Labour struggles have been a central issue in 2020 as retrenchments and strikes surged amid Covid-19 infections and deaths. Three unions representing frontline workers have called for an urgent intervention by employers.
The National Education, Health and Allied Workers Union (Nehawu), the Democratic Municipal and Allied Workers Union of South Africa (Demawusa) and the South African Federation of Trade Unions (Saftu) have called on the government to employ community health workers, who work on outsourced one-year contracts, and casual municipal workers on a permanent basis.
Mass protests held throughout the year have repeatedly called for workers to be insourced, better working conditions, salary increases and the rollout of personal protective equipment (PPE) for vulnerable workers.
Demawusa held its third mass protest last month, despite strict Covid-19 regulations prohibiting gatherings of more than 50 people. Representing water and electricity meter readers, security guards, plumbers and call centre operators, the union said its latest demonstration was to protest against the Nelson Mandela Bay Municipality’s decision to rescind its promise to insource casual workers.
As active Covid-19 cases keep rising in the Eastern Cape, unions are also deeply concerned with the growing number of infections among frontline workers. “We have over 20 of our workers infected with Covid-19,” said Demawusa provincial coordinator Siphiwe Ndunyana. “Some have been self-isolating and others have been hospitalised but since been discharged. The municipality has not been doing anything to help them. In our collaborative efforts with Saftu and Nelson Mandela University, we have been arranging psychological help for them,” he said.
A nurse employed at Port Elizabeth’s Livingstone Hospital, who asked to remain anonymous, says the state of the facility has worsened since the beginning of the pandemic. He says when government officials visit the hospital, management provides a “glossy” report instead of informing them of the critical collapse of the Covid-19 units.
Staff and public at risk
“Livingstone was never ready for Covid-19. The management, at the start of the pandemic, gave a false image of the state of readiness of the hospital. For example, there are oxygen points in the Covid units but they are not enough to meet the [demand]. Sometimes, when the units get full, Covid patients will be moved to other general units in the hospital, which poses a high risk … as those units are without oxygen points.”
The nurse says the worsening conditions have caused infections to spike among nursing staff. “There is still a huge problem with the personal protective equipment. We are given a single gown for the whole day. Imagine attending to an intubated Covid patient, we have to wash the patients and we can’t be two metres away when doing that. Management tells us not to discard the gowns as there is a shortage of PPE. When we go on a tea or lunch break, we take off the PPE, hang them up then reuse them for the whole 12 hours. The health workers are at risk of infections due to this,” he says.
“There are two nurses on the roster attending to more than 45 patients in a ward. The capacity is not there to attend to all of them. The shortage of nurses is a huge problem at Livingstone.”
He also says there are internal conflicts among nurses and doctors, and that management is negligent and unable to make critical decisions in the hospital. “Doctors at Livingstone act as management, they bully everyone at the hospital. They collude with management and say that we must not test patients without them showing symptoms because the tests are too expensive.
“Patients are supposed to be tested at entry points regardless of showing symptoms or not, but this is no longer done. Patients now sit among each other without being tested and this, in my opinion, has caused the high infections in Port Elizabeth. When nurses get infected due to this environment, we are told that we are careless. Nurses are dying and management is negligent and does not comply with protocol,” he adds.
A woman who has been employed as a community health worker for more than seven years says that when she started in 2013 she received a stipend of R1 500. “We protested until the Department [of Health] increased our stipend to R3 500. This work is demanding and difficult. It’s just not easy being a care worker,” said the 32-year-old.
High infection rate
The unions are also concerned about the department’s inability to support workers who have been infected with Covid-19. According to some health workers, there have been staff in the department’s district office who tested positive yet came into close contact with both district and municipal officials. They say those potentially infected were not contacted by tracing teams and did not quarantine themselves as they only heard of the infections through a press release issued by the department weeks later.
District manager Darlene de Vos admitted that there had been infections among staff. “It is true that officials working in the district office have tested positive for Covid-19. The offices were deep cleaned and decontaminated. The Covid-19 protocols are being implemented as per the guidelines. I cannot say anything further on this matter.”
Sources in Livingstone Hospital say the infection rate among health workers has been alarmingly high. An entire ICU staff complement at Livingstone has tested positive and spent 10 days in self-isolation. The hospital’s casualty ward had also been closed because of overcrowding and patients died while waiting to be examined or assigned beds.
In July, community healthcare workers in the Eastern Cape embarked on a sit-in at the office of member of the executive council for health Sindiswa Gomba in Bisho. The protest action was met with excessive violence when office staff called the police to remove the workers from the building.
According to community health workers, this response is an indication of the state’s disregard of the role they play in fighting Covid-19. “We are sick and tired of the arrogance and ill treatment we are subjected to by this department,” said community health worker Nompumelelo Kapu.
The workers’ demands include permanent employment, benefits such as medical aid, membership of the Unemployment Insurance Fund and pensions, and an increase in salary, which currently is R3 500 a month.
In a statement on its website issued on 24 November, Nehawu said community healthcare workers who had embarked on a national strike since 11 November were met with intimidation and victimisation by their employers.
“The government, especially the Department of Health, is aware of the critical role played by these workers in providing primary healthcare in townships and rural areas. They further proved their importance during the hard lockdown by playing a central role in the mass screening and testing driven by the government.”
The spokesperson for the Eastern Cape Department of Health, Siyanda Manana, said: “The matter of community health workers is being dealt with at national level. It cuts across different departments – labour, health and the public service administration – and negotiations are ongoing.”