Apparently I have been uncaring and cold in my condemnation of my friends who have been imitating my fellow UDW students by dancing in the streets. I noticed that there were no petrol bombs and so I will say that perhaps greater strides need to be made in strugglising the liberationary nature of the perpetual medical revolution which will secure the thermometers of freedom and liberty up the bums of those who need it most …

Now having already made it clear that we are operating our hospitals as though we are at war, which is why there is pandemonium in the stadium, folks, it is only prudent to actually identify the enemy combatant that is causing this flood of patients to our hospitals and clinics … and as you may have guessed … it’s HIV.

However …

  1. If we simply declare the HI-Virus an agent of biological warfare, by virtue of its biochemical nature and modus operandi, and
  2. If we declare the civilians who are being attacked by HIV as casualties of war, where
    1. This war must be seen as a war against the people and thus the integrity of the sovereign state of South Africa, and where
    2. This agent (HIV) in and by itself must be seen as the enemies combatant in toto, and
  3. If we also make the infective transmission of HIV from one person to another a crime, because
    1. It is an act of assault, attempted murder and a conspiracy to commit murder, whether or not HIV is knowingly, unknowingly, intentionally or unintentionally transmitted from one person to the next, whilst noting that
    2. HIV is not communicated other than through means of the direct exchange of bodily fluids between persons; then surely
  4. The SANDF Medical Corps is thus responsible for the protection, treatment and remedification of the casualties of war (in specially designed, purpose-built military hospitals); in order to ensure
    1. The prevention of the transmission of HIV from person to person, and
    2. The eradication of HIV from the population of South Africa (and indeed of SADC and the AU), and
    3. The global dispensation, whereby militaries have relatively unlimited medical budgets; such
    4. That HIV would be removed from circulation with 2 years of the initiation of the programme.

To further complicate matters constraints imposed by HIV include suggestions that:

  1. It is impossible to “cure” HIV because of how HIV operates within the body, and that
  2. Vaccines are pointless because HIV exists in multiple strains and variations and each of these instances adapts and varies (for intrinsic survival) in response to pharmo-chemical treatments, and that
  3. The HIV virus in South Africa is already “mutating” to continue existing by evading the intentions of ARVs and immuno-supplements, and that
  4. This is why ARVs are constantly updated, improved or replaced — so that we are continuously playing catch-up with the virus.

In addition challenges imposed by HIV include suggestions that:

  1. While health education and HIV-Aids education is important, in the end, the only means to ensure that ARVs are able to work (when the holistic treatment is adhered to) is to ensure that your are simultaneously building and strengthening the immune system because HIV corrupts the very immune system cells which are intended to protect the body from infection and uses the infected cells to infect other cells and to multiply into infected progeny cells, and that
  2. This is how HIV ensures that the body dies from common diseases like TB, malaria, cholera, bronchitis, pneumonia, influenza etc because the very units which are supposed to contain and overpower these ordinary infections are compromised. This is why we measure CD4 cell counts — this is the indicator of the capacity of the immune system to be able to do its job, and that
  3. If you are uninformed, if you are in denial, if you are irresponsible, if you are careless, if you are disempowered, then you are at risk of becoming an HIV victim. However, when we look at Darwinian logic, in respect of the survival of the fittest and natural selection, HIV is inadvertently minimising the survival potential of people demonstrating “weaknesses” like ignorance, irresponsibility, carelessness, disempowerment and denialism, and that
  4. If our task is to eradicate HIV; then we have to ask whether we are seriously prepared to deal with the reality of admitting every HIV positive person to an SANDF Hospital, of convicting every HIV terrorist (and then admitting them to the SANDF Hospitals) and of actually removing the potential for infection from circulation, such that this means that HIV positive people (as carriers of the virus) cannot be allowed to transmit or spread the disease in any way, and that
  5. No-one seems prepared for this and as such we will have to deal with HIV for many years to come until such time as the virus mutavariates to such an extent that it causes the death of the host before the host is able to transmit the disease, and that
  6. Currently, an HIV-positive person, who is in denial about HIV, who has never been tested for HIV, and who doesn’t practise safe sex, will without treatment, have 18 months from the time of infection to the time when they are no longer attractive (for overt health and aesthetic reasons) to the opposite sex, in which to spread the disease (and death sentence) with impunity, through consensual sex. After this time the only way to spread the disease, sexually, is through rape, which is a crime in and by itself.

Despite all of these things opportunities presented by HIV include suggestions that:

  1. The implications of evading the responsibility of containing and inhibiting the spread of HIV are such that the future generations of any HIV-infected and affected populace will be born into disease and suffering without any choice, and that
  2. HIV-positive people are victims and they deserve restitution for their death sentence because we don’t have the death penalty in SA except for HIV

Now like so many of you I received an email from Mikey Waters telling me that the crises in the healthcare system is the ANC’s fault. Thanks Mike, I would never have been able to work that one out by myself. I have read the DA’s plan for healthcare and it hasn’t inspired me to join the DA (not that they would let me join anyway). But I will say that the DA is right when it says the National Health Insurance plan is bogus, although the DA is being dishonest about why it says we need to create a partnership between the public and the private healthcare systems.

There is no private healthcare in South Africa that is absolutely fabulous, indeed it is only a handful of doctors who are in practice in the precincts of private hospitals who bring credibility to the hospitals in the first place. These practitioners are experts and they don’t have to hustle for patients like their shopping mall, taxi rank, location and township colleagues do. Indeed if we wanted cheap healthcare we would all go to the GP who offers a consultation, generic meds and a flu vaccine for R50; even if we have to queue for three hours and his practice is in the bush.

Further to which given that Medi-Clinic was founded with money from the tobacco and liquor industry (Rembrandt), that a Netcare Hospital in Durban was being used to traffic human kidneys from Brazilians and that Life Hospitals benefit from the near cartel which Afrox holds over the fizziness in your soda, it is clear that while healthcare is a virtuous endeavour, the vast majority of regulations as promulgated by the HPCSA are intended to prevent unethical conduct on the part of the medics themselves.

And has the DA realised that the difference between public and private healthcare is the number of people sharing your waiting room and your ward, the number of people working at the hospital and the number of the unwashed masses you have to encounter? Do they know that the patient volumes in private hospitals don’t make up the case loads needed to train registrars? And that the problem in healthcare is practitioners using so-called “public service” gimmicks to increase the patient volumes in their private practices?

A case in point would be Spec-Savers’ offer of R300+ worth of UV coatings with every pair of spectacles purchased. All plastic lenses are UV coated anyway, and to add another UV coating will cost your optometrist less than R5 per lens (if they did it themselves) and less than R20 per lens (if they outsourced it to another lab), which is hardly anywhere near R300+. Yet people think “that’s real value so let me spend a thousand rand to get R300+ in free UV coatings”. All the while, it is possible for the private sector to be able to provide eyecare at a lower cost than the public clinics — without the gimmicks — it’s just a matter of removing the greed and the monopolistic tendencies.

So, no … Mikey you’re talking crap … in a desperate effort to get the private hospital groups to give the DA some donations, the DA has taken up the call of the private hospital groups and the medics in commercial general medical practice and has suggested that we can fix public healthcare through these public-private partnerships. Would this be like the oncologist from Addington Hospital who took publicly owned equipment to use in his private practice?

What we really need to do is to:

  1. Hand over control of every public hospital and clinic to the medical, dentistry and health sciences schools, and
  2. Create a National Health Savings and Insurance plan which can be used in the private sector, and which can be merged with other Medical Aids and Health and Hospital Funding and Savings products, and
  3. Create a wholly integrated Patient Healthcare Information Management System so that every time you receive any form of healthcare (in public or private) there is a continuous record of it, and
  4. Ensure the affordability, availability and accessibility of public healthcare services by:
    1. Redeveloping and expanding the existing public hospitals and clinics, and
    2. Integrating the clinic, charitable and indigent service units of the private healthcare sector into the public healthcare system, and
    3. Involving practitioners in private practice in the provision of public healthcare services (through the NHSI), and
    4. Involving civil society in the assistance of the provision of public healthcare services (given that God used to own and run all of the hospitals), and
  5. Determine a wholly integrated, centrally mandated Public Health Education Programme (so that we are all teaching the same things), and finally
  6. Improve on the basis of equity, academic credit points and relative numbers, the training, working conditions and remuneration of:
    1. Doctors, nurses and healthcare professionals
    2. Ancillary healthcare practitioners
    3. Associated healthcare practitioners and health scientists
    4. Alternative healthcare practitioners
    5. Traditional and faith healers
    6. Healthcare technicians
    7. Laypersons employed in the healthcare sector, and
  7. Define HIV as an agent of biological warfare and make it the sole province of the SANDF (so let’s have a $5 billion ARVs not Arms Deal)

By doing these things we will begin to turn the corner on the disaster in healthcare and by removing HIV from the public hospitals, by giving the SANDF the mandate to expand its medical operations and to take over as many hospitals and clinics as it needs we will begin to see an improvement in:

  1. The treatment of HIV+ patients, and
  2. The management of the public healthcare system, and
  3. The morale of healthcare professionals and practitioners.

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Avishkar Govender

Avishkar Govender is the Chief Political Officer of MicroGene.

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