From the President
Welcome to our new website, and a belated welcome to 2020 from all of us at the first regional society on addictions, born in Cape Town, South Africa! When we set about birthing this local chapter we had no idea that this year would be The Year Of The Nurse and we had no idea how central advocacy would become in these early months. A happy International Nurses Day today!
We are knee-deep in the COVID19 health crisis. If I look at the media that’s available to the public, and what’s being consumed and shared across multiple platforms I do not see or hear the voice of the nurse. Even in “our year”, we are largely publicly silent.
The struggle for social justice
Here in South Africa where civil society is actively bearing up vulnerable groups across the land what stands out is this: disaster widens power differentials drastically, and exacerbates powerlessness in the extreme. This slope is what tips at risk people into current and future sickness, and early death.
This conclusion is not new. The social drivers of health and illness are well known. We know that communicable and non-communicable disease, and mental ill-health will significantly and disproportionately affect certain members of our community. The majority of our nation will never enjoy the highest attainable standard of health possible, solely due to socio-politico-economic factors. Poverty, gender, age, nationality, race, education and class still determine, for too many people, what state of health they can expect over their lifespan. The burden of poverty costs lives, and is paid in suffering. This is why advocacy and social justice remain the foundations of ethical nursing practice.
Health for All
Our Health legislation clearly defines vulnerable groups in need of critical consideration when health services and social programs are delivered. The Disaster Act which underpins our COVID19 rapid response and operations plan specifically grants government departments the means to act to save lives, bring relief to distressed people, and to mitigate impact.
Technical Guidelines calling for attention to special groups- the elderly, mental health service users, women and girls, children and internally displaced persons have laid out recommendations aimed at prevention and protection. These cover temporary and disaster shelter, water and sanitation (WASH), food distribution, infection prevention and control (IPC), mental health and psycho-social support (MHPSS), essential medical services, protection of human rights, communication and engagement, and health promotion measures.
Human Rights defenders do the advocacy work that ensures that these ideals and principles are realized when people need them the most. Civil society has been forming community networks and partnerships to quickly address the historical social schisms that still exist in South Africa in order to meet basic needs, monitor repression and give technical assistance across sectors. Volunteer via either of those links to make a difference.
Human rights violations in state services
As a nurse I have been documenting health rights violations in my city for weeks now. I am glad that at least they have been documented, and the threads of investigatable violations have been caught and held. I have been intervening to connect service providers and people in desperate need of services- people whose clear and apparent needs have been outright ignored in the most shameful and unethical manner. I go to court on Thursday with my other comrades to refute the request for an interdict to bar accredited human rights monitors of the SA Human Rights Commission from the Strandfontein shelter. Comrades who the local authorities have refused access to monitor a number of times.
At the back of my mind I think about whether my advocacy would be more effective if I was an epidemiologist or a professor of medicine. And then I do a site visit and I see the most basic infection control infringements, operational defects and the blocking of essential health services and I think about the critical viewpoint of the nurse. Nurses see the environment and they see the people. Nurses know the theory of health care and they know the practice. Nurses are aware of the parts, and the system. Nurses provide clinical care, they coordinate services, they educate, research and advocate. This is who we are, what we should be focusing on and what we should be speaking about.
The unique voice of the nurse
Nurses have something to say: something real, valid and valuable to say. Nurses speak up so that the voice of the most vulnerable can be amplified and understood. They don’t need to speak for anyone who can speak for themselves. But they must speak whenever people cannot.
What IntNSA South Africa and I will be saying as loudly, clearly and convincingly as possible is that health is the right of every person, and that right cannot be removed by incompetence, insensitive politics or apathy. We will be saying that human rights cannot be eroded or ignored in crisis; this is the time for them to be especially protected. We will say that ignorance of evidence-based care or technical standards is not an excuse. We will say that nurses and doctors must be held fully accountable for their duty of care. We say that ethical nurses must be human rights defenders, and active in advocacy for all people.
For the rest of this special year we will be saying that nurse advocates must find their voices, and we will gladly help them use them.
IntNSA South Africa