Doctors contributed to poor health of black South Africans
BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7168.1269a (Published 07 November 1998) Cite this as: BMJ 1998;317:1269South Africa's health establishment during the apartheid years had allowed the creation of an environment in which the health of millions of black South Africans was neglected and at times actively compromised, according to the 3500 page report of the Truth And Reconciliation Commission published last week.
In a relatively small section devoted to health, the commission said that, although there was insufficient evidence to conclude that health professionals had been responsible for gross violations of human rights, they had allowed–through apathy, acceptance of the status quo, and acts of omission–the health of millions to be compromised.
Moreover, the report says, some doctors had been associated with the biological and chemical warfare programme which the previous government established. Biological and chemical substances had been used to kill enemies of the apartheid state.
Doctors, too, had planned to use drugs such as ecstasy to poison water supplies to black people, and to sterilise black women through the use of drugs.
The Department of Health had itself failed to provide adequate healthcare facilities to black South Africans while the defence force and police did not provide training or support in ethical guidance to their healthcare professionals. In this process they had subjugated the interests of their patients to those of the government at the time.
The professional medical bodies, which included the South African Medical and Dental Council, had not fulfilled their professional duty to protect the health of their patients. They failed to draw attention to the socioeconomic consequences of apartheid on the health of black South Africans.
The councils and representative bodies, which almost entirely comprised white males, had ignored the health needs of millions of South Africans. In a reference to incidents such as the now infamous death of Steve Biko in police detention, the commission concluded that the medical bodies had failed to conduct proper investigations into allegations of misconduct by both doctors and nurses against political prisoners.
District surgeons failed to record or report complaints of torture or abuse to political prisoners. One district surgeon who had distinguished herself by bucking that system, Dr Wendy Orr, was one of the commissioners of the truth commission.
The South African Medical Association, which testified at the Truth and Reconciliation Commission about its shortcomings during the apartheid years, will be assessing the commission's report in the coming weeks.
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