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11 August 2023 | Story Prof Pearl Sithole | Photo Supplied
Prof Pearl Sithole
Prof Pearl Sithole is a social scientist and Vice-Principal: Academic and Research on the Qwaqwa Campus, University of the Free State (UFS)

Opinion article by Prof Pearl Sithole, Social Scientist and Vice-Principal: Academic and Research on the Qwaqwa Campus, University of the Free State.


It is August and I want to bury my head in the sand to avoid being part of what is turning out to be a condescending South African ritual against women – ‘speak justice in August, and practise injustices for the rest of the year’. The requests to feminists to rise up and give talks to dignify yet another August with sophisticated speak about quite a simple moral matter – women are as human as men. The ritual is tiring and it is creating despondency. How difficult can it be to switch to action on equality and fairness towards women as human beings too? How difficult can it be to be fair? How difficult can it be to see that while the unfairness is structural and cultural, it is social will and moral agency that is called into test? And how difficult is it to realise that in fact not attending to this matter of social justice is keeping all the other architecture of inequalities and unfairness intact? 

August in South Africa is used to pour out pity in the name of physical gender-based violence (GBV) and other social strains women experience – pity poured out by people who are in positions of power with voices that merely acknowledge what needs to be done. The same voices will then go to various corners where they practise professional GBV, and thus endorsing women as ‘secondary beings’ used to shoulder a patriarchal and capitalist societal agenda.

Economic empowerment of women

This year the focus is economic empowerment of women. In a government blog published in March 2023 that was written partly to cast a celebratory tone for International Women’s Day, the President could not resist twinning economic empowerment with the potential to escape GBV:

“The economic empowerment of women is an important pillar of our struggle to end gender-based violence and femicide. We have recognised that unequal access to resources and economic opportunity makes it more difficult for women to escape situations of abuse and violence.”

Clearly this is a much-needed spanner in the works to escape GBV. But the fact is that this society still laments a wage gap and pleads for narrowing gender economic differences in order to escape GBV, speaks volumes about the kind of society South Africa is. The institutional culture that sees women as secondary, almost like pets, must be given reprieve from violence even if it takes ‘giving them some economic empowerment’. The lack of transparency on pay scales across work categories; no women ever in certain leadership positions; and more women being unemployed – are not cited as a violation in themselves. Basically, South Africa is an abusive society to women that avoids the mirror by pretending to attend to physical violence through relaxing the rest of the violations. 

Yet the more tokenistic the talk on inequalities every August and thus the endorsement of structural and cultural injustices, the firmer the country proclaims its affinity with inequality. If the maxim “actions speak louder than words” has been promulgated as useful with regards to socialisation and bringing up decent human beings, the current generation of leaders has failed dismally to use it in terms of political and social will to fight injustices. 

Instead they have exercised a practical display that men are the superior species and that women must take charge of the menial affairs of society in daily life. The uproar against physical GBV masks the major omissions on the kind of society South Africa is while it continues to modernise gender inequalities:
  • Leadership is a male affair, with the top and resource-management positions exclusively male through history. The Presidency is a male affair, as well as the portfolios of Economic Development and Finance.
  • The business sector also continues to have higher pay grades for men and not for women. 
  • In sport, women’s teams are paid less, with public scrounging just to lull the complaints for every major event.
  • Committees can recommend women into positions and authorities can exercise the right not to endorse those recommendations.
  • Institutions, including civil society, can legitimise their existence over the concept of social justice and sustain glaring imbalances on gender in leadership positions.
  • Funders continue to have gender and racial leadership preferences in agencies they fund – the rest of the profiles being the subject of never-ending training on funding proposals.
  • Intersectionality of identity becomes visibly toxic when certain members of ‘the inferior groups’ are given a special place on the ladder within the unequal society – like the conspicuous place of white women in the property sector, and the convenient tallying of all women to generate a good transformation profile for institutions.
Society has modernised inequality

In essence society has modernised inequality – and highlights ‘shallow permits’ as women’s rights achievements. South Africa may shout shallow things like: ‘our women can be car drivers’ and ‘women feature in the Constitution’, but the total lived experience of women at all levels of society leaves little to be desired. Men continue to hover over the prerogative to place women or ‘allow’ them in spaces where it makes strategic support to their own positions or to make institutions look good in terms of quotas. 

In professional spaces in South Africa it is not uncommon to see very capable women doing menial tasks designed to hand over professional products for men to shine in leadership. It is almost like the domestication of professional spaces through importing culture and religion – to underpin institutional chauvinism. And yet policies and strategies make a clear and tacit association of culture and religion only with society out there. Beside gender mainstreaming, which is largely grounded on mere inclusion of women, the damaging role of culture and religion on professional relationships is not on the radar of attention within institutions. Thus, a country can marginalise women’s national teams on the issue of remuneration at the back of what is cited as “the best constitution in the world”, and still talk about the importance of women every August. 

The most disappointing stakeholders in all this are the women’s political formations. In the context of South Africa, ageism within these formations is a huge factor. Those senior women are kingmakers of note. They believe in women as living to support men and are afraid to rock the boat for their own placement in professional peripheral positions. It would be interesting to hear them articulate their status of bondage and why it has been sustained. 

For now, one thing is clear: just like other hegemonies that used ideology and culture to root themselves (i.e. imperialism, capitalism and racial inequalities), patriarchy is not going to disintegrate just because those it serves have suddenly developed a conscience and realise they are not ‘better beings’. Agency, advocacy, and political will are key in fighting for justice. No piece of paper implements itself, not even the Constitution. 

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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