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21 March 2024 Photo SUPPLIED
Dr-Ina-Gouws
Dr Ina Gouws is a Senior Lecturer: Political Studies and Governance, at the University of the Free State.

Opinion article Dr Ina Gouws, Senior Lecturer: Political Studies and Governance, University of the Free State.


In a year where at least 64 countries will hold elections, it is inevitable that we reflect on issues such as the right to vote, the importance of voting, and the role of elections in a democratic process. The truth is, since the earliest elections were held in Greece in around 508 BC, exclusions were part of the process. Only wealthy landowners were allowed to vote. Male landowners, that is. The first popular election where all citizens could vote, and the majority vote won, is believed to have taken place in Sparta in 745 BC. For many centuries, examples like these were very few.

The right to vote

The history of the right to vote is mostly depicted in the history of suffrage – defined as ‘franchise’, or the right to vote – and the exercising of that right. These movements are rooted in the plight of minority groups and generally disenfranchised groups (those discriminated against, such as the poor and the landless), and their fight for the right to vote. You can easily read up on the most chronicled movements in history, such as Women’s Suffrage. The bravery, determination, and suffering endured to secure the right to vote is legendary. And once they finally won the right to vote, this did not mean they could run for office. Another fight was ahead for this democratic right. The Civil Rights movement in America is another example of a movement where the disenfranchised fought for, amongst other civil rights, the right to vote. This included, of course, black women, who were discriminated against from within various Women’s Suffrage movements.

In South Africa, the history of the right to vote is entangled with our colonial history. After the two Boer Wars, decisions had to be made as to who would be the decision-makers going forward. In the Cape Colony, all races had the right to vote – but only if you were male and had the economic qualifications, which means only the male elite across races could vote. In the negotiations to unify the Boer republics with the Cape Colony and Natal at the time, black people’s right to vote came under scrutiny. When South Africa finally became a union, its Constitution was put forward to the British government for approval. The British government was not keen to allow voting rights for black people. Thus, in the 1909 Constitution, only black people in the Cape retained their right to vote. The prevalent racial intolerance in South Africa kept this issue very high on the agenda, and in the 1930s the South African Parliament finally had the two-thirds majority needed to remove voting rights for black people from the Constitution. Finally, in 1951, the Coloured Voters Roll was also scrapped. In resistance against the diminishing civil rights experienced by these groups in South Africa, liberation movements such as the ANC were formed. One of the civil rights they fought for, for many decades, was the right to vote; a right finally won and exercised for the first time in 1994. 

The value of voting

So why am I providing this VERY brief look at history and the right to vote?

The value of voting has lost its lustre in South Africa. Despite all this history of the disenfranchised winning the right to vote, and the great enthusiasm for and faith in this aspect of the democratic process, South Africans look at voting with far less excitement only 30 years after the first democratic elections. Of course, we come by our growing indifference honestly. Those the majority have given their vote to have let us down greatly. And when we look at the candidate lists for the governing party for our upcoming elections, it doesn’t seem that we can expect better.

But this is still a democracy, dear voter! There will be more parties than ever on the ballot in 2024. We have a Constitution protecting this right to vote for any party you choose. What a notion! Looking back at history, especially from the vantage point of this current Human Rights Month, this right to vote is still at the centre of a system where the people have the final say. You must exercise this right with vigour, with determination, and with defiance against anything or anyone who wishes to weaken our country even further.

I mentioned decision-making earlier. This is what voting is. Look around you and decide if you are content with your circumstances. Look at your wider community and communities in your province and how they make an existence, and decide if you are satisfied with what you see and hear. The vast majority of people in this country can’t possibly be content or satisfied with what they see or what they LIVE through every day. Dear voter, neither are you, right?

So, VOTE in these elections if you are eligible. VOTE. It is your RIGHT. 

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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