” Rensburg told Spotlight that the social mitigation measures government announce seem inadequate, particularly for the poor. “Rural communities have among the highest unemployment rates and are almost completely dependent on government grants and remittances from family, so the lockdown could deepen food insecurity.”
According to Rensburg, rural healthcare systems, particularly at primary healthcare level, remain neglected and underfunded. “The lack of outreach services and high levels of poverty often translate into lower health seeking and unmet needs. What this means is that many people don’t know their health status or are unaware of underlying conditions that could place them at greater risk. We need a surge in health promotion activities that inform [rural] communities on how best to protect themselves.”
He also called for the protection and support of healthcare workers, including community health workers.”
As the major social and economic disruption that will be caused by South Africa’s 21-day COVID-19 lockdown became apparent over the past few days, civil society organisations have been warning that issues affecting the poor and marginalised could fall through the cracks.
Spotlight contacted farm worker, and healthcare worker organisations, sex worker- as well as various other civil society organisations to get their views and statements.
Missing from the conversation
Hours before the lockdown was set to commence at midnight on Thursday, the Sex Workers Education and Advocacy Taskforce (SWEAT) and Sisonke, the national movement of sex workers in a statement said this “drastic decision” translates into many uncertainties for unskilled workers including sex workers.
“[We]have noted with concern how sex workers are missing from the general conversations about support for workers throughout the pandemic and lockdown,” the statement reads. According to the organisations it is not clear to them if they will be prioritised in the government’s support plans given that the President said “we are going to support people whose livelihoods will be affected”.
Since Ramaphosa announced the lockdown on Monday various ministers announced details of support programmes for households and businesses. This include special measures including using the Unemployment Insurance Fund (UIF) to subsidise workers in this time. However, these measures do not cover workers in the informal sector and Minister of Small Business Development Khumbudzo Nthsavheni said the support packages of her department is not geared for informal businesses. So, the only assurance that this economic group seemingly has, is the assurance of a ‘safety net’ Ramaphosa mentioned in his announcement Monday. It is also unclear how workers of non-compliant employers that are not registered with the Fund, will be affected. Minister of Employment and Labour Thulas Nxesi during the ministerial briefing this week did say, however, he does not see why workers should be punished for ‘rogue employers’ so it remains to be seen how these workers will be accommodated.
Although there was reference to informal workers, sex workers were not explicitly mentioned once during all the government briefings thus far.
Sweat argues the loss of income that sex workers will suffer due to the pandemic will also mean a “loss of shelter, inability to access food, healthcare, medications and other basic necessities for sex workers and their dependents”. According to SWEAT’s figures (from 2013) there are about 158 000 sex workers in the country – each of whom has on average seven dependants. Sex work is still a crime in South Africa, making it difficult for them to demand labour rights. Questioning the inclusivity of the support programmes for vulnerable and poor groups, the organisation said: “Since the outbreak, sex workers have been the first group of workers to be affected financially by the spread of the virus.”
Outside the cities
Organisations geared toward rural healthcare also raised some concerns. Russell Rensburg, director of the Rural Health Advocacy Project (RHAP) told Spotlight they appreciate that the lockdown must have been a very difficult decision to make. Rensburg said if everyone adheres to the lockdown, it can help curb the spread of infection. “It is not without risk but given the Easter Holiday weekend coming up, it was the right decision and alleviates the risk of the epidemic spreading to rural areas.”
Rensburg said it is now important to prioritise the most at risk populations particularly people living with HIV and TB. “We also need the provincial authorities to work on province specific plans particularly Gauteng , Western Cape and KwaZulu-Natal.”
These three provinces have the most COVID-19 infected cases and at time of publishing Friday the country reported its first two suspected COVID-19 related deaths. Western Cape Premier Alan Winde in a statement said: “The clinical picture is consistent with COVID-19 but we are awaiting the test results to confirm this.”
Meanwhile Rensburg told Spotlight that the social mitigation measures government announced since Monday seem inadequate particularly for the poor. “Rural communities have amongst the highest unemployment rates and are almost completely dependent on government grants and remittances from family so the lockdown could deepen food insecurity.”
According to Rensburg rural health systems particularly at primary healthcare level remain neglected and underfunded. “The lack of outreach services and high levels of poverty often translates into lower health seeking and unmet needs. What this means,” he said, “is that many people don’t know their health status or are aware of the underlying conditions that place them at greater risk. We need a surge in health promotion activities that inform [rural]communities on how best to protect themselves.”
Rensburg also called for the protection and support of health workers, including community health workers.
Healthcare worker concerns
Spokesperson for the nursing union Denosa Sibongiseni Delihlazo told Spotlight some of the major concerns nurses have include issues with personal protective equipment, which is a non-negotiable for every health worker in the workplace during this trying time. “There must be provision of transport for nurses, as essential service workers, because majority of them don’t have cars and are reliant on public transport.” Delihlazo noted that nurses are not well-paid and will need support.
Many Community Health Workers also raised concern that they are not provided personal protective equipment during this time. On Thursday Head of the Health Department in the Western Cape Dr Beth Engelbrecht said CHWs who primarily deliver medicines do not need protective equipment. However Spotlight understands many CHWs across the country will also be part of COVID-19 tracing teams.
There were also calls from the farm worker communities for government to urgently address lay-offs in the sector. Wendy Pekeur, director of the Ubuntu Rural women and youth movement told Spotlight they are concerned because for the farm workers who all rely on their jobs to feed their families, this does not bring any relief. She noted children on farms who are dependent on feeding schemes and who will now miss out. The organisation in partnership with the Carmen Stevenson Foundation on Tuesday this week managed to feed 200 children on four farms.
According to Pekeur one farm in the Stellenbosch area recently dismissed 22 seasonal workers “due to the Corona fears”. “We are worried that the Department of [Employment and] Labour does not have the capacity to monitor violations of labour rights during this lockdown period and precarious workers whose jobs are already insecure will suffer more. And this whilst the sector has a history of extreme rights violations.” Pekeur said in cases where farm workers are expected to work health and safety inspectors who are too few will struggle to monitor compliance on farms. She stressed the need for government to partner with advice offices, trade unions and farmworker committees to make sure all safety measures are adhered to. Pekeur also called on Ramaphosa and Nxesi to “urgently address the lay-offs”. “Talking to businesses alone will not solve the problem,” she said. “Please speak to the workers who produce the food we eat as they have lots to say.”
Minister of Agriculture, Land Affairs and Rural Development Thoko Didiza this week stressed the importance of food security. Didiza said the agricultural sector will continue with harvests and production to keep the food supply chain going during this time. When Didiza addressed the media earlier this week, she only scantly referred to farm workers. She said: “Together with the industry we are working on sector operational procedures that would ensure adherence to the measures announced by the President. This includes the provision of sanitation to employees within the sector, especially farm workers.”
Didiza said the Department has set aside a package of R1.2 billion to help mitigate the impact of the pandemic and ensure sustainable food production also after the pandemic. “The Department soon will make the details of this package together with the application channels available,” she said.
Rights under lockdown
Head of Section27’s Health Programme Sasha Stevenson noted that even as the decision to lockdown the country is supported by the best available health evidence, everyone recognises that it will have wide-ranging social impacts. “The HIV epidemic in South Africa demonstrated that human rights are a fundamental component of public health,” she told Spotlight. “And in a time of crisis, the human rights principles of prioritising the needs of the most vulnerable; abiding by guarantees of equality and non-arbitrariness; and upholding rights to information, participation, the underlying determinants of health, and security for people who are or will become unemployed or sick are critically important.”
Concerns about possible rights violations and what recourse there will be for the public, were also aired at the ministerial press briefing Wednesday. Questions were also raised over the human rights’ training of the army officers and members of the police meant to enforce the regulations. Justice Minister Ronald Lamoela reiterated that the lockdown and the enforcement thereof is guided by the law and the Constitution and everyone will have to act within the law. Some constitutional law experts, however have warned that some of the regulations issued in terms of the Disaster Management Act are too vague leaving people with much uncertainty which will impact adherence. Meanwhile Defence Minister Nosiviwe Mapisa-Nqakula during the briefing said although army officers are not trained in crowd control they had human rights training.
Social solidarity vs Social disintegration
The line between social solidarity and social disintegration also seems to be not all too solid for some. Member of the People’s Health Movement of South Africa, Dr Louis Reynolds told Spotlight the pandemic could lead to social solidarity when “there is adequate support such as food, water, sanitation as well as empathy, trust and a sense of togetherness”. “But on the other hand, three weeks of lockdown in a context of massive inequality such as ours could also lead to social breakdown, especially in townships with large households and poverty and lack of knowledge,” Reynolds said. “Widespread fake news could lead to false hopes or divisions among groups and fuel xenophobic attacks. So, frustration at lack of essentials, a culture of violence, high crime levels, gender-based violence and issues like toxic masculinity, will make things worse,” he warned.
According to Reynolds the lockdown time can be an opportunity for popular education, raising awareness, stopping fake news, preventing unscrupulous people from exploiting the crisis, building social solidarity and supporting each other. He stressed, however, it is vital to make sure that everyone’s basic needs are met in terms of water, sanitation, food, income and social grants.
“We must recognise our indebtedness to those on the front line that includes health workers as well as people in townships and rural areas where the real battle rages,” he said.
Plans for support
Minister of Social Development Lindiwe Zulu said during a media briefing this week social grants will still be paid with special measures for hygiene and other protection at the pay points.
The food banks and local community food distribution centres will provide indigent and qualifying households with food during this time. Old age homes, rehabilitation- and child and youth care centres, will also be provided food. Zulu said community workers will be roped in to deliver food to beneficiaries to limit movement of people.
When prodded during the briefing Zulu did not have much to immediately offer victims of domestic abuse who during lock down will be forced to be cooped up with their perpetrators. She did acknowledge however, that this is a serious issue and mentioned the helpline victims can use to call in to get help (0800 428 428) as well as the existing shelters for vulnerable women that will remain open.
Minister of Human Settlements, Water and Sanitation Lindiwe Sisulu announced measures to get water tankers to drought stricken areas especially in rural areas to improve access to water. Water with which to wash hands is essential in the hygiene drive against COVID-19 transmission.
Despite Sisulu’s efforts on a national level, some residents especially in Khayelitsha complained that the municipality were still cutting off water for non-payment with one community activist Qaba Mbola accusing the City of Cape Town of sending these households to the “guillotine” and “sentencing them to death” without access to water.
*Note: SECTION27 is mentioned in this article. While Spotlight is published by SECTION27 and the Treatment Action Campaign, Spotlight is editorially independent, an independence that the editors guard jealously. Spotlight is a member of the South African Press Council.