The Case of Witwatersrand Health Sciences Faculty'

USING

AN

INTERNAL

RECONCILIATION

COMMISSION

TO

FACILITATE

TRANSFORMATION

AT A

HEALTH

SCIENCES

FACULTY

IN

POST-APARTHEID

SOUTH

AFRICA:

The

Case

of

Witwatersrand

Health

Sciences Faculty'

Tanya

Goodman

and Max

Price

D

uring

the

past

25

years,

truth commissions

have

been

used increasingly

to

effect

political

change

in countries

attempting

to move

from

an

authoritarian government

to

a

democratic

one. Since

1974,

at least 20 such

initiatives

have

been established

in

Africa,

Asia,

Europe,

and

Latin America

with

varying

degrees

of success.2

The South

African Truth

and

Reconciliation

Commission

(TRC),

held from

1996

to

1998,

was

established

as

part

of the

negotiated

settlement

that marked

the end

of

apartheid.

It was

designed

to facili-

tate the transition

to

democracy

and to

help

build a culture

of

respect

for

human

rights.3

Despite

being

hailed

globally

as

one of the

most effective

and innovative

truth

commis-

sions

of its

time,

the TRC

was

essentially

a

compromise

solution

that led

to

many

debates

on its

purpose

and struc-

ture,

on

the tension

between reconciliation

and

justice,

and

on the moral

implications

of

granting

amnesty.4

In

a few specific

ways,

the South

African

TRC

was

unique

compared

to other

such commissions:

It was the

first to have

a committee

devoted specifically

to

hearing tes-

Tanya

Goodman,

MPhil, MA,

is a

PhD

candidate

in

sociology

at Yale

University.

This study

served as

the basis

for

her

doctoral

dissertation.

Max

Price,

MBBCh,

MSc,

DOH, is Dean

of

the Witwatersrand

Health

Sciences

Faculty.

As

such,

he

played

a central role

in

the institution of

the

IRC

and

thus his

role as

actor and

author

is intertwined.

Please

address

correspondence

to the authors

at

[email protected].

Copyright

C

2002

by

the President and Fellows

of Harvard College.

HEALTH AND HUMAN

RIGHTS

211

The President and Fellows of Harvard College

is collaborating with JSTOR to digitize, preserve, and extend access to

Health and Human Rights

www.jstor.org

®

timonies of

survivors of

human rights

violations.

It

also

required

amnesty applicants to

appear

individually and to

account for their actions.

Finally, and most

importantly

for

this

article, the TRC held

special hearings

that focused on

different sectors of

society,

including

the

media, religious

communities,

the

health

sector,

the

judiciary,

and the mili-

tary.

The

Special Hearings

on

the Health Sector

included

testimony

from health

professionals,

medical school admin-

istrators,

medical

associations,

and

those involved with the

Steve

Biko case.5

A

phenomenon

that remains

unexplored

is

the

way

in

which this

innovation

permeated

deeper

levels of

South African

society

and enabled

different institutions to

use a similar model to facilitate

internal transformation.

One institution

that

applied

this model

was the

University

of the Witwatersrand

(Wits)

Faculty

of Health

Sciences

(FHS) where

an

Internal Reconciliation

Commission

(IRC)

was introduced

at

the

faculty

level.6

The need for an internal

reconciliation

process

at

Wits

FHS became

apparent

during

interviews with

faculty

and

alumni that were conducted for

the TRC's

Special

Hearings

on

the

Health Sector.

In

interviews, faculty

and alumni

expressed

anger

and

resentment about the

discrimination

they

had suffered as students

and,

to some

extent,

still

expe-

rienced as staff members.7 As

part

of its TRC

submission,

Wits FHS therefore

included

a

"postscript"

that

supported

the need for an internal

process

of reconciliation:

The

privileged

members

of the

faculty

who were

not the

victims

. .

. must listen

to the accounts of their Black

colleagues

and former

students.

They

must be reminded

of the

many ways

in

which

they, wittingly

or unwit-

tingly,

collaborated with

the

system. They

must be

pre-

pared

to

experience

and share some of the

pain

and hurts

which

their

colleagues

of color

experienced

because of

an

accident

of birth. In

such a

process

we will all under-

go

changes

and

experience

healing.8

Early on,

the

IRC

intended to involve

members of FHS

in

a self-reflective

process

to

explore

the

medical school's

role

in

enforcing apartheid

and

the abuses that it

tolerated,

specifically

in

training

health

professionals

and

in

patient

care and

conditions

in

hospitals.

212

Vol. 6 No.

1

This

article attempts

to

present

some of the results of

the IRC at

Wits FHS. We have used

qualitative

analysis

of

data from

a

selection

of

in-depth personal

interviews con-

ducted

between

1998

and 2001. We have also

analyzed

the

structure

of the

IRC

and examined the reasons for

and

the

challenges of

instituting

such a

process.

We have assessed

the levels of

participation

in

the

initiative, participants' per-

ceptions of it, the

report

it

produced,

and the importance of

the

process

in

light

of its

outcomes.

We

conclude

with an

overall assessment

of the Wits

IRC

thus far and highlight

some

issues for

future research. The

processes

detailed here

are still

underway

and a more

complete

evaluation of their

impact

should be conducted over a

longer

time

frame.

Why Undertake

an Internal Reconciliation

Process?

Organizational

Motives

Although

the

TRC

Health Sector hearings served as the

catalyst

for the

IRC,

other

factors also

helped

motivate the

faculty

to embark

on this

process. Specifically,

the

IRC

was

designed

as

part

of

an

overall

program

of reconciliation to

help faculty

deal with issues

of

discrimination,

racial divi-

sion,

and institutional transformation.

As late as

1997,

faculty

members were still personally

struggling

with

division,

fuelled

by

different

perceptions

of

those

who had been

privileged

and those who had been

dis-

criminated

against

at the

university.

Many

white staff

mem-

bers believed

that

during apartheid

Wits had offered a liber-

al environment

and an oasis of freedom to its black staff and

students.

Black staff and

students,

however,

felt that the

legitimacy

of their

experiences

of humiliation and hurt

pro-

duced

by

discriminatory practices

was

being

denied.9 To

try

to overcome this divide

and to build

common

goals,

the first

goal

of the

IRC

was to enable

people

to

air their

experiences

and hear one another's stories.

A

second

goal

was to

improve

the relationship

between

faculty

and black

alumni,

which was strained because

many

alumni felt no attachment to the institution. The

hope

was

that the

IRC

would not

only help improve

those relation-

ships by offering

alumni an

opportunity

to voice their bit-

terness,

but

that it would also

give

the entire FHS commu-

HEALTH AND

HUMAN RIGHTS

213

nity a chance

to deal with the past by listening

to these

experiences.

Although

the Wits FHS had been

including

ethics and

professional standards

in

its

curricula

since the

early 1980s,

a

third incentive of the

IRC

initiative was

to examine

pro-

fessional

medical ethics and the responsibilities

health prac-

titioners have

to

challenge

or resist unfair legislation.

Part

of the

IRC's

mandate was to

explore

the context

in

which

people

could

ignore

discrimination

and to

expose

the cir-

cumstances

in which

people

failed to act.

The

IRC

also

aimed to recognize

those individuals and

occasions that

challenged

the

system

of

apartheid.

Providing opportunity

for redress

by

building

awareness

of the need

to

implement

certain

policies

was

a

fourth

incentive. For

instance, the

FHS is committed

to imple-

menting

an affirmative-action

staffing program

but has

faced

some

resistance, especially

from

white or

previously

privileged staff.

To give greater

legitimacy

to policies for

redress,

the

IRC

had to

help

sensitize people

to the

history

of discrimination

and the

opportunities

that

were denied to

black staff and

students.

Finally,

as part

of the

IRC

process,

the Wits FHS

devel-

oped

a

plan

to address

specific

areas

in

which

the

legacy

of

apartheid

and the

marginalization

of black

students, staff,

and

faculty

has continued to persist.

A

Two-Phase

Process

The internal reconciliation

process

had two

phases:

Phase one established

a commission of

inquiry-the

IRC-

that received

submissions of

personal

testimonies and

gath-

ered

archival

material to document acts of

discrimination,

as well

as

any attempts

to resist

practicing apartheid

medi-

cine

at Wits.

It was believed

that,

as

in

the

public

human

rights

violations hearings

at the

TRC,

those offering

testi-

monies

would find the

experience

in

itself

to be cathartic.10

This first

phase

would

ultimately produce

a

report

of the

findings

and

recommendations to the faculty on how to

achieve

reconciliation. It was

not, however,

expected

that

the

hearings

themselves would be the forum

for the wider

FHS

community

to hear and

acknowledge

those

experi-

214

Vol. 6 No.

1

ences. That formed the second

phase, which consisted

of

publicizing the IRC report and

involving students and staff

in seminars, debates, and finally

a public assembly. The

IRC

report also offered other strategies

for redress, reconcilia-

tion, and promoting professional

ethics among students

and

graduates.

Challenges

Encountered

Challenges

faced

by

the

IRC

included

some resistance

and apathy from faculty.

In

addition,

there were certain legal

issues

related to

liability

for defamation and

participants'

expectations

for

reparations

that fell outside the mandate.

A

steering

committee was formed to address those

obstacles

and to

consider

such

details

as

the choice of

commissioners,

the

wording

of

the

mandate,

and

issues

of

confidentiality.

In

response

to

various sources

of resistance, the steering com-

mittee

agreed

to include an

assessment

of

opposition

to

apartheid

and to

avoid

targeting

specific

individuals in the

IRC brief. Outside legal counsel

confirmed

that

some

who

testified

might

risk

civil

liability

for

defamation

if,

for

example, they

identified

individuals as racist

or those

in

breach of

professional

or ethical standards. This

risk

could

be

minimized, however, by giving

the Commission

a

quasi-

legal

status

and

by accepting

such evidence on

the

under-

standing

that the

purpose

of the

IRC

was

to serve

the inter-

ests of

truth and

public

benefit.

Also,

a

senior

lawyer expe-

rienced

in

assessing

evidence should convene the

Commission,

and

testimony

should

be

submitted within

the context

of

qualified privilege

and

fair

comment,

with

the accused

party being given

the

right

of

reply.

Another

option

that was considered was to hold hear-

ings

in

camera.

The

university

believed that

hearing

testi-

mony

behind closed doors

might

limit

exposure

to some

of

the

legal implications.

In

addition,

the

steering

committee

took

the view that

some wishing

to make

submissions

might

be intimidated

by public

hearings

and

by

the

presence

of senior staff who

may

still have influence over

their

careers. The

Commission,

however,

decided

to

privilege

the

principles

of

transparency

and

right

of

reply

and insisted

that

hearings

be held

openly.

It also stressed that the sub-

HEALTH AND

HUMAN RIGHTS

215

stance

of the testimonies should focus on

systematic

and

institutional

discrimination

rather

than

individual

behav-

ior, which would protect individuals legally and

from infor-

mal victimization, while still achieving the IRC's

goals.

The IRC was, however, inadequately prepared

for the

expectations

and demands

for

reparation

made by

some

aggrieved parties.

At least

two

written

submissions

request-

ed financial compensation for loss of salary resulting

from

discriminatory practices. Although

the

IRC

made

no

men-

tion

of

such

reparations

in

its statement

of

objectives,

its

close resemblance

to the TRC

(which

did include the prom-

ise

of

such

compensation)

led some

people

to

assume that

the

IRC

had the

capacity

to

perform such

a function.

The Process

The Panel of Commissioners

The IRC began work in May 1998, held hearings

in June

and July,

and issued a final

report

in

November.

The

faculty

nominated an independent panel of three commissioners-

Advocate Jules

Browde,

senior counsel with

a

history

of

involvement

in human

rights advocacy;

Dr.

Essop

Jassat,

an

ANC

member

of

parliament;

and Prof. Patrick

Mokhobo,

then head

of the

Department

of

Medicine

at the Medical

University

of South Africa. Both Drs.

Jassat

and Mokhobo

are alumni of the medical school.

Substance

and

Type

of Submissions

Once

the

Commission was

formed,

all

current and

past

faculty, staff,

and students were sent

an

announcement

inviting

them to submit testimonies. Similar announce-

ments also

appeared

in

the South

African

Medical

Journal

and the Wits Health Sciences Review

(a

faculty magazine),

as

well

as

on

the Health

Science's

alumni Web

page.

A

research

assistant

assigned

to the Commission collected archival

material and conducted interviews. The

IRC

received

a total

of 26

submissions,

most of which came

from

black

alumni.

Six white

graduates

submitted

testimonies,

and

only

one

department-occupational therapy-made

a submission.

The tone of the various submissions was

quite

similar.

Most

people

reflected

on

their

years

as students

or staff and

216

Vol. 6 No.

1

described

very personal

stories

about

the

discrimination,

racism,

and

humiliation

they

suffered

or

witnessed.

Although

the

experiences

described

took place

over

a 54-

year

period-from

1940

to

1994-the

heaviest

concentra-

tion of

incidents occurred

in the

1960s

and

1970s.

Specific

experiences

focused

on how

black students

were

given

unequal

medical

education

and denied

access

to

white

health-care

facilities

or

were

requested

to

leave

the

room

during

pathology

post-mortem

sessions

when

white

bodies

were being

examined.

Even in the

late

1980s,

when

black

students

were allowed

into

white

hospitals,

they

were

denied

participation

in obstetrics

and

gynecology

rounds

of

white

patients.

Testimonies

also recalled

how black

stu-

dents were

excluded

from

social

and

sporting

events

on

campus

and were placed

on separate

honor rolls

and

given

different

awards from

their

white

counterparts.

Staff

members

of

salary

and

bonus

inequities

among

provincial

staff

and of

how black

staff

were

passed

over

for

promotions

and

marginalized

within

faculty

structures.

Many

black

alumni also

felt

they

received

less

attention

from

department

heads

and

were

deliberately

discouraged

from

pursuing

higher

degrees

or

specializations.

Submissions

also described special

universi-

ty

admissions policies

for

black students,

apartheid

govern-

ment

restrictions,

segregated

facilities

at teaching

hospitals,

inequitable

patient

care,

and health professionals'

receiving

inadequate

preparation

for dealing

ethically

with dual

responsibilities

(in

prisons,

for example,

where

health pro-

fessionals'

obligations

as

government

employees

conflicted

with

their

obligations

to

their

patients).

In

general,

many

of

the submissions

pointed

not only

to

overt racist

policies

but

also to

more subtle

forms of

discrim-

ination.

Most

suggested

that

the

faculty

either colluded

with

apartheid

policies

or

failed

to resist

the

government's

dis-

crimination

in

health services,

despite

the

university's

image

of

openness.

Although

few

submissions

specifically

named

individuals as

perpetrators,

many

testimonies

described

explicit

racist

and

humiliating

interactions.

A

number

of sub-

missions were

also careful

to

note and

name those

excep-

tional individuals

who

did

challenge

apartheid

policies.

One

HEALTH AND HUMAN

RIGHTS

217

testimony submitted

jointly

by

two alumni

focused

solely

on

resistance and

opposition

by

faculty

members

and by

the

university

as a

whole.

Assessment

of the

Wits

FHS

IRC

Level

and Type of

Participation

Members

of the

faculty

board

who

first

approved

the

IRC idea

generally

considered the

project

to

be a

worthwhile

endeavor.

Yet,

most

respondents cited

apathy and

low

par-

ticipation

as

weaknesses of

the

IRC.

In

part,

respondents

mentioned

that

logistical

problems

might

have contributed

to the

poor

response.

These

included a

perceived low level

of

publicity,

the

tight

deadlines for

submitting

testimonies,

the

timing

of

the

hearings, and

inadequate

communication

about the nature

and

substance of the

process.

In

particular,

participation by

African

health

profes-

sionals was

disappointingly

low,

especially

since the

IRC

was

designed

to

engage

those

who had

suffered

discrimina-

tion.

Criticisms of

the

national TRC

process

and the

antici-

pated

lack

of

participation

by

all

parties led

some

respon-

dents to

suggest

that

African health

professionals

may

have

been

skeptical

about

what the

project

would

actually

achieve and

considered the

IRC

to

be "a

pointless

project."

Others were

unwilling

to

relive the

trauma

by

dredging

up

the

past."1

Another

reason

offered was that

some African

doctors

were

relatively

comfortable

in

their

current

posi-

tions,

especially

compared

to others

from their

generation

who were

completely

denied

any

form

of

higher

education,

and

were therefore

wary

of

creating

conflict.12

Others

may

not have known

that the

IRC

was

underway.

Indeed,

subse-

quent

interviews indicated

that

many

black health

profes-

sionals were

unaware of the

IRC

process

and some

only

learned about it

after it

was too late

to

get

involved.

However,

in

the

opinion

of

the

Commission,

the

similarity

of

experiences

and

patterns

across

time described

in

the

modest number of

submissions

from those

disadvantaged

by

the

system

were

sufficient to

validate the

accuracy

of the

report's

content.

Another

disappointment

of the

IRC

was that those

indi-

viduals who

cooperated

with

the

apartheid

government

or

218

Vol. 6

No.

1

who

benefited from the system did not contribute to the

process. Because those who perpetrated

or enabled diserimi-

nation did not come forward, some viewed the

IRC

as one-

sided and

able

to achieve only a

"small

victory."113 The vir-

tual absence of participants from the

"establishment" also

created

a

gap

in

the Commission's

ability

to understand

why

there was not greater resistance to

apartheid health care, or

even how that

group

saw its values and ethics and its

role

in

regard to abiding by or challenging

discriminatory practices.

Part of the

IRC's

mandate

was to

provide

a forum

where

those who

experienced discrimination

could

tell

their

sto-

ries. Another part of the mandate,

however, suggested that

such a forum should be done

in

the

spirit

of

sharing

and

acknowledgment. As such, an integral

part of the ideal rec-

onciliation process

involved the commitment from all indi-

viduals not

only

to

talk,

but also to listen.

Some

of those

who testified at the

IRC

were

clearly

disappointed

that more

people

did

not

attend the

hearings.

For

some,

the

"sharing"

component of

the

IRC's

mandate was

always

intended to be

the second phase

of

the process,

after

the

IRC report

had

been completed. However, many

others, including

to

some

extent the Commission

itself, expected

the

hearings

to fol-

low the example of the TRC as the immediate forum for the

wider

faculty community

and media to be confronted with

the

stornes

of

past

discrimination.

Perceptions of Submitters and Creation of

a

Safe

Space

All those interviewed who made oral

submissions,

reported

that the

process

was a valuable and worthwhile

experience.

Most of those who were

initially

hesitant to

come forward were reassured

by

the Commission's

sinceri-

ty

and enthusiasm.

Many respondents

said that the IRC

gave

them their first

opportunity

to confront the

past

in

an

appropriate space

and that

testifying

offered

an

opportunity

for reflection

and

resolution. For

many, preparing

for

the

IRC

and

speaking with others about

their

testimonies

gave

them a

sense

of

closure

and

enabled them

to

experience

some

personal healing.

Some

people

were

eager

to receive the

public recogni-

tion that

they hoped

their

experiences

would

bring.

Others

HEALTH AND

HUMAN RIGHTS

219

were

a bit more

reluctant

to

expose

themselves

or

risk

being

labelled again as "troublemakers."

Such concerns indicated

that colleagues, family,

or

mentors needed

to

encourage

those who were reluctant

to

come forward

to

testify

at the

IRC. However, many

chose not

to go

forward with

a

sub-

mission,

and some

may

have felt that

exposing

themselves

in isolation would make them

too vulnerable.

In

part, this

posed the question

of

how

to

create

a

safe place

so that those

who

testify

would feel secure

during

the

hearings

and to

alleviate concerns about repercussions afterward.

When

power

structures have not fundamentally changed or are

in

flux, people

have

very

real fears that victimization and

ostracism could

recur. It

will take significant

time to

change

the

environment of mistrust that apartheid had generated.

There is also the issue of

whether or not the structure

of the

IRC

was able to

provide

an

appropriate space

for indi-

vidual

"perpetrators"

to

come

forward. Without the incen-

tive

of an

amnesty-type process,

it was difficult to see how

or

why

individuals who

participated

in

apartheid practices

would

be motivated to

contribute.

Getting

such individuals

who still

retain

positions

of

power

to

engage

in an

IRC

process

would

require

development

of

creative methods

that would

encourage

all

parties

to

participate.

Outcome

of

Phase

One

In November 1998, the

final report of the

IRC

was pre-

sented to the

faculty, thereby

concluding

the first

phase

of

the internal reconciliation

process.

The

report

detailed

a

number

of

findings

and

presented

a set

of

recommenda-

tions.'4

Most of the

findings

dealt with the environment

at

Wits

during

the

years

under review and summarized

the

experiences

of

black students. Attention was

also

given

to

the

degree

and

type

of resistance

to apartheid

health

policies

that occurred.

The

report

concluded that

many

of the

prac-

tices at

the

university

were

unfair

and racist

and the "entire

environment

in

the

faculty

engendered perceptions

of

racial

discrimination."115

In

terms of the

faculty's role,

the

report

found that "the

Faculty

as

a whole colluded

with

racial

apartheid

and enforced racial discrimination

in

the

Faculty

or

at least conformed without

any

unified

protest."

Even

220 Vol. 6 No. 1

those

few

"exceptional"

individuals who did

take a stand

were

not

supported

by

the

faculty.

For these

reasons,

the

report

argued

that "it

cannot be

said

with

conviction

that the

Faculty of

Medicine at

Wits was

a

'liberal'

institution."'16

In

its report,

the

Commission

outlined

11

recommen-

dations on which the

faculty

should focus.

Principally, the

report stressed the need

for the

faculty to issue an

apology

and

publicly

acknowledge past

racial

discrimination.

Another

recommendation was

for the

faculty to increase

enrollment of

underrepresented

students and

to accelerate

academic staff

development,

with

special

emphasis

on

racial and

gender

inequalities.

Also included in

the recom-

mendations was

the need to

encourage

students,

faculty,

and staff to

develop

trust

and to

respect

diversity.

Suggestions

for curricular

changes

included

incorporating

human

rights awareness

training

and

developing

greater

sensitivity

to the

socioeconomic

context of health

care. The

IRC

also

proposed the

faculty

recognize

those who did

chal-

lenge

racial

discrimination.

Finally,

further research

was

encouraged

"to achieve a

better

understanding

of

how dis-

crimination came to

be tolerated at

the FHS-an

institution

that

professed

to be

liberal and

antiracist."''7

The

report

received a

broad

range

of

responses

from

both

faculty

and

participants.

Most

responses

have been

positive,

even

from those

who were

initially ambivalent.

One criticism from a

small

group,

comprising

mainly

senior

white staff

members,

was that

the

report

was unfair and

failed

to

recognize

how difficult it

would

have been to

oppose

apartheid, given

the

dependence

of

medical educa-

tion on the

government

hospital

system.

This

group

believed that it

did what

was

possible

under

the circum-

stances and

was now

being

asked to

carry

the

burden of

apologizing,

whereas others

left the

public

sector,

or

even

the

country.

Another

criticism of the

report

from

some

black

alumni was that

it was a

"whitewash"

and that

the

IRC

did

not

capture

the full

depth

of

discrimination that

occurred. The

majority,

however,

have been

excited

about

the

report's

findings,

and more

specifically,

the

recommen-

dations that it

produced.

They

are

looking

to

these recom-

mendations and to

the new South

African

Constitution and

HEALTH AND

HUMAN

RIGHTS

221

Bill of

Rights,

as

well

as

to legislation

on

higher

education

and

employment

equity,

as

powerful

tools

for

change.

Acknowledgment

and

Apology:

Initiating

Phase

Two

After

the report

was

published

in November

1998,

the

faculty

engaged

in a series of

public

discussions

about

the

IRC's

findings

and

recommendations. Workshops

were

held

within

the

faculty,

and the

report

was circulated

throughout

the FHS

and the

broader

university

community.

The FHS

Web site

also

published

the

report.

A

year

after

the

report's

publication,

a

pledge

acknowledging

the

findings

and

apolo-

gizing

to

all

those

who

had

suffered

discrimination

was

drafted

and endorsed

by

a vote at

the

faculty

board

level.

In February

2000,

the faculty

held

a

special

assembly

to

acknowledge

publicly

the discrimination

that had

occurred,

to

apologize

to all

those who

had suffered

and

to recognize

those

who

had

challenged

the

system.

This formal

assembly

was

attended

by

heads of

departments,

alumni,

staff,

current

students,

the

IRC

commissioners,

and

representatives

from

professional

medical

associations.

A

plaque

containing

the

pledge

was

unveiled

and

is now

permanently

displayed

in

the

foyer

of the

FHS.

The current

dean and

four

of

the FHS

were

each

invited

to

the

podium

to

sign

the

pledge.

The

inscription

reads:

The Faculty

of

Health Sciences,

University

of

Witwatersrand, Johannesburg,

commits

itself

to

the

ideals

of non-discrimination

in its teaching,

the consti-

tution

of its student body,

the selection

and

promotion

of

its

staff,

and

in its administration.

It reaffirms

its

rejection

of

racism

and other violations

of

human rights

in whatever

form

they

make

their challenge.

In committing

itself to

these

ideals

the

Faculty

acknowledges

that these

values

have not been

honored,

and

it

apologizes

for the hurt

and

suffering

caused

to stu-

dents,

staff

and

patients,

by past

racial and

other

dis-

criminatory

practices.

The

Faculty

recognizes

the

responsibility

that

staff and

students

have

in

preserving

these

ideals and

pays

tribute to

the efforts

of those

who

strove

to

bring

about

change

for

the benefit

of future

generations.

In addition

to

the

plaque,

the

faculty

unveiled

a statue

that

it commissioned

symbolizing

the

spirit

of

reconciliation,

222

Vol.

6

No.

1

which

will stand at a new entrance

to the school.

This second

phase of the

IRC

has been a significant

part

of

the

process

since it demonstrated

the

faculty's

commit-

ment to confronting

the

past

and its willingness

to

take

responsibility

for failing to present

a

greater

challenge

to

apartheid practices

and

policies. By

officially apologizing

to

black

students and staff

and

recognizing

the hurt and humil-

iation they experienced

as a result of

the discrimination

that

was

tolerated,

the

faculty

has

taken a definitive

step

toward

reconciliation.

Conclusion

The

Significance

of the IRC: Process or Outcome?

Those who

were involved

in

the IRC have

had mixed

opin-

ions

about which

part

of the endeavor was

more

significant

so

far-the

process

or

the outcome. The

initial

hope

of

many

of

those who contributed to

conceptualizing

the

IRC

was

that the

process of conducting

an

IRC

would

engage people

in honest,

reflective,

and

healing

interactions.

That

goal, however,

was

never fully realized,

possibly

because of the low level

of direct

participation

in the

project.

For those who placed greater

sig-

nificance on the

process, the

Wits

IRC

only partially achieved

its mandate and

the degree of success

was modest.

Others who found the

hearings

disappointing

looked

to

the

final

report

as

holding potential

for discussion,

debate,

and

transformation. Still

others, however,

believed from the

begin-

ning

that the

report

would be the most crucial

part

of the

IRC.

Many people who

saw the report

as a catalyst for change

expressed

satisfaction with the

findings

and recommendations.

Overall

Assessment

All

participants

in the Wits

IRC

found it to be

a

worth-

while

experience.

The

IRC

documented

in

detail

many

of

the

discriminatory practices,

the climate of

racism,

and the

sense of humiliation that black students

encountered at

FHS. The

IRC

also identified

those instances where

individ-

uals

resisted the

apartheid system

and

attempted

to

change

policies

and attitudes.

People

were

given

the

opportunity

to

tell their

stories

in a

dignified

and

respectful

environment,

and the forum was

officially

sanctioned

by

those

in

author-

ity.

The

faculty

has

publicly

acknowledged

the

experience

HEALTH AND HUMAN RIGHTS

223

and effects of

discrimination and

apologized to those

who

were

victims

of

apartheid

policies

and

practices

at the

med-

ical

school.

The

degree

to which the

social climate

toward black

students and staff will

change

now

depends

on

the

meaning

attributed to the

public

apology,

the

extent to which

the

IRC's recommendations

will be

implemented,

and on the

rate of

demographic

change

in

faculty

composition. It is

therefore too

early

to assess the final

impact

of the

IRC

at

Wits,

which should

be seen as one

step

in

a

long process

toward transformation and

reconciliation.

Future Research and

Other

Institutions

The launch of an

IRC

process

at an

institution such as

Wits

FHS was driven

by

factors that can be found in

many

large

institutions in

South

Africa,

as well as

in

other

soci-

eties with a

history

of

oppression.

In

fact,

two other

medical

schools

in

South

Africa-the

University

of Natal and

the

University

of

Cape

Town

(UCT)-have

launched internal

reconciliation

processes. The

process

used by the

University

of Natal did not

involve

hearings

but centered on a

symbol-

ic

graduation

ceremony

in

December

1996

to which all

alumni were invited.

That

ceremony

was

significant

for

many

of those who

attended because for

20

years

gradua-

tions at that institution

had been

boycotted

in

political

protest.

The

UCT

process,

which was initiated in

June

2001,

also

chose not to hold

public

hearings

but

instead used

small-group

discussions and

in-depth

interviews of

black

alumni

to document their

experiences

of

discrimination.

Like

Wits,

a

faculty

declaration and

special

assembly were

key

to the

UCT

process.

All

three initiatives involved an

official

apology

and a

public

commitment to nondiscrimi-

nation. Future research

should

investigate

the different

strengths

and

weaknesses of each of

these reconciliation

processes

to determine alumni

or staff

perceptions

as well

as to

measure

tangible

changes

to

policies

and

practices.

In

the

Wits

FHS

case,

a

number of

questions

still

need

to be evaluated:

First,

to what

degree

have the

sentiments

expressed by

the

process

and

captured

in

the

pledge

filtered

through

the

faculty

and

alumni? Do

people

now share an

understanding

about the

facts of

past

discrimination at the

224

Vol. 6

No.

1

medical

school?

And do

people

now appreciate

how black

students

and

staff

were

affected

by

this

discrimination?

A

second

issue

to explore

is

how the apology

has

been

per-

ceived

by

those

who

suffered

discrimination

and

whether

black alumni,

staff,

and

faculty

have

subsequently

felt

dif-

ferently

toward

the

institution?'8

Finally,

now

that

the

hear-

ings

have concluded,

the

report

has been published,

and the

recommendations

have been

acknowledged,

it

remains

to

be

seen how

such

activities

are

translated

into material

and

social change.

How has

the

process

transformed

the ways

in

which

people

interact?

In what

ways

is the

substance

of

the

report

being

used

to motivate

policy

changes?

The faculty

is

engaged

in serious

efforts

to achieve

transformation,

and

as

these efforts

move

forward,

we will

continue

to

monitor

how the

work

of

the IRC is

deployed

to facilitate

these

ini-

tiatives.

References

1. Tanya

Goodman's

research

was funded

in

part

by grants

from

Yale

University's

Centre

for

International

and Area

Studies

and Yale

Law

School's

Schell

Centre

for International

Human

Rights.

2. P. Hayner,

"Fifteen

Truth Commissions-1974

to 1994:

A Comparative

Study,"

Human

Rights

Quarterly

16

(1994):

597-655.

For a

summary

and

references

to

all truth commissions

to

date,

see U.S.

Institute for

Peace,

Special

Internet

Library,

available

at

www.usip.org/library/truth.html.

Since

the South

African TRC,

at

least six more

truth commissions

have

been

held. Calls

have

also been

made for

the

establishment

of truth

com-

missions

in a

number

of other

countries.

3.

The TRC

was

supposed

to last only

two

years;

however,

amnesty

hear-

ings

were extended

until

mid 2001.

The main report

was

submitted to

parliament

in October 1998.

4.

See,

for

example, J.

Allen,

"Balancing

Justice

and Social

Unity:

Political

Theory

and

the Idea of

a Truth

and Reconciliation

Commission,"

University of

Toronto

Law

journal

49

(1999):

315-353;

D.

Dyzenhaus,

"Debating South

Africa's

Truth and Reconciliation

Commission,"

University of

Toronto

Law

journal

49

(1999):

311-314;

M.

Minow,

Between

Vengeance

and Forgiveness:

Facing

History

after

Genocide

and

Mass Violence

(Boston:

Beacon

Press,

1998);

A.

Neier,

War

Crimes:

Brutality,

Genocide,

Terror,

and the

Struggle

for

lustice

(New

York:

Times

Books,

1998);

J.

Zalaquett,

"Balancing Ethical

Imperatives

and

Political Constraints:

The Dilemma

of New

Democracies Confronting

Past Human Rights

Violations,

"

Hastings

Law Journal 43/August

(1992):

1425-1438.

5.

For more

information

on the

health sector hearings,

see TRC

tran-

scripts

at

www.doj.gov.za/trc/special/health/htm.

For

details

on the sub-

missions,

see TRC

Final

Report,

vol.

4,

at

www.polity.org.za/govdocs/

HEALTH

AND

HUMAN

RIGHTS

225

commissions/1998/trc.

For

findings and

recommendations, see

TRC

Final

Report, vol.

5.

For a

critical

evaluation of

the

TRC

Special

Hearings

and

recommendations

on

the

Health

Sector, see

A. R.

Chapman

and L.

S.

Rubenstein

(Eds.),

Human

Rights

and Health:

The

Legacy

of Apartheid

(Washington,

DC: American

Association for the

Advancement

of

Science,

1998).

For another

overview of

the

legacy of

apartheid

health

care and

health

professionals

training, see L.

Baldwin-Ragaven,

J.

de

Gruchy, and

L.

London,

An

Ambulance

of the

Wrong Colour:

Health

Professionals,

Human

Rights and

Ethics in

South

Africa

(Cape Town:

University of

Cape

Town

Press,

1999).

For

commentaries on

the

findings

from

the

TRC

Health

Sector

hearings

related to

violations of

medical

ethics

and

human

rights, see J. van

Heerden,

"The

Meaning of

the MASA

Apology,"

South

African

Medical

Journal

86/6

(1996):

656-660; P.

Sidley,

"South

African

Truth

Commission Calls

Doctors

to

Account

for

Their

Actions

During

the

Apartheid

Era," British Medical

journal

314

(1997):

1849;

L.

Baldwin-

Ragaven,

L.

London,

J. de

Gruchy,

"Learning From Our

Apartheid Past:

Human

Rights

Challenges

for

Health

Professionals

in

Contemporary

South

Africa,"

Ethnic

Health

5/3-4

(August

2000):

227-241;

1.

R.

Williams,

"Ethics

and

Human

Rights

in

South

African

Medicine,"

Canadian Medical

Association

Journal

162/8

(2000):

1167-1170.

6. Known

as

University

of

Witwatersrand

Medical School

until

1996

when the

Faculty

of

Medicine

and

Faculty

of

Dentistry merged.

7. These

individuals

blamed not

only

the

Faculty

of Health

Sciences

but

also the

Transvaal

Provincial

Authorities

who were

responsible

for cer-

tain

discriminatory policies

at

regional

hospitals.

Although

this arm

of

the

government

clearly

contributed

to the

racist

practices

and

humiliat-

ing

climate

that black

doctors

experienced,

the

IRC process was

not con-

structed to deal

with this

issue but

focused

instead on the

immediate

medical

community

of the

university

itself.

8. "TRC

Submission,"

Wits

Faculty

of Health

Sciences,

23

May

1997,

available at

www.doj.gov.za/trc/special/health/healthO2.htm.

9. In

this

report,

the

term

"black" refers

to all those

who were

classified

as

African,

Indian,

Chinese,

and

Colored.

10. It is

important here to

distinguish

between

catharsis,

defined

as an

individual

experience

of

release

associated with

bringing memories to

consciousness,

and

reconciliation,

defined

as a

joint

social

project

that

does not occur

at a

specific

moment in time.

Considering

the

personal

value of

testifying,

not all

TRC observers

agree

that

victims who came

forward to

speak

publicly

about

their

experience

of human

rights

viola-

tions

experienced

a sense

of

healing.

Some

participants

found

that testi-

fying

was

very

traumatic,

and

counselors were on hand

to

help

them

deal

with these

emotions. Those

who

accepted

the

compromise

of

reparations

for

amnesty regarded

the

failure of the

TRC to make

good

on this

prom-

ise as

a double

victimization.

11. Interview with

IRC

submitter Dr.

IS04,

3

July 1998.

12. Interview with

IRC

commissioner Dr.

KPO2,

17

July

1998.

13. Interview with

IRC

key

role

player

Prof.

KPO3,

26 June

1998.

14.

"University

of

Witwatersrand

Health Sciences

Faculty

Internal

Reconciliation

Report,"

November

1998,

available at

www.wits.ac.za/

alumni/irc_rep.htm.

226

Vol. 6

No.

1

15. See

note

14.

16. See

note 14.

17. See note

14.

18.

For an

excellent

example

of the

degree

to which

debate about the

value of

the

IRC

and perceptions of black alumni still

flourishes,

see D. J.

Ncayiyana,

"Pain

That Will Not Go

Away," South African Medical

journal

91/7

(2001):

529;

M. Price and Y.

Veriava,

"The Internal

Reconciliation

Process at

Wits,"

South

African

Medical Journal

91/12

(2001);

and J. P.

Driver-Jowitt, "Let

It

Go!

"

South African Medical

journal

92/5 (2002):

letter to

the editor.

HEALTH AND HUMAN

RIGHTS

227