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

DR RANDERA: Solly thank you very much.  You've referred to the attitudes of medical schools and of course raise the question of institutionalised racism, can you tell us about any direct links that you may have had as a Black student, Black doctor with the Medical Association of South Africa or the South African Medical and Dental Council and their responses to the training of Black doctors in South Africa?

SOLLY RATEMANE: The issues about our training had been sent to the South African Medical and Dental Council and there was no response.  And I think we saw our training as occurring in the context of developments in South Africa and issues such as the response of the Council to the death of Steve Biko made us very unhappy, we could not trust the Council to help us in this process.
 I want to raise the fact that international organisations were even more helpful in supporting us.  I know that in 1986 the American - the Triple A S asked  us to talk about this issue of training of science within the apartheid situation.  It was very clear to us that you couldn't develop human beings fully within the apartheid situation because of the limitations engendered by racism and discrimination at various levels.   
 Internally, in short, it was difficult to survive within those institutions.  Survival was enhanced by attaching oneself to community organisations, community health workers' groups and later on to structures such as NAMDA.  But within the formal structures, MASA, Medical and Dental Council we had no hope that we could get any assistance.

DR RANDERA: Solly one last question, and I want to actually just move slightly away from your presentation if I may and use your expertise as a psychiatrist.  We've heard the stories of hundreds of people and taken statements from thousands of people, the impression one is sometimes left with in dealing with the stories, and especially the torture stories that we've heard, that psychologists and psychiatrists may have played a part in the training of the custodians of these police cells, do you have any knowledge of this?  Would you want to make a comment on this?

SOLLY RATEMANE: I think one's comments would be related to direct and indirect situations, namely that as people came out of detention with various psychological problems, severe depressions, some being totally out of touch with reality, in short they were psychotic.  There was a pattern of diagnosis at some of our institutions whereby there was an active resistance to see detention without trial and torture as a stressor.  That could precipitate their presenting a psychological problem.  It would be as though the person was prone to depression, the person was prone to schizophrenia, despite any evidence from family history and so on.
 The case in mind is a young student who was studying at the University of the North, Turfloop, who went to university to do first year in BA, very healthy.  There was a student uprising in the middle of the year.  She was beaten by the police and held in detention.  She was later admitted to Hillbrow Hospital during my training with some confusion, with some problems in walking and so on.  We did a CAT scan which showed some small haemorrhage in the brain.  The report from the radiographer was that it was most probably TB.  There was no evidence of TB anywhere.
 On emphasising that the only stressor, the only trauma that she sustained was at the hands of the police, I was asked a question and again here fear paralysed me from continuing further in this inquiry, I was asked whether I have done a proper differential and whether TB wouldn't cause the same lesion.  Yes TB could cause the same lesion but there was no evidence of TB.  This lady died a week after admission, and TB would not kill her that precipitously.  Now this was a psychotic colleague who was dissuading me from insisting that this problem was as a result of the beatings, the head injuries suffered when the police beat this young lady.  
 There were a number of people admitted diagnosed as depression, but if you look at our scale of classification in terms of diagnosis one of the axis there says what are the psychosocial stresses, many of our colleagues would not mention detention without trial, or police interrogation or torture as a form of stressor.  It would be as though the stressor is only the political activism and political activism itself it's not a stressor, it's something that people do with passion and they are prepared to die for that.

GLENDA WILDSCHUT: It's my responsibility to invite you, Dr Moosa to do your presentation and then we will do a round-up at the end.  Please go ahead.  Are you going to be using the.....

DR AHMED MOOSA: I am going to be using the overheads and my colleague is going to project for me.

GLENDA WILDSCHUT: Yes.