{"id":97,"date":"2020-03-31T15:01:40","date_gmt":"2020-03-31T14:01:40","guid":{"rendered":"https:\/\/www.protectthepeople.co.uk\/?p=97"},"modified":"2020-03-31T15:01:40","modified_gmt":"2020-03-31T14:01:40","slug":"south-africa-the-coming-storm-in-health-and-state","status":"publish","type":"post","link":"https:\/\/www.protectthepeople.co.uk\/south-africa-the-coming-storm-in-health-and-state\/","title":{"rendered":"South Africa: the coming storm in health and state"},"content":{"rendered":"\n
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soldiers escorting a homeless woman to a sanctuary<\/figcaption><\/figure>\n\n\n\n

“Disasters are political. Disease is also political. Class determines who has medical aid and who does not, who has access to water, sanitation and safe means for heating and lighting and who does not.<\/em>“<\/p>\n\n\n\n

Abahlali\nbaseMjondolo (homeless people\u2019s movement), 22 March 2020<\/em><\/p>\n\n\n\n

David Hemson writes:<\/strong> With a declaration of a state of disaster by President Ramaphosa followed by lockdown on March 26 of all non-essential movement, the South Africa government acknowledged the threat and force of the pandemic. With a weakened state and an economy already in recession, working people are already grappling with strategies for personal and family survival. The question is how effective government measures will be to restrain and control the onrush of Covid-19 and provide for human survival. In the post-pandemic period there will be demands for redress for the stunted conditions of life under capitalism.<\/p>\n\n\n\n

Covid-19\ninitially appeared in the enclaves of prosperity of the well-traveled\nelite. It seemed foreign to the African context. For some weeks South\nAfrica was frozen in time as infection raged in Italy and Iran. It\nappeared to be somewhat similar to the rest of Africa with cases in\nthe units rather than hundreds. All this is now changing rapidly.<\/p>\n\n\n\n

This\nphenomenon of sick rich appeared to contradict the terms of\ninequality of black and white, poor and rich. The early numbers were\ncarefully monitored and those tested positive were isolated. Now,\nhowever, the new cases are unrelated to foreign contact as the virus\nfinds a place within wider SA society. Covid-19 infections have been\nspreading unpredictably and rapidly from the enclaves of prosperity\nto the population of 56 million which has a particularly vulnerable\nhealth profile. Potentially the pandemic could overwhelm the deeply\nunequal, poorly administered and fragile health system.<\/p>\n\n\n\n

Although\nthe African National Congress (ANC), the dominant liberation\nmovement, has ruled for 25 years, post-apartheid reforms have not\nincluded a fully funded national health service. Instead there have\nbeen piecemeal changes which have not substantially changed health\nsystem inequality. Indeed, greater income inequality \u2013 particularly\nrising incomes among the upper 10% — has encouraged growth of the\nprivate health sector in which the rising black elite participate\n(Statssa, 2018). \n<\/p>\n\n\n\n

In\nthe recent period there has been little concern for conditions in\npublic hospitals despite many expos\u00e9s\nof mismanagement in hospitals and, in some provinces, deep corruption\nand mismanagement of health systems. Despite these necessary\nreservations, there are public hospitals and clinics which are\ncompetently managed and are committed to meeting the rising burden of\ndisease. In the midst of demanding conditions, dedicated health\nworkers are undertaking competent and caring work under, often, very\ndifficult conditions. \n<\/p>\n\n\n\n

The\nstate of the nation\u2019s health<\/strong><\/p>\n\n\n\n

South\nAfrica is no stranger to pandemics; its people suffered great losses\nin the 1918 flu epidemic and a hundred years later has the largest\nconcentration of HIV positive people in the world as well as high\nlevels of tuberculosis. The country also had a large-scale cholera\nepidemic in 2000-01 which was shorter lived but extensive in rural\nareas. The continuing HIV pandemic, tuberculosis and the year-long\ncholera epidemic severely tested the post-apartheid health system.\nThere is some advantage: it has also helped prepare for the mass\ntesting and emergency interventions now required.<\/p>\n\n\n\n

The\nepidemics of HIV and tuberculosis overlay each other, infecting the\nsame vulnerable communities and individuals. South Africa has the\nbiggest HIV epidemic in the world, with 7.7 million people living\nwith HIV and half of those HIV positive also suffer from\ntuberculosis. HIV infection is increasing at a rate of 4285\/week and\ntuberculosis at 8654\/week (Avert, 2019 and Naidoo et al, 2017). These\ndiseases have peaked but prevalence is not declining; these epidemics\nare kept at bay rather than declining. Massive interventions are at\nthis stage partly effective, not decisive, in reducing these\ndebilitating epidemics. Despite this, the infrastructure of testing\nand treatment is a resource for responding to Covid-19.<\/p>\n\n\n\n

Government\nresponse to past epidemics has been ambiguous. The rapid advance of\nHIV infection in the mid-1990s was denied by the then President\nMbeki. Indeed, he vigorously argued that HIV virus did not exist and\nopposed ARVs (antiretroviral drugs) being used in hospitals. The\ndelayed intervention resulted in life expectancy plunging from 63 in\n1994 to 53 years in 2004 and is only now rising beyond the levels of\nthe early 1990s (Macrotrends, 2020).<\/p>\n\n\n\n

His\nlabeling of ARVs as \u201cpoisonous\u201d clouded treatment with\ncontroversy and racial innuendo (Nattrass, 2006). Although South\nAfrica has alarming levels of infection, visiting health specialists\nfeel there is no sense of crisis and urgency in lowering the\nprevalence of people living with HIV (Avert, 2020). The mass\ntreatment programs for HIV and TB have been a priority in spending\nleaving an infrastructure in place but they leave fewer additional\nresources for this pandemic. \n<\/p>\n\n\n\n

These\nepidemics have drawn heavily on available funds for investment in\nhealth facilities. It is estimated that the allocation to the health\ndepartment for HIV\/AIDS has amounted to R537 bn ($36 bn) over the\nperiod since 2004 (author calculations from the National Strategic\nPlan for AIDs, 2019). This spending is focused on HIV and TB\nprevention, care, and treatment interventions. Since 2004, PEPFAR (US\ngovernment fund) has contributed over $8 billion to support this\ninitiative (Avert, 2020). While SA now has the largest treatment\nprogram in the world, HIV appears to be accepted as a chronic disease\nalong with obesity, hypertension, diabetes and cardiovascular\ndisease. It has the highest levels of obesity in sub-Saharan Africa.<\/p>\n\n\n\n

These\ndestructive combinations have brought the unwelcome description of\nSouth Africa as the unhealthiest society in the world. This heavy\nburden of disease rests on the black working class which suffers high\nunemployment, poor housing, and violent crime. \n<\/p>\n\n\n\n

Public\ndecline, private expansion<\/strong><\/p>\n\n\n\n

While\nhealth services are at the centre for effective treatment, they are\nfractured by staggering inequality. In the post-apartheid era, class\nallocation of resources has accelerated private health\ninfrastructure. As access to the full range of public health services\nopened to all citizens, public funding faltered and private hospitals\nwere built at an increasing rate. Health insurance companies such as\nDiscovery based in South Africa grew rapidly and now range\ninternationally.<\/p>\n\n\n\n

As\nfunding of the public sector has stalled, health has become a private\nand personal vocation supported by expensive medical insurance. The\nprivate healthcare system it supports opens access to private\nhospitals, gyms, doctors and other health professionals. This meets\nsome 16% of the population\u2019s needs and the overwhelming majority of\nhealth personnel follow this expenditure: about 79% of doctors work\nin the private sector. All medical training takes place in the public\nsector but 70% of doctors go into the private sector (The key source\non this and following data is Maphumulo and Bhengu, 2019).<\/p>\n\n\n\n

Such\nhuge dynamic disproportions distort the health services available to\nthe majority: by comparison the public health sector has to meet the\nneeds of 84% of the population with 21% of the doctors! There are\nradical divisions between the private urban and public rural\nhospitals; just under half the population live in rural areas, but\nonly 3% of newly qualified doctors work there. \n<\/p>\n\n\n\n

Improvement\nof the health of the majority has depended largely on the collective;\npublic housing, water and sanitation services rather than drugs, even\nthough these have been critically important in treatment of HIV.\nDespite this the considerable post-apartheid advance in housing and\nsocial services has yet to be realized in improved health and life\nexpectancy. Where services have faltered, however, the effects are\nclear. The disconnection to safe drinking water to rural communities\nresulting from neoliberal cost recovery in the 1990s led directly to\nthe outbreak of the cholera epidemic of 2000-01. \n<\/p>\n\n\n\n

Health\nservices show the blunt edge of reform; the new elite does not use\npublic health facilities and has little concern for the actual\nconditions in clinics, hospitals and in the small private practices\norientated to poor people. National budgets have consistently\nallocated less than the targeted 15% of the budget to health\nservices. A regime of budgetary austerity (accompanied by profligacy\nand corruption in state enterprises) has further accentuated the\npublic\/private divide as the private sector rises in comparison\n(Valiani, 2020). \n<\/p>\n\n\n\n

The\nlatest available statistics are there are 407 public hospitals (with\nabout 158,000 beds) and 203 private hospitals. The provincial health\ndepartments directly manage the larger regional hospitals. Smaller\nhospitals and primary care clinics are managed at district level.\nThere are over 401,000 nurses practicing nurses in South Africa;\ntheir number has been limited by the closing of nursing colleges\nduring the late 1990s in implementing the GEAR neoliberal program\n(Makhubu, 2016). Unfortunately, the rising demand is not met (even in\nconditions of mass unemployment) as there is a high drop out rate of\ncandidates in training.<\/p>\n\n\n\n

Large\npublic hospitals will be in focus as the pandemic grips South Africa.\nThe Chris Hani Baragwanath Hospital is the third largest hospital in\nthe world and it is located to serve concentration of population in\nJohannesburg. There have been critical reports on its management but\ngiven its location to the centre of population in Johannesburg it\nwill be the key hospital in the defense against Covid-19. High levels\nof wastage, theft and corruption are reported in the public hospitals\n(von Holdt and Maserumule, 2006).<\/p>\n\n\n\n

The\nimmediate focus will be on the ICUs. Although there are offers of\ncooperation from private hospitals, how will the 4,960 critical care\nbeds in the private sector in 2017, with 60% availability, be jointly\ncoordinated with the fewer 2,240 critical care beds in the state\nsector, with 20% availability (Myburgh, 2020). How can this resource\nbe equitably used when there are conflicting claims from members of\nmedical insurance and from the majority of desperately ill\nnon-members?<\/p>\n\n\n\n

Feedback\nloop and prognosis<\/strong><\/p>\n\n\n\n

The\nshack settlements are at one pole of interventions to contain\nCovid-19, at the other are the enclaves of well-traveled.\nSurveillance and intervention has initially focused on the latter. In\nother countries\u2019 epidemics, such poles of poverty and wealth have\nalso been linked by feedback loops as domestic workers from poor\ncommunities work daily in the houses of the elite and return home at\nnight. Local transmission of disease operates in both directions;\nstudies of flu in India show such loops from the slum areas to the\ncities. It is hardly possible for the shack settlements of South\nAfrica not to become more infected than privileged areas over time.<\/p>\n\n\n\n

South\nAfrica has a highly mobile population; the historically ingrained\ncheap labour system involving migration between the urban and rural\ncontexts has drawn both closer together. During a period of crisis\nmigrants return to rural areas potentially carrying disease. \n<\/p>\n\n\n\n

Infections\nhave risen relatively slowly within the enclaves of the privileged\nuntil local infections have risen sharply. From the first positive\nregistered in March 5 there are now over 1,000 at the time of writing\n(March 26); the exponential increase has undoubtedly spurred the\nlockdown. \n<\/p>\n\n\n\n

There\ndoes not appear to have been any systematic modeling of disease\ntaking South African social conditions into account. It is possible\nthat the high temperatures may retard the advance of Covid-19.\nPresently its momentum appears exponential and not determined by\ntemperature conditions. The difficulty is South Africa\u2019s flu season\nonly starts in April when it gets colder. It is unsure whether\nCovid-19 is a seasonal disease but that might not offer comfort.<\/p>\n\n\n\n

Somewhat\ncounter-intuitively, most experts think those on antiretroviral\ntherapy whose viral loads are suppressed will be more resilient than\nthose who are not on this therapy. The ARVs may make the body more\nresistant to infection and the spread of the virus if HIV medications\nare maintained without disruption (Wong, 2020). Such defense could\naccount for 54% of those living with HIV, taking treatment and who\nhave achieved viral suppression. \n<\/p>\n\n\n\n

This\nleaves 46% or 3.5m of those living with HIV who are untreated with a\npotentially high viral load and low levels of immunity, a group which\nwill be particularly vulnerable (Avert. 2020). Most of this group are\nthe \u201cmissing men\u201d who know they are HIV positive but decline to\ntake the free ARV treatment. They may continue to be sexually active\nand could have a high viral load and infect others. Since partners\nand networks of infection are not known as this is not disclosed\nthere are gaps in treatment and continuing infection. The millions\ninvolved in refusing treatment give some dimension to a problem which\nis not found in other African countries and is unique to South\nAfrica.<\/p>\n\n\n\n

The\nmantra of the WHO is currently \u201ctest, test, test\u201d combined with a\nstrategy of social distancing and hand washing. The procedure is that\nthose tested positive are required to cooperate in contact tracing;\nthose named are also then quarantined. Containment would not be\npossible without such intrusive questioning. Such a strategy has not\nsucceeded in HIV-AIDS treatment as it has been contested as an\nintrusion in privacy even though it would lead to much greater\neffectiveness in reducing infection. \n<\/p>\n\n\n\n

\nThe\nliberation struggle drove people to be deeply distrustful, to be\ndefiant, of the state. \u201cUngovernability\u201d characterized the\nculture of resistance then and into the post-apartheid period. This\ntradition and denialism could be\na\nfactor in the poor response to the key strategy of interviewing the\n\u201czero patient\u201d to identify networks of infection. This is how\nthose infected have been isolated. \n<\/p>\n\n\n\n

In\nthe coming period there will be a drive among treatment groups in\nclinics and hospitals to reach this group and develop a defensive\nshield against Covid-19 infection. The urgency of this intervention\ncould also help health services reach the service targets for\nHIV\/AIDS; unfortunately this \u201ccatch up\u201d strategy is late.<\/p>\n\n\n\n

Identifying\nnetworks in Covid-19 is critically important to tracing and isolating\nthe infected. The question is whether the flurry of daily contacts\nbetween people living in poor communities can be unpacked, separated\nand identified and the pandemic contained and ended. There is\nresistance to tracing in HIV interventions. It is also very difficult\nto trace infections in dense settlements. If tracing fails, the\nalternative offered is broad interventions hoping that \u201cherd\nimmunity\u201d is achieved as infection sweeps through communities\n(Myburgh, 2020).<\/p>\n\n\n\n

The\ncourse of seasonal influenza may offer something of an indication of\nthe profile of mortality and hospitalization. Flu kills between\n6,000-11,000 annually. About half of those deaths are among seniors,\nand about 30 per cent in people living with HIV. These also represent\ngroups with the highest rates of hospitalization. Existing conditions\nwill make Covid-19 worse. According to an authoritative source,\npeople living with HIV are eight times more likely to be hospitalized\nfor pneumonia resulting from influenza than the general population\nand are three times more likely to die from it (Nordling, 2020). \n<\/p>\n\n\n\n

There\nare no general models of infection and hospitalization publicly\navailable in South Africa. As in other African countries it is\nanticipated that the slow initial rates of infection will rise\nexponentially and put extreme pressure on weak health systems.\nThrough heroic interventions, African health workers with\ninternational support have controlled the spread of Ebola.\nUnfortunately Covid-19 appears to be more infectious, if less deadly.\n\n<\/p>\n\n\n\n

The\nchallenge of lockdown<\/strong><\/p>\n\n\n\n

The\ncurrent lockdown is enforced in an urban society which varies\nconsiderably from the cities of China, Europe and the United States.\nThe spatial planning of apartheid which segregated black people to\nthe urban periphery has altered, but not substantially changed. Many\ncity centres are now occupied by black people with \u201ctownships\u201d\n(state housing) many kilometres distant on the periphery. There are\nmany small and substantial shack settlements sandwiched between these\ntwo extremes. Extensive suburbs provide for the white and some of the\nblack middle class.<\/p>\n\n\n\n

With\nthe exception of the suburbs, in all three types of urban settlement,\nthere is overcrowding and a poor living environment; there are few\nparks, sports fields, or libraries in townships and none in shack\nsettlements. The open areas are often strewn with rubbish without\ngrassed spaces to walk. These areas are certainly not excluded from\nSouth Africa\u2019s extreme crime levels with high levels of murder and\nwomen and child abuse. Many households are women-headed and\nmulti-generational often based on income from a grandmother\u2019s\npension and child allowances. Services in water, electricity and\nrubbish removal are frequently interrupted by poor service levels or\ndisconnections for non-payment. Rubbish collection is either absent\nor not at the level of former white areas. Devastating fires in shack\nsettlements are also not infrequent.<\/p>\n\n\n\n

Hand\nwashing is a challenge as access to water services is uneven. The\nhighest level of service providing indoor plumbing is available to\n46% of the population in middle class housing and many townships.\nFetching and carrying for domestic use is needed for households with\noutdoor yard connections (29%) and communal taps (12%). These\nhouseholds have much reduced consumption and do not have flowing\nwater for hand washing. \n<\/p>\n\n\n\n

A\nsocial activist recently described the conditions which school\nchildren will now be experiencing: \n<\/p>\n\n\n\n

\u201cA\nnumber of children return from schools that mirror their\nneighborhoods \u2013 with pit toilets and no water, libraries,\nlaboratories or sports-fields. They live in areas ruled by gangsters\nwho peddle drugs and rape schoolchildren. They lack access to clean\nwater to drink or wash with. They have few books or toys. Their homes\nare not in safe, wide-open spaces. Fresh air, clean water and\nnutritious meals are not guaranteed. There is no space to\nself-isolate in crowded homes where infection spreads like wildfire.\nThose who take care of them are often grandparents, who are most\nsusceptible to Covid-19, yet have little access to emergency\ntreatment or hospitalization in far-away, over-extended public\nhospitals.\u201d (Govender, 2020)<\/p>\n\n\n\n

These\nare the conditions which children and their parents will be locked\ninto, cheek by jowl with their neighbours. Power outages are not\ninfrequent as the mismanaged electricity provider, Eskom, fails to\nmaintain supply. There will not be much relief from isolation, most\nhouses don\u2019t have internet hubs; although most people have\ncellphones, data access is expensive. This is hardly a rich\nenvironment for tutoring children or keeping in touch with family.\nThere will be a strong temptation to escape enclosure particularly in\nthe one-roomed shacks.<\/p>\n\n\n\n

Social\nsupport for shack settlements<\/strong><\/p>\n\n\n\n

The\ngrowth of shack settlements has been a desperate response to delayed\npublic housing; they were thrown up to find some accommodation at a\nplace as close to possible work. These settlements are at the centre\nof the dispossessed; some 3.6 million people or 14% of the total\npopulation live in shacks. Many are in floodplains, near the stench\nof waste disposal areas or in crevices between private housing. Local\ngovernments wage war against them to destroy the structures, evict\nthe people and disconnect their \u201cinformal or illegal\u201d connections\nto water and electricity. Again, these connections are acts of\ndesperation even if they can lead to a failure of services. The\ndispossessed of the shacklands are represented by local community\nleaders, inter-connected nationally by the Abahlali baseMjondolo\n(Shack Dwellers) Movement. \n<\/p>\n\n\n\n

The\nquestion is what provision can be made for these communities. During\nthe cholera epidemic of 2000-01 the SA Military Health Service\n(SAMHS) was deployed and set up mobile hospitals and 70 rehydration\ncentres in remote rural areas. This was a high cost intervention with\nambulances, hospitals and medication. Helicopters were used to\ntransport medical teams and patients. On average a thousand patients\nwere treated a day; in total some 98,000 cases were seen. This\nintervention brought down mortality quite dramatically (Hemson and\nDube, 2004).<\/p>\n\n\n\n

The\nquestion is whether the military will be deployed to police poor\ncommunities or provide services. Will we now see mobile hospitals set\nup in sports fields near shack settlements and in densely populated\nrural areas to meet the needs of the dispossessed? Or will its role\nbe that of force and constraint?<\/p>\n\n\n\n

The\nbasics for survival<\/strong><\/p>\n\n\n\n

Sections\nof civil society and trade unions have put forward an immediate\nprogram for survival in a set of demands to make life possible during\nthe current lockdown:<\/p>\n\n\n\n

End\nall evictions and disconnections from water and electricity, shack\nsettlements must be included in refuse removal, workers given paid\nleave, small traders included in relief and provided with guaranteed\nincome, free food parcels, hand sanitizers provided, places for those\ntested positive to self-isolate, free data available for cell phones,\nthe release from prison of those detained for making \u201cillegal\u201d\nconnections, health facilities available to the undocumented\n(summarized from SAFTU, March 2020).<\/p>\n\n\n\n

The\ncurrent mood is reflected in the possibility of \u201crebellion born of\nextreme desperation\u201d and reports of a \u201cdeath wish\u201d among\nworking class youth facing long term unemployment. The labour\nmovement has, for a period, been quiet in the face of the economic\ndownturn.<\/p>\n\n\n\n

The\novercrowded and impoverished conditions of life could provide fertile\nground for social explosions. It seems some employers are adopting a\n\u201cno work, no pay\u201d policy during the lockdown. Others are\nexpecting workers to take their annual leave during the lockdown. For\n85% of black working people (in agriculture, services, industry and\ntransport) it will not be possible to work from home. There is\ndesperation within the lockdown.<\/p>\n\n\n\n

The\nprevailing mood is, however, uncertain. There is broad acceptance of\nthe need for the lockdown but also a keen awareness of the use of the\npolice and army historically in repression. There is also concern\nabout the existing high levels of abuse of women and children rising\nin closed conditions. In desperate times there could be swings\nbetween solidarity and xenophobia against undocumented black people.<\/p>\n\n\n\n

Accumulating\ncrises and a socialist way out<\/strong><\/p>\n\n\n\n

The\ninternational Covid-19 crisis is devastating the lives of working\npeople in South Africa as it is world-wide. However, the economy, the\npeople, the health systems are all more vulnerable than elsewhere.\nEvery crisis, from the Great Recession to the present disaster has\nalso reinforced South Africa\u2019s semi-colonial place in the world\neconomy and deepened its dependence.<\/p>\n\n\n\n

The\nlabour movement watches in awe as governments in advanced countries\nroll out \u201cwhatever it takes\u201d recovery plans of trillions of\ndollars compared to a pathetic trickle at home. Decades of corruption\nhave used up government surpluses and devastated public finances and\nSA\u2019s position in the world economy and likely defaults have\nresulted in high interest rates for loans. In crisis, capital\nabsconds to safe centres and to the dollar, draining the economy of\nresources.<\/p>\n\n\n\n

The\nvirus is shaking the foundations of South African politics. The\ncountry has just been starting to emerge from a period of\nmismanagement and corruption which has left state-owned enterprises\nreeling from a crippling burden of debt. Before the pandemic\nRamaphosa represented a fairly weak presidency attempting the\nrestoration of state finances. By acting decisively and giving an\nauthoritative speech before the lockdown, he has now won respect from\nlarge sections of the population traumatized by the sweep of the\npandemic. Working adroitly to assemble political consent he appears\npresidential.<\/p>\n\n\n\n

This\nrising political capital will be used to bring resources and focus to\ninterventions. The immediate priority is the creation of a robust\npublic sector and health system as an emergency measure. If the\nCovid-19 health crisis cannot be resolved the economy will continue\nto crash. Every crisis has, however, also led to concessions to\ncapital.<\/p>\n\n\n\n

All\nthe unfinished business of the SA revolution is now outlined against\nthe dark sky of disease; the stalled housing program, indecisive\nhealth investment, mass unemployment and declining incomes, rising\npoverty, and the stark inequality of economy and society. The weak\nsupport offered to the newly unemployed and struggling families\ntouches on these issues but without leading to resolution. \n<\/p>\n\n\n\n

The\nquestion is how the labour and social movements will rise to put a\nbold public health initiative, mass housing program and job creation\nback on the political agenda; progress towards the once-promised\nstage of socialism. This crisis has to re-energize the creative\nenergies of working people as in the victorious struggle against\napartheid.<\/p>\n\n\n\n

David\nHemson<\/strong> researches and writes on South African and broad\ninternational issues. He was active in the rebirth of the union\nmovement among black workers in the 1970s before he was banned and\nhouse arrested. Together with others, he has been active in\nsupporting socialist policies within the ANC in exile and beyond. His\ndoctoral thesis was on the history of Durban\u2019s dock workers he\norganized at that time. He has researched and written extensively on\nmunicipal services to the urban and rural poor, particularly on water\nand health.<\/p>\n\n\n\n

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Govender,\nPregs. 20 March 2020. Human Rights Day Letter to President Ramaphosa:\nOvercoming Inequality will help us overcome Covid-19, Maverick\nCitizen: Human Rights Day.<\/p>\n\n\n\n

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Nordling,\nLinda. Mar. 15, 2020. A ticking time bomb\u2019: Scientists worry about\ncoronavirus spread in Africa.\nhttps:\/\/www.sciencemag.org\/news\/2020\/03\/ticking-time-bomb-scientists-worry-about-coronavirus-spread-africa<\/p>\n\n\n\n

SA\nFederation of Trade Unions. March 24, 2020. The state isn\u2019t pulling\nits weight! The anti-viral lockdown is a social-distancing start \u2013\nbut fiscal stinginess and tight monetary policy risk a rebellion born\nof extreme desperation.<\/p>\n\n\n\n

Statssa.\nGeneral Household Survey, 2018.\nhttp:\/\/www.statssa.gov.za\/publications\/P0318\/P03182018.pdf<\/p>\n\n\n\n

Valiani,\nSalimah. \u2018Poorly Behaved Nurses\u2019 and Inequality in SA\u2019s\nHealthcare Sector. February 21, 2020<\/p>\n\n\n\n

Von\nHoldt, K. & Maserumule, B. 2005. ‘After apartheid: Decay or\nreconstruction in a public hospital?’ in Webster, E. & Von Holdt,\nK. (eds.) Beyond the Apartheid Workplace: Studies in Transition.\nScottsville: University of KwaZulu-Natal Press<\/p>\n\n\n\n

\nWong,\nEmily, Faculty Member, Africa Health Research Institute, University\nof KwaZulu-Natal. TB, HIV and Covid-19: urgent questions as three\nepidemics collide, March 24, 2020.\nhttp:\/\/theconversation.com\/tb-hiv-and-covid-19-urgent-questions-as-three-epidemics-collide-134554<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

“Disasters are political. Disease is also political. Class determines who has medical aid and who does not, who has access to water, sanitation and safe means for heating and lighting and who does not.“ Abahlali baseMjondolo (homeless people\u2019s movement), 22 March 2020 David Hemson writes: With a declaration of a state of disaster by President […]<\/p>\n","protected":false},"author":3,"featured_media":98,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[2],"tags":[],"_links":{"self":[{"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/posts\/97"}],"collection":[{"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/comments?post=97"}],"version-history":[{"count":0,"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/posts\/97\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/media\/98"}],"wp:attachment":[{"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/media?parent=97"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/categories?post=97"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.protectthepeople.co.uk\/wp-json\/wp\/v2\/tags?post=97"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}