Community Careworkers continue to work without personal protective equipment (photo essay)

During the early days of lockdown the community care workers were not issued with adequate gloves and masks to perform their duties safely. Archive photo by Lilita Gcwabe

The Michael Mapongwana Community Health Clinic operates in the Khayelitsha Health District of Cape Town’s Metro Region. During the Covid-19 pandemic and lockdown, community careworkers have been deployed to different areas in Khayelitsha to seek out defaulting patients, door-to-door, and convince them to get back on their medication, as well as handing out condoms for the ongoing promotion of safe sex in South Africa. Elitsha walked a day in the shoes of Cynthia Tikwayo while she did her work in the Ndlovini informal settlement in Khayelitsha together with a team of community careworkers – Nyameka Landzela, Nokhanyo Kili and Nombongo Jekem.

Cynthia Tikwayo said she wanted to become a nurse but her parents could not afford to send her to college because they were poor.
Tikwayo leaves her home before 09h00 every morning for the briefing given to community careworkers before going into the field every day. She has been traveling by foot as taxis are only transporting a few passengers as per the lockdown regulations. Though they are expected to report for duty every day, the transport of careworkers is their own responsibility.
The team set out after the briefing to begin with their work on the streets of Ndlovini. Kili and Landzela walk around handing out condoms and kindly encouraging men and women to practice safe sex, many of whom ask for gloves and masks instead.

The demarcation put into effect by the Department of Health has placed healthcare workers far from their homes and often in unfamiliar townships where they have to locate the homes of their patients on their own, leaving them vulnerable to getting lost and violated.

Another aspect of their fieldwork includes “household” visits. As some patients haven’t disclosed their status to their families, going to deliver their medication can be a challenge. Sometimes, they are welcomed and at other times they are greeted with blank stares and are ignored and left outside the gates or boundary walls with no permission to enter.
Each member of the team was given one pair of gloves to work with and one mask which they are expected to use for a full seven working days. They are told to only wear the mask when interacting with a patient in their home and not when between places. Tikwayo wears her mask in preparation for a household visit standing alongside Jekem.
Household visits include checking on the patient’s health and well-being by determining whether they are on track with their medication, using the Catch and Match book that they travel with for this purpose. Tikwayo is seen with one of her patients, Zamubuntu Geja.

“We don’t know whether or not we are infected with the virus. We have not been tested and we don’t have enough personal protective equipment,” Tikwayo expresses to Elitsha, noting that all she knows about the Covid-19 virus is what’s she’s heard on radio and TV as they never received any training in preparation for their fieldwork.

Tikwayo told Elitsha that she wishes the Department of Health and her employer would include healthcare workers in the plans they have regarding the work that they do in the field, especially in situations like a pandemic, in order to have strategies that are better suited to the communities that they serve and that are safer for them to continue doing the work, and more efficiently.
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