Peoples’ Health Movement of South Africa hosted its first SAPHU in December 2013. This exciting project was inspired by the urgent need to develop a new layer of health activists in South Africa and was modelled on the tremendously successful of the International People’s Heath University organised by PHM Global in Cape Town in 2013.
As PHM SA we believe that the kind of changes we need within the South African health system are far reaching and include among others, a real implementation of comprehensive primary health care; a reintegration of private sector resources human and material, into the public health system and a move towards a system of social solidarity where health care is paid for collectively through taxation and is free at the point of service. It remains to be seen whether the SA government NHI proposal will incorporate these changes. What is clear is that there is a significant and powerful private sector opposing progressive reform in health care, possibly supported by some conservative elements within government. At this crucial time when there is an opportunity to restructure the health system, civil society mass mobilisation and co-ordinated campaigns are essential to ensure that the NHI is a people centred one.
In building for this campaign, it has become poignantly clear, that too few of those who stand to gain or lose the most in health sector reform, ordinary South African citizens, are empowered to participate in the debates around this crucial issue. Even more worrying is that many important layers of activists in the health sector do not have the necessary experience and knowledge about health systems, health economics and primary health care to make a real political impact. Activists from across the board: labour, youth, women and health workers activists, are often unable to critically analyse the new health policy proposals that emanate from government or to argue coherently against the propaganda from conservative health economists.
It is against the backdrop of this acute need for conscious, motivated health activists, that the idea of a South African People’s Health University (SA-PHU) was born.
The five day school was hosted at the University of the Western Cape and attended by 45 delegates from all parts of South Africa. Half of the delegation was comprised of leading members of NEHAWU, one of the largest and most influential trade unions in the health sector in South Africa. The rest of the delegates ranged from community activists to health committee members, community care workers, social workers, doctors and nurses. All delegates submitted an application to attend the University stating their current involvement in health struggles as well as how they planned to take the information back to communities to infuse their struggles. On the basis of these answers, delegates were selected. The result was a tremendously diverse and interesting group of people from all levels of the health system and different forms of organisation.
The programme of the SAPHU covered the following areas in depth:
- The social determinants of health globally and in South Africa; Primary health care – what it means, the history of and current status in South Africa;
- Health systems in South Africa – how the public and private sector work and the basics of health financing;
- NHI – the South African proposal and its strengths and weakenesses.
- The final day was dedicated to the translation of theory into action with delegates breaking into groups to workshop how to implement and transfer the ideas learnt at the school.
The format of the SAPHU was intensely participatory with open discussions and workshop groups dominating the process. Interactive games, role play and pictures by delegates were used to make the information interesting and accessible. As is often the case, there was too much to get through in too short a time and with such an enthusiastic and vocal group, time management was one of our greatest challenges! After the campaign workshop, we reported action plans to the entire group and the final day ended with a spirited distribution of certificates and final comments by all delegates. We said goodbye that evening over a South African braai and social where everyone had a chance to unwind and make lasting plans for contact in the future.
Sadly, the final day of SAPHU started with the news that our great South African leader, Comrade Nelson Mandela, Madiba, had passed away during the night. In that time of sadness, it felt good to be among other comrades to share a moment of silence, thoughts on his amazing contribution to our country and the world and importantly, moving songs of remembrance.
Overall the SAPHU was an inspiration and learning experience for all, both facilitators and delegates. We learnt from one another’s experiences, knowledge and political viewpoints. We learnt new ways of learning and interacting and we emerged at the end with a renewed commitment to the struggle for health for all. We can only hope that this project will grow from strength to strength and that it will help build the powerful movement for health we so fervently wish to see in South Africa.