• Health commentary

    Command or Persuade … How people are influenced

    In my previous post I argued against the imposition of further “lockdown” measures to address the rising number of COVID-19 cases in areas of South Africa. This has seemed to be a dissenting view when compared to what is the reported policy direction of government to address the resurgence of COVID-19 in areas of South Africa. I was, however, encouraged to read an article “Call to Action: A people-centred approach to disease prevention in the era of COVID-19” published in the Daily Maverick of 30th November 2020 penned by Yogan Pillay and Tracey Naledi. The article echoes many of the sentiments that I have expressed in articles over the preceding…

  • Health commentary

    The Difficult Dilemma of COVID-19 in our 2020 World!

    I write this article as a 72-year old man with hypertension well-controlled on antihypertensive medication and as such an individual who falls into the group of individuals at higher risk for a more complicated course of COVID-19 should I acquire that infection. I am also a doctor and spent my professional life as both a practicing specialist clinician and a manager of health services. The reason for my stating this at the outset will become apparent to the reader. In South Africa the surge of COVID-19 cases and COVID-19 associated deaths overall first peaked around July of this year, 2020, and subsequently declined. Prior to the surge the country went…

  • Health commentary

    Decision Making in Government … the good and the bad!

    I have just finished reading the book written by John Bolton, “The Room Where It Happened”. Bolton was the National Security Advisor of the United States and worked closely in this position with President Trump. It is a startling analysis of how decisions were made or not made at the highest level of the United States Government during his relatively short term of just over a year as the National Security Advisor. While a number of books have been written reflecting the experience of working with President Trump, this book is unique in that it reflects the experience of a political insider, a person who previously had held senior positions…

  • Health commentary

    “Accountability” essential for a successful nation!

    “Accountability” as defined in the Merriam-Webster dictionary is “the quality or state of being accountable i.e. an obligation or willingness to accept responsibility or to account for one’s actions”. My professional training as a doctor made me aware of my accountability for my actions as a health professional. Accountability directly to my patient, a child in my case as a paediatrician, their parents and extended family. Accountability to the professional body with which I was registered to practice as well as to my employer, a public sector health department and university. Later when I moved into health management in 1995, I became legally accountable in terms of the Public Finance Management Act…

  • Health commentary

    COVID-19 … social distancing is now the last line of defence.

    In the term “social distancing” I include the full spectrum of measures introduced to counter the spread of the coronavirus. With the lifting of almost all the restrictions on the movement of individuals in South Africa “social distancing” to prevent the spread of the coronavirus becomes the last line of defence. Recently pictures on social media have shown groups of apparently well educated and informed people in South Africa happily congregating in groups without masks completely ignoring the need to remain at a safe distance from one another. Counter intuitively some are those who continue to work from home due to their age or because they have co-morbidities. For riders…

  • Health Commentary

    Quality … the Holy Grail often sought but never found?

    I have just finished reading “Zen and the Art of Motorcycle Maintenance” for, I think, the third or fourth time. The book, subtitled, “An Inquiry into Values”, has little to do the motorcycle maintenance other than in an allegorical sense but rather explores the journey of the author Robert Pirsig in pursuit of understanding the meaning of “Quality” against the background of a two week motorcycle trip across America from Minneapolis to San Francisco. The author of this unique book and best seller over the last forty years was committed to a mental institution earlier in his life, probably with a form of catatonic schizophrenia and subjected to electro-convulsive therapy…

  • Health commentary

    Leadership or management … the challenge of making decisions

    I have been reflecting on the challenges President Ramaphosa faces in dealing with the COVID-19 pandemic and his struggle to match the need to consult widely and the need to take decisive decisions that have and will affect the lives of so many. Leadership, irrespective of position, requires the ability to motivate people and take an organisation in a given direction possibly different from that which it had previously taken. Management on the other hand involves systems and processes that allows an organisation to function efficiently and achieve its goals and objectives. Both expect those involved to act in an ethical and honest manner. This lead me to think about…

  • Health Commentary

    COVID-19 and Corruption

    On 23rd July 2020 I wrote an unknowingly prophetic piece on the Cancer of Corruption in Health. In that I used examples of corruption in the health sector that I had encountered in the past. In doing so, I had no idea that the cancer that I had described and which I concluded could be excised by good and honest leadership had progressed to such an advanced stage in South African society. At a time of crisis, with the country threatened on many fronts by an unprecedented pandemic, one would have assumed that even the most hardened criminal would have hesitated to steal the scarce resources needed to save the…

  • Health commentary

    The Cancer of Corruption in Health

    Corruption is a word that has become all too familiar in the lexicon of the ordinary South African. Billions rands of government funds have ended up in the hands of corrupt individuals many of whom by virtue of their positions should have been people with integrity and above reproach. Transparency International reports that the Corruption Perceptions Index places the country at 71 out of the 180 countries. The 2017 Corruption Watch annual report quotes the then Economic Development Minister as estimating that corruption costs the public sector at least R27 billion annually. During my initial experience heading the Free State health Department in the late 1990’s I uncovered corruption at…

  • Health commentary

    Groupthink … in a COVID-19 world

    Groupthink is a pattern of thought characterised by forced manufacture of consent and conformity to group values and ethics. The concept originates from the work of a social psychologist, Professor Irvin Janis, who coined the term in 1972. In groupthink groups of highly intelligent people at times make poor decisions when insulated from the divergent opinions of people outside the group. Under these circumstances a person within the group, although holding an alternative view, will withhold that view to appear to remain part of the group, while the group will reject an alternative view originating from outside the group. There are many examples of this and its negative consequences within…