Address by Nelson Mandela at the graduation ceremony of Medunsa

23 March 1991

Mr Vice-Chancellor,
Members of the University Community

I am honoured to be invited to be present at this graduation ceremony, especially as it marks the progress in achieving unity in the University, unity of purpose towards dealing with the problems and challenges that lie ahead. In this period of transition for Medunsa, for our entire education system and for the country as a whole, the more unified we are the better are able to deal with the challenges.

The problems and challenges that are faced in this University mirror the problems and challenges of the educational system in general and that of the country as a whole.

Some people appear to hold the view that we are already in the new South Africa. Changes are said to be so irreversible and improvements already made, so substantial, that protest and struggle are said to be unnecessary.

One needs merely to look at some of the statistics for training of the medical profession to realise how untrue this is and how skewed our social order remains in its provision of basic services.

We note with continued concern and anger that of the 1300 doctors produced annually by all medical schools, only 300 are black and of these, only 120 African.

We know that the same picture of neglect holds for the training of blacks as health workers in general - dentists, dental therapists, physiotherapists, radiographers, occupational therapists. Degrees awarded in Nursing education and administration, oral hygiene and pharmacy also reveal that very few of these graduates are black.

We, in the ANC, believe that a democratic South Africa requires not only the enfranchisement of the black majority but the empowerment of ordinary people to take care of their own lives.

But the way in which professional skills are distributed means that knowledge and science remain the preserve of whites. Paying for such knowledge, or not having access to it and consequently dying young or contracting illnesses unnecessarily, remain the preserve of blacks.

Apart from some extremists, there are few people who do not recognise the crisis of apartheid and the apartheid education systems. While there is widespread recognition that apartheid must go, our crisis continues because there is not always a willingness to take the steps necessary to remedy the situation. This applies to all areas of South African life:

-political, white minority rule is doomed, but there is not yet an acceptance that freedom and equality, unqualified by a minority veto, must replace it.

-vast disparities of wealth are recognised but any talk of an economic growth path that includes redistribution is treated as outside of legitimate debate.

-inferiority of black education is recognise by and this is glaring in the case of Medunsa, means are not provided to remedy this.

Recently, we have heard a lot of the deracialising of land ownership. All people can buy land on the free market, but the existing land allocation, born of apartheid, born of forced removals s and other crimes, is to remain untouched. We are told we should put the past behind us and build anew.

This is a very unsophisticated way of insisting that existing disparities remain permanently.

In the same way there has to be a recognition that when we look at the provision of education to black South Africans we start with a situation of vast disparity. Any attempt to address the provision of adequate education must immediately pour resources into the upgrading of facilities, and the upgrading of expertise.

To speak of rationalisation of educational facilities as if these disparities do not exist is another way, as with the maintaining of existing land disparities, of ignoring the inequality that exists.

We know that for some time Medunsa because of its origins has been viewed with suspicion by democrats. But we are in transition in South Africa. Many things are changing, but exactly what type of change results and how we all contribute to that change depends on how we operate in each of our respective spheres of competence.

It is not too late for Medunsa to lay a key role in transforming the present South African health system into a system that truly serves medical needs and not primarily that for the elite of our society. The origins of this University, as an inferior child of apartheid, are no bar to this University making rapid strides to ensure that it is counted as one of those that helped - in its own discipline - building the new SA as a truly democratic state.

This is not just a question of health. It is also a question of peace. There cannot be peace while our people lack basic social facilities, including basic health care. There cannot be peace, while the overwhelming number of doctors and medical facilities are concentrated in areas of accessible only to a small section of the population. The rest of the population cannot be left free to contract diseases without proper medical attention.

We will not allow this to continue and unless there is a recognition that an element of the new South Africa is the urgent remedying of this situation, we will remain-as we are in substance, in the old South Africa. We have to choose whether we remain in the South Africa of inequality of wealth, opportunities, health, housing, education etc, or whether we are to make it possible for this new South Africa to be, one which truly belongs to all who live in it. If we choose the road of progress e have to take steps to ensure that this new nation will provide for basic social needs, including health care.

I have referred to the encouraging signs that all sections of the University recognise the need to break with the apartheid past and join in rebuilding Medunsa as part of the SA of the future, the SA where health care will be a human right accessible to all.

But I think there are some specific elements in this process that are worth mentioning: For there to be confidence in this venture it is essential that the University show the community that its facilities and expertise are made available in ways that they recognise as socially beneficial. I am not suggesting that this is absent, now, but it is important that it be more prominent and be seen to do so. In addition, the communities need to be involved in the projects, in determining what the needs are and how resources should be allocated.

This is not something that we see as being required only in apartheid South Africa. Even when we are free we will want our communities involved in public issues in education, wealth care and numerous other issues where decisions are made which concern their own lives. We want to empower them against apartheid but we also want them to have a say in the running of their own lives, to have professional decisions democratised. And this is necessary now and in the future.

Related to projects, is research. We feel that it is crucial that all research undertaken in medicine be responsive to the needs of the community. It is sometimes said that scholars must be disinterested, meaning not swayed by passion. We feel, however, that scholars must be engaged - actively committed to ensuring that their profession be part of the process of bettering peoples' lives. We therefore consider it very important that research projects be manifestly socially progressive.

The University is well aware, also, that the exclusion of students is an issue that arouses very strong emotions. It is essential that teaching and evaluation methods be raised to the highest level of competence and that academic support programmes be made effective. It is not the fault of the University nor the students that Bantu education has impaired our students' abilities. But it is the responsibility of Universities to ensure that students' potential does emerge and that no step be left unturned to ensure that this happens.

Before concluding I wish to make some remarks on the current political situation. I have made continued reference to transformation necessary in the educational and health systems in this country. In a sense, nothing of a substantial and enduring nature can be created until the question of political power is resolved. WE can begin a process of substantial change but it can only be adequately backed up in a truly democratic state. Only truly democratic state has an interest in freedom and social justice.

We, in the ANC are determined to create such a state as speedily as possible. When the opportunity to explore the possibility of a negotiated settlement came to the fore in the late 1980s we immediately grasped it and set in motion an initiative that has resulted in a series of talks between the government and ourselves.

We do not go into these talks with an open mind as to the final outcome. We will accept nothing less than the basic democratic rights universally recognised as necessary in any social order. If one person one vote is the norm in every democracy, we do not see why the people of South Africa should settle for less. We therefore seek a constitution that is based on the principles of non-racialism, non-sexism and democracy.

Believe is through a thoroughly democratic constitution-making process. That is why we believe that a Constituent Assembly, elected on the basis of one person one vote is the most appropriate forum for making the new Constitution.

The Constituent Assembly would be elected on the basis of proportional representation, so that the support hat any organisation commands, the extent to which its vision of a new constitution is shared by the electorate, would be reflected in the vote. Whoever gets the most votes would have the dominant say in constitution-making and that is normal democratic practice. At the same time this process is inclusive in that any organisation that commands support has the opportunity to stand for elections and make a contribution to the process.

We also campaign for the replacement of the existing government by an Interim government to oversee the transition. We do this because the present government is a negotiating party. It cannot simultaneously act as 'referee'.

We need to negotiate a new government, with greater representivity and legitimacy, which at the same time has the capacity to govern effectively. This government would oversee elections for a Constituent Assembly and ensure that there is freedom of political activity in the period ahead. This government would operate for a short time, so that elections for a truly democratic government can be held as soon as possible.

This, we believe is the path most likely to lead towards the speedy termination of apartheid conflict. We cannot really build much of enduring significance until we have peace. There will not be peace while black South Africans are denied basic rights. I therefore hope that all that are present will join us in demanding Peace and Freedom now! And throwing their weight behind our call for an Interim Government and Constituent Assembly.

Let me conclude by expressing my congratulations to new graduates. You have had opportunities open to few of our people. I am sure that you understand how and that you will use your skills to serve them.

May I say to the University as a whole, thank you for inviting me to deliver this address. May I wish you well in the year that lies ahead.

Source: Nelson Mandela Foundation