Address of The President of South Africa, Thabo Mbeki, on the occasion of the tenth anniversary of the Democratic Nursing Organisation of South Africa (DENOSA) - International Convention Centre, Durban
06 October 2006Programme Director,
President of DENOSA, Ephraim Mafalo,
General Secretary of DENOSA, Thembeka Gwagwa,
Members of the National Executive Committee,
Chief Executive Officer of the International Council of Nurses (ICN), Judith Oulton,
Former President of ICN, Madame Stallknecht,
Leaders of the nursing profession from the SADC countries,
Distinguished guests and delegates,
Ladies and gentlemen:
(Apologise for the absence of the Minister of Health who has been hospitalised.)
It is with great pleasure that I join you today to celebrate ten years of the existence of the Democratic Nurses Organisation of South Africa (DENOSA). As we know, the journey of organising nurses in this country is a long one, dating back to 1914, when the first ever association of nurses was formed.
Like all else in our country, apartheid intervened and by 1993, on the eve of our country’s freedom, there were a total of 21 race-based nursing associations representing over 150 000 nurses. The consequence of this was acrimony and isolation within and between these associations to the detriment of the profession.
It was therefore important that the Concerned Nurses of South Africa brought together representatives of many of the different associations so as to forge unity. This was indeed a significant step because for the first time in the history of our country, the nursing profession was able to speak with one voice.
This unification was part of the first steps of the broader transformation processes that were taking place in our country and for the nurses this represented a practical expression that their profession was also part of a national movement towards the formation of a non-racial, non-sexist and democratic South Africa.
From what I understand, it is clear that there is commitment to ensure that DENOSA becomes a fully representative and leading organisation of all our nurses serving and empowering its members, themselves to continue to be the best in the world.
As we celebrate a decade of the existence of this non-racial, non-sexist democratic body of the nursing profession, I would like to touch on two areas of the mission of DENOSA. These are:
• To stabilise a harmonious and co-operative relationship between members and their employers; and
• To promote and enhance the quality of patient care and health standards, inspired by a caring ethos.
Indeed, it is critically important that we pay particular attention to the achievement of these objectives.
We have to focus on this mission because the nursing profession as part of the bigger family of health professions is driven by a set of values that are regarded as sacrosanct and a critical feature of the medical profession. Accordingly, it is not an accident that nursing is regarded as the foundation of health care services in all countries.
Given its pre-eminence within the health care system, it is clear that this profession should take up the mantle of leadership to promote good values, determined to respect the dignity of all who need health care.
For many years the nursing profession has occupied the moral high ground among the majority of our people because of the commitment, selflessness and the preparedness of most nurses to go the extra mile to ensure the well-being of their patients. Many of you would know how you become so attached to the patients that when some of them pass on you have felt the same pain as those close to the departed.
Even when it became fashionable, among some of our people, to use the legitimacy of our struggle to engage in acts that are inimical to the same struggle, many of our nurses correctly took the position that their patients were their first priority.
Indeed all of us felt very proud when nurses would never be seen near any pub or shebeen while in their nursing uniforms. It is because of this respect for your profession that you also earned the respect of our people.
I must therefore take advantage of this historic moment in the life of DENOSA to convey our special thanks to you and all the nurses in our country for giving pride to our nation by your devotion to the service of the people, even in circumstances in which your working conditions were not up to standard. Many thanks. The nation is proud of you.
In recent times there have been reports that the standard of our nursing profession is declining for a variety of reasons, including the significant migration of some of our most experienced nurses to developed countries, as well as the erosion of the ethos that has guided nurses for such a long period of time.
As far as the migration of nurses is concerned, government is attending to it and is determined at least to reduce the number of nurses we lose to other countries. It is also perfectly obvious that we must work even harder to train and develop greater numbers of nurses.
It is on the issues of the decline of expertise and a caring ethos that DENOSA, working with government and other stakeholders, should make urgent interventions so as to ensure that this profession continues to occupy its rightful and respected place in our society.
Florence Nightingale, the pioneer of the nursing profession, showed through her compassion, her integrity and her dedication that she too embraced the universal values that we call ubuntu.
It is surely in the spirit of Florence Nightingale and our ancient wisdom that we need to strengthen our people’s contract, based on the moral tradition of fairness, social justice, compassion and care. For it is only through human solidarity and the restoration of human dignity and self-respect that will we build a healthy, prosperous, and peaceful nation.
Necessarily and correctly, DENOSA fulfils a critical role as one of government’s important social partners to improve and expand access to good health services. Without compromising your ability to represent your members, it is very important that DENOSA helps our nursing profession to uphold its high levels of commitment to professionalism and devotion to the welfare of the sick.
Together, we need to engage in united action against anybody who might give this noble profession a bad name through their unacceptable behaviour.
As we know, the history of nursing in this country has a rich heritage despite the setbacks that were caused by apartheid. Stalwarts of the nursing profession like Cecilia Makiwane laid a good foundation of providing selfless nursing care to the poor. We must continue to respect this legacy.
Further, nursing is still a female-dominated profession and, as a result, all the challenges that women in the broader society are facing also apply to this profession and to DENOSA. In addition, nursing continues to be a route of access to the health sciences profession for all sections of our society.
Government fully understands that it has the responsibility to work with you to ensure that such access is expanded even more. As the health demands of our people increase, we must be able to respond immediately and effectively.
We need to make sure that our members become good conduits through which services can be channelled to all communities, not only to save lives but also to convey messages about the importance of maintaining healthy lifestyles.
Ann Bradshaw, writing in the British Medical Journal more than a decade ago, asserted that nursing is not independent of the mores of society. She went on to ask whether the change in the identity of nursing noticed in the United Kingdom’s National Health Service merely reflected the moral state of society and health care within it?
Similar questions could be posed in our situation. Bradshaw talks of “a new orthodoxy, which has brought fragmentation to the nursing profession as each nurse is taught to become a wholly autonomous practitioner; hence, the ward sister no longer inducts her charges into a [nursing] tradition but rather takes on the role of a detached business manager”.
(From website: www.bmjournals.com taken from Bradshaw, A., “Nursing and medicine: co-operation or conflict?”, BMJ 1995; 331:304-305 (29 July))
We would need to look at some of these issues as we observe, during this year, the international year of celebrating human resources for health. It is therefore very significant that the Ministry of Health launched the National Human Resources for Health Plan, which seeks to address major issues affecting health workers. These range from planning and development to the area of management. At the same time, the relevant government departments are attending to the issue of remuneration of nurses and conditions under which they work.
It is our expectation as government, that DENOSA will assist the Department of Health in implementing the human resource plan and in re-positioning the country’s nursing services so that we are able better to manage our health care system based on effective, compassionate and dedicated service delivery of health care of the highest standards.
In this regard I believe that all of us should pay particular attention to the 2006 World Health Report entitled “Working together for health”. Correctly this Report says:
“Developing capable, motivated and supported health workers is essential for overcoming bottlenecks to achieve national and global health goals. Health care is a labour-intensive service industry. Health service providers are the personification of a system’s core values – they heal and care for people, ease pain and suffering, prevent disease and mitigate risk – the human link that connects knowledge to health action.
“At the heart of each and every health system, the workforce is central to advancing health. There is ample evidence that worker numbers and quality are positively associated with immunization coverage, outreach of primary care, and infant, child and maternal survival (see Figure 1). The quality of doctors and the density of their distribution have been shown to correlate with positive outcomes in cardiovascular diseases. Conversely, child malnutrition has worsened with staff cutbacks during health sector reform. Cutting-edge quality improvements of health care are best initiated by workers themselves because they are in the unique position of identifying opportunities for innovation. In health systems, workers function as gatekeepers and navigators for the effective, or wasteful, application of all other resources such as drugs, vaccines and supplies.”
These comments of the World Health Organisation draw attention to the critical importance for us to empower you to the fullest extent possible, if we are to achieve the goal of a better life for all, which includes health for all. I would urge you constantly to engage government in this regard so that together we respond adequately to your needs.
I am confident that consistently working together, listening to one another, attending to the various problems that confront us, learning from the good practices of those many experienced nurses and placing the patient first, we will undoubtedly be able to retain the values and service that have made nursing such a respected and valued profession.
Once again, I congratulate DENOSA and its members on your tenth anniversary and wish you nothing but the best as you begin your second decade.
Issued by The Presidency