Special Hearings — Health Sector Hearings — 1997-06-17

DR A MOOSA: Archbishop and Commissioners, thank you.  Thank you for allowing me to make this presentation.  I have a few documents which will form the basis of my oral submission to the Health Committee of the TRC and this submission is made in my personal capacity.
 I am of the opinion that this information should be brought to the attention of the Health and Human Rights Professionals Accountability Project and thank you once again for allowing me to talk to you today.
 We've heard Professor Solly here talking about training during the seventies.  I am going to take you back a little earlier.  I entered Medical School in 1958 and I am going to reflect on the medical training that we had during the 1960's, the late 1950's, 1960's and these are my personal recollections.
 At the time, I don't need to remind the Commission of the apartheid climate at the time, but there was a total onslaught on human dignity at the time and there was a separation of virtually all amenities, services, governmental departments, recreational facilities and this extended into the universities.  Our career choices at the time were very, very limited, not because the faculties were necessarily closed but because of post-qualification limitation in work opportunities.  So most people who went to university at that particular time had one of three choices.  They became teachers, they became lawyers or they became doctors.
 What was university life - I was at a White liberal university at the time, what was university life like at that particular time in the late fifties and the early sixties?   The first thing that greeted you is the fact that there were no African students.  Now I make no apologies here for talking about people in terms of their colour and their race because these were the classifications that were used at the time.  There were no African students on the UCT campus.  The only African people working there were people who were employed as labourers and as assistants maybe in some of the laboratories.
 There was an unofficial quota system at the time.  It was never really spoken of but it was obvious there was an unofficial quota system at the time because the figures for admission into first year medicine were always very much the same.  They were always in the region of about 20%.  In our first year group there were two ladies of colour in our first year group, in first year medicine, in 1957/58, just two, just two female admissions.  
 Some of the social aspects on the campus that greeted you first of all is that all the residences were closed.  You couldn't stay on the campus no matter where you lived, no matter where you had to come from you had to travel by segregated public transport, buses, trains.  The clubs on the - all academic or social clubs on the universities were closed.  The societies, you couldn't really become members of them because they were mostly in-house sort of things.  There were sports facilities but those were segregated.  There was a Rag, the Annual Rag for example, the sum total of your contribution was that you were allowed to sell the Rag magazine on the streets but you couldn't participate in any of the student involvement in the Rag.  In short there was a total lack of integration on the campus.
 This lack of integration continued throughout our medical school years.  There was an unwritten law that things should be separate.  In anatomy in the second year of study, in the anatomy laboratory we were separated into a smaller lab.  All the students, all the Black students were separated into a smaller lab.  
 In third year the autopsies that we attended, the post-mortems that we attended, they would only show Black bodies if there was a mixed class.  If there was a White corpse that had an interesting pathology these corpses were eviscerated in an ante-room and the organs from these bodies were brought in and displayed to the class.  You weren't even allowed to see a White corpse.
 Ward separation in the hospitals was complete.  Groote Schuur hospital, which was where we trained, was separated by an invisible line, and one side of the line was a total no-go area.
 The staff complement at the academic teaching hospitals was all White.  There were no lecturers of colour, both at Groote Schuur and at Red Cross.  At the smaller new Somerset Hospital, which is in Green Point there were people in training there who were some of our lecturers and some of our registrars.  
 At the time it seemed, either through paralysis, as Professor Solly here has said, or whether this was an extension of the general perviation of the apartheid system, the professorial attitudes, the attitudes of the lecturers, the attitudes of the students, no one really stood up and said hey, why is it that 20% of this class is not allowed to participate in all of the activities, all the academic activities, all the social activities of the rest?  
 There were exceptions.  There were exceptions, there were people who were prepared to stand up for us, people who were prepared to mix with us socially, people who took us into their homes, and here the people who stood out - Dr Raymond Hoffenberg, who went on, later became a real thorn in the side of the government, so much so that he was banned under the Suppression of Communism Act, had to leave this country on an exit visa, went on to become the President of the Royal College of Physicians in England.  A very, very prestigious post.  This is how they could sacrifice a man like Professor Raymond Hoffenberg.
 Ralph Gurr was a surgeon who also left the country despondent, became a surgeon who rather went to continue working in the States, the United States.  Dr Saunders at the time too was a man who stood up for us at that particular time.  
 I don't need to remind the Commission of the political climate at the time but political organisations were all banned.  The ANC was banned in 1960.  There was very little public participation in political activity.
 During our clinical years, which is the years when the students enter the hospitals and when they are trained in the hospitals, the tutorial groups that we were in were separated along colour lines.  This was to facilitate those of us who had to go in residence for example at the time when you do midwifery, when you do obstetrics, we couldn't go and deliver, we couldn't work in the White wards in the obstetric wards.  So the tutorial groups at a very early stage were separated along colour lines.  As I have said the White side of the hospital was a no-go area for students of colour.   One couldn't, for example, join a ward round, sometimes there were these grand ward rounds at which the professors would be shown problem cases and they would go from one side of the hospital to the other and we were never allowed to go on the other side.  The other 80% of the students could do that.
 When we qualified we found that internship posts were very, very limited.  The only hospital in the Cape, in the Cape Peninsula rather that would take us, was the new Somerset Hospital, and that had a very small complement.  It is probably not an accident the fact that they could only take about 15 doctors there, it was probably not an accident that only 15 or 20 students were admitted into the first year. 
 The separation of doctors continued throughout our internship years.  There were separate residences for the few - there were three or four White interns with us.  They had a separate dining room.  There was obviously the very sore point of differential salaries.
 If one went on to postgraduate training at the time that was also separated.  Those who chose to do postgraduate training found that if they were training at the Somerset Hospital they had no access to training, for example, at Groote Schuur or Red Cross.  There was no access for them to the grand ward rounds, as I've mentioned, on the White side of the hospitals.  They had no access to the special clinics at Red Cross Hospital so they couldn't do a full rotation through cardiology and allergy and dermatology and such things, as the other trainees did.
 Postgraduate scholarships sometimes had to be given up because no posts were available at medical schools.  Students who had gained scholarships, for example, and wanted to pursue a line of study which entailed them to enrol at an academic teaching hospital found that they would have to give up their scholarships.   Many graduates were forced then to go overseas to pursue their studies.  Most of them never unfortunately returned, and those who did return found that suitable placement in hospitals became very problematic because they were not given the sort of posts that they deserved, they were offered junior posts, they were told to do their training all over again and that sort of thing.
 For those who went into private practice we found we couldn't practice where we wanted to.  We were forced into the ghettos.  There were further restrictions on Indians who couldn't practice in areas which were not designated as Indian designated areas.
 In the early 1960's students were required to seek permits from, I think the Home Affairs Department, if they wished to study at the White universities.  This permit was granted on an annual basis, it had to be renewed annually.   Specialists who chose to practice in the medical centres also required to apply for permits to practice in those centres.  Similarly other health workers experienced similar problems and difficulties.  
 Just to remind the Commission, Professor Solly has already mentioned, in 1975 there was the threat to close Natal Medical School to Africans because they were building Medunsa.
 In 1976 there was a similar threat to close UCT Medical School to Indians and Coloureds and there was talk of having a separate medical school, based possibly at the University of Western Cape.  
 A watershed year Steve Biko's death and the inactivity, the total incompetence and inactivity of the Medical Association and the Medical Council to do anything about the death of Steve Biko.
 In 1978 Medunsa was created and Medunsa was eventually inaugurated then to cater for medical training of Africans.
 If the Commission can just indulge me for a while I want to show some figures which will graphically demonstrate how entrance into universities was a very, very ....  
 If we look at acceptance in first year medicine in 1981, these are figures which come from the South African Institute of Race Relations in 1982, if we take them by University and then look at the population groups.  In 1981 Pretoria admitted 220 White students only.  Wits you can see the similar preponderance of White students with a scattering of students of colour.  The Free State was similarly all White.  UCT was almost all White.  Natal, which was the only medical school at the time to admit Indians and Africans obviously had no other students there. Stellenbosch was almost completely lily White.  Medunsa, which had then come into being and was taking its third or fourth year of intake had 40 African students and five.  Out of a total then of 824 students who were admitted into first year medicine in 1981, something like 80% of them were White and 20% were students of Colour.
 In 1980 the doctors who qualified the figures show the same sort of preponderance. If we again take it these are doctors then who qualified in 1980 per university.  Pretoria was 169 White doctors; Wits 176 as opposed to 15; Free State 61 Whites only; Natal, as we have said before, Indians and Africans; Stellenbosch all White, 114 and UCT 137 White with 21 students of Colour.  Again out of a total of 657 graduates in the year of 1980 only 19.9% were students of Colour, or rather were graduates of Colour.
 This sort of bias continues if one looks at the enroled dental students for the years 1979 - 1980.  Out of a total of 942 enroled students 12% only were students of Colour.  That means 88% of dentists who were going to be trained in those particular years 88% were White.
 The figures become even more alarming if one looks at the number of pharmacists.  In 1976 there were 51 Coloured pharmacists and 122 Indian pharmacists.  In 1973 only two Africans were allowed to qualify as pharmacists and there were 12 registered African pharmacists only in the country as opposed to 4,693 White pharmacists.  The source is the same, SAIRR.
 This continued even with our nursing colleagues.  The population group here shown, African, White, African, Coloured, Indian, and out of a total of 55,000 close on to 60% were White.  These were White registered nurses, these are nursing sisters.  About 60% of them were White.
 I've presented these really just as a reflection of things which I experienced and things which I remembered as a result of my training and my later passage through into the medical world.  Thank you.