special Mental Health Workshop 1997-11-20 Cape Town https://sabctrc.saha.org.za/hearing.php?id=56347&t=&tab=hearings https://sabctrc.saha.org.za/originals/special/mental/1mental.htm DR ORR ... to look at the whole health sector process. But I think in addition, we are hoping that out of this workshop will come issues to do with reparation and rehabilitation and I think Hlengiwe is going to speak to that issue. MRS MKHIZE Thank you colleagues. I will also like to add a word of welcome. This part of the process is very, very important for us because it gives us an opportunity to make sure that in our recommendations, we do not compromise mental health related recommendations. I know some people have been concerned that this won't get the publicity that the health submissions got. I should think really we must understand that what is important is not so much the media drama, if we work and we carefully examine issues and in our report, mental health related issues are not compromised, I should think we would have achieved our goal. So, the numbers are not very good, but I hope we will be creative and make sure that we cover the areas which have been identified in the letter of invitation very, very carefully and achieve what we have set ourselves up to achieve. And the first question which most people have been asking is, why a workshop in mental health following the health hearings? I should think Wendy has in a way tried to link the two. To add to what she has said - as a Commission we are really in search for a name for an institution which will address the needs of people who have appeared before the Commission with overwhelming emotional scars. Our mental health institutions have over the years been accused of committing gross human rights' violations and I looked at the submissions, those concerns that had been raised time and again, even in June when we had the health submissions, there was a theme whereby people constantly raised concerns about mental health institutions. Experts within our profession have also been accused of being instrumental in devising torture methods. That again, hasn't been given the attention it deserves. The mental health directorate has been left without a Director for more than a year in the history of our country, so all those things are just raising cause for concern as to who is going to address the issues which have emerged in this process. In terms of the mental health directorate, in terms of its location, it remains a cinderella within the Department of Health and mental health related concerns flowed backward and forward between health and welfare. In one of the submissions here, I don't know if you've all got the submissions that I am referring to, there is a call for instance which has been made by a well-known psychologist Professor Victor Nel whom we had thought he would be here, who is making a call for a creation of a human service department or ministry. This is a bold call for the creation of help and guidance centres under the human service department or ministry. In his words, he is saying medical gate keeping to human services, will be replaced by a system better able to avoid physical treatment of psychological distress. Individuals will often be self-referred, deciding themselves whether to present at a health clinic or at a health and guidance centre. Cost offset benefits will accrue through the avoidance of expensive medical treatment and the reduction of client loads at clinics. At the same time, a broad base will be established for the development of the full range of human services within which known governmental organisations could be accommodated. I would like to add three things to Prof Nel's proposal that what he is saying, it offers a concrete step to a promised move from institutionalised care to community mental health care. Secondly it opens a window opportunity for other people like business, the churches and so on, and angels of course as he referred to them, to be part of a solution in healing the wounds of the apartheid experience. Thirdly, SAISA has already made a call for the independence of SYCO of the control of psychology from the Medical and Dental Council, so SAISA and Prof Nel's position, can merge well if carefully examined. And they can lead to concrete results of strengthening community base care or promotion of well-being rather than adherence to occur. Here is Sats Cooper, just when I have finished to talk to what SAISA had said. I am sure if he had indicated that he will be part of us, he will articulate that better and there will be an opportunity for him to articulate that this morning. It is very, very important for us to be clear about what we are saying. The question is how will the TRC process be carried forward. Really healing the memories of the past and developing the culture of human rights' is a major challenge, especially for our profession. Professionals with psychological skills have an important role to play, especially to facilitate processes which will address generational, emotional dilemmas. As I have said, there is a big question whether mental health care as it stands today, will be in an opportunity to assist in this task or we need to carefully examine Prof Nel's proposal as well as SAISA's proposal, because if we do not do that, the opportunity will be lost in terms of creating a new establishment which will make sure that our skills are not compromised under established professions, or professions which have dominated this field over the years. So we are hoping that as we are guided by experts who will be talking to different areas, we will spend some time in workshops and get clarity as to where, what we want to recommend in our report at the end, thank you. CHAIRPERSON Thank you. The next section, if you remember the invitations we spread up the topics according to the focuses as you can see on the programme. We actually didn't get any submissions regarding Legislative Regulations which was a shame. We had one person who could have come, but they had to come up from Cape Town, and we didn't have enough flight tickets for that. It is very short notice, but I wonder whether we could maybe open it up, the discussion, we've got half an hour to not in terms of a submission, but maybe Sats Cooper, you've just arrived, I don't know whether you are how on foot, but I wonder whether we could actually open up the discussion in terms of Legislative Regulations of Mental Health, because we actually haven't got a spokesman for that particular section. What do you people think? Mr Cooper, do you think you could - could you please come forward? MR COOPER As you are aware, the current dispensation is one (indistinct) with transition, because the legislation is being revised. We have a Health Profession's Act that is currently under consideration by the National Council of Provinces and it is almost a foregone conclusion that that will be adopted during this session, however, there is going to be probably an amendment to that legislation in February session, because it has been raced through by the State Attorneys and there are grave problems with that legislation as it currently stands, so I would imagine that the Commission and the Health Sectors generally, but more specifically the Mental Health Sector can give some serious consideration to impacting on how that amended legislation can be in February. That is one. The second is that the Mental Health Act is currently being considered for revision. However, and I don't want this to be looked at as a judgement of the people responsible for the process, this legislation is likely to end up becoming just like the Health Profession's Act which is really the Medical and Dental Council's Amendment Act, it is going to be a patchwork quilt to make the current legislation a little more acceptable in terms of the new dispensation. However, it is unlikely to meet the serious challenges posed by Mental Health generally attributable to living in an apartheid society, which is one of the serious problems that the Mental Health sector has not even come to terms with - the serious stress of living under an apartheid society. As we know, at least one in two persons going to Doctors' surgeries or receiving or requesting medical help, have a psychological rather than a somatic base to their illness. This is true the world over. In South Africa the research shows this but the research is dated to the 70's. And given the massive social transformation that has taken place in the interceding years since that research was conducted by the HSRC, we can safely say that not less than one in two persons going for help treatment, suffers from a psychological base rather than an organic or somatic base to their illness. That poses severe consequences for the whole system of Mental Health delivery, but Health delivery as well because there has been a bias to somatic health rather than look at the psychosomatic and other tenant consequences of living in a highly stresses, highly divided and highly racist environment. What it does to both black and white, what it does to people who have been living under this (indistinct) over a long period of time. In making these submissions, it is noteworthy that the submissions are being made and I am saying this with a smile in my face, that is why I pitched here a little late, being made also on behalf of the professional board for psychology. It is noteworthy that when submissions are made by various sectors, it tends to be the darkies who come and front for the people who have been responsible for these conditions. In the business sector, for Cyril Ramaphosa to be one of the leaders in presentation, is a supreme irony. For the Mental Health sector, for Sats Cooper to present this, is also another irony, but this has been a late motive that I am sure the Commissioners have taken note of. There seems to be a clear cowardice by white benefactors of the past system, to actually confront their benefit during this era under consideration. I would imagine that there are very few now, within the Health Sector and indeed specifically in the Mental Health Sector, who would acknowledge participation whether overt or covert for the gross and lesser human violations that have taken place during their period of untrembled control of our society. Having said that, I think it is important also to recognise that there are many people who having benefitted from that past, and who have been trust into serious positions of prominence within particular sectors and particular fields in health, are now apparently prepared to make some concession to creating a climate for reconciliation. There is no way to test their subjective commitment to this process, but we have to only go on their objective statements to that effect. I have had certain comments from colleagues about the quaint and particular involvements that they have had and how they have been subject to scrutiny by the previous security apparatus and so on and so on and so on. But nevertheless, all that type of witness really amounts to trivialising I think this whole Truth and Reconciliation process. A position which has not been fully canvassed, certainly not at all with the professional board, but within the psychological fraternity and within SAISA specifically, is one for specific reparations for specific care giving for rehabilitation purposes for those who had been affected directly by gross human violations and a suggestion I would like to put forward, is to consider a particular list of people who could be enabled to get assistance should they have been victims of gross human violations during this period under review, and should they have come forward to so testify and so claim that they have been affected by gross human violations, I would imagine that one needs to look at the kinship relationships. One needs to look at at least the first degree remove in terms of the victim. By that I mean if it is myself, you should look at my parents, if they are alive or step parents or other extended network, because one of the problems with our legislation is it is a narrow (indistinct) christian western one, that excludes the extended family network and the result is a vast number or our people, get penalised. For instance in the welfare system, legitimacy begins to be, was the norm rather. So what I am saying is we must look at the parentage, so it could be a grandmother who is that parent and then below, the children and offspring and other dependants, or people relying on me, that at least those three generations, my generation as an affected individual, the people above me and the people below me, need to get treatment, because it does have very severe effects. From my own particular experience with having been a victim of the repressive system in the past, I know that there are very close family and friends, comrades, who even 20 odd years after a detention, and that detention may have been for a very short period of time, and may have involved some verbal abuse and a few slaps, are affected by what has happened to them, because there has been no resolution of that. I think all the trauma other torture rehabilitation work that have been done from the, during the period of the 1980's to now, have really touched the surface only of the problem. So, this method may actually create a window of opportunity for those people who have testified before this Commission, and I would imagine you need to give a period when those people who have not testified because of the cut off date, being in December because people may not have been informed, or many people like I know colleagues who have just said, what is the point. It has happened, I have been a participant in creating this new society, but why should I come there and cry? Why should I come there and seek some restitution. We should give them a window of opportunity over a few months to actually come and seek treatment. There is nothing that can be done to impose on them to seek assistance, but that assistance should be given. An additional point is one that I think the Reparations Commission has been battling with in terms of assisting people to get on their feet. A point would be to look at the legislation in some other societies like in India where you have the so-called untouchables, who have been given a particular status in the society. There is a particular affirmative action status, that they enjoy. Indeed a court system applies in many states in India for those Hurijans or formerly untouchable groups of people. My suggestion would be that victims again to those two generations removed on either side, should have a certain preference in the State sector for employment, because that is our tax money. It is not asking private businesses to employ them, it is not saying to Sanlam who has come here and talked about we couldn't do anything about Steve Biko's death in our building, nevertheless Sanlam is known to have employed a lot of ex-Security policemen and so on. It is not asking them, it is saying to this government that controls our tax money, use it to benefit those people who have sacrificed singularly to make this society possible, give them preference. So it is a form of super affirmative action, affirmation. And that should apply for a particular window period. Maybe over a 15 to 20 year period and it normalises thereafter, but that would be a very positive way of saying to people, when there is a job and the choice has to be Lionel Nicholas and myself, and if Lionel Nicholas but he had been a victim of gross human violations, that example, that is why I can use it, then one of us should get the preference for the job, because there has been that degree of suffering. Those are some of the practical suggestions that I would like to make to this process. The other thing is and this is particularly affecting me. There are people in society who are being paid by our tax money, who have been responsible for gross human violations, or actively colluded in gross human violations. Why should our tax money be used to maintain them in either civil service, in either educational or other capacity? For instance Amid Bauer, who is the principal of Natal University, Durban, was the Chief State witness against me in my trial. Why should he be paid with my tax money? He has never come to me to say I am sorry, I was a kid at that time, I was abused or whatever, he has never done anything like that. Why should that, I am giving you merely one example, why should that be? Why should our money be used to carry those sorts of people whatever their current political affiliations are? So, I have covered in a sense some general issues, but also more particular ones which I think that the Commission should consider in its wisdom. CHAIRPERSON Thank you Professor Cooper. Thank you for that and also for the personal angle, because I think really I mean it isn't the usual hearing this, and it is nice to get more anecdotal material. It is all being recorded. Can I bring you back to the legislative part of it? You mentioned the Mental Health Act and that it is being considered. Could you perhaps say a little bit more about what the, where it is at at the moment, your thoughts about the actual sort of philosophical strand overhead as it stands at the moment, and where it needs to be changed? MR COOPER The Chairman, of this Commission was the Chief Director of Mental Health and (indistinct) and abuse, and she will know that when you are in such office, what happens is that you get put into a situation where you have to carry a lot of bureaucratees. There is almost an environmental push to get certain existing things sorted out, without consideration of the greater vision. And I think that the current encumbrance are actually trying to grapple with that mix. There is Melvin Freedman and there is Dr, who was previously at UDW, Ugan Pillay, who are in that division and are trying to get better legislation, but I think the philosophical basis of it should be our society has been a peculiarly disturbed one, given its abnormalcy. Our Mental Health Act ought to be predicated on that abnormalcy. It is not denying that we ought to make the apartheid base a precept, a key precept of well-beingness and that that Act ought to become rather than merely a reactive enablement for people, suffering mental distress and discomfort and serious illness, ought to be a proactive one towards creating a well-beingness, towards creating psyco-sosio oneness, equity, the intent of this Act under which the Commission is operating, so that we truly can integrate Mental Health into positive ways rather than just simply labelling them as we have done in the past. So I think that that vision ought to be there, and the Commission would do well if it can impact on that legislative process, otherwise you can get State Attorneys who simply do (indistinct), alteration of Acts and try to bring them in line with the new constitution and new dispensation, but it is really the old functionalism in a new order, and will we not then be perpetuating a reactive process, rather than create a very proactive stance saying well-being is paramount and how do we look at the different elements of assisting create that well-being. Yes, being reactive, providing tertiary but providing secondary and very importantly providing that primary preventative approach to Mental Health, and that means dealing with the issues arising out of race. In our society, right now, even though apartheid does not exist, it exists deeply etched in our individual and collective psyches. When we look at each other, we say well, that darkie, that whitie, and we are in two's about how good we are, what a great man Mandela is, but in our heart of hearts, we believe that actually kaffirs shouldn't be ruling. How do we attend to that type of aspect in our society? I am talking about a deeply engrained racism which if we continue to gloss over, we will be creating future nightmares for our children to confront. Let the nightmare of the past be one that we at this time, hopefully in our maturity, come to terms with. All those things, I believe, ought to be informing that Mental Health legislation. CHAIRPERSON Thank you. Can I maybe put it to the panel if they would like to ask Dr Cooper any more questions? MS WILDSCHUT Although my name is here, I will say my name first as instructed by the Chairperson, Glenda Wildschut speaking. I wondered whether you have any comments on whether in the legislation, we should be considering (indistinct) more specifically, I know legislation is often more broadly written, so that people have some interpretation into the legislation, but we have had quite a lot of difficulty in the past with that legislation being interpreted in a very narrow medical model and should we not consider something in the legislation which would help us to include other treatment modalities in Mental Health care? MR COOPER I think Glenda, that is very pertinent to what I am sure many of my colleagues, as I see them here, I see Dr Baqwa, I see the other colleagues in front here. I think that we and I am not excluding the other people, it is just because my line of sight is there, I think that it is important to include or make some sort of a preambilatory statement about utilising the richness of our cultural variables in society. Because sometimes, and this is a debate that some of my colleagues know during the post-detention sort of interventions, sometimes, it may not be one on one, once a week intervention for years on end, that is going to work. It may be actually helping the person to connect with a few other people, doing some group work, or doing some community rehabilitative stuff where they can interact with others who have gone through the process and have come out more whole, that those types of modalities may be more important than doing text book one on one, classical western interventions, which actually are going to be very, very costly and you are going to then find you are creating like we have created fantastic jobs for lawyers in our new society, we are going to be creating fantastic jobs for psychologists, psychiatrists, psychiatric social workers and so on. I think the sooner we can put that in a sense down, away from those elites to community based interventions, so that if there is a serious community based intervention preference will be given to that, rather than keeping me in money and paying me to provide that service which is going to be too expensive and there are not enough psychologists as you know, and psychiatrists certainly, to go around to help. So I would say the more community based there are and the more they have related to doing other things, getting on with your life like the stuff that I am sure, my colleagues, particularly Professor Seedat will address and the work they had been doing, in treating people like ordinary human beings, letting them get on with their lives rather than treating them as a special case that always needs to be continued with that umbra of this person is unwell, this person will continue being under the pall of receiving some tertiary intervention. So I think community intervention is very important. MRS MKHIZE Just one question, because to me knowledge is the gist of everything, including intervention and whatever functionaries we have to do as Mental Health profession. How do you think the Acts can facilitate the issues of creation of knowledge and the acquisition of knowledge or ownership of knowledge that integrates the cultural knowledge, the experiences which people have said in the field, as well as the social aspects. What I am trying to say here is that at the moment, we talk again and again about the fact of how we have used the knowledge, that is foreign to our practices as a guideline for what we are doing but I think we haven't done very much in terms of how can we facilitate the process of we as people, I shouldn't be saying as blacks, but everybody else who have had enough experience in the field, including the traditional healers, how can we facilitate a process where we can have, create our own knowledge, the knowledge that we can own and recognise and that will guide us in our operation? MR COOPER I think that that one is a much more difficult one to address, because you see, there is an epistemological base in the society which is very clearly Euro-American in foundation. And to integrate cultural experiences, whether immediate or handed down over generations, into that ethic begins to be almost some form of atavism that you actually are going to wear a (indistinct) and so on and here we are a society wearing society you know suits and ties and dressed in a particular mode. I think it is incumbent on intellectuals to put forward their beliefs and I am saying without fear or favour, is actually missing the point, because you know that we are informed, essentially by a media that is ensconced in the western ethic, so that if you come with anything that begins to threaten that comfort zone, people are going to trash it. That has been a position more recently with the call for an African renaissance and previously with Africanism and Black Consciousness and searching for different ways on intervening. So I think it is up to the intellectuals within those fields, to come up with viable modalities, other wise you see, the advantage of the western system is it has been tried, it has been tested, it does work within particular contexts. Transposing them hocus bolus to ours, is an issue, but if we transpose them understanding the cultural issues in our society, and without just throwing the baby in the bath water off western intervention out, but saying X works, whereas W and Z won't, would be a way in the interim. But I think it challenges leaders in the field to be more forthright about their belief systems. I don't think you can legislate for that. You can actually hint at being more culturally sensitive and being more historic in approach, rather than being totally ahistoric as we are in the society and transpose a Euro-Western modality or set of modalities of intervention. CHAIRPERSON Thank you Dr Cooper. Can I maybe, I have just been handed a note - okay, Hlengiwe Mkhize would like to ask you another question. MRS MKHIZE Thank you very much Sats for an exposition that you have given us. I just want to get your thoughts in this because for us, really it is important to make sure that we make recommendations which will be helpful in the process hopefully. Regarding you know, especially around the review of Mental Health Act and the issues around the Professional Board of Psychology that is very, very important because how the needs of people that you were referring to, are addressed, will be to a large extent, its success, will be determined by where the body which will address these is located. I mean, my limited experiences in the ministry of health was that what we were doing, really were working on reforms because by virtue of being located in that department for instance, psychiatry as a profession is well established and as much as there was a general move towards saying look, let's move towards community Mental Health care, clearly you could see that in reality the traditional way of handling mental health will dominate for many years to come, because people who are strong is there are people who are strong in terms of psychiatric care and those are the people who are in control and moving towards community Mental Health, was often seen as a chaos which one cannot manage. So, I am still really not sure in my own mind, I mean, when before you came in I reviewed what the submission we have got from Victor Nel where he is talking of a, where he is proposing a human service. I have forgotten how we phrased it. I mean people who have read his work, they know what he has been calling for for a long period of time. But it is like a human service department, which can accommodate more and more the expertise. You spoke about race related issues, which we know they are an issue in Mental Health if you look at Paul Saunderguard's work, it raises that a lot and many other people. But I don't think within a Ministry of Health, it can be accommodated as a serious text. I just wanted your comment, I know you have spoken to it, but still there are gaps as to what are we saying. MR COOPER Yes, there are a couple of issues there. The last one, first. I think it is a difficult one when we have inherited the old system and we have a (indistinct) of Ministries, particularly in the latter years of the previous government, they just started creating new Ministries. The approach of, well that is the suggestion if I hear it correctly from Victor Nel, is one that is akin to what applies in the United States, Health and Human Services. That takes account of all health, all welfare, social interventions. But, we have got - you need to also balance that against political territorial and other realities. Will a new government in power want to divest itself of some of those Ministries when it actually provides positions for patronage or other reasons for a lot of Ministers and a lot of Directors General and so on and so on? And my sense is that is going to be one of the hardest nuts to crack because rationalising those Ministries from the almost 30, to a smaller, more manageable number for a country of a fairly small size in world standards, is going to be a very difficult task. There is going to be all sorts or arguments when you know just four years ago, those same people were arguing what we are thinking. But now that they are in there, it is not going to quite happen. So maybe we need somebody like the Commission, to actually say there ought to be some rationalisation here because we are getting fractured service delivery. Even if we don't consider it, the issue of an underpinning threat of human rights' violations (indistinct) in the apartheid past, just in sheer deliveries, service delivery terms, it is fractured one Ministry replicates what another Ministry does, the gross wastage and so on, just doesn't bear scrutiny. That would feed into what the Mapaya Commission for instance is tasked with doing, in terms of suggesting a rationalised format, and maybe this Committee of the Commission, should be actually having some interaction by party interaction, in a sense, with that Commission and the Commission for Public Service at a broader level to say don't we have a gross human wastage? Our budget when at least 60 percent of it, goes to keeping the Civil Service, how on earth are we going to create the types of job opportunities, the types of other service delivery, infrastructure issues for a society, let alone those people affected by the apartheid past in the singular way that the Commission is looking at it. So that may work and I think there will be support, certainly from the Private Sector and also from Sectors of the Media. They will support a reduction in the Civil Service. The Civil Service will go screaming, but I think it is an issue that is so important that it may even be one that the Commission would want to ask for a National Referendum on. Do we deserve a tax base that is overwhelmingly geared at supporting Civil Service dependency or should we be looking at turning that around and creating the majority of the fiscal base for the nation. It is something that the Commission could look at. In terms of where some of these issues are going to be located, I don't think you can really legislate things out of existence, neither do I think that you are going to succeed in legislating things into existence in a very simple manner, because we have got perhaps the most advanced constitutional democracy in the world for a very underdeveloped society and you are going to have all sorts of private initiatives, individual group, institutional initiatives which you are not going to curb, but I think that diversity will actually add to the process if we have got a central grouping that succeeds the Commission to look at servicing those victims for a limited period of time, we don't want to create another bureaucracy and another tax burden for a society that is already one of the most highly taxed in the world. But for a very limited time, and that that should be open to appointment at that period, with some people from the Commission moving on to it, but also new appointments, but for a very temporary, fixed period of time to facilitate a process, rather than become the institution, providing it, so that they can monitor it, they can do it in different sectors in society, both private, public, the institutional other sectors. In terms of psychology very specifically and the whole psychiatry and psychology debate, I actually think that maybe sometimes we have overplayed this one. I think that there is a very important role psychiatry plays, but it is a finite role. And psychiatry, I don't think has even pretended to want to be the (indistinct) in terms of well-beingness, it firmly rooted in the tertiary intervention modality, we don't have a social psychiatry, a primary community psychiatry movement in this country. And psychiatry does have a very important use, however, the other professionals allied, like psychology, social work, nursing and so on, should be playing an important role in shifting the (indistinct). I think in the past, psychology hasn't done that, because it was under medical hegemony. Psychology is beginning to do that and bear in mind, we have got at least ten to one, the number of psychologists providing mental health intervention than psychiatrists, so there are more of us and we are more trained in psyco-therapeutic techniques, which psychiatrists are not. So, therefore we should be utilising that resource. The Government itself, the public service administration has determined that psychology is a scare resource. The Department of Health has prioritised psychology as second in terms of prioritising its health delivery system. Now, we need to use those as positive and turn them around. What is happening within organised psychology, is we are reviewing the whole basis of our training and looking at a new training dispensation for the future, very plainly, I, many of my colleagues sitting here, and others out there, believe we are training people or rather educating people with a major in psychology who are trained for nothing. They annually join the list of jobless and unemployed in the country. If we were to be a little creative about it and create for instance a B-Psyche degree in keeping with international standards, create a four year degree in stead of that honours tagged on, which also doesn't give a person any professional status, a four year degree, you will find intersectional collaboration from social work and so on, to create a mental health counsellor, an Aids counsellor, a family counsellor, a personnel counsellor rather than a lower level psychologist. In the second year they do a wide range of subjects in psychology. In the third and fourth years, they start specialising in particular fields of intervention possibilities and do an internship during that time - approximately nine months over two years. Do away with this masters level, if we add on one more year, you would get a D-Psyche degree including an internship and then you would actually have psychologists calling themselves Doctors, like happens in the rest of the advanced world. So you create that stream. That doesn't mean you take away the academic or scientist stream. We are talking purely the practitioner route here and that is where we are making the suggestion that things should go. However, I should point out that the city universities, significantly white universities, are the ones that are going to go screaming into the new millennium on this process. Because in a sense they have the most comfort zones to loose, whereas the traditionally black and the newer Afrikaans institutions in a sense, they are African more than the other city Euro-American institutions. They want to do it and for instance Transkei University, the University of Port Elizabeth are starting with a B-Psyche degree next year. And more people then will be employed in all sorts of areas and that group of people will be an invaluable human resource for change in the society. As you know, the subject that is more favoured by first year university students, in urban and rural, black and white universities in this country, is psychology. This large number, and then you go into second year and third year and then when you go in to honours and masters, you have to have a graph that is a few hundred feet long, because it can't contain in one small linear depiction, because it doesn't bear scrutiny. Our masters' training is perhaps the most expensive of all the trainings in our society. Minister Zuma has talked about the medicals, but if you look at the psychology costs, they probably are at least one and a half times that of medicine. That cannot be sustained in a developing society with the types of needs that we have, so we need to be realistic. So it has to be change that has to come from within as well. CHAIRPERSON Thank you very much Dr Cooper. Thank you also for making this room feel very big. It was beginning to feel a little bit small and full and comprehensive. I just got a note from a Dr Madega Mabla who is representing Melvin Freedman, who is willing to answer some questions on legislation, but I feel you weren't here in the introduction, we are actually going to, it is a very task driven forum, this is not a sort of normal type hearing. I think we will have a chance tomorrow in the workshop to actually, and I think you have actually given us a lot of material which we can use to guide our thinking around the legislation. So I would ask the Doctor to join that group tomorrow. In terms of time, we are not going to be able to open this section up to the floor and I would like to thank you very much, and hope you didn't feel too, as you say like (indistinct) when our job today is not to hold a glove over the coals, at these participants here. DR COOPER I don't feel responsible for the past. I feel very responsible for the present and the future. CHAIRPERSON Excellent. All right, if we could move on to the next section which in Psychiatric Interventions in Government Hospitals and Community Settings. Could I also invite participants and Dr Zanele Baqwa will be speaking to this and Ms Jeanette Mohapi, who is a Psychiatric nurse. If you could get to the table. Could I also invite participants to make notes with the view to tomorrow and really try to sort of think quite concretely about where we can go with these groups tomorrow, because we do want a product at the end of these two days, a very concrete product. I hope you will stay, Sats. Are you coming tomorrow? Okay, good. DR BAQWA I would have loved to comment on what Sats was saying, because I have been doing a little bit of thinking about it, but I think if I want to split myself into two, which I tend to do, ever since I came back from exile, is that I would like to be part of that workshop on legislation as much as I am also, I know I am involved in another workshop on community Psychiatry because there are a lot of multi-variate factors in the process of changing rather than just change or reform as Hlengiwe was saying. Let me just now go to my submission which is I hope, won't bore you because I tend to have a sort of literary philosophic incline in everything I do. I don't know whether it is a talent. I have covered my submission in three parts and I would like to tell you what those parts involve. The first part I have just tried to introduce, my introduction was an attempt to depict in context the violence prevailing in our society, wherein I tried to pull a thread through organised violence from the apartheid area to the organised violence of the immediately pre and post-1994 periods, and also violence as manifested recently in what I term social violence including abuses of human rights in psychiatry institutions, what I term this whole part 1 as a prismatic view on our national psyche. Part 2, was sort of an examination of conduct and use of psychological interventions, by individuals and institutions in relation to conflicts of the past. I am looking at specific examples of practises at different psychiatric institutions today. I am looking at the disjuncture as it still exists today between psychiatric care for white and black patients. I am looking at antithetical views to human rights and human dignity at psychiatric hospitals. I am also taking a critic of psychiatric academic teaching of medical students and registrars much in line with what Sats was saying. I am also looking into the enquiry into the transformation and reconstruction attempts so far and I would like a little bit to have a critic at the TRC Health Sector Hearings of June 1997 in Cape Town, which I think it is called for. We always have to evaluate ourselves as we move on. Part 3 might go over to the workshop really, where I am looking at improving the legacy of apartheid on Health Care. Strategies that will consolidate and contribute to the prevention of gross human rights' violations and I think that is where that philosophical basis of the Mental Health Act and other ... (tape ends) UNKNOWN ... may be used as slave labour and they were literally allowed to die from what could possibly be called criminal neglect. These private psychiatric camps were set up with an agreement between the apartheid Department of Health and Smith Mitchell, which is now known as Lifecare. Subsidised by tax payers' money and hidden from public scrutiny, they remained a secret for almost a decade, before being discovered by us. In fact the government guaranteed a 90 percent occupancy rate and to meet this demand, psychiatrists used the Mental Health Act and the country's oppressive involuntary commitment laws. Briefly as our submission to the TRC shows, up to 10 000 Africans were incarcerated, many were reportedly excessively drugged, the majority of the 10 000 slept on mats on concrete floors, dormitories were crowded, squat toilets ran down the middle of the sleeping quarters and up to 30 patients at a time, shared communal showers more often without hot water. The lack of beds was blamed on the patients. The Department of Health said like so many Africans they preferred to sleep on the floor. Black patients died form easily treatable illnesses such as pneumonia or respiratory diseases. At least 80 African patients died each year. The bodies of those patients who died, and whose families did not claim them, were used for anatomical studies. According to one annual company report, a suitable cement slab with drainage has been set up in our hospital mortuary for this purpose. Electric shock treatment was given without anaesthetic. The reason given for this by the Chief State Psychiatrist at the time, Dr P.H. Henning, was it is simply too expensive, too slow and too risky. Africans appear to be more susceptible to the affects of anaesthetics and because we treat more Africans than whites, we would have to double our staff if we used anaesthetics. Inmates were hired out to companies to perform labour without pay. Their days began at 05h30 am and ended at 05h30 pm. Contracted out to local companies, the labour force made coat hangers, wire brushes, rubber leg guards for miners, mats, sheets, clothes and aprons. This was called industrial therapy. In 1975 articles ran in the Sunday Times and in the Rand Daily Mail. These articles confirmed the existence of thousands of black patients accommodated in converted mining compounds, mine hospitals and old hotels which the article concedes are a disgrace. Most of them ranged from the utterly dreary to the downright frightening. I am quoting now from these articles. Thousands of blacks who were neither criminal nor dangerous, are confined behind metal and barbed wire fences, have to use hideous single lockups and look like something out of (indistinct), have only crowded treeless quadrangles to relax in. The usual treatment for blacks is shock treatment. The establishment of private psychiatric hospitals to incarcerate blacks, was one of many programmes implemented during the apartheid era to forward the suppression and the oppression of the black population. There is no doubt that these institutions treated blacks differently to whites. There were in fact another facet of the primary architect of apartheid, psychologist Hendrik Verwoerd's vision of South Africa. With millions of people faced with substandard education, unemployment, no opportunities and subsequently low moral, it is no wonder that these psychiatric camps could be established, or that the reactions to apartheid oppression was easily defined in psychiatric and psychological terms to justify their incarceration in psychiatric institutions. Various reasons were given. Because the black South African broke curfew, or were considered decedents, others physically ill from the poverty caused by apartheid, sought help from general hospitals and were in stead transferred to private psychiatric camps via State institutions where they were literally turned into institutional cases. Thousands of patients were syphoned out from State hospitals to use the words of a previous Commissioner of Health and contact with their families were severed. Because of geographical distance, or because of forced removal of the family to a destination which remained unknown to the patient and the hospital authorities, in the sense the black South African had no community to return to even if he was eventually discharged. I would like to put it in a little bit more human terms and use a couple of examples and I won't use the patients' names. I will call them A and B. Patient A was admitted to Sterkfontein in May 1974 and transferred to Millside Hospital from Sterkfontein. Millside Hospital complex near Randfontein that is. In September 1974 his sister visited him and found that he was reported to have died from septicemia. The family then made arrangements to collect the body. When they arrived at Millside to do so, the body identified as their son, was not their son nor were any of the other bodies in the mortuary at the time or any of the living patients in the hospital. In the mean time, the body labelled A had been buried by the authorities at Millside. There was no record of an inquest into the cause of his death. The mystery has never been solved and A is still missing. When he was admitted to Sterkfontein, he had sceptic sores on his ankles and these for many of you who will know, are signs of pellagra, not mental illness. And that pellagra is defined in the world book dictionary as a disease marked by eruption of the skin, a nervous condition and sometimes insanity. That A was allowed to die from an easily treatable illness and that those entrusted with his welfare and care regarded his disappearance with cold indifference, is an example of the lack of respect held for black people and how easily South Africans under the poor conditions many lived in, were frequently misdiagnosed with mental illness when the provision of proper medical care may have been all they needed. Then there is a case of a young black mentally handicapped male inmate, I will refer to him as patient B. B, a black mentally handicapped inmate of the Millside complex was taken home over a period of two years by two white male nurses and sexually abused. He was also used to work in the garden, run errands and clean the house and on occasion was given a bit of money for that. As he later stated to one of the other nurses, in a full statement he gave to her, he was taken to a bed and pinned down. Both of the male nurses then took turns in sexually abusing him and made him sleep in bed with them. The Mental Health Act provides for disciplinary action against staff members. It means discharge and the removal of his name from the register of the Council with which he is registered at the bare minimum. Both male nurses had no disciplinary action taken against them, because the testimony of the mentally handicapped person was deemed to be unreliable and in fact from our information, they both are still working there and the one is promoted into a senior position. In the grand scheme of apartheid times, where can we list cases such as A or B or the statistics of hundreds of unnecessary deaths due to exposure, neglect, electric convulsive therapy and other barbaric mental health practices? B's case might seem like the lesser abuse, but this case shows that the Mental Health Act of 1973 and its various amendments, serve to protect apartheid psychiatrists rather than the vulnerable citizens they were given the task of protecting and helping. 115 patients went missing from at least one private psychiatric institution over an eight month period alone. A woman admitted her 80 year old father to a psychiatric hospital, believing he would get rest and care. Within 24 hours, he was missing and within a week, he was found dead. What did the Health Authorities do about these incidents of abuse and the number of deaths that we reported to them? They did nothing. What did the South African Society of Psychiatrists do and its affiliated bodies do, they did nothing. And after they did nothing to correct the abuses, they did something. They amended the 1973 Mental Health Act, implementing Section 66(a), making it a criminal offence to publish information or photographs about the continuing crimes and abuses committed upon people in psychiatric institutions. CCHR has never been one to do nothing. We bypassed the local government authorities and psychiatric bodies, and took the matter to the United Nations which instigated a World Health Organisation investigation into the camps. The 1977 WHO reports confirmed the high number of deaths. What did the Health Authorities and SBS say and affiliated bodies do about the damning report? They did nothing and black South Africans continued to die at an alarming rate in these private psychiatric camps. Sometimes up to 80 patients a year. According to WHO, the release of the WHO report and I am quoting from their statement there, the release of the WHO report was followed by a campaign of denials and attempts to cast doubt on its validity on the part of the South African officials and representatives of the medical establishment. Then the American Psychiatric Association did an inspection on the camps and in its 1979 report, the APA stated the most shocking finding of our investigation was the high number of needless deaths among black patients in Smith Mitchell facilities. At none of the facilities did we find evidence of adequate medical care during the patient's final illness and further we saw charts of black patients in their 40's and 50's who were apparently allowed to die and further, there is good reason for international concern about black psychiatric patients in south Africa. We found medical practises which were unacceptable and which resulted in needless deaths of black South Africans. This is an indication of possible gross criminal negligence and should have sent alarm bells to the Health and Psychiatric fraternity, it didn't. In fact the APA report was condemned apparently because one of the APA members who officiated over the inspection, was yes, black. A subsequent 1983 report on this issue found although psychiatry is expected to be a medical discipline which deals with a human being as a whole, in no other medical field in South Africa is the contempt of the person cultivated by racism more concisely portrayed than in psychiatry. Further quote - all the black patients, that is over 10 000 of them, are certified and transferred from institutions on an involuntary basis without their own or their family's involvement in the decision process. The report concludes this situation has no parallel in the history and present state of psychiatric care. It certainly does have a parallel in the ownership and trading of slaves. The dehumanised view of Africans cultivated by racism finds various expressions in psychiatry. One of them is the theory which relates certain forms of mental disorder to different levels of development of the races. The long history of CCHR's fight to expose and rectify the gross apartheid human rights' abuses committed in the name of therapy by psychiatrists, affiliated with these camps, and within the Department of Health, is detailed in our submission. The degree of attack levelled at us for having exposed these abuses internationally is also detailed. Suffice it to say our members were harassed, followed and activities were monitored by the Bureau of State Security, BOSS. It bears comment that if psychiatrists, health officials and the private psychiatric camps had nothing to hide, such a torrent of discrimination and attack, would never have been directed at us. We also note that no representative of the private psychiatric facilities life care, appears to have, or are giving evidence to the TRC. Were they called to testify, have they made any approach to the TRC? Has David Tobasnic, Smith Mitchell's Director been called to account for what happened in his institutions? Where is Dr J.J. de Beer, psychiatrist and former Minister of Health who reportedly set up the agreements to channel blacks through Mr Tobasnic's facilities? Nor has the SPSA's earlier submission to the TRC admitted any guilt or responsibility, it merely serves to continue to shoot at the messenger. In fact it is a white wash of the greatest psychiatric tragedy in the history of this country and one which continues to this day. In 1991 staff at Millside Hospital complex, the Smith Mitchell or Lifecare facility, publicly complained about the high death rate from negligence and winter cold. Reportedly 35 mentally retarded children and youths also died between July 1988 and November 1990. 24 of them, as a result of pneumonia, tuberculosis and other respiratory ailments. Children dying from the same conditions that patients 20 years ago, were dying from, is a disgrace. Tax payers' money was used to fund these death camps and while today, State facilities such as Valkenberg are to be closed down, these private psychiatric institutions with their sordid history of gross human rights' violations, remain open and profit from State subsidies. There should be no compromise on this. These private psychiatric facilities must be shut down. Certainly there should not be State subsidies for these facilities at all. Section 66(a), the provision of the Mental Health Act which provides for the legal cover up of abuses being committed in psychiatric institutions generally, must also be abolished. Finally, and 27 years later, we are still waiting for answers. We are still waiting to see honesty, to hear admissions, to know that there is nothing left to hide and to see the SPSA, the Medical and Dental Council and individual psychiatrists who treated at the Smith Mitchell, Lifecare facilities, take responsibility. In particular, we reiterate sections of our recommendations. Point 1, that all psychiatrists and psychologists found to have committed patient abuses in violation of a hypocritic oath, and other ethical codes during the apartheid era and especially in the Smith Mitchell psychiatric facilities, and who have not availed themselves of the TRC amnesty, be investigated and where there is evidence of criminal abuse or neglect, be prosecuted. Point 2, in light of a gross human rights' violations committed in the private psychiatric institutions, all records and documentation must be subpoenaed from the Department of Health, Lifecare and formerly Smith Mitchell and the individual Lifecare psychiatric facilities which would cover and determine how many death occurred in the private psychiatric facilities over the last 20 years, what drug experimentation and sexual abuse of patients in these facilities, has occurred. From these, there should be an investigation of (a) the drug practices within these facilities and any cause or link to any death, (b) who the medical officers were who had the responsibility to investigate and report on each death and who did they report to and what annual reports exist on the deaths in psychiatric institutions, (c) all records and documentation regarding the burial of patients who died at the Smith Mitchell facilities should be subpoenaed from funeral parlours and a determination be made as to where there were communal burials, and if so, where these are, (d) all records, memo's, correspondence and reports held by the SPSA in relation to this Smith Mitchell facilities, during apartheid, should be subpoenaed to determine to what degree the failure of the SPSA to carry out proper, independent review of the medical records of patients who had died in private psychiatric facilities, may have contributed to prevailing human right's abuses and deaths occurring in these institutions. We have made many recommendations for reforms based on our history of successfully fighting for patients' rights. We are not anti-medicine. We believe in proper and competent medical care. We believe in the right for people to seek help from traditional healers and all this we will present at the workshop tomorrow, under the heading of the way forward. The continued silence by South African psychiatrists with the exception of one or two, like Professor Simpson and especially by the SPSA in the face of gross human rights' violations, having been committed within their camp, is unconscionable. During apartheid, the SPSA claimed that it inspected the Smith Mitchell facilities, and found no support or allegations of inadequate psychiatric care and that extensive and advanced psychiatric services were given to all South Africans without reference to colour or creed. This was a lie when you review this against the findings of the World Health Organisation and the American Psychiatric Association reports. During the American Association for the Advancement for Science's visit in 1989, the Statement released by the society again echoed the lack of responsibility and contradicted their constitution which is to uphold the principle of human dignity and psychiatric ethics. The society stressed to the AAAS delegation that although they were inspecting the facilities, the responsibility for psychiatric care was not that of the society and it distanced itself completely from the treatment and handling of patients in these institutions. This too is false. If the SPSA monitors the ethics and practises of psychiatrists, it should be ensuring that proper care is being given by them. The Nazi holocaust and apartheid have common realities. Without the driving forces of psychiatry and psychology, the holocaust and apartheid would simply not have happened. And I think our next submission will give you more information on that. While we certainly believe in forgiveness, the first step towards this, is for psychiatrists and psychologists who actively participated in apartheid, to come forward to the TRC and to admit their crimes. Those who remain complacent or justify their actions as just doing their job, or claim that psychiatrists were a tool of political corruption, should be rooted out to meet criminal, not disciplinary charges. They must not be able to evade the consequences of their actions. As a protection against current and future psychiatric and psychological abuse, CCHR recommends that a loyalty oath of mental practice be implemented which we will present at the workshops tomorrow. All available medical, professional and ethical codes have failed to ensure compliance by professionals in South Africa's Mental Health industry. CCHR's loyalty oath of mental practice should be signed by all psychiatrists and psychologists, psyco-therapists etc, before they are allowed to practice, especially when employed by the State. The oath requires the practitioner to sign this and as a legal document,legal action can be taken against the professional who violates it. Finally today, we call on the TRC to unequivably condemn the psychiatric abuses that have been committed against South Africans in psychiatric facilities and condemn those professional bodies, health authorities and practitioners, who were a party to them. Thank you. CHAIRPERSON Thank you very much. Just before I put it to the panel for questions, I am curious but I think it will be getting off the subject to examine the relationship between CCHR and Scientology? UNKNOWN I can answer that quite easily. CCHR was established by the Church of Scientology when it was Scientology that first noticed the gross abuses that were going on in institutions. It is not Scientology's mandate to get involved in investigating and exposing abuses, but to forward its ideology of Scientology. So it established an independent social reform body to carry out that function, and that was done in 1969. CHAIRPERSON Okay, thanks. I would have caught you at lunch for that answer, any way. Okay, can I put it to the panel for questions? MRS MKHIZE Paul, thank you very much, this is the second time. We missed this opportunity to interact with you when we had our Health Hearings, but I just wanted to ask you for interest sake, one question. Why are you not so popular, by you I mean your initiative within established groups, not only here, world wide? I mean it might sound like an unfair question. What you have said, it makes a lot of sense, but you scare people off, why is that? UNKNOWN Well, the thing is that we go straight for the truth, we confront a lot of the crimes and abuses that occur in the mental health field, that many other people don't want to confront or deny are there. We certainly with the Smith Mitchell exposure, were heavily attacked because we are attacking major vested interests both from a business and a psychiatric point of view and people don't like to be shown up for what they are doing. We are a watch dog of the mental health field. And we will look in every nook and cranny to find the abuses to ensure that our mandate is carried out, which is to clean up the field of mental health. If we were popular, I would say that we weren't doing our job properly. CHAIRPERSON Thank you. MRS MKHIZE Just one last question. You see, I don't know, I mean it might not be relevant for our need, but sometimes as I was going through your submission, it is like you deny the relevance of the biological explanation of people's problems completely. I don't know whether I understood what you are saying, very well. I know for the purpose of human rights, our concern, that is really not a problem except that sometimes, we might refer our people to psychiatrists who work within a biological model, but when I was going through this, it was like as far as you are concerned,the biological explanation of people's psychological problem is a farce? UNKNOWN I think the answer to that is psychiatry and psychology predominantly believe that man is an animal, which comes from studies done by Willem Wund and the stimulant response, studies done by Pavlov to quote just a couple. We believe that man is a spiritual being and as a spiritual being, it is that nature of man that needs to be approached when he has a mental problem. And that if you are looking at it in that context, as man a spiritual being, then it is function over structure which is the opposite of man being an animal, which is structure over function. Does that answer your question? MRS MKHIZE I am sure these people will follow that up, because some will argue that there are other beings besides the spiritual component. UNKNOWN Well, the belief is that man is as a spiritual being, is a spirit, has a mind and has a body and you approach all three of those, whereas when you look at the standard view point of psychiatry or psychology, they say that the mind is the brain. We don't agree with that. If man is a spiritual being, then surely his mind is an external, non-physical entity that manages this structure of the body. CHAIRPERSON Okay, I think that will continue, that debate. Can I just say looking to the section, we did say the use of psychology and psychiatry as an instrument for political repression, I don't think we have talked about sort of, I think we have touched on social repression, but I don't think we necessarily political repression. I think the indications we have had are quite broad, going back to the Police and the Military and I think we are still yet to pin down psychology and psychiatry's ... UNKNOWN Well, in summarising down a 150 page submission, we had the dilemma of how do we fit that in into half an hour and with the arrangement made yesterday, we have managed to organise to have it split into two parts. Certainly this is very relevant and we do want to see the recommendations we have made on the Smith Mitchell facilities, take place and on the political repression's side, Mr Lawrence Anthony will be covering that as we certainly couldn't have got this down into half an hour. CHAIRPERSON Okay, thanks. All right, then if we all break for lunch now, which I believe is next door. I presume it is here. COMMISSION ADJOURNS CHAIRPERSON I am going to introduce Dr Bhana from KwaZulu Natal, thanks for coming. You are one of the ones that have come from far, far away. It depends on how you look at that, in miles or sort of political situation. We look a little bit sparser than we did before lunch, it is a bit concerning, but I would like you to make your submission. DR BHANA Thank you. It is interesting that in the submission made by Sats this morning, he reminded me of something I had actually repressed quite effectively, namely my own period of incarceration which ... (tape ends) ... it seems to be for us in KwaZulu Natal, a pretty important area. I will talk about that just now. Before I sort of go on, let me just give some background to this submission that I make it as a former member of Progressive Organisation, namely OASSA, the Organisation for Alternative Social Services in South Africa which was involved in attempting to provide alternative social services for individuals and communities at the time of the rule of the former apartheid government. In doing so, I wish to draw attention to the fact that an earlier submission was made by my colleague in Cape Town, Ann Harper. I unfortunately was unable to get that submission to inform my own, but nevertheless. I also am somewhat humbled by being asked to make this presentation, because I think there are probably many individuals and organisations out there actively involved in rehabilitation and reparation who are possibly better qualified than I am in making the submission. A name that comes to mind for example, is Blade Nzimandi who was clearly at the heart of the conflict in KwaZulu Natal, in terms of observing that process and so I would like to make it plain then that I do not officially represent any particular organisation. I make this submission to add to those that came before and also in the short time that was afforded me in getting this together, which is about two days, less, I have managed to speak to a few colleagues etc and run some of this by them, but clearly the final form of submission, will come to you with lots more comment by a number of individuals. Let me just say that the submission I am making, is based on the information from a wide variety of documents, that OASSA itself produced and I think it probably was a pretty good tying in terms of documenting the events, experiences etc, that occurred and it was probably one of the more prolific periods around documenting issues affecting individuals, organisations, communities around of the affects of the apartheid system on the mental health of individuals and societies, communities. OASSA had a number of conferences, four in all in fact, annual conferences. I have taken information from those documents as well as from mental health practitioners, involved in providing services to individuals and organisations and from academics who wrote about the influence of an apartheid system on the mental health of individuals and communities. The submission by SAISA provides a useful backdrop to what I am about to say. As an Organisation OASSA was formed in 1983 to develop more appropriate mental and social health services at a time when the repression of the apartheid State had increased significantly. It had a broad base of activity which included research, education, media and emergency services, including what was at that time called detainee services. The organisation aligned itself with the Mass Democratic Movement of the time, and its mission statement if you want to call it that, was that it was vigorously opposed to apartheid and economic exploitation as well as social policies that were directly responsible for producing ill health. However, OASSA came into being because Mental Health Services were almost without exception unresponsive to what (indistinct) called the social context of deprivation. A deep cynicism of a family therapy association in the 80's, in the early 1980's, was witnessed when it decided to host its conference at Sun City while (indistinct) about the breakdown of the family system in South Africa, was I think something that resolved many individuals that this type of myopic perception of mental health in South Africa could no longer be (indistinct). Essentially, the connection between health, mental health and the social context of deprivation particularly, suggested that those who fell within a lower socio-economic structure, received indifferent mental health services if at all. To this day, the provision of mental health services continues to be selectively provided to those who can pay and who are located in urban areas, while little exist for those in rural areas. OASSA has sought to highlight the intrinsic relationship between poor mental health and apartheid and between apartheid and poverty and to find ways of countering these influences. The relationship between politics and economics and its overwhelming influence in social conditions, could be seen everywhere, it was discussed nowhere. It was one of the other sort of real light motives to this organisation that we could talk about it as colleagues, we could talk about things that were going around, but we never actually organised around it. There was sort of a major impetus that was building to get to the point where OASSA was formed. Initially, much of the work that OASSA was doing, was in support of activists in townships, direct support through counselling, training workshops and recognising and dealing with individuals, showing classic signs of trauma and together with NAMDA holding first aid workshops to deal with injuries from buckshot and the like because hospitals could not be trusted for good reasons and which have been provided at this hearing. One of its tasks, as one of its tasks, OASSA sought to dispel the naive contention among mental health professionals that politics and mental health practise should be kept separate as it was argued that it influences the objectivity of the professional. This is something that Mohammed has already referred to, that the Scientism of underpending professional activity was used to advance the idea of the dispassionate, uninvolved a-political professional much like the church using its doctrines to justify its (indistinct) to the pain and suffering of South Africans. When OASSA entered the (indistinct), charging academics and academic departments of using science to support the work of the State. Notable HSRC, CSIR are organisations that had been directly involved in this type of activity. Fortunately there had been some significant changes to that level. But also at a level and a type of research and training that was taking place within various institutions. American and European psychology was pursued as the standard because it had all sorts of racial implications and that this has had an impact in terms of the psychology that is actually practised today. The development of an indigenous psychology is difficult to see around one. The impetus to develop an indigenous psychology appears to be only gaining ground recently and part of the impact of the apartheid ideology and the establishment of universities which essentially were meant to produce mediocrity, was that an indigenous psychology was not readily apparent in any of the research or the material that was produced. It was perhaps the clear association between politics and mental health that epitomised OASSA that helped it to refocus the attention of health care workers on a need for social change as part of an effective treatment plan. It also marked a shift towards a more humanitarian mental health practice. The problem was not always one of bad genes or bad luck or even just a poor environment, but one that the majority of South Africans found themselves in through the systematic application of the apartheid ideology. I have a number of objectives that OASSA actually outlines and I am not going to go through all of them and I am just going to pick just on a few here in the interest of time. But clearly it was to provide a better mental health service to individuals who had no access to such services. To help other progressive movements in dealing with its own fallouts. Today we talk about burnout, it those times we talked of people who were severely psychologically damaged as a function of torture etc. There was a strong debate that occurred within OASSA about should we do research on the affects of apartheid on individuals and the concern was that this research would simply be used by the State in furthering its own ends. And that debate obviously meant that some of the research that would have been done, was not done. Nevertheless, it did clearly see the need to redistribute and develop knowledge, experience and skills, workshops, conferences, publications and by the collection and dissemination of relevant information. It also saw the need to unite health workers across the specialised fields of activity, social workers, nurses, psychologists, psychiatrists, doctors all tended to operate in terms of their own particular training and philosophy and there was a need to see that health was not the prerogative. Any one of those and there shouldn't be a pecking order and so that is one of the things that was also attempted. I am not sure to what extent this was successful. Another objective was to develop structural models of appropriate social services, to assist wherever possible with the implementation. When we look at these, and I have a number of them here, these objectives, it is evident that many if not all of these needs are even more evident today. The advent of democracy in South Africa has had the effect of refocussing the energies of progressive organisations from challenging the State to find ways of cooperating and assisting the newly elected democratic government to provide many of these services. The destructive forces of apartheid had held together many ideologically individuals and there were clearly many people within OASSA who could be at completely different acts of the spectrum ideologically, but who together in the interest of fighting against the oppressive system of apartheid. Once the system disappeared at least in terms of a significant event, the cohesiveness that characterised most progressive organisations at that time, appeared also to have disappeared. While new progressive groupings have emerged, the single minded focus and energy of early organisations appear to be lacking. The way forward was now faced with innumerable permutations and never ending rounds of workshops which served merely to signify that there was great uncertainty about how to proceed. I can say this with some degree of certainty for example the Mental Health Act and what should go into the new Mental Health Act, etc. Neither government nor progressive groups could foresee the enormous difficulties involved in social transformation. It is one thing making an argument, an eloquent one at that for change, it was quite another to produce change that would have the desired impact. The challenges facing mental health services, can be seen everywhere from Health, Welfare and Education to Housing and Safety and Security. I believe though that progressive organisations have yet to find their voice in this new dispensation. An independent and critical Mental Health grouping is vital in ensuring that there is continued focus and providing services to those who are marginalised. I believe the legitimising of SAISA was an important step in beginning to address some of the issues relating to providing services especially to the poor and those who are not urbanised. Ironically the need for mental health services is as great today as it was prior to 1994 if not more so. In KwaZulu Natal, youth who had given up much in the struggle for liberation, today find themselves unskilled, unemployed and psychological defeated into personal violence, substance abuse and crime, are (indistinct) to their lives. These individuals feel little hope, because little has changed for them, but also because there has never been available mental health services that would help them to heal and I think this is the point I made with the personal statement about many of us that may have gone through a period when we directly faced the oppressiveness of the apartheid system, but were made to deal with it or dealt with it or did not deal with it, but it became or was repressed. For many of these individuals the period in which the experienced repression in massive amounts, the ability of OASSA to respond or of any progressive organisation, including NAMDA etc, to the needs of these individuals was sharply limited. In 1986, at the first OASSA conference Patel reflected on the issues confronting black families at that time. These words that she spoke at that time, represent a painful reality of problems of old, that are still very much with us. I quote - in the present South African conflict a new generation is emerging who knows only violent conflict, rather than how to express their feelings or to love. The task is to fight and to survive. The social milieu is one which encourages the suppression of feelings as being heroic and the expression of it as cowardice. No doubt, the effects of the present conflict will leave lasting scars on generations to come. In a personal communication with Freddie Staborough who is the co-ordinator of a group that runs trauma workshops, counselling groups etc, in Port Shepstone area on the south coast of KwaZulu Natal, told me about how the effects of the lack of services is having accumulative effect on individuals. If you will recall, the recent bus accident where in a number of Inkatha Freedom Party members died, threw up a host of underlying psychological problems among the families and survivors. What really was going on here, was that earlier traumas experienced in the bitter political fighting leading up to the elections and since then, had never been resolved. The trauma suffered originally was not dealt with because of a lack of mental practitioners who work in rural areas, inadequate mental health services in general, as well as the historical neglect, not to forget destructiveness of the policies of the apartheid system enforced by the previous elite. Culture demands that individuals learn to cope with such events, further contributes to a (indistinct) attitude of trauma. In keeping with the classic trauma model, poor coping and a lack of support to ensure the wellbeing of this individuals, have led to a decrement in coping resources thereby making them even more vulnerable to minor or unexpected stresses. Lack of resources and the almost complete absence of any psychological services for such individuals ... CHAIRPERSON Sorry Doctor, sorry Doctor. DR BHANA The lack of resources and the almost complete absence of any psychological services for such individuals means that the frustration and inability to deal with traumatic events, leads to acting out in the form of spouse and child abuse as well as substance abuse. The cycle of violence continues. In a chilling statement, around the issue of AIDS in KwaZulu Natal among a segment of youth in the townships, a chilling statement is infect one, infect all which essentially says and let me preface this with the explanations given for the cohesiveness and the togetherness of youth, is that in the struggle, in the time of the struggle, they bonded. They work together, they supported each other, they looked after each other. That bond still exists. Now, what has happened, is that AIDS has presented itself and in the context of that particular event, they have recognised for themselves that there is little hope for them. These individuals have now embarked on a cycle of self-destructive behaviour. They don't want to have any tests done on them that would reflect whether they are AIDS positive or not. They recognise that sexual conduct or sexual behaviour is closely linked with interpersonal violence, the use of safety measures is often issues around the demands of the male over the female, which often results in violence. So both males and females recognise that they are trapped in the situation and that they will live life for the day. I am not going to give a lengthy submission of this, I will in the report that I submit to you, that the effects of the apartheid system are I think only, my view is that we are only beginning to understand the sort of deep-seated effects of this. Not only among people, older individuals, but among the youth. The premise for the existence of OASSA was that the State was neglectful at deliberately destructive with regard to the mental health of its citizens. The New South Africa has not changed reality for most South Africans, and especially those in KwaZulu Natal with political conflict is still ongoing. Shobashobane and Richmond are points in example. If mental health workers are to break the cycle of violence, which is now feeding on itself and it can no longer ignore, desperate need for mental health service is part of a primary health care model. The need for training institutions to examine the relationship to broader context, especially with reference to an African character was recognised as early as in 1986 at that first OASSA conference. Training student nurses, students, nurses and volunteers as lay counsellors and Sats has already mentioned the model that SAISA is adopting and pursuing, is a useful and important first step in helping to break the cycle of violence because my submission earlier on was that if one does not provide services, especially to these individuals where nothing really exists, the cycle of violence continues. It simply reproduces itself in different forms and it may not be called political any more, but the violence continues. Trauma counselling skills can and should become part of the training of primary health care personnel. Systematic efforts that bring together the training programmes of health departments, community organisations, including churches and various NGO's involved in doing trauma counselling, should be prioritised as a major mental health initiative. Whereas previously the State and progressive organisations were in opposition to each other, the need is for new partnerships between these two sectors. The need is greater in fact, than ever. The Department of Health Education and Welfare should strife to promote delivery of services through partnerships with those community organisations, NGO's, etc rather than attempt to say we will provide mental health services to all. It is not going to happen. Professional associations such as SAISA as I pointed out earlier, promoting the broadening the (indistinct) such as lay counsellors in various areas, is vital to creating a humanitarian psychology, and must be applauded. Prevention programmes that focus on developing viable conflict reduction models within our schools, should be seriously considered as part of an Education curriculum. If you talk to youth today, the solution to any problem is to fight or engage in some form of behaviour that leads to injury of another person. It is almost an automatic response. NGO's such as a Trauma Counselling network that is active in Port Shepstone on the south coast of KwaZulu Natal, play a vital role in service delivery. They are in fact the only ones who train individuals around trauma counselling. Currently various models are available to make this a workable prospect and I will present a separate submission where these models are provided. It is not for me to go into them here. What I would like to say in conclusion merely is that the State needs to enter into partnership with such NGO's to provide training that is relevant to the needs of particular communities. It should not rely or even expect the formalised health sector to be able to meet the needs of survivors of violence. I would stop there. CHAIRPERSON Thank you for saying what you did, not stopping. I've got a question before I put it to the panel. We put your submission underneath a section of contributions of progressive organisations. I know in such short notice, you had to do a broad, but I am curious. Are we saying that progressive thinking or organisations or - have sort of somewhat been diluted since? DR BHANA In terms of the way in which OASSA operated, or even NAMDA for example, the single minded focus that they have because there was a common enemy, the differences could be simply ignored and work towards a common goal, was often something that motivated many people. What has happened since is that in the (indistinct) between the transition and a transformations that are taking place, defining roles, relationships, where people fit etc, has not occurred in a very smooth way. Which is with hindsight, to be expected. In addition, individuals have, some individuals and a lot of those individuals have experienced burnout and have said I want time for myself, etc and have gone off to do things which they have felt they have neglected in all this time. Many of these individuals have also joined the government, so their world continues, but no longer as this easily identifiable common united force for social change and I think to some extent that role is slowly being picked up by the NGO's, etc, and they should be fully supported because I think it is important for those sectors to be the conscience of the State to point out the inadequacies, to point out the need for services etc, and where they should be delivered etc. Because they are closer to the people and their needs than any State department, health department, any education department, etc. I think that is where the shift is occurring. CHAIRPERSON Do you think there is a racial split in terms of progressive thinking about psychology or I mean, is there a split within psychology, different schools, essentially Afrikaans schools or I am spreading them, I am polarising them, but I mean is there a black culture of psychology developing and the white, is it integrated? Can you fill me in? DR BHANA That is a hype question to answer. Perhaps my colleagues can help me there. What has changed is that the content matter of psychology has shifted. In some places it may not have shifted as substantially, but it has shifted. What is also changing, the question was asked earlier about how does one encourage and develop new leadership, new researches, new intellectuals? Part of that has to do with for example one of the journals in psychology there are essentially two journals in this country. The one is the South African Journal of Psychology which was, well if people talked about irrelevant, that was it. It was irrelevant. It had publications that talked about stuff that nobody could really understand or even considered. It was like you could be on a different planet. Psychology in Society came out as an alternative to that and some very useful work has been published in that particular journal. The journals have shifted since then. One of the policies that has emerged at least in terms of Psychology in Society, is that people talked about the difficulty of writing, and there is always the difficulty of writing for lots of different reasons. But when people now write and submit articles or whatever, whatever it is that they submit to for example Psychology in Society, the Editor then works with that person to get the article published. It is no longer we send it out to your reviewers and we will do a scrutiny of it and reject or accept it. Another sort of development has been under the sort of leadership of Norman Duncan, the special issue on by the South African Journal of Psychology, around black authorship, trying to encourage black authors to ... (tape ends) ... but it is more than just the question of representivity, because if you look only at that level, it is easy to have old wine in new bottles. You just produce a black face, or put a woman who is reproducing the old concepts and the old ideas without creating a genuine shift in what we should be looking at, does it represent the world view of this country's population? Does it look at for instance the majority of the people, of this country's people are not violent. They have not engaged in violent behaviour, how is it that the majority have succeeded in being resilient and in maintaining the humanity despite the cross levels of dehumanisation that has perpetuated through the exploitative system? When psychologists investigate and research, they always look for deficits, they are always looking for pathology because they are ready to attach a label. I think if we can recommend that the intellectuals, social scientists in particular begin to relook at how to investigate the phenomena that are of paramount importance for service delivery and for the teaching programmes that students go through each year, that we should be looking at without dramatising exploitation and oppression, we should be looking at the resiliency of this country's people and how that can be harnessed to promote positive mental health for all South Africans, given that we are never going to be able to in the short or mid-term, produce the kind of mental health workers we require at the level of service delivery. We have to get creative and really look at the organic systems of healing that underserved and unserved communities have forged in promoting their own well-being. In conclusion to my very brief presentation, for many people what I said may be old hat, but it bears repetition, because for most psychologists they have not acknowledged the omission at the level of knowledge production. They have not acknowledged the biases, the distorted images of blacks and women that occur in psychological literature. Psychologists, organised psychology is yet to acknowledge this complicity and the exclusion that they systematically, perpetuated by virtue of silence. At the same time, right now there is a thrust of those of us who work partly or fully within academic institutions will know, that the publish or perish phenomena has arrived in South Africa and so there is a major thrust to publish irrespective of what you publish, the social relevance is ignored. Whether it is linked to transformation, the promotion of democracy is ignored, and when such questions do come up, one is very squarely and clearly told that that has nothing to do with psychology or with academia, that academia is neutral. And yet, historically if you look at it, it has never been neutral. So I am hoping that in the discussions that unfold, this kind of area be taken up, we not be able to legislate against people pursuing certain kinds of research but we can certainly create mechanisms that discourage omission. Thank you. CHAIRPERSON Thank you very much. Thank you for being brief. Given that you have been brief, would the panel like to respond? I would like to respond first of all before I give my colleagues a chance. Do you have any suggestions as to a kind of new system of production of knowledge? I need to put some thought towards that? MR BHANA It is easier to critic than to formulate constructive recommendations, and I recognise that. It is a very difficult area to cope with and to deal with, but I think at a very basic level, institutions that produce knowledge, need to be encouraged and they need to be very strong reinforcers to ensure that at a primary level there is representativity. That the systems producing knowledge represent various interest groups and the diversity that this country contains. It is absolutely important. Secondly to really look at creating those think tanks that receive institutional and political support and these think tanks really need to look at, or be encouraged to examine from another perspective and to (indistinct) theoretical analysis from creative perspectives. I think you know, that is perhaps a life long endeavour, but really to take the chances and to be encouraged that production of knowledge is not related just to publications. Most academics find that their jobs and their job security is related to the number of publications that they churn out and that needs to be discouraged if we really want to create incentives for people to take risks, and to be asking questions that they hadn't asked before. I think there is a lot of creative ideas, people have at an intellectual level, they have the (indistinct) of ideas and projects that they would like to embark on, but it is the mechanisms that enable that, that needs to be set in place. It isn't so much that there isn't a willingness. I think you can easily put together in each province, a major think tank that look at production of knowledge for a comprehensive mental health system. It is really looking at what will enable that. CHAIRPERSON Thank you. Panel? Dr Wendy Orr? DR ORR I think you probably answered part of my question in your reply to the previous question, but I was going to ask if there is any discussion within an academic circles and between universities and tertiary educational institutions about the kind of issues that you are raising, and if not, is there anything that the Truth Commission or the profession can do to try and facilitate and kickstart this kind of discussion? DR BHANA I think Irwin is probably going to talk about that later when he looks as progressive attempts. There are pockets of activity,these are really marginal voices that continue to try in addition to their full time jobs on the side kind of, as an appendix to their regular jobs, to carry for the activity and I think what that needs, that kind of activity needs to be centralised, instead of kept (indistinct) and the Commission would do well to work through institutions such as the CSD, the HSRC - all of the major research bodies, or the bodies that fund research need to be encouraged and need to have the appropriate political endorsement, to centralise activity that is going to enable the democratisation of knowledge as well as the production of relevant our bodies of knowledge. So it is really essentially working through the institutions that support research. MS WILDSCHUT It is Glenda Wildschut again. Looking at the collaborative study that was done sort of World Mental Health activities, and looking through that report, it became very clear to me that very little work has been done in examining the relationship between structural violence and interpersonal violence. Rather a lot of work has been done in looking at the causes and the nature and extend of interpersonal violence at different levels, whether it be political and so on. And it seems to be that that is an endeavour. That is something that is very important for this country that we have come through a long period of structural, institutionalised violence through legislation, etc, etc and what impact that has on interpersonal violence, and every time one looks at the report in the newspaper, people individualise almost the escalating violence that we have and attribute all kinds of reasons to that. It seems to be this lack of understanding between structural apartheid and structural - if you can comment on that. ... personal story in that the issue around rioting or (indistinct) observations that one has made and so on, and try to make sense of that, is also an issue of confidence and that if one is not in an academic environment, it is very difficult to actually write because one doesn't have that kind of support and confidence in actually writing that and I think as you mentioned it is a good idea to in a sense, create a milieu where people who are in a non-academic environment can actually begin to develop that confidence and to be able to write down what kind of observations people are making. It is interesting to note that in your review, the more relevant writing and research is being done by alternative organisations such as OASSA and other non-academic institutions. It is often to those works, that one has to look in order to make sense of some of the things I have mentioned about the relationship between structural violence and interpersonal violence. DR BHANA If you read the written submission, you will see that historically most of the writing emerged from white English speaking or white Afrikaans speaking universities, and even up to now, academics associated with the historically black institutions, hardly ever write for a whole host of reasons, but there is definitely the issue of confidence, the issue of being over-awed by the idea of writing and the research continues to be mystified and couched in esoteric terms and the attempts by black academics to engage with research, is discouraged for obvious reasons, but it is always presented as something that is a preserve of geniuses. That it is not ordinary human beings who can research and write and unfortunately the only geniuses you get in this country, happen to be white. That is a major problem. At that level, it is quite important to be looking at these institutions and encouraging and developing these think tanks and these writing forums where people are encouraged and enabled to write and create a space for writing. If you look at the student numbers for instance between UCT and Western Cape, you understand why people in the Western Cape don't have the time for that. At organisational level, the demands differ. As far as coming back to your first issue of violence, I want to say that those who have the power to define the problem, also have the power to define the solutions. Historically violence in this country has taken on various definitions. In the former years of institutionalised apartheid, it was defined as a black on black problem, blacks killing blacks. Inkatha/ANC problem. It is now being rapidly being redefined as a criminal phenomena that if you lock everybody up that is violent, we will have peace in this country. One wonders why these selective definitions of violence continue to pervade the media, public and political discourse and it again comes back to the point I was making, we need to look at how for instance, research violence, what kind of questions we are asking about it. And why do we only ask certain questions and not others. Why do we continually define it as primarily an individual phenomena when we look at interpersonal political violence, but we ignore the fact that State machinery continues to justify violence in various forms. Internationally that is the case. If you turn on the television set, adults and kids immediately learn that it is okay to be violent. The message is conveyed that it is okay. It may not lead to violence, it may not be the course, but it conveys a message. So we have to look at, I agree we have to look at the interface between the structural and the personal. Small studies conducted by various people are beginning to show that people who are likely to engage in political violence, that is not ideologically based, are also likely to be violent in the interpersonal relationships. CHAIRPERSON Thank you. MRS MKHIZE Just a brief comment. I should think you really don't need to answer this, because you had spoken to it. When I was going through your submission, my problem was that it is like in this country, unlike other countries, surviving from human rights' violation of whatever nature be it oppression or dictatorship, usually people have an opportunity in some instances even their capacity, to articulate their experiences and to develop the whole culture of human rights' around their profession. In this instance, I mean here, you said something somewhere about the politics of knowledge production. I was just thinking that we are trapped. Most people who have the capacity, who will be even reviewing, let's say the work of the Commission, are people who are also part of the leaders. They can only be critical of the past to a certain degree and so that for me is a problem. If you look at how for instance the Jewish community has taken up the holocaust experience, they have done a lot of work in terms of research and everything, uncompromisingly so, but as you have said here, that most people who are really survivors of the apartheid experience, I know you are one of those people who have been trying to get people to write, to contribute even what you referred to as alternative models of knowledge production, but I don't know what are we going to recommend. I thought your submission - it raises critical questions but in our context, I just see the process being reviewed by people who really be trapped in their own problems related to the past, and it is likely to be a compromise. DR BHANA Can I just say that academic writing is only one form of writing. There is a rich heritage of writings by novelists, poets and other forms of writing. I think we should be cautious in thinking that it is only those who are academically trained can articulate best the experiences of the people. If you read the works of people like Don Mathera, Mphahlele you will understand the psychology of this, of the oppressed people in this country, far better than any psychologist could ever articulate. So I think there are the forms of writing that we can be proud of and look at. CHAIRPERSON Thank you, but does that answer your question? PROF MAGWAZA I should think for us as a Commission it is important what he is saying, because really we tend to rely entirely on authorities. Like we think of Don Vorster because he has written 20 books and 20 articles. I think even with our writing up of the research, we had the report of these other alternative forms. I for one didn't think about it as I was looking at it. But I should think that it is very, very important. It is good that we've got it for our records as to how we take the process forward. CHAIRPERSON Thank you. I agree. I think it is an issue how we even pitch our report writing and in which style we actually choose to report on that as well. Thank you very much for that. Professor Lionel Nicholas? PROF NICHOLAS Thank you Mr Chair, for the opportunity of speaking here today. My presentation will comprise four parts. I have made a previous presentation to the TRC and I will like to just continue from there in my first part. I will try and find out particular questions of psychological involvement in torture or promoting torture, and I got some replies from the main people who employed psychologists in (indistinct). Also I would give you a brief overview of what those replies entail. Then I want to particularly focus on psychological and psychiatric testimony within the TRC and I will focus on six cases specifically which I see is an abuse of psychological testimony. Thirdly, I will offer a pet theory of mine that can elucidate the relationship between the torture and tortured. And fourthly I will spend some time looking at the implications for the future, and I am planning to do all that in about ten to fifteen minutes. Firstly the people that I wrote to on behalf of the TRC, to find out very specific questions which I will read to you as well, was the South African Medical Services who employ psychologists in their arena of psychological services, the South African Police Services, who have a psychology section and the Human Sciences Research Council and they are kind of the main (indistinct) of employers of psychologists. I was quite taken aback that all of them replied extremely confidently that not a single psychologist or a single effort that they could trace, had ever even remotely contributed to a violation of gross human rights' or in any particular way. What I also found interesting is that two of them had very similar (indistinct). Basically that in the military and the police, they are only speaking of people who are psychologists and registered within their service. There may be psychologists in other services who are not working as psychologists, who are employed in other categories, and it was not their brief to provide any information on these others who may be out there. They are sceptical that this may happen, so in effect the official record from these services are that there was just never any focus on these, there were never any role of psychologists in this. But they do concede that possibly people may have heard that psychologists did X or Y, it was just never within their particular service. The only rebuttal to that that I could find, was in Breton Breytenbach's book, The Confession of a Terrorist, where he talks about his personal interactions with psychologists, who didn't seem to be very humane. But to give you a flavour of the kind of responses that we got from the services, I will look at the Police Service report that I have here. I wanted to know obviously the numbers of psychologists and the assistants in the rehabilitation of torture victims and the nature thereof, and they were very clear that no psychologist were involved in the assistance and the rehabilitation of victims. The main focus of psychologists in the Police Service, is the police members or their families and not anybody else at all. That is the main focus initially. Whether psychologists were involved in interrogations of prisoners and the nature thereof? Nothing of the kind happened. They only mentioned one psychologist who was involved in (indistinct) of interrogation techniques, but was only applying this to serial killers and to nothing else, so that is the only psychologist that gets mentioned. Whether psychologists were involved in research or experiments or on intelligence, industrial, military or prison setting that could have violated human rights' and the nature thereof? No psychologist was involved in this. It is the policy of the Police Service to register all the research projects and after they checked all of it, they found not one research project that link to this. And all research is done on the basic principal that the respondent's privacy and rights are maintained and respected. The duties and obligations of psychologists assigned to work with political prisoners and detainees. Again they indicated that the focus point of the service was always only the police officer, not the community or the detainees or prisoners. Any research that would shed any light on the violation of human rights'? They also then indicated that no research was done in this regard. And they would go on to comment that they can't talk about anybody who is not officially working for them, and that is very similar to the mortuary response. Wendy even arranged a private setting for us where we could try, because there was some things that were secret, but the secret things we found were really of no consequence. It had to do with research into a subliminal technology, some issues around hostage taking, but nothing that anybody couldn't know about. They were very careful to indicate that this was very secret and then again, they also said that none of their psychologists were involved in anything. If there were psychologists, they weren't under the ambit of the people responsible and who were reporting at that time. The HSRC just sent me a letter saying that they had never done anything at all that is related to any of this, and they unfortunately cannot help me. So that is the first section on official culpability of psychologists which came subsequent to my previous submission. My second part, which is really the part which I am most interested in because I am also most concerned about, which is psychological and psychiatric testimony. The specific testimony that I am going to focus on is the testimony of Brigadier Cronje, Captain Hechter, Captain Mentz, Van Vuuren and Venter and Captain Benzien. What I have done, was to with the help of the TRC get hold of the psychologists' reports on these people and how psychological testimony was then used in mitigation and my main worry is that all of these reports have been - the main issue under mitigation is that all of them suffer from post-traumatic stress disorder. I don't know, I don't think judgement has been levelled on the value of this particular testimony, but the main thing about post-traumatic stress disorder is that internationally people will be very surprised to hear that it is even being thought of that it could be applied to perpetrators. This was a category developed within the diagnostic and statistic manual, version 4, and this is a manual that virtual all psychologists and psychiatrists use particularly for official diagnosis where there are any official repercussions within the legal system and generally used in the mental health system. The main issue that I found troubling was that even though it is fairly clear that this was not the original intention through this kind of diagnostic category, it was just accepted that even though the perpetrators didn't conform to the major criteria of this diagnosis, that the testimony still went on. I just spent, I got the stuff pretty late, and I spent quite a while reading though 800 pages of testimony on the one case, that I want to discuss in a little more detail. It does seem a little bit funny at times, but I mean I anticipate that should this be successful, you would get hoards of applications saying you know this is great, and this is why I really wanted to place a bit of focus on it. Now, when the lawyer for the survivors of torture questioned, he did in fact also use - this is a photostat from that manual - he did ask the psychologist in the Benzien case that in his criteria it states quite clearly that the person's response to the event, must involve intense fear, helplessness or horror. Now, if you are a psychologist, you know that this manual rarely says must. It is really saying this is an absolute requirement. It always says these are the main features, there may be deviations here or there, you should consider X, Y and Z, that is how, that is the terminology in which this manual describes. Right at the start on the 7th line, this is what is said. The way that the testimony then continued was that the psychologist who testified in the (indistinct) said well, obviously it doesn't conform completely to this, but there are all these other indicators. The other indicators that were within this diagnostic category could be a result of a range of other problems as well, and if you go through that manual you find that these problems are there as well. I was thinking there were 50 pages of testimony and the testimony should have really stopped at that point. When you testify in a professional capacity as a psychologist, and you use a particular diagnostic category, you have to conform and say okay, this is it. Otherwise you have to use another category. You have got ... (tape ends) ... in fact take place without the psychologist either from the TRC side or from the survivors' side, be present, and that would be a strong recommendation from me for the future. The other part of this was that in the end, the psychologist did in fact then say no, she believes that Benzien did experience helplessness or horror and my next question will then be, she doesn't talk about the intense fear, is what are the mechanisms underlying somebody who repeatedly exposes himself to the same phenomena and then repeatedly said that he experiences this phenomena. It just doesn't make sense. This unfortunately didn't come up in the questioning. You know we can still stretch the argument to say regarding to a situation, he can have his experiences, but you can't say that five, ten, fifteen times over a period of 15 years, this person then subjected himself to these kinds of things. I also think there may be a case for this kind of testimony to also be referred to the professional bodies, not just for (indistinct) and saying this is the kind of testimony that is being presented and the TRC might consider doing that as well. The other interesting aspect about this kind of testimony which is given in the other five cases, now in the other five cases, the psychiatrist I don't see his name on this reports, who presented the testimony in the Cape, that according to the scale that he applied, a scale that is developed for survivors for these traumatic events, that none of them experienced intense fear, helplessness or horror. So, that already will exclude them in terms of using this diagnostic category, even though this is then offered. Then another interesting secondary argument is made in Benzien and in the other cases, which is if you participate in gross human rights' violations, if you torture people, you obviously as a human being, if you are not totally blunt, you will have reactions to it, you might not sleep too well, you may lay awake and so on, because you do this and you may do it on a regular basis, but then you make the argument that because you are experiencing this, you must be excused for actually doing it in the first place. This is also an argument that comes out of it. So your current state for example, which is the result of it is then given as an excuse for why you are doing it as well, and that doesn't make much sense either to me. But that kind of testimony was also allowed in this kind of professional psychiatric and psychological testimony. The other thing is this PTSD seems to be such an attractive category for people evaluating them, that even if it clear that you don't suffer from it, for example, in two of the cases, two of the ones presented here, the person presenting the report, is so convinced that you must that the first case an explanation was offered that you are so blunted that you don't realise that you suffer from it. Which is a bit if you are a psychologist, you know how strange that must sound. And the second category given in one of the reports is a group report written for the five people, is that there is some question that the person might be suffering from border line personality disorder, and the one personality block the other one out, so according to this report, everyone in this group is suffering from it - some may not know, others know, some aren't helpless, but you know, PTSD is the flavour of the month. I just hope - I am presenting it here hoping that something can still be done in the period to try and at least get a psychologist or psychiatrist to offer some rebuttal testimony when testimony like this is presented. In looking at some of the testimonies from survivors, what I was surprised at is that a lot of the memory loss had to do with identifying co-conspirators and people who were with at the time. There seems to be no credence given to the fact that it is possible through some psychological conditions, for memory to be blocked, for memory to become vague and just for natural conditions, but there are also well-know methods of jogging your memory, of exposing you to material that will allow you to regain certain memories, that it doesn't seem to factor in that somebody can get a week to go and sit with old trial records and say okay, would you remember of these people, that is a possibility. And the other thing is that once somebody seems to come to the Commission and say well, they are sorry and so on, it is almost as if suddenly they are elevated in a very high moral ground, much higher than anybody else there and they are allowed to get away with that as well. For example, in Ashley Forbes' questioning Benzien about it, and trying to get Benzien to indicate exactly what he has done, some for which his memory is vague and some for example where his memory is very clear. Now, when you have memory problems, it usually affects a range of your certainties about what you remember. You don't like have a memory problem about one particular area and you know everything else about all the other areas, and that was striking about the testimony as well. That somebody would say no, he knows everything about what has happened in the range of circumstances and he is very clear for the last 20 years, he can remember it, but he gets very vague and so on in other areas. And this is Mr Benzien's response to one of it which links up to my other theory. He says Your Honour, it shocks me and causes me to be sad to presume or that I had presumed that this meeting is truth and reconciliation, and that Mr Forbes now puts it to this forum that I tried to put a bag over him while he was in hospital and he was detained in Grootte Schuur hospital at that stage. I think it is - I don't know what to think Your Honour, I am acceptionally disappointed. This is somebody who has tortured somebody and who is apparently you know, sorry that he has done so. I leave it to you to assess the flavour of that kind of response. I don't have much time to go through some of the other bits that I think stands out in the actual testimony that I have gone through, but those kinds of inconsistencies are repeated within that testimony and I would hope that a professional able to evaluate that would be present in future submissions of this kind. Let me skip over the double bind theory and it is in that submission, so you can read it should you be interested in it and go on to implications for the future. I am a bit hesitant to do this part of it because it almost seems to me as if this Reparations Committee is kind of the stepchild of the TRC. You know, I don't have much faith that you are going to harness to many resources or that - I mean I appreciate it, but it was a struggle just to get me up here to be able to speak on this, and I know that the people here are making valiant efforts. But nevertheless, in terms of implications for dealing with this particular part of my submission, which partly also has to do with what is the knowledge base that underpins what one would evaluate and understand under the psychology or psychiatry of torture and oppression. I know that in really most of our institutions, more than 90 percent of our institutions, the study of these kinds of phenomena in a range of disciplines, not only psychiatry and psychology, anthropology, sociology has really not had a high profile. I think that from this Commission that especially State linked institutions should have a period, a focus period where they adopt the issues that have arisen from this Commission, as a high profile nodule point of investigation, practise, training to redress not only the (indistinct) in knowledge, but also that there aren't enough people being trained in this country to deal with the issues that are coming up, even if we do set up Reparatory structures, but secondly internationally the field of torture studies and rehabilitation is extremely weak theoretically. I mean if you attend the conferences and read the journals as I do, you can see that there is a general multi-disciplinary approach, there is a general approach towards providing testimony that allow some kind of (indistinct), but theoretically it is very underdeveloped. The other thing that stands out for me is that there have been huge resources harnessed in the process of the TRC period. I don't know what the plans are, it doesn't seem as if it is that explicit to in fact maintain those resources so they can provide the research base in some form, so that they can provide access to the public to still continue to see video archival material and continue to consult transcripts of testimony and to continue to see to what extent this process can remain as open and as public as it has been in the past. I am going to stop here, I am a little over enthusiastic on this topic, so I will leave it for questions. CHAIRPERSON Thank you Lionel. Dr Wendy Orr? DR ORR Thank you Lionel, I found your presentation very pertinent, it raised a number of issues which we obviously have to take into consideration and I hope that as we both live in Cape Town, we can continue this conversation at a later stage. Just two comment really. When you were talking about the response of (indistinct) and the South African Police Services, just to reinforce what you were saying. Thulani and I went to interview a psychologist who used to work for the South African Police in the 1980's, he no longer does, and he said exactly the same thing. When we said was there any involvement in torture or developing techniques of torture, he said psychologists were involved, but that work was contracted out. It was not police psychologists who were used. So that just, as I say, underlines and reinforces. I mean those were the words that he used, the work was contracted out. And then to say that I think a number of us are also extremely concerned at the way in which psychological testimony has been used at amnesty hearings and the diagnosis of PTSD has been tossed around, and we have been in conversation with members of the amnesty committee about it. I want to thank you for jogging our memory and for prodding us into actually being more proactive about what happens, and I think your suggestion that we have either a TRC or a victim psychologist present, is a very good one, thank you. CHAIRPERSON Glenda Wildschut? MS WILDSCHUT Your comment about the Reparations Committee being a stepchild of the Commission is something which resonates with us in a very interesting way, but perhaps to comment about that is that the Commission is a microcosm of South Africa and society at large in a way. And that the issues that are being struggled with or people are engaging with outside, are also the issues that we have to in a sense negotiate within the Commission. And in a sense, all of us have to accept some culpabilities with regards to that, because the sort of sensational legal stuff become the focus of attention in the media and in people's minds and the real issues of peoples' pain and peoples' emotional needs in a sense, get relegated to the lesser beings. It still happens that most of us in RRC are mental health practitioners who have really battled to put mental health issues on the agenda of the Commission, so I am in a sense being a Truth Commissioner in a true sense and actually telling you what the difficulties are with regard to where we - but we have as you say, you know, tried to battle on. Wendy has commented about you know, our communication with the amnesty committee with regard to the use or the abuse of psychiatric and psychological diagnosis in the attempt of getting amnesty. And perhaps again to those people who are interested in research and looking at this, I think this is something which really has to be written about. The process of the Truth Commission and how in some instances, it is again being abused by people who have in the past been beneficiaries of the apartheid system, and are now again using a particular forum to be beneficiaries and how difficult it is when one sort of at the cusp of that, to ensure that some attention apart from the sort of sensational media attention, is drawn to those very important issues. How can we go forward in the future and make recommendations when these things are being abused like this? I mean what kind of things do we need to say to the nation at the end of the day? So that is the dilemma I find myself in. What do we say to the nation you know when in fact these things are being abused? I think I hope that we can engage with the comments that you have made in the workshops, because I think they are really very important and if we loose this opportunity, we are not going to have another workshop. We are not going to be able to lock horns with each other about how we need to move forward. CHAIRPERSON Thank you. Professor Magwaza? PROF MAGWAZA (Indistinct) that most of the psychologists have said that they were not involved in the type of work and the work was contracted out, I think my issue here is that we need to shift this for future recommendation, that we shift, we don't shift but we balance the focus between omissions and commissions. That is very important if we see it within the context of non-repetition of the violation of human rights. I think in the future psychologists have to come up as a critical mass where they have to take it upon themselves to be watchdogs for omissions and not to be passive and find a way of absolving their guilt by the fact that they didn't actually engage in commissions. I think the pattern, if you look even the pattern of violation that has happened here in South Africa, is that even when these human rights' violations were committed in those years, there were very few vociferous psychologists who actually highlighted the omissions that were being made. We didn't come up as a critical mass and I am also, this is why my concern is that one of the things that we need to highlight for future sake, we should give the balance between the two. And then the second comment which I have is related to the diagnosis PTSD that while we feel that it should not be used, that we also have a responsibility as psychologists not to perpetrate the use of the label itself because it also comes from us. We are using labels and failing to, sometimes we fail to relate to the real experiences of people. Probably we should also act as role models that when we talk about people who have been traumatised, we don't see them as labels, but we also relate to their experiences and we use that type of language when we communicate. CHAIRPERSON Thank you. It seems we are making comment, good comment, but we can go on and asking questions. Hlengiwe assures me she has got a question. MRS MKHIZE You have made a bold statement that our Committee is a stepchild of the Commission, we will write this under your name for the next Commission meeting so that people can deal with it. You see, regarding your comments, first of all really I want to say for me, being in the Commission, I have come to appreciate the problems regarding the status of psychology and psychiatry as a profession in this country. When we started we went down to Durban to meet with Judge Mall, who is the Chairperson of the amnesty committee, just talking about the role of psychologists in that committee, looking at both people who will be victims there and perpetrators. His responses were clearly that you know, this will interfere with the legal process. It is going to create a lot of confusion, that was his response. And whatever recommendations we have put forward regarding a significant role of mental health professionals, the committee has not responded to that and for me, that has shown that the status, I am pleased that SAISA President is here, even from the government's side the status of psychology is not I should think, it is not good enough out there in public. I should think mainly it is due to the fact that it is one profession which really was reduced to a profession for a few, for the elite and which was developed as of no use to the larger community and as a result not only I would say people have suffered, even the very people who dominated and possessed the profession. And then also a second point you made. I said not only within the commission, but also in the government's side, many times Thulani when he started, he was designated a mental health specialist here, many times he came up with very good recommendations as to what should be done for witnesses and so on and those recommendations were turned down. Whenever commission representatives were meeting with government, they will take out anything which has got something to do with psychosocial support because they felt you know, it wasn't understood. Some of the problems we have experienced here, they reflect the problem with this profession. I wanted to say this during the SAISA conference but I couldn't get there. I am pleased to have had an opportunity to say this. Then you raised also another important point when you say people who appear before the Commission who say I am sorry or express an apology of some kind, they then get a special treatment. Within the commission, I know people who have started writing like Graham Hayes, criticising the commission, looking at - I should think we need to look carefully at the interface between religion, psychology and politics. And that is how I should think the commission has suffered because of that. There are quite a number of people within the commission who come from a religious sector and they are informed by certain (indistinct) as to how to you know, deal with the wrongs of the past and in a way that is much more understood than what you will expect when you are formed by psychological (indistinct) or philosophical framework. I don't know whether you would like to comment? PROF NICHOLAS There is a rebuttal to that somewhat in that in studies of testimony, I have experienced that a lot of just ordinary people express the pain and the trauma that they have suffered in psychological terms and I think through the underdevelopment of psychology for various reasons, maybe not only just that it wasn't seen as not useful because the previous government excelled at expanding anything that might not be useful to the popular, so I wouldn't go for that, but for me the main issue is that more often than not, people have testified have expressed their pain in psychological terms, but historically and at that point have not had any access to any kind of professional mental health practitioner to assist them, either at the time of the trauma or subsequently. Part of the reason is that there is very little access to mental health services outside of urban areas for example, and I think there is a strong basis for the commission to recommend that those mental health services should be mandatory in rural areas where they may be situated at hospitals, day hospitals or community centres. I am not making a plea for extra work particularly for psychologists, because I think we need to reconceptualise those divisions as well and to see how where there is more human service orientation under which a range of professionals would work cooperatively to assist people. So for me an issue is that many of the people who are coming for reparation, wherever they are located, they have no access to any kind of mental health, whether it is in relation to the trauma or elsewhere and that there should be some obligation within the reparatory process to make that just available, to say a decision needs to be taken that in hospitals there is somebody who can provide that. CHAIRPERSON Thank you. I was trying to organise a programme. I think for time sake we better move on. Can I just raise an important point that Dr (indistinct) has just made, Cooper not (indistinct) about he is on the war trail and he is raising a good point about really there being a case for the psychologists in question to ask the Professional Board of psychology in terms of undermining the credibility of health professionals engaging in testimony which is unscientific and unprofessional and attempting to defeat the ends of justice. There might be an issue for that, I think we have to discuss it within the Truth Commission, but he is also offering his support as the representative from that body to take up the case. I think we shall get back to you on that issue, but thank you for raising that, it is important. Thank you for your testimonies, thank you for your time. I think programme wise we are going to have, we are going to ask Paul Saunderguard to have his half an hour and then we are going to move Dr Bhana, is that all right, after lunch? Is that okay, or else we will have a cold lunch basically and then we will snip half an hour off the preparation for the groups at the end of the day. I think that will be quite quick. I think we will formulate questions and just bring that to the group. Is that all right, you don't look too happy. Thank you. Paul Saunderguard. MR SAUNDERGUARD Thank you Thulani. Firstly good afternoon to the Chairperson and the members of the panel and to all the delegates. Just for the benefit of all in attendance, let me give you a short background on the Citizens' Commission on Human Rights and its role now and in the past. CCHR was established in 1969 by the Church of Scientology as an independent social reform body to investigate and expose psychiatric violations of human rights and criminal abuse and to clean up the field of mental healing. The co-founder of CCHR is an eminent Professor of Psychiatry at New York State University and the author of over 20 books, Dr Thomas Zass. At the time of CCHR's establishment the victims of psychiatry were a forgotten minority group warehoused under dreadful often terrifying conditions in institutions around the world. They had no legal rights and could be arbitraly incarcerated and barbarically treated by psychiatrists who were above the law. CCHR is now an independent organisation with more than 128 chapters in 28 countries. Its mandate is to investigate and expose psychiatric abuse of human rights and in the course of CCHR's 28 year history it has researched psychiatric abuses in many forms and worked with religious leaders, government officials, police, politicians and community and parent groups to effect changes. The Commission include doctors and other medical specialists such as neurologists, educationalists, artists, religious leaders, attorneys and civil and human rights representatives who advise and assist in their professional capacity. CCHR has also received acknowledgement for its work from leading professionals and international bodies such as the United Nations Human Rights' Commission which in 1986 acknowledged that CCHR had been instrumental in the enactment of more than 30 pieces of reform legislation in the mental health field around the world. And today that figure has moved up to more than 100. We have learnt from 28 years of experience and many government enquiries we have participated in that in order to bring about true reforms and a better future, there must first be honesty, admission, nothing left to hide and responsibility. With this, the past can be cleaned up and the future become a new road to build upon. One of the greatest crimes that an individual or group can do is to do nothing. That is what apartheid psychiatry and psychology did. They did nothing to stop its abuses in the field of mental health and as my colleague Mr Lawrence Anthony will present from our submission, psychiatry and psychology were not mere passengers under apartheid, they created, built, manned and navigated and advised the apartheid ship. In 1974 CCHR first exposed the horrors being committed on patients in the private psychiatric camps owned by the private company Smith Mitchell and Company. I say camps, because these places could hardly be called hospitals. As we uncovered, there was an incredible lack of care for blacks in these institutions. DR BAQWA "If we unearth his bones, the pain would come again" "Here are the bones of the skull - the whole skull" Said the Premier of Mpumalanga Matthews Phosa, as he carried high another plastic bag containing skeleton remains of one of the three young men whose graves had been identified by an investigator for the Truth Commission. I watch in horror as a psychiatric nurse challenges a violent psychotic patient pointing his finger at the breast of this unfortunate patient who is frightened by his omnivorous power. Another nurse yelling in reciprocal crescendo as argument continues with a patient who eventually screams: "I am not your insane child at the beck and call of the staff, I have my human rights". You can imagine how I was smiling when I heard this - so it is sort of even reaching our mental patients in institutions, that there is a culture of human rights moving into our social circles and institutions. But I wish to add another form of violence now, the type that results as an abnormal human reaction to the above-mentioned violence, the violence of a society brutalised by itself, a society traumatised, an indirect form of violence flowing from the erosion of the human spirit and moral norms. In short, an almost state of anarchy, a regression to a more primitive mode of leaving the wild west of our times. Psychological reactions are as much based on individual organisations as much as environmentally effected. Explanations have been looked for - and some of them I like, socialisation - for example, problem solving by using violence, children emulating their violent environment, break up of families, refugee existence, alienation, discrimination, frustration, socio-economic conditions - the list can go on but I think for me, it is appropriate that I bring up a little bit about what mental health is all about. She says that mentally healthy people should be in touch with their own identity and feelings, that they should be oriented towards the future and should be fruitfully invested in life. Their psyches should be integrated and provide them a resistance to stress. They should have autonomy and recognise what shoots their needs, they should be masters of the environment. Several facilities were found to be unsuitable for patient health care delivery and certain hospitals were mentioned. What was common to those was the overcrowding of patients in wards, rows and rows of beds in one hall, neglect of patients akin to asylum like conditions of mental institutions depicted by Michel Fukou in is brilliant book: "Madness and Civilisation - Sanity in an Era of Rationalisation or Reason". Young criminally charged youths were mixing with veterans who had killed and raped. I tried to argue for the protection of the younger ones so that they can be roomed in solitary rooms, which of course had no proper locking mechanisms anyway. I was told by a consultant there, that patients had a right to some enjoyment - some sexual enjoyment, in their miserable conditions. I guess he thought he was being liberal minded in the human rights oriented context of the new South Africa but the issue was rape, it was not - I was not talking about consented sexual activities in a mental hospital, but another issue. I really wondered how they could all be clustered together and it made me think of how psychiatric services are organised in this country and it made me think of referral methods but I was told by some wise psychiatrist that of course we are a developing country - we have problems, and this is some form of picking up the people who are ill in the society - police are doing that work for us. I must in kindness, say that that hospital also had a football ground so that they could play football there but of course security was inadequate and that is another of the findings of the Health Committee that was investigating psychiatric facilities. She also comments on the staff at Fort Napier, that was comprised mainly of frustrated Rhodesians who had dispersed at the onslaught of Chimorenga. Now, that was that time but now they are confronted by another Black wave of doctors from the continent who came in with the 1990 ...[indistinct] door opening to let in life and purify the air. But now, in those societies they tend to verbally criticise because of this sensitivity and they used to say that we are much better off but I am wondering because we are not doing those investigations - as Cooper had also said, that community extended thing, the supportive network element so we have to bring families in but that will come in another part. If the society was invited - which I would like to do, in changing our perceptions and services, to get the people to come into mental hospitals - not just visitors, families - the few that that can, but to open up and let this mystery disappear and let the people decide how things should be done, especially now that we are de-institutionalising - that we are moving towards primary health care. But the Pretoria West people or the people at Pretoria West who had originally catered for the White working class of that area, again erected obstacles to this process just like you saw in Pietermaritzburg and the directives from the Director General of Justice - that is the legality part of it, are also very hazy on this matter so that confusion abounds and patients are caught in the middle. Even patients who are discharged from that hospital are not allowed to stay in three days after being discharged. If no-one claims them, they are just thrown in. There are no social workers in that unit, there is not community involvement again. What perceptions emerged from this unfortunate situation is that burials are being erected in the name of legality where really, a general hospital has a duty to admit ill patients. But also the facilities for car of these patients are lacking, these patients cannot even stroll the grounds as they are situated on the fourth floor. Psychotherapy Dear Doctor - says Cooper, is almost an ...[indistinct], except for the tolerance, the tolerance of the presence of some of us overseas trained psychiatrists who almost an exotic element. The reasons given are usually that psychotherapist ...[indistinct] or that the numbers of the population in demand are huge and that there are a few psychiatrists or that it is the domain of psychologists. CHAIRPERSON Excuse me Doctor Baqwa ...[intervention] DR BAQWA Am I taking too long? CHAIRPERSON No, I mean I like it, I was dreading this moment all week but I am going to have to say: could you summarise and also could I have - just in terms of time, the section where you want to do a critical analysis of the health sector hearings, could we perhaps leave that to the end and incorporate - maybe have a session on process. DR BAQWA ...[inaudible] CHAIRPERSON DR BAQWA ...[inaudible] CHAIRPERSON DR BAQWA ...[inaudible] CHAIRPERSON DR BAQWA "When an active attitude against discriminatory acts is not taken or when the State does not take a firm stand, the person faced with his or her unethical acts and desires is granted the possibility of magically excusing his own participation" I know that the Health Department had a conference on that and many good papers have come and I know that they have researched very seriously and I have brought that paper with me. Then I went into the understanding of psychiatry in our institutions and the treatment thereof, which are quite conservative and very, very outdated and lacking understanding in the context of our society and we will deal with that when we come to the workshop. And then within that I was also looking at human rights violations and the understanding of the patient or the client or the person and our understanding of ourselves too as caregivers. This has been a mirror of such gross - allow me to use that, ignorance or uncaring or negligence of these very important basic glasses that are looking at another person, that this has to be part and parcel of our teaching of medical students in psychiatry. Especially now in South Africa, post-violence and this trauma and our victims that - not our victims, but the people that have been parading in front of the TRC that are going to need care. We need to be able to understand what trauma does to peoples and communities, we need to understand that certain people survive, certain people do not and we need to understand what composes that - what makes people survive and what makes people not and then get into that so we can help. CHAIRPERSON DR BAQWA Well, I deal in psychotherapy and when people say certain things, sometimes I cannot help but look at things from an analytical point of view but I do understand, we will work with that. CHAIRPERSON CHAIRPERSON Can I just ask that you also summarise and not actually read ...[inaudible] MS MOHAPI Doctor Zanele has already highlighted some of their problems and needs but as psychiatric nurses, we all feel that there is a sense of urgency that situation and nursing care should be upgraded because the standard of nursing care has really gone down. We have a role to play - we have to as psychiatric nurse, to help in prevention of mental illness, promoting illness, helping people to get cured, help them to understand their experience of their personal misery. However, we are unable - we do try, but we are unable to carry out this function. One of our roles which we are supposed to really be implementing is to create a therapeutic milieu. Now, this means that we must scientifically manipulate and plan the environment in such a way that the patient quickly gets well and off he goes but we are unable to do so because of staff shortage. So, more than focusing on the nurse/patient relationship which is supposed to be interpersonal, we are more inclined to be rendering custodial care - that is, we quickly rush to the patients to the bathroom but in fact we do not take them to the bathroom, we use a hose pipe to shower them down so that we are quick and we rush them through and use that one towel to wipe them, so that we are through quickly because of the facilities. Now, the other problem is that hospitals like Doctor Zanele said: "The institutions are overcrowded, overcrowded not because of new admissions all the time, overcrowded with people who have been in these institutions for more that 20 years and I again blame apartheid. In 1997 I went to do psychiatric nursing in Bupule Hospital, when I got there it was about the time when the homelands were the in thing with independence, homelands and so on, now Bupule Hospital used to be mainly a very, very, large psychiatric institution. Now at that time the patients had to be transferred to all over the show so that we make room for general medical care of patients, so three quarter of the hospital patients were removed to all over. And then, again we are supposed to be advocating on behalf of clients and their families - I must confess we are not doing that, we are there - some of us, to impress the psychiatrist. My experience of 31 years dealing with the doctors, is that there is this power struggle of who is more knowledgeable than the other one. We as nurses, there is this power struggle that we became nurses because we had brain deficits or something - we are feeble minded or so. And another thing, we have this ethical dilemma - we often use our patients to cover staff shortages in performing manual work which should be done by hired people. In the guys - that we are empowering in occupational skills or in vocational skills when really and truly, some of the things should be done by some of us. CHAIRPERSON COMMITTEE ADJOURNS ON RESUMPTION CHAIRPERSON PROF SEEDAT I first became interested in this question of knowledge when I was a student back in 1985 at a historically White University, one of two Black students in the class - each day I left the programme wondering or feeling schizophrenic, feeling disjointed - I wondered whether I needed to check myself into one of the psychiatric institutions because the language that was being used did not speak - to my experience, to my psychological experience, nor did it speak to the experience of other Black students that I dialogued with. Each day we entered into a class in which there was unbridled competitiveness in which students refused to share notes with each other, in which there was extreme competitiveness to get the distinction and I wondered whether these people would make good psychologists and have interest in human welfare. I wondered how was it that sitting in this class of nine people where there was a lack of appreciation for each other for the backgrounds that we came from, how that related to my bus ride home everyday in which people had no hesitation in sharing the potato chips that they would take or the sweets that they would have at the end of the day. UNKNOWN CHAIRPERSON Thank you Professor Umspangele. UNKNOWN CHAIRPERSON MEMBER CHAIRPERSON Anyone else? WHO ELSE Okay, thank you very much, cheers. CHAIRPERSON Okay, moving swiftly on ...[inaudible] back, Professor Simpson, would you like to go to the table? PROF SIMPSON ...[inaudible] we might call a light ...[indistinct] I hope that Saths will forgive me if this presentation is fronted by myself, I hope he will look upon as a very, very pale darkie. As former President of another of the progressive health organisations - OMEGA I think, that this presentation will also partly reflect their views. And if that statement included the provision of mental health care specifically so named, it might also help to give a greater status and recognition to the fact that we are not looking after either the physical or mental health of our people properly so long as we continue to neglect mental health. And even although there was a supposed prohibition on the use of straight-jackets, this often merely resulted in the replacement of abusive straight-jackets with the replacement - with the abuse of handcuffs, chains or other means of restraint. And I have given details of a case where in one of the academic departments not very far from here, when a young doctor complained of patients being kept in handcuffs for a prolonged period, the doctor was in fact - soon found himself without a job and with a letter having been circulated to suitable people to ensure that he had great difficulty finding a job anywhere. And there was a stage when professors were given Government fundings specifically to tour America, North America and Europe to speak to leading psychiatrists and to try and persuade them to overlook the sanctions and to come and speak to South Africa and every such visitor was regarded as a great propaganda victory for the State. And of course the method of persuasion involved explaining to them about the enormous and amazing changes that have been made in mental health in South Africa and why they should therefore support these by coming out. In my earlier report I identified - and will not go into it today, some examples where racism and other issues in the treatment of patients let to deaths of patients. I also mentioned examples which I think are instructive in a number of ways and one of the points that comes across very clearly in some of the people that I have named earlier - like a Doctor Verster and a Doctor Plomp in Pretoria, was that those people were officially in private practice but they - in some cases, even testified to the fact that they worked solely in producing medical legal reports and psychiatric and mental health reports for the security police. However, if I make sure that my staff hires outside people - mental health professionals who can do that, it may be much more valuable. And I would urge the TRC investigators to act through the Department of Justice - through the State Attorneys and Attorneys General, to get the information about what payments were made to what individuals for services in the so-called human rights and political cases. Because I know these gentlemen at times - when we were trying to scrape together funds on the defence team to see if we could afford a cup of tea during the tea break, would boast about getting R6.000-00 to R8.000-00 per day - even when they were on stand-by. And the only way that they could possibly have obtained knowledge about what had happened in consultations between myself as a psychiatrist and the defence lawyers, were if there had be bugging of our private conversations - either in the lawyers chambers or in the rooms provided for us at prisons when we went to speak to the political detainees. We had one example in Pietermaritzburg Prison where one of the more junior lawyers joined our consultation rather late and afterwards revealed to us that when he went in and said he was here about the Twala matter, they guy behind the desk at the entrance to the prison said: "Have you come for the tapes"? and he realised afterwards - when we put the pattern together of the referrals that were made later to what we had been discussing, it seemed highly likely that there had been a taping of a - there was an ongoing taping of our consultations and they thought that this was someone sent to fetch them. I have information from a couple of sources that one or two of the individuals who were named in earlier evidence - when they received their phone call from the TRC, were observed to go green for a week or two. But because there was nothing else that happened, have since relaxed and continued in their usual inconsiderate manners - suggesting that they feel that nothing else will happen. I am concerned that the only mechanism that may appear to be open to us - and it may not be an adequate one for the purpose, is to refer to the normal Professional Associations or structures. We are fortunate that SEISA has reconstituted itself and SEISA may be able to take some of the necessary action. Certainly, there has been absolutely no transformation whatsoever of the Society of Psychiatrists of South Africa and I would consider - on the basis of their past history and their current constitution, that it is absolutely impossible to conceive of them taking any action against the people that your Commission are interested in. I have letters signed by the Registrar of the Council who was sitting there when they made that submission to you, dealing with other complaints that have been made. Complaints about doctors like Doctor Sirgay Portem, now perhaps ...[indistinct] for Mental Health in South Africa ...[indistinct] who - in one case we had affidavits from him about how a detainee who developed severe symptoms while severe interrogation, how he had explained to him that the fact that he was here was entirely his own fault and that all he needed to do to be released was to tell the police exactly what they needed and therefore it was very foolish of him not to do so. And he said in his affidavit that he had recommended to the police that they should finish their interrogation as soon as possible, by whatever means they thought fit. The Medical Council sat on that complaint that was made by five of us from Durban - five senior physicians, psychiatrists and psychologists, for over a year and then did nothing. I have identified elsewhere in my full submission to the Health Hearings, other examples of misconduct and unethical conduct by the Medical and Dental Council which adds to our concern. If such problems happen to me repeatedly, the likeliest conclusion I think is that these are general patterns and frequent patterns and that is why I think - not because they happen to me but because they may represent a general pattern, that they may be a serious problem. And if you believe that this might be damaging to him, you can ask the questions doctor, you can provide him with sedation - use any drugs or other means you wish to sedate him and relax him, and you may then ask the questions but they have some questions they want answers to and on that condition they will withdraw all charges and release him immediately". I refused of course, the lawyers refused of course and on the following Monday morning when we arrived at court - and I remember Saths and I pacing in the corridor outside waiting for it to start, the State arrived and said: "Oh by the way, we released him last night - the case has been withdrawn". I will not go into other details of other cases that I have given but I recommend that we examine those in the same sense of the problems that need to be addressed. One other case that I think is indicative of this type of involvement, is the case of a man Ibrahim Ishmail Ibrahim - now a member of Parliament, who during his detention at John Vorster Square was tortured, was treated badly and was very severely damaged by this. In the documentation that I was able to obtain in preparing a report for his case, we discovered absolutely clear proof in writing - and we are providing copies of the documentation of this to the TRC, that in fact his severe condition was recognised by one of the district surgeons, Doctor Edward Krousy who behaved honourably in this matter. He recommended that the man who was in such severe distress should be transferred to the Department of Psychiatry at Wits University. His senior district surgeon, a Doctor Willem Johannes Marthinus Petrus Lindeque, in his notes stated that he had intercepted these records - he considered the recommendation inappropriate. He had phoned Brigadier Erasmus of the security police and in his own words in writing - in consultation with the Brigadier, had decided that instead of sending him to the clinical facilities at Wits Department of Psychiatry, he would transfer him to Pretoria Prison. At the Pretoria Prison he was put - not even in the medical section of the maximum security section, but it was said that he was transferred in order to give him access to the outstanding skills - very extreme words were used, of a Professor Plomp there. Yes, I guess torture will do that to you, in my experience it does a hell of a lot more than that. It was interesting though that the clinical instruction to provide mental health care to someone in need, was intercepted, discussed with the security police and resulted in a referral to someone whose only skill that was relevant, was in writing exculpatory reports for court. Compared to the millions of cases of PTSD that have been diagnosed in victims, if it is the proposal of some of our colleagues that this is now a sudden epidemic of PTSD in South African perpetrators and torturers, then this is something I think they need to write up urgently for the world psychiatric and psychological literature as we are in the presence of a major epidemic completely unknown to science. It is also important to register - from those of us who have been studying the effects of trauma on memory, that no case is on record as yet on earth in which case major - exposure to major trauma, particularly as a witness - which is the situation of these people, have led to the extraordinary convenient variety of memory disorders that seem to be being described in this case. If the Amnesty Committee continues to allow such testimony to go unchallenged by those of us who are competent experts to the contrary, then unfortunately the Amnesty Committee would have joined in human rights abuses and their condonation and this must not be tolerated by the Commission. To ignore that - and there is a tendency in some quarters to see PTSD as the be it all and end all, to see it as the badge of honour or the badge of entry for concern and treatment is a problem. You may be horribly traumatised and develop lots of long-lasting conditions but not PTSD. And again, from the follow-up of Dutch resistance workers and Scandinavian resistance workers and of Holocaust victims, we know that there are real measurable and serious impacts on the second generation. Even where the second generation - which is not the case in our country, was themselves in no way directly affected by the trauma - we are seeing third generation effects and we must again allow for that if we are to provide proper and comprehensive care. I will - in the interests of time, reduce my claim to any further time but I hope that there will be time for you to read the full reports in detail, thank you for your time and your support. CHAIRPERSON Thank you very much Professor Simpson, wonderfully well toned and articulate and smooth as always and witty. Would the panel like to ask any questions? Glenda? MS WILDSCHUT But what worries me the most perhaps about your submission is number 9 and the whole issue of debriefing and preparing people for traumatic situation and debriefing people after a traumatic situation and your contention in the submission that that has absolutely no impact on PTSD and so on. And both yourself and myself and other people have been involved before in working with political detainees, ensuring that they get debriefing immediately after the traumatic situation of being in prison - targeting people who - targeting is not the right word but, identifying people who would be targets of the State and would potentially be detained. PROF SIMPSON MS WILDSCHUT PROF SIMPSON MS WILDSCHUT ...[inaudible] the comment of debriefing also has wild and unsubstantiated claims made for it and I just think that maybe we need to modify that sentence a little bit because we need to ...[intervention] PROF SIMPSON ...[inaudible] MS WILDSCHUT PROF SIMPSON PROF MAGWAZA PROF SIMPSON CHAIRPERSON FLOOR Just for one minute ...[inaudible] CHAIRPERSON Can I just ask that you use that microphone there? FLOOR Oh, I thought my voice was ...[inaudible] CHAIRPERSON FLOOR CHAIRPERSON PROF SIMPSON The issue of finding what academic standards should mean is finding high quality answers but not being the sole source and the sole arbiter of what questions need to be answered, that has to be done with community as well as the process of finding the answers. CHAIRPERSON Welcome, could you introduce yourself on your area of expertise for the panel because it was a ...[inaudible]? MR ANTHONY Thank you Madam Chairperson, my name is Lawrence Anthony ...[intervention] CHAIRPERSON Mr Chairperson. MR ANTHONY In order to fully understand the origins of apartheid, it is necessary to examine the intellectual justification for institutional racism and the rationale which motivated the creation and implementation of one of the most evil social and political systems the world has ever known. While the Psychologist Association touched on this in their June submission, it fell far short of the inherent role of psychology in creating apartheid. The apartheid system came about as a direct result of political acceptance and implementation of pseudo scientific, psychological and psychiatric racist theories and ideologies - factually, apartheid was a symptom not the cause. 1797, Benjamin Rush the father of American psychiatry whose face still adorns the seal of the American Psychiatric Association, declared that the colour of Black skin was caused by a congenital disease akin to leprosy, called Negritude - the evidence of a cure was when the skin turned white. In 1851, Samuel Cartwright discovered a mental disease he said was peculiar to Blacks, named Drapetemania, in which Black slaves exhibited an unnatural and uncontrollable urge to run away - the cure for this was whipping the devil out of them. Rats became a major focus of psychiatric and psychological studies from which human behaviour was predicted. Stripped of his soul, man was now only a collection of chemicals and genes and presumably could now also be treated as an animal. Accompanying these studies and theories was a new-found science of eugenics. Here began a paradigm shift away from spirituality and religion as the assent of materialism took place and the new psychiatric and psychological perceptions of man evolved. Definition of the word: "eugenics" - according to Websters, is a science concerned with improving the breed or species - especially the human species, by such means as encouraging reproduction by persons or races presumed to have desirable genetic traits and discolouring the reproduction of those people and races deemed to have undesirable genetic traits. Concepts of social and racial hygiene had already emerged and together these horrific concepts created psychiatric eugenics which glorified superior races and justified denigration of so-called inferior races, especially the coloured races. Immuel Kreplin - the most influential psychiatrist of his time in 1918, announced in Germany: "An absolute ruler guided by our knowledge of today would be able to intervene ruthlessly into the living conditions of people". His prediction subsequently found expression in two of the most evil systems of our time - nazism and apartheid, as will be revealed. In 1921, CT Laurim of the South African Native Affairs Commission declared: "Just as the war needs the chemist, the physicist and the engineer, so the native question needs nature scientists, namely the political scientists, the psychologist and the sociologist. Director of the Keizer Wilhelm Institute in Germany, Psychiatrist Eugene Fischer urged the annihilation of Black children and stated that Black were devoid of value and useless for employment other than manual labour. Psychiatric eugenics had influenced a major nation on a massive scale. Practical implementation of psychiatric eugenics principles had begun with vengeance. Ruden and his fellow psychiatrists - and there can be no doubt here, did not inherit eugenics from the Nazis, it was they who fed it to the Nazis cloaked in the respectability of the science of psychiatry. It was estimated that over 300.000 mental patients were murdered in German institutions before, during and after the war. This was a separate programme independent of the Jewish Holocaust, instituted and implemented by the psychiatrist into whose care patients were entrusted. In South Africa the eugenics movements took root early this century and deliberations and conclusions on the inferiority of Blacks were disseminated nationally. As an example, in a massive disinvestment - I beg your pardon, massive disinformation campaign between 1920 and 1928, over 2.000 copies of racist theories and ideologies were regularly distributed to universities, educationalists and politicians by HB Thanthom, President of the South African Eugenic Society. Funded by the Rockefeller Foundation, psychological testing - especially intelligence tests in South Africa, could be perceived as a scientific means of justifying class inequality through racism, educational selection and individual merit" Doctor Hendrik Verwoerd - himself a prominent psychologist, left South Africa to further his studies at German universities in Leipzig in Berlin. Psychiatric eugenics theories were rife in German universities and academic circles at that time. On his return, Verwoerd took up the chair of Applied Psychology at Stellenbosch, from where he went on to espouse and politicise prevailing psychiatric eugenics theories. Former Prime Minister, BJ Vorster, former President, Nico Diederichs and others as young men, followed Verwoerd to Germany on German Government bursaries. Strong links between Afrikaner nationalism - the Broederbond and the German Nazi Government prior to World War 2 and during World War 2, are well known. One shudders to think of the consequences for Black South Africans at the hand of Doctor Ruden and his psychiatric eugenics if Germany had won the war. In South Africa in 1927, psychologist, ML Fick developed a standardised intelligence test for South Africans, in the South African Journal of Science he concluded: "The inferiority of the native ineducability as shown by the measurement of actual achievement in education, limits considerably the proportion of natives that can benefit by education of the ordinary type beyond the rudimentary". Fick wrote of the Zulu: "The medians were so low that they almost tally with those found in the case of educable defectives". Fick equated the intelligence of Blacks generally, with that of mentally defective Whites. Subsequently, Fick was involved with the development of the South African Group Intelligence Tests with psychologists, KR Wilcox and ID McKrone, using a grant from the Union Department of Mines. Wilcox also provided various racist theories as a major means of dividing the colour casts. He strongly advocated criminalising sex between colour casts and advocated that Black were to be kept well away from White communities as poor Whites were considered to have a germ plasma which could be rehabilitated and their stock improved. Thus began a national programme rooted in scientific, psychological and psychiatric eugenics theories as a primary means of addressing the problem of the poor White - principally the poorer Afrikaner. According the Shaun Wittaker, Black people were to be the chief source of cheap labour, the exploiting of the cohered labour thus had to be justified by building the myth about the inferiority of people with colour. Prominent Australian psychiatrist, Harry Baily on a visit to New Orleans in 1957, boasted that it was cheaper to use niggers than cats for brain experiments because they were everywhere and they were cheap experimental animals. Professor of Psychiatry at UCLA, California, Doctor Jolly West - who is best known for killing a full grown elephant cow with an LSD overdose during experiment, stated during the 1960 riots in Los Angeles: "Genetic and racial factors make young urban Blacks prone to violence", for which he recommended castration and psycho-surgery. In South Africa, Educational Psychologist EG Malherbe, originally headed the educational Committee for the Carnegie Commission, in one paper published as late as 1950, he said: "In tests applied to non-Europeans, there was a lower average intelligence in Europeans. Natives learn more slowly than the European in activities requiring thinking in order to overcome difficulties. That myth was legitimised by fabricated psychological IQ tests. ML Fick went on to become a psychologist for the South African Bureau of Educational and Social Research where together with other racist psychologists and psychiatrists, Wilcox, Dunstand and McKrone, he contributed to the development of the South African Group Test of Intelligence, using a grant from the Union Department of Mines. The design and purpose of the test clearly was to demonstrate the inferiority of Blacks. Dunstand further stated that American psychiatrists and psychologists of the higher standing agreed with him and that American Blacks produced only inferior lawyers and doctors, no surgeons of note and that Black do not develop poets, investors, scientists or painters and any art they may display is generally of the crude type. In a presidential speech to the Association of the Advancement of Science, Dunstand said: "All of the considerations I have placed before you and many others suggest that in natives there is such a deficiency of brain cells that neither education nor environment, nor any other factor can lead to their rising to the level of the advancement of the higher White races. From the investigations we have made, it would appear that the intellectual capacity of the average native is very much lower than the average European" I pause just to mention that anybody involved in this field will recognise all of those names, there are some of the most prominent South African psychologists and psychiatrists who were responsible for the creation and design of all the testing throughout South African society at that time. Eugenics theories even went to far as to prompt the measurement of the brain capacity of natives compared to Europeans. Based on a 1934 survey, Eugenist HL Gordon, claimed that the ranking order for brain capacity was one European, two educated natives, three psychotic natives and four normal natives. In 1946, the Aptitude Test Board was replaced by the National Institute of Personnel Research - NIPR, of which Bicheval and Psychiatrist RWS Cheetham, later became founding members. The NIPR dealt with personnel tests for industries, Government, education, commerce, civil service, defence force and social welfare and was able to permeate every part of South African industry, employment and education. Wittaker in knowledge and power states: "The NIPR carried out the most intensive psychological research for expropriating the labour of African mine workers and it was with grave concern that this author notes that much of this has remain confidential and unavailable to the public". He continued: "Scientific racism infiltrated every sphere of South African life through Government agencies like the NIPR". This amazing disparity of assessment techniques between Black and White patients at a prominent psychiatric institution under a prominent South African Psychiatrist, adequately proves that nothing has changed and that psychiatric eugenics is alive and well in South Africa today and still operating under the guides of help and therapy. Whittaker sees the NIPR as a functionary of the Government and the industries need to exploit Black labour. The aforementioned is clear, Africans were to be used for manual labour and the monotonous work while the better paying and academic jobs were to be reserved for the Whites. And it had all been perfectly justified with pseudo-scientific rhetoric by psychologist and psychiatrists degrading and dehumanising Blacks and tragically denying them their right to be equal citizens. His eugenics logic argued that if Black competition in towns meant fewer jobs for Whites, then send the Blacks back to the rural areas - even if there were no jobs for them and give the Whites what was supposedly rightfully theirs. The concept of apartheid was developed and refined in the pseudo-scientific studies and treaties of psychologists and psychiatrists, decades before the apartheid Government came into power. The principles of a superior race and the concepts of inferior races given infinite credibility by the psychiatric and psychological communities, were seized upon by morally bankrupt politicians who could now comfortable proclaim that there was a wealth of scientific proof that justified the suppression of Blacks. The Black had after all, already been dehumanised by the studies. As Witney Harris - a Prosecutor at the Nuremberg Trials after the Second World War, wrote in his book: "Tyranny on Trial" - "Hitler realised that his aims were in direct conflict with the moral teachings of Christianity, he therefore needed to convince a nation that what he was doing was right and the easiest way to do this was to give such wanton destruction a scientific label of approval". Psychiatric eugenics provided both Hitler and Verwoerd with ample pseudo-scientific proof, all - with ample pseudo-scientific proof - I beg your pardon, with all the pseudo-scientific proof they required to create two of the most evil systems in history. The proof of the inferiority of people of colour provided the ammunition for the apartheid Government to embark on a masterpiece of disinformation and propaganda which laid into the minds of South Africans, to the extent that many Whites - not being aware of the true origins of this false information, considered that they had some sort of God-given right to be the superior race. Conversely, many Blacks subjected to a barrage of repressive laws and social and political exclusion, tragically considered perhaps that their lot in life too was a status quo determined by a higher power. It is incumbent upon us and our duty - as our duty and responsibility to locate and identify all false psychiatric, psychological and eugenic study, aptitudes and IQ tests and to expose and discredit these. It is further incumbent upon us to advise the nation of the truth of what took place, to describe to the people in detail the nature of the disinformation and propaganda which we have been subjected to and to publicly invalidate the studies and their authors - South Africa will not be truly free until this is done. In July 1996, the President of the Society of Psychiatrists on a national radio show about psychological and psychiatric testing, indicated that where possible we will try and develop new tests that are culture free and would apply across all culture groups. The question that begs an answer is: "If the testing was always scientific in the past as was claimed, what is the basis and the nature of the changes taking place or is this in fact an acknowledgement that the original scientific tests are being altered by the Society of Psychiatrists and other, only because it is now politically expedient"? These tests were used as the basis to justify massive human rights abuses, are they now to be arbitrarily changed? - either way, the test were politically motivated. It is important at this point that we recall the World Health Organisation Report of 1983 on The State of South African Psychiatry. Although psychiatry is expected to be a medical discipline which deals with the human being as a whole, in no other medical field in South Africa is the contempt of the person cultivated by racism, more precisely portrayed than in psychiatry. And this situation has no parallel in the history and present state of psychiatric care, it certainly does have a parallel in the ownership and trading of slaves. As unpalatable as organised psychology and psychiatry and the individual psychologist and psychiatrists may find it, the inescapable conclusion is that these professions created and continued a massive contribution to apartheid by providing the tools with which the politicians could justify their inhuman policies - they are a day factor cause of apartheid. This may not be easily confronted or faced up to but then the entire purpose of the TRC is to confess crimes and claim amnesty. The treatment of Blacks by these professionals during apartheid was not therapy. As the TRC has already heard, these practices assisted the security police and others in the most brutal tortures as well as psychological warfare. Under ...[indistinct] all this, was always the insidious ideology that provided the justification and excuse for the heinous crimes to be committed. The invalidation, refuting and disregard for Blacks is no less a crime and we must take effective action to correct that. As such, we formally request of the TRC: That the TRC recognises that racist psychiatric and psychological ideologies and instruments, have destroyed lives and severely violated fundamental human rights of millions of Black South Africans. That the TRC conduct an extensive investigation campaign to identify and locate all eugenics, psychiatric eugenic studies, papers, treaties, documents and conclusions and any related written or taped material that exists within our universities, the NIPR, HSRC, Psychiatric Institutions, Political Parties, Government Office or at any other location and to have these expunged. That all psychiatric and psychological materials relating to scientific proof or justification of the inferiority of Blacks, be located, exposed and publicly invalidated. Thank you very much. CHAIRPERSON Thank you, I said to you that I ...[intervention] MR ANTHONY I beg your pardon. CHAIRPERSON Managed to keep to it. Does the panel have any questions or any follow-ups? MS WILDSCHUT CHAIRPERSON Hlingiwe Mkhize? MS MKHIZE But having been part of the TRC process, I cannot acknowledge the seriousness of these theories - their impact. I mean - I should think it was Zanele who was reading some of the comments - you know, because people who were influenced by this kind of thinking and they internalised it at a deeper level and then the things they did to other people are just overwhelming. MR ANTHONY This is deep in this nations consciousness, I know it - having been to school in White South Africa, this information came into the classrooms, it came into the playing fields, it was disseminated right through this country and it is incumbent upon us. If we really want to do something, these studies must be dug up and they must be exposed for what they are, thank you. CHAIRPERSON Thank you. So, if I can invite you to come back early tomorrow morning - 8H30 I mean by early, everyone was aware of that. Can I have a show of hands please of people who are not expecting to come tomorrow? Not - two of you? And everyone else is expecting to come? Yes, it looks a bit of a lethargic sort of nod. Yes, is that a yes? Good, good. HEARING ADJOURNS