SA’s poor critically underserved by healthcare, including those on Zuma’s doorstep

The country’s poor, it appears, remain on the fringes of national healthcare interventions, as two institutions have recently highlighted just how dire the situation is for those in rural areas, focusing on Nkandla, Eshowe and Melmoth in KwaZulu-Natal.

The South African Human Rights Commission’s (SAHRC’s) recent visit to a healthcare facility in Nkandla where only one nurse was in attendance, and schools in Eshowe and Melmoth where several Covid-19 safety issues were highlighted, has raised red flags over access to healthcare in these areas.

The SAHRC’s inspection last month revealed that healthcare facilities and schools in rural KwaZulu-Natal, as in many parts of South Africa, are still worlds apart from meeting the needs of the poor, despite increased healthcare expenditure over the last year.

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At the hometown of former president Jacob Zuma in Nkandla, the commission’s visit uncovered a critical lack of oversight, as there weren’t even any senior managers to greet the SAHRC’s delegation, said the commission’s spokesperson for KwaZulu-Natal, Lloyd Lotz.

“On entry officials were made aware that no senior staff official was present on the said date of inspection. One was currently on leave, the other was attending a workshop. The only healthcare official present was a professional nurse. Of most concern was that the professional nurse was the only healthcare staff [member], servicing healthcare users on the said date,” said Lotz.

When queried on the lack of medical staff members, the only nurse on duty replied that this had been a long-standing issue, which at times affected clinic’s ability to render its services to the community.

The official recounted the various tasks he had to do all on his own, which included consulting, dispensing medication and keeping a close eye on those in need of maternity care.

There was also a shortage of admin staff and sanitation facilities for the general public were also insufficient.

Situation at schools equally dire

The SAHRC’s Covid-19 school monitoring is ongoing and being conducted in all provinces. This information, including any complaints or calls for investigation, would be collated and taken up with the Department of Basic Education.

The commission was monitoring schools in Melmoth and Eshowe on 18 February, a day after their planned visit to Nkandla. The institution was assessing the observance of human rights at these facilities, and compliance with relevant legal prescripts regulating such facilities, including compliance with the Covid-19 regulations.

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The overarching issues observed at the rural schools included that almost all schools that were visited in the two rural towns had issues with access to running water.

“Schools had resorted to filling up tankers with rainwater, sourcing water from boreholes, and in one concerning case, water had to be sourced from a neighbouring court, for cooking purposes,” said Lotz.

The monitoring team also observed generally unsanitary toilets.

Hand sanitisers weren’t adequately or visibly distributed around school hallways. A shortage of classrooms also indicated issues with overcrowding, meaning no adherence to the required social distancing.

“There were incidents observed where learners were sitting in close contact with one another. This was to share textbooks,” said Lotz.

The team also flagged the lack of necessary response from the provincial education department, or the district and circuit offices, to the severe resource constraints faced by several schools in the area.

Poor urban communities equally underserved

Meanwhile, poor urban areas don’t appear to have fared much better, as a study by the University of Stellenbosch found that the first wave of the Covid-19 pandemic hit poorer communities much harder than more affluent communities.

Lockdown regulations held little benefit for socio-economically vulnerable groups whose living conditions prevented them from adhering to measures. The study also suggested that the number of Covid-19 infections were significantly higher than the reported rate.

According to Dr Jane Shaw, a pulmonologist with the Biomedical Research Institute Clinical Team at Stellenbosch, the study’s findings showed that people living in certain low-income areas were more than twice as likely to test positive for Covid-19 than people from areas with a higher average income.

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‘This is likely due to socio-economic factors in low-income settings, such as overcrowded living spaces, which make it almost impossible to practise social distancing and self-isolation,” she explained

Almost a quarter (23,7%) of the group of 405 Cape Town residents in the study were found to have been infected at some time during the first wave.

“The infection rate in this group was also significantly higher than the infection rate reported in the Western Cape [1,6% at that point in time], indicating that there probably were far more infections than were documented in the official statistics,” said Shaw.

These findings also suggested that lockdown regulations meant to curb the spread of Covid-19 held little benefit for those whose living conditions prevented them from adhering to measures such as social distancing and self-isolation.

The researchers appealed to decision makers to consider alternative prevention measures to protect vulnerable communities from Covid-19 infection.

simnikiweh@citizen.co.za

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