not go the route of Zimbabwe. Given the unfolding humanitarian tragedy, South Africa should partner with UN agencies and the international donor community to first bring about a cessation of hostilities, second, to provide humanitarian assistance, and third, to broker a long-term political solution to break the impasse. South African civil societies such as Gift of the Givers could assist with humanitarian assistance, while South African corporates could examine ways with their Swazi counterparts to kick-start the moribund Swazi economy.

 

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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