It has been six months since the first case of COVID-19 was reported in South Africa. From the onset, it was clear that the spread of the virus would impact the country in a unique way and that addressing it would require a tailored response.
The country has high rates of comorbidities like hypertension, obesity, tuberculosis, HIV, and cardiovascular conditions, and people with comorbidities have a greater risk of developing complications when infected with coronavirus.
In South Africa, the spread of COVID-19 has also highlighted existing inequalities, including in access to health care.
Johannesburg-based advocacy organisation Rural Health Advocacy Project (RHAP) is working to ensure that South Africa's response to COVID-19 doesn’t leave anyone behind, including those in rural communities.
Global Citizen spoke with Russell Rensburg, the director at RHAP, about the organisation’s work in the time of COVID-19.
What is the biggest thing you want the general public to know about what you've observed and how the COVID-19 crisis has evolved?
We are primarily a health advocacy group, rather than a provider of frontline services, so our observations have been on a system level. At the onset of the pandemic, very little was known on how the pandemic would play out in the South African context.
What we did know was that globally, people living with non-communicable diseases, particularly those living with diabetes, had a greater risk of complications if they were infected with coronavirus.
In South Africa, there are over 3.5 million people living with diabetes, with only a third of these people currently on treatment. This means that potentially over 2 million people do not have their diabetes under control, which places them at incredible risk of COVID-19 complications.
We also know that, until we have a vaccine, the best way that we can protect ourselves and others is to strictly adhere to the non-medical interventions like handwashing, physical distancing, and wearing a mask.
We co-authored a study that surveyed over 6,000 people across economic statuses, and found that less than 60% of those surveyed consistently adhered to these guidelines.
So the big message we would give to people is to firstly wear a mask, physically distance when you can, and know your health status.
How is RHAP tackling the needs of various people and communities amid the pandemic?
As we don’t work directly with communities, our role has been primarily to support organisations working on the frontline.
Working with our partners we hosted a number of information sessions where experts orientated community organisations on COVID-19, how it works, and what can be done to protect oneself.
This is on the understanding that changing social norms is not easy and to do so successfully we need a whole society approach.
In addition, we also acknowledge that the pandemic laid bare the impact of poverty and inequality in our society and an increasingly weak state riddled with poor governance.
In this respect, we worked with other civil society partners like the Budget Justice Coalition and C19 People’s Coalition and Civil Society Forum that RHAP founded.
In these fora, we supported advocacy for stronger social impact mitigation like the increases of child support grants, disability grants, and old age grants, as well as the expansion of social security to include the unemployed. In addition, we also supported advocacy for increased accountability from the state.
What's the most inspiring thing you’ve seen as the world tackles COVID-19?
What has been inspiring is the increased focus on the building of a more inclusive society that is premised on a dignified life for all. However, this future will not be handed to us; it is something we have to fight for and the increased global solidarity can certainly aid that.
Has COVID-19, and the global response to it, changed your perspective of anything essential to your work?
Our response to this is evolving and, if anything, it has strengthened our view on the need for universal health care as a public good, rather than a commodity where access to health care is dependent on your socio-economic status — not your need for care.
We are also more convinced that health is much more than health care or treatment of disease.
Good health is determined socially and unless we address these determinants such as access to education, food, and so on, we will be ill-equipped to deal with the long tail of this pandemic.
How can people take action and help your efforts?
There are various things people can do. This includes acting locally wherever you are to support calls for more inclusive support to people in need. Amongst our founders is the Rural Doctors Association, which is an organisation of doctors working primarily in the rural hospitals.
As the organisation is part time, RHAP can facilitate channelling funding to hospitals to support activities that look at improving the conditions of health care workers including psychosocial support and rest facilities, as well as consistent access to personal protective equipment.
Many of these hospitals also have strong links to the communities in which they serve, and with funding can help support efforts to mitigate food insecurity, equip communities to make and distribute their own masks, and campaign to help community leaders support changing norms.
At RHAP, the pandemic has changed the way we work as the work has moved mostly online. We are having to learn new ways of work, as well as learning to communicate in a different way.
We would be interested in learning from others on how we can better support better dialogue and sense making.
We also anticipate greater engagement with partners at the local level, which will require us to travel more extensively within the country so access to an all-terrain vehicle would greatly aid our efforts.
This interview has been edited for length and clarity.