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23 November 2021 | Story Gcina Mtengwane | Photo Supplied
Gcina Mtengwane is a lecturer in the community development programme at the University of the Free State, QwaQwa Campus. He believes democracy is more than just voting. It is the expansion of self-determination opportunities.

Opinion article by Mr Gcina Mtengwane, Lecturer: Community Development Programme, University of the Free State.


Voter apathy has been diagnosed as part of the reason for the low voter turnout in the 2021 local government elections. The turnout was the lowest since democracy the dawn of democracy, with only about 12 million (46%) of about 26 million registered voters casting ballots. Apathy among voters in representative democracies is defined as a lack of interest in voting. Some choose to view this apathy as a threat to South Africa’s democracy. But it may not be the case, as some would like to put it. Instead, it may reflect the evolution of South Africa’s democracy and the expansion of choices available to South Africans outside of the voting principle commonly used to define democracy.

While I am inclined to agree with the view that this voter apathy has some messaging on the state of South Africa’s democracy, I argue that it is only a small part of the big picture. Democracy is, among many other things, the freedom to make choices. One of the permissible choices is the right not to vote. Defining the success or failure of democracy by voting is quite restricting and problematic   at least for me.

Local government is about addressing challenges in daily live

Local government is mainly about addressing issues and challenges in our daily lives. It does not require much of an overly ideological stance. Put simply, a community member at an informal settlement or village does not need to know the works of Marx, Fanon, and Biko to know that she or he does not have a road, potable water, or ablution facilities. It takes building materials, not political slogans or party ideology to build a house for those without houses or to provide food for the hungry.

What is more interesting has been the activism of young people outside the banner of political parties. Young people are engaged in issues that affect them in their daily lives. They are also engaged in lending a helping hand to others. They are doing this outside of formal party politics. The writings of Adam Prezowski (2003) identify ‘autonomy’ as the ability to participate in the making of collective decisions, which is a paltry notion of freedom. Prezowski asks whether democrats should value the freedom to choose. He further asks whether people value facing distinct choices when they make collective decisions. In the absence of concrete answers to these questions, Prezowski comments that “true” democrats must be prepared that their preferences might not be realised as the outcome of the collective choice. When many people cannot vote for what they most desire, democracy suffers. The low voter turnout may indicate that none of the political parties offered what most South Africans desire, hence they see no impetus to vote. 

Democracy is more than just voting

Democracy is about the expansion of opportunities and choices. Choosing not to vote does not necessarily reflect badly on our democracy. Instead, it speaks positively on the freedom of citizens to choose other arenas through which to have their issues heard. It is the freedom to decide on the relevance or lack thereof of the formal party-political system. The choice not to part take in party politics has allowed young people such as Lonalinamandla Bawuti, who responded to the plight of a young boy from the Eastern Cape living with his grandmother who needed support to go to initiation school. Bawuti appealed for assistance from South Africans to get the youngster to initiation school. 

It is the freedom of a group of businesspeople putting money together to create boreholes for a community without access to potable water. It is Nasizo Mndende,  a young social work graduate in the Eastern Cape seeing the plight of young rural girls and starting an NGO to educate on sexual and reproductive health rights. It is young people creating crowdfunding for students in need of university registration fees and for students wanting to go to university.

It is many others doing what they can with what they have and their influence contributing to change in communities.
The point I am making is that democracy is more than just voting. It is the expansion of self-determination opportunities. Low voter turnout may not be such a disastrous thing after all. This is because a lot of young people are contributing to making a better South Africa outside of the confines of political party membership.

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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