Community health workers could soon be on the front lines of the fight against the coronavirus without the masks and other protective gear they need to stay healthy, says the secretary of the Gauteng Community Health Care Forum Tshepo Matoko.
Gauteng Health MEC Bandile Masuku announced early in March that the province would train 1 000 community health workers to trace the close contacts of coronavirus patients. But the call to action has been met with some backlash from unions and health workers who say they have been risking their lives for too long with little pay.
It's not just the tracers who will be at risk. "If there is a suspected case of Covid-19 in my catchment area as a community health worker," Matoko explains, "I'm the one that has to go out and show the tracers where they live."
Community health workers across Gauteng have already started reporting shortages of protective gear including a lack of respirator masks. These masks are the main way health workers can protect themselves from contracting the virus, which is spread through droplets in the air when people cough or sneeze.
At a training session for staff held in the Merafong municipality two weeks ago, workers were told protective gear "is a crisis", says Neo Maleka, a community health worker from Carletonville who attended the training.
In addition, a team of 48 community health workers in a Gauteng clinic Matoko visited were given no masks to protect them, just one 750 ml bottle of hand sanitiser to share.
The health department is working with donors and businesses to get protective gear to health workers, Health Minister Zweli Mkhize announced in a statement on Tuesday.
"No worker will be fielded without the necessary protection. We wish to reassure our valued health professionals that their safety is in the forefront of our agenda. We cannot afford to lose one healthcare worker to Covid-19 or any disease for that matter."
For many health workers, it's a scary state of affairs.
"I don't want to contract the virus while on the job," says Maria Molefi, a community health worker in Midrand. "I already got TB because of my work."
Community health workers have long fought the health department to be made permanent employees.
In 2016, five health workers from the forum took the department to court after it advertised posts for community health workers without notice. Despite winning the case, and a statement from former health minister, Aaron Motsoaledi, declaring that they would be made state employees back in 2018, not much has changed.
At the moment community health workers around the country have one year agreements with the health department, Matoko says.
"That means they get a monthly stipend, but they don't get the benefits other health workers have, like medical aid or pension."
And that stipend is meagre: A mere R 3 500.
Now, in emails to Gauteng health MEC Bandile Masuku, which Bhekisisa has seen, Matoko demands that all community health workers be made employees of the health department, and that they must be given equipment to protect themselves against the coronavirus.
The MEC promised the health workers would get permanent posts by 1 April, Matoko says, but so far, there's no evidence it will really happen.
Matoko's plea reads: "This is not the first time community health workers have been tasked with serving the working class to prevent the spread of infectious pandemics. Community health workers have been on the frontline of the struggle against HIV and TB.
"Many lost their lives in the service of their communities."
The premier's office did not respond to Bhekisisa's requests for comment.
Meanwhile, in the Free State, a very different situation is unfolding.
The South African Red Cross Society deployed a team of nearly 20 tracers to find the close contacts of people who tested positive in a Free State Church, Divine Restoration Ministries in Bloemfontein.
The Red Cross tracers received 5 days of training weeks before the pandemic even hit South African shores, far more than the 3 hour crash course the Gauteng community health workers received.
In the Bloemfontein church, just five people tested positive for the coronavirus, but the handful of people created a lot of work for the Red Cross tracers.
"There were 1 032 names on the list," explains Claudia Mangwepape, head of the humanitarian organisation's Free State arm.
Although Mangwepape and her team worked for more than 12 hours to get in touch with everybody on the list as soon as they could, they had the comfort of a full protective kit, including special respirator masks designed to protect health workers from infection, and surgical gloves.
It's a stark contrast - the Gauteng health department's tracers lack most of this gear.
Says Maria Molefi: "We are risking our lives to save others. I love my job, but I need protection against coronavirus and we deserve to be paid well. We do more than our part."