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Vote of Thanks, Dr. Nkosazana Dlamini Zuma, Minister in The Presidency: Planning Monitoring & Evaluation, On the Occasion of the Send-off for South African Medical Students 4 July 2018

Victoria de Giron Havana, Cuba


Comrade Programme Director;

Ministers of Health and Higher Education from the Government of Cuba and the Republic of South Africa;

Head of International Relations for the Communist Party of Cuba;

Representatives of the government of Cuba and senior officials from South Africa

Our pride: the medical students who bring us here

Esteemed guests

Friends and comrades

I am tasked with the daunting task of offering gratitude on behalf of over 57 million South Africans, a majority of whom are greatly talented but with limited prospects for development.  This daunting task, of offering gratitude, should also be on behalf of the billion strong army of our people who occupy our continent and are still confronted by the triple challenges of unemployment, inequality and poverty. 

This task is also compounded by the fact that the offerings of Cuba span over six decades and the relations between our peoples have been since before the beginning of the new world.  Our intertwined history of being the oppressed and suffering under colonialism and imperialism is one that has made us stronger in our resolve for a just and fair world.  These are the ideals that our forbearers fought and died for, including Jose Antonio Aponte, one of the first free slaves to lead an insurrection against Spanish Colonialism in Cuba.  Indeed, our common history, and dare I say destiny, takes into cognizance the contributions of great Africans and Cubans such as those of Comrade Carlota Lucumí, who was amongst the first to lead the Triunvirato Rebellion, during the Year of the Lash (1843) against the Spanish slave masters in Cuba. 

It is this courageous history and selfless contributions of millions of Cubans and Africans that provides the requisite wind to these sails of gratitude, I wish to offer.  I undertake this task of offering gratitude amongst family, as I have come to love the ways and the people of Cuba since my first encounter with them during the World Youth Festival of 1978 hosted here in Havana. 

In order for me to adequately capture this gratitude, we shall have to take a short walk down memory lane to a time prior to the conceptualization of the Nelson Mandela Fidel Castro Medical Programme.  We do this, so that we may accurately recall the reasons for the programme.  We also do so so that we may recall the objective of improving the quality of life for our people, particularly for those who live in rural South Africa and in the former Bantustans.  In 1990 at the dawn of our democracy, the health care system was fragmented and was with large disparities where:

·      Average per capita public sector health care expenditure was R55 in the ‘homelands’ compared to an average of R172 in the rest of South Africa[1]

·      There were 22,260 medical doctors registered in South Africa out of whom only 6,087 had a registered medical specialty.

·      The ratio of doctors to population in the metropolitan areas was approximately 1:700, compared to 1:1,900 in non-metropolitan areas. In the homelands it was estimated that there were up to 30,000 people per doctor.

These figures were compounded by the growth of private health care which saw the rapid rising of medical doctors in the private sector wherein in 1980, forty eight percent of doctors were working in the private sector by 1989 they had increased to fifty eight percent.  With urban migration, in 1990 seventy seven percent of doctors resided in metropolitan areas and female doctors comprised only about one third of total doctors; with very few of them being African female doctors.[2]  That was the state of affairs we inherited and from a human resource perspective we were quite clear that we had to address:

(1) The overconcentration of health personnel in urban areas and in the exclusionary private sector;

(2) The insufficient personnel who were also not in possession of the necessary training, orientation and skills;

(3) The under provision of health care, in rural and peri urban areas as well as informal settlements.

Of course all these and the other challenges that continue to belabor our society find root in the planning systems and approaches of the Apartheid and homeland governments. 

Being African and orientated through African culture, we did what was natural.  We searched amongst our family members, before we could turn to friends and acquaintances, to assist in solving these daunting tasks, including those that confronted our healthcare system.  We took to heart the words of Jose Marti who said Cuba’s “homeland is humanity”.  We took into careful consideration that Cuba as a member of our family had and continues to have, a solid reputation of assisting us and our sisters and brothers on and beyond the continent.  In our struggle for liberation and our fight against imperialism and colonialism, it was the people of Cuba and el commandant Fidel Ruz Castro who were to be found at the forefront and side-by-side us, in Angola, Algeria, Guinea Bissau, Guinea Conakry, Ethiopia, Zimbabwe and Zambia, to name but a few.  It was the people and government of Cuba who were first to respond during our recent challenge during the outbreak of Ebola in some parts of West Africa.

Esteemed guests;

In Zulu we have a proverb that says “Idumela elihle nokuhlonishwa kubaluleke kakhulu kunesiliva negolide.”— [“A good reputation and respect are worth much more than silver and gold.”]

Reflecting on the arrival of Cuban troops in Angola in 1975, it is said that President Nelson Mandela, whose centenary we celebrate this year, said: “it was the first time that a country had come from another continent not to take something away, but to help Africans to achieve their freedom.”[3] And of the Cuito Cuanavale victory in Angola in 1988 President Mandela said it “destroyed the myth of the invincibility of the white oppressor and inspired the fighting masses of South Africa.”

It was therefore natural that in seeking to integrate and improve the inherited nine health care systems we looked to the people of Cuba.  It was in Cuba that we found the inspiring story of healthcare and education systems which were amongst the best in the world despite all the adversities thrown at the people of Cuba by the enemies of the revolution. 

We could not have chosen a better partner to comprehensively address our challenges.  Today, thanks to the help of partners such as the people of Cuba, these seven hundred graduates will join the army of 232 587 registered health professionals, of which 45 615 are medical practitioners and 12 997 are medical students.[4]

Seven hundred is by no measure a small number, even if it was we choose to recall the words of President Castro who said; “I began revolution with 82 men. If I had to do it again, I do it with 10 or 15 and absolute faith. It does not matter how small you are if you have faith and plan of action.”  The most important features of the training here are compassion and patriotism. 

In SeSotho we say to the people of Cuba Realoboga letle lietse jwalo koho babang. [Thank you may you also shower others which such [gifts]]

These conscious and patriotic graduates will join a health care system that is gradually gaining the trust of our people, wherein the General Household Survey released by Stats South Africa last week tells us that about seven in every ten households makes use of public health care institutions as their first point of access when their members are ill or injured.  Our preference would have been one hundred percent, but taking into account where we come from this is an improvement.  Our priority is not about a choice between private and public health care but rather access to quality health care for all at all times, especially for the most marginalized no matter the status or income of a citizen. 

This is the context of our National Health Insurance, which these seven hundred graduates will form a core part of and with the learnings from the Cuban system will assist in improving it.

I therefore wish to also take this opportunity to thank the students who must have been the seventeenth intake of medical students and the largest we have ever recorded.  It could not have been easy thousands of kilometers away from home, where at times it may have felt like the journey would never end and perhaps was not worth your time and attention.  Siyabonga, and I know we have lost some along the way, to those families and friends I reoffer our deepest condolences for those who passed on with their boots on.  To you today’s graduates I offer to you a reminder of what Jose Marti said: “Talent is a gift that brings with it an obligation to serve the world, and not ourselves”.  It should therefore be not in our making to serve self but rather selfless service should be in our DNA.  Sow forward and plant the seeds of healing and services to the millions who are in desperate need in our country and on our continent.  Emulate the healers of Cuba as you drive us to that goal of quality health care, promotion, prevention and treatment which are cardinal features of the health care system we are delivering.

We are not yet there. We need all of you to place your shoulders to the wheel in the service of our people in the most remote and unreachable areas in our country.  As you do that, lift just one more child or young person with you.  Take heed of what Tata Madiba said, during his first speech as President to the OAU:

“Africa shed her blood and surrendered the lives of her children so that all her children could be free. She gave of her limited wealth and resources so that all of Africa should be liberated. She opened her heart of hospitality and her head so full of wise counsel, so that we shall emerge victorious. A million times, she put her hand to the plough that has now dug up the encrusted burden of oppression accumulated for centuries.

If freedom was the crown which the fighters of liberation sought to place on the head of mother Africa, let the upliftment, the happiness, prosperity and comfort of her children be the jewel of the crown.”

Comrade Programme Director;

Lastly, but most importantly, I wish to extend our gratitude to the families and communities who have raised these magnificent and talent young women and men.  Thank you for having borrowed your children to our just cause of a better nation, as well as continent and the world.   Millions in rural and marginalized South Africa will benefit from this talent which was chiseled in Cuba. 

It is “in the unity of our nations [that] rests the glorious future of our peoples” as once said by Simon Bolivar

!!!Viva la Hermandad industructible entre Cuba y Sudáfrica

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