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24 February 2025 Photo Supplied
Siyanda Magayana
Siyanda Magayana, Senior Officer: Gender Equality and Anti-Discrimination Office, Unit for Institutional Change and Social Justice, UFS.

Opinion article by Siyanda Magayana, Senior Officer: Gender Equality and Anti-Discrimination Office, Unit for Institutional Change and Social Justice, University of the Free State.

The recent executive order by US President Donald Trump to defund and dismantle Diversity, Equity and Inclusion (DEI) initiatives is more than just a bureaucratic shift. It is a declaration of whose lives matter and whose do not. Removing DEI initiatives and policies, notably, those that centre on marginalised groups, racial minorities, and LGBTQI+ individuals does not erase their struggles and existence in our society. Instead, it exposes the entrenched unwillingness of power structures to validate and acknowledge these realities. The fact that some leaders feel they can simply ‘tick off’ or ‘untick’ human rights and social justice efforts from policy reveals just how expendable these communities are perceived to be.

We need to be clear, erasure at a systemic level does not translate to actual erasure. Marginalised people such as women, queer individuals, black and brown individuals, disabled people will continue to exist, resist, and demand their space, regardless of this order. The removal of systemic and/or institutional recognition and support does not make discrimination disappear. Instead, it amplifies their oppression by stripping away their right to exist, and legal protections that have been fought for, for decades. We cannot have one person deciding to erase the fight of numerous people in just a matter of weeks.

These policies and initiatives were primarily designed to address systemic inequalities and create spaces where historically marginalised groups could thrive. These initiatives of redress were not just for the benefit of the marginalised only, they were for everyone. Therefore, the dismantling of these initiatives will perpetuate and recreate unjust and unequal environments for all.

What is the impact for the Global South?

It is almost tempting to think that the dismantling of DEI initiatives in the US is an isolated issue with no direct impact on our realities in the Global South. However, that assumption is both naïve and dangerous. The ripple effects of regressive policies and initiatives in powerful nations often influences global attitudes, social narratives, and funding. The move by the US devalues global perceptions and the importance of having DEI initiatives in, and for other governments; and there is a possibility of these institutions disregarding and/or following suit in their own countries.

For black and other racially marginalised communities in the Global South, particularly in Africa, this is alarming. It needs us to ask the question, if major global powerful entities dismantle such initiatives and no longer prioritise DEI, what does it mean for marginalised groups and identities within our countries and communities? It reinforces the idea that the oppression of certain groups is not a crisis, but a norm. In the same way, it weakens the push for LGBTQI+ rights, gender equality and racial justice, which are already met with precarious conditions in many countries due to their colonial legacies, systematic inequalities, and conservative cultural norms.

Impact on the diversity of women

The dismantling of DEI policies and initiatives does not only, unfortunately, impact non-normative or those identifying outside of heteronormativity or the gender binary. It also disproportionately affects women, especially those who face intersecting forms of discrimination. For instance, for black women who are already navigating the dual burden of racism and sexism; the dismantling of DEI programmes translates to fewer systemic protections against workplace discrimination, less access to leadership roles, and diminished support for reproductive justice. This extends to women of all races, ethnicities, and backgrounds; no woman is exempt from this decision.

This is even more damaging for non-binary, and trans identities as it reinforces rigid gender norms that limit their autonomy, agency, and expression. It further signals a broader societal regression that undermines the existence and rights of these groups, as well as the progress made towards gender equality and sexual freedom for all.

Men, too, of all races, identities, and backgrounds are affected by the dismantling of DEI initiatives. For instance, black men are already subjected to systemic racism, and as a result of this they are vulnerable to losing economic opportunities and educational equity benefits as initiatives set up to address systemic inequalities. Similarly, the systems that deny trans rights enforce toxic masculinity, thus punishing and discriminating against anyone who deviates from heteropatriarchal and narrow gender norms. As such, white men, for instance, who identify outside of the gender binary and heteronormativity are equally going to be affected.

While it may appear that the dismantling of DEI policy exclusively affects trans individuals and those that identify outside of the gender binary, their removal sets a dangerous precedence for everyone, including cisgender men and women. The erasure of non-normative identities and systems that affirm and acknowledge them are not just about gender identity, but more about controlling how gender is expressed, who gets to belong, and who is deemed worthy of rights and dignity.

“Discrimination Does Not Know Your Postal Address”: Discrimination Against One is Discrimination Against All"

Prejudice can and does affect anyone, anywhere – therefore, it is a dangerous myth that we can selectively uphold human rights. That we can, for instance, advocate for black liberation while turning a blind eye to the struggles of queer, trans and other marginalised groups. That we can rightfully fight for gender equality while remaining silent when non-normative and gender diverse populations’ rights are erased. And similarly, that we can advocate for diversity but only when it is convenient, comfortable, and easy to digest.

It is high time we realise that discrimination is never just directed at a single group, but rather, it is about the broader systems of power we exist in that decide who gets to exist fully and who does not. If these initiatives and support for gender diversity and other minority groups are removed from policy and other critical institutions, then tomorrow, it could be you or any other entity that seemingly no longer fits within the acceptable limits of the norm and/ binary.

The erasure of DEI frameworks and rights of gender diverse persons in the US is not a problem isolated from ours as a collective, it is ours, too. It serves as a warning sign that marginalisation and discrimination is becoming more acceptable, normalised, and institutionalised.

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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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