THE TB STORY

Inl,clad ","h th, dl...... Aeonunlllw .tirrIa.. I. Ihal 23 lIlOpeq:lIa "'-'" died from IIw d.... inIIw Iat 10 yUIS. It .. c:lHtty theIlUInb« OM IlitIIr 01 ....1... and if;' IIw~l oo..o"on _1",* 01_ '"

""'" """

Tuberculotil ~ e1urty lhe men!.no.. ...... Iri South AlIa lOdlIy.P\ooI>allty tweMy I*lPit • lily die I,omt~ in South Altica. n...__"",., .,.~ • lID lIlO and12lXXlO~C_oIl~uc::to

yeti" and Ibout 10 rnoUton I*lPt ...

The ..I.llon.hlp between dl......nd epartheldHealth in South Africa is politics. The fact that some diseases SOulI'l Alrb I\u riOrb hig..-are rife amongst certain population groups and not amongst TB iIlCk»lIc:, in IN WOf1d and_

parts of South Ame. prObably hlIwlheothers has to do with a long history of discrimination, labour IlIghnt ineldeool III !he world. ISMexploitation and apartheid. The fact that some people receive bo_ on Wnlem CaptJ,

bener health care than others is directly related to the way In it':":~:ac'r....~::':::'-=which the country Is run. The lact that the colour 01 your skin TB without _ Qetling aic:k. ,.. •and how much you can pay if anything plays a role al all is Ilrf.lth WQ,lllf • Im In fllllulat cont-el

with TB ilWm. and car,.,. many In mycertainly politics ... Thereare literaly thousandsol case studies body butI'd probably _alIt TB. My

that illustrate these points but lew so clear and complete as body WOVI(l I)t .ble 10 eOl'lI/of the

CEORIC DE BEER's story about TB when he talks aboullhe :::-:"'~=':~l~l=:::effect of apartheid on hearth in South Africa. ..."~ I.om _ ......Jnutrifion. 00' gift

~ M:II. 00' -. aubjllcleCl to " .....e-,~~00' IlI'W.ic.ltt.... Ad!..~ ....", won. IIC:k ot IlMcl and 100on. my deIwl_ woukl bf..... GOwnand IN~ woukl Ihm lIPfad IIImy tlody and I would get TB III bKtI.eI tor", At IhM I)OItIII ""OUid Itert

C I ~\

-r"~E:Q..e. •.,. !'ION€­

"""N.....e......e. I w..y

bON" 'to., 3 ....":>1

Ibe Fl 1="EIoo'~Q..

< cs'Z...

FOCUSON

HEALTHRead inSide:What IS PHC"

A dIsmal pIcture

ShockIng Stallsllcs

Health .1nd Jushce

MOlamb,can War

Healing Church

Fragmenl(lllon

N('w Slave T.adf.>

:t~~~'ji\' lj- ..

T~¥:· '(i"',==d

STORYtrtlm~. 1 /",

COlMIII'"g ftr>(! oe"t'lOC!"ll .11 l~

(l,ll."e"! ~~'",IlI()mS .nd PlU " on roQI"'" PI'OOIe 11"" "'lNIn~ In~1 TB is a1I'!iOSI~ 01 ll<"'~r'Y l1li' I!Ml!11en<:e 11 you..'~ _11 011 'I.:kle$ nQ1 mIIt~, hO'""'uth V(lU lire I!Moose<llQ Ihe (Me_.V"" a,,, ""Iuall~ ,"'h .....'V 10 ~l lIIedose.owe

A" Imported dl"easeTB "10 f>j!W d'selse ,n "'!nca Thp,,1l"'a~ no TB In A!"CI 5.0uln 0' lr>eSahara tn p,e-colon,al Hn...., Tr-.ere 'Sclo'lI' P'OOI 01 II'll' In &ll,lh A1r'(1I In.e1"5! nul~I'II~' '''''''''951 tile ""'!"CI"·l'<Jp"llll!on prOMlllv 1\II1'If'e:"l!d 'n It>e16JO',IO 18(;(h 'n "II<1'"g outposlS­01"""5 ...11",1' tl@(),,11IJ ..... re com,ng,nlO con1act ... ,'h m'u,on,,"es,1';":1",, In" Dine. essp."ltllllvf"'Of,><'II" co''''''Il! 'le1tloe'ml!n" aUI1Ilol (l"eMe o,a not plea!! I,om "\f're111 IMI SIIl!Jl! II wllS conta.ned onlv"re ... PtrOP'1" got ,1(_ Thl! 'tlle'e5I'ngq"eShCY1 1l00UI 1 B ,s ",nil I'lII'9t'Nl'lI1>111>......" InDll'~ ,ay '30 ve~'5ago

.."" flOW Wh,," I' os ,,/Ch ~ malo.a,S","!!/! \'mv d..., 'I nnlspr,30 DeIO'e.',., WhV hn'l I'"Ce l<Jken 'OOI~

Need lor worker.WMI t>appeneo wn tt>a, polO W<JIOIICO_eo on It>e W'lwa'ers,and ,naDoul '886 SOulh ."oe!J', hlIlO'Ychlp,ged d,amallc.tlv at ,,.., po.nl,and so did lhe hllto,V oIluNrculosl,

AI Ihe m..ws dl!llele>polil, lhe mineowne'l nlltl'ded Iwo 11'001 01 ...OtterlSk,lled .nd unsk,tle'Cl WOlkers. Thest,lled workers _.e OrOl/9hl in IromEu'ope • Ihev we'e mlnerl I'omEngl.nd .nd W.les TI>tl unlk'lleaworllefl did nOI UISIIO Ihey had 10

be C'"'".Th'l wlS done Dy a"v,"9 people oil

Ine Ilnd Ih'Ough • v..'ely 01llchnoquel Fi,stly. Ih,ough I,milin'illhe llInd l.a,lable 10 ·AI,I<;.8"· peoole10' Igrlculture ."d In,OlIgI'I ,mpollng\IIxes whICh harl '0 be pa'" ,n cnhThe onlv w.y lou,n m~IOt,n"WIS to !)Kome. w'oe laDotJft" HUIlun. oolt tlx.,.. dog lax" . lheUPShOI W85 thel people we,e lorceclolllhe IInd .nd Inlo ItIe mlllllS

The lend ActOoe' IIle l",,,n a numD'" 01 II~ _,eIlIlsed '"I"cllng ICC&U 10 lhe 1I'>d.aM Ihese _e 11,..1Iy conaalldalea

page 2

."'" 'eV'MHl Oy HlIt 1913 Llnd Ac::1wnich II'IlIde ruSI mo.. Ihan 12'llo 01Ihi, co,"'t')'·. land Iv.ltable lor'Alrican' re5ldenCII end ag,icultu'e.So Ih" tand became o\lt!!r-c,owded.I••ml"ll !)Kame mo" rl,lIlCult ."0som" mOr, rnIIn we,e 10rClld 10 gOloItIe m,nel 10 !!It,n. tov,ng Th" 'elullWIS lhal Ihe m'flIt ownerl gol lhewOItlo,ce Ihey needtKl••nd ,n ltllllOng ,un lhe wo,klore, i•.."n goltube,culosll 11 il 1C1....,1y as ,impleu thst

The wh,te mi""'1 came In I.om

1ul)erculOS<J '5 last IpreadongIt>1l"''llh ,he W~le," Cape Th".t!'(l'On 's now Ihe ..ea w,'h ttleh'ghe!1 ,OCoden<:e of I"<J d,!jf!a$oll 'I'rne ...."oIe wono

AccOld,ng 10 the d'V'llonllcounc,1 an "'$t,mlled 9 000 c...." 01TB _e ,ecorded In lilt! WesternC/tpe oU""ll 19l16 Thi$ ....as e 3El'IO",>crease a""'" lhe pr.....1OUS yel'.

South AI,ICI hll • f1.It>onll,oco<leoce at 300 10 ~ TB ClSftoer 100000 oeopIe bul CltPtl Townnu SOO 10 600 cues per 100 000people EIsles Rwe" Ra\lt!!tllnlUd.Kauel5.....1. ,.".,.."93. C'OUIOfdI~nd Khll"'l"al'la we... 11,,,, worsl

""015Healltl work.., menl'Q<\el! lhal

Eu'ape W,lh TB.•nd cond,tlonlin lhemln", a'e 1010IuI.'y 'de.1 lor1.,,",m'I'Ion of 'ube,culosilWork",'s were wo,k,ng unrl.'g,oundclOse 10 people coughing UP lhed,sease end WOIt,"'iI If' ,nc.ed'DlyDM cono"'O"1 Bllck ....o.k .........erec.owded .ogethef ,n comPOUndswhere th"V ....., $ltlep,"g lore,allyalmost on I~ 01 one anolhe. Theywe,,,, led 0'1" ma,n mell a day. lheVei,,,,,d ve'y low .....get. Ihey got lick.lhey gOI weak. 'hl')' gOl hung'Y. lheywe,,, una"" Dhvltcat Ind llIycttolOlli.cal ""H, as a 'esutt 01 INllf bc"ng"pPtld oil the la"!! 10 go and wOfk.a"!! DIlSlcally Ihly got IUberculos'l.AO<I 01 COtt".,fI.tly tooll;1 DICk 10 lheIlI'II IfPI One '"elrch" m"nllons

lha. by lllOO Ibou' 70 out oI ....ery 1000 blICk m'n"" ....~ dvi"ll 01 T8.

The mllllllto..d a \It!!'Y almplepolicy,I you gol alck wi.h .ubefc:ulOli1. yOUwer. senl home lodie. Unlonuna'.lybelOr" you dittd you pelHd thedi,ell" on 10 peopte in the 1ft!.. 11....11 II 'his po,nl only, wlll'l them,n_Ork'" liking TB blCk 10 the....'11 .re. Irom which .tley c......""It 'he disease beg.I" to lP,ud.

That In IISI'II i, • cle., indicallonIh!l Ihe p,oceu 01 d,,,,,"g people 01.he I'nd. 01 lorcl"ll men OUI 01

lhe Icute Il'IOrtIge 01 hOuIr"ll ,n lheCaPtland lhe 'null'''lllMtrelOWd­"'g I'll(! a lOt 10 ao ""Ih rtTe 'Ipod$preld,ng at lhe dlle,... The[)eoputy MedlClll Ollocef 101 meO'.'llOn.1 Council. d1 $Ie",a"F'She' said: -OvererOW(lin'il IS lheIlIWI;on Unemplovment .. "Ia.ndthll leld5 10 even mo.,overcrowdiPll·"

• 54nla IpoI<espe,\IOP IIdlSet:lml1nutflfjon Ind alcohol and orvgabuse '0 lhe ClIuSft AccOId,ng 10health W()Ik",. ., Ihll '''9'011.cono,llOl\S did "",t gel Iny Gene<du""ll lhe PilI two ye....no TBcould al,1l be seen as ,ea<;h1P'iJ'Plde..uc praparTlonlon lne C.pe

"'.tg'lCutlur, Ind onlO the mIne•. Mdhad lne elleet 01 de5l1oylng IlIe '''flleeonomy tt crUled cond'I,OI'\S 01poverty and mllnur"'I()I\' cond"'OIl$uno", wI'I ,ch lI'Ie dIsease COUld nlilvspte"d. unde, wh'ch people woulono. hive 'he ",lu'll Immun,'Y Ihltcomel w,lh good heetrh .nd goodnut",ion

In lacl .nolhe. ,nte'esling efleel 01th" hut ,,~ ...u Ihal PtlOPte begln.oI,ve mOle Ind mo'e In lewe' Ind lewlfhull 10 Ihlt lhe.. "'11 In lac. grelre,ov".c,owdlng. So wll'" Ihemin_O,k.r, came blCk w,tto. TB.IheV IClually Ipreao the di.....lurer that Ihev ...oukJ'have " ItI. hutt.I~ hid not been imposed in the 11..,piKe.

from ItM ~Innlng lher' _ •difter..-.l Pill"," 01 T6 in wl'llllminerl. Mot! TB u-. .motlll'twtli'tl worI<.... on ..... ml... .....lound In ,...,. whOM IungI& heelaIrudy Men ~...., end ",...""a<:'plitlle to 'Mo di..... bytiliC lIle. But ...n.n whiM .......dol' ,lo,*, T8 tI"'Y of\Ml did not paa..... di_ 011 to tllelr ...... tn<ldlild,*,. This 'I not ...,pn.lng ..while ml".... rlC~ bene. pey,

"W(lI'klld on ...Iet~ '0' shone.thin. end H..-d In muoel'l ben"clre;,I/Mle_ thIn bllet wM.... ln8dd'rion wt\ltl wOfll'" _. DU..,gl.......ngthy~k....d.~muJNIl...., through tt*I' ahffl

TMlr ,eleli'*y prMledged ~ionhed • 10110 do with the IKt hlltM....,. bcJI..- ne I iecl Itleir apK/fi(::.".... INlI •• Imm;;.I"tl 'MYbfOu9/ll wilt> them • lraditlon 01mUlllnl "Id' un;onl,,,, whichpromo~ 11*. lntefHIa and ...grO\lp of wnll" they 1'1., polllic:.l~ which profKt.cl them lrom '''''_ "'1tI......pIOItltlon that black",In_ uperlenced.

01..,.••nd ..l1heldT1'lII "'I~P 01 TB ,'Id !he wlr i(_Md, 10 our ..xi" hlItOt'l' 8Nllooonditiorl8 in South AlrieIIls 1Oct.ru.t it bKomn • .,..y u.-tul '''ninSIpotnl ',om .,.tuch 10 underalancl IN,...,honufip bell"'" dl.._ end.oel" ... and In Soulh Alrlclapec;JIleally. ttw ....tlon...ip berw.endi..... end Ipllr'held.

It It ,rUllor ,lIl\ellth problem, nOl/ul' lor tubtfculotl,. U'1'00 look lllhedl_ pelt,," In SOuth "'rice~""Iy you wllIllf'CM'N'and INlI by.nd Ietgt .nila people .utfaor Irom

Ithe Cl.... of _a11h and obMlly ­~"Iy they 4ig lheir -.. gr_

rwilto IMIr IMth Orlhayaul", aimpIyIf-. the CliM._ of olClage. al'd oICl.. c:om. ,.;u, • high .1&f'lCi&td IIIliving .nlch mH,.. 1NI1 mew. peop~I.... 10!9'. Tt"r.lor.~ ,..... I'"coronary Cli.._, Ill. c_•. the.rItolrlll•• bule&lly w,..1 are known.. 1Nl ag.......U... ClI_.

Black~ In SOuth Alrk:a. and.., the ·AlrIc... · populallon In~ &Ioow a pln.,n 01 dl...... ofpO"""y. Tub.,culo.l. I hav.....plllined· oe-majork~•• theinltctlDw diM-. lilt. t,phoid.......... ord'•••_ -..eh",,"I'~

.,,'-'!tia W'hid\ c.' ... Gian1\oMwhIch kill. you It you ...malnourithld.

Undilrlylng .11 01 till. la a 10(:1.1conl..1 01 malnul"I'on. In 11'1.l)anlulta:l'. lor ...mp~. 2O'Ilo 10 3O'lIo01 chlld"'n u".,.,li ... will IhOw.lg,..of malnutrillon. Whit. chlld.... &110avfl... from ma.... _ ,..I~

~. but if !hi ~Ud hI~ latoll ....lnOo.JrishId &I the _ liIN__ di. I I I I I 1lecoIM"""bor.. UMdn.... a _'1Ol' blIIl<Il IhIiI Ih"diff..~ In d1_ pan.m. obMIty

al'd _"h on !tie arM nand anddi_ 01 pow.rt) on thI 01'*"hanG. ~I whal 11 eel*l the twoworld. o. SOUlh Alrka. It 111IIJogge"'lId thel _ NI", III 1dv&nQldlnclultNiliJol(l 1,.1 --'" on !hot _hind, and '1hltdwortd~onthe oa- hand. ThIII It ia timply •_, 01 _ paop4e d,o.'oplngI.."" 1\'\In otnIf1" and .. a ~n_ paopIot hi... dirt......1 clI_pall.ml.

ThoI hlllory 01 TB In tIllt eOlJnlryndic.l" Ihll Ihlt if; IncorrK!. Tilt

~_ .. --­.,_ ....... _._­___ "_11 , " PI__-,._Iie "1 t...•----- , ~___ ",.-,a_..... _ 114_--- ~-. " .. -'.',,, _.,-

din....... di·....~_aclU&llythe r..ull 01 the Inleflie:tion toIIr­!WO modIt 01 ptoducdon; Mr­'h. colOnIal c.pilall., mod' ofproduc:tlon which wo I,. ~ g'Id onSoulh "'rieI. and the "....d.tlng,.-ditllribullve. mueh mew. damOeB­tic lICOflOflIy lhll ••11l1Id In the pill. ItIIlmpartanl lhll 11 It nolllmlSfy IhllPlOP" .t. ad...aneinO al dHlIlf.,,1..In. but that beelu.. 01 IhIiImpoMd ptOdueIion modII eoncIl­tion& .,. in 'Cl getting -.e.

f ........_noTBandISOyMBIQIO the.. _ ....., IitIlII lI'lIIJnutritloro.nw. a.. Afrie&n I&ngo";1I thtI....... I'OCl worCl kw malnUlrllion and~ m;ghl toll a lradicolllon lllalll didnot ..ill. Th_ -. t1IN.'Ioo. In

tll'Ml 01 w" or In tll'Ml of drought.IMll tt-. WO not a kind 0' ongolngptoClMol 01 chronic ....lnuttltlOO'l •••1.... .".. lIlOI'*lt.

Not""" po,ertyTO~lhat~ablttunhlir'1Nl It .. I\Ot I~ po 0 any Ihalll .. noIjull , third-"l con"l •~ Ca~ wor"-Ing In thII Cl""tO' had.mon.U.I.d Ihat n whlll.plOp'. hI",llmll.r 1.01 poverty.ItKIH 'amil. which btok.... 8P&tIby I'" mlgBm labOur 'Y'1IIm willI"", chlldr.... with malnutrition I"ma.. 0f!Ifl thIfl lamll... whll:h ""'"maMglld 10 hokllOO'''''' In _ way

or anot""'.And finally Nllo¥d lI'lII••ioIl11d In

.".. ItI2O't and _ Into Ihf lt3O"tIhf poor whI!eIln SOuth "me. NId a...." almlUor pall.,n 01 dia.... 10blKk people In South Ame. lodayThla wu changed b~ a eorwelooa~olllleal p'ogramll'lll 10 provideNIOUn:et. .:hool 'Mdlng. Jobt and a..."illy 01 01"'" polllk:allhl"",. T.....dI_..1 mIIflllonld a.. flOl Ill n,mono.1 ~afllcul.. popula!JonOIQUPI which .,. bkkw..d. Ill., a..dtiIel"'lIId by 10(:1&1 ...."iorwhlpa.

... hII, KOr...llk end pon ..-To conclud. Ihll ..OU....nl 00'l

..-1nIIid and ,..." - it ia noI~ •Ql lion of ........ ,~. 11 iI not jl.-t r.ciIldiIIel_lCII. or Ilrat and II'*d WOtIclIMng logatfllf In _ oountJy. lilt thII.oclal, .conom'c "nd polltlc"lIIruetU01lt lhe! CIIlIflTllne paopIII'thMII/I. In thII SOuth AII1cIn con\eX1IhoM lIIructu__ the~e- 01 " IIlIlooy of c.ob' U m. 01n 'I l1li opp: I 1 ion IInCl of coo lOl11OC,..poitwtion. A hiatory which"" IoundIU '.llne....nl wPlhln aparlheid_.

WhIIn we _ tailing 1IbOuI..1I'...._ a.. toOl IIalng .Ilout pItIyapaMIIid. WII .,. nolllloltung IbOuIII'lIIIKlIhM lOi... .,.Mgrtog&I&d. Wa_t&ll<1ng 8bOu1 IhIi hlltory IhII ...~ In a partk:ul&r struet"". '1"'"who~ hlltl'llll"nd .,.1..... mlgran'1&bOUt. group _ &nd _eomk:q»cYration ... NeIly .... piIIr1i 01~WhicfI_ofeourw,lhMit you .... 110 "'*'9' .... haIthpaItam it ::IC*n' hIIp 110 pI&y COII'Il.'b'c~ wi&I1 001l'IO 11~ 110 .. in.....--

You IiCtuelIy IwVII 110 I.ftCIo thehlllOry and ,.conllruel aoc:Jely~. .C __.:-..- -., .,....,..- -_", __ TNo-"''''

.... -C'"::: -- ., ~.. ,- - -~ ...., .....-".. , ­_I .,..... _.,H_._H _ _ ,...::z:: - "" • l" M.. ":':"_ ., .:. ::'::"101 :.::r-"'--.,-~I__• ·_c:a.e·_!----_: -­_....-...._---_.- --

WHAT IS BASICPRIMARY HEALTHCARE?

The moment one moves in health circles. progressive health circles that is, the word isprimary health care. 11 turns up in nearly every conversation and before long one knowsthal without knowing what primary health care is about one will nol understand thehealth scene in this country, or for that matter in the whore ollhe Third World.

The olliClII delinl1,on rNds " 10I1Ow1:-Prim,,,! he.1I1l c.,. is .sunl,'1 !tullll C.f. ...­"fll.tlfUlfy KCClul()/<l to ,rnjitndu.1I .nd I,rrHij., ,n '11I/comm"",1Y by mHn• .cc.pt.bJCI 10 1_. Illraupll ,,,.,, lullrHf"PPIIIIO(! .no .1 I COIl Ill., ,,,. commun,ly Ind COl/,lIryeIrIlflortJ. I' '0'171I In IIII.,p,., PIIlt 01''''' country) ""./rll.y.ten! 01 ...Ilien Jli.11M "",,/Ius end01 '11e.,....III«."1I1(J(Jeconomic l1fJ"lopmlnl 01 m. communj/y."

.....SANITATION

NUTRITION, HEALTH,HYGIENE TRAINING

-.......,,

LITERACY

ADEQUATEWATER SUPPLY

What I1 he.lth?Whll il gOOd he.llh? WII tile titlt p,oblem the.. peoplet.c~led .hd in IM end II'>ey '11'_' He.'lh i. nOI IU'1 •.,Iu.tion in which. petlOf\ no '''''Ill< .ulll.. I,om • d<llIl1e.h.,l1h ,•• Il.t" 0' coml>'el' phy.iesl (Ihe body}. ""n1.lo1 (th,mind).•nd .ocl,1 Uh' ,n.."",,_nO W111-bei"", In othe<Wo.d. tMy -aid that In O,d" to be hltllthy one I'.. 10 ~...M"thlly, In • tlNlIlly .n.i,,,,,,,,,nt The,.'O,. It I. goi"" 10be lhe 'hPO",'bil'ty of hI.llh wo.~enend Mlllh 1>1.""". tolook ., lhe .oci., .nd POIitICII en""onm.nttoo. I-IlIlth I. nOIIu" • que."Of'l 01 goU'ng 1"'10.•pl;nt., GpC/rI(iGnl .nd.SCC;f\llio", 10 _,."body

I-Ittltlh Cif. dlMt' r>Q( only CO., money it "10 Mod.loIs 01peopl••nd. nelwOf~wilh 101. 01 o'glni,"ion.'.~i11o beh,fI(Jit. Helllh Cl" 'S .11" .lIthl responllb,lily Ollhe Slit•. Beingin.,g.-..d with (he Stile mll'" be,ngln..ol..d wilh poli1ic•.To del'"e, proper hellth C'f' then .......nl work'ng with thflS1.Ioltl. con.,nci"" "'Cl Slit. (h'llhfI'••,. belt" W'YIIO bflngh..,11I to .11 people In Ih. counlry, If the St.l. C,"III1I1""llion. of In .n'fi'onment which i. not ""'/lhy Of ,n whichhUllh CI,e Cln nOI be deh.e,e<I P'Ope"y tIeClUM of. IIC~ 01money, t"nlPO'! 0' W'le' Of wh.t_, th",. lh.~IIwno

11 .11 hsppenod 10 ye......go It I pllQl ulle<l AII\'\I-AII wheree.pe<1.,nd lhOH whQ Clre. ."..., In inlfinltlONll eonle_"" heIIlll ThCI)I d...... UP th.. delinition ItId I declltlliotl 01 topaln" cO'teri"" .11 IIpOI(:II 01 thit definition ... lh • finllchI1leoge Ihltlher....iII be "." eccepllbIe IeYel 0' hI.1tn 10. IIIPIOPle ot lhe world by the year 2 000-

"Hul\lllo, Ill. ~ beClme 11>81' ......, ct'(.nd .11. 'flCludelllle_le ot Soulh Africa.

\

/

_.

Tr>e,. I,e _ very leatne(J dellnitlons wIth ,mp...ssi.. wOIdSll~tiblng P,imary Heal,h Care. 00c1Or5, educators and hIIIlthwo' ...,..a .....l~ lffOIll1 wIth great Mse.•ncIllla~.... tlil 01lime belore 001 '811llte!l Ihal ItMIy are I.'."'Q aclually about.people', programme In which 'i,ll 01 a1111'1ey WanllMlrybody,me.onll'Q U'. people to PIIncipole.

Le". rr- deJctlbe prImary !lUllh ca,e ,n WOId, tllallT\il"."""'" 10 11) 01 usso mal W\l ea" makell. peoPle'S pr<>grammeand not IOmflthing tn" ,'ays hidden in some fund,', andPllIn_,' afl,cln and compute.",

plan gOOCl health 10< III m,ght lOOn gel onto a collisioncoul'sfl wilh Ihe Stile.

The Principle.The pllnc'ples of primary hNlth ca'e 100II O'I!'y gOOd onpape•. Ihey I'e .eal, moral an" JUII. they "e al,o I'ulyCh,lshan bul ,n a coonlry sucn ., ours Ihey arl ra. I.ombeing .uaineo Apal1ne;" Ind an unla" economic syslemoUen ItaM In the way of it

TI>8'1 ••e live keYllhal unlock Ine world 01 prim.ry Ileallhc"e. we will tackle and ,oplaln lllem one by one.

e EtMnU.1 heelltl ,.... tI>ould be prO¥ldHTh" il 0 .... 01 IIle moal ImPOrtlnt prlnclplee 01 PHC. Whalthl' essential health ca.IIS. was <;!ellly outlined .tthe Alm.-

AlII conl"er><;e. H included balaies luch It tile ,,",ucalion 01peopll lboul hl.llh probllma In tllel, "IIS. how lhey,..nPflvent Il>em .nd how Ihey can conl'oI Ihem. Educ:ation.boul hOW to glow lood .nd wh.t propel" nUI"tlon 11. how toQlI1 cll.n wallr ana belic unllaUon. Thlrl II .I lot 01empnUll OIl moth" .I"" Child CIII. ramlly plannll'lg.Immunlllt'OIl agalnl! all the ma;af Inlecllous "IIIISIS. Thlprev.... lIon .In" cont,OI 01 dlilltasel tn.t lie common to tilearel and how 10 t.eal them U well as o'dlnary diseases''''''Inju,lea. Euenli.1 he.IUl ca,e llto Includes the pro.,aion 01e..nll.1 d,uga.

The a,.U 01 tile cllnka where theae servicel lie olteredshould h.... been taugflt to dllllnoae .nd lre.' 1II"".escorreclly. How good and elli<;ient these p'imary heallh cafeWOfkers Ire la the key 10 the Quality or PHC. )

SKILLS RElATED TOEMPLOYMENTAND INCOMEOPPORTUNITIES

IMMUNISATIONAGAINSTMAJORDISEASES

CHILD-CAREANDHOME RUNNING

METHODS~

INCREASINGLANDPROOUCTIVITY

• PHC I, PIIr1 01 , Jwl.nd "Ir aoelll Md __1e:_-'0$HMfl1FO' ""mlfy ""1It/'l Uf. Ihil ........ basic: ""'I'ibutoon 01I'" _11111 WI,l'un IhI counlt)' wiUl • IjlKiI'ic loo::~ on thI- Somaoo.. .r.ould not ,.. .tat _t/'l Cl,. ;...ttlIC8u.. heI..... CoIn PlY lor it For PHC thoI~ 011..IOCIIII .nd KO-lOo. d..elcpm.", _ .. IftIoI III peopeIll... In~ ..y In .......ay IIw counlt)' ~ gootIrnacl. This....... lI'II "lItll 10 ocne !or ltII 80dy IIlI'I es I'"0ICiI1o<Islboul ..tlom 11'" .,."... Befor. P'f""'t)' 1tI'l C".l:In WO<1t'I is _ ..t)' 11'111111 citi~ atIould "' n 1tQ"'I ..y In I""pollllClI.ncI deeillon m ing P'O(I". TII. rillhllO .nMl..th'OUllh Ill. poIillcal PfOCHI. ,h.t ,vlfybody II"'Cat.. ,o~" ...bll IOCGm•. 11 11111 i' not 10 It i. ""llly p<».lbl. 10 bflng.boul • Pfim.'Y ......nll Cl" .yl......

• PHC ........... 1_ of !he hMltIl ....For INny. marry ynt'l tIoI(litalI ha... bftft ltII <naIn l.xu.oI....1ttI MI'Wcn ....., "_ uHCI "p _ 01 ltII ....,lIblemonI'Y IIIll reIOUfCII;. For PHC l1'li tIOapW ItIOulcl bI •IUPllO<1 apl.... lor till PHC~_ IIIll not .". 0ItII< ....y"0Ufl0. A. _ .. 10 IPI~ 11 • recent PHC T"lnIrIConllfanc:. Ifl BrOldl"I'oom ..Ill "Till cl,nlc. IPHCIIhould nol bI.,.. lNIbl11 01 11'11 r.o.pilll. to ...IIiell I""y ....tllC""'. tl'll r.o.plllll I/Iould blCOfTlI tII. blDia. 01 11'11Clinic•."

Wily ttle locul on thesa Clinic••na tl'lli, PI'sonnel?810::.".. tI'IIy eoIl .... to rutl. Ill..,. "'ch mora PIOClIl••nll,"'Y dIli..... ,l1li P'fIeI'C11 ......OC. _. il 1& "IIOId molLTIlIy 1nl'" 1im.11ll hllllh~t 00 I.,.,..... lor InIny mora_.

T"" llel 11111 lI'II Ioo::~ ItIouId bI on rr. PHC clonoc••nIlI"" """"" ItIIy 011.. doll noc l1II1 lI'II tIOaptll....not Important TIlIy ItIoukI fUll not 1Iow up !hili""'"Plrt 0111'11 bullgIl .nd 'lIP moll doclorl.nd nlltlllla"Cl1Qu_t1 _.y I,om _ .. ,''''' .f. I\IIIllIll most.

Rhhly .. 11111 u_ 10'lIo 01 lI'II Soum AlfClf'l ,,""11budlllt I1 'Plnl Oft ...hll COulO III cl• ...., .. po....,lIliv.I'IIlIth CIf.

AIIO Impofl.nl iI Ih •• PHC _,kl<' I/Ioulo III 1,,1ne<!'PKiliCllly 10' ItIIl' lob. in till 11.10.•1>11 .rainlng ll'lOUIO notlUll loc". on IUfIClIon.nll In • IIosplial Htu" .. II.ppen.P......try.

/'

• PHC e.,. thould be m.diI uti...., ....., Ieee.....'OIl. mMn. il should bI ...ltl'lin "11;:11 01~y NO! onlymull II'lI Ie<Vice poifll bI ..ml'lin "'~blr 0i1l1nOl (tillWorld HNlltI OrgeniM_ U)'Il!1/loukl nOIlN1mor. lIIan5,,,,,'.....eyl ._,_y_ aIIO bI abIr 10 .fford tl. Sut tillPHI;~ IIOIt I..".... I,.." dir_. _cc.II. It!'IQ.... INlI .,.,. ItIOuiO be IQUIl ICCIII 10 ttII ......QUlIlIy O! Cl.... n.. fnMns 11111 ttII.. lrill bII In ......,OiItnbulion IInO"lI ttII populllJon 01 "'hal_, "lIOIIrell....blI.

Till ",...,It Soutll Alric:.n 1II.lh 1)'11_ p11}'1 h oc: .,'h11111 prIncipII..mOll 01 I"" hI.lm C_ I.t~ilia 1.1118 .In till cilia••nd "'Ofl 01 it Wllh bell" QU'~ly. 10' "*"it no11'11 ritn

• The eGI'/WI'lunlty ""'., per16elpll.. fullyTtI" i•• bIIK.nd -VlmPQ<Unl princIple ,"",ch InOS1 01 ttIIlllN. __ "WiItI1"" -V bill intlnlionl in prog-... ....u..CIlI poojlctl. ilmUll! It It.bII.c Or, 11 g,,'.AI prirciple.lfor- 6011 nOI ifftlOhol ItlI e-wnunlIy In _ pWlnOng, _

fUf'If'IlnQ _!hIe-ll.llllOort 01_ prOjl(:'l or Id>e.... " ....NnolbI.lUC:CaII. It mUll be tIIIcommunoly·. 11..1111 prOllCL11'lIy......, bI PI" oll! Tllet ....y ttIey ~11ook.h.. it. m.... it """0__ CI"y l! Illtougll. TNI' y hMlmle<VlCN WIN notc..ll. "'Of. olPl'ndlflc:y bul Mll OroeIOp !hi lDolit, 011'"communlly 10 lOOk .ftl< llNlI. to I"e .pp.op".rrresPOn.lbllily. Ill. Plrt 01 ttle! oemOCIl,OC prOClIS.Il;, IIlfl otSoulll AI,ICI·. lutu...

COMMUNITYPARTICIPATIONIN OEClQlNG ONAND SUPPORTINGPREVENTATIVEHEAL TH PLANS

'"

'DU''''DN '0'PARTICtPATIONtN COMMUNITVANO POllTlCAL LIFE

To InI"!tII1 prirw;;llIe -or' .. 1rlC1ly T"" on"Ol._,~ofttII eotnm_y can be ...,.,~.... it" "'PPIf1I on _rlgIlt ....y It can .110 bI..,.,~if'gI,nonlyl!'ll"t1.ItII!IOwId 10~I ttIIc_Iy In 11'11 ....It.... 01 mec.noc. It "". 10 CIO ...ltll .,.. image 11'011 r-ryttwno 10 CIO ..I.......IIh is up .""... too prollSlionrl Ind OUI 01 'IICII lor I'"oldinr", PIf'IOn T... ,,,Ul/dIl. 1111 OOCIOr .. God.no IhInu... m. dlsc;p1•. 8Io::..... ollhll m,th .....'" oll.n '1111 upby I'" ....nll "'0"'" I".mlllv,.. 1111 communily ,.ncI, 10pu," t""i, own mOflIllUCIIIll PIOpl. in th.t dtrlCllon.no.... _i.io", 1I••n 'nd '1'lI Plfloclll.1Ion IS nol'/uly lhll.. in.....

ConclusionSeicl Or Erich 8uch '1 • ,~ NImdI confef'enCl. '""""IpMklng .bouIlI'IIlIlCl/iCIlion ol prlmlly tIIIltfl Cl.. on till-.a.lllll tIorneIanos ..,.....)'1 01 "'IITII Cl'" In " .."-IIntl1 0011 /lOt "'"' '1Mdr,,,. 01 .,.. PHCIPIlrQKh.. T'" ''''' !eMu'" 01 m. PHC 1PIl'0ICh ." /lOtblfng eor'lClty IPpliIll .nclltII t ... i. lICond cll.. Till. il,........11 of.n unlull POIi.lclllyll.",. one 'hallllfpal""lldoubrr Il.ndlfdl. blockl .dltQu.rr .oclo-.conomlc<lI...lopmrnl .nd Ill..... 1'lI.ltll ""'k:,. such _Ig.."IIOII<eII Ihl! 10Ci1 ....1111 _ft...... torCIll 10 I.bourundor unlCClpllbII O::ondmon••nd I'" poor .....jlKtect tod;g dllpe, InlO llIIif ....ply ooo::ket. Till.. c"eum.Ilnc:1II\IIIll IQ bI Changlll -

01"",,,,,, words built Till ..IIU.......II 0.. Such _10come to 11'111 o::onclullOtl 'rfllc:tIId In lI\.r fNI at 11'1•• __ol~"""" 0

HOMELAND REALITY Tne "I""""" .. _ WGt.. by in~\llIeml,n'.",nce ollho!bO,e_.

T.. M~" o.'lrlC1 01 G&t.o......... .. on ,1OIf,1t(I ,t.IlInd. m_ybel_ Nelwru', • ..., r.,'-l. Gal.nkul... (>1 Cou...... .,... or~--""MU HEALTH SERVICESMtlal. nu 152 OOD _'- le""" I>y

• 0... 2liO bed ho.ptl.1• 11 pe<,pt>er.l cl",•.:. III,'&d by nu,",ng , ..It'.• one /nObile ClinIC

GAZANKULU HEALTH BUDGETIn l!1a I '''~ ".,.ltn b"d~t lor 'he who" 0' <>-.I"k ..l" I"'" tUl' theMtW. 111111"") ..... 1 ...,11_At In,. t, 'M 'unnlrog Costl or tile J""""nnblJrg Gene,.'Hotjlllll "."" A&o ...'11..... pet yur

ACCESSI81l1TY OF HEALTH SERVICES• Hall,,,,, peopl, ot 1Ml1I. I, .. mort tnln 5 km 11_1'" nea,."....llh I ".,celWHO ,.com_tld_l'O" " I... 1nl" 5 km)• T'nll ....lo hoop,tl' " t"" ont~ "01011.1 WnOCh ..,"" 110,._ ....Ioon• 10 1'" 01 hosp".II<lm...lOnl com.l."", only 8 ><I ..g ... ,_cloon' to ,.... ",,"oHJI. IhOu(j" Ill" I>OsO,ll1 ...... 50 .'lIagft• ~I' who 10•• In n.HghtloUHI''9 Lebcw. ",ay nol 'l" 10T,n,....,,, •••n ,t or 11 cloM' 10 Ih." .'II.~ 1nl" In. n..'ulL._. nospot., ano .ICI ,et..

TRANSPORTH'e'e '. no "'" "t.l<;ePeople 'ely on la.., 10 gel 10 Ine hotp'lll~ ..es I'e ",g" Ind mos, ~ople con nol I"o'd l!\em11 COI'" 8Oc: 'e'\I,n f,om ,ne nelln' Y,III\lIl'O 1111 nooP""lndA,O, II nlg"l 11 ~otlt A16 ,el\ltn 1'0lIl lne 1\I'IMOl Y,lIlg<f 10 IMnOW,llllnd Aeo 11 n,gn,

WATERTne,e III ,65 bO''''''''es ,n Mne ..One lip fo, 760 jIIt09Ie

LA.DTne,e Ite '2tI1leOll1"IQ\llre kmV,ijages Ire clo..ly 10000ItIe, 10 ' .... '" '0 1"",'eGlccesl,a ..""One plol 1I IbO\l' '/, Hee'lre wll,cll '. ~Iel"f InlOeq\llle '0''\lbI'"lIney

FOOD PRODUCTIONTney Cln·' Il'C/dIJC••nO\lgn 100(1 on,,,," land PtO"o'o<leGlnd InlydO nol "".. enO\lgn tnOOl'\' 10 Il\If '00<1TtwI ,el\lll ," tnlln\ll""onAn I.eflgl Ilm"y h.es on In 'neome 01 A~O 10 Rf;S PI' monlllTho! cool 01100d I,om lne IOCII ....1lI''''"'k.''in'IlI nornelln(lt .."'110 mOfI l"ln ,n 1nl Rel>Ul>hC

. , .. .,.

WHAT OTHERS SAY•••The Ob.gcle.

··WIlen we asked the plooee~

of rural health programmes wevisited in Latin America whatthey $IW as the major obsta­cles to bringing ellectivehealth care to the people, themost commoo replies were'doctors' and ·politics· ..o ....... _...w _ ...

Degree 01 humlllly"It may be that the success or laltute ot the World HealthOrganisation's campaign to achieve 'Health tor all by lhe year 2000Will hinge on the degree of humility exercised by 'prolesslonal'healltl workers ,owards their primary health care 'colleagues' in thesuccesslul development 01 balanced health services which are.vaitable to all. In most countries Ihe introduction 01 primary healthcare services Is like Irying to riI a lower layer Inlo a mUIIHayeredcake. It'aces the problem 01 Intergration intoa medical system with• well-guardecl hlererchlcal structure or prolessional dominationWhich must now provide lor the upward mobility In skills. rankingand the rewards 01 a new class ot worker.

.. It would be unrealistic to suppose that every primary health careworker will be content to remain so until retirement. Many will wlslt..10 be~ome 'prolessionals' themselves,"

_ McO....,. CIlllC

.... 7

HelUh Ind Ju.llce··Health can be relaled to jushce lhrough the concept 01: Whateverhealth services arenailable should be equally available to all unlessan unequal distribution would be to 'he advantage 01 the leastlavoured.

"Th!s application 01 just,ce 10 nealth care has proloundImplications for the allocation 01 resources. the design 01 healthcare systems and the roles 01 health-related lnsstltutloll!~".

0.._ H.•..,....

A CASE STUDY Hanover is a town like any otherKaroo town. Nothing specialabout It except that It lies right next to the main road to theTransvaal and travellefs can actually see pal1 of thetownships -the wood's too flat there 10 hide them away. Justanother dorpie one would think. True, until maybe one hasread this case study. Crisis News did, and in April on lhewayto the North we turned off the N1 to see if it was all true. Wespoke to the people there and found that nothing much hadChanged since 1984, the date of the original report.

A DismalPicture

~"·-IUtJ.... ,, __~ ..,.. E.... ....,... ." ..

id Cam '81'~ ..... 11044.1,Md .... ' ; 1...IIoIol,,"",~iIlApl1'" n.r ........ , ctllJl..... ~laMIoI'l.. a I ."pt' """_"'1 Dfl ......"c' t ....

__ •• dI_IlrMf --,I);' ., ......wtlIIII ... '-t It __mad -r.....,l', , f lIorp".TPleN_1'Iuoi8 f of. • ,. In ..ft.. " III III .' IoufI..-HaI'I(Jrt8' I'Iat no hwp/laI and no~7 doclOl'. UrIIil -e>PI'O.um.'-I)ISI.. INlnIha ago u..1'I..:l~ no IOcoIIlclinic 101" II'It p"1_ 10 ~,.. and.nUIW from Cc, bel, ........:I~_on I pen-Iimll bQ. Ahhough.permIlntn! "UrN _ .... by !tieHealth~ In IwguIl 11lll3.I...... wu no Mlequate bulkling l/wIlcoukl _ as • e!inic, ThoI munl.clI*ily was Io.eecl 10 \.IN _ of !he$Ul>«oi......me hoo-. whicto lKked ••U'>e neceulIfY IlICiIiI;e. and -.qui~

menl. The building In.II eoukl ,.....been LlMCl ... dinic InRMd~o..teellhto n\ItM lor family pIIonnlng - •NMce wfllc:h hlId alto only ...::.,,11,been elLttllitn«l (ThoI clinic 1000y""i1110c.r~in • "00..1" ,,,. ..irdotp~QUI~ • dlSI.ne» ',om IlI»f;iflly IhfIll«. ,_nshlp - EO/lOt).

The (Ii,l,ie! ~tor I,om Richmond....i1. Ha_ twice I week 0l'I r ....·d~.oo rhurgys..... it .ubticllt«lby !hi munlc:;I)t~tyand • COt*IIlallorlco.b ~ (rh~ '" ".<1 trlOI'e ,/\anrJ04dIl«I by ISI68, 'hough rll, ._.Income pe( ~hoId fl-o h¥dIyri...... Edi/O(~ Another~'romDeAa. viJib only once I _~ ons.'l,ln:l.lys and d'l8ffjIM R4 ~, COI\I.lII­lalion .. he ha I wholly priv"._I

-verY "-ople pr..... hom in ... 01I\ew'Ig 10 pey~ ..".._._!MyI\a'4 _ eont..-- ... him IIfId It*:• not wiIhouI C8lde.

Aa aup. Jaclo: put it: 1 dO not llIO to"" ooetor lrom Rlch'ood mot...... "*~ pir* ".1 ' .........-""''11 iI..rong with~ IiIOI'Md'l06~ leg.• ell-. not man.".

AnlI.1Nd'oer said: 1 ..... P"lIIO1Dr'l Mos" (Or) FWlWiOlMmour .....0".' -...cl in. row IiU e-_ in~aurvrr lot~.-

&..,.... ambsll.ncaTt..,. is.n .mbulanQi..w::.. but nohospital fV.", .,."."..". Mleordittgto ...tHHnff - EdofOl} 'n caMa all_~V !toe petienl hu 10 be..ken 10 Richmond - IIboul IU MI• ••V - wtIe<. !he d'SIriet doctor it'''IIonecl. IM hot le Itlen only .1UlUln U..... IHYlng !toe nurse linA;ehmondlIO lite hotrlnltieM'bout...nert 10 Nncl Ih. I08lienl. OTher.......,,-.cln... senllO De Aat .bouT61 km ••IV as. lloelor it eons"ntlyon duly lher•. AppI..nlly before Itlenu," Ilfl...-d (In HanoYtfl 1*19"hid to lIrat gel I*mlaalon 'rom !toeIf.unlclp.lity betor. Ihey eoukl hi...n .mtlullne•. Th. people 01H.fIOV'I' __ Ihus lotelly depen­d.nl on the judgement 01 municipaloUleltl. aboul the ..rloua_ olIh,'r ca... 11 Ihi...a. 1'10I ~sitlle

because 11'1$ ImlHllanca.lS unlVlII­atllt (11'1$ ambul.roc:e drhr., I••Iso lhotIOUI la~1 .nd POll drhltrl. I Clr hU 10tit hl...::l 11 .~traordlnary prk•. Fa,...mplt. 1/1 lnhabllanl Is charvtdA40 'or • ,tlUfn Irlp 01 83 km 10Mkldelburg .nd Itle Ia~J 10 De ....,.81km c:a.1I A:JO. (Thal."IIIt", .110lilt.. /.,.. h.!w"ISln sharply since •Edilor).

lIoneeonskler. lh.IKlthat4ftollilt respotlOents um ltsa then A50.

monlh IIId aboul :lft bal_... A50end R100 I fIIO('Ith.INon it it ob.-Ol.thlil people e.tn lind 1","".1_ In,,"'1 diffieulTV lpeyin; lor Irenaportl.

0 01 POfarty

HMI G 6tl;necJ by lhe Wortll Httlt"Orgtnlulion at a ....11 ol-~, _""11ptlyaieal, mantel Ind aodtl _ •bting~ "one conskltR "" -blKk-

,

po()Ullllon 01 ..._ ~lng 10!he erllerlon. I ftIY~ plctu.. 01!he hMlth .tau or !he~_ \IN- '"'" prM. 0GeI0f in. britIlInlliMew~ thll .,., of !he111,__ anIOnD~ ...cl vwyyoung ehlldren in ...mmer it 1l_1fO...tl<'lll.... {U,ullly d/,.etly rtI"", 10• ** 01 elMn w.,., ,vIII.bM.A«OtlJino 1'0 rMldenr. rN _,.,&/r....tIonolllllU. -..It .hvldfulol0I.IIUdIt ,.. ItX rN ..Ilde 01 rN~ i&.1iI tne_ ·fdilotJ.

Thlf; _ conli"",.d by !he dl'lrid"",..: -S'omach probl_ .... _ 01!M m.lln IlIn_ .ttM ~nt".

in win•• chlld••n ..,1I11f ....JnlyI,om bronc:hllll. pnaumonlf; ..,.,QItw,II."'Il probNme Ilncl!he clooclOl"ItllId tnal Iul*c.uloeil it II~I •wld••pr•• d eondltlon In Ih.~.,.Ha astlmatad tr>al ....,.,_od 10 Ihlld penon ;ain_••.,.

°lnleetad. Thll .... eounlatad b.,. ItwdJllrlct nu,.. In lIIa, I.. cual ...."'1Oan1 .1 tMI llm. IJ.......,., '9&(1.BUlthe did q"",111y her .tlt_nlwithIha admln'pn lhal_ X..,• .,..oIlNeommunlly _.1IiII raquirad 10 truly_Itw_"~of_pjoble....

R.f".. it eoU«:tadln .n open eart.tIlChed '0 • tr.c,o•. TtIa bucketIytltm or .._. dllpoHl I' notonI." polentlal lth hiWIrd tor thernunieiP*lily won concemaod. DuIlor ....c_....ty .nola.. ,1'oIy... hancl'Ia(l .1 the hot",1 time 01 thf,.,.Women tutterWoman ","la, motU., Irom Inlllm­mation 011.... bI8ddtr which OCCUI1lmora 0Iter> in win•• and !ha......eonslder" numbeI1I of ea_ 01paMc: and ut...... aw......ta. 8aeau.."'illad madlgjl ..",ica If. not "'ail-• bIt immadl.I.I., on cal•. 11 CORti ......",..,tl lhe" J••tllI .n unlralnad.Id ... ., .om.n con,ld ... c1IUltlclllfllty quaWliad ... midwif. by"'100I'I of he,,;ng I)OmI c.h~dren InCl,"pariance pthlrad thrllUll" IN.,..... Sh. I1 kno..n .. Ih."uO.dv.ou·· (TIl••• , ..11"~Iiw ,...,.tt. abouf ",.1r.I:IiI;on.1 tIIrtll .n.oo.m cllarly1hOw. W..,.mbOI. on,Ile ';rM 01 rile....lfC"".. Till communiI)' III1If&POl' ltigllly ollhlll .orrwr~ ..".,.w. .,.1I1d '11' 1O..".Il;p.. TM~ """"""""ty -.M 011...ClII HlIM rtelp oI'hI bfrlll .lIl1od1n1from rhl nafpllbouri"" tllaek'own.lllp • ftl//Ot J.

Bro6ten hon)etM!g...ion lIr.klfblldl r-.ull' In un­Itlbll andbrok... IloomM.Womtn ...lit! behind In • 1111. of InIKurily InClI.." (whllI ...... 'ry 10 IMf! _mor'IIY.,..".... Ef1i/OtJ.." par...tIIIac:omI H".ngad oItan Itw mol'-alonl ha. 10 , d lor !hi 1.m1Iy,"'....ng no m bI.. "",ouel'll'd.Mental M.lth I. clOllI.,. .el.led 10aocill WIll tiling. whicll In I~n

dIpIIllI' on poIotoeel and ac:~_1Of. con.·dering!lll1 3'" oflhaIId)ouf 10":' qulllionIo:I ....... un­....pIoyId and 48'- _. .aming.....dIr R50 a month. 1I " "';CIIn, till''M p........... 10 .u",IvI" le....... / TIl.IMWI'IplO)''"'"'' ..,. IlIt1 "KIl«I anunoItIC'" es' oy IliI88 - EtII/OIJ an.of IN' moIlltrikJni obIenI.borll w..I".t n ou. eomp".,nll ....commor- 1tIglng ',om mild ...._dilor'Cle" '" tot.1 bralk-down.

AlcohOl end pro.U1tullonPradiClIb•., .lcohol playt. major rolenot only 10 ....ppon • vary~...i""omI (ptOd«;"." end UIHirtg - 11111Q-g1/td '1/IJOfr• ...m.... ·flll/O(J b<.CIS • main. of makl"'ll !he po•..".$lll/oItion mor.tolIr.~. ToqllOtltnlrninist... 01 tnI ApOllo/le Churell ­-ht till poor (m.nl drink to 1111' ....can lorlllt hi. pcwerty".

Poorerty and h"ng... .... .lllged"to 10 ctmI 'fOU"'Il 0irtI into Pf'OIlI­lution. WhIoIl eonlllilCling linnI pitdl.."ta _ IN' town 10 work on rOIdIor .I.cb Ic.-I cabin, one ~ ­young Ill,. ll,.....,inQ OUI 01 Iown,II'o'ing wtIl1~ work 1l1nV', par­haPl "Iralcklng- Mtll them lor _t1m.. They .IIurn hOn'Ia pII.,IicaJIyInd mentllty "bumt-ouf: -0... it'191-""": ttlIloCIII ..y.

Ioc'" COIMlIIoMG1clll'el!'I, eondil~ In ..._ inIM IOClII .1I't'ironfl'llinl. IUCl'l .. bII:Ihou.lng, Ino /mpro ••m.",.1I.,_",r line. IllfU. ucePf lex.r.,II,r luou.lou'. n••rly .mp'y

1J'<OPIli"~c_" Iw<IIIn'Ile centra 01Ill' 'colourld' 10.".llIp. ..Il'clldol",' ...... IIouII 'Ill dllllC' Ed;/O(Jov..c.owding. lIek 01 p"y.'c.1.m.nlli'l. 10. Incom••nd""hl1llnlc: pjlCuc.. c.,..d throughapa\tly o.';mpfy.1IC:k 01 rftOIloeK.,.....'.11 InCl ...tltn IhiI tow lth1IIIu.. Th. dl.t,lel nu .empt\I.IiMd t...., ignorance WI$ •major IlCtor. She pul it lortnriglllly.··Hull. (Ih. plOp'" " .. Ile.ngnondMldablwu...,n nil." (WIlIn...ItI. nobody In tII. communitycould _bar 'Il)' 1!:Nt:,'lonel"...._ rtNf on ItNIIII malf...._ fM 1*11 l~r)'NfS ·Et1IlOfJ.

IblnutrlUonAAotIIII elUlIIr of 11$..... concatt"malnul,ltlon. SII.p1. lood. 0' thecomm"lIlty .re 1'i'lII1lI PIP. bMn•.tw.-d .nd eotIIa. f.1Ih ....tlllIaIand truol ar. luJ.UriaI lor wt'IIcft _hit 10 pIi., higrl pne.. ~ .....,. IIHy tor Yi&amIM InCl bIIanc:1OdIntak•• ThlIIIKtlof poorcllatca.lIl)1_In l.... phytlq... olcl'lold.anwhO_. lithe. IlnIlllor "",1'1IlI orthlnwith b1c.lId It_hi. IT""._."ill • Il""'~ 01 cJoIIdrttl wIIllfhjdittdolplt~P" I Kin''''fdi/OlJ.

" If; no! IIct-"olOg.,. or bIttIIr tIoeW­1111 .1Ona tIIIt ...... 1:toId ro"rldHanovar 01 I1I he.JIh, but rather tilltl:.lbllIIullon of tpproprllll 1OcI.I,POIlIll:IJ and .eonomic oondiUor..o

-'

SACLA HEALTH PROJKTSGrappling with e CIIrlatlen epproech to Helllth Cere In South A1rlceSacl. Health Projects originated In the South African LeadershIp' A.uembly (SACLAIConference in 1979. A number of people felt that somethinQ posItive should come outof the conference, and to that end a health clinic was set up In CrosarNds. There havebeen many change. over the past 9years, but Ihe Christian basis and motivation tor theproject remains central to its whole being.

HMJItt-. ~IIOn..... rllol ...,.", ,.,..,._-,ds.:..._C__-=II

11'l11l1ll. the dlnlc: _ ~ toclc-.during the ='$~)Il!~c:onIict.and in JanuIry '.7, .,.,. muetl...-..uon .. i' ."IQ. s.d.I 1ItoPlojM:b _ too",..,. TNs IOW 'eo ..' 01~ bMlc hMnPIll'ojeaawil. • '*'v-c- C*l... 1or '*"'k"lClP«'cNldtM'; ~I c:IiNc:a and • com­munIIy ....1Itt won..-. 1CHW) Pf&"jItc:I. n- pooj«:to .. .-.nea .". belieI'll'IM from I Cl'wiatlM pelinl 01 .....~ la ITl<Id'l more 10 hMllIl 01... thin• Illl'lp'- eur,ll... ."';c. wh_petiIrlb .,. IIMIed 101' their ptIy*IllCOt'ditlon wiltlOUI f9td lor the .mo­IlonaI, toeiIII. polilic.lll .nd ':OllOlTOfcIUtut oIlhe 1Mi-.id...1or community

The CtlrI.llan Mlu" 01 s.cta He,nhProject. la ..idenI .c I number 04........, ........... '#rill IOOIl 81 ,b oItr­_.Structurals.c&. .....1th P'tottel:llallt quill 0.<­Iy undw the~ 01 .. ehurd'l. I1it,~ 10 .. ao.rd or t.bIoonof IN Anglican Churdl ICPSA), and~ o..TOliO TuIu it tIWpelJon. fUl ...... "O..... 11001".'11coomomin..~ boItI~Md chuldl .-pi I It.I~ W'Id ...." ... poOl'u''ng ow.......

S..H A"'Uo",......... P«Ii«t fftI*U lhe humlIno..,...~ience ..cl tilt, 01' •• Indioriduab

rnoo __ ..... '"ll ....~ I

I.... ;0 no I'Iierwd'lleal .UUCI.... Allwor..... ...... en equal My in a'decitlDM wtllo::tl .... mede. On .....Irldl"""'" ~UM !heR 11I10-..and l'..nd ip llet>IoMn lhe m"......... an opm J,JMCe IOf COMrotltII­liofl The .lIIt1' ar. I,.. 10 'orgi", and"""" OIl, "Ofrnlllly wilh ,,"UCIl lir;g­Ing and ,-"",hi...

Crttical .nalyal."The church', ,oIe in eachplace I. 10 clarify the melning01 human promotion and lovelor OfIa'. nalgbou, in lerm, 01health. To do to. 11 It neelS­ury 10 make a crlllQI analy,i,01 lhe praMnl ,ltuatJon 01community health, the Image­hQrll.Qfl 01 QOlII,nmenl poliCyand the lmage·horil.on 01churc policy",

0.__= ' lAO' 'I

Foc", of our ConcernAll peopIrI need aoaqutl. Ilea""Qq

Whid'I..-nIll\at "" projecl_ be"...., clNI' tbouI lhe 101:\,1. ot IhtIr

coo_n. Tht' .t.Iff ... led b)' the........ Of Jefw who JocUMd hiliIima end tow 011 the marglrwlilraclpeople 01' Plrlefllna FOt!hllf ,_en al1a"'pt I' "*'" to plooiOfr _c... lor In. ........., W'Id -"0 IOfIIanclicappeo ellikken. both 01' wr.omwill _ be .oJt 10 be -.ducaltd,hOld d-.. jobs. be 'Il....1 Iuda.. OfmAk•• 'IlrMI conUlbUllon Iotoelety.

The 'Spacial Clin!Q'. o..ct al NorwCto"'C*:I. e.".. lor"""ty peop.Iawith etlronlc eondlll_ fllC'll .. dill­baI••. h~nen.lon. t'pileply and..1II,,"a, The ""pha", " on educat­In'lllM'09l<l 'boullll~' eonctilion. tolhallhey unOt..t.Ind and ... tblt toIn"g.." 11I'1 diN'" and 11. prob­lem. In,o their ....lI"I'd.y ilia.

TUlng P.uentl sertoualyIn mucll h••llh e... the petienl illIr.\IICl ... htlpl_. p......., physi­cal "body"' Wilh the C/'I,i";'n unCla'­lteneling ot toClaty, pao,pla .........eel a. in,,",,,,,,td belngl and. being....lthy hal 10 do .,11I the In~l­liofl 01 pnytlell and prycnolOilic:al-'I-bIlng,~ ara ~IOfa in­'fOfwd In 1IlI'ng ~ibilily IOft!'lai, own hM11II in Of'dar 10 CfMledignity and tI"'"9Ift 'JlI'IIfr I""" 01­~

Al ll'II pI'lylliol -etY .cs.y-earecentR' in Sit. 8 110 KIIIyeliIIhad'Iik!'en wtIh ph'flic:al an<IIOf mentalIIandie.IPt _ t'M!II<l Time .. apenIwill'l ..... dliIcl..n·1 0'I'I0ltler I d'­ling I\\I<t Pfotllarnl. lhei, d\iIkf,conclIillon Md tulure potofnWIQ WIllIf the dlfl......t ••yr 01 c:opi'''Il. TherncMIlIrf ",n the Ctn.... and /NU thadIelNonI. The tlrengltl which In..nu 'Il1IIIn I"""" e.... be ....own in lhei,prttlclpatlOll in , _vino cooper..1iIII.1'Iic/llOfbllll In"" 10 Mm _-,.Community Bued HealthF,om • Ctlri.II,n p'''P''CIi", 11I.11111""" 'r' _n 10 belli. '1tf)Of'I,lbi­Ut~ 01 111I commllnity Ind paopteIIhovId b. lllo_d IQ dlICUff .ndhi", e My In dlCi,!on' """dln'll'hei' own ....11\'1.

Till CO,,"mUl\lIy H.."h Worlle""projKI 1..1"1 'ey' P«lPI. Irom 111Icommunity 10 be .... I!to worli:•• rncI10 1IC1lItIll c:ha"ll'l fIl thlir eorn­munlty In e oornmunlty fUpporti",

prog..mrnl .."* !toen en opprn-_,.

11... one. So I... 11 people In Sill BKhtlyellllh., 11 In Ne", Crouroactl.nd 11 In li'IlI rUl'lltownl 01 MontlgUlt.nd Mhton h.... been Tr.lned,

The community II Ilrll Infonnedabo<.lllhe CHW project andlhey thindecide ...hether lhey ""1'11 II.nd wtTo&hould be tr.lned, The me.1 Impor­111'11 role of the projecl I1 10 teKhpeople In the commu.n"y hOW to behllllhy and hOW to pr_nl Illnesl.Through their gra,,'OOII wo,lI ...Ith1Ic1l people Ihey become aWlre IhltlII-heltth hll underlying ClU_ ­urwmploym.nt, O'ifIrCroWlllng••nd..,owerty, 11 ttlerefa.. becomes prior­Ity for t/>em 10 belnvot"fi! in v.rloulcommunily d.v.lopmIlU prO;KtlIUCh 11 crKhlll, or Mwi"lilgroupl.

BrCMMI.r I..un of H••lth.nd SoclelyAllhI recent publicity gin to TB hllIhown ve<y cle.,ly, tl'lere lire fundl­mlnlll Ilnlrt ~t.....n ill helllh .ndlperlheld. Speaking out Ind IctlngIQllnll ,he Immoral Ind unju,t w.yIhll money II lpenl on health InSoutll Alrlca 11 pen 01 thl Chril,l.nwitne.. for julllel.nd plllce. Alllheprojeell "" community bisect. .ndtherefore .ccnlibll 10 thON who I, ...aoml dlll.nel ..... y '.om C.peTown'l IJ\OrmoUS hQt9it.ll. TheemphlSll ;1 lunh... on primary, pIe­vlnlltl... he.Hh Cltl .ncl no, onapecl.lll.d, I.penlive cul'lti"e M',vien.

On. 0' 'heir dacto.... Ivan Toml,1'111 refUNd 10 ClO hll mllilllry servIce

Church end MHlclne"•.• the Church and MedicinehIve ,,[ too mUCh in commonin the way 'hey understandIllness end dlseese and sin.Bo'h are p.OOlem orientated."

Rev Or Peter Bellamy {U.K.)

..... 0.__"" tu...)

In ttll SAOF. enmlnlng hla IInhbel.....n 1'111 work wilh SACLA Inclhil ClII-up 10 theSAOF, he lell Ih.IUa Chrilllan he illId to "IUNtO jIInlcl.pate In the "'''nce 01 an .mmQf.l.nd unlull regime. HII llklUI wi1l begreatly mllNd fo. lhe 21 monlhlhellIn prison.

Although Ihe project ....y otlen 1111snon 01 III own vision and gaels.ndm.ke mlltakM, Ihe 1"" .r. conlln­u.lly Inspired by l!le eumple 01Chrllt "'ho Clled 1o. peopll .ndhealed lhem. Pl'ly lor thl projects UtlllY continue In Ihllr ...ork to conti­nue the mlnlslry of Chrlll. 0

Nol .",.ng.ll,m"Medical miSsion IS nol a loollor ev,ngellam. It has, velue In Itselfand, il i1 does not have that v"ue. it is not WOrth doing •••"" ... the quality 01 Ihe Christian heelth care ministry is not melluredby Ihe healing of I lew sick people. IhOse ...hO Cln gel to hospital.The Christl,n obligation, tlebt, If you went to use Ihet word, la to tilewhole community, _.~

' ....CIIC_........

..

The stark reality ofSaid none other than PW. Botha on Itdue 10 progress in the fields 01 medical Ileader!M He added Ofl thal same daNationalist Party has neYe\" shirlt.ed itswere these wise WOfOS Ofllhe same CKbroughl great prosperity 10 Soulh Alril

• Doctor/people r.tioI.. '9&5l1>1rllOC.... IO _.olll_ ..,...on ""a! ...-.ss .'61 , <lOCIlH ..... .....,.

25 lJOO~. "",Ie on _._"....u I ... h«,., 150 ,Itt ",uona!~ IS 1 lot -,. 2 320 PIOPe.whod< IS ._VS _!eO OK...... "c WHO 1lan<W1II.

'10••••• OIlS ......._'.'.....

A«II '" lhe <I0oI:100' 10 -....100'\ "110pleyl ....... '''onge:t .016 men me".tlen-,,,,.' co"'o."lOn ......ong......'n'fl I 10330. -..;, t>leckl •

llOCto.- '''' _ry " 000 PIOPe."'"'oo 'col__', '00 1 :zoo.............., Ioo.....,y 7)(J 'n IP016 01 r". rtIt~t""...tI ., ,he _UI 1.c"Il""".Ilrll po-lIOOmIne",ty wfti16 'r'14 110policy _m. ro De _gned 00c."ied our 10 """" I~,' d;IP'''''''''loon,

• Nu.....,t,oc"'d,ng 10 ,,,. Sou,~ ..."ielnNu,..,. ...IIOCI.II In. cO"""y hn1,5 b1ace "u ',e 'colou,ed', 1,_page 12

..•• Ieu 1ft... )(J 0lXI .0"""_" pe,

...., .""g6l•• 'O,.I._OC.'oon 0' A'iH""lira... 8".g...... , .. HOIP,I.,(tNc:e)c_ ...". tnO<. '1<6n 120000"'m_."" I'<II.~' or R~moo..... fipencl,lu'. PG' l'Il..nt pe<dey on &r6ll_nslfl ~I ...Rle,eO ...ft," '" Jo.........o". IHos6>rlel ~ IS !lItHO PIe5)

• llle expectancyL". uj»C:1M>Cy •• et_,ed I' ::Ill~tI 101 aU !IlIof;<I Sou'" Afnuns........ '''' _lie Soul" """UII'." •• 53

• ExpenditureSoutn Atnu. __ ,.l&U...., ~n"aIlIS 11 ._ "" Ihe

heallrlOl'''"~'Ill "",.. ~ 'ellby "'~...I ,_tc I' 01" .....Iimn range I...... :!'ClIo 10 .........••Il"1o 01 N GNP IGroIa ~I""'"

P'O<koCII Sou'" A',Q _s "'.less "'......._1Iy on ....IIft _ docl~•• ' m c"....,.'" ",""'ft "",,'"_, 6'110 01 GNP on _'.Qe. _ab<> ....... lnAn ......y Th"o Wo""sUI" ,..,:1....,,'11'_ ,.. "'hoc;a

r.....y'" ."00< U". Mallft_il'fl...'IOCII.., .'10 .-. ",lQUIcl'lc" ... , I,o.. Wfto g.'s .".,Mpen<ll ,n1y on I". CO!Ou< 01 ~....,.~,..."" VOU h •• ,O/'en IofCfll'0 h•• ) Pe, ~... , 1ft. 101., .....11 ..blldge' "Ioe6I.' R~5' 10 Mlpen, on''''' ....tIl.. 01 .ac.. """.P41'SQn, R2~9on .een -COIO,,""'- p.'Ion. R265 on••eft "' ..en pe,"on ent! onl, R, '510'ue" black peflon

In '93<1185 only '2, 7'lio lR400 ...,II,onl0' 11>. R3,2 b,lIion "..n" o""~ ....• 1I0001,.d 10 ,,,. ~2.1"" o. ,,,.POPullll'on ,,,., .'. 10."'9 I.. lhe so­e'lI~ _."".......... 2.2"lIo0l1fIe '0161 ""11"~'. cl"ec'.cl IOW",OI "'.,...,.",.P'OII""''''"The J_"'-"g ~61 ' .......1

---

Tre mon <leam ""'Ot 'CO!our_' ISlWOOl .. Ivgto .. I", wll!tet

o

-

• Who dl•• from what?Olln, nllu••1Cluln 01 dUln,"".,n,,elll'" la n••" PIOtllt"'. Wllfe lhemOll cOmmon If' In, Cl" or ",ni,...e"" A'''II' 0011, .. ,nlechO<4 <I,...,"....., ...... _',COtnmot1 "UN ot"",'h In till">';The <HIll" ,ale loo ,nl.-;t'OUI':hHas.... 11 limes h<g_ IQ,'COl__"lfllln10< wn'le$

n .. "".n. rIle 110ft! ""'._ .. !>2....... nlll....' lor _,..... 'Mn ,...-"1' ."" lot l~uI_' " .. 31,...... hog-

It .. _ laCI ""'. ~ aI __ ogst tlIlC~1 _ ~.••

etIokII ... 1Nl !'la" _ I"!! 'MC'" \No<IlItn 1WI~ 10< wI'Io1eI ...... 1>glA ..~

• Inlanl rnotbllty rat.om...... .......,.. eatt_ QUI __ I,.patl .,.. ......... 1lW ......._ '-'d1Ml __36__ 200-..

....10I--,1OOOOot_llheytNCll__-.. 'Ot-. ... 5ouInAlnc:a .......ogon .. only 12 1* lCOl1Aa;on:Iong to prOI' J 11... IN ............-. tIIar:I.s .. to i* 1000 _ Iof....... DlM:~1 • f;M _ tie • I'ogn ..

""

Truth about health

facts and statisticslE! 22 May 1988: '"Our counlry today.echnology and knowledgn. is a worldf". -In the social wellare fiekl. theresponstbil:tyI~To crown it all. lhere:casion: "Tho! years since 1948 have:.a:

lnal,n 1nl! 'wM. nurses lOt e~,..-, lIe<••re only I,' ....'_ per 1000 01,.... -".I>Oft on ,"" non-_pendlnt homelands "" on IIoemajO! Sou,,, .o.f,oc.an _. tl>e<e ,f,,.I nu,", lor ..-y , 00ll Tlw most_.. pr_. ~_I­__.. ,"" ,mlMola'l«,npr_

O! .....song ca" 10 ''''' d11le<enl lac...,,__ .t>(l ,... o,Il~IH'I(:'. onwor_'''lI ,_,11_ ....cl ",..,.,

t>ol'I_ oofll~'nclb1K" n"'lIft TileMooYe hgu.. _ oncllldea nonP-'''''''O ....<WS /.... proIasooft__ • iOI0I1_~"ol a''''''ull-""'''ll concl.I~I'nlIl""S onIIaIn,he "'oO

• Hospwl bedsThough ,...... ,f,' '__""hleS" 10<...,., wll'M on ""- c_..... u__ ...only 2 "<lIcl<1.1 btoG' Ior '1'IOn-....~ .'or _I')' ",I'",. 1\ot.p".1 bed.

the JOI\anMtburg HOSp".1 ,wl'litel"'.,101.101 I '70be<l.~' -""11"" ,.oe Only belwel!n &5O.n<! 900In p." II, 8.,."••",,1'> (black) n••• 10 med,UI beds.na In ""-oe bedoceup.nc:y of 0 ••, 200"10 ,

It> Ill. Ca.,. ,...." I1 • 101.1 01 2 ~74

1l0lpil.1 bed. In ,11 ""JOt town•. fhllIS' _·~·IIO"..I'I'O" "I. at I t>&O101 ....oy las people. '" IhI ~PI,.... .'... IhI 101.1 ",,",bit 01PfOV..-.:ItI.nd P""'" bedt ••• II.blol

-"

'I , 372 __ ylekll 1 _ lOt eYef's'

38S jMIDple ItllhI ""'''OPOI''ltI''UI11 15321 _ ....It~._M;"""' 'Ill. 01 , _ lOt ISo:! IleOl)IeNe .., 3O'Iro 01 'heM c'W bedt _ ,"Pf II~1I

fOl $out" "1'11;1 ...~... III IIl8""""0lI0101.... (01)'1 .._ l/'Iefe ..goI'N'ral'" I _ 101 le Il\In 200IlotOPIe _ III "'Oil , 1Ire" , tiedlOt lIOO PIOl)Ie In aa.... l.IIu IN .1"".. 1 .... 1 mlncl .. K__mel... I\O ....po~

.Oentl.tIR.....cI'I ,_,.. r..., 1!r"1. 01.....,ca ,_Id by detII.... C_1>1 OOtle 0'/ dl<l"l 'I'IIIIP..II ..no51" tIQ I1 0..."~,,r" 'ne COl' 01lr "Il ""'''"II'no .._ CII"II",..,~ ~Oll 01' 3O'Iro T,.." .., looftII"y ..n.,. de"".'1 Too 'ewdl<l".I...o,~ ," '''''1 .....

• OI.crlmlnaUonWI'II" TB I. ~"1th.d.mO"1l11m,tII,.1111 COftlpe"""on lll., 'I P.'d our...... IQ' .Il. d,U'''''1 '."" g,ouP'.Wtolres ..." 1111 P'''' oul up 10 IU3 201,'eo!OU'KI' Ull'O RH 111. IIId b1ac:~.

......'m..n at R2 462

In "'..,nc, 10 lh1 P'esid,.,!"...ftII"-l .llOul IOC'" -,,,, ....1;1P'OIoP''''Y _ incrllOld I!'Ie IQIIow,tIQIh'.......U

Truth about poverty

, No _ Il\In ..,.., cl Soutn ..._

"O....hOIl;Il U'" '"1 Ill'" IIle_____clR2lOpow-.. 0llerII,_ -.cl> III IIle~ ' PI:l<t Elouodl _____ 23000..-_ ....--• 'hi ._. -""'Y oncDnNI !orlIIac:U '.. 1~ _ only AJS2 _-, The -. wage 10< • Saulh"'netn clornI:I4ic _ ... iI ~1 _-• R8.21 boIoon .. "*" on I...................c. 01 11\1 Secu"" ~0tCeI

Sou," "'''CI IP,,,d•• 1"11"oeoc...~ cl III buOIJII' on <IIOtIon<:e,All ""e..."" Il\IfIlIOIIl ""= I,.:S..I, trod "'e$00.., U_

• No I... 11l1" 12 ct'IllS oul 01 e--,.~AIl In _nl on .1»"""'"

Truth about socialwelfare

• By lll16 'hi,........".plvo et31000 _1'''Il ""'" 10' "'"'". I",..., IIm' ye" '1\1,..... , shorll." 01lIS 00ll "n,,, 'Of bll<:~~ Th"lhonaOI,w,M \lfOW '0 2 m~"on "n,1Sby lVl1O.11d 10 ......1)1 3 m~100., by lne11'_'2000 )

T_ .... ._--

The stark reality- - " r--...;;.-----

THE HOWIt 11II1M witl'll1"rl go.1ion 01 thI_ClIlId hoT """Ilf>dwitto itc_ 10doflet_ "'p11l1menl. oflMeltll Then.tt., lhe tri<I".,.,.1 Netiont tl'rlrti_. ltM ntlblitl'l1T'rltl1 01 I tepMated1pel1 nt 01 he.llh 10' white•• onelot Indll Ind on, lot 'colouredi'Ind 1Iltly • g,nlt,l h'"11'1d,p."menl 11111 I1 IUppoeed 10 IoollItt,. l"'I\III'h Ittl'" ofbl.,.k peopleIIhoM not In homIIlt'\dll. e.,.hhllllh d1p.'tm,nt nl" III ownlTlin"I" 01 helllll wilh.' itldeputin."C..II,I'I ,nd 'dmln"I ..".,Pt.-net. Eae:tl "'1 III own l'rIahnpoIoc:y ..", Neh blll'''\>C'aey ...... upI",..n._I ol mer..,. trom ltleIlrNdy limited I\IIItJI budge! jusl 10NtI'1III1 J.... itnlQ... ""..iI.... oIIl'rI '"'""I"I.nd !her'OIPUt_\NTIet,. 'nd lhe mil~ 01 Rand Ihlllmounl. to. At .Iw'ye till UI_pe.,..,'0011 lne billl • ..., Ill,. '0' • 1}'Slemll'llt .ml nil to begrll 10 Wend ,nemoney on aelull hellth c... 01 Il'IIPIOPI"nd not on III own upkeep

THE EFFECTTill. w.llage 01 mone, 1I nOlI"" onlyprobllf!l IhII (I0Il Wlln ' ..gmenta­Ilon n.... I. IlIo • _>oUt wllllge01 "IOIII'CII Ind ..1I11d PIOPIe r,.,.dll,-,_ he.lth poIlC_ C.MI.dI_T..... Ii'll prObl_..In eommvniCl­lion. non cc>ooe<lhon btt__1....lc•• Ind ••,n compelltlonbtt_ them 11 I,.,. (:OIl ol thIC*)I)II1hI., ,.... 10 ....... It Ilto puta• 101l'ty unnec_,., et,....c loe....onlo helllh .....ic. Tn. tooI,"I.I'I..IIhnic.lI., 11.lted Ind llIop1. '.omon. homellnd I" tlOl IUppott(l to'nd up In the nOlplll1 0' chnic 01anolhe' homel.net...... Ihougl'l .1might III jU11 ""011 lne 'old or"....Anotne, IIlnout 'null gI IIlII"",""Nation .1 Il'rI dlltullOn' OIl'"poIIlibillty Whit. Ih. SoulhA.,1can oo-nment "' utlimIletyrnpontibiI ,eft thI condi!lont thatb.1IId IlI-fttIlUl Ind 'or IhI IIet thllthI '-.iMino hellth~ 11'1

In I towlIfy thIII ..-ugg.. wi1to IIMeIIh policy IIWII ~ fl(lI """PPIY1dIqI'_ "-"'" r;:e... filIf ltle ....;ortly01 ill peapII It ha *" Iound_ry 10 ""a11 14 dil'1e<1I'l1....'lil... 01 ,...., W!'ly t'rIs II'Iit~'rId _ ..... .".,.. it hitlNng on IlM/Ih c:..ln SlIi • .n

THE WHYThe wny lhiI l1li1 ~~I 'rid it"Iti¥lty limply. T C..llior'l cl 14declIrtmenls iI I 10 enlnlf'lChIPI,lh.ld. Though Ihl p....nlregl.... give. I numbe, 01 worded,..tonl. In whl(:l'o 'Ulonomy.•11·d.ltrml",tlon Ind rwglon.lIuUonh_ I promlnenl plICI but hollowIIOUnd II'rI ",.In '''lOll iI t""MP noronly wl'ille. colourld 1nl! All." apet1but 1110 Xhotl. ZUlu In(! snl"llllnInd .... ,body elM..nee ,Iil60 About .to 000 South

A'rieena _. forcij)ly "mo.,d '.OInthei, h_ ",-n July IndOctolM, 111M, I y..' .,., ltle oIIlci.Itll.mlnl Ihll the SIll. h..IUsperld«llor~.....cwm,

The IbowI! ill me', glimp" 01' South"'"ee the 'world lelde' In helllh'. Ipoetu.. 01 lhe ·P'QI.llII',Iy'" If>d IWlI,... 10 I" ·,~lity'" IhIN41toonll..1 RIg"''''!WII ......n lor IIM10...1 ....111 01 the Soulll AI,gnpeople 0- lhe pell 40 ,...... •

• In JMuary '.1 • 70 year-old~lln _mln coll.pHd 'fomI.tig.. and C1led .'Ie. q .....ing 10' liveIMlurI 10 fee..... her petWon

• In I(aUIIhong '*_ 'I k) ~ of!he tDwnlNp', ..otntlllweeooethtrIn"'l''''''' ~Iing•.

• 'n ..., ,_ It» ILlS.~..1uMd 10 ~y OUI • 70 ~ oldSowetan women', ,*,Mlr! *-'..her _ owed N,.1.

• In S."l.m~ 1"7. yol,Ing eh,ldaullemlg trom _. ctenyclr.6onan<!' .wpec;led kklney.bIeft.t ••,.fuNd tr..tm.nt It trls whilev.,WftOQmg~al~he ...Inc",.. .... sub.-quent!y 'h'd on !he_y 10 • L....... ClinIC.

• By''''' mor.than 22 mllllonSoulh""lc.In, 11111 did nol h.~ K~'" 10electr!eity.

"When Inlutlle..bounds .no.r I.epproprt.te. Soulh--loo""ten how to r••d••sues ... ~~ IIIIon, 10 ued haw.. bee: ome to Irwtftu.Itonaf unflllmel'

Rev. Peter Storey

• FOI'c:1Id '.mew. ,n South A'rig"... uptOOled 3.S ","loon people,more mln 10'!i0 01 the popuIlltion.

• In 1987 • pIlnel 01 doctor. who1"lled "lIIed dltaln, •• I"Johlnntlbu'll. ,elUltd • IludrIlIeg,~ Ii'll' 72!t 01 lno.. _el.,mea they Vl<e'II au.aulled inde1lJf1t,on and of theM 11'!1llhowed.'ol~.

FRAGMENTATIONdefIeS the laws of logic

Officially the existence of 14 different departments of healthis called reglonalisation and ~own aHalrs" but In reelity itboils down 10 the further raclallsation of South Africa', healthservices.

Inaclequale. !hey gn b1_ ".1!wMMlncl~ndenlM hetl'h ....lhOlflle.wh'n llllng, go w'ong. ThernpontlbHity _. 10 be aI__ v­that of tnotn.. deP6flmenlwhile lhot....1conl.Olllill ~...II" P.tlorlll ..no001.. OUl'lhe bulk of.", linancet'OtIt>e ridk:ulo....ty low tludget 01 It>elIom'l,nClI , ... 1oI""a andGaunllulu .gm~ tiN"""" InIt\iI; iN...,

To '1I"lIt'. wtlt' e....a. the1••II....nl.11on of Soulh Afrlea',I'INIth IN'oor_e,_..~"Ily.. thIo rural ...... Ceclri<: de e... an•.,..,~ liekrwor~ told IM anInM"'I;r>g .umple,

Mln the Norlhe,n Trana.....'," hetxplllr..cl. "You ha~ Iou, 01 111'1ho,...ltnd .fllU Int••m1Ililed withMch Oilier like Ilnge,. 01 ahaklnllhand, • completely Impoaible 10••pt.a,. oul r,Uonall)" org.ogrtphlc:.ally. but _r1hal....'lo.ptlldelll' ..-ldminiItratJwety.aeeoodlnlil 10 Itomelend policy. Ha.Nd'I 01' Il'leM hon I '. od. ha ItI OMI_art,..."l of 1I••lIh, lit 0 .....mlnll." 01 " ..111'1, III ownbII...uc,8q'. and it. 0Wfl IllpeNl..

,ar lor "'" mlmber 01 1h.1our_racy. 11 has ita own nunlng•••on.IIOft. and 11. 0Wfl poIlelet.. ThewI'IOIe bualntea 11 ,leatly ",a'I&'1I.11.

-V0\.l"''''' allua11on. "',..... people"III'ho afl li...lng In Llbo"'. Ju.' w.1k",rOIl IhIt fOld 10 • ,link InGaunkulu tlIeau.. it III much '10..,lI.n Ill.~ dinle. Thll , ..11..big problems It My. 1Ilol ~Ilenl huTB or illl'll ~Oenl: 11 !hi mo,,* 01.mIlnoufilhld ct!ild. bIcIuM ltafflrum IhoM I'loIp/talI or dlnIc:I cannot do follow up riIl1I. TI'wy can'doif bIeIu.. ofllellllly II'wy can' doloIIow-upeln _1hoIr C:OuMry. Theywould fINd !hi permlUlon of lOOMolllelll Itom Ih.1 foreigngovernment·

De 8Mf lJOI" on 10 mlntlonupe,llnu. Ihe" h' ...1 h.d 01hoIj:llta/I eloN to Meh other Irying 10eombel • polio epldemic In 11182,'ndbIinll unIb6Iloc:o-oplll'''wlth MC:hother on • IfnmunillIIon C*n~1gn

1lIC:.'... thI .....llh wor.... _11(l6dthll although the hoIp/tIlI .....dDaI 10 or-. ....-lIoIr. eo-oper.tlorlhI(l 10 be 'roulld UlfOUlilh the

NItPICII.... dlpertmlonl. of healll'l amith • eOUPlt of hl.'ll(lflOkllom.lr.. • ••". Und.f 'hl.1condition.. roull,.. ,oor(lin.lionbKlme • major dlpionlatlc~

Ounng Itn la".. polio "*"•. thwI_1IUdd«l11y '1MnaOI cl ¥lCCinM6uI 10 !hi lid Ihll .". fIIOChIt$ Inthe eitiel. w,"-enlfdren _11'IIrdIy.1 rtaIl bul ..no hid ..ad aboul lheea_ in l1'li fUral _h, Mlddenlydem.nOId ....."'el...tlon 01 their.Irel<l" ....ecINlIl(l ,hlld..n. Tn....... no prgper (:Onlfol 0 ' wn..1lhI.....1OC1n...nould ha gone •••prlorlly ."'" Ihl. '11U11.d In •1hor1IogII ......... II .... moal n.I~.

Trying 10 uplaln how ItlI POIkyof_I of IhI/Iool' .1.. idllO employ••1" _ pos.lbIe. only .t11I1-.o IPIIlllhI Iaroguage 01 lhI homeIlnCI cane...... ita own ldioc:incral:iM. c.el,1I:<le e.. el... 11'11 IoIlowing .tory:

"SIlllu....... hoIp/t.aI tin on IhIbord.. 01 Llbow. ami Gaz.nkulu InIhI Nonhem TII 1. In 1918 !hiSoulh Alrlean gO 'nmenlg..... ,1 10lllbow. 10 Hmllll.,.. on • tempor....,.b••I•. unlll .u,h Um... 1nlCOI'IIOIklatJon PIOPOIII. __ liI'IIllyIOrtIId out. In 1.1. !hi hospital w..tKan _." IrOlft LItlOw. and I\I.ncIIll_ 10 o.ur.kulu.

-SO. one fric\l" !hi Gazant.uIuhoIIlIfl au~li.. 1"lold 10 IIklconlrol 01 l1'li hoIpItal. InCIlo move!hi lIbowa ..tt\orili.. out. OnMonda" 1h1 lollowing -.... lneLebowa lIO'II'"nmllll wllMlr. allPeell IPNklng 'llIfl. Pe<ll .pe.kingplIl.nlt w... 10'dld InlO.mbulMeft, "ong IIriItl lMi' Ill..• n(l drip.. 'nc1 lak.n 10 011\11'floIplIal. 'IOUncI lIbowl. Tl'Ilrty~1iInI. and twlllIy !OU, out 01 thirtyeight Ill" 1MInbeo.... -..:l '"

''"''''''''"lI that iI IlOI '-1111 _ .IQIInaItMtY" Iddad 01 Beer. "1tlIn I00I'I'know whll' 11. 11 11 no! lunnyuntortunelitly.~.. GrlI 01 !hi'0f'\MqUInC.II I. lhel peopI. Ihlnbegin to IdlnUly hI.lth _l'IieM withPfU11c;utlf ethnle ll'OUPl'. So on. 011Ilol eon.-quenc:.. la lllal people In1hI.,.. ...............tPid_ 01 UIIhealth _.ioII whin the llme eame10 run thl Immunilallon eampAignaoalnI!POIiO. Not bIc:au. thepeopllIhlmS.I ..... "avI .n ethnlec:on.dou..-.. but tlIcI... t!'lly_1Nl con~ toeaIlid withinI" .....lth 1IrYII:e.1nCI they begin 10mlt!nlat the kincl of lIoIallh IoIMc:eIhII tnay will gel "0Ift I hullh MIY'ioIIfIII apu.k•• dlff.._ languaue~.

On lne furtherlrlliJmenlallon of thlhllllh 1I.,le... Itlloullh Ih.Impllmlnllllon 01 Ihl n.wconsUtullon wllh It. lri-cemelllcomponents it 11 De 8Mf'. ocNnIonINI!hIOO ••'''.....I ......:.:::the alOIft 1nI0 III IIniIItper1lI _ I.,. • health 11 c:or_lIId.fllgl'flllltlllion ,.. "-n liken 10 •point _,OIl1l1 ""'!eh 11 eannot fiIOwlttloul dllyl"'ll till .... of 1oliJ1c". 0

_15

MOZAMBIQUE'S HEALTHSovth Africa's policy of destabilisatlon of neighbouring countries I'\as had far reachingeHects. In Mozambique their support 't)( RENAMO t\as led to the near destruction of thecountry's primary health care system that washalled asa ThIrd World model. Theout-lylngclinics and rural hospltals became a specific war target becaulMl of their IlUCC9'I. Thesehad become the back-bone of rural development. To destabll.., the country and createfurther insecurity in the population, they had to go, and that with South African supportDirectly and indirectly we have a lot to leam from this. Health Is strategic, health IspoUtics

0Ju •• _ .. ..-._.. • _.TNo__ n .... _ .... _ .-..-.....

'I , .. _ _ .. _ _ •.

Gua~ el IA'I},e:(!)£t.(I~

CIlIA~IlA ~A A_eat.S _. r:;U~"A&IU'",••11."

.'

•.. Ca

·...r " ,'.

projlcta. ir>cluCl1"ll '11'11;1,11­IUIII achemes .nd .verylh­Ing llIal mak.. • poIiti..contrlbullon 10 'urel~pment. Thl1l Ir>eluclelIh. p,lmlry hnUh c.,.'ystem, onl 0' 11'I' poII­Ilb....lon .ucc..... 0'

m."rIIl, Ifm"nd .mmunl­lion. lrelnl"ll, ifI"llIg.fICIInform.lion '''Cl commu"ica10". lQulpment. The ....1"ta'ge1I .re tII. "lnl(lOrtl­lion 'ou.... commu"lcItion.y...m•• ,,(1 .11 0111...co"omlc (lIV.lopmenl

D.C.C. CSAOCC). In1111111110", South AlrlcltNlgln 10 Imple",..,t I.. 10tal""'.gy' policy. Thl.."II.OY I. dell".,;1 by~or\I; .. IhI mobItll.Uon01 .n 10fCI. In dll...... 0'ap&I1h11d .nd 'flCllmpulllI broed ..nge 0' poIillCII,dlplometlc. lCQflomlc .ndmlllts')' lecllq.

All ot South A'rlc.'.n.lghbou,l"g counl,le.h.W. bH" .ubJlcted 10llomtl IltaCkl, the SAOFcfOlll"ll thll' border. and"Idlng ."y pl.ce lhey...'d 10 be Ill.....dquart·.... 01 opposltlofl 10 thll,apsrlhlld tlIlllml.

To .ch..... thl. goIl InMol.lmblque. Pretorll h.rellld IlfOI'Iy on Il'III u.. otlU'fOIllt. tOfCII. TIM c»-• tebltlHllo" In MollmblqueI. Clrrlecl 01,11 In "'" ",me 0'lhe Moumblque NlIIONIIRI.iltlnce (MNRI beU"kno"", .. R....mo. ...lIleh..... c'MIId by Rhodllll',Cenlrellntllligenao 0'11....11lion I" 197&. Ju.t before21mb.bvre'. Indlt"lfldlf\Ctl,Soutll AlrlCOl I"hlrlt.-:l llIialorCl. ThlymOYeClIIM ...holl01 Rlnlmo 10 111I e."ernT,........I wIlIre the SAOFlrelned them and .uppllldlhem ...itll uml, Sl"CI IhII"'y llll1cr., Ih. 5....·•tICIlQl 111.1 ch.rt-goId Indewer lhe 1111 ,_ I'M'"moslly bl'C.uII ot thlNkomltl Acco'd, 501,1111AlrIcI-" IUpPOrl 10 RenamohII bIIfI under _", W......con'ronled ...llh IhlllUppon.. I riollllon 0' lhe Accord,SoutI'I "'ricin oIllcllll andgov""m.nt mini""..mphIUc.lly dl"y Iny...ill.nee 10 A.lllmo ....erbI._ lIon .............. t In1.41111..., Inl"llgItf'IcI In "'"SAOF, w/llch U..yclllml""c.nnOI control. NOIwi\hI\ll>di"ll, IhII. contln­uld In.olvlml'" ... ltllR_mo I. acClpll'd lWOr1d...1dI .. tecl. ThI••upportcorn.. In 1111 fo,m of

South AI,ICIl, whlll .t warwith In own people, ~

w.gl"lil In L>IldK"r.cl wI.egal ...' Ib nllighbou'" ThtIlull.ring '.om .partheill.Ulll<;he, tar beyond thebotdaf. 01 1l'I, fWpubllc.WllI. thll .,,1<:. IUboullftt.1I.cI ot th. war onMoz.mblqu-e'l '-Itt!. it Is..-_ry 10 .~plaJn wh~

South "lrlc& In 1nl_lied In.and IoC1t...ty~ In. II'HId.lt.ltlllullon" 01 thl,Migllbourlnll country.

Prtltortli'. potJcyAI Il'l' he.rt 01 ScxJItl "trl­CIl", policy of clnl.b1t"tlonI, the ne<ghbowing COlI<>­tr...• .y.t_ of ,..naporta­lion .nd communications.TheN ... r~ul.r1y HOOlag.cllo Itflautll thll.1I ttlldeifI tII. .-gIon 01 Soulhoer"A',if;I 'Iowa th'ough tl'MlRepublic, 01 the '~Io"'.tlllI....y U"k. nm"I"II _Im,ough Moumlllque, _1m'ouoh A.t1go1. Ind lOulh 10the ~k:, It i. mo<. Ih."o;olncidenCl 11\11 lh. CH'IIyON IlOI HbCI~ ifI IhIp..t lioht )11" i. lhelOulh..... roul. to SouthAlric. and 11. portl, Thll,.Il.... y llnk p,ovld.'P,etoril ...lIh CCN'lalcletlll*toreign income bee..... IIClrrlet tl'Ml bulk 01 Ill. Itllde01 21mbll, 21mbaDwe andM.II. ItId II~I llall 01ZIl,.'. ml....I ••porU,

I" order 10 ....Inl.lln thedepe"d.ne. 01 the ..-.."Iri. 0" S.A" P,I1O,.pUrlue•• poHcy 01IllQAtIIion .nd dHlruc:t1oflw/lich hU crippled ....gto­bou,lng .conomle••"dClUIIOd hUmin IUtl.,lng on.d.....Ilt1ng ee....

In o'der to ,1ICl_ IhlldIPoHIdltflce on 5."', the 10­c.U.d F,onlllne It.te.Chmble, 21mbllbwe, 8011....1nl. Tlnz..... AngOl. IlI<lMoumbiqUl), and .u~

quetl)r MsII", S...1l11111dand lI'IOlhO lormilClll'lll SA

-"

a.......vlOlllion 01 Ih.eon.."IiQ<l.

Mother andchild Cllre

Witllln I priml.,. ...elmCl" 11'.1 .t.... Cl" 01 mol..... _ellllfl"n CIf.i... Illghpr\ofily SIIj;IIie1 ',om I... )

_17

--_.. ---~~._- ..._-­_w. '._..nd ""PPOfI .11I 11'''.... '"~_I... 11..... tl.., moll 04,Il. 0 ..1-I1'1"g POlt. did.ltCelve '1Il..11f ...",,11Is 01d'ugl.nd "'ll1on. WI.h'Ill w.... '" on 'h. 'OIdIh.. bItCom. hlllfcloul.•nd111I1 end 1••nl9Ofl I/>oflltgll"'.,. ._ 10 _ p<0bl_.

HNlth ""OC'" "'.. bHnIflqlllftl

Community~rtIeI~tion

eom "'" paltJciPl.oon .._1 1 10 P"""'Y ,....MCif'. T ... I...g••c..,.ditnJplion 01 f\l' ..lcom ......liII I\Q In .... ..,. ...dIIl.Oy«! I... communi"OtIlI"iutiotl fllCllaI"" 10""ppo<t prim..,. hNllh call.Comm..nal vll.OII wllflhell C'f' WQ<tlf. Wlf,......, ,... CQmIf.lonll orI... p.lm.l1Y .....lth Cl"'\'IlIm, T... wld p'Hddlllf\lcHo" 011 v11l1ll11h.. C• ..- .....nl' IlllwOft... 10 abando<llfl."POIII ""'-' In ,••, 10 tIIIItl~ Of bee.... I •• , lICk or_.

.....e""l. 01 tile.. ItI..cQJnd \l'Ie dilpl..c.....". 01J>IOple. mo.. "'"'' 2 m;uior'iJ>IOp\I ~, .ICC•• 10 ....lIhcar.bl',... _04111117 b ...where ,,"Jlh _," .1Iy1d

""'" I... fOU'''''''' 10 ltlIm,...,~ 10 de"ll'l'_11\I1 PIOP!IIl.,..:l ..way I"Mapulo city....... oI_oul·lying ....I..m,. dinrQ _- 11 nogI\t foIow"'ll ..__ ot ..lIICkI _ hl-

nappongl 01 "-'Ifl~ ..T... lolS 01 ICC". h~

.....deIl mouwn '" 1111 ,....._ ........ peoploI ... ­'" _ 01 hIallfl car.

.....-SinoI 1982. Soulh All-.~..Iion ".. '*' enj"o I VI' ~ 1Il11l"1l _.IlId 011 .... '-11\ 04 ....Moamblclfl people. tiledlIplIic_t of ..,;~ 04~ .nol .... lMIiberlllldell.UC!ion 01 "-lttl '-eII"IieI ..... CIi'- .......1Uf­Ible ""!leti"" Ind !he _ 01IIIouAnolI 01 ,...... _ 01tllolm CIlIklr... e,.~_ ,...•• III .1ImlI..., 4,5miloon people 0tII or ••OUI_lIlion 0114 million .....ifl """ or ..~ Ioocl lid,_ ... ItooI comboIo..,~01 _. d*ll"M'If.....1 _nat..... "'-'«I...

tile lIfVIlono 01 IINIIIIIIgIIIlft b1_""'_~~"""""ln""_lion of......,. QII_~u.ipI IIMIIII _ No_ 213_110I'-__11II _1_ I>ed _

, 100000b\'_Indoll._ ...... 312 _ beIn

IooCed Of bcId1lI~.ThoI• ~ ..._ 31' cri .... _~_III~""_k.

"_~"'noIiU... pl_. MolMlClolcluli-ouId lie-. I\Id It! 1 121oul4l"lng _ b\' ...._ of 111M __ 01 0I'iIl' •3:2'1. AIIhouQIl ,....". ........110I'-'" beIn 1Wll1'''''_.... _ "I ."-conl~In _ ..... Ifle dItecI~ brouglll • I'IIIt 10 ....p....oo... faIlld.~ 01IlIe '*""0'" IIIItI 11I_ outwitII onll' m cllnlcI .1 ....11.... oIl"dep,,,,,,,,CIi.

Till prooI_ 01 T.,. lnolZImbezilIIhIII borde' Mill";__ Plflicularly r..dIy Ill.and bl' ll1M ZIombtzIl hidk* SA 04 "- primlry "-'"_ rwtwork _ TeM 4ft.Till oIher nor1hempr~01 CIbo DoIgM!o _ Ne...alto IUft_~ In

anotller victim Of ApaMoumblq..., whIcIl I'led. IheIr '_OOOik .,.... in...... Tile nu_ oIl1iHage "'111" 10. III.ck orllrNt ltablIiIo"ll inn.-- _ PlOOiloca 11.- __ IINIth M;lft•• Ill. __ "'-1l'O. '" Z._,iol, " at.....~ INI_....... 01 po;m.,y _ Cl.. unilIl l'.ned "'"~ ""'..... U. 11dlttric:~_ll'Ieirown-.ft'I...cI IhfOuOl'l ...... 01 .0 , in ,... But~ ••'oM it~~.. tmtlul__ ~ ~ II'IiOdle....tIon ..-y. b< IIW .. ..... ... '"lily d,'ficult 10 MlPPO'l olll1NlIW..__ OOIty~1t1t..

SI..... d,ollghlt. Iht ""octU..., OUI-¥ng _ IIoem.Ift , • ....., 11.... ... .. IPlI O'F1t" .'f'(I.m••,.,.t.,. ..""'••mined ...... till in _ in 'Ill wOO'k,...... Irlined in _'0)'«1 b.,. RenAmo....-';0."""'. lM ....."" '""" ""10 1 321. fOlH__ _. =.'1_ wilh !lie 3lXI In _ou;I..,.,. ".-1_._&IC".lIy .... 1\IIl'lIIoM.., h ........ __ ~-.:l IlI80 'ICl COOII, , ,po.llngin wI'Iicl'I"--.., IIW and Io'OKI lID _ ... _ """0"1. roll lrJ •dtiIiM pep tU'OO' c:-...cl end..., ...... "'1nC'" Support ,,.Items ~ool< _ ...-cs .............. lIIlI 01~ ~ __ In ,. _ A aueeeulul pr"""")'"...." G .:"__ 10 ...gr+L Tile1O ....... .".lMotW_" R......mo _i'l .....lled c..-"ysMmabo_ KCom~..,;"liI pn."mKitt__ -.tuoe .he.r..... __10 IN........, ---' - teOUIa< ... UtIecI iftsUllllly ancl the.... In South NItI;:II ....ong~ _ __ ...pploes Cl!~ cl.. ... bay_1Itd 10

DurtneN_"_ot _conlKbwoU>lhelllgn. del'" Noli.......".. mor__ w-r. "". IIMIIh __ _ 01 !he .......... It w" 1Non.)5 Imt>uIoInc__end ..... nnl~ ...... clollkuh enough '0 IUpply _ 0itI\r0'ftId In n.gr.nIl~in .. ..,1nNIn'= .. PiOO~"', Nol ontrI5icIIIwy IDCII_ daItoy IhIy.110 ••11ft Ill. PlIi '-During .... !b.iOio .......c.. 04 July 111117 many 1IcIpo_III Pltilnt. lncIuchng pteg­..."t "'OIIIetl __ kl..., and11_ !hen IielI people hi..blcome .,..id 10 .tly In r-­pIIll.

loaotKCa.

MOZAMBIQUE

_ ' .. _.. -_ _..- ........... _-­.. ,..._--­....._---

Id tly Aenerno B, Ihe.ndol'980. U he.. IIl ..... k........koclnappeQ••no (OIlOCllUylQl ""'1111 ..... ~ ...s I1Id loll•• I..... bIIongongs l'Uough1ooC'''lI by lh. ,n_~15Till.. stll,.IIC' do notonclu<le IN ••Ilage heI.1h_kl<. _0 p_llIy h ....call1,O IN brunt 0' ,,'"

AI 1'" I'me 01 ,noepend·e"c,' I'" H· ""re only 10o:tocIO.... I>OlIl MOl.lmtloc;.".nd POrllIge", ,n II'>"C......II)' Mozambique ...s.....y. ,11""" on "".11 I"'"call ·~r.n~- CIOClorsl"om IN out_I 10< 1111,,,,11 ..... By 1!lllti l1li....er. 1)0 MOllmb.canOOCIQ<S .no l30 c_anl'" aur r.... CQOPIIan~ 1oOtI,,~.m. In. larg O•R.".mo .nd no In"number 01 doclors WOfkingIn In" ,ur.1 .r,," n....O'Opp"d sUbllant,.'ly,......,,'11 m.", 0' I~e C1'llrtc'hoIpOl......lhoul doelOf. In,gl3. 'n 11" l.mtl"z ..p,o.. nc. OOtlo............~""lI '" 13 01 l1li n","I..CI. 6y 1/le...., ol 1.lI'Ier" .... only one doelOft.h '" one o••noc;l In 1M2,""....... ST,lI 72 CIOClors.....~.ng .n ,he "r..1 'relSlln...... 111'0 o. 1 "oc.",10 J906 000 I*lPlej By 190&11'11'" ..Ir. only ~ dOCIO,.I"rr ,n 'UIII ..eas" 111'0 o. 'dOClo, 10 '61 000 peo9IfI

Dealh ret"T _ 01 d.""," 4ul1Qtill is~ Till

"", ~

H.alth work....N.I_.I 1l1I'"'ts cIo no!reco.d .M Cl.... 0' ......,0._ _",,,,ppong. ~I t""show _ It lMl! 21 .....111work....... been "".re,..·

..•• hIS Illllyed .... 1<0<: ......hthe 1><0000ammes 100..g__ltellTB T"""""'berolc.... reponed leII I,om l~

111 on lNO 10 I 500 '" ,.O! ...... only • ge9 ~

1"11"" Hid In" ""111'>.....-. been allow«J 10luncl'on newm.I'y. I SOIlcould ....." bM'n ,••a,to

V,II'll" '0' lepe.. n.....epell""ly blen In,c~e<l byR"n.mo .nd Ihe nulln..o,k... k,on'IlP.d .ndmu.dered rh.. has 1I<!101l1f!CIQ..,.. 01 .- 01 1_••IUlI" ten,,"

T.... s-'Y 01 dun ".'1<.. anot"" componenl olp"m..y he.111l Cl" As~ PIa.. _1_-.1 10_ I,om ,_ nomn__Iy I,om 11..,.. 11100,1,_1...Ie- '"IlIlI,.... m.y n....oh.n lOst HSy ICCISI 10~I •• n .. lie, Ren.rnotol<l,e.. 011." pollul. wll",,"pph.. by plac,ng CleadbOO'" 'n II1e ....111 All"',..........,Ill • g.oup 01t'ad,IIon.. m"'...... I,om'N ,n,_ o' 1111 Inn....._ pr_nee , IloO_one 01 11'_ ' ..._s IIow '0 <lrSln!KI 1_""'11 w.re, pumpa _"100con.Ulnlly brelhng 40wwI_hI.. 1111 ..at 1",..1_n•• m.d. n....'.en.nce"u.ly Impossible

'gllnl1 mellln. 00110."l1OQpong cOlJllh. o,pI>ln..·la IUMtC_S.nd IIlIn..

Succesl'ul ~.cc,n'lIon

r1QlII'" • I1ogI1 ~eI 01communlly p""C'oIIlO"_. 900d Iogts'n:s IYS.....lS'h••accones~.M_.",11 SPIt"OC (Iow) lemplll''''..S10 ' .....'" .lIee-"'" InC,loelllrCh IS ""jIIJ'O ... 1'11..II'IIH cono,lionl c." l)I me!Ille ...ccin.',on cO""'g'1'1.1 '1'>0." ~O"III1.nl

,mp.o••men' In conlr.1l11'11P'''Il.......... '" flr"1 ."1S""0" .Heeled Oy till .... I1Is_ hle_y " ..n.op1eOPeOPII ne.. Ins ICe"S 10'I"",",on PO.l. 'h'supply 01 _I.os.n. 10'••h!Qe"1Of. ano "KCIfW$1\1._ .nl,,"uPled .no.1IIOPe,a"on 01 _le IUmsh ••• bee" h""red by INCOR".n, d."g". 01 "1'C~ In.om. oltl1e ..a, dlS'''CII Ihl..accinal'on c~'.g. il ..10.. IS !Ylk

Other effect•laprClly .nd luMtC\llo...PIOll 1100 been.IIK,,", by ""' _ ..dllgnQIllC IK.III_ ...1>1<;_. Ieu .« bll..nd IN 1><0-.._ 01 Cl<lr9"n•• __ e".loe P.I,._n.... louno ,I ,nc",.,nglyd,lI,cull 10 lollow III'OU1ln,l1eu cou' .... 01 U"'lm"ll

Tubl.culO.JI '•• commond'..... ,n MoztmtllqUl An..I.matld 2~ 700 NW caws01 YB OCClrf'lO ,n 'ae& 01_ ...." .......pec:I-.I 100" "'!lou' If..l....... Till

Vacclnatlonprogramme.V.ccin.,lon p.ogrlmmesag.....1 f>I_nllbll d, ___.. ll... _ .."ou.ly"'I".pI-.I _ .1 • .­cn,ld••" ... U"P'O'ICI-.I

OMel'

Mtn,.ltv 01 Hfo~ln S~O" 11..,11'>'1 car, I'>IS .ulle-eel ......u_ O! me ....r Up to 198<',n~, •••,ng nlImb... 01P'''lInll'' WQII'>In .lIencHO~hn,CI g'~1 bunl ,nIW)sP'I'!s .nCl b'Ougl'>1Cl'U_ to _I,... C''''IQSlnc. II'lIn III.e nes ......C1llShC IeYII,ng 011. wn,l. on11'11 p'oY,nc" ",••1 .'II<;I.,;lby In....' numtle" If. II~I

"""g To l'Ia"". baby ,no"",1 In. lpec 1cl,n"" Of ,n."0Ip,1I1 b.com.'nc.... 'ngIV C1,U'cultPre-oOOlrIoly .._n wtIo,~

I., _.y ltom 1111 c~nlCS

COlrkl lIl.y _ ,n _ ...• nacnICI 10 ,_ mal 1y

....".lO•••'IU'.. bI<111 s.nc.

.- f10SIIIs "_ 1110 _~_ • '..gel n ..'00 .,..'0 to S1'y on t......M,ny o'l~oe,"k.plac ..n,gnl.nd IIII ..o....n 1'1 100.1"'0 10 1t....1 10 11'11"mll&rtlily unil' .11.. o.,~ ,1'1

'''1' .!'Iete RInlrno _..11. St.IL."c. show In..•n....,....... 10 I..... CIINQ1>eIo.1 g"""ll blnh _ 1111

"11 ol ~''" ,n 1111'''''lfn,ly ,,"i1s ".~e<l,QPPId sn.tply In l1li ....•_ To.SStII ..omen on1111 r_••reas. PIOlI'.m­....1 10 .,.,n ".dot_1 bo,tn.1lend.nl'lIe\'I.n ," 1988

IIHhn '~I'" ot. counl...,..01............,1Ml by It. ,..t.1'lI

fI'lO'"I;I~ <I" 5"'¥I~'........,_1...... 1........... ot 1--" in 1M3_1hIt out ot....."000 chold' m "*'bIforI11•.., en.., .Mf. ..,ItblntlOly The QlWIlI ..,. 10<Mo~'mboq'" in IMS _lIt,m.''';! '0 III 200 Pe< ,000 Su,...~. COfnp.lll.o inT.,. In '9ll7 glY' mo<1.IIt!'r.'" 0' UM" li¥tI••• U._ "' Pe< 1(100 Th.1........ :"n "" child.... otl/'\e p._ne. ~ bIforI....~ 'lIChed "'I 101 011;'"

W., .nd do ..1bilIisI.00f\... ..t" ,1tCl '0 I'II~.

CI\III<l 000 '0 ".. ..MoJ:.n'boq". ,.. 19l1ll 110...,"n • IoW ot m 000 coh;Jclde••n. bel=U,,11I8110'.(I'" petlOd I"'" Sou,n "1'e11n.. *0.... '''VO'''''') MOSIot Inll. o..tn. ,r, COIusedby 01 •••••• ,n.1 ."p ......nl.blI or COII'I be c",1dby .,mple Ir••' ....M uncl".-mel c:iKU....'-.

The ... "- .110 "'tee:l!Vk~"" _ ....._ IIlOu.._ ot pe<>pIR The .........ot tn. ......._ O..Klly • ....,byR_moac:t_uPlO t9ll8•• COtlIe<'4t_ lOO 000Mol' 01 'he dud.ncl '"IU/ed•• , c,.,III'" The la.lli'..umbe" or ..ounded n ..put • b'll 'l,a,n on I....c.paclty 01 tn. P(O~,nc..1,,\Cl ""t,ocl _P'"11 Th'!Cl'U_ 1If""" _crowd-,ng Tna m b... 01WOUncleCl ", 110 ow..-a._ 11 up.ary 0111\11rehaboht.lJo" __

TM cOil 01 ••rT". COlII 01 10 h••lln ..._I• ...,. t.,m "mostImpcKllblI,o Cllc.. tall Youc.n' IlUI • prl(fl on 3:10 000ChiIO, no Oled bI<:.....01 In. O. On Ih.Idd,hon.l butclln OIO'Ie.1eIha! I .. iftc._ In Clltonocmalnulrrl,on bung. TheCOlI 01 0IInIg. 10 hea/1Plburld"'ll' alone by thI_ ot19l1ll Cltl\ll1O 1tIOuI1W3 100oool""!hal 01 ....... c:ontlntlR71OOooo.

uucn ot the de.lroy.,;!equ,pm...1 Cln only be"pllc.d ullng 10•• lg ..••ch",lli' .. lIlCn Mo••mb!_QUI .Imply doe. "01 n...O.. lng 10 ,n. Konomlccrr.,••nd 'nc.....d..pend,lu,. on delenc. lhenlllln budg., In IOC.1Cl,(flneY has been coulp~ lne pi< ""'11"~I"'" on .....n 1'1.,..... It..d<ly I.om R3.oo pi<

Clplte (pi< pe_I In 1117410 RI.oIl! pet capite '" 19l12.Tn. p'OpO,I.o.. 01 11..COunIr(. budgeI -" onI'leaJtl'I '011 I",", :1.3"0 in1115 10 11.2'li in 1112. 1I1e1110 R1.ll0 PI< CIJl'te In 1lltlll1'1'1111 .. 1-", 01 IhI lOll'-"o..ng '0 IhI ecOnomICC"". ClIuHd by''''' ......hehelllh ""';<:11 _re 1110tOtCld 10 IncrelN I"" I"tl'lly 11..:\ 10 cllltge OUI·pa,i,nts .nd In_p.III.. I•.T"'. lee IS .1~1 nomine! incomp .. ;.on .. ,Ih .1'111peopII ,n Ihe a1 .,... 01Sov!n Alnca 1O pey

T~ lutureAlll\ouliln ..... poel.... _ g""'._ cu"enl .IIM of IheMozamblc.ln IIoNUn~.110 on... In ..ample 01• people" Iblllty loconl,nuewor~l"ll unde'11'11 moll d,lIlc"n coond,t'llnII'hO to "build .tl ••O......clion Mo.. h••nnwork... I" 11,1 at lhe..PORI _ 11'1'1' do ....~.'ned'fhcull Ino OI ..g..O'"IOU''''''' 10 gel tnIOoC"­InO to ~ec:C>f\II' people.T ."n"'9 COUBel and "1/11'1.....'......re '1~1 held. __lIh WQf\I." I,om tne....... 'emoIe par.. 01 lneCOOUnl...,. .!III .nend

He.lllI posl. "u, be.nrebuill. In t986 ot all theCl""" 11111 _. de.trOlledo. clowd by A....mo. 27 01,he ooH'y'lng pga.. heO been<lOpe"", .nd 54 _ POIII_.~

P'ogramm. U""lI'"hi.. bftn adIp_ 10 .,...'t coond,lIon. Mo­umb'Qu. 11,11 011••••p'_", ne.lln Clre •.,. .....Ind b~ now it.1IIo 0 an.umpl. 01 ho.. ~ ,••ble 10,esi.1 .!temp.. ,o 0111'01' it

51111 Ihou.ano••ndInous.l\d. ot clYl'..... Oil inMoJ:.mbtQue tHlClIu.. SoulnAI"c. 11.. d'C'O'O to"'PPO" R_ Io'~,-,

econom,co ano polit,c.1""'-. T.... ""lIbl1_loon ll'0lI'• ...-"'"" I\ungerend ItICre_ng ,•...,.../111 •IhI ,..,. .lIeclS na. 0Ie_...."ee..... __ in 11\11•••• n.1 01 ,p,tln"dMo..mboq...·• people n...b.com, th. ~ICllm. 01.patll'lald iU'I" muc:n la lhePlOpl. 01 50""0 .ndCrO O.d. .nd La.ul-k p..... __..__ ..­_...... ._........---"-'_'_"U>C'''' ...__ac... _

-, 0

HEALING AND SHARING"'an, CIluoclle. _ tominlI ~"., .... unity

OII'MQ _ ~ '0' .... 10"'" 01 urnty.We ........,.. 10 blc:ome mote inc.....,..

imoif""ll mcre ptIticJp.e,_. "'-'finlloIhet'I. c_tfOutoonl;~ a,. __"w_

Ine 'ab'I. in """,,-, and in bnot.

S.., ... _ mor._?1;10 _ hI., .ach o'he,·, ..outNh'1;10 _ hi.. Heh 0/".,., c,IH.nd "/JfIllIer?do ... •hll. o",../>oI 'Id ..11'1 ... h...?

Are .... III 1/1 _ mO ""IO...<6. ""ily_ perl.c<pellOtl.

itt _.II,p.M WrW<». ,_.... _.mcre_It'

We Inte _ ..._ •• _ ...~ inOfolt... '...w-._en _'oe. _".tIQtIt;'he btok.- 01 0... worl<I~"."peOC.pl.on oIllIe

"'01_" oIlne Sod)' 01 ell.....lod'" ,n D'olllll..... IfIe ..1IoJe C'NIIon

fl'OII1' III ' ',101 111. 'Ollerh " ,1'0., ill /11 God

L~ IIlh. _ " "',lIln .eeh 01 ....• md,~><1...,•• W• • ull /de..,.ty cr<,...... do 110' """. A'IIo _.....111<1 I",", "." tOOIJ:

W• ............_ .llOctf out ....,..Ou''''~UIC-,

Ou' m.-.s. Ou' ,...."' ...Out ,lIlIoons ..tllUn out , .

We.re ....,"'" _ butdlfl«1W1lh 0""..ft>Ch _ ......not .1Ied.

fl"'fI 10Q'1t<tt God _ low.tdI IIlOQllOU"" u,. W.... "01" dowllllyI'u"llled HP""'on•. b)' illll....bI' Illlllllll _ 01 IUJlarlon,

Fo. m,,,)' 01 .... LOId. IfIe __, 01mOl''''t1,ow.tdI A'1toIene"."m. Ih'IIoaI beyOtld' I'NICh.

loollll 11.. _-.." 01 "." commut>ftlls.of"." M_ 0' out hurnanlrilld

So _)' 011" _ ... IItfNIy ......, lace a Mot0I~..........,"""" _d,,._.

So ....", __ It.~ lhe" """"" <Iign/l)'..,. GPP'I'Hd. It. delJtlrtld0I1Iduc1l1Otl. ,."" ,"" ....~....1I1OIfflK:II .h",,1d 11... _,IOh" ..lIy Ill.,,,

loolt It 11'0' p'N''''d minor")',11., ..... uplhe """"CII oIlhe Httlllot lhe" own /11111111

P... , ><1"'glO CIot'III.__.... bJ_._ A'lIo __ '0 ........, ../10/1.

... dlM:_«I fllal.dl~ClHId ..an be able.1Id a I""" Ilc<tll DOd)' IlOl to boI<I:

'''', ",_ C... be _/IoIlr..." ... _ ... Droit......._ 11111 lhe De",1I(1 """I IIObII 01 11""'1/1ec:h/eY.ml/lll 'OUnd 10 III It" III.n ..1IoJe.

So ....,,,,clI our .mpry 1I.1Id, 10 .111.. 01

00"''''''10 Ileal",. tltoll II04Incl ut:_ .... /hi ptoc Il'"'fully I"", _ ..........dI_~.

_to

THEOLOGICAL REFLECTION

A Healing Church In search of Wholeness11 " no good Ch,islienl sayIngsomll1l'1lng with Hlell liPt slidple.chlng .nothef gospel wiltllt>eircountry", healll'l Cl,. IYltem. Goddldn"t Py Wllh hillips IlUIl" peoplewell! lowd by him and then dol'INllng mir~l.with the rich alone.Hild he doolI INlt, everyone wouldIUlve nOllee<l lIIe Incompatil)ilily.Wl'\lIt he &aid slid whIt he did wasauni,y: othe<wise theIr would N1\o1l1been no ChUfCh IlXI8Y.

The ultlrn.lle InJultk:.In I "nle the IINlI Injus\Ie., lheult;mate (njullice, i, Ihe injusticeot hulll'! Cl" 11 your neighbour"" • !)illget' house Ih.n you. 'Im.v nOI be lUll, but you u,n li.ein••mall hau... 11 you. nll1llt!ou, hilliI bIll u, Ind you have 10 wllk. It isunjuII: 0' il your neighbour ell"ea, cake and fancy 100<1 snd youhlye to get by on .craps, Ihar.bid But I1 is nOll'1lng complted towhether you neighbour I'll' anunlli. consumptIon or health Clue.11 you. by vI,tue 01 lhe cOlau. 01your .Idn or the ,,'ne» 01 you,pUf$e, .r. In. posl1ion 10 gobbleup IlIe 1le.1I11 clfe ....hlch ....Ouldh••e lI.ed you' neighbo... ,.. hIe,IlIen Ihl' .hOW, the uUim.ateinjusl+ce

So, il you .....nt 10 pfelch lheGo,pel 01 God'. mhn'le 10000e .Jldclre '01 all people. your counlry-.1Ie1llh c.re sySlem m.y e'tilnlulllybe Ihe Gospel yo cl .... lty preachano .... hlch 11 .cl lly hea,d Bodyc.re I. inc.maled ....ofd. and IlIali.....hy it IS 10 cenlral 10 IIleprelchtflg 01 II1e GO$pfll Howm... ch lIme d'd Christ and Ilter tt>e.polll.. nOI spenl on IIle subl$CI.Cllrill lIealed • blino beggar, •p,osllt ...te In Ifo... ble, Ihe sl••e o. asoldIer o. Ine occupymg po.....,He e~ptH;11ld Ill' .0110....ers 10 dOIhe Silme

SO. flellller IIIl.llh care nOf tilecll... rcll can shO.... prelefence 10 IIle_aUl'ly or IIIO$e ....oo h.e In lo....nsclose to ....Ilere doclOf$ cnoose 10ll.e lor Iheir own convenleneG. 11II'IP" dO Il'Ien the Inctrrnlllld wordstl'l-ey ptoduee In Il'Ie lorm D. heallhcare "' gospelll'lal i' nol Ir... e 10Cl'lr'lt.

Compusk>nCII,ist p.oeleimed Ihat GodreIgned ind III.t l'Iit rul. bee.mehidenl .... hltflevel the underp.... il­eged _re relieved, Il'Ie brollen­l'Ietrled eomlOfled an<! sinner'Olgl'tiln, he .'fi'med Il'IaI il ....15Goel".....111 Il'Ial IhtrIe IIClS be done.

C"'i~1 lnlfodueed • panlc... larten,'bilily 10 .uflering .... lIlehen.bled hIm 10 .nler InlO Ihe

1).. 20

expertence 01 the one ho,ultered He dIed on the era .

One c.nnot claim Ih ..compassion i. unIque toCII,iltianity but 1I 11 an Inll"n$;';:elemenl of .ny tlttaling ....hk:h ItIrue 10 Ihe Ipi"t o. Christ.CompassIon 'Of Il'Ie poor and tilehelplUI Is 10 be oll.rld ll'IOulany upeetalion 01 re ardbecause 'uch compa..1OIl Is a"lIeclton 0' God's Mlu,e, TllulIIle Quahly 01 medic.Jc.rell nOllObe regul.ted by Ihe 'billty 01 lhepal"nl 10 pay. Till. II m sharpconlflsl 10 Il'Ie ··m.rlletll'lg" 01med,c.1 cafe .... tlttre Il'Ie palienl itregarded .s a "conIum,," ....1'10must conlnbule 10 tile proMs 01pftvately o ....nld hospll.l, .ndservIces. nlls Is. sincere reality ,nSoull'I, Alric, .... he'e !Ilk o. tileprlvellnhon o' cerllin heeUI'IservIces " heard moft .hd moreloudly m govemment CIrcles

D.spile • long hlllO'y 01medic.1 mvot'tilmenl, .nd In IIleIl'Ilrd ....orld In Il'Ie lorm O. millionI'IOsplllls, tM Church', IUIUftconlfibutlon 10 medicine .... IUp,im.rlly be It the poinl ....h.'. il

reHects end embodIes Chrlsf.o .... n teaCl'llng, eumple endJudgement. In Ihe I",se'de'tillOped .re.. I1 needs 10 use theriCh potenti.1 01 III vlll.gechurches .nod congregations 10Inlllate aCllvltie$ wl'IlCh ....ould lead10 prtmary l'Iealll'l cafe

NHd of reM••'Both ChufCI'I .no medicine standin need 01 rene I,norderto 'ind.gftater degfee o holen"s Il\lInIl'Iey no.... pass"•. To enable lhem10 see lhe paltent/congregationmember In a ....,de/ conltxl llIaniust lhe ,Iekneu end ilS lrealment.In A'rica en4 Soulnern Atrlca I1...... Ihe SClrCily ot W"'It,n ItylemediC.1 care "JOU'ces and IIletln.nciet Imponiblllly 01eXlen4lng Il'Iem which broughlinlO loe s lhe dlSp.uily bel....een11'I0StI .e 1Io .....reltlrve(l.nothem.jority 1'10 .r. dep"v.d.

So IlIe concepl 01 I'II1Uhbeeeme rtdlcalilld by m.atchif'lllll10 Ihe dimension OllJOCill jUttlce....hlcl'l ,tiled e1l'1lcalenod pollllcllquetllons 'bOut resource.IIOClllon.

beCO<flo* CI.lIf Intllhellllre mlnyIIIlngl .....oog In In. presenlde"V"y 011 o.,lto care System 10Ine majorITy 01 Ine P«Iple.

Jflus Cl'lflll declll'ecl Inll' hent<,l come 11'111 .... m,gOI "",ve hIe.lInd nl.. I1 lIbunClllfllly- (Joho10.10) Bul 1""'~tlClllnllol.,nlne$filII ot 'l,IlIneu 0 .....oolenelS.tonlln"," 10 eK'PI mOSI people..... n.g In Sou," AlrOCll. Tois I'te",,"'y I' ue I1 ..unde<ltancl tnal10 De ....1OIe IS 10 be .n IOUnclcondlllOll. n..Ully, utlCllmlfllShe<1."'1aC! Tne nl,lffllln 'lImlly, wnet".._ lal~ lbou' oncIJvldull per$Of'II,

tam,l... "101:111'0111. cOftlm.Un•.loes O. <Iil1'O<'lS ,. d ... lOe<:l. b.ok.l'I.aJoel'lall!d lInd ..C~

In In,. CDUI'Il.y. 100.,nelcl..lbOur pracliCes lIIlO me unlll"Olllf·bulron 01 .... ,Un 10<,l.esouK" I" Imonglt lne '001tauS" lor tn.s brokenroe'll SocIilJ"'luSIICes sucn as lne..e 'lIOool bepas.....y ",cpleo "t tne COIl 011people's poysocal '114 mental ....eltbe,ng Tne Cnu"n an<,l allCn"stlaos nave I taSk beloF1lIncm 0

tt.o __

The money requiredto provide adequatefood, water,education,health and housingfor everyone intheworldhas beenestimatedat $17 billion a year.It is a huge sum ofmoney

... about asmuch asthe worldspends onarms everytwoweeks. ",",'-.......--.J

pfoblems Ihll If. the root ClIU..01 .ICkn.... ill commuollies.

It. htallng churchThe C...... fen coulcl lI'l," chtllengemedicln. 10 lIdmi'l Its 11Ick cAcompetence in VlIfioul IfNI 01di..... by diIPlly""i! its ownIbll.ty 10 011•• 1l.1ItmenlllnG Cif•.Th.. il coulcl diminsh the need 101medicllllllliOflIO 11!&11tIe doml'"01 ,,*,lcil'lll woulcl oecome morerestrlcled 10 acull illness ancl .tslfelltmenl, Fo. tom. 'eason t/'Ie,nu.cn n.. oOl_lnll" "hellllh",ofk~ Io(! In ,,'.chlng IOfalte<nlIJYllhtt...S it hat tended10 aDlIo(!on liS Vl!fy spec.1I1mln,SI.., Oll'lNhng

TM cnUKn needs 10 'ecower ,IS,,",qUI role .. 11 cl!&n..1 lh,ougn",I'locn C/lrill beocomel ItICI,na\f10 'ecooc.I., .....1 lIl'ld IOflll_Pellllpl 1I WOUld be .... ,.. lOllop11'IeO,"'ng 1ItlOul l/Ie ~HelI"ng

Cnl,l"1'l i1nd 'nsl.acl.d.moost,ne...nal II 100111 "U 10 thal olhe~

....OUla ""ve model. 10 Idopl andaclapl to Ihe" 0"'0 lilullllon

In South Ahlca10 !fIlS IUue 0' CRISIS NEWS II WIll

In ...rch of whole.,...One 0111I. blllc conceptlont 01.per-.on .... nev. 11'1 In. Bibl. I. one01 Iota lily. Ht J, ,payChotomal1cbeing Ih'o".gn end lI'lrougn. wiln.Jllh.tl 1111'"'.11" nOl ju.llnlll'"body h.t. 'lOul A person 1$ •liVIng IOUI. He'lll'l I, 10111 II •PlBOnII ...1I-bIong. It • tQCi.aIh.t""ony '!'Id lutlic. Thll VIew......Iready taUI'l by John Wtl$1eyin me mid-e'llhllll'llh CenlUIY AtUf'" It In.l. Chri.h.n doclOfSew_1Iy "'It onel bIlllWeCl lhal'lOCk ptl'torl is not j ....11 ~tle"ng

t>ocIy. I O<"f'fliIed moncl. Of Iwoul'lded 10 It. ~11"'fIoIe pel$(ll'lIn 0II\ef WOfd$. pullly lechnoalItlCl me<lJCII ....~l.lte nol enolI9hin lhem~. 10 meel!hl Me'<l$ot..._-

In lhe Gotpelt we _ Je.USlSll

p,nche,. IUCh., Ind huler Heco"",,;s..o!lllO n., O.Klples 10 aoIn. ..me (Mill 10). lln(l In theBook 01 ACIt _ see Ihe etlechwe­nu....,In ",1'lIch th" ,ommln<,l"'.. ObeYee! A malor leillure 01Ihis he'llng In tne Ne... Teslamenl"'.. thal It ...... healing Ihe ....noleman. meehog tIOlO nil phySicalIfI(l p.ycnOIDglnl surrerlOg lu~e

Ihe phy..,,,n, ... hole heallogIn'Qugh Ihe PO...er ot In, SP'''I. 00<,loubt emplOYee! lIIe $Ie...ar01h,p01 medic,ne So tOCl'y while being'geou 01 GOd' mltlculousne,l,og 00_' ...e ,an 'ISO use ou'tllenls lor medical hel'lOg anacounselhn.g

The Chu"" S/lDUIO .ecogolseIhll c1'S1u'bed ,ellhonSl'tlpsconl"bule I"~y la physOC.t' andPSYCIlolo9JCII dlneu Hunh IfIO~u 011 lhe oilier nan(!Imply In. atlll'ly 10 g'o ....pnylOCllly, mental..... lOI:.ally ana'" QUI '1I1l'onsn.p ""In GOCI500" 'nd economIC "'luSllCesslltld on Ihe .....y OI ...hOleness IfI<lchurcnn must la~e ,esPOO"O~lty

IOf wr-. ll'loly 1)I'....nl ...1I<Menesslnem..el~ The ,nu,cn m....1.ecogn.,1I ... nf'n Ind ...,-e lheStile 0' organl$lng 1)OcI_ 1)I' ....f'n1...nolllo,,, In. PlOple 01 10.:omml,ln,lI1S T/Ie ,nl,l,cII mustla~e al'l open and atl.... stllrllllIgalnSI s..en 'OCI.I In,usllces

TI'le cl'lt.u,n neeas 10 I/O muchlu<the. Inlln tuploflng Inemelolng ot healtn 10 relallOo 10IIlvallon Tne cnurCn neeOll 10promote ne.llh an<,l hnllhy hv,ng'1'1 a posillfil leOH Ind prOVide aIUpoo.1 SYllem 10f thOal ....no ale"lIble 10 become S'C~ 11 ....Oylaoeed '0 In,lt hom In ._cluslve,ol.'fll 10 Ine Indlv,<,lUll Io(! In1I11evlltong IICknell aller I!

<,l.v.'opl 10 I,ndong "'lIys 01prev....llng "s occurrence ,n theIIfSl plac. 11 lhooula looll ~I InclIdcl.ell Ih' 10CIo-economlC

page 21

DN RIGHTS AND RESPONSIBILITIESRev Peter Storey. Head of the Central Methodist Church is one of the few c5erics inSouth Africa that has spoken I,. public about health and justice and the possible roJeo'the church. He does this in a very Of'iglnal and challenging way. We pick uponsomeofhis topics.

r". word he.MI'\Q In Ill. Blbllc.1HtM'II' and Gr"k __n, ,,'v.elon"'Id PNCe, end boItl."... word. Inlut" Imply an lnlegrlty•• lull......MIl .....llNtlon .nd whoIlMlna of~. The .- appfOKtl In~ 1*. IOw...,. • .-. holittlcundentanetinO of .... lunetioning ofiJldMdu.lIt in eom<nunify 1$11.....'_e "roUM"" "'....f1ls BiOIa'unde..1anOit'lg of wtIoIoI........

On hMtth .. a batehUrNn I1QhlAllowing lor • ,"om,nl, th,

nat'owtll' lnletpr.latlon of "'llthcar•. ju.tlce mMn, ~bllitr 10thIo tlnl avail.b,- he.JIfl ca,. by I'IWoO"rd'" of ,ac.. ..... ,"igion.kleIotlon or linancOIoleir~ ...Thit~ the proIKtion of myhMlth Md !he bUun,w" 01 my ill..._Ill my buic huonan right. .1lCI.... pro¥iIlon cl .ucl'l ....llIlh CMI1Ncoi.... not. prl,,;19 but. mat..,of tlmple hum.n ju.IIc:•.

Furthermore ~n theoIoglc.1uncMrat'l'!dlng. 01 jUlllc. 1&11 u. lhalit .. _ thin • .,It" even­"'endedn,..: tmI1 wtlere ,,,.. h..tlMfl • lIi.torical boI.. .;ntl anypet-. Of 9fOUCl, tulllce ""y~I ~bltlll, eorrwaf04 biD. Henc>I- tpeek in~I C>tclet of-God .. on In. ... 01 .,.. poof'"

.....tIh ... political probl.mTill!. 01 tuttlcl In till l ...llllbUily ofhllllh uti Clnnot IIkl piece In •"lCUum. In IPM Contl.t 01 SouthAlrlce. lfUI JuttiCI In hllUh Clfl isImpOlllbl1 10 Itllln .lthoutlu~ta1 pr:Jlillcel chi"'.

Pt>o9lII 01 ~~11n ....ry tph-.of SOuth AlriCIn life hi.. 10 I;" wilh!he conll"ldic:tlorl of Irylng to doll-tlcI in I t InUy unju.t MIdeIyT,.,,,or- jumc. in r-Ith Clre i8 •politlCll plobilm bltor- iI .. Imldlcel onl. But Ihl "lIl1ngdlldpl,""" !hi doc:Iors lno:! hulllIwon.... will be Judged by 1111 cIeg....they lllow Ihlt Iyllemetilld I'tll to••111 0' 10 which Ihey try 10 ...adlCllI

••On the moralty of monnn-. 11 I\.IrdIy an~whIl' • __gllrirlg eumpII of "I ""--lily of-reform- lhIn tI'IIII wtIlch __ In....., Cl'" Aefonn lOll. Iof the(!IIpfi'. Id majority hlllIl<In IhIIofmof~ IIn'Id c:rvmbI Irom !tie'tlb* 01 I ptl"UJ9I'd mlno.ity..tu ni, .... rlfotm _t I __

_ 22

genlfOUl IMlplng 01 crumtt bulI.cludlllny In"lIltJon 10 Ilkl I 111111 1111 IIblllItHll.

Conlldlf the """"0- oommunlClId when I ,..~I iI bulh in~. ptIIUmablybKa,oll!hi okl_ ••~'" -In lhittheblIc:l<I_ told "you CIn ...... 1111 01<1_ now. 11 It no good 10 UIInymO.... Contidl. Ihe gronIrIl1f1lilJolity of IoCIling I Mc:ondgl'M! hoIpitIlln.,..,..." ot Prelorilo

whin IlIrgI' populltion 01 peopIl InM.meIodll'lu no l\oIpitlllllll. (ToIdd I IOcII nOle: ~de. !hi..1InIionI to afOOll Sc:huur in .,.._re of Clpe Town, .Ilill Mite:hIlII'.....n dllPill "Il'iota~don not hi.. _. -Editor)

EIc:/'I of IIlIM ........plIIlPu·. ofan Offlc:ill lltitudl D4n01Cl 1111 by anId.olOgy 01 "Cl. I .up.lo.Hy,compouncltod by rigfll_1 Indlgrlll'lion wt\en pl'Oj)l1" gfltiludl lor 1111erumbllt not lorthc:omlng,

Till ..-m)' of hMJlh 11 ClIIIdlpenheld .nd unlll iI ill_rid, or H

~ry, bl..I'" oulolllll.ly,11 i.dUlk:ull to .....n 0-1 to gripe .tlhlreditlonll '-UII probl..".. 01 whichGod kno... _ NI" ",ffic:lent

A ch.bnge 10 doclo,..In !hi d\u.rc:hlt _ !lid to flKh Ipoint wI\Il1I _ identitiId Ip&rttoeid• I he<aI)' - I1'1III1.. noper-.. c:ouIClp'of.. 10 follow ItII tMd'lingt ofChriII Ind IUPClOf\lpertheKl. I WOUld_nt 10 tugg_t l!\al nodoc:tor Cln In"ood COntCllne. IIkl thlHippoc:.llk: Ollh ,..peellll)' wllh 11.<telnt Iddltlon Ihll ),OU will notd;sc:,lmifllll 0I'l tile ball. 01 flU IJldl!\al you hi... I rupont.ibilily 10 1111community) without bIoc:oming I1I1110ng. .cti"l .n.my 01 IlIil'''''''''''y 01 ape~, Till righ_ of~ South AtriCln 10 iUluc:. andhIIlttl CIII demandt lhiI of yOU.

On Plfnttsdon 01....tth ..mee.One 01 11\1 Clndlel In lhI dar. OfSouth AlrlCln society IIIh1t _ .......hid I pertll!. flllI;..I)' chllpmldlc:11 se...lu 10' our 10.1_PIOPI•. WI Cln bejuttlyproud 01 t!\attrldillon, .....,. if llIe dlstribullon o.IUCtl ut. "ill ".nltI if to milllonl ofOUr rwll poor

But ioUlIId of I repic! and highpriority -...pII\IiOn 0111.. t1ll_, OUtgo.." .....nt _ till. of -prtdliM·tion~. I find ItII If"......n.. forprinlhlllon nOI only hO'yuncon.lncln" but fmmorlJ Indwithout human corn~on, Theymlk. "lIllh c". I mllll. 01sc:coonl;n" In"nd 01 Clfln" .nd IIfnd iI .trlngl INIt I iiO...rn""nl 10obHUld ""'Ih controlling ...". .....

ot ou, IloH••hould .....n, ,o.bdic.,e.1 • PO;nl wh••• lhey 1Wl~. ,e'l'Hpon.lbll,ty tor thOI...me Ilvet.

W. nttd ....., "'P. not ••tapotc:k...ds Wl'Ialh.... like ~ M not.wI'MltI ijbt<lIion c_ '0 SouthAl.oe.&. jIf,.",..tion .ill no! tie .n.....~On It. """'IIQ....• ...-round Inlll therMdk:Il Df'o,...JonTt.. 1Mf1;C;'INI-. r>t •~y ...u _.. ....."" eM. orov.....1I>e

onYOhoas • - ....IIlOI09'''''''' of iliam,:"IC" p.ol••• ,o.. '''11 ."empo-mg 01 "'" commun..,. Tilemyltoq.ue ••...._ding "la PfO'­.. noI".1I _ .. I.ull fIoullll is Mldomd~~ by (l(l(:ton ,,*-"\11

The Prote.I.... ,el_loon _mythologlUd lha 0""1 .nd ......,."-. ,.in•••• _1I ......nt <athe.

I"..... m.,..l..., A .,m.la. "'or"...11On.. 0Wf_ III 11'I<I ...*'al llfot_ion.

On pArtklpAtIonEm_et......' 01 IN paOllIa 00PIllltJlNlion II'loullI _k In)I'I'I me"X! \SoWn AHO "" _1Om UCl. I. Itngtw ll'I..l on'V two OUI 01 ttw1y 1___, 01 lhe SA ~"lIi<:" MdOantel eounc.t ..... lay-(lt....1 T.....,,~ tl\al "" lI""ffll POPUIarionis "P...."Iad br tht oo...n_appoon..... otMoulllyo dOltS not l'lOklbec ..u.. of I..... un.ap......I..I.....

""Ufl ol ''''' 00 • ' .......nt And can ittI>I true 11>I1 '" 'M3~ 1_ 01 theTnitty '0Ut _boIl1C' PI"'O"I.wlWn by,•• the tnOIl ",....Int h...II" c...need. 'ta 10 tI>I IounlI I.. lne tlladlcommun'ly? P.rTlCipatiQfl .. r'r'Of"'hlIn .. ''9h' . 11 is .. lftPOt'Iibfl<tyHt<e ........1 udly rKognls. II'IIlSOUlh Al<k:. i. • ••y "'01'1 oncomp.nlon .nd 0 01 duly 10OIl' ntUOhllOur CMuI wl" "11 you,h.l ,he Soul!> ",1,It.n public I. lheIHlt \I_'ou, In Ih' W..".n.orItlPem.PI rh. corPOfll. (;.uelly 01 oursoc'l'Iy h•••ncOU'I\I"<l ..n 1if>(;<I.ln\lap<ri' .mong indl.io:Tual••

On the .k:kne..01 0"" I societyU IN com.......ity _ 10 1f>OuI1Ia' it••nponllb,lity 'ot I.uly perllCipaTi"f'" /I..lIh c:... II'I<I'tI I.. my language_ f'Itad .. "....-;,. -.tUlI ........

10 unlOck ,,.,. """ 04 compa.1On.nd neighllOuriy lOo. In SOulh "I.aDon" 1I1.1nl.. ,"- wo'd... an.1I....pl 10 aplr!lUlIli.. 'he llfoblelft.The .1... ol hlNll" ca.. in 011.country .. • 11\0I11 .nd IjIirllualp'oblam _ It•• lit ..ct. 1OCial)'",It••••,11 .lImlt••nd _ "'.. losiOf pa.".~ _10U0nd lhe kaylO '1Ia.hor..nu••"lch Ilu i.. 'h•U....IMm..tion ol' "'" tOf ""......a01 olll&" we ...... noI begun 10Ul'IlIerIllnd whal iI _ 10 -00 ao01". _ wouIcl h Iham 00 10011 - or ao -.0.. o "..;ghtlou<IS .. _Ill Icr4 oun..""-. ThePOIll,(;I.n. t..lI I'" COUl'llry bye~poIo"'n; ....,. anti...... of"'"" ....On ol,.CIIC.I.t.p8 Ih.1cou IM t.lk~Why can ... not '1OIIc:a lhe _...,")ouIh p,ep&rae:t....• d"_ in

(whiI" KI'IOotI • ""'"=" If•• /IotcIlpotcll 01 •.,..*.1 ..nCI 1lOk1;e,,!~...... - Md thna petiodl 10leael'I "" ~ of Iile and the ......ol' "".11/1 eM, ~l Of'\IaniIUtionIIfk, SI Jotw>•• NoolIhuII)l'Da ItIlI AeclCroM 00 1l'If0000h • hInlIluI of"0111"1-. II'loullI tI>I PIr1 ol'~Khoot .ytlabtd.

Why CIf! _ ncM ""'it'"'" ...........to.. 1VllOn&l MnnC* open III..._ III tI>Il-.:! lotan """"""'"c.o••-cullu ... l p'OIl••mm.. 01lIa ••lap ......11n _ ","Ill Ir_. cityc:entr.. ....., lOwnI"'e-1I1l1ua ._

avai/able _ of Il'Ia fInaIl .fOlI ..­1\'IOIN.11d young re pi. would tI>I..,..... tor two )'NB or 1heir w-.

Why un _ I'OlIt~ of~",,*,oc:al gtl(lul1a .. _ or two ......tint on the t __~ INlIOC100 "' 1 ,.tio It __ thin In.....'Why Cl.. .. noI ta'9't ..,.,...d'um'I cor'Oll"'VItion in~ __.. .. POI..,till canl... loo prirnatyhNlth car•. aud't _ i. bei"f GOne in_ P<Irt* ol' L.IIi...........k:a? Thecl\ufC/le. ""'.. IN Ii"ll" most wllIa­.-InI'.·II,UC1u•• I.. Soultl AlrieIana I ....i. cono,ega"O'" claim 10bel.... In ca,ing lor~ lit..,..chun:h tonII,ega,ion... ingrow..nory /luddl...ho could b..chIIT"'lJ'tI 10 Ilk. ,heir own faitnMfioualy by becoml"ll pat! 01 tnanation', ",.llh • .,..Itm,

On ... Md btrth control......-~n •• 1UCCM'd wll/lOut\lrallj)lng I nI'II" of proper tu andbir1h control acIucItlon. 11 Il'OUbleI"" lor 1...._ thalli> ll'la ltca of !heIItnoeI (IallOddll AklI tt>ruI ItllIcounlry will .tlll 101"pedll It•.ducatio.. b'c.u,.. 01 '0"'''Cll¥InoItC __ of propflaty. TheINotIl,m • Iftel the ClMnlIl _ailwtllcIl will "op ut lrom edo.. tIWng!he COlllllO<ri .. I'OlIt~ .......,~'I '10 &lop ll'la"- of Akk.WI'IIIfIll __ ID PC!9''''*-> CDIIUOl"J111porat ?I,tha..-~petory

~ In the ~try. By .._. Ial Iho-a ~h "'Ig~

,c'up". Opl oUI 01 .ctl~.ly

pr~ bInl'l control ""tit.....bu1lal '"""' I'OlIt ~I ; I ...... IN

_u

The new Slave Trade

.....-......""'......., _......,.._.".,. ...••__,.__..... _ 1 _.~_ ...... ...-_ h--,.._--_.._- .....--..._ __,.., ... _ .. _ ... 01 ........-,." _....,-_ _._"" " , __ _" I' "W, __....,._.." _..._-...-........••::::_~_~ft:~_::::_::::_:"~.:::'~' ..::-:-:::::::::::::::::::::::::::::::::.:::::~ __J----

_.~ ,.......,,-.., ~. .. ..." ....• ~r ••_, •.,.

COUIH. F,om tile ...try beginning 01thei, lra,nlng they thould be In"'OI'illdIn community 1l.1I11l .nd lleIIncouIIglld 10 learn r,ome.pe'llInceCl .,II.lIt l'ItI.111'I ...orlle".nd ptramedlcl. Snng you, prim.ry1'I11.1I1l Clrll nUfllll. and .11 lno",...ntflil1fld nulHl ..ho fun ll'le ruralc'inle, 10 tile IIullllnt dOCIO~' IlIClulll1l11l1 .nd 11IIIhlI5e worke,. 'Illte thelrllIlIllly ...,tl'llhe .tullenl.: 0

o......:r W"",... ..,too' If"'" ,,. Ut'".........."'''' coun"," 'QOloe ""~"ulr" cite " 11'1. 'eCln' N,mIJICOtlI./e<IClI.

knowledllll ...here I1 belong•. ""'1'1 Il'Iepeople 1l0.. hard ...o,k .nd.ull.rlng g tl'lem m.t cl'l.nc•.

W/wII 11mbou,ne ....y••Dout thedrain 01 m&d'ClI petlOnnllll,om onecountry to.lIOthe, .Iso .pp11n to thed..ln 01 he.Uh pe,sonnel t'om 1I'lol,u'll arel. 10 the cities ...itl'lln Icounlry, .. th" I....ery .pphc.blll '0SOuth Africa.

O.... ld We,nllf. • .IIII,ng 'ufll­hnllh lunCl; hom lhe lltin Amerlclnco...ntrl.. Ind k.ynote ,pe.ke,.1 tile1988 N.mdl conre'ence. Slid tIlet0.... 01 the ....y. in ...hicll SouthAI,Ic.n medlcll school. COuld ~eep

yOlJng docto,. In Itle counlry and lIf!tIhlIm 10 I"'" ,n the rural IfIlU"'''' bycll.nglngll'llllt method o! training.

"'TI\lI mlldlc.1 lIudentl thould 011o,tenUlted to...a,d' communrty ne&dl11 • mUCIl e"hll' 'lallf! in their

It is a known fact that South Africa is losing agrest numberof its doctors to overseas countries such as the UnitedKingdom and especially the United States. It is also knownthat medical schools in South Africa have mostly failed todevelop a commitment in young graduates to the country'shealth services. A survey of the 1983 Wits medicalgraduates revealed that one third have already emigratedto other countries and another third plan 10 do so. Theirreasons for leaving are varied but almost all relate in someway to the political and health crisis facing South Africa.

n ... type or brain d.aln (lQet not only.nK! Soulh Africa DuI tile whole 01the Third World. O. fl A. Llmbou.n._01, u rollowa:

~... how much helIlln ca'laI'IouldaCh,llllln consume? W••II recogniset/wlt ItIIlUI .,e Ilmil. to 'he .mount ormoolIy '1"+(1 100d ...hlch _ lie

,."lIt"" 10 /wIve ...hen othe..... lrpoverty Of.,.lVing. Yet. In the UnllllOI(I~om and othe, count,i"......rewilling to d ..... (\()(:IOI1l,nlo ou' 1.1"+(1.I,om dlIveloping COUnl,ilI•.

'"W1I.,e ...ml"'il 10 pull (\()(:Ior. Intolondon ...hefe the docIo' p'0f'0l110n1.0.... 10< each 400 peraon. ',om layC,."".I AI,lea whe'lI the p,opol1lonI. one 10' 50 000 peraon•.

·Wh.1 killd 01 mOfllily I. It ...~"" are co.......mlng t1'lll1le"th carll 01ollle,,? HNllh lu.tice I. mO'1I ,.aie.1th.n .ny olhe' lu.tlce. In o'dlI, 10' u,to ""'11 f,om 70 10 72 ye.r. of 'lIlI, ,1l.11_ bring doctol1l f,om • country...he,e thll ••IIf1gll hlll.pan i. 35ViI"'?

·'NO... .....tIlIn _ SlY. 'Slap doi"'il th~kind 01 Ih''''iI' 1I0P $(ju.lldllring thehlllllh c.rll 01 the Indi ...,du.!' ....lIryoltlln _get I/It ,eply Ih.1 hum.n 1,IeI. IIc,eel. .nd Iheology .nd biblicalql'OUlllons .re uMd to .upport tilep_t pracllce. But tn~ "'11 mu.tremembll'· th.t thll pe,son I. "C'&d'0 God ...'thln God'. di"',"e pU'PO'II....hich 'I to bring .11 peoplll 10 him.Therll I. nOlhlng UC'lId .boul .nindl ...ldu.r. long8\llty In itseU, TIle<eI. nothing IIC'&d .bout.n Indl ...iduIIbeing .ble to .....110... up g'e"quanlilllls 01 hlI.lth ca'e Llle In theBiblll la not .ae,td In ;"elf but IsIIcred ...Ithln the p .....polft 01 God 10b,lng .n hum.n blIings to 1lIII00001llp...l1h eaeh othet'lId commu",on ... llhhlmNlI.

"M.ybll ,n the lu'u". g'oupa 01CIl,I.II.n. will come 10 uy thatbringing cloclO<s from de....loplngInto hlghty .,fluent counf,ln I••mod.,n lIqul....llInl of thll.I....e tr'de01 th... centu,;" .go."

Following Or Lamboumes line 01Ihought. pll,h.p. in Ihe futu'.dO<;tofl ...ho h .... 1I .....d Ihel'pri'illllglld p(nltion in South AI,lellobecomtt p,oI••lon.llIlIIllh workll"... 111 .pply Ih.I, .ccumullllld_2.

~. r ....~ .. __il .e-T_- ....-."'-...........--_.