Back to South Africa… The final day of our course on health an human rights involved a series of extremely well designed site visits put together by the local OSI team. I joined the group going to Khayelitsha. This is a very large township on the outskirts of Cape Town, larger than many cities, but with many of its population still living in corrugated iron shacks, sharing a common water source. We began with a visit to an AIDS treatment centre, run joint by Médecins Sans Frontières and the Treatment Action Campaign. MSF is very well known globally but TAC may be less so. This was the organisation that spearheaded a legal campaign to force the South African government to make available prophylactic treatment for HIV positive expectant mothers. Their work encapsulates the case for linking lawyers and public health professionals to combine forces to work for health and human rights.
Needless to say, this was an incredibly inspiring visit. The team working in the centre combined idealism with realism and vision with pragmatism. Despite what others would see as insuperable odds, they had put in place a system that was delivering much needed anti-retrovirals to several thousand people. It had been a long struggle, in the face of long-standing denial by some senior South African politicians, supported by a range of individuals promoting the most bizarre ideas about the nature of AIDS and how to treat it. It was only because the authors of the South African constitution had included a legal right to health that it was possible to force the Health Ministry to make treatment available, yet another example of a health ministry that had lost sight of what should be it’s role in advancing the health of its people.
Our second visit, a short distance away, was to a rape crisis centre. Rape is all too common in Khayelitsha, as in many parts of South Africa. While an appalling act anywhere, its significance is even greater here because of the very high prevalence of HIV infection. The centre is staffed 24 hours a day, seven days a week and it provides all the essential services for the victim in a single building. A particular success was enlisting support of the local police, so that a dedicated detective is on hand to collect evidence and statements. The conviction rate remains low, but it is a start.
Then it was off to the University of Cape Town, where we met with Prof Solomon Benatar at the University of Cape Town. A remarkable man, he had been Chief Physician at Groote Schuur Hospital but combined this with an outstanding publishing career in bioethics and human rights. It was absolutely fascinating to listen to his account of the transition in South Africa but also a little depressing as he shared his vision of the future, one that unfortunately seems to be shared by many of my South African colleagues.
Our final visit was to IDASA, whose name recalls its origins as the Institute for a Democratic Alternative in South Africa. In particular, we learned about its Africa Budget Watch, which seeks to introduce a greater degree of transparency into government spending in the continent.
It was one of those days that was exhausting but inspiring, and grateful that there are so many people prepared to take on the really hard issues and make a difference.