Page 75 - A Widening Idea of Health and Health Research - The South African Medical Research Council from Creation to COVID

A Widening Idea of Health: The SAMRC from Creation to Covid

African legislation on domestic violence and gun control. What previously had been
thought of as a private problem was by then well on its way to becoming recognized
as a significant public health issue. ‘We need to develop interventions for primary
prevention and prevention of its long-term health consequences’, insisted the unit’s
head, Dr Rachel Jewkes.
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To that end it adapted for use in South Africa ‘Stepping Stones’, a programme to
promote greater communication in sexual relationships, which was able to reduce the
incidence of genital herpes by a third and to curb risky sexual behaviour by males,
at least according to its own research in the Eastern Cape, while its 2002 report on
‘Rape of Girls in South Africa’, showing that school teachers constituted 33 per cent
of the perpetrators, triggered closer monitoring of the implementation of existing
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disciplinary measures by educational authorities.
Two other research units with a public health orientation, the internal Health and
Development Research Group and the Developmental Pathways for Health Research
Unit at Witwatersrand University, were concerned chiefly with the health of urban-
dwellers, respectively residents of five poor communities in Johannesburg and children
born and bred in Soweto. Strongly reinforced by the findings of the former unit on the
high levels of iron found in the blood of children in the five Johannesburg communities,
the Government began to phase out unleaded petrol nationally from 2006 and paint
manufacturers to cut the amount of lead in their products, while, building on the
insights of the Birth to Ten project (now extended to Birth to Twenty), which was nested
in the unit from 2011, the Developmental Pathways for Health Research Unit was able
to demonstrate convincing links between physiological characteristics in infancy and
childhood (e.g. low birthweight or obesity) and health risks as young adults.
Away from the cities, the Wits–MRC Rural Public Health and Health Transition
Research Unit concentrated on gathering extensive social and demographic data from
a typical rural region, Agincourt in Mpumalanga, in a bid to identify the determinants
of public health in such areas. As with several other public health-oriented research
units, surveillance research invariably morphed into intervention research, ranging
from ensuring that grants and old-age pensions were paid to promoting HIV
prevention and improving child health. Its motto, ‘Making rural voices heard’, sums
up its goal neatly, which its director hoped would balance the national vision of public
health by ‘providing a counterpoint to South Africa’s urban bias’. 88
Amplifying this rural voice was the research of the University of the Transkei-
based Oesophageal Cancer Research Group, which the MRC had helped set up in
1998. Its focus was broader than that of the PROMEC team, which had long been
concentrating on the aetiology of the disease there (see chapter 2). To its analysis of the

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