About 60% of community health workers, including lay counsellors, home-based care givers and TB DOTS supporters have been paid their stipends of R1 500, despite promises that all payment would have been effected by last week. The Department blames the slow processing of payment on the late submission of contracts for this financial year by non-governmental organisations which contract the services of community health workers.

‘€œSome of the delays are caused by the NGOs’€™ late contracting with the districts. We had meetings and it was agreed that NGOs must have signed their contracts with the districts by the first week of August, but it took longer for some NGOs’€, says Dr Zuki Pinini, of the HIV and AIDS and STIs Directorate in the Gauteng Health Department.

But Pinini concedes that the department’€™s own finance systems are also to blame.    

‘€œIt also depends on when the contracts are received by the provincial office. For those who submitted on the due date, in the next 10 days they will be paid. From the time the finance (department) receives the contracts, it takes about two weeks. But, also, we’€™ve got a system that has got restrictions. It processes a certain number of claims at a time. So, it may vary from 10 days to 15 days’€, she says.

She says all lay counsellors and care givers in the Ekhuruleni district on the province’€™s East Rand have been paid up to the month of July. But there are delays in paying workers in other districts. The counsellors have vowed that they will not return to work until they have all received payment.

‘€œWe don’€™t have any choice. We are going to sit down and not go back to work until (the) last person (has) been paid. They pay a certain group. They want that group to go back to work. It’€™s not fair. If they pay, let everybody get paid. If we decide to go to work, all of us will go to work. But if we don’€™t decide to go to work, all of us will do that’€, says Lucky Mokone, a member of the lay counsellors task team in Gauteng.      

‘€œHome-based carers and DOTS supporters are not paid. Those people work hard every day. Some of them have not been on strike. They are working’€¦ helping patients in the field’€¦ in each and every community. So, it is unfair for them not to be paid at all, even if (it’€™s for) a single month’€, adds another task team member, Balise Mahlangu.  

In some districts, community health workers have gone without pay since April and this has taken a toll on them. Mahlangu appeals to the national Health Minister, Dr Aaron Motsoaledi, to intervene.

‘€œThey treat us as door mats ‘€“ which is painful to us. Some of us are on treatment. They need this money to buy food for themselves. It’€™s so painful to stay more than four months without being paid and you are expected to go to work every day. And how do you survive as an individual caring for someone who is hungry and very, very ill and you, yourself, are also hungry and sick? It doesn’€™t make any sense. We are working eight hours a day. Some of us are working more than eight hours (a day), especially those who work in the field and in the hospitals. Then, we are suffering from not being paid. We are oppressed. The Minister has got to make sure that the oppression is stopped and we are not excluded anymore’€, she says.

The Gauteng Health Department says it is working on devising a system that will ensure that community health workers don’€™t encounter the problem of non-payment following this saga.

‘€œWe, as a department, are working on a plan on how to work with our counsellors and carers and what is the best method that can be used for their payment. The Department is still looking at that. We’€™ve got options, but we have not chosen one yet’€, says Dr Zukisa Pinini of the HIV and AIDS and STIs Directorate in Gauteng province.      

A meeting between the department and the workers is scheduled for the 4th of September to discuss these options.