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09 July 2024 | Story André Damons | Photo Stephen Collett
Thought-Leader panel discussion July 2024
The University of the Free State (UFS) hosted its UFS Thought-Leader panel discussion in collaboration with the Free State Literature Festival, featuring Gert Coetzee, former editor, Volksblad (left); Sanet Solomon, Lecturer, Department of Political Sciences, Unisa; Prof Francis Petersen, Vice-Chancellor and Principal of the UFS (centre, facilitator); Ebrahim Fakir, Consultant Election Analyst, Electoral Institute for Sustainable Democracy in Africa (EISA); and Prof Erwin Schwella: Director, Centre for Good Governance in Africa, School of Social Innovation, Hugenote Kollege.

Even though there might be concerns about South Africa’s newly established Government of National Unity (GNE) and the associated challenges, there are also hope, optimism, and a lot of opportunities that come with this new reality.

This was according to the panellists at the University of the Free State (UFS) Thought-Leader panel discussion, titled Navigating a new era of democracy in South Africa. The discussion took place on Thursday (4 July) as part of the 2024 Thought-Leader Series presented in collaboration with the Free State Literature Festival. The discussion was facilitated by Prof Francis Petersen, Vice-Chancellor and Principal of the UFS.

The panellists included Ebrahim Fakir, Consultant Election Analyst from the Electoral Institute for Sustainable Democracy in Africa (EISA); Prof Erwin Schwella, Director of the Centre for Good Governance in Africa, School of Social Innovation at the Hugenote Kollege; Sanet Solomon, Lecturer in the Department of Political Sciences, College of Human Science at the University of South Africa; and Gert Coetzee, former editor of Volksblad.

Substantive uncertainty

Fakir started the conversation by saying that over 30 years, South Africans have experienced the use of authority without accountability and power without responsibility. The seventh democratic elections may usher in a new era – an era of substantive uncertainty.

“Substantive uncertainty is important for any democratic society, because it means that anyone who wishes to acquire power can no longer simply rely – as the governing party has for the past 30 years of our democracy – on the support of voters in an unqualifying way. Which means that in a year of substantive uncertainty, a key aspect and a key element of democracy, namely uncertainty, comes into play.

“In so far as uncertainty and substantive uncertainty can be a boon in a democracy, it can also be a bust. Why? Because substantive uncertainty comes not just with the uncertainty of political parties assuming a level of political support in society, it also means that a set of rules by which we engage in political behaviour become uncertain.

“One of the most interesting features post the 29 May elections is the uncertainty about the formation of the government. There are no rules governing how coalition must or should be formed. There are no guiding principles on how this should happen,” said Fakir.

According to him, there are potential benefits, but also significant risks. The first benefit is that there is now space for citizen activism and for influence of political parties.

“There are significant risks to what we do now. If there is going to be a fundamentally new policy regime, in what direction will this flow? I think we must hold out hope for this new form of coalition government, but we shouldn’t be blind to the fact that there are two significant features that will impact the evolution of this GNU: South Africa goes to a local government election in two years’ time.”

“The ANC goes into its own elective conference in a few years’ time when President Ramaphosa comes up for a potential replacement. And this is a significant risk for how the GNU evolves and which partners continues to remain in this, and which don’t.”

No trust in a single political party that governs

One of the things that started happening in 2019/2020 was a push for people to select their government not only from political parties, but also to have individuals representing them at national level. This led to the introduction of the Electoral Amendment Bill. This all came together with the 2024 election where you had independent candidates participating.

“For a number of years, South Africa enjoyed a single party-dominated state, where you had stability in terms of how your country would be governed and who would be in government. The drop in the support of the ruling party has created a lot of challenges and a number of concerns for people,” Solomon said.

According to Solomon, this does not necessarily have to be a scary time for the country, as one of the great things about democracy is that it moves. Eventually, all democracies move from a single party that dominates to a more competitive democracy.

“This is also something to be excited about. One of the concerns was that South Africa could be like Germany where it took six months to form a government, but fortunately we didn’t find ourselves in a situation like that.”

“While there are a lot of concerns, I think the results from the 2024 elections showcases that South Africans don’t necessarily trust a single political party to govern the country, but rather want different political parties to come together. While this GNU will come with challenges, I also think it holds many opportunities,” she concluded.

A new ethos is needed

Prof Schwella introduced three sets of variables; the first is somewhat philosophical and therefore on the level of inspiring ideas. The second is much more institutional. It links to having all the ideals of democratic government and governance, but is it governable? This links to the third, which is more practical, namely – can you implement it impactfully?

According to him, the current disposition has hopefully relieved the country from not only continued state capture, but from the capture of inertia to create new, exciting, and inspirational opportunities.

“A new ethos of continuous quality improvement at the level of implementation through a process of assessing needs to be established, which will then have to be continuously built back into the redesign of the system. There is a lot of hope and optimism in that.”

“Share that journey with us, co-create an exciting and prosperous new South African state. We nearly lost it in the first 30 years of democracy. We stuffed it completely under apartheid. But now is the opportunity. Now is the chance. Let's get together and just do it.”

Be careful of what you wish for

For Coetzee, the way forward is not clear cut, and the country now has a window of opportunity. How this opportunity will be managed is what will set the future, he said.

“We can see where we are now and the main positive of the government of national unity is that we have a government of national unity – a little more than a month ago this would have been unthinkable.”

He talked about the composition of the cabinet and said the DA should be careful of what they wished for.

“The DA got six very important portfolios. Which enables them to make a huge difference, but each of these portfolios can also be a poisoned chalice. Of course they have Home Affairs, so if there's a delay with my passport now, I'm going to be fed up with the DA.”

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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