Navigating an uncertain world - Helen Schneider

The School of Public Health (SOPH) was established in the early 1990s, at the dawn of democracy in SouthAfrica. It was an initiative of then Rector Jakes Gerwel, as part of an assertive broader project of the University of the Western Cape (UWC) as the ‘university of the democratic left’. The leitmotifs of the new public health programme were primary health care and district health systems, social justice and equity, redress and transformation. When I joined the SOPH in 2011, nearly twenty years after its first beginnings, I was struck by the enduring presence and power of these values and how much they still frame the agendas of teaching, research and engagement, both in the School and in the broader university environment.

It is thus entirely fitting that, one year after his passing in 2012, the University decided to honour Jakes Gerwel’s legacy by establishing an award in his name, with the support of the Mauerberger Foundation. This is to be given each year to an alumna or alumnus of the SOPH judged by staff and students as making an outstanding contribution to the field of public health. The first recipient of the award in 2013 was KirstieRendall-Mkosi and the second was Saadiq Kariem in 2014. Both have been significant players in public health - Kirstie with her work on the quasi-feudalsocial relations which perpetuate dependency onalcohol in rural areas of the Western and Northern Cape; and Saadiq as a critical voice inside the ANC during an era of AIDS denialism. Each, in their ownway, has demonstrated the ongoing role of public health as speaking truth to power in post-apartheid South Africa.

As you will see in the individual stories of our graduates in the pages of this annual report, we have no shortage of deserving future candidates for the Jakes Gerwel Award. We are privileged to count among them senior Ministry of Health officials, practitioners at the frontline of the Ebola epidemic, and activists campaigning against botched sterilisations in Chhattisgarh State in India.

As two thirds of our students come from beyond South Africa, we have engaged over the last two years in a systematic way with the rapidly evolving new landscapes of educational access through on-line and e-learning modalities. In 2014 we piloted the shift in the delivery of a few Master of Public Health (MPH) modules from paper-based distance learning materials (expedited in large boxes to students each year) to UWC’s integrated on-line Learning Management System (a SAKAI e-learning platform referred to as iKamva). We have also been experimenting with the dizzying array of associated technologies for interaction with students at a distance, whilst remaining sanguine about the limits of technology in education. We have found that the years of investment and experience with educational design and development of distance educational materials has prepared us well for the transition. In this regard, we are hugely indebted to the role played by our educational specialist, Lucy Alexander, who has steered the distance-learning endeavour in SOPH for many years and who stepped down from a full-time position in 2014 to pursue a wider range of interests.

In this report, we profile a new development in our educational programmes in the field of Pharmaceutical Public Health. In partnership with Management Sciences for Health, UWC’s School of Pharmacy and Richard Laing of Boston University (also an extraordinary professor in the SOPH) we offereda series of short courses during our annual Winter School in 2014. In 2015 we are developing these into accredited online modules for both our MPH and occasional students.

In addition to our MPH and Postgraduate Diploma, which remain the SOPH’s flagship courses, we have seen the growth and consolidation of our PhD programme. This has been significantly supported by the start of Wim van Damme’s tenure as our SARCHI (South African Research Chair Initiative) incumbent in 2013; and also by the availability of funds to appoint post-doctoral fellows across a number of projects. These are the pipelines of dedicated academics we hope will one day lead the SOPH.

Any discussion of our teaching and learning activities is not complete without mention of our annual Winter School short course programme. In 2013 and 2014, the 21courses offered at the 22nd and 23rd editions of the Schoolattracted 250 to 300 participants each. Winter School

remains singularly the most energetic moment in our calendar, during which the face-to-face engagements with mid-level and frontline health systems players feed us as much as they do the participants. 

It is hard to capture in a few sentences the essence ofthe research and engagement endeavour in the SOPH.More than two dozen projects over the period included the multi-year projects that were featured in previous annual reports, such as PURE (Prospective Urban Rural Epidemiology) and DIAHLS (District Innovation and Action Learning on Health Systems). Our project themes continue to address health interventions (HIV and TB, maternal and child health, chronic diseases), social determinants of health (nutrition, diet) and health systems, and involve a wide range of partnerships and networks across the globe.

As indicated, 2013 saw the inception of our SARChI Chair in Health Systems, Complexity and Social Change,and the finalisation of a memorandum of understanding with the Antwerp Institute of Tropical Medicine (ITM). This signaled the start of a significant new partnershipfor the SOPH that has spawned a number of capacity building, research and fundraising initiatives. One of the highlights of SARChI was the hosting of the popular Emerging Voices for Global Health (EV4GH) programme, linked to the International Conferenceon AIDS in Southern Africa (ICASA) and the Global Symposium on Health Systems Research held in Cape Town in 2013 and 2014 respectively.

SARChI forms an integral part of our now well established portfolio of health systems research and development activities, much of which is conducted collaboratively with partners at the University of Cape Town. Over the past two years we have significantly deepened our capacity, thinking and contribution in this still emergent area of public health. We also successfully organised, together with five other partners, the prestigious biannual Health Systems Research Symposium of the Health System Global Society in September/October 2014.

In 2014 the Centre for Research in HIV and AIDS wrapped up a large five-year programme of work funded by CDC (Centers for Disease Control and Prevention) which, with Christina Zarowsky’s return to Canada after five years of dynamic leadership, concluded a significant era in the life of the Centre. In late 2014 the Centre underwent a formal review and its future will be finalised in 2015.

Other developments in the period included our partnering in the National Research Foundation funded Centre of Excellence in Food Security hosted as UWC, and the awarding of an Extra-Mural Medical Research Council Unit entitled ‘Health Services to Systems’. As with SARChI, these initiatives are funded in one way or another through the South African fiscus, suggesting a welcome new trend towards providing core research funds to institutions such as ours.

As these pages attest, our research productivity in the collective of staff and associated honorary appointments remains high, and in this regard we were ranked in the top ten departments of the University for the period 2011 to 2013.

Finally, our wonderful building and facilities havegiven us unparalleled opportunities to host seminars, meetings and visitors to the SOPH. In 2013 and 2014these included the annual David Sanders lectures, a‘20 years of democracy’ seminar series, Emerging Voices for Global Health programmes, Jakes Gerwel Award ceremonies, our Summer and Winter Schools, HIV-in-Context symposia and seminars, amongst countless other events. We owe the convening power of our building to the generous funding of The Atlantic Philanthropies, which has played a crucial role in supporting the SOPH over many years.

These achievements have not been without their losses and challenges. In mid-2014, just weeks after we had appointed her as a new professor, Meera Chhagandied tragically in an accident while travelling; our staff have had their fair share of ill-health; and our much liked former Dean and strong supporter of the School, Rati Mpofu, passed away.

Also, despite our stability and apparent progress as a School, there is little room for complacency. Universities in South Africa are facing an unprecedented wave of critique. In the many commentaries on the situation in higher education institutions, a core theme has been the dismantling of the myths of the ‘new South Africa’ as a ‘rainbow nation’ of racial harmony, and of higher education institutions as spaces of reason and enlightenment outside of these social tensions. This is occurring against a backdrop of increasing skepticism of the South African state’s responses to the enduringlegacies of racism, inequality and injustice, and of a world beyond that is steeped in senseless violence. Itis altogether a context of deep uncertainty, requiring us to see ourselves in new and self-critical ways and in which there are no clear guides to action nor simplesolutions. Our challenge over the next few years will be to find ways to navigate this complex world in new and generative ways, whilst learning to live with being unsettled and uncertain.

School of Public Health, University of the Western Cape
Robert Sobukwe Road, Bellville 7535, Republic of South Africa
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