Special Hearings — Health Sector Hearings — 1997-06-18

CHAIRPERSON: Thank you Dr Barker.  You've been very disciplined in putting your ideas forward.
 Dr Barker as you know I've already submitted a number of questions to the Medical Association. I think there are other questions that we would like to submit in due course, but again, and I don't want time to become the only factor today, so I'm going to actually ask a few questions and then hand over to my colleagues.
 My first question is related to your apology. As you know within the South African Medical Journal a number of people have already criticised that apology as being superficial as not taking into account real disclosure but referring to generalities. I wonder how you would respond to that?

EDWARD BARKER: As I said in my presentation Mr Chairman, that was a step along the way. It was a statement of intent and it was not meant as I said, to be a plea for blanket amnesty or an attempt to simply close the door on the past without examination.
 The opportunity to examine and really to come to terms with our past, to explore it fully has only been provided by the existence of the Truth and Reconciliation Commission.  I think you would agree with me that, but for the existence of this Commission, it would have been somehow not even possible to spontaneously and for ourselves, go into this exercise of self-examination.  We are so grateful for this opportunity because without it we couldn't have carried forward.

CHAIRPERSON: Can I just follow it up Dr Barker and ask, does the apology include, or can you respond to the idea that MASA, quite often you mention yourself that 1989 perhaps was the final breaking point in terms of your declarations, but many individuals during that period and other organisations who stood up for help in human rights were criticised within MASA and within the South African Medical Journal, does the apology also include some of the remarks, statements made by MASA in response to those groupings?

EDWARD BARKER: Yes Mr Chairman it has to do so in view of our urgent drive towards unity throughout the profession and the closer and closer negotiations that have been going on over the past two years between ourselves and these very people whom in the past we regarded as our enemies, whom we criticised, whom we kept at a distance, attacked.  Yes we are and have been for the last two years, approaching them and are coming closer and closer, we are now at a point where I can see a very real possibility that within six months the profession as a whole in this country will be united under one umbrella organisation.  So that this is a necessary part of that apology.

CHAIRPERSON: Dr Barker I want to just come to one point of the segregated hospital issue, the separate facilities for training.  In your own document you refer firstly to a resolution that was passed in 1970, I think by the Tanzanian Medical Association at the Commonwealth Conference and then subsequently a resolution passed at the 1973 World Medical Association again critical of what was happening in South Africa in terms of health services and the role that the organisation played. Now both you and Dr Mandell have been part of this organisation for a long time.  We need to understand what happened in that period.  Dr Ramashala has already referred to the responsibilities of health professionals being one of caring and speaking out when that is being contradicted.
 Given, and again going back through your document, there was a letter written by doctors from the Medical School in Natal in the '60's, raising the question of discriminatory practices.  I accept that you say that the organisation has always been open in terms of its membership, but yet there were glaring examples throughout this 29-year period that we're talking about, and why was it that it actually took the Association such a long time to come out with clear policies when you were clearly interacting not only within the country but outside the country as well.  I accept again when you say that other medical associations also didn't take a political position on issues, but yet at these international conferences MASA was being criticised, can you comment on that?

EDWARD BARKER: Yes Mr Chairman, as I stated at the beginning of my presentation, MASA was essentially a part of the White establishment with, and it shared by and large, not entirely, but it's membership by and large shared the world views, the political views, political attitudes of the White establishment in this country which regarded the sorts of criticisms which you've mentioned as motivated by enmity to the country as part of what later came to be known as the 'total onslaught'.  The total onslaught mentality was certainly extant and operative in the White South African context in those days and the explanation for this lies in an understanding of where the White population of this country stood in relation to all these matters.
 The other point is that it took a long long time for those of us who recognised the difference between problems of ethics and morality and problems of politics, but there was a vast difference between the two large numbers of members. Very large numbers of our members for a long, long time failed to see any difference.  A political stance, even though it might be based upon what moral basis, if it was antagonistic to the current status quo, the actions of the country or particularly the Association or the Profession, this was regarded as an attack and was opposed with vigour.  This of course was completely wrong. It was not what doctors should have been doing, but it took a long, long time, certainly up to 1989, before those of us who had for years been trying to make the right noises and persuade the Association that ethical behaviour in relationship to the population it left their patients in relation to the structure of health care had nothing to do with politics and should be a concern of all 
members of the Association no matter what their associations.  It was only from 1989 onwards that we had sufficient support among our membership to be able to drive this forward.

CHAIRPERSON: Thank you Dr Barker.  May I ask Dr Hanekom who would like to speak?

HENDRIK ANDRIES HANEKOM: Just to add to what Dr Barker said, on page 95 of our submission I think there is a specific answer to your question which is very clear that these deeply ingrained discriminatory attitudes pervaded our society and MASA did not escape them.  MASA tolerated a system in which doctors  treated patients and colleagues differently based on the colour of their skin.  MASA was so wrapped up in its White male elitist educated professional world as individuals and as a collective organisation, and as part of a broader society from which doctors were drawn, that it failed to see the need to treat all people as equal human beings.  Perhaps the same could be said of other groupings in society.  MASA allowed Black and White people to be treated differently and this is the form of human rights violations for which it stands disgraced. I think it's very clearly stipulated in where we come from and I think this part of our submission also answered the question that you raised.

CHAIRPERSON: I want to come to the question of Mr Biko. I know from your submission and reading the journals, your branch and you yourself were very vociferous at that time, but you were saying in your earlier statement that there seemed to have been major outcry at the time within the Organisation.  But yet when it came to the actual vote within and supporting the initial response of the South African Medical and Dental Council, the organisation came out in support of that initial decision.  Perhaps you can just give us more details on your own experiences and your feeling now on how the Organisation responded?