​COVID-19 - The NHI will not be able to do it alone

Authored by: Chandu Kashiram, IRMSA Risk Intelligence Committee Member

COVID-19 has confirmed what Dr Nicholas Crisp had warned us all in the run up to finalising the IRMSA 2020 Risk Report. He warned that the NHI cannot solve all of our Nation’s social ills. Each and every department across the social spectrum has to deliver if the NHI is to succeed.

Assuming that all intentions and plans to install a “world class” NHI system in South Africa are successful, it will still not be enough. COVID-19 has placed the best NHI systems in the world under considerable strain. This is mainly due to the system not taking care of the poor and the indigent.

According to a recent Daily Maverick article by Richard Poplak (27 March 2020), between 1.1m and 1.4m households fall under the informal settlement category in South Africa. This equates to between 2.9m to 3.6m people.

Although the Government has reacted swiftly to put into place the 21 day lockdown, at a practical level the lack of housing, exacerbated by the sheer lack of basic necessities such as running water and ablution facilities, has made the lockdown impractical in poorer communities.

Social distancing is nearly impossible to achieve where the disenfranchised live between four to six people in a little one to two square meter shack. Washing hands and staying germ free is a big ask when most people do not have running water and share toilets across many shacks.

COVID-19 is putting the spotlight on lack of service delivery and has placed the entire Government into fix-it mode, at huge cost to the economy and the people of South Africa.

So what is missing?
COVID-19 is also one of those risk events that is a serious “wake-up call”, not just in our country but the world over. It is forcing each country to take a hard look at the following –

• Basic human needs such as housing / shelter;
• Basic infrastructure such as water, electricity, sewage systems, roads, waste removal etc. - that should provide all our people a safe and clean environment;
• Access to basic healthcare.

The above basic needs are not a “nice to have” but also enshrined in our Constitution as basic human rights.

Preventative Measures
Simple risk management principles require us to identify the risks, and put into place effective preventative and corrective risk mitigating actions.

The Government has put an effective council that is putting plans together and working as a team to beat the COVID-19 virus. Labour and business are also part of taking corrective mitigating actions.

One of the Ministers even mentioned that the process is unfolding into the development of a blueprint on how various parts of government, labour and business can work together in future to deal with any major challenge.

My view is that they should not merely come together to face major challenges or disasters but continue to work together as a matter of course.

COVID-19 should be used to understand and develop solutions for the following -

• speed up setting up of the infrastructure fund that will be required to get our health system to “basic delivery” status;
• Ensure that frontline staff have the necessary PPE and equipment (in this case ventilators) or in another situation burn units etc.;
• Step up education, training and development of healthcare professionals in the area of disaster management;
• Analyse the supply chain to determine key strategic industries that could be local e.g. producing ventilators, masks, hand sanitizers etc. This will assist in creating jobs and making us less dependent on imports;
• The analysis should also consider basic requirements to deal with other disasters such as fire, floods or any other extreme weather events, natural disasters and climate change;
• Build up a national disaster relief fund;
• Accelerate the allocation of “land parcels” to relocate communities to a safer environment;
• Accelerate implementation of basic infrastructure that can provide for the poor and indigent;
• Significantly step up and install appropriate communication solutions to reach all communities in cities as well as rural areas;
• Continue to and sustain training of police and defence force frontline staff in the areas of community policing and crowd control in a crisis situation;
• Ensure that leadership has the ability to take decisive action and to stand their ground, especially when such decisions appear to be unpopular; and
• Develop an electronic / technical solution for the collection of social welfare grants.

Note that the above is by no means an exhaustive list.

In conclusion, we are merely a few days into the 21 day lock down and already many gaps and missed opportunities of the last 25 years of our democracy have been starkly and unambiguously been revealed.

The COVID-19 has ruthlessly placed the truth in front of us all and left no place to hide.

Let us therefore use this opportunity to learn from the mistakes of the past and begin our journey to recreate a better South Africa for all of us. The preventative measures are not aimed at Government only.

Business, Labour and all South Africans have to do their part to build a much more resilient South Africa.

Whilst we contemplate how we will work differently in future, let us also acknowledge to good work government, labour and business has done so far to deal with COVID-19.

Let us also acknowledge the frontline staff, the doctors, nurses, healthcare professionals and each and every person providing essential services during these extremely difficult times. To make sure that there sacrifices are not wasted, PLEASE STAY AT HOME! 

ENDS
 
MEDIA CONTACT: Rosa-Mari, 060 995 6277, [email protected], www.atthatpoint.co.za 

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