Equality or efficiency? Public healthcare reform through Fanon’s “zone of being” and “zone of non-being”

The recent directive by the Ministry of Health and Social Services requiring government employees to seek treatment in public hospitals has generated considerable public debate. At the heart of the discussion lies a tension between equality and efficiency. Some civil servants argue that, as contributors to the state machinery and providers of essential services, they deserve priority or differentiated access to healthcare. Others maintain that public institutions should serve all citizens equally, without hidden hierarchies. This policy can be meaningfully examined through the philosophical framework of Frantz Fanon, particularly his concept of the “zone of being” and the “zone of non-being”.In The Wretched of the Earth, Fanon describes colonial society as divided into two spaces: the “zone of being”, occupied by those recognised as fully human and entitled to rights and dignity, and the “zone of non-being”, where the marginalised endure neglect and structural exclusion. Although Fanon wrote within a colonial racial context, his framework remains useful in analysing contemporary institutional inequalities. Access to quality healthcare often serves as a marker of who occupies a privileged space in society. If government employees previously accessed faster or better medical services, formally or informally, they may have occupied a functional “zone of being” within the healthcare system. At the same time, ordinary citizens facing long queues and medicine shortages remained in a “zone of non-being”. By directing government employees into the same public hospitals under the same conditions as everyone else, the state symbolically attempts to collapse this divide and affirm that all Namibians are equal before public services.From an equality perspective, this initiative carries strong moral weight. When policymakers, teachers, nurses, police officers, and administrators rely on the same healthcare facilities as the broader public, they directly experience the strengths and weaknesses of the system.Internal hierarchiesShared experience can generate accountability. It may create political pressure to improve infrastructure, staffing levels, and medicine supply chains. In this sense, the policy could foster national solidarity and reinforce constitutional ideals of fairness. Through a Fanonian lens, it appears as an effort to dismantle internal hierarchies within a postcolonial state and to affirm the dignity of all citizens equally.However, equality within a strained system does not automatically produce efficiency. Public hospitals already struggle with long lines, staff shortages, limited infrastructure, and slow service delivery. Integrating thousands of additional government employees into an already overburdened system may increase patient volumes without a corresponding increase in capacity. If no additional doctors, nurses, administrative systems, or medicine supplies accompany this directive, waiting times could grow longer. Civil servants may spend entire days in queues, disrupting operations in schools, ministries, and other public offices. Teachers absent from classrooms and administrators missing from their posts due to extended hospital visits could indirectly affect service delivery nationwide. In attempting to create equality in healthcare access, the state may inadvertently shift inefficiencies into other sectors.The issue of medicine availability presents another concern. If shortages stem from procurement delays, logistical inefficiencies, budget limitations, or weak distribution systems, increasing demand without reforming supply chains may exacerbate scarcity. More patients competing for limited supplies could lead to faster depletion and increased frustration among all citizens. The policy itself does not directly address structural problems in pharmaceutical procurement or inventory management. Without systemic reform, equality of access may translate into equality of shortage rather than equality of quality.Superior treatmentThis raises a deeper question: are we solving one problem while creating another? The initiative is commendable in its pursuit of equity. It challenges the perception that certain groups deserve superior treatment in public institutions and attempts to erase symbolic divisions reminiscent of Fanon’s “zone of being” and “zone of non-being”. Yet equality must be accompanied by capacity expansion. Without increased investment in healthcare infrastructure, human resources, digital systems, and supply chain management, the reform risks deepening frustration across society. True transformation requires both moral commitment and practical implementation.Ultimately, the directive represents a powerful statement about fairness and shared citizenship. It reinforces the idea that no Namibian should stand above another in accessing public healthcare. However, its success will depend not merely on who stands in the same lines but on whether those lines are shortened through meaningful reform. If equality is paired with investment and efficiency, the policy could strengthen both healthcare and national unity. If not, it may expose systemic weaknesses more sharply and amplify pressures across the public sector. The challenge, therefore, is not simply to merge zones but to improve the conditions within them.*Sakaria Johannes is a graduate of political science from the University of Namibia. He can be reached at sackyuutsi@gmail.com.

Equality or efficiency? Public healthcare reform through Fanon’s “zone of being” and “zone of non-being”

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Namibian Sun 2026-02-27

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Equality or efficiency? Public healthcare reform through Fanon’s “zone of being” and “zone of non-being”

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Namibian Sun 2026-02-27

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