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Infectious Diseases

Updated 29 May 2020

Covid-19: The plight of gogo Nobude and other old persons living in townships

Nobude Ngqola is 82 years old and lives in a leaking shack with her eight children. She has been terrified to leave her shack ever since she heard about Covid-19. Siyabonga Kamnqa visited her to talk about life under lockdown, her Covid-19 fears as an older person and her hopes that a house will improve her situation.

The tiny passageway leading to gogo Nobude Ngqola’s shack in the densely populated TR Informal Settlement in Site B, Khayelitsha is difficult to navigate. Washing hanging from fences and shacks built metres from each other makes it difficult to move freely. Despite the warnings about physical distancing, women sit in groups in the shade busy with laundry. They are not wearing masks. It’s an unseasonably hot day for May.  

We talk inside the tiny three-room shack that the 82-year-old gogo shares with her eight children and grandchildren. Seated on a worn-out sofa sipping tea, Ngqola says she has been terrified to leave her shack ever since she first heard news of the spread of Covid-19.

On 24 May, the Western Cape government reported that there have been a total of 1 853 confirmed Covid-19 cases in Khayelitsha – a number that is greater than that in some of South Africa’s provinces.

Leaky shack

It may be sunny outside today,  but Ngqola’s  daughter, Nomawesile Adonis (39), says when it rains things can get bad very quickly. Winter is not the best time for Ngqola and her family. “Water pours through the gaps and turns the shack into a mud pool,” she says pointing at the holes in the roof. 

To keep warm during winter, the family often relies on an imbawula (a makeshift fireplace/coal stove), but when a neighbour got burnt and killed by an imbawula, the children decided to buy a paraffin heater. “But many of our neighbours still rely on an imbawula to stay warm despite all its dangers,” says Adonis. “We are just hoping that our long wait to get a house can come to an end soon,” she says.

Ngqola says “back in her day” there were no deadly diseases like Covid-19. “We only heard tales from our grandparents about a deadly flu disease that claimed many lives some years ago,” she recalls. “I have gathered a lot of information on the radio about this virus. I always cover myself with my scarf whenever I sneeze. Fortunately, I am always alone in my bed.” 

Ngqola recalls how she arrived in Khayelitsha in 1987 from the Eastern Cape in search of greener pastures. “I found a job as a domestic worker. Despite the little money I earned I managed to save some and bought material to build my own shack,” she says. Now, 33 years later and still living in an informal settlement where there are limited basic services, Ngqola has to share an outside tap and toilet with dozens of her neighbours.

She recalls attending several rallies in Khayelitsha prior to the elections in 1994, where politicians promised houses for the poor. “I registered together with many others in the hope that I would move into a new house soon. But a number of years passed without getting any house,” says Ngqola.

Now aged 82, frail and battling diabetes, Ngqola tells Spotlight her only wish is to finally get keys to a new house before she dies. With the Covid-19 pandemic ravaging the Western Cape, Ngqola lives in constant fear of contracting the disease, mostly because her living arrangements are particularly dire for someone her age.

'Mission Impossible'

Ngqola’s fears are not misplaced. People over the age of 80 years and those with chronic diseases have been shown to be most vulnerable to Covid-19. Dr Tom Boyles, an Infectious Diseases specialist at Helen Joseph Hospital in Johannesburg, recently raised concerns about the effect of the deadly virus on the poor. “If and when there is significant community transmission in SA, I think people living in informal settlements will be at the greatest risk of infection because they will find the preventative measures [physical distancing, hand washing] more difficult to adhere to," Boyles was quoted as saying.

The People’s Health Movement (PHMSA) has been calling on government to fix the social determinants of health that include decent housing, access to clean water and sanitation and good nutrition.

While the Covid-19 lockdown regulations state that people should stay at home and practice physical distancing, Ngqola says where she lives, is a “mission impossible”. Sharing an outside toilet and tap with dozens of other shack dwellers puts her at high risk.

“I often listen to the radio and hear them say we must practice physical distancing. How do you do that in an environment like this? This Corona is going to claim many lives in informal settlements. I know I am old and sickly and can die anytime. But I’m just worried – more about my children,” she says.

With winter approaching Ngqola’s daughter is also worried.

“Winter in Cape Town means shack fire season. Our biggest concern is what will happen to her in case of a shack fire. Her legs are failing her, and someone has to help her to the outside toilet. But we always have someone with her in the shack in case of an emergency,” she says.

Adonis says winter also means shacks are flooded during heavy rains. They have to mop up water whenever there is flooding, she says. Ever since the outbreak of Covid-19, Ngqola’s children have ensured that they keep their distance and wear masks whenever they serve her porridge or help her go to the outside toilet. 

But it is difficult.

'No elderly person deserves to live like this.'

Adonis, who works as a domestic worker, knows the high risks of Covid-19 and says she always buys sanitiser for her mother and siblings. They are however grateful for the food donations they regularly receive from neighbours during the Covid-19 pandemic.

Recently Ngqola was also among 10 families who benefited from food parcels donated by local football stars Mark Mayambela and Ayanda Patosi who both grew up in Khayelitsha.

“No elderly person deserves to live like this. I just can’t imagine how she has managed to survive all these years. We will definitely return and see what we can do to improve her situation. With winter approaching, something needs to be done to repair the leaking roof. But she needs a house as a matter of urgency,” Mayambela said.

Umelwane (neighbourhood friend)

Ishrene Davids from the organisation Ikamva Labantu tells Spotlight that for an older person like Gogo Nobude who is frail, accessing help can be nearly impossible.

Davids says their home-based model provides an essential safety net to support both frail older persons and their caregivers in township communities. “Our fieldworkers walk door-to-door throughout Cape Town’s townships, searching for senior citizens in need of support,” says Davids.

They refer to these fieldworkers Umelwane, which means "neighbourhood friend" in isiXhosa. “These clubs follow a stimulating programme which includes education around healthy living practices, creative activities (beading, choir practice, sewing etc.), social entrepreneurship, as well as eating breakfast and lunch together every day. Importantly, they are able to be among their peers in a social environment, away from the stress and isolation of their homes. Our senior participants also have access to the emotional and physical support that our field workers provide,” she says.

The organisation operates 21 Ikamva Labantu Seniors Clubs around Cape Town’s township neighbourhoods but had to stop on 17 March 2020 as a precautionary measure to ensure physical distancing.

Government responds

When approached for comment on what the department is doing to safeguard older people like Ngqola in township communities, Mark Van Der Heever, spokesperson for the Department of Health in the Western Cape referred Spotlight to the Western Cape Department of Social Development.

During a media briefing this week, however, Dr Keith Cloete, Head of the Western Cape Department of Health, said Khayelitsha is among the hotspot areas the department is prioritising. Cloete said part of the department’s refined strategy is to focus and streamline testing and screening on “high-risk groups such as health workers and the vulnerable people”. Those older than 55 with comorbidities like diabetes are deemed “vulnerable”.

Spokesperson for the MEC for Social Development, Joshua Chigome, said there are facilities such as old-age homes where the sick and elderly are accommodated but a decision is taken by the family of the elderly whether they want their loved one to be taken to an old-age home. “Most families prefer to take care of their elderly themselves. We are unfortunately unable to decide for them if their granny needs to be taken into one of the facilities that we provide as the department,” he said.

Chigome said that if the elderly people, like Gogo Nobude, show symptoms of the Covid-19 they should "immediately go to the clinic and get tested" He said older persons in communities that are not living in care facilities are targeted and exposed to the same messaging and campaigns aimed at all citizens by the media. 

Khayelitsha Development Forum (KDF) chairperson Ndithini Tyhido told Spotlight the Covid-19 lockdown period has left many elderly shack dwellers high and dry.

“The sad part is that these are people who are at high risk of contracting the coronavirus. Our call to government is that they should prioritise densely populated informal settlements by providing free sanitisers and masks,” he said.

Meanwhile, ward councillor Lulekwa Jali said they are aware of Ngqola’s plight and her matter was forwarded to authorities for urgent intervention. “We’ve engaged with relevant authorities in the City (local government) and they agree that something needs to be done to assist her. It is painful to see an elderly woman living under such poor conditions,” she said. 

This article was produced by SPOTLIGHT – health journalism in the public interest. SIGN UP for our newsletter.

Image credit: Siyabonga Kamnqa, Spotlight