TRC Final Report

Volume 4

Chapter 5

Subsection 22

Apartheid was a process of dehumanisation. It reduced the majority of our people to objects or physical entities. Imperceptibly, medicine also became dehumanised. The focus was on the disease and not the person, their family and community. South Africa is politically free; however, our people need to be healed spiritually, mentally and physically if we are to create the type of society and country that we all desire. Doctors, medical schools and their teaching staff, and medical students can become important instruments for this change. The most important step in this process is to re-humanise medicine… In short, change is not merely desirable, it is essential. The narrow outlook of the past can no longer be justified.

PROFESSOR B. MAHARAJ

■ FINDINGS ARISING OUT OF HEALTH SECTOR HEARINGS

138 Health professionals who were named in submissions as having contravened ethics or acted unprofessionally will be referred to the appropriate disciplinary body, together with as much information as is available, for further investigation and suitable action. The Commission has neither the resources nor the time to conclude investigations to the point where individual findings can be made.

The Commission finds that

139 The South African Medical and Dental Council (SAMDC) failed to exercise its statutory obligations by neglecting to investigate the conduct of Drs Tucker and Lang pertaining to the death of Stephen Bantu Biko until ordered to do so by the Supreme Court.

140 The Medical Association of South Africa (MASA), its standing committees and its special interest groups failed to fulfil their stated aim of protecting the health of patients, by neglecting to draw attention, amongst others things, to:

a the effects of the socio-economic consequences of apartheid on the health of black South Africans;

b the fact that segregated health care facilities were detrimental to the provision of health care in quantitative and qualitative terms;

c the negative impact on the health of millions of South Africans of unequal budgetary allocations for the health care of different ‘racial’ groups;

d the fact that solitary confinement is a form of torture;

e the severe impact of detention on the health of children.

141 Academic institutions, even those that did admit black medical students, failed to provide equal educational opportunities to black and white students.⁵¹

142 Education in respect of human rights for all health professionals failed to address crucial patient-care issues.

143 The former government, and more specifically the Department of Health, failed to provide adequate health care facilities to black South Africans. Health care resources were thus unequally distributed and inappropriately allocated and used. Certain aspects of health care provision have been particularly underresourced – for example, mental health care and primary health care.

144 District surgeons, with few exceptions, failed to record complaints and evidence of torture and abuse and, where such recording did take place, failed to take any steps to report or halt such abuse. Some district surgeons, in turn, either withheld pertinent medical information or reported such information incorrectly.

145 The South African Nursing Council (SANC) and the SAMDC, as the statutory bodies governing health professionals in South Africa during the period under review, failed to:

a speak out against segregation of health care along colour lines, thus compromising ethical pledges taken by doctors and nurses and failing to advocate adequate care for patients;

b confront local authorities who refused to allow emergency services designated for white patients to offer emergency care to black patients at the scenes of accidents;

c react to gross inequalities in the provision of training facilities for various population groups;

d draw attention to the lack of facilities and resources in institutions providing health care to black patients;

e conduct proper investigations into allegations of misconduct by doctors and nurses against political prisoners and detainees.

146 The SANC established surrogate nursing councils in the ‘homelands’ without due consultation with the nurses working in those areas. This undermined the professional status and the international recognition of those nurses.

147 The South African Medical Services (SAMS) of the South African Defence Force (SADF) failed to provide adequate mental health support for SADF members, particularly conscripts exposed to violence.

148 Members of SAMS, under the leadership of the Surgeon-General, were directly involved in the development of chemical and biological weapons to be used against individuals and in unrest and combat situations.

149 The Department of Health, the SADF and the South African Police and Prisons failed to provide adequate training, support and ethical guidance to those health professionals in their employ, who were working in environments in which there was a conflict of interests between employer and the patient. The interests of the patient/client were thus frequently subjugated to those of the state.