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13 March 2024 Photo Sonia Small
Prof Sethulego Matebesi
Prof Sethulego Matebesi is an Associate Professor and Academic Head of Department of Sociology at the University of the Free State.

Opinion article by Prof Sethulego Matebesi, Associate Professor and Academic Head of Department of Sociology, University of the Free State.


There was a time when weekly news coverage of South Africa was dominated by various forms of racism, racial discrimination, xenophobia, and related intolerance incidents that painted a grim picture of respect for human rights

However, in the history of contemporary South Africa there has been plenty of optimism about the prospect of deepening the understanding of human rights in order to entrench a human rights culture among citizens. This optimism is underscored by a range of deliberate actions by the South African government to promote, protect, and monitor the development and observance of human rights through, for example, the South African Human Rights Commission and the Commission for Gender Equality.

Yet, while these institutions – and many other policy instruments to ensure compliance – are central to creating an environment conducive to advancing rights enshrined in the Bill of Rights, citizens also hold significant responsibility to prevent the escalation of discrimination and racial tension. But many of us face an uncomfortable truth we have become accustomed to avoiding: the ability to show unusual restraint in the face of injustice.

The challenge of combating practices that glorify intolerance

Beyond formal political rights, human rights also entail the progressive realisation of the right to the structural social determinants of well-being, such as access to clean water, food, and a healthy environment. However, while the process of social change in South Africa has many unique attributes, the response to the process reflects two extremes.

There are, on the one hand, those who cultivate an image as defenders of the rights of the ‘oppressed’ and are predominantly black activists, and on the other hand, anti-transformation forces who stall the move of the country towards a more inclusive and egalitarian future and are primarily white activists. These activists, whether advancing the reclamation of rights, perpetuate legacies of the past instead of asserting a positive commitment to eradicating socially constructed barriers to equality.

These activists are found everywhere. They are part of our education, religious, political, and social establishments. Reflecting on the painful past of the country, these activists do not help foster diversity as an ethos but advance the conscious and unconscious practices of structural racism. Aided by hyper-personalised social media feeds, these activists can stretch the boundaries of logic and destabilise fragile and established democratic and human rights.

The problem, they claim, is that those who embrace diversity and want to find amicable solutions to longstanding social injustices are either advocates of white supremacy or want to abrogate their right to freedom of expression. In such cases, when people in a hate frenzy find something to hate together, they become bonded. And anything contrary to their beliefs goes into an echo chamber of mockery. 

I do not want to establish a potentially trivialising affinity with branding activists who assert their rights as an attack on human rights. But attention is drawn to instances where noble objectives to confront the tentacles of human rights abuses have been weaponised against what is perceived as ‘the other.’

But how can we navigate this fundamental societal defect? Collective agency to advance the ethos of human rights

After three decades of democracy, attempts to eliminate systematic and institutionalised under-privilege must be welcomed. Likewise, our response to the perceived threats to efforts to enhance diversity as an ethos in public institutions and society matters. In many instances, when subjugated to hatred, hostility, or even violence, there is a tendency to believe that the best approach to such an absurd situation is more absurdity. At its most benign, such a response is not helpful to efforts to embrace diversity. At its weirdest, it garners public sympathy for hate groups and activists.

While there have been concerted efforts internationally and nationally for the progressive realisation of social rights and efforts to strengthen democratic resilience and rights-respecting societies, South Africans have been passing the buck. Rights-respecting citizens have a choice to make. They can continue to pass the buck or help build a culture where everyone achieves their potential and develops into responsible citizens.

I am convinced that beyond formal politics, the attainment of respect for cultural diversity and professing the freedom, equality, and unity of all peoples are contingent upon our collective activism and shared commitments to these values. This collective approach – although some may view it as illusory – is, in fact, our most potent weapon. Reinforcing its commitment strengthens our collective agency and resolve to respect human rights and fundamental freedoms.

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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