Community Health Workers (CHW) are hailed as the backbone of health sector, and yet they remain underpaid and marginalised.

During the Covid-19 pandemic, the health department enlisted CHWs to bolster screening and testing. Many workers, though, say they are once again falling through the cracks, this time with shortage of personal protective equipment.

Sharing their stories

Ntando Ngobeni* has worked as a CHW in Tembisa since 2006 and says that despite some improvements, her employment status is yet to be changed from temporary to permanent staff.

“They took us from NGOs and brought us to the clinics but when we have to receive protective equipment, they tell us that it is for their staff, so we don’t know whose staff we are?” asks Ngobeni, adding that while she was supplied with hand sanitiser, but struggled to get masks.

“They should’ve tested us before we started going to the field. We do door-to-door screenings but we don’t know where we stand. They took us for one-day training and told us the PPEs will always be available but sometimes when we have to do screenings, they say masks aren’t available,” says Rose Mazibuko*, another worker.

CHWs earn a stipend of R3400, an amount that they say is too little for years of experience as frontline community workers.

“We are not benefitting anything. We go out to do screenings but we don’t know what is going to happen at the end of this. We get a stipend and we’ve been working here for years. What can you do with a stipend of R3400? I think they should take us seriously,” says Ngobeni.

“We want government to absorb us. We’ve been in this field for too long, since 2009. Some have even passed away and didn’t get anything,” adds Mazibuko.

Black women most affected

The majority of CHW are of women, falling through the wage gap between men and women across sectors. CHW workers, like other women, also have the burden of juggling work and raising families.

According to The Right to Dignified Healthcare Work, a report by Oxfam, black women who work in the health sector as nurses and CHWs are exploited and underpaid. The study also questioned the government and other healthcare officials have done so little to improve the working conditions of CHWs. The report also questioned why CHWs continue to work without medical aid and earn a “meagre” R3500, “if they are lucky.”

CHWs have for years been described as “volunteers,” despite their long work hours with insecure contracts. They are at the mercy of criminals as they work in the communities and are excluded from benefits such as the Compensation for Occupation and Injury Disease Act (COIDA), which would offer relief if they are harmed in the line of duty.

Nurses also affected

The report, which looked at the inequality within the health sector, found that the unfair labour practices and poor treatment of healthcare workers had left the quality of healthcare services compromised. This unfair environment leaves the country with a healthcare system that is ill-prepared for the COVID-19 pandemic.

Despite women making up 90.1% of nurses in the country, they remained invisible, unrecognised, sexualised, and undervalued, the report added.

The study also highlights the disparity between payment and hours worked. In some cases,  nurses can work more than 24 hours without taking a break.

#Care4Carers Campaign

Several organisations have come together for the #Care4Carers campaign to ensure that the human rights of healthcare workers are upheld and end inequality and injustice faced by CHWs and nurses. The campaign is also fighting for the delivery of quality healthcare services. The campaign is also calling for better compensation for women and fair and safe working conditions.

Oxfam South Africa, the Young Nurses Indaba Trade Union, the National Union of Care Workers of South Africa, the Treatment Action Campaign and the South African Federation of Trade Unions, have all come together for the #Care4Carers campaign. – Health-e News

* Not their real names.