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22 October 2021 | Story Prof Francis Petersen | Photo Sonia Small (Kaleidoscope Studios)
Prof Francis Petersen is the Rector and Vice-Chancellor of the University of the Free State (UFS).

Opinion article by Prof Francis Petersen, Rector and Vice-Chancellor, UFS.


 

October has become synonymous with a sensitivity around mental health issues and orchestrated attempts to reach out to those burdened with the strain of work, financial, and personal pressure.

But towards the end of 2021, we find ourselves in an altered world, where reaching out has become a bit of a dilemma.   
What we perhaps need now is to go back to the drawing board. And start with one.

Social distancing seems to be the exact opposite of social outreach. It seems to imply withdrawing a hand instead of extending it; staying static instead of going out; soaking up support and advice instead of selflessly sharing it. So, how on earth do we reach out to people under these circumstances? 

Effects of isolation

One of the great and sad ironies of the COVID-19 pandemic is that it has not really resulted in the overriding sense of community and solidarity that often accompanies severe communal hardship. Normally, there is nothing that unites people like a common adversary. But even though we are faced with a situation that affects absolutely all of us, so many people have never felt so isolated as now.

We are all in the same boat. Yet many people constantly feel as if they are drifting alone on their own little life rafts, just hoping to survive as they desperately try to ride out the storm. 

Psychologists on our campuses report that they are seeing more students than ever before, as more of them seem to muster up the courage to attend an online counselling session – which some find less daunting than a face-to-face consultation. And while it is encouraging to note that those in need are indeed making use of the services on offer, these virtual interactions have their own challenges and limitations. Counsellors find it difficult to read patients’ body language and to gauge aura and atmosphere. It is often hard to reach out and connect with someone who is not near you. 

Our limited and restricted interactions seem to worsen the isolation. Although we are down to alert Level 1 in terms of lockdown regulations, many individuals and workplaces are still cautiously – and wisely – limiting social interaction as far as possible.  We don’t just bump into colleagues and acquaintances in passages and at meetings anymore. And if we do see someone, our masked faces often expose little about how we really feel. Social media profiles similarly reveal very little, often displaying smiling, positive images that may be deceptive – not to mention several years old.

Deliberately reaching out

I believe what we need now is to deliberately reach out to those around us. We simply can no longer rely on chance encounters to find out how people are really doing. And when we do reach out, our interactions need to be deeper than just the superficial enquiries about physical health. Our concern needs to stretch further than just wanting to know if those around us are physically surviving this pandemic. We need to be sensitive enough to pick up whether they are coping under the huge mental strain that fear and uncertainty can bring. And we need to offer genuine care and support if they don’t.

It starts with self-care. The old adage that you ‘can’t pour from an empty cup’ remains true. We need to look after our own physical and mental well-being first.

Institutional self-care needed

Institutions need to do systemic self-care too. We need to have risk strategies and measures in place to make sure that we survive the ramifications of this pandemic. And once that is in place, we urgently need to take care of our employees.
At the University of the Free State (UFS), we have started a comprehensive, integrated effort to look after the health and wellness of our staff as well as our students. Programmes have been put in place to monitor and evaluate mental-health needs, and interventions that are carefully designed to address them. Self-care workshops, podcasts, and webinars frankly address issues such as ‘loneliness and working from home’, ‘building resilience’, and ‘managing fatigue’. 
I believe that in the current climate, initiatives such as these should no longer be seen as extra add-ons offered benevolently by employers; it should be viewed as equally essential as a pay cheque at the end of the month.
As institutions, we are continuously pre-occupied with how we can serve the masses. Programmes and policies are developed to apply to all. But from time to time, we must also be able to reach out to the one. We need to be able to cater for those individuals at risk of falling through the cracks.

At the UFS, we launched the No Student Left Behind campaign at the beginning of the pandemic to ensure that all our students were able to make use of online teaching and learning facilities to complete the academic year. 
And here lies another bit of irony – this time in a positive sense: Technology has actually enabled us to be more personal.  Using advanced data analytics, we can pick up patterns in how students use our online learning offerings, enabling us to zoom in on those who are not regularly logging in and may need individual attention and assistance. We can identify what they are struggling with and help them – one by one.

One person is all it takes

To me, the ‘value of one’ is poignantly and heart-warmingly illustrated through the ‘Khothatsa Project’ (derived from the Sesotho word meaning ‘to inspire’), initiated by our Centre for Teaching and Learning. Students were invited to write about how individual lecturers inspired them, to which the lecturers replied with a letter of their own. Small, personal exchanges in the form of old-fashioned communication. One lecturer, one student.

It once again proved how one small act of kindness and recognition can spread much wider than initially intended. Because in the end, these stories were put together in a publication, shared on online platforms, and now serve as inspiration for many students and lecturers, as well as a wider readership – many of whom are yearning for this kind of personal exchange.

Lea Koenig, a now retired lecturer in Extended Programmes offered on our Qwaqwa Campus, accurately sums it up in her foreword to the publication:
“To connect with another human being on a cognitive and emotional level leaves permanent, healing change. This is transformation of the purest kind. I am proud to be part of an institution that can showcase these relationships and the change it brings in our lives, but also the huge potential to change the world.”    

Lea’s words and the entire Khothatsa Project once again reminded me of the immense potential and saving power that lies in sincere one-on-one interaction. And maybe this is how we should approach Mental Health Month this year. As an opportunity to really reach out and get involved with at least one person who is taking strain.

After all, a drowning victim does not have much need for a shower of virtual well-wishes and a stream of sympathetic words. He/she needs something tangible. Something close and real – a real-life life buoy. 
And normally, one is enough. 

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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