Every day, we hear about the harmful impact of COVID-19 – the number of infections and deaths; the number of jobs lost. We won’t truly, however, get the full horrific picture until we see the pandemic through the eyes of our South African community healthcare workers, especially those serving the poverty-stricken rural areas.
At the very frontline of the battle against the coronavirus for almost two years, our rural healthcare teams have lived through a nightmare that has changed many of them profoundly. Already responsible for demanding community programmes, these people were suddenly required to labour away for up to 16 hours a day, surrounded by suffering and death that touched them to the core.
Ironically, the same caring qualities they need for their profession have made them all the more sensitive to others’ suffering. Nevertheless, they continued to deliver outstanding work, even when the pressure was on to speed up the South Africa rural vaccination programme.
“From my very first COVID-19 patient in March 2020, I was traumatised,” remembers Sister Portia Baloyi, based in Lesedi district of the Gauteng Department of Health. “Though very sick with all the symptoms, he refused to ‘die in hospital’ and I found him lying all alone in a shed outside his house.”
The fear of infection that the pandemic brought into our world became a daily theme not only in the communities that Sister Portia and her team serve, but also in her own life. Making her rounds in Ratanda, Vischkuil, Devon and the Lesedi farms during the lockdown – for 16 hours a day, seven days a week – she was horrified to encounter the same predicament again and again. She would find 10 people crowded into one small house, all surviving on two people’s social grants, and not a face mask in sight because no one could afford it. The lockdown had destroyed any small income they could generate. Of course, when they caught the virus, they got really sick.
It seemed to Sister Portia that she could sense the virus when she entered a home. “I became terrified of the virus and of seeing death,” she recalls, “and of infecting my family. I avoided my husband, children and friends; my colleagues became my friends. My family was also scared – my children locked themselves in a room when I entered the house. I had to educate them on the virus.”
Her responsibilities weighed heavily on her mind and she was torn between the fear of infecting others and the need to fulfil her duties. “At one point, all seven members of my healthcare team had tested positive except for me. I told my manager, ‘If I don’t carry on, who will?’
“I did what I could, even making sure that the poor people got food parcels and other assistance. There was a voice inside me that kept saying, ‘If it’s not you, who must save the people? You can’t stop until you save them.’ It kept me going and drove me. Our mobile service vaccinated up to 110 people a day. I would add up the daily vaccinations – the farms had only about 12 workers each, but if we visited five farms, we could reach 60 people in one day. This meant driving around on bad muddy or gravel roads for hours.”
What also broke Sister Portia’s heart was the plight of the undocumented people, who could not be vaccinated. “I have no peace at night because of them,” she confides.
Eventually, the psychological burdens became too much. She became depressed and had five briefing sessions with her manager, which helped her find her inner strength. “The virus and the pandemic taught me to be strong and responsible. I realised that everything and everyone matters, and that I should appreciate life. By God’s grace, I only caught the virus once, and didn’t have to go to hospital. No one trained me to handle all of this, but I discovered that I could.”
In the Western Cape, one of Sister Portia’s peers fought a similar battle against the virus. The Matzikama sub-district healthcare team under Dr Elsa Eygelaar has been reaching out to rural communities daily even before the pandemic. Now, a regular screening and testing programme covers small, remote communities including Doringbaai, Ebenhaeser and Kliprand. The latter – consisting of a few RDP houses along the R358 – voluntarily went into total lockdown after almost a quarter of its 250 residents tested positive last year. Sister Levona Cloete of the Bitterfontein Satellite Clinic remembers her team’s devotion to this distressed community.
“One Monday in June, the community care worker contacted me to express her concern about the fact that 10 people at Kliprand had symptoms. Six of them tested positive. The next day, the principal contacted me – there were more possible cases. Together with a councillor and a member of Aurum, I braved the wet, slippery 80-km road to Kliprand in the pouring rain the next day. ‘Sister, drive safely; the Lord will protect you on the road,’ one community member had urged.”
Within three days, more than 10% of the community had tested positive and three people had died. The once active community was like a ghost town, its two shops and one school shut down. The residents ran out of supplies and many organisations donated food parcels and medication.
“Our healthcare team was constantly attentive, either visiting or calling to offer moral support, and to show that we were there for them twenty-four-seven,” remembers Sister Levona.
Healthcare staff are, unfortunately, not immune to disease and both she and her husband also tested positive just before Christmas when they were on leave. Selflessly, she is grateful about the timing, as she did not have to take sick leave and had been able to render healthcare services to a community in its time of in need.
“This was one of the battles that I fought in my personal life and in my 34 years as a nurse,” she says. “It was the hardest; you can’t fight by yourself. You need your colleagues, your family, your friends… and most of all, you need God.”
For Dr Mauriza Janse van Rensburg, clinical manager for the Saldanha sub-district, the pandemic brought plenty of challenges and in many ways destroyed the team’s efforts to grow. The impact of the pandemic on the people around her touched her deeply and she expressed her fear and struggle to plan around the unknown in a short poem:
“I did not plant the seed of COVID-19,
I did not give it water to grow,
I did not ask it to grow thorns to hurt you –
Please help me de-root this tree!”
Her team, a large one, has done outstanding work amongst the business people, including the fishing communities and companies such as Sea Harvest, to encourage testing and vaccination.
“All employees have contributed to the fight and are still doing so,” she says. “Our district works closely with local private entities, the municipality, WOSA and a disaster management team. A triage area team at Vredenburg Hospital screens, tests and educates patients with commendable dedication and empathy.
“The vaccination roll-out has been successful, but it meant setting up vaccination areas early in the day and making sure that the people felt safe and comfortable. Nothing was ever too much for the team. We often got home late to our families, had to face riots and even had an armed robbery, but we also had much-appreciated cooperation from private businesses. At this point in the pandemic, we can finally say:
“At the end of it all,
The mountain we had to climb, is merely a hill now.
We are turning our sunflower heads to the sun
And our diamond tears are shining…”
Close collaboration with local communities and companies is key to successful outcomes in healthcare, not only during the COVID-19 pandemic. Another Western Cape team which has rolled out successful vaccination campaigns is the Cederberg sub-district vaccination team under Sister Magdalene Sandt, primary healthcare manager. Together with the Cederberg Matzikama Aids Network, the team has maximised farm workers’ access to testing and vaccinations.
The latest viral mutation, the omicron, offers a glimmer of hope that the pandemic could ease up soon, but our unsung healthcare heroes’ quiet perseverance and dedication still need to be known. No uncharted community is too small for them to attend to. They have shown immense selflessness, but at the risk of their own health. They have shown amazing courage, but battled terrific fear. They have been deeply impacted by the suffering they witnessed up close, but have made a difference to millions of South Africans. Because of their hard work and moral support, many rural South Africans have survived the pandemic and can have real hope that the virus is being “de-rooted”.