Harsha Kathard: Inclusive Practices Africa, Professor: Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town.
Roshan Galvaan: Professor: Inclusive Practices Africa, Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town.
Sharon Kleintjes: Vera Grover Chair and Professor on Intellectual Disability, Division of Intellectual Disability, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town

COVID-19 pandemic is disrupting human ways of doing and being worldwide and showing up the faultlines of existing systems. Upheaval across sectors including higher education reveal how longstanding social and economic inequalities entwined with the persisting influences of colonialism and apartheid  shapes our current reality. Existing curricula and mental health challenges stand to be escalated amid the COVID -19 crisis without the much needed and long delayed actions of decolonising of curricula.

The COVID-19 pandemic is resulting in a widespread health, social and economic crisis with consequences affecting the everyday lives of students, teachers and communities, with people who are already marginalized within systems rendered most vulnerable. As the higher education sector in SA and countries internationally urgently adopt measures to prevent the spread, face-to-face academic programmes have been suspended and supported through remote teaching via online platforms. Most of these academic programmes were not designed for remote teaching or  emergency teaching on online platforms, nor has the current education workforce been trained to utilise these platforms optimally. In this context, educational efforts remain experimental, trial and error, attempting to find quick solutions in a difficult situation. While there is good support to escalate the learning curve of educators on how to do online learning at a technical/ practical level, a blindspot remains in that this transfer/translation of method does not constitute significant curricula change in itself. We argue that the consequences of  missed opportunities for decolonising the curriculum will be highlighted again in COVID-19 crisis context.

This rapid shift to  remote teaching on online platforms is unlikely to change the issues of deep concern that plague learning in higher education.  On the contrary, the rapid shift to remote teaching via online platforms may adversely affect students who struggle to learn in the current system unless there is very careful thinking about how such learning may be best supported. At the outset, the appropriateness of the shift within our current framework  of engagement and inclusion is questionable. 

Students in conditions of poverty, living in complex and difficult circumstances, requiring reasonable accommodation due to disability and experiencing discrimination due to gender, sexual orientation or racism, for example, are likely to experience challenges with access, support and learning. The shift from face-to face to online/remote learning will benefit those with privilege and infrastructure and will therefore reinforce current  structural inequalities. Universities therefore must reflect on how they reinforce structural inequalities, by discounting the deep context of learning, even when they are well-intentioned.

The impact of recent student protests, water crises and the now COVID -19 pandemic have been recent opportunities to seriously reflect on educational programmes. Have we used these opportunities sufficiently? The academic programmes  and their curricula, by their very nature, continue to be planned and implemented with inherent inflexibility to social challenges or disasters affecting the public. Therefore, we continue to struggle with how to meaningfully change a rigid colonial  system. Moving to remote teaching via online platforms as the only response to the COVID-19 pandemic without decolonizing the curriculum is a technical and reactive approach. This approach will replicate and entrench the curricula injustices with lasting effect. In a world of uncertainty, a colonial higher education system must stop to  reflect on its on how programmes are offered in climates of uncertainty will become more equitable and inclusive. 

How does this situation impact on staff and student mental health?

Our learning from student protests of 2015 and 2016 showed the strong links between a colonial curriculum and mental health. Black students in particular struggled with a colonial system which privileges control in the name of care and compassion. Colonially-inspired  individualistic interventions mask systemic problems, including curricula challenges. Upon reflecting on learning and being well in a Faculty of Health Sciences, students voiced the experience of “Umgowu”1 as a consequence of being given individualized mental health options to cope. These options often did not serve their needs – as students.

In a health sciences educational setting it is particularly important to note that the students’ role in this context is that of a trainee health practitioner, for entry into professions which require high levels of personal resilience, and high levels of human relatedness in the patient-practitioner interface.  In addition to providing education in the practice and technical skill set of working as a practitioner, researcher, policy maker or implementer – key roles of health practitioners – the learning environment must also prepare our students to build personal and relational resilience, in order to work as well-adjusted practitioners in stressful health provision settings.  Further, the influence of the unequal practitioner -patient power relationship in achieving health outcomes for patients must be addressed. The overall formation process for practitioners still frame practitioners as god-like experts while patient expertise-by-experience is viewed with little value. This approach undermines and detracts from work to build the power of individuals in communities’ participation in their own health and wellbeing and in their recovery from illness. Further, the way in which the role of expert is assigned to students ignore their own humanity and fragility: the myth of the practitioner-patient divide leaving little space for student practitioners to bring their personhood to their training experience in current programmes, the very time during which student practitioners should be supported to develop personal, interpersonal and environmental skills and supports to cope in their professional settings.  They are learners requiring supports, including changes to alienating aspects within curricula. 

Staff and students’ with potential or actual mental health conditions working and learning in a deeply colonial context have insufficient space to bring this aspect of their experience to their learning environment, possibly deepening the progression to and impact of a psychosocial disability, with barriers to participation creating an inequitable and exclusionary environment. Marginalised students are burdened to struggle as individuals to assimilate and a discourse of blame prevails. This discourse is evident in the ways that student experience challenges in academic programmes and with throughput. Their underperformance or drop out attributed to students not taking care of themselves or not being sufficiently resilient. This approach absolves the system of its responsibility in the perpetuation  of the problem as well as in the individualised, medicalised approach to interventions. In this way, systems remain colonial and violent towards black and all marginalised students and staff. Rather than implementing systemic changes to eliminate such coloniality, responses to mental health challenges perpetuate coloniality through clinical responses such as individual counselling and medication as the most viable options. What we need is a way of thinking systemically to unpack the relationship between a problematic curricula and mental health challenges. This systems approach will avoid the pitfalls of replication of a colonial curriculum and will open a space for considering our collective health and well-being.


  1. Mental Health Working Group. Report on the Faculty-based engagements with stakeholders: understanding “uMgowo”. Cape Town: University of Cape Town Faculty of Health Sciences, ; 2019.