For many South Africans, Freedom Day is no longer a day of celebration. For older black South Africans and people of colour who lived through the horrors of apartheid, there is perhaps still a reason to celebrate, but given the youthful make-up of South Africa’s population, the commemoration of our first democratic election is wearing thin.
The universal franchise that was ushered in on 27 April 1994 has not translated into universal freedoms that are widely and deeply felt by the majority of young South Africans.
As a country, we have failed to significantly transform the lives of the majority of South Africans. Extreme poverty and all the associated indignities of poor health that accompany a life of deprivation and hopelessness are endured by at least a quarter of all South Africans.
This has happened while an overwhelmingly white minority has expanded their power and wealth in an economy based on the ownership of assets acquired through genocide, slavery and coercion.
The necessary transformation that our country needs requires complex interventions at both an individual and a systemic level. Extensive and radical compromises and sacrifices are needed at a personal and generational level, given the extreme inequality in which we find ourselves.
This can only happen if the institutional and organisational framework within which this personal transformation is to take place can manage a transition that is able to shift power while increasing the well-being of the majority, as well as including the minority who are being called on to sacrifice growing privilege associated with deepening inequality.
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Health is foundational for a life of dignity and South Africans require a transformed healthcare system to be free. Community health systems are recognised as an integral part of addressing poor health outcomes for the majority of South Africans, given the majority of the population’s reliance on the public healthcare system.
According to Statistics South Africa, 82% of South Africans fall outside the private medical aid net. Integral to community health systems are the local organisations and institutions that reach poorer South Africans who at a household level rely on community-based organisations delivering services in homes, schools, community spaces and primary healthcare facilities.
Shifting power while giving equal attention to understanding difficult and complex concepts like whiteness, privilege and black trauma requires a radical approach to well-being.
The National Strategic Plan for HIV, TB and STIs for 2023-2028 builds on the National Development Plan 2030 and, given the nature of our society, relies heavily on community-based health systems working in partnership with the public healthcare systems.
The plan relies heavily on institutional and organisational arrangements that are embedded within communities for its success. Transforming the current health system to be more effective in addressing HIV, TB and STIs is going to need a transformation of the entire public health system as well as the complex ecosystem that determines poor health outcomes.
This cannot happen if the organisations and individuals that work within this ecosystem are untransformed. These organisations and entities are involved in service delivery, resource mobilisation and management, and executive oversight, and range from political parties, social movements and government departments to community-based organisations.
Included in this are knowledge-producing organisations like universities, think tanks and councils that drive the information-gathering, analysis and intelligence needed to implement programmes that improve health outcomes.
Power shift
The narrow definition of transformation that has corrupted much of our society and economy focused singularly on racial justice in a manner that did not recognise all the privileges that come with being white, able-bodied, cisgendered, heterosexual, male and relatively affluent, and all the oppression that comes with being black, disabled, gender non-conforming, gay, female and poor.
Policies and programmes have used blunt instruments like affirmative action across employment and procurement to make poorer black South Africans more included in the economy and enjoy a better life.
The organisations and institutions – be they in government, the private sector, political parties, social movements, trade unions and community-based organisations – that have applied transformation policies have failed to shift power away from the existing pattern and culture to a more collective, inclusive, poorer and black community – and stakeholder-owned partnership with the majority of South Africans.
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What would it mean practically in organisations and in the health system to intentionally shift power to poorer black South Africans, while being inclusive to retain skills and develop the next layer of leadership to drive our country’s development?
Working at a large national non-profit has given me the opportunity to implement transformation both inside the organisation and in relationships with all stakeholders within the national health ecosystem.
Shifting power while ensuring dignity throughout all succession and related practices where all South Africans are treated as individuals of value and worth, must be supported unconditionally. We have to take collective ownership to unlock the potential of poorer communities and community leadership through increasing capacity and supporting communities to lead and own community health systems.
Delivering services while simultaneously increasing the confidence of poorer communities to lead is necessary for successful transformation. Transparent succession planning that follows fair processes that negotiate the sacrifices, commitment, dedication and support of both disadvantaged poorer communities and privileged, wealthier and middle-class South Africans, is not easy.
Shifting power while giving equal attention to understanding difficult and complex concepts like whiteness, privilege and black trauma requires a radical approach to well-being.
Compassion and solidarity are needed over competitiveness and individual accumulation to deepen our freedom so that we can flourish as a society.
National stakeholder-driven negotiations on platforms such as the South African National Aids Council and the National Economic Development and Labour Council would do much better at delivering freedom if closer attention was paid to the quality of our own and our country’s transformations.
We cannot celebrate freedom in an untransformed South Africa that is made up of untransformed South Africans. DM
Mohamed Motala is the Executive Director of the Networking HIV and AIDS Community of South Africa (Nacosa).
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Mr Motala what a beautiful article but you might be attacked verbally for saying like it is. The ANC’s missrule has made the conditions of black people worse. To some in the white community this erases the past and absolve them of responsibility of where we are as a country. N3 Durban after Leondale off ramp shacks with rocks on the roof, immediately after that empty land owners in Australia. That can’t be allowed to happen.
Woof woof, wrong tree dude.
The problem facing South Africa today is not whiteness, it is the failure of the Black government in every sphere, coupled with a total Black disregard for the consequences of that failure. This failure has resulted in extreme suffering of South Africa’s peoples and is guaranteed to ensure even more suffering in future. In the circumstances the absence of reflection by Black authors on this state of affairs is significant. Nothing in this article mentions the lamentable failure of State hospitals or, indeed, any health “service” put up by the State. Nothing is said about the corruption endemic in these ‘services’. There is seemingly a willing blindness among Blacks, who seek refuge in narratives about “whiteness”. Transformation (i.e, a country that actually works for its majority, rather than a kleptocratic ruling minority) will only come when Blacks stop worrying about whiteness, acknowledge the role of Blacks in creating the current hopeless position of most Black people in South Africa (and indeed Africa) and start taking responsibility for the outcomes they are currently generating. One can only build by building, not by fantasising about taking away the strength from another perceived as being stronger. This victim mentality, which is used to justify the unjustifiable, presents the greatest possible threat to the peoples of South Africa.
Transformation means that the majority must transform from a rural peasantry, to the demands of the 21st century. It’s not about skin colour as the ANC think. Where ,what was the economy before the settlers came? Capitalism has proven to be the preferred system world-wide. Get used to it.
The settlers were not invited here, they came in and stole what didn’t belong to them. The Americans and the British are the most addicted people from prescription drugs so much for the modern life. Am privileged to be on both sides of the divide. Capitalism is fading and is cannibalising the citizens where it was perfected. The number of people living on the streets in the biggest Economy in the world has risen sharply over decades. Modern slavery being shouted on, disciplinary action overall abuse by Mr Suit.