The Western Cape Division of Well being and Wellness says it has no plans to adjust to a 2025 Labour Court docket ruling that neighborhood well being employees (CHWs) have to be absorbed into the formal well being workforce.
For many years, CHWs have been functioning as part-time employees, employed on a contractual foundation, incomes stipends, with no pension advantages. Most of those employees had been employed by non-profit organisations, and contracted by numerous provincial well being departments. The court docket dominated that CHWs have to be absorbed into the well being departments’ formal labour pressure, the place they’d earn salaries and qualify for a pension.
However the Western Cape just isn’t planning on altering its relationship with CHWs.
“Over time, we have now constructed sturdy partnerships with non‑revenue organisations that recruit and make use of the neighborhood well being employees, guaranteeing providers are tailor-made to the wants of the neighbourhoods they know greatest,” Maret Lesch, a spokesperson for the provincial well being division, tells Well being-e Information.
In line with Lesch this mannequin has been efficient and sustainable, and the province will proceed to associate with NPOs.
“We recognize the very important contributions of each neighborhood well being employee and can proceed working with our companions to make sure they carry out their roles with the respect and help they deserve,” Lesch says.
Partnering Organisations
Nobuntu Mfengwana (53) is a CHW in Cape City working for Philani Vitamin Centre, one of many NPOs contracted by the division.
“Being thought to be a necessary employee looks like an insult to me. I see myself as a susceptible employee,” says Mfengwana.
She’s been working as a CHW for various organisations since 2012, gaining intensive expertise over time. She earns R4900 month-to-month – an quantity she says just isn’t sufficient to satisfy the fundamental wants of her household of 9.
Like many CHWs, Mfengwana is hopeful that the Western Cape well being division will finally observe the lead of different provinces and combine them into the formal well being system. However this appears unlikely.
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“Within the Western Cape, we’re stored at midnight. The DoH stays silent on this concern. We see different provinces making progress in using CHWs inside their well being methods. Figuring out if the Western Cape won’t pursue that route could be preferable to being left uninformed,” she explains.
Provinces such because the Free State, Northern Cape, Limpopo and Gauteng have began absorbing CHW into the everlasting well being workforce.
Working beneath excessive circumstances
Group well being employees usually spend their days conducting house visits, strolling in neighbourhoods that ambulances generally don’t attain.
“Crime is rampant within the communities we serve, and we threat shedding our cell telephones and gadgets, and even our lives, when doing fieldwork,” Mfengwana says.
The work they do contains tending to severely unwell sufferers. The COVID-19 pandemic highlighted the important operate of private protecting gear (PPE). However her superiors seem detached. “Gloves, aprons, and masks are at all times in brief provide. If you happen to don’t get any, you’re by yourself,” she says.
Mfengwana recounts strolling lengthy distances between house visits, generally with a number of visits that required strolling half-hour aside. She believes transport must be supplied to succeed in every day targets. “Throughout Cape City’s wet winters, we’re supplied with gentle jackets, and on scorching summer time days, we stroll kilometres with out solar safety,” she says.
Poorly paid stipends
In line with Mfengwana, their workload usually exceeds their official duties, but the Western Cape Division of Well being doesn’t appear to worth their efforts. Mfengwana notes that over the previous 14 years of service, she has needed to reapply for her job yearly.
Philani Vitamin Centre didn’t reply to our queries.
Cynthia Tikwayo started her neighborhood healthcare service in 2011, and has at all times been vocal concerning the disagreeable circumstances by which they work. She at the moment serves as a CHW at Michael Mapongwana clinic in Khayelitsha, working for TB HIV Care. Her month-to-month stipend is R3700 a month.
“The stipends are decided by the Western Cape Division of Well being and Wellness, and are in step with the nationwide minimal wage stipulations”, says TB HIV Care spokesperson Aziel Gangerdine.
He provides that they haven’t acquired any complaints from staff concerning disagreeable working circumstances and PPE points.
“Inner processes are in place for all employees to boost issues associated to office challenges,” Gangerdine says.
TB/HIV Care is predicted to signal an settlement with the provincial well being division to proceed rendering well being providers.
Mobilisation of CHWs
Tikwayo is looking on employees within the Western Cape to unite and organise, as a substitute of boycotting strikes organised by competing unions. “Unions representing the CHWs are politically competing, and I want this might come to an finish. The employees are divided due to the politics throughout the unions,” she says.
She believes that the WC well being division will, sooner or later, completely make use of the CHWs.
“I do have hope that someday, we will likely be absorbed by the Division of Well being and be entitled to the advantages of everlasting employment. We name on the federal government to cease outsourcing this service.”
In his 2025/26 price range speech, Well being Minister, Dr Aaron Motsoaledi stated R1.4 billion had been put aside for the everlasting employment of 27 000 neighborhood well being employees. The nationwide well being division didn’t reply to queries concerning the strategy being adopted by the Western Cape. – Well being-e Information
