From afar, South Africa remains a fascinating country that managed to avoid a bloody civil war through an extraordinary reconciliation process. South Africa today looks a lot more like a rainbow than it did twenty years ago when it freed Nelson Mandela and thousands of other political prisoners. Whites, blacks and coloreds--the term for the original bushmen who settled the land-- share buses, beaches and swimming pools.
Three decades ago, policemen could enter homes in the middle of the night, arrest couples of different races found to be in bed together and take away any light-skinned children from a black mother fathered by a white father. Now Robben Island--once infamous as the place where thousands of political activists were imprisoned and drugged into submission--is a museum--a monument to the past. Some of the most popular daytime soap operas feature romances between people of different skin tone and advertisements include strikingly handsome people whose race cannot easily be determined.
There's a softer and different revolution underway in South Africa that has not yet garnered headlines. This rapidly developing nation--one of the basic four committed to reducing greenhouse gases with China, India and Brazil-- is prepared to take another path regarding one of industrial societies' biggest health problems--that of cancer. When Mandela was freed, 1 in 20 South Africans developed cancer. Today the rate has increased to 1 in 4. Around the world, cancer this year affects 1 in 3. By 2020 1 in 2 will develop the disease. Finding and treating cancer receives most of the billions of dollars spent each year on the disease in industrial nations--some $100 billion in the U.S. alone.
The limits of this focus on treatment and detection are already apparent. Many countries face tremendous shortages in oncology nursing and medicine and lack the resources to treat all patients now. Around the world, screening programs to find breast and cervix cancer are not always tied with followup and treatment to those who need it, especially lower-income people in areas that lack basic health services.
Convinced that South Africa cannot afford to take the western path against cancer, the respected eighty-year old Cancer Association of South Africa--the largest nongovernmental agency in the health sector--is setting its sights on a vitally important tactic--making prevention the cure for cancer. To its credit, the government has acted to ban smoking in public and the mining and use of asbestos. Visitors are surprised at how clean the air is in restaurants. It is not widely known that the U.S. has not yet acted on either of these two fronts. And in some U.S. states, like Wyoming and Pennsylvania, tobacco lobbyists-- with appallingly close personal ties to Democratic governors-- have effectively bollixed efforts to reign in smoking. In those states, teenager smoking and the use of chew tobacco are increasing.
While South Africa gets credit for tackling these two important cancer causes, there are other serious problems where the nation has yet to act. Why does the country manufacture or import and use pesticides like lindane that are banned in many developing countries? Why is it legal for an airplane to fly over homes and schoolyards and spray banned pesticides on children? Johann Minaar is a general practice physician in Groblersdal, Limpopo. Through detective work involving careful monitoring of enzymes in his blood, he figured out that his disabling neurological symptoms were being triggered by his neighborhood vineyard's patterns of aerial pesticide spraying. He also linked a range of health problems in neighboring children, including breast growth in a five year old girl and severely disabling neurological symptoms in others, to use of dangerous pesticides.
The local wine grower's response to these serious health problems? "What I'm doing is perfectly legal."
Indeed, some things--like apartheid and slavery--can be both legal and immoral. The pesticides that the airplanes are spraying have been registered by the South African government, because that government lacks experts on the matter. The future of South Africa depends on its ability to produce healthy children who can participate fully in building civil society. So long as banned pesticides are regularly used, the nation's capacity to protect its children remains endangered.
Scientists explain that only about 25% of all spray lands directly under the path of the airplane, leaving the bulk of the pesticide to drift up to 3 kilometers. By what logic can a nation that prides itself on protecting its youth condone such exposures in the modern world today? Certainly the spraying of humans with compounds intended to kill insects that are banned in many countries is a violation of basic human rights--one that no nation can tolerate if it wants to create a safer and more equitable world for all its citizens. The Cancer Society's campaigns signal an important shift in public policy--reducing known and suspected causes of cancer is essential to promoting better public health.
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