South Africa is an incredible country caught between great potential and difficult times. Poverty is rife and countless people are living under abhorrent conditions. Many schools are ill-equipped to provide children with a decent education, and healthcare is limited or inaccessible to those who cannot afford private care. Although social safety nets do exist they are either rapidly depleted or plundered through state-captured mechanisms. These conditions combined with (and contributing directly to) extreme levels of unemployment leave the majority of South Africans desperate and needing to ‘hustle’ for whatever informal work and alternative income streams they can muster.
Into this mix of socio-economic disparities enters the global disaster that is COVID-19.
PANDEMIC PROBLEMS, STATE SOLUTIONS
Pandemics the world over follow transport routes. They are a close friend of the traveller, the frequent flyer, the public transport user, and South Africa was no different: the virus secreted in on the back of travellers unwittingly enlisted in its spread. South Africa’s initial response to COVID-19 was swift and uncharacteristically decisive. Lauded by the World Health Organisation for taking immediate action to prevent the spread of COVID-19 infection, we appeared to be making great strides in comparison to many of our first world counterparts. Non-pharmaceutical/behavioural interventions, screening and testing, and contact tracing have rapidly been touted as foremost in our prevention armoury, and South Africans were quick to adopt as many of these new measures as their lifestyles and livelihoods allowed.
After almost half a century of responding to HIV/AIDS and TB, this is not our first pandemic; South Africans are no strangers to the devastating effect of an invisible threat. The move by Government to enlist the support of scientists from the outset of the pandemic was in brilliant contrast to their response during the early years of South Africa’s AIDS denialism response.
However, recent posturing by scientists and politicians have brought to light concerns that our response to COVID-19 is imperfect, and there is a desperate need to recursively review strategies and information in order to continuously adapt as more information becomes available.
Furthermore, the structural reforms required to bring about true freedom and equality in South Africa are yet to be fully implemented. This lack of reform complicates the threat to our current response to the pandemic. Given the vast inequality in access to resources for most citizens, avoiding the impending onslaught is all but impossible without swift, proactive support and reform, underpinned by a collaborative and transparent approach.
SMALL NECESSITIES = MASSIVE RESULTS
While the first few cases of COVID-19 were quickly detected, and transmission remained relatively controlled to small and wealthy communities, the virus has now spilt over to areas where structural drivers see high density and under-resourced individuals unable to access clean water for handwashing and where physical distancing is all but impossible.
In such settings, where unemployment is high and job security is low and where starvation has become the reality for even more people than before the lockdown, behavioural interventions of masking-up, physical distancing and hand washing (let alone sanitiser) appear to be dystopian luxuries.
When caught between starvation and infection prevention, starvation inevitably and obviously wins out. Many are forced to stand shoulder-to-shoulder in long queues attempting to access social grants and food parcels from public facilities that have, despite efforts to rapidly capacitate themselves, been largely overwhelmed and under-resourced for decades. This risk is compounded in places of work such as factories, mines and warehouses requiring staff to be in close contact despite the dangers.
Wearing a mask, although not a perfect solution, goes a long way to protecting oneself and those around you. There are studies proving that 100% mask compliance could completely flatten the next curve, allowing our economy to safely reopen. However, incorrect mask wearing etiquette results in an increased risk of self-infection. Mask design and appropriate community-level education are vital to ensure this intervention can help prevent onward transmission of COVID-19.
To protect workers, across the many economic hubs, requires a level of empathy by corporate citizens beyond what has previously been engaged in, though this is ultimately to their benefit – sick workers and sick customers directly affect your bottom line. It entails swift action to revise processes that guarantee staff buy-in, while simultaneously ensuring that staff are protected not only while travelling to-and-from work, while at work, but also within their social environment.
This requires corporations to understand their employees’ individual struggles and living conditions and provide appropriate support mechanisms. Institutions and organisations, from schools to mines, home affairs to factories need to critically evaluate the interventions they have rapidly, albeit bravely, put into place in order to ensure they remain relevant and sustainable to protecting their teams.
Without workers, our industries will fail.
Without schools, clinics, hospitals, libraries, social services, municipal buildings, courthouses and other social services, South Africans are left stranded.
CEMENT OUR FOUNDATIONS WITH SOLUTIONS
Within this context, it is vital that we nurture grassroots-driven movements, allowing communities to guide how we implement behaviour change, and how we mobilise under-resourced settings where structural drivers impede individuals’ abilities to enact recommended COVID-19 prevention interventions.
We are a country that has been left bare by colonialism, Apartheid, and the continued structural and institutional corruption. The result is a country at massive risk of collapse, expedited by the arrival of SARS-COV-2. And so we watch as transmission becomes increasingly entrenched amongst the poor and working class… what are we going to do?
For a big-picture solution we need more effective infrastructure at schools and clinics; we need cities that ensure even the poor and marginalised have access to housing, fresh running water, and electricity, regulations that are geared to protecting workers, and large-scale investment into healthcare personnel and teachers… But we won’t get that while COVID-19 is waiting like a bull at the gate.
And so, for now, we have to settle for a compassionate but powerful response: physical distancing, mask wearing and hand hygiene. We need to make this easier and more affordable for the most vulnerable amongst us, because they are us. To quote Ghandi, we need to lead the change we want to see.
There is great potential in the smallest of actions.
Our value systems are being tested, but they all – from economy to humanity – will demand we do the best we can.
To protect me. To protect you. To protect our children.
To bring great and powerful change, together, to our country.