While many are celebrating the news that South Africa will soon move to level 3 of the covid-19 lockdown, a foremost infectious diseases physician warns that those in rural areas will be at even greater risk of contamination.
Dr Jantjie Taljaard, who heads up the division of infectious diseases at Stellenbosch University, believes that a “particularly high-risk period” awaits the nation. “There is a misconception that rural areas are at a lower risk of infection. A decrease in awareness about the prevention of further spread of the virus also puts everybody at increased risk.”
This follows an announcement by Cyril Ramaphosa that the entire country, including all covid-19 hotspots, will be moved to level 3 next Monday, allowing for a number of regulations and restrictions of movement to be eased. The president says this marks a significant shift in the approach to the pandemic.
A surge of infections, particularly in some metropolitan municipalities, has placed South Africa on warning that its fight against the pandemic is only just beginning. While rural communities are currently experiencing a lower infection rate, this might not always be the case.
Taljaard tells Sinesipho Tom that those in some farming areas are, in fact, at greater risk of infection, where people often work in large numbers or confined spaces like factories or pack houses. In the last few weeks this has already contributed to a higher infection rate in the Witzenberg region, one of South Africa’s key fruit growing regions.
If further outbreaks were to occur in farming communities, people would be at a disadvantage, Taljaard explains.
Many rural areas currently have adequate public health resources to handle normal circumstances, but an outbreak of SARS-CoV-2, the virus behind covid-19, would test this infrastructure to the limits.
He says, “Rural areas have less resources for medical care in general compared to metropolitan areas. The hospitals are smaller and there are fewer personnel. So, in this sense, they may not be able to manage as well.”
Taljaard also emphasises that South Africa does not have a “memorandum” for this pandemic. Other public health crises like HIV/Aids and TB cannot be compared to covid-19 because these diseases are transmitted differently. It also does not affect as many people at one time and their outbreaks have evolved slowly over time. “Our only privilege, as a country, is that we are three to four months behind other countries, so we can learn from them.”
Discrimination against rural citizens
Meanwhile, Ivor Price reports that the Rural Healthcare Advocacy Project (RHAP) last year found that rural communities in Mzansi, which make up 40% of the population, already face immense difficulties in accessing adequate healthcare – even before covid-19 struck. A RHAP report, titled “Protecting Rural Healthcare in Times of Economic Crisis”, found that austerity measures were hurting rural health.
The RHAP also red-flagged failure to fill vacant posts in the rural public health sector, as well as a lack of specialists and community health care workers. The report says, “Rural citizens have, by and large, been discriminated against. They have not received an equitable share of public health financing as historically the emphasis has been on urban areas and hospitals as opposed to rural communities and primary healthcare.”
Spotlight, published by the civil rights group Section 27, reports, however, that rural healthcare workers in many parts of the country have used the past seven lockdown weeks to prepare for the worst. Many traditional leaders and NGOs have also raised awareness of the deadly virus.
“The chief and the headman are working very hard to tell people and spread the word to the sub-headmen and all other traditional structures to make sure people stay informed,” says Phumzile Msaro, secretary of the Xhora Mouth Community Health Committee in the Eastern Cape Wild Coast. Here a local hospital converted an old parking lot into a covid-19 screening station with headman sharing homemade cell phone videos to spread factual information.
‘Protect people before money’
Duncan Masiwa reports that some Free State farmers are rather anxious about how level 3 will expedite the spread of the virus. ANAT Group co-founder Sabatha Segoba says he does not believe rural farmers have been equipped to adequately deal with the pandemic.
He believes it would have been better if officials from the department of health committed to frequently visiting farms to ensure that covid-19 screening is done correctly and daily. “I think it is important that (especially) farm workers are not only educated, but also informed. They should be cautioned that they might be putting another person’s life at risk if they don’t follow precautionary measures on and off the farm site.”
Segoba says that the movement of people should be monitored up until the country eventually reaches level 1 of the lockdown. “I hope and pray that farmers in rural communities make sure that our people are protected before we make money. That means following the necessary steps before we start operation.”
The African Farmers Association of South Africa (Afasa) has also urged farmers to be vigilant. Its chairperson, Neo Masithela, says: “Since some measures have been relaxed, we are calling on all farmers not to relax (in raising awareness) because the nation depends on us for feeding them. We must be extra cautious and continue to protect ourselves and others.”
Afasa serves on the department of agriculture’s covid-19 advisory team, says Masithela. “As farmers we are optimistically ready. I’m convinced that our farm workers are also ready, but we need to continue complying with the regulatory framework that government has suggested.”
The poor remains poor in all lockdown levels
The gradual easing of the unprecedented lockdown might bring hope for those who are now able to return to work, but this does not promise relief for the poor in rural communities, reports Noluthando Ngcakani.
Mervyn Abrahams, coordinator of the Pietermaritzburg Economic Justice and Dignity Forum in KwaZulu-Natal, tells her that food has become increasingly unaffordable for low-income households and this has deepened the hunger crisis in the country.
As we enter level three of the lockdown, Abrahams believes that there will be no major change to the plight of the have-nots. “In any crisis, it will always be the poorest of the poor who suffer the most. They are the ones who carry the biggest burden. All of government’s responses have been in response to the corporate sector and not sufficiently supportive of the informal sector. As long as that is the case, life will continue to be difficult for ordinary people. And as long as income is insufficient, life will continue to be difficult for people, no matter on what level the lockdown is.”
Abrahams adds that the country’s poor do not have the luxury to pick their battles against the rampant virus. According to him their options are always between food or hygiene and never both.
Dawn Noemdoe reports that Morajee Naik, a magistrate at the Bellville Magistrate’s Court in the Western Cape, also worries about the destitute and the needy. He plays an active role in the Wellington community where together with the People’s Food Bank and community radio station Radio KC they have already fed close to 25 000 people during the covid-19 lockdown.
He says, “The inability to work and do day-to-day jobs have left our people dependent on social grants and charity. The soup kitchens play a huge role in our society to assist in the alleviation of poverty. We will continue to strive to provide at least one cooked meal a day.”