Facts, fiction and mini-skirts
As South Africans we are living through very interesting times. With our own eyes we see the new struggling to be born. During our lifetime we are exposed to the images of the slow death of the old, and its desperate and hopeless efforts to secure its survival.
And because, for us, every development of significance around us is without precedent, we search constantly and continuously for levels of understanding of our reality and forms of action to respond to this actuality, which would assure us that we are masters, or mistresses, of our destiny.
For this reason, and for those among us who see themselves as agents of progressive change, complete and accurate knowledge, representing accurate understanding of objective reality, liberated from prejudice, false assumptions and propaganda, becomes an imperative and inalienable condition for the untrammelled but responsible exercise of the hard-won right to self-determination.
We have the possibility and latitude and the necessity to speak thus because we live during our own age of revolution. Exactly because it is such an age, all of us face the demand to understand objective reality accurately and objectively, to enable the revolution to decide on the correct strategy, tactics and operations.
Respect the truth
In this situation of an inevitable contest about the future of our country, information, facts, the truth, themselves become an area of contestation. The truth manifests itself as truths. Opponents of change see it as their obligatory task to falsify reality, in their interest. The imperative to understand the critical difference, and in some instances the contradiction, between essence and phenomenon becomes ever-more pressing.
Mini-skirts achieved their high point as an indispensable item of women's fashion and an iconic representation of the ethos of an age during the 1960s. Even at the height of the craze, when it was virtually a social offence not to show a considerable part of women's thighs, the statisticians remained loyal to their profession.
They spread the notion, not difficult to understand even by the most discreet observer, that mini-skirts showed or suggested more than they revealed. Presumably to demonstrate that they said what they said as an objective fact, without fear or favour or prejudice, they said the product of their trade, statistics, was distinguished by the same inherent features as the mini-skirt.
Thus they stated, with no sense of embarrassment whatsoever, that more often than not, the statistics they compiled and published, like the mini-skirt, showed or suggested more than they revealed.
In a manner of speaking, what this meant is that one had to use one's head to visualise what lay beyond the hem of the mini-skirt to arrive at the reality suggested by the mini-skirt. Thus they urged that consumers of published statistics had to use their brains to discover the fundamental truths, which these statistics could only suggest.
Perhaps unconsciously, and with no deliberate intention to act as spoilsports, cold-blooded enemies of unshackled fun and a delightful indulgence of human frailties, these statisticians served as the contemporary representatives of the stern Thomas Gradgrind in Charles Dickens' "Hard Times".
Nothing but facts
Dickens described Thomas Gradgrind as: "A man of realities. A man of facts and calculations. A man who proceeds upon the principle that two and two are four, and nothing over, and who is not to be talked into allowing for anything over...With a rule and a pair of scales, and the multiplication table always in his pocket, Sir, ready to weigh and measure any parcel of human nature, and tell you exactly what it comes to. It is a mere question of figures, a case of simple arithmetic."
True to form, Thomas Gradgrind, schoolmaster, opens the story told in "Hard Times" with the words; "Now, what I want is, Facts. Teach these boys and girls nothing but Facts. Facts alone are wanted in life. Plant nothing else, and root out everything else. You can only form the minds of reasoning animals upon Facts: nothing else will ever be of any service to them...Stick to Facts, Sir!"
Thomas Gradgrind, a man of facts and calculations, spoke as a representative of what modern philosophers would characterise, in the context of what is described as periodicity, as the modern age. To explain this in simple terms, Thomas Gradgrind would have been quite right to see the mini-shirt as representing nothing more than a short skirt, factually seeing nothing beyond the hem sewed in the clothing factory.
The philosophers we have mentioned would then proceed to teach us that Thomas Gradgrind is nothing more than a relic of the past. This is because we now live in the post-modern age. Post-modernism demands that we see beyond the hem of the short skirt sewed in the clothing factory, and therefore what is merely suggested by the mini-skirt.
And thus begin the troubles with which, in modern times, we must necessarily contend. Post-modernism, represented as enhanced human capacity to understand objective reality, dictates that, even out of self-respect, we must see and speak about the unseen world above and beyond the hem of the short skirt sewed in the clothing factory.
Daring to define what is meant by "post-modernism", the Cambridge Dictionary of Philosophy says it encompasses "rejection of the picture of knowledge as accurate representation; rejection of truth as correspondence to reality;...and a suspicion of grand narratives, metanarratives of the sort perhaps best illustrated by dialectical materialism."
Clearly, in our philosophically post-modern world, Thomas Gradgrind and Karl Marx would appear in world statistics as mere ciphers among the unemployed, and perhaps the unemployable, unless they repudiated their faith in Facts. Their grievous fault would lie in their rejection of the proposition that truth, manifesting itself in the forms of Facts, does not necessarily correspond to reality!
In the light of the seemingly permanent war in our country about which facts are in fact facts, about which facts in fact reflect objective reality, and which do not, many among us face the same fate as would befall Thomas Gradgrind and Karl Marx during our post-modern era.
Findings of the Daily Dispatch
Earlier this month, the East London newspaper "Daily Dispatch" published a dramatic report headed "Why Frere's babies die", alleging an extraordinarily high death rate of neonates at the public Frere Hospital located in the city. Among other things, the newspaper said:
"Hundreds of newborns are dying every year at Frere Hospital's overburdened maternity section - and the institution's own records reveal the scale of negligence behind many of the deaths...The Dispatch team spent nearly two months walking the maternity wards with hidden cameras, attending the mass burial of dead babies and interviewing medical staff and heartbroken mothers...Minutes from weekly management meetings reveal damning admissions by doctors that patients were dying because of outright negligence...
"Two thousand babies were stillborn in the past 14 years at Frere, according to the Abortions and Stillbirth book in the labour ward. Last year's figures appear to be the highest on record, when at least 199 babies were stillborn. Frere's official baby mortality rate exceeds provincial and national figures as contained in an unpublished report by a unit of the Medical Research Council."
In his 'Comment', Andrew Trench, Deputy Editor of the newspaper said: "There are many truths behind the Frere baby death scandal. There is no single person to blame. This tragedy is the result of our collapsing public health system, bereft of funding, resources and skilled staff."
The Eastern Cape Department of Health responded to this report and questions posed by the newspaper through a full-page advertisement in the newspaper entitled, "Department responds with facts to the 'Daily Dispatch exclusive investigation on baby death at Frere Hospital', saying:
"The Eastern Cape Department of Health is extremely disappointed that this publication didn't even bother to contact us for confirmation of facts before printing such a misleading statement about Frere Hospital."
The Green-Thompson Inquiry
Deeply concerned about the picture presented by the "Daily Dispatch", the National Minister of Health immediately sent a team to Frere Hospital to investigate the situation at the allegedly affected section of the hospital. The members of the team were the special adviser to the Minister, Professor Ronnie Green-Thompson, a specialist in obstetrics and gynaecology, Chief Director for Hospital Services, Dr Thabo Sibeko, and Dr Nat Khaole, Director for Women's Health.
On 22 July, ten days after the publication of the "Daily Dispatch" report, the Minister of Health, Manto Tshabalala-Msimang, announced the findings of this team. Among other things she said:
"Basic equipment was available and interviews with the clinical staff and hospital management indicated that no baby has died as a result of the non-availability of equipment. Therefore, the statement that health workers 'play God' and decide which patient lives or dies because of acute shortages of equipment was not found to be true....
"The general complement of doctors is reasonable but can be increased...Although there is largely a commitment to service delivery amongst staff, the current levels of staff complement was the main area of concern. There is an urgent need to increase the number of porters, messengers, general assistants and clerical staff and ensure that these categories of health workers are available at all times so that clinical staff can focus on what they have been trained to do...
"The District Health System must be strengthened to reduce the number of unnecessary referrals and enable the hospital to concentrate on the high-risk patients and thereby improve the peri-natal outcomes...
"The Saving Babies Report (which aggregates the figures for 164 sites and considers 20% of the births in South Africa) provides the perinatal mortality rate of 27.9/1000 live births. Frere Hospital's rate was 29.2 for 2005, 34.5 for 2006 and 32.9 for 2007 thus far. These figures are for the deliveries at the hospital using the denominator of all live births at the hospital. They do not include all the live births within the catchment area of Frere Hospital and therefore need to be adjusted by using (as the denominator) all the deliveries in the referral area of Frere Hospital.
"The neonatal mortality rates per 1000 live births for 2005, 2006 and 2007 (to-date) were 5.5, 12.9 and 9.5 respectively. The Saving Babies report figure is 8.5/1000 live births. Adjustment also needs to be done here also.
"Further review of data relating to Frere Hospital catchment area is necessary since Frere Hospital is a referral facility that receives complicated pregnancies from various lower level facilities. The national Department of Health will also be initiating a national review of the peri-and neonatal mortality rate in a similar approach as the Confidential Inquiry into Maternal Death."
Rage
On 22 July, the SABC reported correctly that "A report released by the health department has dismissed as lies media reports that any of the reported 2,000 infant deaths at Frere Hospital were a result of equipment and staff shortages."
On 23 July, the SABC further reported that, "The furore over the death of babies at East London's Frere Hospital rages on. The Congress of SA Trade Unions (Cosatu) has now entered the fray, accusing Manto Tshabalala-Msimang, the health minister, of protecting her provincial counterpart...Meanwhile, the minister and premier expressed confidence in the health MEC. Today Cosatu accused them of closing ranks around the MEC. 'It is very unfortunate that the report tabled by the minister of health is contradictory, in terms of not being able to publish the causes of death of the infants in this hospital,' says Xola Phakathi, Cosatu's provincial secretary. The Democratic Alliance said the report raised more questions than answers and that it would submit questions to Tshabalala-Msimang in Parliament to clarify her deputy's comments about Frere's maternity section."
In a statement issued on 25 July, the health spokesperson of the DA, Mike Waters, said: "We are concerned that the Minister (of Health), who has specifically stated that no heads will role (sic) after findings of catastrophically high death rates among new-borns at the hospital in recent years, does not want to release the report because it may point fingers at specific practices and specific actions by hospital management. She would then be under greater pressure to act...
("A full copy of the full report was not released. The DA has since then been attempting to obtain the full report, but officials say they cannot get hold of the Minister to get the go-ahead to release it. Unless the report is produced within the next 24 hours, the DA will submit an application in terms of the Promotion of Access to Information Act to demand its release.")...
"The appalling findings of an under-cover investigation into Frere Hospital by the Daily Dispatch made clear the consequences of the complete disregard that many officials have for the lives of the patients they are responsible for. If officials at the hospital are not held accountable for their outrageous failure to ensure that the necessary equipment is in place and that doctors and nurses are able to do their jobs properly, then the inevitable consequence is that babies will continue to die..."
Fact vs Fiction
Here we have a clear demonstration of the problem our country faces - when are facts, facts and a truthful representation of objective reality, or should we resign ourselves to the notion that we live in a post-modern world, which includes permissible 'rejection of truth as correspondence to reality'!
With regard to the specific issue we are discussing, it is clear that the DA representative, Mike Waters, has decided that the "Daily Dispatch" reporters published the truth, whereas Professor Ronnie Green-Thompson and his fellow medical professionals told lies through the statement read by the Minister of Health.
For this reason he describes the assertions or claims made by the "Daily Dispatch" as "findings", and the findings made by health professionals as amounting to nothing more than a cover-up to protect public health officials whom the "Daily Dispatch" and the DA have found guilty of gross criminal misconduct.
The Minister of Health acted urgently to establish the Facts about the situation at Frere Hospital, repeating to Prof Green-Thompson and his team, after Thomas Gradgrind, "Now, what I want is, Facts... Stick to Facts, Sir!" For his part, Mr Waters of the DA took the position that he would accept the report of the Green-Thompson investigating team as factual only if it endorsed the "findings" of the "Daily Dispatch" as a faithful representation of Facts!
The simple truth is that the DA, perhaps taking advantage of the liberties afforded by post-modernism, is making the statement that everything is Fact - truth corresponding with reality - if it communicates a negative message about the ANC and the government. On the other hand, members of the ANC, such as the Minister of Health, remain committed to the discovery of Facts - truths that corresponds with reality - precisely to empower themselves, our movement and government to act correctly in the continuing struggle to transform our country to ensure that we achieve the objective of a better life for all our people.
The statement read to the media by the Minister of Health on 22 July contains statistical information on perinatal and neonatal mortality contained in a "Saving Babies Report", as well as Frere Hospital information on these issues for the years 2005-07. The Green-Thompson report also makes some comments and recommendations arising from the fact that Frere is a referral hospital.
The facts communicate the conclusion that neonatal mortality at Frere Hospital is not significantly different from the national incidence of such mortality. Verifiable Facts therefore make the statement that the "findings" of the "Daily Dispatch" about the neonatal mortality rate at Frere Hospital are false.
But as the SABC reported on 23 July, and despite what we have just said, "The furore over the death of babies at East London's Frere Hospital rages on." And so might it continue to "rage on", because for the DA and others it is not the truth that matters - Facts - but the pursuit of an agenda centred on winning political victories over the ANC and the government and positioning themselves as the principal actors with regard to defining our country's future.
Fighting on all fronts
As soon as it could, the Ministry of Health sent the Green-Thompson report to the Chairperson of the National Assembly Portfolio Committee on Health. Mr Waters of the DA is a member of this Committee. He will therefore receive a copy of the report from his Committee Chairperson. For reasons that are not difficult to fathom, as it not difficult to imagine what the miniskirt does not reveal, Mr Waters nevertheless went so far as to threaten legal action if the Ministry of Health did not treat him as a special member of the National Assembly Portfolio Committee on Health.
He demanded that the Minister should provide him his own private copy of the Green-Thompson report. He had succeeded to convince himself that the report would be suppressed because he could not imagine that there could be any truth other than the virtually oracular "findings" of the "Daily Dispatch"! At the same time he knew this as a matter of fact that our movement and government would always lie to cover up their criminal misdeeds!
For Mr Waters and the DA what is at issue is to fight on all fronts, to secure some political victory, including destroying the credibility of the Green-Thompson report without even having read it. For us the issue must remain the objective to achieve a better life for all our people, including the accomplishment of the goal of health for all. To realise this outcome we must remain steadfast in our determination to understand the objective reality in our country, searching constantly and continuously for levels of understanding of our reality and forms of action to respond to this actuality, which would assure us that we are masters, or mistresses, of our destiny.
We wish the national and provincial Departments of Health and Frere Hospital success in their efforts to implement the recommendations contained in the Green-Thompson report. We salute and thank the staff at Frere Hospital for its "commitment to service delivery", which was mentioned in the statement made by the Minister of Health. We also join the ANC leadership in the Eastern Cape to express our confidence in MEC for Health, Nomsa Jajula. As always we must continue to search for, respect and defend the truth. Sooner or later those who try to falsify reality to achieve partisan objectives discover that lies have very short legs. The struggle continues!
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