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11 March 2022 | Story Prof Frikkie Maré | Photo Supplied
Prof Frikkie Maré is from the Department of Agricultural Economics at the University of the Free State (UFS)

Opinion article by Prof Frikkie Maré, Department of Agricultural Economics, University of the Free State.
In William Shakespeare’s play Julius Caesar, Mark Antony utters the words: “Cry ‘Havoc!’, and let slip the dogs of war,” after learning about the murder of Julius Caesar. With these words he meant that chaos would ensue (havoc) to create the opportunity for violence (let slip the dogs of war).

The recent invasion (or military operation, according to Russian President Vladimir Putin) by Russian armed forces into Ukraine brought the famous words of Shakespeare to mind. Putin cried “Havoc!” and his troops created chaos in Ukraine. This is, however, not where it stopped because the dogs of war have been released into the rest of the world.

What is the impact on South Africa?

The day after the invasion we felt the bite of the dogs of war in South Africa. The rand suddenly weakened against the dollar, oil and gold prices increased sharply, and grain and oilseed prices on commodity markets increased 

This was before the rest of the world started to implement sanctions against Russia, which could be described as a shock reaction due to uncertainty as to how the situation would unfold. In the days after the initial market reaction we saw the markets actually “cool down” a bit, with most sharp initial reactions starting to change back to former positions. This period was, however, short-lived when the world hit back by closing airspace and borders and refusing to import products from Russia or export to them. The sanctions were in solidarity with Ukraine as an attempt to bring the Russian economy to its knees and force the Russians to withdraw from Ukraine.

Although the sanctions against Russia should certainly be successful over the long term, it does not change much in the short term and we will have to deal with the international effects of this conflict. The question then is, how will this affect South Africa?

Although there are no straightforward answers, as the impact will depend on what one’s role is in the economy. One thing for certain is that the total cost will outnumber the benefits. What affects everyone in South Africa, and the starting point of many secondary effects, is the increase in the price of crude oil. Russia is the second-largest producer of crude oil in the world and if the West is going to ban the import of Russian oil we will have an international shortage. Although the banning of Russian oil is the right thing to do to support Ukraine, it will have devastating effects on all countries in the world, with sharp increases in inflation.  

The increase in the price of oil not only drives up the cost of transportation of people and products, but also manufacturing costs. Fertiliser prices are correlated with the oil price, and it will thus drive up the production cost of grain and oilseeds.

Speaking of grain and oilseed prices, the Black Sea region (which includes Russia and Ukraine), are major exporters of wheat and sunflower seed and oil. The prices of these commodities have soared in international and South Africa markets over the past few weeks. Although it might seem like good news for our farmers, the increase in prices are offset by high fertiliser prices and the local shortage of fertiliser. This may lead to fewer hectares of wheat being planted this year in the winter rainfall regions.  

Nothing good is coming from this situation

In terms of agricultural commodities, both Russia and Ukraine are important importers of South African products, especially citrus, stone fruit and grapes.  Alternative markets now need to be found for these products which will affect prices negatively.

Although one needs to write a thesis to explain all the effects of the Russian-Ukraine conflict, the dogs of war have been slipped, and it is clear from the few examples that nothing good is coming from this situation. In short, we will see higher fuel prices (maybe not R40/litre, but R25 to R30/litre is possible), higher food prices, higher inflation and a higher interest rate.  

These factors affect all South-Africans, especially the poor and some in the middle class who will struggle in the short term. The time has come to cut down on luxuries and tighten belts to survive in the short term until there is certainty about how the havoc in Ukraine will play out.

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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