Accessing healthcare should be a straightforward matter for all South Africans, but for some of those who live and work on farms, it has long been a challenge. The ongoing Covid-19 pandemic has put their struggle into sharp relief, and reinforced the importance of reducing barriers to health services.
In a country marred by stark inequalities, access to healthcare has long been a challenge for many South African communities. This includes farmworkers and dwellers in the Cape Winelands District. For these communities, the ongoing Covid-19 pandemic has brought renewed awareness of the barriers to accessing health services and information.
This is according to Sara Claasen, a farmworker in the Cape Winelands District. The lockdown has resulted in less work for those living in Claasen’s community. “Sometimes, [the work opportunities are] a bit better. And then it seems that we reverse…we go backwards,” she said.
It is difficult for farmworkers and dwellers to isolate when diagnosed with Covid-19, as the houses in which they live seldom have enough space for it, according to Sara Claasen, a farmworker in the Cape Winelands District. “We have small houses. Two bedrooms – the one is for your kids, the one is for you and your husband. What if the one person is Covid positive? Where will the other one sleep?” said Claasen. PHOTO: Tamsin Metelerkamp
The pandemic has had a negative impact on the growth of employment in the agricultural sector, especially due to regulations and restrictions in terms of agricultural activities, according to Darryl Jacobs, deputy director general of the Western Cape (WC) department of agriculture. “Coupled with other factors, like the impact of the drought and the increase in minimum wage, farming enterprises had to reduce their activities, and some even closed their doors, which led to job losses,” he said.
The number of people employed in the agricultural sector dropped from 842 000 to 799 000 between the second quarter of 2019 and the second quarter of 2020, before rising again to 862 000 in the second quarter of 2021, according to the Statistics South Africa Quarterly Labour Force Survey for 2019 and 2021.
The job losses within the primary production side of the agricultural sector were not as substantial as anticipated under lockdown, due to the agricultural sector being declared an essential service, according to Jannie Strydom, the chief executive officer of Agri Western Cape (Agri WC).
“In some of the commodities like the wine industry, flowers, […] and so forth, in the beginning [of the lockdown] they could not function. And we know about all the alcohol bans that we had,” said Strydom. “If there’s any risk for job losses, it would be in those commodities, for sure. Especially the […] wine industry,” he added.
For some of those living on farms, job insecurity during this period has impacted their ability to afford treatment for Covid-19 infections, according to Rosy Links-Frederick, a community worker living on Flenterskloof Farm in Simondium.
“We have to share our food…our medicine.”
“It’s difficult to buy medicine at the pharmacies because of the money problem. Farmworkers get Covid, so if you have medicine, you have to share,” said Claasen. “We have to share our food, our medicine…what we have.”
The WC department of agriculture has assisted farmworkers who are struggling with unemployment by facilitating their inclusion in income assistance and humanitarian relief programmes, such as the Unemployment Insurance Fund and the Temporary Employer-Employee Relief Scheme, according to Jacobs.
Trouble with transport
Transport is a challenge for some farmworkers and dwellers who need to visit healthcare facilities for Covid-19 testing and treatment. The difficulty stems from the remoteness of farms, and the lack of private transport in farming communities.
This is according to Wendy Pekeur, coordinator of the Ubuntu Rural Women and Youth Movement (Ubuntu). Ubuntu is a non-profit organisation that runs an advice office for workers in the Cape Winelands District, as well as training programmes that educate local women on land and labour rights, said Pekeur, who lives on Elsenburg farm just outside Stellenbosch.
The pandemic has had a negative impact on the growth of employment in the agricultural sector, especially due to regulations and restrictions in terms of agricultural activities, according to Darryl Jacobs, deputy director general of the Western Cape department of agriculture. PHOTO: Tamsin Metelerkamp
“[Accessing healthcare] is a challenge, because the town areas, the clinics, the state hospitals, are far from the farms,” said Claasen. “You have to take a taxi. With the taxi violence and taxi strikes, it’s difficult to reach the state hospitals.”
For members of Links-Frederick’s community, the journey to the clinic is made on foot. “We don’t have transport to the clinic…we walk,” said Links-Frederick. “This place is not safe, but we [walk with] a lot of women.” The distance to the nearest clinic is around five kilometres, said Links-Frederick.
“Many of our people don’t really understand the dos-and-don’ts, and the danger of Covid.”
The distance between farms and healthcare facilities has also impacted the ability of some farm dwellers to access the Covid-19 vaccine, according to Claasen.
“In delivering healthcare services to communities in the Cape Winelands, we realise that there are sometimes vast distances to travel for healthcare,” said Sandra Maritz, Cape Winelands District communications officer for the Western Cape health department (WCHD). “During the rollout of Covid-19 vaccination, we continue with our efforts to make services as accessible as possible.”
Teams from the WCHD have been running outreaches in farming communities across the Cape Winelands District, in order to provide registration and vaccination services on farms, according to Maritz.
“The department of health and the department of agriculture [in the Western Cape], and our organisation and various other organisations… we frequently had meetings, and still have meetings, on Covid and the response,” said Strydom. “I think there’s an absolutely huge effort from both departments to get access to farmworkers. But one must understand, some of the rural areas…they are quite far from town and the health facilities.” He said there could therefore potentially be issues of accessibility in some of the more rural areas.
The members of Agri WC have also tried their best to assist farmworkers in registering for the vaccine, and have taken them to centres where vaccinations are taking place, according to Strydom.
There is a need for more education around Covid-19 and the vaccine in local farmworking communities, according to Sara Claasen, a farmworker in the Cape Winelands District. PHOTO: Tamsin Metelerkamp
Access to information
There is a need for better access to information around Covid-19 and the vaccine in farming communities, according to Claasen.
“The first thing for farmworkers [should be] education around Covid. Many of our people are illiterate, so people don’t really understand the dos-and-don’ts, and the danger of Covid,” said Claasen. “Sometimes people don’t understand how important it is to wear your mask, or how to wear your mask, when or where. That thing must be really deeply educated to our people, so that people can understand the danger.”
Claasen said that in her community, a lack of information around the Covid-19 vaccine has resulted in reluctance among some community members to receive it.
“People [in farming communities] are afraid to use vaccines due to fake news,” said Pekeur. “There is not much information around the vaccines.”
Sara Claasen, a farmworker in the Cape Winelands District, talks about the challenges that farmworkers face in accessing information about Covid-19. AUDIO: Tamsin Metelerkamp
“Since the start of the pandemic, we have collaborated with other role-players to strengthen our efforts of sharing information,” said Maritz, on the WCHD’s efforts to provide Covid-19 information to farming communities. “These include regular updates to local media and influencers […] and one-on-one engagements with farm owners and their staff to share information. We work closely with the department of agriculture to further tailor and distribute information to these communities.”
Supporting farming communities
Landowners and farmers play a vital role in facilitating access to healthcare for members of farming communities, according to Nokuthula Mthimunye, gender programme leader at the Association for Rural Advancement.
“In many instances, farmers transport their workers to private doctors operating in the nearest town. Farmers pay all costs and recover it from the employee’s wage,” said Mthimunye.
On Hartenberg Wine Estate in Stellenbosch, farm management has provided farmworkers with support and transport for Covid-related issues, according to Willie Booysen, the assistant farm manager at Hartenburg.
“We are really open-minded about it. We try our best to keep up the basics like social distancing. If there’s anyone who needs to go to the doctor [due to Covid-19], we will provide the transport,” said Booysen.
Booysen told MatieMedia that he has also assisted farmworkers in registering for and accessing Covid-19 vaccinations.
“We have enough information, because our manager and supervisors are teaching us about Covid,” said Nolusindiso Kilizwe, a farmworker at Hartenberg. “So they’re telling us all the rules…they’re telling us everything about Covid.”
Willie Booysen, the assistant farm manager at Hartenberg Wine Estate, talks about the support that Hartenberg farm management is providing for farmworkers during the Covid-19 pandemic. AUDIO: Tamsin Metelerkamp
The farm management of Hartenberg Wine Estate in Stellenbosch has provided support and transport to farmworkers for Covid-19-related issues, according to Willie Booysen (centre), the assistant farm manager at Hartenburg. Booysen works alongside Nolusindiso Kilizwe (left) and Zimkhitha Sinyuko (right), who are farmworkers at Hartenberg. PHOTO: Tamsin Metelerkamp