Return from South Africa

You’ve already read some health care stories from my recent trip to South Africa, but now please permit me some general summations of other things I learned.

I imagine I am somewhat typical of my generation in the United States, in terms of my limited understanding of the recent history of the country.  Many of us felt tremendous admiration for Nelson Mandela and his colleagues after the multi-year struggle against Apartheid, but it was difficult from afar to understand the brutality of the regime under which that social, economic, and legal policy was enforced.

Apartheid was not just white domination of blacks, although that was harsh enough.  The legal system at the time also deprived other non-whites, i.e., “colored” people, of their rights.  Among other insults, the government produced the Group Areas Act, permitting the government to forcibly relocate over 150,000 black and colored people from their Cape Town homes.

One area so affected was District Six, home to some 60,000 colored people.  In 1966, District Six was declared a “white” group area, and over the next 15 years, this vibrant, mixed neighborhood in the middle of the city was systematically razed, forcing the residents to move to new depressing and physically inadequate townships on the outskirts of the city.  (Some of the streets on the Cape Flats, cynically, were named for those destroyed in District Six.)

At the District Six Museum, there is a heartfelt story that captures the loss to this community:

Let us not let the topic of this story minimize the human hardship.  Rather, it is precisely its elegant simplicity that gives a hint of the sadness of the time and the inhumanity of the regime.  Here is a portion of the 300 meter long memory cloth on which former residents of the District have written their testimonials:

At a visit to the prison on Robben Island, we heard from this gentleman, who had been brought to the island as a 25-year old political prisoner in 1981.  Upon arrival, he was intent on meeting “the old men,” Mandela and the others who had already been imprisoned for many years.  He eventually succeeded in entering their cell block and upon meeting Mandela asked, “So what are we accomplishing by being locked up here?”

Mandela replied, in essence, “It is all part of our plan.  The day will come when the power of our cause and the pressure of our allies around the world will force the government to accede.”

It took many years before that was to take place.  Mandela was finally freed in 1990 after 27 years in prison.

I asked the gentleman, “So, was Mandela really seen by all of you as the leader, or is that just a mythical impression we get from abroad?”

“Oh no,” he replied.  “He was the acknowledged leader, a man of great character, modesty, and kindness.  He had the respect of all here, prisoners and guards alike.”

Year later, when Apartheid was ended, Mandela visited the judge who had sentenced him to life imprisonment at Robben Island.  The judge described him as “a saintly man.”

Many topics I cover on this blog rise or fall on the issue of leadership. Whether or not Mandela should be described as “saintly” is not the point.   He was, after all, a human being with his own flaws.  But by any measure, he was an extraordinary leader.  How many of us would have the patience and perspective to say, while sentenced to life imprisonment, “It is all part of our plan?”

People of this stature come along very infrequently.  Gandhi, King, Mandela.  While they hope to succeed in their cause, they also are prepared to give their lives in the knowledge that they have moved events forward. 

I don’t know if any of them read the Pirkei Avot, teachings of Jewish sages of old.  There is one lesson that seems to apply to their struggles:

You are not obligated to complete the work, but neither are you free to desist from it.

Dear health care folks, I don’t mean to equate what we do with what these great people experienced. However, those of you who are involved in trying to save the hundreds of thousands of people preventably killed and harmed in hospitals every year may feel great frustration at the slow pace of your work.  And, while we don’t risk our own lives in our daily work, we do often face the calumny of our colleagues and the disrespect or disengagement of those whose attention is placed instead on the business aspects of the profession. Apathy often reigns, too, within the profession and among the public.

So whether you are in South Africa, the US, or elsewhere, when you feel it is just too hard to remain passionate about your cause, please be assured that your leadership makes a difference.  Again, please remember:

You are not obligated to complete the work, but neither are you free to desist from it.