/ 19 July 2012

How government starves the welfare sector

Cerebral palsy patient Tsholofelo Phiri has personally appealed for her home’s survival.
Cerebral palsy patient Tsholofelo Phiri has personally appealed for her home’s survival.

"Please, please, please, I beg you! Who will take care of me?" This was 22-year-old Tsholofelo Phiri's appeal to the government to stop the closure of the West Rand Association for Persons with Disabilities. Phiri has lived there for three years. Born with cerebral palsy, she uses a wheelchair, has limited use of her hands and cannot speak, save to mumble "yes" or "no".  

Phiri was speaking at a meeting of welfare organisations in Langlaagte, south of Johannesburg, in June. She uses software loaded on to her laptop, provided by the association, which produces a United States-accented tinny voice from the words she types.

At the meeting, attended by about 100 people from welfare organisations, a handful of government officials turned up to listen to organisations that desperately need funding.  The organisations deliver services to children, the elderly, disabled people and those struggling with alcohol abuse and HIV/Aids. Although the organisations are contracted by the government to care for the vulnerable, it is not providing enough funding for them to do so. They all deliver the welfare services the government is legally bound to make available to South Africans.

If there is no intervention, Phiri's home will be closed in six months. The association needs R500000 from the government to keep running – or R6-million a year – but it receives less than a third of this from the department of social development. Its closure will force Phiri to move back to her sister's shack in Kagiso township where her most basic needs will not be met.

A few weeks after the meeting I visited Phiri at the association in Krugersdorp west. I found her in an arts and crafts class where she and 10 others, who also need special care, were making photograph frames from paper. Sitting up in her wheelchair and smartly dressed, she greeted me with a huge smile on her  beautiful face.

Afraid of being dependent
Her head was tilted to one side, and her hands pulled in close to her body with her fingers curling in against her palms. She tried to paste a decorative leaf on to a sheet of paper, but got too excited and struggled. She battled to hold on to the glue. Frustrated, she pushed the material aside, but a carer helped her to finish the job and almost instantly she was smiling again.

Apart from the software that helps her to speak, she also has a special wheelchair provided by the department that has been adapted so she can operate it with her right hand. She can reverse, turn and speed forward with surprising ease.

But Elisma Fouché, the school's social services manager, said Phiri's chair was more than just that: "She is very afraid of being dependent on other people. That's why she loves her chair."  

Her independence became apparent as I followed her across a patch of grass to the office where her computer is kept. She sped ahead and I had to skip paces to keep up.

Although there are special keyboards with larger buttons, Fouché said Phiri had taken a more difficult route and taught herself to type on a normal keyboard. The reason for this is hard to fathom, because her hands seem to have a mind of their own and constantly move from side to side.

Child-headed household
She spends many quiet hours in front of her computer, writing poetry and essays. If she returns to Kagiso, she will not be able to take her chair or her computer with because she fears they will be stolen. She will not be able to move freely, or express her feelings.

Phiri's mother has died and she does not know where her father is. She has no other family, except for her 21-year-old sister Tumi, who lives in Kagiso township. Phiri was born in Kagiso, but attended West Rand School for disabled children until she matriculated. She lived in residence there, going home at weekends. After she finished school, she returned to Kagiso to stay with her grandmother and sister. But her grandmother soon passed away. This left her sister, then in grade 11, with the task of taking care of her.

Phiri suddenly found herself in a child-headed household. During the day, she was alone at home, a shack the size of the bright and sunny pink room Phiri now stays in. She lived with her sister for eight months until Fouché found her in the township after Phiri was referred to the association by her former school.

At the home, Phiri is assisted by carers to bathe, eat and dress. Fouché said the state wanted the families of people like Phiri to contribute to living costs, but their family members often lived in poverty. This is true of Phiri's sister, who is 21, has a child and does not have her own home. Phiri's only source of income is government grants.

This year, the department will spend about 93% of its R104-billion budget on social grants for the elderly, Umkhonto we Sizwe war veterans, children in foster care and those whose parents or guardians earn less than R2800 a month, the disabled and those caring for people who cannot care for themselves.

About R6.5-billion will be divided up between the cost of administering social grants, social fraud investigations, bursaries for social workers and the National Development Agency.

Grants
This leaves only a fraction of the total social development budget – about 0.76% – for the funding of non-profit organisations that provide. These services typically include family counselling, special work facilities for disabled people who want to earn money but cannot adapt to the labour market, home inspections by social workers in cases of child abuse and neglect, homes for the elderly, children and the disabled, and community projects such as food gardens. The department could not provide a breakdown of how this money was divided between the different vulnerable groups. Although grants often go towards the funding of organisations, they do not cover all their costs.

People like Phiri are eligible to receive two grants: a monthly R1 200 disability grant and a subsidy of R1 523 that goes to the association. But Fouché said the cost of taking care of those in frail care came to at least R5 700 a month.  

This means the home has to raise at least an additional R3 000 per resident a month. There are 47 permanent residents in the home, of whom 13 need full-time frail care. "The centre has a monthly shortfall of R78000 for food and basic care, and we are not even talking about water and electricity bills. The state prescribes how we should care for the disabled, but it does not pay for the service. It says we have to fundraise, but we cannot manage to raise R3 000 per person a month."

If the home was to close, most residents would have nowhere to go.

Raymond Nicholson is 31. He is in a workshop at the West Rand association that allows disabled people to perform work for a small amount of money, typically less than R100 a month. The purpose is more to give such people constructive activity and an opportunity to socialise. None of the money earned goes toward the association.  

Safer
"We package things and put stuff together," Nicholson said, "like these tap tops." He showed me two small plastic discs, one with a blue mark for cold water, the other with red. "We call these sleeping pills because it gets a bit boring and then some people fall asleep."

They also attach the chains to bath plugs. I tried to pinch the metal hoop closed with a pair of pliers and failed. Everyone laughed. One of the workshop members then gripped the plug with the toes of his left foot and attached the hoop using a pair of pliers with his right foot, seemingly without effort.

Nicholson also participates in the association's drama group. Last year he received a special mention and a gold certificate for his role in a play. "I was the big bad wolf. I was very proud of it, because it didn't take me so long to learn the words."  Nicholson said that he would be lost if the home closed: "I will have to find something to do, otherwise I'll lose my mind."  

Advent Nyumba has been in the same workshop for 16 years and has lived in the home for the past three. He was born in the nearby township of Munsieville and was in high school when he was shot twice in the back. "My whole left side doesn't work anymore," he said. He is afraid of returning: "Where we live, they don't see disabled people as normal. They throw rocks [at us] and are miserable with us. It is safer here."

When asked what he would do if the home closed, he sighed. "I would have to move home. With the money I get here I buy soap, do washing, coffee, buy airtime, anything I need. The rest I save. There, there is nowhere to work. Most jobs say they cannot take disabled people."

The need for government support for the disabled is substantial. In April this year, the South African Social Security Agency paid out disability grants to close to 1.2-million people.

Feeling the pinch
The 2001 census found there were about 2.26-million people with disabilities in South Africa. Black South Africans constitute about two million of this group.

The disabled are not the only group struggling. George Petzer is the manager at the Floroma Old Aged Home in Roodepoort to the west of Johannesburg. The home provides frail care for 60 people and another 74 who are self-sufficient live in private cottages on the premises. Petzer said 90% of the people living in the home could not afford the accommodation because they received negligible private pensions or the state pension of R1200 a month. Statistics South Africa estimates there were about 3.9-million older people (above 60 years) in South Africa in 2011, or 7.7% of the population. In April this year, 71% of elderly people received grants. StatsSA estimated that in 2010 nearly 41% of the elderly lived in households with a per capita income of less than R570 a month.

Petzer said the home cost about R4-million a year to run. It costs about R5 000 a month to care for a single person in frail care. This covers board, lodging and special nursing care. The government grants, which include the old-age pension of R1200 and a subsidy of R1 523 that  goes directly to the home, adds up to R2723, leaving the shortfall to be paid by the home or relatives.

Another big expense is rates and taxes. Last month the home owed the municipality R82 000. At R80 000 a month, the home is liable for about R1-million in rates and taxes a year, a quarter of its total operating expenses.

Annatjie du Toit (71) told me she was feeling the pinch. I found her sitting in the sun on the small porch of her small flat at Floroma. She keeps it neat and decorates it with pot plants, but the wall needs a coat of paint. The cottage costs her R1500 a month  excluding rates. In June, she said, the electricity bill was almost R200, up from R170 the previous month. Her state pension of R1200 goes toward rent. One of her daughters supports her with extra money for groceries, toiletries and electricity. "Without my daughter's help, I would be done for," Du Toit said.

Mutual respect
Children are also hard hit by the lack of funding.

StatsSA said that in 2010 about 62% of the country's 18.5-million children lived in households with a per capita income of less than R570 a month. Two grants are available to children: a R770 foster care grant and a R280 child care grant. The foster-care grant is provided to families who look after children who have been removed from their homes. The agency paid foster care grants to 544968 children in April this year. The child-support grant is paid to parents or caregivers who earn less than R33600 a year. In April, the agency paid out child support grants to 11-million children.

Petunia Phaka, a social work manager at Child Welfare South Africa in Vosloorus, told of the struggle social workers face in delivering child protection services. "How can I conduct a home visit [to investigate a child's home circumstances] without a car to go there? With no telephone, how can I make a follow-up call?"

She questioned the government's relationship with non-profit organisations. "Are we partners? Is there mutual respect? This is not about NPOs, it's not about the department, it is about society taking care of its children. They are not numbers. They are flesh and blood who need serious investment to become contributing members of society."

Nelly Sibanda is 57 years old. One has to be 60 years or older to qualify for an old-age pension. She cannot read or write and recently lost her job. She looks after her seven-year-old grandson Tshephiso Sakgeto. Both his parents are dead. Sibanda receives R280 a month as a child support grant. She said the agency has refused to give her a foster-care grant because she is the boy's grandmother. Now, she had come to the Roodepoort Child and Family Welfare Society to ask for food. The organisation was low on stock and she left with two cans, one of baked beans and another of mixed vegetables.

Challenges
Another foster parent, who asked not to be named, said the child support grant of R770 did not cover the expenses of the five-year-old HIV-positive girl in her care. Transport, food and clothes cost her more than R1 000 a month. The girls' brother (11) also stays with her. At the moment, she receives only a child support grant for him – R280 a month. Although she used to bake cakes to earn money, her oven is now broken and she has to look for a job.

According to Angelique McAdams, Roodepoort Child Welfare's chair and fundraiser, the organisation serves a population of 350 000. The department subsidises social work salaries and a small portion of administrative fees, but the organisation has to pay for running costs that include rent, rates, transport, stationary, accounting fees, workers' compensation and employee taxes. To raise extra funds, McAdams works full time without a salary, but it is still not enough.  "Every month we have a shortfall of R50 000 – and that's in a good month."

Lumka Oliphant, the spokesperson for the department, said it acknowledged that there were "challenges" within the NPO sector.

"The minister of social development is in dialogue in provinces with NPOs. These dialogues will culminate in a  summit to be held in Gauteng next month," he said.

Watch a slideshow on the welfare crisis, narrated by Heidi Swart.mg.co.za/welfarecrisis

Heidi Swart is the Eugene Saldanha Fellow in social justice reporting, sponsored by the Charities Aid Foundation, Southern Africa.