Let's follow our conscience

August 18, 2000

Brenda Gourley looks to a medical school that was a voice for justice in apartheid to guide the anti-Aids fight

It might not seem like much to institutions able to measure their history in hundreds of years, but when the University of Natal's school of medicine turned 50 this year we had much to celebrate.

This was a school that was, by any definition, special. Established at a "white" university to make it possible for black people to become medical doctors at a time when the Nationalist apartheid government had recently come into power (and was none too pleased to give its grudging approval to a project that had been many years in the making), it was the first institution of its kind in the country and remained the only institution of its kind for several decades.

Stripped of almost everything by a system that was to be labelled a "crime against humanity" by the United Nations, the school's undergraduates comprised many of the intellectual elite of the country's oppressed communities.

The apartheid regime came to regret its decision to approve the school and tried several times to close it. It became apparent to the government that not only was the school a place where students would learn to become good doctors, but it was a place where they would become active in the fight against apartheid. The corridors became a hub of political activity and its residences the target of many raids by the security police. Some of its students became legends through their heroism - among them black consciousness activist Steve Biko.

Many students and staff were harassed, banned, tortured and hounded into exile. They demonstrated leadership, vision, courage, sacrifice, intellect and a generosity of spirit. Many times they acted as the conscience for the rest of the university, and many times the rest of the university did not heed their conscience.

Our "new" democratic government, of course, has a different view of the medical school. How could it not when so many of its high offices are occupied by alumni? Among the 1,200 guests at the school's 50th anniversary banquet were countless people who now hold political office: heads of important national and provincial government agencies; hospital superintendents; heads of business empires, research councils and institutes; specialists and doctors with busy and successful practices; and academics who have brought great lustre to the school in a variety of ways - not least their contribution so amply on display at the 13th international Aids conference held in Durban last month.

The school's staff deserve special mention for many reasons, only one of which is the response to the controversy fired by president Thabo Mbeki in his questioning of the causes of Aids.

The school has, over the years, had many extraordinary people in its midst, people who set an example for academics in any place where injustice exists. These have been people who have soldiered on, not only in the face of serious under-resourcing, but also of active hostility and a host of other demeaning, hurtful and often personally insulting circumstances. Their intellect, ingenuity, care and compassion have never been more needed than now, as we in Africa face the greatest plague the world has ever known.

It is an irony that a school that should now be able to enjoy the gains that its prolonged hardship has brought instead finds itself at the epicentre of the HIV/Aids pandemic in KwaZulu-Natal, where infection rates are the highest of anywhere in the world.

Not only that, but now the school finds itself having to wage an odd kind of battle with government authorities about the nature of the disease. Once again the concept of academic freedom is at the fore. Once again we need to reflect on what tenets of democracy cannot be sacrificed. Once again the medical school staff have not been found wanting.

They have soldiered on to deliver a good education to their students, while at the same time producing extraordinary and groundbreaking research that has saved lives and has won accolades from all over the world.

But, recently, the school has been at the receiving end of vocal and often ill-timed criticism from various sectors, including government and alumni, who claim it has failed sufficiently to advance the cause of African doctors in particular, despite the fact that the school has produced close to 3,000 black doctors (including African, Indian and coloured) during its 50-year existence.

There can be no doubt that the school, like every other institution in this country, was constrained and shaped by the apartheid era, which influenced not only attitudes and policies, but also the legal backdrop against which medical training took place. It is also possible that the university authorities at the time might have done more to challenge the status quo. The university is aware of this and is committed to doing all it can to rectify the situation.

Having said that, I believe there can be no more fitting tribute to the uniqueness of our medical school, its achievements and the power of individual actions, than having former president Nelson Mandela agree to attach his name to the school - which now becomes The Nelson R. Mandela School of Medicine - and to have this exceptional man present to celebrate with us at our anniversary banquet.

In his closing speech to the Aids conference, Mr Mandela spoke of the dangers of focusing on a dispute that is "distracting (us) from the real life-and-death issues we are confronted with". It is incumbent on everyone, but academics in particular, to apply themselves to the scourge of Aids. As Mr Mandela added: "History will judge us harshly if we fail to do so now, and right now."

Brenda Gourley is vice-chancellor of the University of Natal, Durban.

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