Special Hearings — Mental Health Workshop — UNKNOWN

PARTICIPANT: Okay thank you very much. Before we move on to the next point I just want to say. You'll remember that this morning Wendy's input was exactly on the issue that Saths has raised. I mean basically to say what is important is to be conscious of the TRC mandate. Because we know at the end we will look at recommendations which addresses our focus, our point of focus. The statements we have, people who have come be forward, reporting on their experiences. So I mean, that really is very, very central to our concern.
 And regarding Victor Nel's proposal and what has been said, I should think through this discussion we have in a way brought the two views together. And I must say those of you who have looked at our policy document were proposed that people access reparations initially and rehabilitations for a period of six years. And during that period ministries will have time to incorporate in their planning whatever have been initiated. So the idea of the enabling institution with a limited life span, it fits in with our thinking. And of course that it should be intersectorial. Also there's that in Victor Nel's proposal. One can match all these ideas together. So thank you very much. I should think that point has been put together. Wendy?

MR GREY: (...indistinct) continue with

PARTICIPANT: Wendy, Wendy where's (

PARTICIPANTS TALKING SIMULTANEOUSLY: ) You see, I mean if we had sufficient grounds we can. I mean Wendy earlier on spoke to a proposal which was made May or June, that the Medical and Dental should be proactive.
DR. ORR: Oh ja.

PARTICIPANT: Ja, and that already has been taken, ja. Can you lead us to the next point please as to how it should be debated?
DR. ORR: Well the next issue we looked at was education and training. I don't think we believe there was anything particularly controversial in what we were suggesting but perhaps the rest of the group might like input. On point which I forgot to make and Paul you should have reminded me about was that of oaths and declarations and how relevant and appropriate they are. I mean it's all very well stand up and say take the Hippocratic Oath or the Declaration of Geneva but what does it mean for your day to day practise and does it make a difference to your ethical or moral conduct as a health professional? And I know CCHR has proposed one overriding loyalty oath which all health professionals will take. The British Medical Association is working on also one oath. It's kind of an update of the Declaration of Geneva. Which all health professionals will take.
 But I think in addition to that, simply taking an oath at the end of your period of training without working through and discussing the issues and practically problem solving around issues which those oaths raise it's absolutely pointless. I mean it makes those oaths not worth the paper that they're written on. And I think it's absolutely essential that those things be included in training. And that also part of the job of whatever it's going to be, the watch dog body, the ombudsperson, etc, would be to ensure that, that professionals do in fact maintain the promises which they made in those oaths.
 So that the other points that we raised was that we need to look again at the skewing of funding allocation which seems to go primarily towards traditional Euro-Western medical model training and research and it should perhaps be reallocated. Medical dominance has not resulted in good care and we should be looking rather at multi-disciplinary teams where we make the best use of everyone's skills, knowledge and expertise and where the doctor is not necessarily the head of the team. We raised the issue of access and I think this follows on Saths' point. Access for victims to, both to training and education and to services. And referred to the programme which is being introduced in India for the untouchables.
 Rural areas need a particular focus. Mental health care needs to be included as part of primary health care and traditional healers needs to be included as part of training and that in training there should be cross-disciplinary training. So that, that we try and break down the (...indistinct) as a hierarchy and flatten it out and have nurses train with doctors and physiotherapists train with pharmacists or whatever. But basically in the training attempt very, very to, to do away with the hierarchy which exists in the present health sector.

PARTICIPANT: Thank you very much. If I may just ask for clarity. Are you proposing that there should be a more, a module in human rights during training instead of just expecting people to take an oath at the end?
DR. ORR: I think we would want more than a module. I think we'd want human rights and ethical issues to be incorporated into everything that students are taught. I think having a separate module makes it very easy to split it off. And we've used the word split more than once today. And to put it in a box and not include it in the way in which you interact with and treat your patients and clients every day. So while I think you do need specific teaching around those issues, it also needs to be incorporated on a daily basis into what is happening at the bedside and in the clinics.