Opinionista J Brooks Spector 20 December 2012

The greatest legacy of all

While playing an embarrassing and ridiculous cat-and-mouse, hide-and-seek game over Nelson Mandela’s hospitalisation, the South African government has missed a golden opportunity to boost the nation’s confidence in its public institutions.

Welcome to the “Where in the World is Carmen San Diego” game of he’s in a Pretoria military hospital; no, he’s in a private hospital somewhere in the city. And then, he’s in the hospital for tests; no, it’s pneumonia; no, it’s really an operation for gallstones. There will probably be a few more such iterations before Madiba is discharged from hospital.

The thing of it is, of course, that all of this toing and froing has been both embarrassing and unnecessary. In a radio interview, presidential spokesman Mac Maharaj described the miscues as a “learning curve” – but surely by now that office should have graduated from class? Let’s be charitable and say they were spooked by the tragic consequences of the stunt by a trio of Australian radio pranksters who tried to reach someone by an international phone call to a London hospital who could tell them about the Duchess of Cambridge’s acute morning sickness?

But of course the local and international media will always have an unrelenting interest in learning as much as possible about the health circumstances of someone like Nelson Mandela – because South Africans as well as people throughout the world are intensely interested in him, his life, his health – and his extraordinary legacy. By contrast, if it you or I were in the hospital, we’d be hard-pressed to get anybody but our immediate family members and a few friends even vaguely interested in our circumstances – let alone our legacy.

The American way of dealing with this kind of national health crisis may not be perfect, and maybe it fits American society more than it might South Africa’s with some rather different thoughts about talking publicly about someone’s health, but it may also offer some lessons for those responsible for managing the news flow for VIPs. If the president, or a former president, has to undergo in-patient medical treatment, the usual rule now is to establish a regular briefing pattern right at the beginning and then issue fairly detailed medical bulletins whenever warranted.

With the US president, for example, his primary care physicians or surgeons now routinely address a press conference at the beginning to establish a baseline for all future comments and media releases. The pattern now is to provide detail that is so complete, observers sometimes are tempted to shout back at the briefers, “Enough, already! It’s too much information!” Newspapers, television and websites routinely vie to provide the most complete information possible for readers and viewers, based on information from experts as well as the briefing materials from his doctors.

This approach did not happen spontaneously, of course. The White House never issued regular bulletins about Franklin Roosevelt’s disability or his various illnesses. But by the time Dwight Eisenhower had had his two heart attacks, the authorities were increasingly becoming comfortable with increasingly open communication with the media – and the country’s citizens – about the health of its presidents. Now even an American presidential candidate’s yearly physical becomes the routine subject of a media release. Here in South Africa, in the coming days, as former president Mandela recovers from his treatment, the Presidency can still make a new effort to take the media, the nation and the world into its confidence regarding their famous patient’s condition – as well as his recovery this time around.

At Madiba’s age, of course, there will almost certainly be another medical event around the corner. And once again, everyone around the world will want to be kept informed about it, even as they offer their prayers for his recovery. The Presidency will want to have learned from the way it has handled this event to make sure it starts with a clean slate with the public the next time.

But what if Madiba’s medical care could, besides doing the obvious in health terms, also serve yet another purpose that helps the entire nation? What if the next time around the former president is admitted to Chris Hani-Baragwanath Hospital in Soweto? It would be an ironclad certainty hospital administrators would go into overdrive to ensure their famous patient received the best possible care and support – and we do know a hospital like that one does have excellent doctors on its staff. (As a comparison, American presidents routinely use a major military hospital in the Washington suburbs for their care, just as thousands of uniformed service personnel do every year.) The symbolic value of the country’s most iconic citizen being treated in what is possibly the nation’s most iconic healthcare facility would be immense. And the positive impact on the hospital would be astonishing.

But let’s carry this idea just a bit further. Let’s also suppose that, inspired by this public-spirited behaviour, the Presidency issues a revised instruction to all of its senior officials that requires that they and their families also make use of the state’s medical facilities – just as Madiba has done. That would guarantee sustained pressure to bring these facilities up to standard for the benefit of everyone – and make them “Exhibit A” in Health Minister Aaron Motsoaledi’s drive to reform the national health system, building a solid foundation for the planned National Health Insurance programme.

And if this kind of leverage works, why not make use of the same positive pressure to improve the country’s public education system? Send the children of the government’s civil servants to public schools, thereby sending a message to the population as a whole that the government believes in and trusts its institutions to do right by its citizens. And by driving this revolution in his final years, even now, this could become one of Madiba’s greatest legacies to his fellow citizens. DM


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