Alex Hospice and Rehab Centre’s Tebogo Mohoa and Ethel Mokwena take care of 30 people in temporary premises. Photo: Oupa Nkosi
The level of care provided to elderly and terminally ill patients at hospices will drop instantly. Nurses and administrators at old age homes won’t be paid their stipends. A three-year-old will stop going to crèche in Alexandra, Johannesburg, and life will grind to a halt for a pensioner.
These scenarios illustrate some of what could happen if the South African Social Security Agency (Sassa) fails to pay its beneficiaries on April 1. Although the concerns may be unwarranted — the state promises the payments will be made — the uncertainty has sparked concern among institutions that care for beneficiaries. The social grants crisis has exposed how much non-governmental care institutions such as hospices and old age homes depend on the agency.
In Alexandra, the Alex Hospice and Rehab Centre is the only one of its kind in the township, which is home to more than 200 000 people, according to 2014 census data. The facility takes care of 30 patients with terminal conditions, all of whom receive disability grants of R1 510, due to increase to R1 600 on April 1. The hospice takes a “small percentage” of the grant to cover additional costs.
The facility’s co-ordinator, Ethel Mokwena, said a lot of their money was spent on the logistics associated with applying for a Sassa grant. “To qualify for the grant, they must see a doctor, then get an affidavit at the police station, then they need to see a Sassa doctor. That’s not cheap.
“Both of our vehicles are broken here. It’s R30 for a local trip and up to R200 to go to town with a private car,” she said, adding that stipends for nurses, administrators, a chef and cleaner would probably get cut if the grants didn’t get paid.
Administrator Tebogo Mohoa added: “So the Sassa grant is vital for us. And it won’t just be these patients affected. Many also get pension grants and their children and grandchildren rely on them. I can’t imagine what will happen if it doesn’t come in.”
Last month the Gauteng health department visited the facility and issued a warning that it was not providing the type of care needed. It is a far cry from the ideal, envisioned centre, which would be able to take care of 65 terminally ill patients.
The hospice operates from the premises of the Alexandra Secondary School, an apartheid-era school for coloured children before forced removals in the 1980s.
Its blue and brown walls are cracked, its furniture worn out. The patients sleep on hospital beds and the equipment used to treat them appears new. But everything else, one of the nurses said, is either second-hand or on the verge of falling apart, and replacements are rare.
In 2010 the centre moved into the facility from the neighbouring suburb of Bramley because the landlord “raised the rent from R1 000 to R10 000 a month” for the warehouse they used. The centre’s relocation to the abandoned school site was supposed to last only 16 months.
The hospice owns land in the East Bank section of Alexandra, where the new building is to be built. “But people usually only donate to us on Mandela Day. We are trying to start a celebrity pledging drive to raise money so we can at least lay the foundation of the new building. We can’t continue to scrape by,” Mohoa said.
In the new building, Mokwena imagines, “we will be able to treat children and start nutrition programmes. That’s what’s needed here because these patients also have children in need of care.”
An astonishing 70% of South Africa’s children depend on Sassa grants for nutrition, health and survival, a study by the University of Cape Town’s Children’s Institute has found.
The uncertainty about social grants being paid on April 1 will not only directly affect these children, but also places at risk “one of the most successful poverty alleviation programmes in the history of South Africa”, the institute found.
Aislinn Delany, a senior researcher at the institute, said the estimated percentage of children who are dependent on welfare was drawn from figures in Statistics South Africa’s 2014 general household survey.
“There are approximately 18.5-million children in South Africa. Data provided by Sassa indicates that almost 13-million children receive a child grant. This is equivalent to about 70% of the children living in South Africa,” she said.
Delany said, even though the child support grant is set at a low R380 a month, it is considered one of the best tools to fight poverty because “there is a substantial body of research that shows it is associated with improvements in nutrition, health and education outcomes for children”.
For the Orlando Children’s Home, one of the oldest orphanages in the country, the threat of Sassa grants not being paid doesn’t pose a serious risk. The home’s manager, Miriam Mazibuko, said a quarterly grant from the social development department safeguarded the institution.
“We aren’t collecting foster grants here either because those children are usually placed with families, so there’s no risk. We survive off the departmental grant and donations,” she said.
But for Sindisiwe Ngwenya, the collapse of the grant payment system would mean her three-year-old son wouldn’t be able to go to his crèche. She has a temporary job and earns enough for her to get by, but not enough for the crèche.
“I’m just hoping the money will come in because if I don’t pay at crèche my son must stay at home. Even thinking about it is just stress.”
Old age homes, such as that of the Roman Catholic church in Alexandra, also get a departmental grant. They receive about R12 500 every four months to take care of the 35 elderly people in the facility. This includes preparing daily meals, personal care and medical check-ups. This week, one of the facility’s managers, who did not want to be identified, said the departmental grant was not enough.
Most of the 35 residents receive grants of R1 510 a month. This money goes to the centre, which gives residents “10% back as pocket money,” said one of the caretakers.
“That 10% is like Christmas for them; they go out into the township and spend it,” the manager said.
Despite the departmental grants and donations the suspense created by the Sassa grants crisis has created anxiety.
“Personally, myself and my staff are very worried about it,” the manager said.
“We had a regional meeting as NGOs who take care of the elderly, and someone asked about it. The regional Sassa officials told us they are also just monitoring it on the TV.”
Johannesburg resident Samuel Malele is worried. A month ago, he saidhe was frustrated by standing in queues waiting for his grant and didn’t think it was enough, but remained grateful. Now the 64-year-old, who collects scrap to make up for the necessities his grant can’t cover, has started to worry.
“Many people said we won’t get paid and the government said it will be fine. So I’ll wait and see. But really, I can’t think of what will happen if that money doesn’t come,” he said.