Cosmas Desmond crossfire
The import of luxury cars, such as BMWs, 4x4s and, particularly, Alfa Romeos, should surely be banned by the government, since this country obviously lacks the infrastructure to sustain travel in such cars. There are thousands of square kilometres in South Africa where these vehicles could not travel without damaging their suspension. We are a Third World, developing country and as such we are not capable of providing suitable road surfaces for such vehicles; we do not have autobahns like they do in Germany or a complete network of super highways that are necessary if such vehicles are to be used cost effectively. So, even if people are presented, free of charge, with such vehicles they should not be allowed to use them. True, there are many roads on which they can travel and in so doing they would benefit petrol stations, eating places, hotels and so on. But why should those who happen to live near such roads benefit when others cannot? After all, we are firm believers in equality: if not everybody can have something, then nobody must have it. That is something like what passes for logic in the government’s approach to the use of Nevirapine to prevent the mother-to-child transmission of HIV. Everything down to the last syringe, swab, toothpick, or whatever, must be in place in every single health facility in the country before one mother can be given one dose of Nevirapine and thus save one baby from a premature and painful death. They do not, however, apply this logic on a broader scale. Did they even apply it when introducing legislation permitting abortion on demand? Or free medical care for pregnant women and children under six years? Far less do they apply it to themselves. Is President Thabo Mbeki going to wait for the delivery of his R500-million jet until we can all have one? While I unlike Mbeki believe in leaving medicine to the doctors, I do not believe that the debate about the provision of Nevirapine to pregnant women and anti-retroviral drugs in general is a medical one. It is a political issue. The issue has now been referred back to the Cabinet. And what do they know about medicine? They could not tell an industrial solvent from a vaccine. But while we wait upon their wisdom, more than a thousand babies are doomed to die every week. Even under a black government, I believe there would be more urgency if these babies were white or even cows with foot and mouth disease. We are, after all, accustomed to black babies dying in large numbers. (I remember doing some research many years ago that showed that the infant mortality rate in the Limehill resettlement camp during the first year was 22% 220 per thousand. When this research was published, no shock or horror was expressed, but many “progressive” people said, “Is that all? I thought the figure was 50%.”) The government’s macroeconomic policy is geared towards creating a business-friendly environment to attract investment so that the president can have his aeroplane and the military can have their war toys not towards caring for the most needy members of our society. Babies are expendable except perhaps at election time. And the poor are certainly always going to be with us, if we continue to have a Thatcherite government.
For the past three or four years, the government has looked for and used every possible excuse not to supply Nevirapine and other drugs to pregnant women and others: even if they are free they are too expensive; they might have unforeseen side effects in 10 years, by which time all the mothers and babies will be dead anyway; the drugs are toxic like Disprin. And so on. They have never looked at positive ways of helping mothers and babies, apart from giving them vitamins. It is almost as if they do not want to find a solution. Was the ill-fated Parks Mankahlana really expressing government policy when he suggested that it was cheaper to let babies die than to care for orphans? It is very sad, therefore, to see a representative of such a reputable organisation as the Health Systems Trust, Dr David McCoy, providing the government with a putatively medical rationalisation for their inertia by emphasising the difficulties in terms of infrastructure, personnel and so on. He need not fear that anybody will ever induce them to do anything “rapidly”. (Is the good doctor, by the way, also as good an economist, in that he can pontificate about cost-effectiveness?) Of course, more and more excuses can be found if that is what you are looking for. But if you start from the premise that people come first and, more specifically, that the government is committed to “putting children first” remember FW de Klerk and Nelson Mandela at the World Summit on Children, the ratification of the United Nations Charter on the Rights of the Child and so on? then there would be no need for excuses. There would be plans and resources for a comprehensive health service. The money is there. Or at least it was until it was committed to the R50-million arms provision or put back into the pockets of the wealthy through tax cuts. It is a simple question of priorities, which our purely pragmatic, principle-less (apart from “I’m all right, Jack”) government does not seem to have. Cheers,chaps! Cosmas Desmond is the editor of ChildrenFIRST magazine and a former Amnesty International official. He was banned by the apartheid government after he exposed the misery caused by forced resettlement