Committee Report on Cuba study tour

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Health

20 February 2019
Chairperson: Ms M Dunjwa (ANC)
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Meeting Summary

The Committee discussed and amended their Report on the oversight visit to Cuba from 1 October to 5 October 2018. The purpose of the short visit was to see how South Africa could learn from Cuba in terms of their Primary Health Care system.

A substantial amount of time was spent discussing the rude behavior of some students towards Members. Some of the students were drunk and it was felt that this created a bad impression of South Africa. Members were initially partially divided on the severity of that situation as some were uncertain about whether it should be inserted in the report, whether the observations were collective, how many students were involved and whether the Embassy and the University should be informed. The Committee decided that the following sentence would be inserted in the Report: ‘that the Committee observed that some of the South African students behaved in an unacceptable manner, a manner unbecoming of South African students in a foreign country.’ One of the Members felt that the complaints of the students should also be considered. Members decided that with regard to the Report, firstly the incident should not be over emphasised, and secondly that it should adequately convey all their views. Another important issue raised was that the Minister in Cuba had expressed disappointment with South Africa for not honouring their invitation. The meaning of a word like ‘Polyclinic’ was explained and the spelling of words like ‘Malignant tumor’ and ‘Pneumonia’ were amended.

The Committee agreed that a lot could be learnt from Cuba. It was a leader in the area of Primary Health Care.

Meeting report

Committee Report on Cuba study tour

The Chairperson said that this presentation on the Committee’s oversight visit to Cuba was meant to empower Members and remind them of the relationship between Cuba and themselves. Amendments would be suggested to make the report better in form and content. It was noted that there were presentations which were in Spanish and the Embassy has been requested to provide translations. The Committee agreed to proceed with a page by page presentation of the Report.

The Chairperson enlightened Members about the meaning of a ‘Polyclinic’. She said that they are hospitals, but they are also community health centres.

Ms E Wilson (DA) said they are classified as clinics and they are outpatient service delivery centres with doctors and ambulances. They attended to emergency cases.

Ms Wilson noted that on page five, the word “Malign tumor” should be “Malignant tumor

The Chairperson noted that the word “pneumonia” should be spelt with a capital “P

Mr A Mahlalela (ANC) noted that on page six corrections should be made as follows: ‘76.5’ years in women and ‘80.45’ years in men.

Dr P Maesela (ANC) noted that the first paragraph of page six should be corrected to read “The Committee was informed that life expectancy in Cuba...

Ms Wilson commented on page seven and referred particularly to paragraph 3.5. While she commended the manner in which the paragraph was couched, she noted that on the arrival of the Committee in Cuba the South African students were very rude to Members and some of them were drunk and that kind of behaviour did not create a good impression. She wanted the Committee to take note of it.

The Chairperson wanted to know if it should really be noted.

Commenting on this issue, Dr Maesela said that since the information has not been reduced to a formal report and finalised, Members could not be made to deliberate on it and so it was “too late for tears.”

The Chairperson took another perspective on the behavior of the students’ whose behavior was condemned by Ms Wilson. She said Members did not   have a face-to-face engagement with the students on the issue at the meeting which would have required the Committee to call students to order. If such a situation had arisen, it would have been reflected in the Report. However, it does not mean that it should not be addressed. It was however not raised with the students, the authority of the University and the Ministry. For diplomatic reasons where those in charge of issues regarding protocol raised it, it could then be formally reported in a letter. She said it should however be noted.

Ms Wilson agreed with the Chairperson on her position since there was no engagement with the students and all those at the meeting. She noted however that at a diplomatic level there may not be a ‘checkmating’ mechanism since it was a South African delegation and South African students were involved, no one else was involved. She suggested that the report may be phrased to read “the Committee was concerned about the treatment of the Committee and the behavior of the students and that this matter must be reported to the relevant authority”.

The Chairperson said that the Honourable Wilson  gave the impression that the entire group of students acted rudely  when only two students committed the unruly act, so to paint all of them in a bad light may not be ideal.

Dr Maesela sought to know if there was a collective observation of some individuals behaving rudely. He said it would suffice if the report showed that the Chairperson with other Members present observed the unruly behavior of some individuals. This can be  raised as a complaint so that anyone reading the report including the Minister would know that some individuals behaved in a manner that was not in the interest of South Africa.

The Chairperson admitted that it was a collective observation but could not recall if they attempted to know the provinces the students came from.

Dr Maesela   noted that one of the incidences he noticed was that of a students who was tipsy and acting in an unruly fashion. The student was called to order and immediately left the room. He assumed the student was   trying to instigate and agitate others to protest but did not succeed in that plan.

The Chairperson said that since it was a collective observation, the complaint should be phrased in the way suggested by Dr Maeselela which was that “the committee observed the unbecoming conduct of some students.

Dr Maesela said that the Committee did not sit down to discuss and take note of it rather it was only a personal observation which was not collectively discussed. With that it would have been noted and brought to the notice of the officials and the Student Representative. He said two students   were the mastermind behind the unruly behaviour, one sat down and the other went out of the meeting. However, the matter should not be over emphasised in the report because students are always like that, always seeking attention.  Since it was omitted after the discussion, it would be justified to bring it into the report.

 The Chairperson said that there was a serious concern about the conduct and the persons in charge of the Mission. She said the concern was raised with her and because of that behaviour some points were raised in the presentation particularly about how to deal with the concerns of students when they were preparing to go to Cuba. However it should not be ‘overlabored’. She suggested that the views of Dr Maesela be adopted to the effect that they observed  “the unbecoming conduct of the students  they met with” She said that if the departments sought   further clarification they would be afforded this view rather than including  about the issue of tipsiness  as suggested by Ms Wilson .

Ms Wilson said that what she wrote was ‘that the Committee observed that some of the South African students behaved in an unacceptable manner, a manner unbecoming of South African students in a foreign country.’

The Chairperson asked Members if they were comfortable with that.

Dr Maesele said that there were more serious issues about the students’ conduct which are not being made part of the report. The focus was rather on two students who walked out of the meeting. He said the students did not cause any consternation which required cautioning from Members. They acted rudely with their body language but they later left the meeting. Part of the complaints of the students was that whenever they are expelled from school for misbehavior they find it difficult to continue their careers elsewhere. This was part of the issues the students wanted the Committee to address with the Cuban Government. The unruly behavior may not be their natural behavior.

The Chairperson said that the matter should not be over emphasised. She admitted that while she was chairing the session she recalled on two occasions when she had to call a student to order in the presence of Members. She also recalled when one of the Committee Members, Honourable  Ndaba (ANC) had to interject.  The Chairperson admitted that it was not just about the two students. She suggested that the Report should be couched in a way that would adequately convey the views of all Members.

The Chairperson referred to some missing points on page eight regarding the statement of the Minister in Cuba who formally expressed disappointment in South Africa for not honouring their invitation. That point should be reflected on because it was raised during their interaction with the Ministry.

Dr Maesela said the complaint of the Ministry about not honouring the invitation should be reflected in the report since it was officially raised and the failure to honour the invitation happened on three occasions.

The Chairperson referred to the recommendation in bullet one on page 11 and sought Members’ opinion on this.

Dr Maesela   said that even if it is centralised it should be under the Department of Higher Education or the Department of Health.

Dr S  Thembekwayo (EFF) concurring with the position of Dr Maesela said it should be a combination of the Department of Higher Education and the Department of Health because after the completion of their  education  they are supposed to render their services in the Department of Health.

The Chairperson moved on to the second bullet on the recommendation. She suggested that the paragraph should be rephrased.

Dr Maesela   suggested that the first recommendation covers the second recommendation.

The Chairperson said that the recommendations may not be implemented soon and the provinces will continue to send students overseas for studies. No one is sure how many students would be sent out and which province would be sending students out to Cuba. The centralisation may not happen soon but should. The sentence should rather be rephrased without anything being diluted.  She suggested that philosophers may be able to rephrase it better.

Dr Thembekwayo  agreed with the Chairperson. She said it was just a summarised version. The   centralisation is to improve coordination. The point owns it all. 

Dr Maesela (ANC) also agreed. He said the first bullet dealt with the future and the second dealt with the current happenings.

The Chairperson read out the third bullet. Bullet three which was on the orientation programs seemed to be addressing the psychological support mentioned in the fourth bullet.

Ms Wilson felt it should remain as two bullet points because  it was to prepare them psychologically for what they were going into  and secondly, they were able to get the psychological support for the  situation they were facing.

Dr   Thembekwayo   agreed with Ms Wilson based on the point that an orientation program was a program of its own kind which could not be compared with the others, while the psychological support stemmed from the after effect of the orientation program. The two cannot be combined. Each one stands on its own.

The Chairperson read out the fifth recommendation.

Mr Mahlalela said the sole objective of the visit was not to check the condition of the students. He suggested that the recommendation must reflect the main issue of the NHI (National Health Insurance) which was the excellent outcome in relation to effective implementation of the primary health systems in line with universal systems which was to be implemented in South Africa. He said there were lessons   learnt and recommendations made. He suggested that ‘lessons’ should come before the recommendations.

Ms Wilson said that the students’ recommendations should be included in the bullet points. The Embassy complained that the   students and the provinces thought that the Ambassador and the embassy should baby-sit them. They expected the embassy to book their flights. She said there should be a program where students are taught the role of the embassy in this process.

 Dr Thembekwayo emphasised that the recommendation was about the visit of the South African students in Cuba, but all the reflections and lessons learnt were dependent on a higher level. A report on those who committed errors in Cuba should be included in the orientation programme.

 Dr Maesela said there were certain things that were discussed with the Official and should be recommended, especially their studies on molecular medicine, pharmacopeia and vaccines. There was great potential of entering into partnership with South Africa with the possibility of having exchange programs so that South African students could study their molecular medicine, an area which they had high expertise on.  He referred to the anti-cancer research medication and other things they had discovered about the treatment of gangrene. That was why they no longer had to perform amputations. The medication they developed may be effectively worked upon in South Africa with ease because the Cuban Government struggled to get the ingredients. He said they could act in conjunction with South Africa and make them available universally. He was not sure if the Chairperson spoke with the Minister at her level about that. He disclosed that that was what they were exposed to as a study group. They discovered that why their primary health care system was excellent was because they had a corrective rather than a preventative part of medication.

Dr Thembekwayo said the reason why the last subheading was “lessons learnt” was because the Content Advisers relied on the first paragraph in the background rationale.

 The Chairperson said that the visit to Cuba was to learn good practice and in learning good practice there were issues that needed to be focused on, in terms of the report.  She said issues on training of doctors should be summarised and expanded to include issues like pharmacology.   On the issues of manufacturing she proposed a sentence that would summarise the issues   instead of going into details since all the members were at the tour. She also suggested that the word “lesson learnt” should come before “recommendation”. ‘Lessons learnt’ should be the fourth point, then ‘observation’ should be the fifth point.

Ms Wilson said she would prefer the word “observation” to “lesson learnt

The Chairperson upheld the phrase “lesson learnt”.

The Chairperson presented the report. She said that study tours were supposed to be for a week has been condensed but hoped that the next administration may extend the period of study tours for the Committees to learn extensively, and so that other countries may also understand the purpose of the visit.

Members had no issue with other sections of the Report and adopted it with the proposed amendments.

The meeting was adjourned.

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