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No abstract available.
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Acessibilidade aos Serviços de Saúde , Migrantes , Humanos , Zimbábue , África do Sul , Apartheid , Imigrantes IndocumentadosRESUMO
This article explores why white supremacists regard self-directed mobility by people of color as threatening by examining a controversy that unfolded in a mining town called Springs during the apartheid era in South Africa. Drawing on archives, oral histories, and testimonies, it shows how white residents of Selcourt and Selection Park, along with their allies in the town council, prevented Black workers from walking and cycling through the suburbs. Infrastructure and social disciplinary institutions proved effective in forcing Black workers to largely comply. It argues that the white supremacist disciplinary imperative against the workers arose directly from the characteristics of their mode of mobility. In their open embodiment, free from the confines of mechanized transport, and slow speeds, the workers engaged in a sustained refusal of spatial segregation. The article highlights how racial difference as an analytical category sheds light on mobility control within regimes of white supremacy.
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Caminhada , África do Sul , História do Século XX , Humanos , Caminhada/história , População Negra/história , Ciclismo/história , Apartheid/história , Racismo/história , Relações Raciais/históriaRESUMO
Since South Africa's first democratic election in 1994, the student leadership profile has changed dramatically at historically white universities (HWUs). Given the postapartheid South African context where this study was conducted, and how participants navigate multiple role identities within a multicultural setting, the article elucidates student leaders' self-reflection on their role identity and draws on identity theory from the discipline of social psychology as its theoretical framework, while referencing the roles model from leadership studies.
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Diversidade Cultural , Liderança , Identificação Social , Estudantes , Humanos , África do Sul , Adulto Jovem , Adulto , Masculino , Universidades , Feminino , Apartheid , AutoimagemRESUMO
BACKGROUND: Zimbabwean undocumented migrants rely on the South African public health care system for treatment of non-communicable and communicable diseases, surgery and medical emergency services. A gap remains to understand undocumented migrant experiences at a time when accessing public healthcare has been topical in South Africa. AIM: This article aimed to describe and understand the experiences, challenges and health-seeking alternatives of undocumented Zimbabwean migrants in accessing healthcare services in Nellmapius in Pretoria. SETTING: The study was conducted at Nellmapius in Pretoria. METHODS: A qualitative descriptive research design was used. Structured interviews with 13 undocumented migrants were conducted by applying purposive and snowballing sampling techniques. The data were thematically analysed. RESULTS: Migrants reported that the attitudes by healthcare officials suggest unwillingness to provide services to undocumented migrants, aggravating their vulnerability and perennial illness. Migrants faced challenges of discrimination, a lack of professional service delivery, a lack of financial capacity to pay for services and a lack of documentation evoking health-seeking alternatives. CONCLUSION: Migrants continue to face challenges while accessing subsidised health care. This study confirms that medical xenophobia is generally present in the public health care centres, at least for the sampled undocumented Zimbabwean migrants. The majority of undocumented migrants cannot afford to pay for private healthcare.Contribution: The findings of this study inform national, provincial and local healthcare facilities to be ethical and provide dignified quality healthcare to undocumented migrants in line with international practices.
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Migrantes , Humanos , Acessibilidade aos Serviços de Saúde , África do Sul , Apartheid , Zimbábue , Pesquisa QualitativaRESUMO
This is a reflection from three Black South African doctors - two women and a man. We studied at the institution that we are currently working in, which is a former white university that was not permitted to train Black medical students by the apartheid government. We experienced the segregation in healthcare and witnessed how our communities did not have access to it. The COVID-19 pandemic unearthed major challenges and asymmetries, particularly for the Black race and poor countries. For countries such as South Africa, it brought back memories of the apartheid past with the history of segregation and discrimination.
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População Negra , Atenção à Saúde , Pandemias , Feminino , Humanos , Masculino , África do Sul , Segregação Social , Apartheid , Discriminação SocialRESUMO
While global health leaders call disparities in access to COVID-19 vaccines an 'apartheid,' this gap is not the first such disparity. The recurrence of these gaps in low and middle-income countries and especially in Africa, raises questions about their determinants and about the persistent failures of global health institutions to remediate them. We interrogate these determinants and questions by examining: (1) the distribution of COVID-19 vaccines; (2) primary determinants of vaccine access including availability and affordability; (3) factors affecting availability (hoarding, COVAX, and manufacturing capacity); and (4) factors affecting affordability (pricing, intellectual property rights (IPR), the TRIPS waiver and a potential pandemic treaty). We conclude that IPR constrained the affordability and availability of COVID-19 vaccines in ways inadequately addressed by COVAX and a waiver compromise thwarted by political, corporate, and philanthropic interests. While stronger limits to IPR in a pandemic treaty and a reformed International Health Regulations will not resolve structural inequities, they could meaningfully expand LMIC autonomy to protect public health. We urge equity-seeking Global South and North actors to fight for such IPR reforms as small and meaningful steps towards a more equitable global health order. Otherwise, criminally racist 'apartheids' will continue to be the norm when it comes to the distribution of essential health goods during global health emergencies.
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COVID-19 , Vacinas , Humanos , Vacinas contra COVID-19 , Apartheid , COVID-19/epidemiologia , COVID-19/prevenção & controle , ÁfricaRESUMO
OBJECTIVES: The COVID-19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors-a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post-apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID-19) pandemic (ca. 2020-2021). MATERIALS AND METHODS: Data came from 88 adults who participated in a follow-up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID-19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID-19 stress was calculated to evaluate the potential effect of stress sensitization. RESULTS: Fifty-six percent of adults exhibited moderate-to-severe PTSD symptoms. Greater childhood adversity and higher COVID-19 psychosocial stress independently predicted worse post-traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non-significantly worse PTSD symptoms from COVID-19 psychosocial stress. DISCUSSION: These results highlight the deleterious mental health effects of both childhood trauma and COVID-19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.
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Experiências Adversas da Infância , COVID-19 , Transtornos de Estresse Pós-Traumáticos , Criança , Humanos , Adulto , Transtornos de Estresse Pós-Traumáticos/epidemiologia , África do Sul/epidemiologia , Apartheid , Estudos de Coortes , Seguimentos , Pandemias , COVID-19/epidemiologiaRESUMO
The International Convention on the Suppression and Punishment of the Crime of Apartheid (1974) and Article 7 of the Rome Statute of the International Criminal Court (1998) recognise apartheid as a crime against humanity, characterised by a practice of systematic oppression and violations of human rights with the intent of one racial group to maintain domination over another. The term 'medical apartheid', although without a formal definition in international human rights law, has been used similarly to refer to situations of pervasive segregation and discrimination in health care, based upon race, and characterised by stark inequality in health care accessibility, availability, acceptability, and quality. This paper, using a combination of literature review; data on attacks on Palestinian health facilities, workers, and transport; and information from Palestinian and Israeli government authorities on referrals to specialised health care services, examines the ways in which Israeli policies and practices can be understood to constitute a form of 'medical apartheid' that deprives Arab residents of the Palestinian territories the full realisation of their right to health.
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Apartheid , Transtornos Mentais , Humanos , Árabes , Atenção à Saúde , Direitos HumanosRESUMO
BACKGROUND: South Africa's rates of psychiatric morbidity are among the highest in sub-Saharan Africa and are foregrounded by the country's long history of political violence during apartheid. Growing evidence suggests that in utero stress exposure is a potent developmental risk factor for future mental illness risk, yet the extent to which the psychiatric effects of prenatal stress impact the next generation are unknown. We evaluate the intergenerational effects of prenatal stress experienced during apartheid on psychiatric morbidity among children at ages 17-18 and also assess the moderating effects of maternal age, social support, and past household adversity. METHODS: Participants come from Birth-to-Twenty, a longitudinal birth cohort study in Soweto-Johannesburg, South Africa's largest peri-urban township which was the epicentre of violent repression and resistance during the final years of the apartheid regime. Pregnant women were prospectively enrolled in 1990 and completed questionnaires assessing social experiences, and their children's psychiatric morbidity were assessed at ages 17-18. RESULTS: Full data were available from 304 mother-child pairs in 2007-8. Maternal prenatal stress in 1990 was not directly associated greater psychiatric morbidity during at ages 17-18. Maternal age and past household adversity moderated the intergenerational mental health effects of prenatal stress such that children born to younger mothers and late adolescent/young adult children experiencing greater household adversity exhibited worse psychiatric morbidity at ages 17-18. Social support did not buffer against the long-term psychiatric impacts of prenatal stress. CONCLUSIONS: Greater prenatal stress from apartheid predicted adverse psychiatric outcomes among children born to younger mothers and adolescents/young adults who experienced greater concurrent stress. Our findings suggest that prenatal stress may affect adolescent mental health, have stress-sensitising effects, and represent possible intergenerational effects of trauma experienced under apartheid in this sample.
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Apartheid , Trauma Histórico , Adulto Jovem , Adolescente , Feminino , Humanos , Gravidez , Adulto , África do Sul/epidemiologia , Estudos de Coortes , Saúde Mental , Estresse Psicológico/epidemiologiaRESUMO
Nearly 30 years after apartheid's demise, a reporter revisits children's health in South Africa.
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Apartheid , Saúde da Criança , Criança , Humanos , África do SulRESUMO
Black and low-income neighborhoods tend to have higher concentrations of fast-food restaurants and low produce supply stores. Limited access to and consumption of nutrient-rich foods is associated with poor health outcomes. Given the realities of food access, many members within the Black communities grow food as a strategy of resistance to food apartheid, and for the healing and self-determination that agriculture offers. In this paper, we unpack the history of Black people, agriculture, and land in the United States. In addition to our brief historical review, we conduct a descriptive epidemiologic study of community food-growing spaces, food access, and neighborhood racial composition in present day Philadelphia. We leverage one of the few existing datasets that systematically documents community food-growing locations throughout a major US city. By applying spatial regression techniques, we use conditional autoregressive models to determine if there are spatial associations between Black neighborhoods, poverty, food access, and urban agriculture in Philadelphia. Fully adjusted spatial models showed significant associations between Black neighborhoods and urban agriculture (RR: 1.28, 95% CI = 1.03, 1.59) and poverty and urban agriculture (RR: 1.27, 95% CI = 1.1, 1.46). The association between low food access and the presence of urban agriculture was generally increased across neighborhoods with a higher proportion of Black residents. These results show that Philadelphia neighborhoods with higher populations of Black people and neighborhoods with lower incomes, on average, tend to have more community gardens and urban farms. While the garden data is non-temporal and non-causal, one possible explanation for these findings, in alignment with what Philadelphia growers have claimed, is that urban agriculture may be a manifestation of collective agency and community resistance in Black and low-income communities, particularly in neighborhoods with low food access.
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Apartheid , Características de Residência , Alimentos , Abastecimento de Alimentos , Humanos , Philadelphia , Análise Espacial , Estados UnidosRESUMO
In the 1980s and 1990s, South Africa was considered a global leader in the development of unmanned aircraft largely because of the Seeker, a drone created by the state-controlled armaments industry during apartheid. This article examines how military power, state-enforced racial hierarchies, and global exchange are made visible and obscured through the drone's unmanned system. It advances the concept of drone infrastructure, which updates theories of the drone that focus on optics and verticality. Drone infrastructure studies the web of relations organized by aircraft systems and articulates how the interplay of visibility and invisibility affectively and materially structures drone systems. The study starts with the 'invisible' transfer of drone technology that led to the Seeker, pointing to a shared genealogy of warfare linking South Africa, Israel, and the United States, as well as the 'secret' use of the Seeker in the South African Border Wars. It then turns to how, in the post-apartheid era, the Seeker was refashioned as a technology of national protection and democratic advance, a 'visible' symbol of the new state. Contemporary efforts to use drone aircraft in South Africa for wildlife conservation in the 2010s aim to overwrite these earlier uses, describing the air platform as international aid. Yet, the Seeker's militarized infrastructure continues to shape drone use and the logics of white supremacy persist in the networks of relations organized by contemporary drone use in South Africa.
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Apartheid , Dispositivos Aéreos não Tripulados , Aeronaves , Israel , África do SulRESUMO
Inpatient psychiatric treatment and violence assessment are strongly influenced by a patient's race and class identity. The authors argue that psychiatrists enact a crypto-apartheid wherein they recognize and condemn the structural racism and classism disadvantaging many patients, but through violence risk assessments and dispositional decisions, psychiatrists also function as arbiters of public safety and repeatedly disadvantage less-privileged patients to further symptomatic decline or even subsequent incarceration.
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Pacientes Internados , Psiquiatria , Humanos , Pacientes Internados/psicologia , Apartheid , Negociação , Violência/prevenção & controleAssuntos
Equidade em Saúde , Vacinas , Apartheid , Vacinas contra COVID-19 , Saúde Global , Humanos , África do SulRESUMO
Black South Africans accounted for 6.2 out of 6.4 million people living with HIV in South Africa in 2012, highlighting extreme racial disparities in HIV infection. These racial disparities are the result of structural and historical factors, specifically, the racist policies which were facilitated by segregation before, during, and after Apartheid. First, we describe the theoretical context of how racist policies and segregation are linked to HIV prevalence. Next, using data from a 2012 national survey of South Africans (SABSSM IV) and Statistics South Africa (StatsSA), we describe the race-specific geospatial distribution of HIV in South Africa, provide empirical evidence for the impact of Apartheid on important risk factors for HIV infection, and describe the relationship between these risk factors and HIV within racial groups. Using multilevel logistic regression, we find that segregation increases the odds of HIV infection among Black South Africans, even after adjusting for many covariates which are sometimes blamed, in place of structural factors, for a higher HIV prevalence in Black South Africans. We found that the estimated odds of infection in the most segregated municipality was 1.95 (95% CI: 1.15, 3.32) times the odds of infection in the least segregated municipality for Black South Africans. In addition to segregation, we also find other covariates to be differentially associated with HIV infection depending on race, such as gender, age, and sexual behavior. We also find that the HIV infection odds ratio comparing Black and Coloured (i.e., multiple ethnic groups with mixed ancestries from Africa, Asia, and Europe) South Africans varies over space. These results continue to build evidence for the influence of structural and historical factors on the modern geospatial and demographic distribution of HIV.
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Apartheid , Infecções por HIV , Etnicidade , Infecções por HIV/epidemiologia , Humanos , Políticas , África do Sul/epidemiologiaAssuntos
Direitos Humanos , Racismo , Feminino , Humanos , Masculino , Apartheid/história , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , História do Século XX , História do Século XXI , Infecções por HIV/história , Direitos Humanos/história , Racismo/história , Minorias Sexuais e de Gênero/história , África do Sul , Tuberculose/história , Pessoas FamosasRESUMO
PURPOSE: South Africa has long endured a high prevalence of mental disorders at the national level, and its unique social and historical context could be a contributor to an increased risk of mental health problems. Our current understanding is limited regarding the relative importance of various social determinants to mental health challenges in South Africa, and how existing racial inequities may be explained by these determinants. METHODS: This study attempted to elucidate potential social determinants of mental health in South Africa using data from the nationally representative South African National Health and Nutrition Examination Survey (SANHANES-1). The main outcome of interest was psychological distress, measured with the Kessler-10 scale. Hierarchical linear regression models included covariates for demographic and socioeconomic factors, count of traumatic events, and a series of stress-related constructs. Analyses were conducted on two populations: the entire sample (n = 15,981), and the African subpopulation (n = 10,723). RESULTS: Regression models on the entire sample indicated racial disparities in psychological distress, with Africans experiencing higher distress than White and Coloured individuals. Results within the African sub-population indicated geo-spatial disparities, with Africans in formal urban settings experiencing higher psychological distress than those living in formal and informal rural locales. Across both samples, results indicated a cumulative association between count of stressors and traumatic events and distress. CONCLUSION: We found racial disparities across several mental health-related domains. Africans had greater exposure to traumatic events, social stressors, and psychological distress. This research is a necessary foundation for public health interventions and policy change to effectively reduce inequities in psychological distress.
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Apartheid , Angústia Psicológica , Estudos Transversais , Humanos , Inquéritos Nutricionais , África do Sul/epidemiologiaRESUMO
Vaccine apartheid is creating conditions that make for premature death, poverty, and disease in racialized ways. Invoking vaccine apartheid as opposed to euphemisms like vaccine nationalism, is necessary to highlight the racialized distributional consequences of vaccine inequities witnessed with COVID-19. This commentary clarifies the concept of vaccine apartheid against the historical and legal usage of apartheid. It reflects on the connections and important disjunctions between the two. It places the intellectual property regime under heightened scrutiny for reform and transformation. This commentary finds that drawing on the intersections between a human rights and health justice approach can provide creative and novel approaches for anti-subordination. It concludes that acknowledging and naming the structural injustice of vaccine apartheid is only the first step towards providing redress.
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COVID-19 , Vacinas , Humanos , Apartheid , COVID-19/prevenção & controle , PobrezaRESUMO
There are many reasons why the international community as a whole should advocate for COVID-19 vaccine equity: global economic recession, uncontrolled outbreaks with higher risk of virus variants and persistent unsafe travelling in an era of now vaccine-preventable cause of death. This inequity is an avoidable threat to global health. Funding agencies, policy makers, drug companies and NGOs among others have the moral duty to end this vaccine apartheid and to make vaccine equity a reality. In this viewpoint, we discuss how inequalities in vaccination access affect a proper control of the pandemic, highlighting specific consequences on child health.