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Reflections then and now: Visiting South Africa raises more questions than answers

By Erlyn Macarayan
on January 22, 2015

It has been almost a year now since I first visited South Africa (SA) back in April 2014 for the Australia-Africa Universities Network (AAUN) conference. At that time, I visited Gauteng, Pretoria – a very beautiful city with probably many other secrets I have yet to discover. I then returned just last September for the Emerging Voices for Global Health (EV4GH) program and the Third Global Symposium on Health Systems Research in Cape Town. I cannot help but reflect now on these two trips I had in South Africa after my recent travels around Europe and here in the United States (where I am currently staying), as well as based on my experience living in the Philippines and in Australia. (by now you probably cannot help but think that I am a ‘happy flier’ like my compatriot Renzo Guinto 🙂 ). I cannot help but be so much disturbed on how huge inequalities are all across the world and even within each country I have visited – In South Africa, that inequality was very much pronounced.

So let me start by telling you the story of my first visit to SA – I participated at the AAUN forum, which was held at the university of Pretoria (4-7 April 2014). My five-day stay in Pretoria was exceptional and remarkable – leaving me a lasting and inspiring memory. Coming from the Philippines and arriving in Africa for the first time, I have to admit that I was weary to explore the area. Most of my friends from Africa were telling me about the very high security risks. A friend of mine who stayed there even said: “You can hear gunshots at night from the hotel… and chaos on the roads, violence, etc… I would advise you not to go alone… a wise option would be to play chess in the hotel room”.  In fact, the UN considers South Africa to have an extremely high crime rate. So why then do I say it has been exceptional and remarkable?

Upon my arrival in Pretoria, a city about an hour away from the OR Tambo International Airport in Johannesburg, I could not believe my eyes upon seeing highly gated communities in the area. Gated communities are believed to be a strong response to rising crime levels. Such gated communities would then have their own security controls and most strikingly, most houses would also be enclosed not only by high walls but also by electric fences with burglary gates, windows and doors. Some even have their own security response systems. Every house I saw had signs on their walls saying “armed response [call numbers]”. These led me to more puzzling questions: What happens if we cannot afford such security systems? Are people just paranoid about their safety? Why are they feeling this way?

Staying just a few minutes away from the conference venue, I decided to just walk going there (I also happen to be a happy walker). However, people kept on convincing me not to do so and instead asked someone else to drive me to the venue – for which I also had to pay a lot of bucks. From the venue, I decided to walk outside and buy some stuff in a nearby store. The traveler side of me kept on saying I have nothing to worry but I was always reminded of what everyone told me about safety. Turns out that I never looked at anyone and never even smiled at all. When a young boy approached me to ask if I was looking for something, I walked really fast to stay away, but he just kept on smiling and said, “I was just going to help you”. At that time, it was very hard to just show my friendly and approachable self to people; but looking back, I could have just even smiled and say thank you to that young boy, who may have just been concerned.  This made me think: Although taking the necessary precautions are needed, should we always keep ourselves hiding in fear? Why do we fear?

For the AAUN conference, most delegates came from other parts of Africa and only a few of us represented Australia. I eventually realized I was the only Filipino in the group. Although not affiliated with Africa by birth or blood, I have never felt as interested in this place. Issues not only in terms of healthcare, but also in politics, social development, and economics were exhilarating. I joined the workshop with a focus on public health and I then struggled to find words to describe how debilitating the reported health issues in Africa were. Returning to Africa a few months after, for the EV4GH venture and Cape Town symposium, I can recall how most health issues I have heard the first time I was there were the same health issues I heard in Cape Town – and even worse with the addition of the global health concern on Ebola. The difference was that during the first time I was there, our focus was mainly on Australia and Africa while in Cape Town our focus was on a more global response. Meeting people who had the same advocacies, commitment and passion for health and who were coming from all across the world was for me a great first step in addressing our many health concerns.

But the excitement (or should I say inspiration) grew after both conferences. In both instances, I noticed an undeniably strong segregation between the rich and the poor. In Pretoria, there were some areas that were called “townships” – I thought it was the counterpart of what we call “slums” back home. In Cape Town, we visited a similar area which my co-EV4GH fellows called “Khayelitsha”, one of the largest townships in South Africa. Most people I knew would advise me not to go in these areas. However, these areas were very significant in the history of South Africa, particularly in its liberation struggle during the apartheid. Although these areas are much feared by tourists, I see those in the townships as collective heroes that were vital in the fight of President Nelson Mandela. It would have been great to know them more and hear their stories. Just a week ago, an article of Public Radio International was titled “South Africa is a less equal place now than under apartheid, author says”. I eagerly wanted to know whether people from there felt the same.

Is it proper to keep ourselves away from them? Just recently, Pope Francis – also a happy flier – visited the Philippines and gave these lines that struck me most: “[All people are enjoined] by the duty to hear the voice of the poor. It bids us break the bonds of injustice and oppression which give rise to glaring, and indeed scandalous, social inequalities”.

I felt the desire then to go and listen and see beyond what my data (as a quantitative researcher) offers, but I never did – not on my first and second visits. I only had the chance to observe but I can imagine that stories of how they have lived before and the inequalities that exist now may have been almost the same. Are our problems cyclical? If we are making progress, can these people really feel it too? In one area in Pretoria, I remember I saw a long line of people gathering in a vacant lot. When I asked my local friends what these people were lining up for, they said these are people from other places in Africa who line up every single day to get their social grants from the government. These grants are then handed over as cash to vulnerable individuals – people with disabilities, the elderly, orphans – who either have to line up to receive their social grants or can do so through the bank. I was told it is such a huge progress with the government providing grants for their vulnerable despite their very limited resources. I also saw similar progress in Khayelitsha. I remember how I and my other Filipino co-EV4GH (Renzo and Mai) even said: “Our slums [in the Philippines] look worse than this!” In Khayelitsha, they have free water services (when in the Philippines you get billed no matter what) – and they have well-arranged water systems too! But as former South African President Thabo Mbeki has said, “poverty is not only expressed in shortage of food, shelter and clothing. It is also expressed in high levels of crime, including violence among the poor themselves, especially against women and children, in many instances accompanied by substance abuse”. Such cases are still indeed very visible in South Africa, but are we making progress? Are we doing it right?

Upon talking with the locals, statistical data may truly not be able to capture the whole situation in an area. Numbers are enriched by hearing people’s experiences and stories. Although HIV rates were reported to be declining in Africa, the way people saw it when I did talk to them (on a few rare occasions) was different. In one story of a local nurse in Pretoria, she mentioned an inexplicable child health situation – that in every group of children born in their hospital per day, more than half of them were HIV-positive. Worse than this is that although mothers were advised to breastfeed their babies to strengthen their children’s immunity, women will not do so due to fear of being stigmatized by others, who know that such breastfeeding is greatly recommended for HIV-positive mothers. How can this be? When can pride (and even status) weigh more than life?

Other than poor socioeconomic conditions, the stories I heard about politics in South Africa were very striking. Some even believed that the apartheid order may have been less susceptible to corruption than the current political system – I am not sure about that though! But people I met there all expressed how corrupt their government “was” (or “is”). Now, more than twenty years after apartheid, the country is still being headed by the African National Congress (ANC), which has been ever since the ruling party of post-apartheid SA. The ANC is a ‘happy ruler’, obviously. But if people believe that the government is corrupt, why then are the same leaders elected? (People told me that the ANC are actually quite proactive in trying to deal with poverty, and their policies are not all bad, it’s more the leaders posing the problem. But it’s not up to me to assess this.)

To conclude… South Africa is a very beautiful country with undeniably rich natural resources. I have never enjoyed nature as much I did in SA – while visiting the cradle of humankind, looking at big diamonds, and meeting its “Big five” (which is the collective term for their 1) African elephant, 2) black rhinoceros, 3) cape buffalo, 4) African lion and 5) leopard), among many others. Most especially, I have never found a country with such unforgettable history with a very diverse and unique heritage and with people so inspiring and hopeful. The place and much more the people I have met are truly remarkable. Indeed, South Africa has great opportunities, yet it is often mismanaged and challenged. The two visits I had may have not been enough for me to say I know South Africa very well – but I confidently believe that the country is faced not just with the challenge of continuously fighting for freedom but also by the struggle for liberation from poverty, lack of education, health and social inequalities, and huge income gaps between the rich and the poor. In South-Africa this fight seems even more pronounced and urgent than in many other places in the world.

War is not yet over in South Africa, so does it need another Nelson Mandela?  As these short visits raised more questions than answers, for sure I’ll go back to South Africa one day to find out more.

Hopefully by then, a new Mandela will have stood up.  Perhaps one from the townships?





I just would like to thank Kristof Decoster and Shakira Choonara for providing valuable feedback to this article. Thank you as well to the Australia Africa Universities Network and the Emerging Voices for Global Health program of the Institute of Tropical Medicine for funding my trips to South Africa. I wouldn’t have had this lasting experience without their support.

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