Education And Debate

South Africa's Health: Impressions of health in the new South Africa: a period of convalescence

BMJ 1995; 310 doi: (Published 29 April 1995) Cite this as: BMJ 1995;310:1119
  1. Rajendra Kale, editorial registrara
  1. a BMJ, London WC1H 9JR
  1. Correspondence to: Dr R Kale, Laxmi-Kunj, 37 Shanwar, Pune 411 030, India.

    South Africa is a fledgling democracy. With a fair, and generally peaceful, first election in April 1994 it has shown the world that its people can make decisions that would do credit to a more mature democracy. Fears that the end of apartheid would be accompanied by a bloodbath were proved wrong.

    South Africa is an extreme example of inequity in every sphere of life including health care. This series of five articles tries to capture a picture of the health of South Africa. I spent three weeks in South Africa and met doctors, administrators, politicians, and others who could enlighten me. In Cape Town, Johannesburg, Pretoria, Durban, and Kwazulu I visited hospitals, townships, and shanty towns that I was told were representative—and safe to visit.

    This first article looks at the period after the elections and describes immediate gains and losses. The next three articles discuss the role of the traditional healers of South Africa, the country's mental health profile, and its medical workforce. The last article considers the South African government's plans and the dilemmas faced by its health planners while restructuring health care and undoing the ills of apartheid.

    Inequity in health care and apartheid

    Apartheid made South Africa unique. Racial discrimination exists in every country where people from different racial groups live together, but in South Africa racial discrimination was legalised and executed to perfection. With the death of apartheid South Africa has lost its dubious distinction. Apartheid caused inequity in health and health care.1 2 3

    The changing face of South Africa

    South Africa formerly consisted of four provinces: Cape of Good Hope, Natal, Transvaal, and Orange Free State. These have been replaced by nine new regions—Western Cape, Northern Cape, Eastern Cape, Orange Free State, North-West, KwaZulu/Natal, Gauteng, Northern Transvaal, and Eastern Transvaal. The country has a total area of 1221031 square kilometres (the area of …

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