South Africa: Eastern Cape's Struggle Against Covid-19 Continues

Workers in the healthcare and funeral industries continue to face life-threatening situations even as the number of coronavirus infections in the Eastern Cape is dropping.

A slight decline in the Covid-19 infection rate in the Eastern Cape has been welcomed by healthcare workers, those in the funeral industry and businesses catering to tourists. But the province, which suffers from systemic problems with providing adequate healthcare, has to be vigilant as the system remains fragile.

Livingstone and Dora Nginza hospitals struggle with a shortage of beds, insufficient oxygen tanks and poor infrastructure. Authorities have reshuffled hospital management on several occasions to try to better the situation.

In December 2020, the Department of Health and the World Health Organization reported that a new variant of Covid-19 was discovered in the Nelson Mandela Bay Metro. This came out after a fresh surge of more than 179 000 infections in the province.

This second wave resulted in an alarming rise in hospitalised patients from mid-November in the metro. Nurses claimed that management at the Livingstone Hospital instructed staff that patients would no longer be tested on arrival and that only those who were symptomatic were to be isolated. This, in their opinion, contributed to the province's high infection rate.

In early December, the metro was identified as a hotspot and a 10pm curfew was imposed. Later, more municipalities in the province became hotspots, including OR Tambo, Sarah Baartman and Buffalo City Municipality.

"The cases in December were averaging between 1 500 and 1 700 daily, however, the picture has ... changed in that the number [has] dropped to below a thousand daily, averaging [at] about 700 daily," said provincial head of communications Siyanda Manana. "The Nelson Mandela Metro and Sarah Baartman have shown dramatic improvement since the intensification of interventions. There is still worry though in districts like [Buffalo City Municipality], Amathole, Chris Hani [and] OR Tambo."

Stressed healthcare workers

Those on the frontline have been working tirelessly since the outbreak. Many others have lost their lives - the death tally of health workers in the province increased to 161 by December. In the midst of the gloom of 2020, the decrease in the number of infections by mid-December was welcomed by health workers who feel emotionally distressed by losing colleagues and being at a greater risk of infection.

A nurse at Livingstone Hospital said: "We saw the magnitude of the pandemic. People were dying at every corner. We lost colleagues, and this would make us think, 'What if we are next, what will happen to our children?'

"I have two children and every day I dreaded going to work. I still do. When the numbers were dropping, we forced management to give us a few days leave so ... we [could] recuperate. I took only a week off work but that week I was the happiest I've been in months, and when the leave came to an end, I literally cried the day before I had to go back to work.

"When my family and I were watching the presidential address, my youngest daughter burst into tears. She is only five years old and can barely understand English but when I asked her why she was crying she said she wanted me to stop working now. I was shocked. I had to convince her that I wasn't going to die but I was giving her false hope."

The nurse continued, "There are times when I just wanted to resign but the management at Livingstone told us we can't resign during a pandemic. After all of this is over, nurses will be admitted [to] psychiatric hospitals. This is just stressful to us and our families."

As infections decreased, Livingstone's on-duty staff said this eased their anxiety. "We are seeing [fewer] patients admitted. Currently there are [fewer] than 16 patients in three wards and the rest of the wards have at least 10 patients. We are really seeing a decrease," said Xolisile Booi, shop steward for the Young Nurses Indaba Trade Union.

Although new infections in the Eastern Cape are said to have decreased, there are concerns over the alarming rate of Covid-related death in the province.

"The hospital [Livingstone] has its own mortuary, the management hired extra porters to help with the transportation of bodies. When nurses helped porters transport bodies to the morgue, we found that there are bodies outside the refrigerators. When we asked why the bodies were laying outside, they told us that the fridges are full and that there was no space for new bodies. The area smells as bodies are starting to decompose," said Booi.

Hospitality industry struggles

Lodges, hotels, bed-and-breakfast establishments and restaurants were among the worst-hit businesses during the hard lockdown. Many lodges in the Sarah Baartman District opted to close as travel bans halted tourism. When lockdown restrictions were eased, some reopened, attempting to quickly acquaint themselves with the new normal.

In East London, a guest house owner has been picking up the pieces after struggling to remain open over the festive season.

"The impact of the December lockdown caused a great loss of income. I had full bookings in my 25-room guest house and in December we had only five rooms occupied," said Noluthando Mahamba, owner of Ubuntu Guest House. "Guests cancelled and others just didn't pitch up. Some had booked nine days but cancelled on us. I am now considering retrenching some staff. I also have tourism students working at the guest house. I give them what I can but things are very difficult."

Overwhelmed undertakers

Since the beginning of the pandemic, funeral parlours have had the enormous task of burying those who have died from Covid-19 while running the risk of becoming infected. Undertakers are required by the state to bury Covid dead in three days and to wrap coffins in plastic as an extra precaution. As bodies flooded in, morgue workers across the Eastern Cape - which has had more than 8 662 deaths - were exhausted by the constant work. Burying four people a day, companies such as Sobekwa and Soji Funerals found the toll financially draining.

"Our business has been struggling to [keep its doors] open ... since the start of the pandemic. People have a false perception of funeral parlours. They think we have been cashing in [because of] the countless deaths of our clients, but this is not true. The regulations of the Financial Sector Conduct Authority states that local small-scale parlours [must] be underwritten [by] large insurance companies. This has made things difficult for us. When we need to claim from the insurer, it takes them weeks to pay up," said owner Ntobeko Soji.

"When our members need us to conduct their burial, we struggle to cover the costs and because of Covid regulations, we are required to bury a positive patient within three days. We have no choice but to go ahead with the funeral and cover the costs personally. We are running [at] a loss."

The second wave of infections concerned funeral workers, who worried they would have to close down in the face of the overwhelming demand for burials. Municipalities have not provided help.

"From March to November 2020, we couldn't keep up with the consistent deaths. We had a struggle with personal protective equipment (PPE) and, because we are financially strained, we wrote letters to the government requesting assistance but we never got a response," Soji said. "It seems the government was ... concerned with taxi drivers more than [with] us.

"Funeral undertakers are the ones at risk of infections because loved ones are not allowed to get close to the coffin, so when it is time for the burial, it is our staff [who] handles the coffin and buries the body while PPE [is] scarce, and we can barely afford [it]. We saw some form of relief from December 2020 to now, as the death rate has gone down. We are conducting [fewer] funerals a week. We need [the] government to intervene and assist local ... undertakers.

"We can't even afford to pay rent. We have since vacated our office space and sit outside the building in our car and wait for our clients there."

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