November 4, 2020

Oxygen and suffocation in South Africa’s Health System

Salimah Valiani

Though not adequately acknowledged, nurses are the oxygen of healthcare in South Africa. COVID-19 has amplified this reality while graphically exposing the suffocating nature of inequality and under financed public healthcare. Drawing from two recently published articles, I will problematise widely held perceptions of nurses by elaborating on the systemic forces that make for extremely challenging working contexts lived by nurses. Presenting testimonies from nurses that highlight their day to day experiences at work, I will argue that misogyny is at the heart of the tendency to blame nurses for many aspects of the health system far beyond their control. Secondly, I will present a collective solution toward restructuring the health system and begin overcoming the misogynistic focus on nurse behaviour. In greater detail, I will expose a little discussed aspect of the newly legislated, National Health Insurance (NHI), which I argue is its major flaw. Beyond the NHI, I will present three elements that I argue are key to achieving sustainable universal health care in South Africa. The premise here is that universal health care is a public service that women in particular value given the disproportionate burden of pain and unpaid carework carried by the majority of women. The two articles from which I will draw are “Public Health Care Spending in South Africa and the Impact on Nurses: 25 years of democracy?” (published in Agenda, Special Issue – Gender and the Economy in Post-Apartheid South Africa, v. 33, i. 4); and “Structuring Sustainable Universal Healthcare in South Africa” (published in the International Journal of Health Services, v. 50, i. 2).


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Salimah Valiani

About Salimah Valiani

Salimah Valiani is an independent researcher of world historical political economy. She is the author of the research monograph, Rethinking Unequal Exchange: the global integration of nursing labour markets (University of Toronto Press: 2012), and authors’ editor of The Future of Mining in South Africa: Sunset or Sunrise? (Mapungubwe Institute for Strategic Reflection: 2018). She has also published a range of policy papers, journal articles, and popular articles. She has served as a researcher and economist in unions and nongovernmental organisations in Canada and South Africa since 2001. In 2012 she received the Feminist Economics Rhonda Williams Prize – an award recognising feminist scholarship and activism in the spirit of the African American economist and advocate, Rhonda Williams.