By Izak Smit, PPS Group Chief Executive Officer
“Keeping a person from illness deserves more merit than curing him.” - Saint Vincent de Paul, 16th century AD
I am of 1967 vintage. Ask an AI agent or Google what defined that year and the first successful human heart transplant will be near the top of the list. It was performed in the early hours of 3 December 1967 by Dr Christiaan Barnard, with his younger brother Marius as his right-hand man, just 15 days after my birthday. It is a historic feat that South Africans are proud of.
My father was a surgeon (and I am happy to say a PPS member) and hence Dr Barnard was a hero to him. Dr Barnard’s biography, One Life, published in 1969, held a proud place in his library. It has been on my to-read list for many years and I finally got to it during the recent year-end holiday. It is quite a story. Of what it takes to become a medical professional (our members in this field can relate), of client-professional relationships (most members can relate), of advancing the frontiers of science and of perspective, the theme of this edition.
I have a faint memory of my dad’s specialisation studies in the early 1970s. While he was studying, I was not allowed to make any noise, which was an impossible expectation of a three-year-old. When he finally qualified as a surgeon, my first question was whether I could now be noisier! Once, in my excitement to see him returning from the hospital, I slipped and cut my head on a steel windowsill. It needed stitches. That was no problem – dad could handle it – but he did not have any pain-killing injections at home. And because he needed to get back to his studies, there was no time to drive to the hospital. The result was stitches without pain relief. It probably explains my lifelong fear of needles. In later years, he would sometimes take me to the theatre hoping that I might consider medicine as a career, like him and like his dad – my grandfather. But I often fainted when the scalpels started cutting. At least I am in good company. Chris Barnard also passed out the first time in theatre as a young medical student!
At PPS, Dr Marius Barnard is as much of a legend as his brother Chris. He was the inspiration behind a major life insurance product line – critical illness (also known as dread disease in other parts of the world). South Africa is known as a major innovator in insurance. It is something that stirs national pride, just like that first heart transplant. And critical illness cover is right up there, as acknowledged by actuaries worldwide. Marius Barnard pushed for it. His key idea was that as a surgeon he could “repair a person physically” but only insurance could repair a patient’s finances after illness. He repeatedly argued that many patients survived illnesses medically but “died financially”, and insurance was the way to protect against economic hardship. Marius’s view can be summarised as: “We celebrate the skill that pulls a patient back from the brink. But the greater act of prevention is the quiet work that keeps people from the brink at all – health-wise and financially.”
“Perspective not only changes what we see but also what we build.”
Which brings me to perspective, the lens we use to look at things. Perspective not only changes what we see but also what we build. Chris Barnard looked at a failing heart and asked how to extend life. His was the crisis lens. His knowledge, skill and precision pulled patients back from the brink. Marius Barnard looked at the same illnesses through a wider lens and asked how to protect life’s fabric – work, dignity, solvency – long after the stitches were tied. One lens delivered heroics in hours; the other delivered resilience over years. Both were acts of care but they solved for different crises: Chris’s for the body’s survival; Marius’s for a household’s survival. Together, they remind us that progress is not only in spectacular interventions; you also find it in quiet systems that make catastrophe less frequent and less fatal. And the most powerful perspective combines the two: building organisations and systems that can act brilliantly at the edge but design ecosystems that keep people away from that edge. Innovation at the edge saves lives; innovation upstream saves futures. Perspective determines where we focus and how we execute our genius as professionals.
Prevention is, at its core, an act of perspective. It asks us to lift our eyes from the urgency of the present moment and to look instead at the horizon far down the line, at the patterns, behaviours, systems and risks that shape tomorrow’s outcomes long before they materialise. Where reaction confines us to the visible crisis, prevention demands a different lens: one that sees the forces building beneath the surface.
The world of medicine illustrates this shift so powerfully. For centuries, the doctor was defined by the drama of intervention. But the most forward-looking thinkers in healthcare argued that the true work of medicine lies much earlier – where choices are made, environments are shaped and suffering can be avoided altogether. It changes the question from “How do we fix this?” to “How did we arrive here and how do we ensure we never do again?” Andrew Weil, a prominent American physician and health pioneer, said: “The primary function of doctors should be to teach people how not to get sick in the first place.” It is interesting to note that the word “doctor” comes from the Latin word for “teacher”. Even Thomas Edison predicted in the 19th century: “The doctor of the future will give no medicine but will instruct his patient in the care of the human frame, in diet and the cause and prevention of disease.”
Perspective requires the humility to accept that the most meaningful work happens long before the applause and that the greatest victories are the ones never celebrated, because the crisis never arrived. Prevention is unglamorous, often invisible but always forward-looking. It is a discipline of seeing differently, of choosing the long view and designing systems that keep people, organisations and societies away from the edge, rather than rescuing them from it. The most powerful solutions are those that prevent the problem from arising.
This idea finds a powerful modern echo in the work of Dan Buettner, author, National Geographic explorer and host of Netflix’s Live to 100. In The Blue Zones, Buettner reveals that most of what we call “healthcare” is really “sick-care”: a system built to treat disease after it strikes, not to nurture the habits that keep it at bay. His core insight is elegantly straightforward yet transformative: The greatest predictor of vitality in later life is the daily lifestyle you cultivate decades earlier. Today’s dominant approach waits for illness to emerge, get diagnosed and become irreversible - reacting only when symptoms demand it.
Buettner’s Blue Zones wisdom urges us to expand our view across lifetimes, spotting risks early and treating prevention with the urgency of any crisis. Instead of probing “What’s wrong now?”, we should ask, “What path are you on, and how can we steer it toward thriving?”
Buettner highlights the primary chronic diseases - heart disease, cancer, stroke and diabetes - that claim most lives worldwide long before their time. These are not random bolts from the blue; they are gradual drifts shaped by years of everyday choices. Drawing from the Blue Zones - places like Okinawa, Sardinia, Nicoya, Ikaria and Loma Linda - where people routinely reach 100 in robust health, he shows these threats are largely avoidable through proven, community-tested practices. View life through a short-term lens and they look inevitable. But Buettner’s wisdom, backed by decades of fieldwork, equips us to forecast and sidestep them with intentional, early shifts.
Among them, natural movement reigns as the ultimate “longevity drug”.
Buettner redefines longevity not as stacking up more years but as filling them with purpose and vigour - a sentiment echoing Chris Barnard’s wisdom: “The value of life lies not in the quantity of days but in the quality.” This demands flipping from today’s comforts to tomorrow’s aspirations. Enter Buettner’s Power 9: nine universal habits for exceptional longevity, like moving naturally every day, finding your purpose (or “ikigai”), and nurturing family first. It is not elite athletics; it is foresight training - adopting these practices now to safeguard the vitality you will need at 80, 90 or 100, from hiking with grandkids to walking your dog or dancing at weddings. Among them, natural movement reigns as the ultimate “longevity drug”, woven into daily life through walking, gardening and chores. Yet sleep in rhythm with nature, a plant-slanted diet like Nicoyans’ and strong social bonds (like Sardinia’s tight-knit circles) are equally vital. You cannot out-walk chronic stress or isolation. The Blue Zones path moves us from crisis mode to communal foresight, pulling levers when change is easiest and impact is deepest.
perspective
It is striking how much clarity we gain about our careers only when looking back. Closed doors start making sense. Soon after qualifying, Chris Barnard worked as a general practitioner in Ceres. When the town’s doctor returned, there was not enough work for three doctors, so Chris had to leave (last in, first out). It felt devastating at the time, yet it pushed him towards specialisation and changed the course of his life. If not for this, he would probably have retired as a general practitioner in Ceres, with success defined very differently. But he once said: “True success in medicine comes not from what we scientifically achieve but from the hearts we heal.” What a beautiful pun! That is perspective!
And that is our collective purpose at PPS! It is what drives and motivates us every day.