David Sanders, whom many of us knew as indefatigable, resolute, pioneering, principled and seemingly indestructible, died in his sleep of a heart attack whilst vacationing in the UK. Trained as a paediatrician, David was a key figure in shaping the practice and the conscience of public health both in South Africa and globally. Over the past three decades, he worked tirelessly to ensure that population-oriented approaches based on social justice and equity were translated into health programmes that would benefit all – and particularly those most marginalised in society - and particularly children in the rural reaches of Southern Africa and in our underserved townships across the country. His contributions to public health, child health and social justice are immeasurable and, not surprisingly, PHASA recognised his Lifetime Contributions to Public Health at its 2014 Conference.
David was born and grew up in Zimbabwe, then Rhodesia, where he trained as a medical doctor. His family emigrated to the UK where he became deeply involved in progressive health politics whilst specialising as a paediatrician. He returned to a newly-liberated Zimbabwe in 1980, which offered the opportunity to apply his progressive thinking to health sector reform. While working for Oxfam, he pioneered a novel CHW program, the subject of which was explored in many of his publications, including the seminal book, the Struggle for Health. He then moved into academic positions, running departments of community health at the University of Zimbabwe, and then the University of Natal, before moving to UWC to found its School of Public Health, a School which has gone to achieve excellence in its commitment to health systems research, focused on the social determinants of health and building a district-based public health system. The UWC Summer and Winter Schools have trained thousands of cadres of health workers, students, activists and practitioners in a range of areas relevant to health systems thanks to David’s vision and foresight. And one of the ways this PHASA Conference will honour David is by serving at tea times the hallmark peanut butter and/or jam wholeweat bread sandwiches that were characteristic of the Winter and Summer Schools at UWC. Not only should you teach and preach healthy living, but you should live it out by example. Which David did.
Of course, no tribute to David can omit his huge contribution to global health advocacy. He was a founder member of the International People’s Health Council which then gave birth to the People’s Health Movement, for whom David played multiple leaderships roles. He helped to start and maintain a PHM chapter in South Africa which is now one of the most active country groups for PHM in the region. David’s incisive analysis left no doubt that a more just and equal social order was essential for global health. He ruthlessly critiqued the impacts of structural adjustment, development aid and neoliberalism on health – challenging all of us to be more critical in our analysis of what is needed for Health for All to become a reality.
David was a mentor to many, and a mentor to many of mentors. I was a 4th year medical student when I went to visit Oxfam Projects David was running in Zimbabwe in 1981 and his work inspired me, as it has done to thousands of others. Much of what I learned about what a young student in the health professions could do to change the world came from seeing David and his colleagues go about doing exact that – change the dreadful infant mortality and poor child survival in rural Zimbabwe with good quality, basic health care, emphasising Community Health Workers and a focus on the social determinants of health – but all the time recognising that health is political and the upstream determinants linked to poverty and injustice must remain part of our change strategy.
David’s commitment to CHWs as a vital component of Human Resources for Health has shaped PHM SA’s work in many ways. We are partners in a CHW self-organising network with other Civil Society groups thanks to support David mobilised through international networks. PHM runs a short course in the Political Economy of Health, framed as a People’s Health Universities and intended to build activism. The South African Peoples Health University chose to focus on training CHWs over the past few years to develop their skills and agency to address Social Determinants of Health in their communities. So, I can share a second way in which we will be honouring David – through the introduction of an award, jointly run by PHMSA and PHASA, for a CHW or CHW group project successfully addressing the social determinants of health. PHM and PHASA have agreed to develop the criteria and process for this award over the next year and we plan to make the first David Sanders award for a CHW project addressing the Social Determinants of Health at the next PHASA Conference.
However, no tribute to David can ignore that mischievous smile and wicked sense of humour. Those of you who worked with David and knew him socially will know that David’s politics was always accompanied by a dry wit that he could exercise liberally – on others and on himself. He was generous and warm and a legend when it came to the PHASA parties – yes, nobody could dance with quite as much enthusiasm and elasticity as David could. He lived life to its full, but cogniscant of how important it was to care for others – a true African who understood ubuntu in practice.
To his family – Sue, Ben, Lisa and Oscar, we share with you our deepest condolences and thank you – both for your own activism and for sharing David’s activism with the public health community, from which we have all benefited hugely. Let it be some comfort to you that David’s work and his vision will live on in the ongoing commitment of many public health activists across the world and in this organisation to a more equal, fair and healthy world.
And, lastly, to pay tribute to David in another way, we are going to watch a very short video clip. This was a video clip that David wanted to play at a Training of Trainers for Public Servants International on the NHI in July but couldn’t because of AV issues. Let’s hope the AV works out here. You will see why it is a fitting tribute to David because it speaks exactly to the causes of the causes of the causes that David taught so clearly and simply to so many. And the clip is free to download so David’s legacy will also leave you with a practical tool to advance the Struggle for Health – in your teaching, in your training and in your capacity building wherever you might be located in the health system.