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19 March 2021 | Story Nombulelo Shange | Photo Andre Damons
Adnombulelo
Nombulelo Shange says this year it is important to look inward, focus on individual healing, growth and reflect on the losses pre- and post-COVID-19.

By Nombulelo Shange, lecturer in the Department of Sociology, University of the Free State

With Human Rights Day nearing it is important to remember the sacrifice of those who lost their lives in the 1960 Sharpeville Massacre in the fight for our freedom. This year I think it is also important to look inward, focus on individual healing, growth and reflect on the losses pre- and post-COVID-19.

The strength and resilience of the Sharpeville community is an important reminder of the hardship we have to overcome; it is an important reminder that we can overcome even this challenge. But on this Human Rights Day our strength lies in our vulnerability and being strong enough to admit we are not okay and ask for help even when societal norms make it hard to do so. Do this without being embarrassed or carry resentment when those we lean on can’t be there because they are also not coping. And for those who give a lot of themselves, it is okay to admit that you have nothing left to give and that you need time to replenish yourself because you can’t bring light into other people’s lives while your own flame is dimming.

The collective cannot be strong when individuals are broken

Many of us were raised in families where communalism, ubuntu and caring for the collective are prioritised over the individual. And to put ourselves and our own wellbeing first feels like a betrayal of these virtues we were brought up with. But I would argue the opposite is true, the collective cannot be strong when it is made up of broken individuals.

Not putting ourselves first would be a betrayal to the same ideals of ubuntu many of us were brought up with. It sounds like a contradiction because we are taught to look at the world in polarised ways and ubuntu ends up being portrayed as a philosophy that puts the masses first and sometimes at the expense of the individual. We see this kind of thinking and application in our own lives where families and communities at times uncritically impose ideas and practices that seemingly benefit the community over individuals. We see it in African discourse that theorises ubuntu and its relevance to traditional and modern spaces, its relevance in human rights discourse, decolonial discourse that broadly calls for “African solutions for African problems”. All of these are important and provide useful analysis, but they sometimes erase the individual.

Individualism is associated with Western imperialism and is rejected and vilified

Individualism is often rejected and vilified because it is associated with Western imperialism that saw the introduction of a greedy capitalist system in Africa that goes against almost every core belief we have. The capitalist system broke our connection to the environment and turned it into a commodity to be exploited for economic gain. It pushed competition and individual wealth over social wellbeing and community. And most importantly it took everything from Africans, our land, language, culture and sense of self. So as we grow and rebuild, it is difficult for us to imagine that these two seemingly contradictory ideals can coexist, where individualism is celebrated and encouraged for the betterment of a collective that will be stronger because it is made up of strong individuals. Instead we polarise, we conclude that if Western imperialism is exploitive and individualism is closely associated with it, then individualism must be bad too. If ubuntu and the collectivist thought around it protected the environment and promoted social wellbeing, then collectivism is good and to question it is to put your own selfish individual needs over the needs of the community and collective human rights.

But if we step away and look at ubuntu beyond our polarised ways of thinking, we see that ubuntu does place a great deal of importance on the individual. The main theoretical tenet of ubuntu says, “Umuntu ngumuntu ngabantu”, which translates to “I am because we are”. This expression shows the mutually beneficial coexistence of the individual and the collective. The collective is nothing without the individuals, and if the individuals who make up the collective are weak, the collective will also be weak. Individuals also need the community for their own enrichment, sense of self and overall wellbeing. If individuals are not nurtured and supported by the collective, they will not be able to give back to the collective, and the cycle continues.

It is time for us to focus on healing and introspection

So, what do we do when our collectivism is threatened by a global pandemic that is threatening to topple even the world’s strongest nations? What do we do when we can no longer tap into the collective strength we have built everything on? So much of our way of life is built on this collective strength as Africans, from the monthly stokvel meetings that offer people solutions to the worst socioeconomic challenges, while offering support and strength. Even church spaces are more than just a place to worship. It is here where people discuss the challenges faced by the community and offer whatever they can to address them. Our funerals and weddings do not just bring families together they bring communities together in shared grief or celebration. You do not even have to invite neighbours to events. The moment they see the tents, chairs, animal sacrifice etc arrive, they come days prior to the event to help the family prepare, celebrate, or cry. Even our ritualistic healing practices are not an individual lonely process in the way that Western biomedical models offer healing. At some point or another, the involvement of family and even the community will become important in African healing practices.

COVID-19 has threatened all of this and future environmental and public health crises might test us even more than COVID-19 has. I think this is the time for us to focus on healing and introspection, many of us were broken long before the pandemic hit. We have carried past intergenerational traumas into our present, but we have an opportunity to ensure that we do not carry them into our futures. We have been depleted by systems that seek to erase our entire existence as people of colour, women, LGBT+ communities and people with disabilities. After a while we start to believe that we are not worthy of love, we believe our poverty is a result of our own laziness and discount the fact that we have been starved of opportunities and resources. We stop challenging the abuses of our individual and collective human rights. This forced isolation is an ideal time to reflect on these things, heal and build ourselves as individuals through talking and sharing deep intimate pain with loved ones, trying to be in nature, attempting to “phahla” or mediate. The process will be different for everyone. Our own mental health depends on it and so does part of our ability to access our human rights. The restoration of our strength as communities will also depend on it during COVID-19 and beyond.

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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