South Africa has introduced sweeping measures to curb the spread of coronavirus, including closing schools and preschools, banning gatherings of more than 100 people and emphasising frequent hand washing. On Monday 23 March President Cyril Ramaphosa went further and announced a nation-wide lockdown for 21 days with effect from midnight on Thursday 26 March.
The lockdown will be enacted in terms of the Disaster Management Act and will mean that from midnight on 26 March until midnight on Thursday 16 April, all South Africans will have to stay at home.
While commendable, these measures seem to forget the realities of low-income earners, who cannot afford not to work.
“We need to be educated about the virus, have testing stations closer to our communities, and provide the facilities and the community with the sanitisers,” says Mpho Mkhize, a mother of two children who are in Grade R and creche. Despite fears of the coronavirus, Mkhize is still expected to show up at her work as a manager for a printing company.
Her concern is that everything is coming to “a standstill and it’s frightening”. “Our government can do more about this crisis than just shut down everything … Not everyone can afford [hand] sanitiser, gloves and masks. They should be providing those to the public as part of the precaution,” she says.
Mkhize also fears becoming homeless if she is forced to stop working. “If we don’t have anyone to look after our kids, it means we should stay at home … How are we going to pay rent with no income?”
Barbara Stemmert of the Ikamva Labantu Charitable Trust in the Western Cape explains that with schools and early childhood development (ECD) or educare centres closing, parents are concerned about the safety of their children at home during the day. But she acknowledges that keeping children in groups places them at a greater risk of contracting Covid-19.
Making sense of the virus
Georginah Hloka, the principal of an ECD centre in Tembisa, is uncertain about the merits of closing schools. “I am on and off about it. Now if the government is saying we must close, where will these children be the whole day? That is my concern.”
Hloka says schools are like a second home to some children, a place where they “spend most of their time”. The lack of adult supervision that results from suspending schools could mean children are in danger of being exposed to violence. The virus could also easily spread among unsupervised playmates. “They need to be checked before eating to see if they have washed their hands. [Also] anytime when they go to the toilet.”
Mkhize points out another aspect of the problem, saying, “Some parents are expected to work and don’t have anyone to look after their kids … Now creches have closed down, it means parents should also stay at home. That also means no income at home and [everyone] will go hungry.”
Susan Goldstein, deputy director at the Centre for Health Economics and Decision Science Research, emphasises the dangers of unwatched children. “In South Africa, any unsupervised children are at risk of all sorts of things.”
Hloka fears for parents who are not well informed about the outbreak. An article about talking to children advises parents on ways to engage about the coronavirus. But, as Hloka says, this is often not helpful as a lack of information means parents are ill prepared.
Covid-19 and impoverished communities
“Township neighbourhoods don’t have the same advantages as those better resourced,” says Stemmert. “Social distancing, self-isolation and purchasing hygiene products, let alone extra food to stock in the cupboards, is out of reach for many. No work, no pay is a reality.”
According to Stemmert, Ikamva Labantu understands what the suspension of their activities means for vulnerable families. They are making contingency plans to support their beneficiaries. Ikamva Labantu has established systems and broad community outreach: “We are committed to providing fortnightly food and hygiene parcels through this network to the households of 74 preschool children in vulnerable households in Khayelitsha and Gugulethu.”
“[Children who normally attend schools or creches] will go hungry for the holidays, which is always a concern,” Goldstein says, especially for undernourished children and those who are HIV positive.
“The biggest worry is that we know we have over 7 million HIV-positive people. Of those, around 2 million are not on treatment. We also have a lot of diabetes.” Also, what is concerning for Goldstein is “the spread of fake news and snake oils [false cures or immune boosters] that will impoverish people and drive them to panic.”
Hloka says that for communities who cannot afford extra purchases, the government has to step in and assist. “They have to provide health measures such as face masks [and] gloves. Give soaps to the community to wash their hands at all times.”
Shakira Choonara, health researcher, activist and member of the African Union’s Youth Advisory Council, says the government must immediately announce either a financial package or a parcel of food and basic necessities to cushion the blow for those who will be most affected and cannot afford prevention measures. In providing these necessities, Choonara says, the government must consider how to ensure they are easy to access. This means they cannot rely on the usual lengthy queues at the Department of Social Development. “One measure could be a temporary increase of social grants.”
Straining public healthcare
Choonara says the public healthcare system is “not at all” ready for the pandemic. Poor detection and testing and health facilities that are not quality compliant, clean or well equipped are just some of the issues. There are also always long waits for referrals. Choonara wonders how we expect either prevention or treatment. Unless there is a well-resourced effort to prepare for the emergency in these areas, the spread will be alarming.
“Neither children nor their families have access to quality healthcare. That is the current reality. Coupled with having a health system which will be strained under a rise in cases, this is set to worsen. Parents and caregivers are going to also be hit economically, meaning enablers to access health such as money for transport to travel to health facilities will not be available. In the absence of a vaccine and based on these realities, even though the youth have a lower risk of mortality, they may not be spared without being tested or treated in time.”
Facts correct at the time of writing.