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I wish to comment on the article appearing in the November 21 issue concerning the South African government’s apology to APA for having denigrated and dismissed the 1978 report of the committee that visited South Africa.
It is morally fitting that Professor Freeman, director of the South African Department of Mental Health and Substance Abuse, has apologized for apartheid’s abuses of the mental health system directed against that country’s black citizens, including psychiatric patients. Dr. Freeman’s apology is quoted as endorsing APA’s criticism of medical treatment by South African psychiatrists who practiced during the apartheid era.
As I found necessary 15 years ago through the columns of Psychiatric News, I once again am impelled to repudiate the discriminatory medical conclusions of the special APA committee to visit South Africa, now replicated. There is simply no truth in the assertions that South African psychiatrists denied black patients proper medical examinations, did not use appropriate antibiotic treatments, failed to overcome language barriers (by the use of interpreters), and were unfamiliar with tardive dyskinesia.
What is true, by the committee’s own recognition, is that South African psychiatrists used lower doses of neuroleptics than their American counterparts; hence, the likely explanation for the rarity of tardive dyskinesia among South African psychiatric patients.
South African psychiatrists were not the perpetrators of politically motivated apartheid abuses. As physicians they rendered nondiscriminatory medical care, psychopharmacological treatment, and psychotherapy. Just as American psychiatrists render nondiscriminatory treatment within the politically motivated and sometimes abusive managed health care systems under which we are required to practice, South African psychiatrists by and large provided dedicated treatment within the framework of a socially unhealthy system. To this end South African psychiatrists practicing in the post-apartheid era will not be blamed for the currently escalating social ills of a South African society transitioning through a refreshing democracy. Homicide, rape, suicide, drug abuse, and AIDS are all on the increase. In addition, current South African health care is plagued by corruption. Millions of dollars earmarked for AIDS education disappeared and was never accounted for.
Fair-minded American psychiatrists will take stock of the fact that it is the government of South Africa that is apologizing to APA, and not South African professional bodies such as the South African Medical Association or the Society of Psychiatrists of South Africa. Simply stated, South African psychiatrists, as doctors, have nothing to apologize for other than fate assigning them to be born in that corner of the globe.
Theodore Pearlman, M.D.
Houston, Tex.