Jabs bring relief to village of care

Just past Izingolweni, halfway between Port Shepstone and Harding, you turn left onto a rutted dirt road that winds along the edge of a deep valley. On the crest of a hill is a fenced cluster of green buildings — the Ntokozweni Village for the Vulnerable. Like many parts of rural KwaZulu Natal, you won’t find it on Google maps. But, if you get lost in the vicinity, ask anyone and they’ll tell you exactly where to find it. 

The village has been an oasis for nearby residents for nearly 30 years. It provides care for older people, runs an early childhood development programme for 60 children, offers after-school extra-mural activities and supports young people with technical and vocational education and training. And each day, scores of people arrive at its gates for a midday meal. 

Beauty Nkonyeni has run the centre for 29 years, taking over when her husband, Enoch, a pastor, died. Between the residential buildings are sunny courtyards, some grassy space, a classroom, a playground, and a large number of water tanks. Plastic containers are tied along the fence. 

“Those are our sanitising stations,” says Nkonyeni as I fill out the Covid-19 screening form. In February last year, a month before lockdown began, the Ugu district municipality’s water system collapsed. 

“Exactly when we needed water for extra hand washing and keeping clean, we had none,” says Mike Webster, who runs a charity in Port Shepstone and helps Nkonyeni with maintenance. “We bought a borehole pump but that did not work. We dug to 180 metres but found no water. Having tanks everywhere is our solution to maximise the water [draining] off the roof.” 

In the courtyard, caregivers and residents, some in wheelchairs, warm themselves in the mid-morning sun. 

Thandazile Mbuthuma, the supervising healthcare worker, has worked at Ntokozweni for 19 years. “When Covid first arrived, the old people were frightened and confused. Many residents have problems remembering things. They kept asking why their grandchildren were not visiting. Eventually, in level two [lockdown] we allowed visitors to come to the gate and this helped,” she says.

Caregivers also had trouble getting residents to understand the need to use masks and follow social distancing protocols. 

“We would put a mask on a granny and five minutes later they would take it off, complaining that it was hot,” says Mbuthuma. “They would quickly forget, and say, ‘how can I talk and how can I breathe?’ ” 

There are three residents in each bedroom. Caring for them requires hands-on work — bathing, feeding and administering medication. 

Nkonyeni found herself endlessly troubleshooting. 

“In the beginning, during level 5, the stress was about getting food and cleaning stuff because all the shops shut down. We were not given any PPE [personal protective equipment] by the government and we did not have extra money in our budget. Our mop broke and there were no mops in Izingolweni. The government was wrong to lock down the mop.

“Once I had to go to Port Shepstone to find cleaning materials and a kind shop owner opened his shop for me, although he was not meant to. I had to look out for the police. I was very frightened because we nearly got caught — as if we were doing the wrong thing, whereas we were just struggling to get the things we needed for our people.”

The after-school and the preschool programmes were also closed for six months. Nkonyeni lost touch with local residents, many of whom relied on a midday meal from Ntokozweni — their only source of food.

“The children had to stay away from us. I wasn’t sure if they were okay and if they were hungry. Then we distributed some food parcels donated by the DG Murray Trust in our bakkie,” she says. “And we started doing takeaways.”

In July last year, three older residents at Ntokozweni tested positive for Covid-19. Ntokozweni’s residents have monthly check-ups at the clinic in Izingolweni and Nkonyeni suspects they may have picked up the virus there. 

“The department of health came and screened and tested everyone … Eleven people were positive and sadly six passed away. Five caregivers were positive and thankfully they all survived,” she says.

“It was very straining. Every day we were getting a message that someone had passed on. We couldn’t go and sympathise with the community. We were sitting looking over the hills as people buried their loved ones. It was so sad. I kept thinking, am I the next?”

So, when the Sisonke study undertook in February this year to vaccinate 500 000 healthcare workers and the government announced its vaccination programme for people aged 60 and older years old, Nkonyeni, together with the department, wasted no time getting her staff and residents registered. 

The government’s vaccination programme began on 17 May and, by the end of the next day, all 33 residents in Nkonyeni’s care, as well as three staff members and four people living nearby, had received the first dose of the Pfizer jab. On 30 June, they received their second dose.

“In the morning of 18 May, a team of trained professional nurses and community caregivers arrived. They explained the procedure. We set up chairs in the dining hall, followed the protocols and our older people received their injections. The nurses then attended to the very frail in their own beds, ” Nkonyeni says. 

Ethel Zulu, who has worked at Ntokozweni since July last year, said no one has reported any adverse reactions to the vaccine: “Everyone was scared of Covid before, but now they are free.” she adds.

In the preceding weeks, the health department invited Nkonyeni to a meeting at Murchison Hospital, on the main road to Harding and Kokstad, to plan and set the date for the vaccinations. She then liaised with the Izingolweni clinic to ensure the older residents and the staff were registered. “We used a form and the number *134*832*ID number*. It was easy,” she says.

Resident Mary Ngcobo, 78, who is diabetic, said neither she nor any of her friends were frightened of the vaccine. She said her arm was a little bit sore after the injection but otherwise she has had no side effects. 

“I would like to see my sister, who lives at uMtwalume, and my daughter who I haven’t seen all this time. Now I have had my vaccination, maybe they will visit me,” she says.

According to the department, as of 30 June, the total number of Pfizer and Johnson & Johnson vaccines administered is 290 666. In KwaZulu-Natal, 643 144 people aged 60 and older have had their first Pfizer shot and 92731 the J&J jab. In Gauteng, 675 451 had the first Pfizer and 126 908 the J&J vaccines. In the Western Cape 418 074 people had Pfizer and 91 756 the J&J.  

Nkonyeni says she was “beyond relieved” when people in her care had been vaccinated, and that the process could not have gone more smoothly. 

“Life will be much better once every­one is vaccinated and we can look after the young again too.” 

But she was disappointed that her staff, who despite being classified as community care workers and who were in direct contact with vulnerable people, were not included in the Sisonke study. 

Nigel Garrett, head of vaccine and HIV pathogenesis research at the Centre for Aids Programme of Research in South Africa and part of the Sisonke research team, says the Sisonke trial had tried to focus on rural areas in KwaZulu-Natal but did not manage to reach everyone. 

Once the Sisonke trial finished, roughly 700 000 healthcare workers remained unvaccinated. Since then, a further 450 000 healthcare workers received their jabs. 

Meanwhile, the preschool has reopened for 20 children, and Nkonyeni has applied for funding to build so that all 60 children can return. 

Extra-mural and after-school activities are still on hold, but hungry people can pick up a takeaway. Nkonyeni also needs more money for salaries and a car but, as she says, “at least they have had the vaccine now. Knowing that removes at least one layer of stress.”

This article was commissioned by the DG Murray Trust. Jess Nicholson is a writer and copy editor based in Durban