Insights

Covid-19 preparedness: Townships, downtowns and informal settlements

By Mmamoletji Thosago 

There is an urgent need to slow the spread of the coronavirus (Covid-19) in SA, irrespective of location. Urban areas likely to be hardest hit. Townships and informal settlements accommodate the majority of those urbanising from rural areas as well as migrants from other developing countries. The coronavirus thrives in crowded zones.

On Sunday afternoon I scouted three townships and one Johannesburg downtown market to casually assess preparedness.

Johannesburg downtown market; mood: ready

The Kwa Mai Mai market seems prepared for a Covid-19 outbreak. This is predominantly a medicine market after all – traditional medicine. There are also food stalls, traditional healers, traditional clothing venders, informal car washers, a tavern and primary boarding school. I noticed that all food stalls have water basins and soap. Across the street there is a running tap – works well for car washers but anyone can make use of it, so I washed my hands using a car washers’ green dishwashing liquid, which is used as a car soap.

Ekurhuleni; mood: business as usual, no urgency

Sadly, I do not find any Covid-19 preparations in Katlehong and Thokoza township markets in Ekurhuleni, despite these markets being adjacent to several health clinics. Economic survivalist mode has taken the upper hand here. The food vendors have wet hand cloths but that is inadequate for the virus outbreak. From casually conversing with Bo mma (female food street vendors), I’m informed that business has always functioned this way and they can only stretch a rand so far.

Across the road one guy is sharpening his skinning knife between two pavement bricks. No, he does not rinse it. He skins iskopo (cow head, a food delicacy for men – cultural symbolism is that men are heads of the homestead), with that same unwashed knife. There is no running tap close by to wash it.

I need to use the bathroom and go down the road to the nearest petrol filling station. Bathroom usage is charged at R2; the door has a slot just for R2 coins. I feel cheated: there’s no toilet paper, the toilet does not flush properly and the soap dispenser is empty. If you do not walk around with toilet paper and a hand sanitiser in your bag, you are in trouble.

Vilakazi Street, Soweto; mood: not losing the market to Covid-19

Vilakazi Street attracts tourists interested in township apartheid history. Its restaurants and that helicopter/wax statue place are fully prepared. There are water, sanitation and hygiene (WASH) items including hand sanitisers and wet wipes. These restaurants are owned and managed by locals and they are aware of and practising ways to reduce the virus’ spread. I will be having dinner here, there is a reasonable African cuisine buffet special plus I can use a contactless payment method when settling the bill. Most importantly, I can wash my hands.

Rapid awareness coupled with concrete intervention is needed to curb transmission as much as possible. Critical experience from China is that during the initial outbreak in Wuhan, the response was not rapid and the virus spread swiftly. Across the rest of China, rapid response was applied and transmission cases dropped.  Based on my Sunday afternoon observations I suggest the following rapid interventions:

Rapid intervention suggestions  

Government

  • Governments need to have a unified message across all spheres and platforms. This should curb the emergence of misinformation and fake news.
    • Awareness posters should be displayed at taxi ranks, bus stations, train stations, open markets, street poles and places of gathering such as community halls, churches, schools, etc.
    • Municipalities with public Wi-Fi hubs, such as Tshwane (Tshwifi), should forward awareness video clips to municipal account holders’ cellphone numbers.
  • Water and sanitation (WASH)
    • Water and soap are not readily available in the informal sector, including at food vendors. Some areas are underserviced, particularly informal settlements.
      • Government should make use of community care givers to distribute hand sanitisers door-to-door including to informal traders. Some would be from the Isibindi programme, whose child and youth care givers are already trained to deal with households infected and affected by HIV/Aids.
    • Build trust and assurance with communities
      • Train and educate community leaders. They are often asked for advice.
      • Inform communities about the symptoms and the importance of self-isolation and teach them about the procedures to get screened and treated if symptoms develop.
      • Ensure communities that updates on family members in quarantine will be maintained.
      • Respect community cultures while also limiting spread – lessons from the Ebola outbreak revealed that handling the deceased during burial rituals without protective gear increased spread. Ensure that the deceased are buried in a safe yet culturally dignified manner.
    • Establish mapping tools for monitoring purposes. For instance, exchange information with pharmacies on sales to track spreads, especially for newly infected locations.
    • Zone hotspots: clearly mark red and green zones to ensure rapid response in critical zones.
    • The R5bn fiscal contingency reserve and R35bn s16 PFMA emergency expenditure limit should be used for rapid investment into healthcare and for necessary equipment purchases such as ventilators – especially into township and informal settlement areas that will be most affected.

Schools

  • School principals and teachers and school governing bodies should be trained and informed about Covid-19.
  • Posters on symptoms, preventive measures and nearest screening locations should be on classroom walls and handed to children to pass on to their parents/guardians.
  • To avoid delayed and disrupted curricula due to the closure of schools:
    • Online curricula platforms should be updated and circulated
    • Lessons should be conducted via radio and TV channels or online

Business

  • Businesses should support working from home for workers wherever possible or provide alternative means of clean transport to avoid use of crowded public transport (not everyone would have been screened and tested prior to commuting). Working from home support may include supporting the upgrade of home Wi-Fi. Telecoms companies should explore offering large-scale roll out of dongles to support this at cost price on temporary contracts.
  • Office entry points should have a sanitiser bottle within reach.
  • The World Health Organisation mentioned that contaminated cash might be a common carrier. Banking platforms mimicking mobile money need to rethink the platform and come up with inventive ways to allow a receiver to transact without needing to withdraw cash – Zimbabwe’s EcoCash is an inspiration.

Labour

Organised labour represents labourers with financial precarity who are likely to continue working as their jobs are a necessity not only for themselves but most likely for other family members – multigenerational financial support (referred to as black tax in SA).

  • Organised labour should cooperate with businesses in ensuring that workers are screened, and transport systems are clean and safe.
  • Quarantined labourers need to be protected and be entitled to their sick leave with pay.