Nomalanga Mkhize, Business Day
ABOUT a decade ago, one
of my childhood friends, Michael, called me to tell me he had made it into the
SA-Cuba medical training programme. Finally he could ditch his job at a
Nelspruit mall, where he worked as a low-paid casual behind a shop counter.
He should never have been
behind that counter in the first place. Michael was smart, gifted but had no
money to get to university and, in the adverse conditions of his rural high
school, produced competent but not outstanding matric results. When he left for
Cuba, it felt like he had escaped the social dead-end that was our Mpumalanga
village by the skin of his teeth.
In the days when we
chased lizards on Mpumalanga’s giant rock faces, my playmates and I were
blissfully oblivious of how the structures of inequality had set starkly
different life courses for us. I, having won the lottery of being born to
educated parents, would enrol at Rhodes University, confident that I could make
a success of my life.
But by our early 20s
almost every one of our childhood friends had become casualties of SA’s grim
social reality as they transitioned into young adulthood. In the late 1990s
they were succumbing to HIV/AIDS, alcohol abuse, violence, unemployment, crime,
unstable work, you name it. That this is the fate of that majority of young
people should be cause for panic among policy makers and politicians. Yet
almost all of our state institutions and leaders face the crisis of youth
unemployment and deskilling with lethargy. Who can blame them? They will not be
here to deal with this problem in 2030, will they?
As things stand, there
are 2-million people enrolled in SA’s higher education system as a whole but,
as we all know, about 5-million are basically sitting at home or engaged in
risky pursuits.
Notwithstanding the
criticism and debates around the Cuba programme, its greatest strength is that
it was designed to identify and recruit bright rural kids like Michael. My view
is that the medical training programme embodies that reconstructionist
"RDP" spirit that we seem to have abandoned wholesale as a country in
our pursuit of the kind of economic development that seems to benefit the
long-term wealth of our historical super-rich "1%" and their handful
of black economic empowerment partners.
What was important about
the development approach of the Cuba programme is that it explicitly and
overtly puts the most "marginalised" but meritorious youth at the
heart of the recruitment strategy for our future public health.
It seems to me that in
its very design, the programme takes into account structural inequality and
historical oppression so that it can find those bright black children who would
otherwise not make it into one of our eight medical schools.
In doing this, the
programme does not view these young people as having intellectual deficits, but
the opposite — the fact that they were competent in the midst of dysfunction
demonstrates what they are capable of.
Second, the Cubans do not
treat our students as though they are aberrant, second-rate burdens on their
education system. They are considered capable citizens from the global South
who can be taught medicine in Spanish. Further, because they are trained in
preventative healthcare, the Cuban-trained doctors are going to be a rich
intellectual resource for SA, which spends significant public resources
treating preventable diseases.
While the Cubans see a
potential doctor to train, in SA much public discourse around university entry
continuously juxtaposes the need for transformation against the fear of
"dropping standards". The debate should focus on expanding equitable
access, not preserving historically unjust institutional cultures of
exclusivism.
Third, the Cuba model is
a responsive bottom-up social reconstruction model. It recognises that the
future capacity is in the villages and townships.
Sure, the end-game is we
must train our own doctors right here at home, but the transformative
philosophy of the Cuba programme should be at the heart of our entire
development path.
