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Domestic workers: Access to healthcare difficult for most

Domestic workers: Poor quality of life a reality for many
Domestic workers battle for maternity benefits and care.(Photo: Freepik)
Written by Lilita Gcwabe

Although welcomed, the recent increases in the minimum wage for domestic workers do not translate into better health outcomes or a less stressful life for these women. Many have to weigh visits to health facilities or time to buy medicine against losing a day’s pay.

A Quarterly Labour Force Survey conducted by Statistics South Africa in 2020, revealed that one million people, mostly Black women, were employed as domestic workers. This number includes those who are employed full-time, those who live-in, and those who work part-time.

Last month, Employment and Labour Minister, Thulas Nxesi, announced an increase in the National Minimum Wage per hour worked. It increased from R21,69 to R23,19 from 1 March 2022.

However, many domestic workers in SA still experience long working hours and unfair pay. This leaves many vulnerable to a poor quality of life – unable to take care of their health needs and their families.

Domestic workers share their struggles

*Thulisile Ndonga has been a domestic worker for 12 years. She is from the Eastern Cape and currently lives in Mamelodi, Pretoria. Ndonga started cleaning at a hotel in 2013 and later moved on to houses in 2016. 

The 35-year-old has been living with HIV for three years. She has experienced several challenges when it comes to managing her health and work demands.

“I have to plan my days to make sure I will be able to go and get my medication. I haven’t been working as much lately, and mostly have part-time jobs, so that has made it easier. It gets difficult on days when I get very sick with flu and feel so weak that I cannot go to work. I have to call in and let them know I am not coming which puts me at risk of either losing my job or losing the money I would’ve made,” said Ndonga. 

She has only disclosed her HIV status to one of her three current employers because she fears discrimination. The possibility of losing her job has also entered her mind. 

“When they know that you are positive, they treat you differently if they even let you stay. It’s like they become worried or disgusted. You are either not allowed in certain areas of the house, allowed to touch certain things, or even sneeze,” she explained. 

A heavy burden to carry

She lives with and takes care of her elderly mother, two sons, and her nephew. Ndonga’s mother suffers from arthritis and requires constant support and medication. 

“We spend a lot of money on medication for pain management and ointments to apply on her legs and ankles. In 2019, I once spent hundreds on a new pillow because the doctor said that if we could not afford a new bed for her then we should try to get a pillow to alleviate the swelling in her lower back. I am lucky that my sons have had no serious illnesses or conditions which require visits to doctors,” said Ndonga. 

Ndonga said that she has been fortunate when it comes to her wages and has been paid fairly. But her concerns about being able to afford her and her mother’s medical needs are growing since her jobs are scarce. The money she earns has to go a long way as she is the family’s only breadwinner. 

Uphill health battles

A member from the South African Domestic Service and Allied Workers Union (SADSAWU), who wished not to be named, confirmed that accessing quality medical care is difficult for domestic workers in SA. 

“It is not easy for them to take days off work because they will lose money. So, many domestic workers continue working with pain until it worsens and requires attention. Some of them work overtime and receive no money for it. Employers complain and workers can’t get everything they need to get done at the clinic,” the member said.

She added that the increase in wages is welcome but means nothing to those domestic workers whose employers refuse to comply. 

Prone to depression and stress

“This increase makes little difference because of the rapid increase in the cost of living. Domestic workers come into our offices, crying about their salaries and how strenuous their work is. When they ask for increments, their employers threaten to replace them. There are only a handful of employers who are good to their workers.”

SADSAWU aims to educate workers about their rights and advocate for their fair treatment in the workplace. They also provide support to workers in their cases of unfair dismissal and wrongful practices at work. 

“Domestic workers are women who are single parents, sisters, daughters, and grandmothers. We see women still working at retirement age; waking up early to go and clean someone’s house. These daily challenges definitely make them vulnerable to depression and stress. Many of them are being paid below minimum wage and some are unemployed for long periods of time. Some are only working twice a week but have a long list of financial commitments to meet. There’s no money for school uniforms or even food. Depression and stress easily creep in and although we provide support by referral to help, many other workers suffer in silence,” said the SADSAWU member.

Finding time

Mara Mokena* is from the Free State and has been working as a domestic worker in Johannesburg since 2013. The 53-year-old lives a stone’s throw away from her local clinic in Tembisa.

“I have to make sure that there’s enough money for transport and food. This is in case I arrive at the clinic too early and only get helped in the late morning or afternoon. I have to often save up money since I don’t earn anything on those days,” said Mokena. 

Mokena said she often uses her lunch break to buy medication at a nearby mall. 

“I often get headaches and back pain. A few years ago, I sprained my ankle and I sometimes still feel pain on the left side when I have been on my feet for too long. After work, the pharmacies are closed in my area and haven’t opened by the time I leave in the mornings, so I buy it during lunch and eat on my way sometimes,’ she said. 

She suspects that she experiences back pain and headaches due to the toll her job is taking on her body.

“I have plans to stop working when I turn 60. I still have enough energy to carry on and need the money. But, doing this every day, is very tiring,” Mokena concluded.

Not enough to cover basic needs

Data from a SweepSouth study showed that the cost of living for domestic workers rose by 44% during the COVID-19 pandemic. This reflects a rapid rise compared to 2019. A domestic worker can be described as a single caregiver who sacrifices variable cost-items like food to stretch their earnings.

The study, which surveyed 1 300 domestic workers, found that standard industry rates are not sufficient to cover workers’ basic needs. The company is using this data to better understand domestic workers’ needs and to advocate for change in the sector – Health-e News 

* Not their real names








About the author

Lilita Gcwabe

Lilita is a multimedia journalist with an interest in rural advancement in the health and agricultural sectors. She’s committed to reporting on social justice, and early childhood development. Lilita believe in the power of representation, as an essential means of rewriting our stories.

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