WASHINGTON -- South Africa's apartheid system still haunts the country's medical profession, which failed horribly to uphold ethics and human rights under a racist government, according to a report commissioned by that country's Truth and Reconciliation Commission.
The report chronicles incidents of white doctors covering up the torture of black patients, blacks being denied health care, and hospitals turning over untreated black patients directly to police. It was put together for President Nelson Mandela's government by two U.S.-based researchers and was released recently at a Washington symposium.The report by Physicians for Human Rights and the American Association for the Advancement of Science calls for a series of reforms, including the removal of doctors and other medical professionals who still fail to understand the abuses of a racist era.
A spokesman for the South African embassy, Daniel Ngwepe, said he had not seen the report and could provide no immediate comment on it.
Its basic findings were presented earlier to the Truth and Reconciliation Commission, which submitted a report on apartheid era health care to President Nelson Mandela. A 10-member team evaluated apartheid's health system with more than 100 interviews with health professionals, academics, government officials, representatives of community groups and others.
The racism that infected the country was so deep that it will continue to cause "pain and injury" to the medical system, the report says.
It documents an era in which South Africans were served by two separate systems: "one a world-class medical care system for whites and one of filth and degradation that deprived many black people in South Africa of all human dignity."
It cites rigid segregation of health facilities and grossly disproportionate spending on health care for whites.
"The report shows the variety of ways in which the culture and legal structure of apartheid continue to influence practices within the health sector," Dr. Audrey Chapman of the American Association for the Advancement of Science, said in an interview. "It's a legacy that is self-perpetuating."
Chapman, co-editor of the report, commended South Africa's post-apartheid government for beginning to address problems in the health professions, although its system of government institutions is "ill-equipped to prevent abuses like those documented."
The worst offenders during apartheid, she said, were district surgeons who turned a blind eye to torture of political prisoners, denying medical services and sometimes participating in coverups.
The report recommends that health professionals be required to comply with human-rights standards as a condition for licensing; suggests reform of professional organizations, including removal of individuals who committed abuses; and appeals for training and monitoring of health professionals to protect human rights.
In addition to denying health care to blacks, the accusations against doctors and nurses include issuing false statements and forensic evaluations to protect police against charges of human-rights violations.
The most famous case of medical abuse was the 1977 death in detention of black consciousness leader Stephen Biko. The South African Medical and Dental Council initially found no wrongdoing on the part of doctors in Biko's death. Eventually, however, two physicians who treated him were reprimanded, and one was stripped of his medical qualifications.