Face the People portraits and stories honouring community health workers portraits - Gabrielle Le Roux photographs - Kali van der Merwe
Judith Joseph – Elsies River, Cape Town I nursed for twenty one years, then I focused on the community because it was always my vision when I was nursing that one day, when I’m not nursing anymore, I wanted to work in the community. I wanted to work with old people and with children. And then one day I was invited to a meeting, and there I was elected as chairperson, and I knew nothing about Health Committees and stuff. I just had to start taking leadership. Next I got the job of a home-school teacher, working with street children, youth at risk, children who drop out. I am a very curious person, I want to know what’s going on in that auntie’s house. I want to know why that child is on the street; or why the child is fighting with the father or mother. Where there’s a problem with a child I go and visit the family and get the whole history of what’s happening in that home. By doing this I can help that family. Our children end up in jails, and there are always questions that need to be asked behind that. Basically I work with everything together: I work with health and crime, and I see to everything at one time. The team I work with on the home-schooling project functions very well, we all do our different tasks and if we can’t manage something we ask for more support. I believe in teamwork, to take everything upon yourself is too much and it exhausts you. I got involved with Gun Free South Africa and have recently been made a project manager there too. Over-crowding in houses, too many people in one home; that’s why now we have such high TB and HIV figures, actually in my area we have the highest TB figures in the world. Then I see that the work is far from finished. It will take years before it’s finished. My message is especially to women: if we are healthy and can do something with our hands, we can also put bread on the table. There are organisations where you can learn to do handicrafts or learn how to plant a vegetable garden. Join an organisation, get active in your community, you can make something of your lives and also feed your children. I want to change children’s lives, I want to get the children off the streets. Children need to have another vision in life. I always believe that if you turn one child’s life around, then you have achieved success.
Nophelo Nogqala - Khayelitsha, Cape Town I come from the Eastern Cape, Stutterheim. The people I loved most were my parents who brought me up very well. They taught me how to live with poor people, and not discriminate against them, to be able to share with other people. I live in Site B Khayelitsha, seeing problems like poor people, sick, suffering from TB and HIV, taking medication without food. They have nothing to do, no work, even their families are not working, just sitting around. So I decided to help these people because that is how I was raised. I felt sorry for them even though I also don’t have. To help I cook soup, I started a soup kitchen. I use my own money. I started with thirty people, but as time went on they told other people, and more keep coming and now perhaps they are fifty eight or fifty nine. With the people who help me, we are six women. Every month we contribute R20 per person to buy groceries for cooking. Sometimes I go around asking from people in my community. From some people I ask for a cup of rice and some a cup of soup so I can cook for the people. When I started in June 2004 I tried to get help from different places. Unfortunately my applications were rejected. Then I went to Social Services and they told me to write a business plan but I don’t know how it should be done, I don’t even know what a business plan is, and that is what is holding me back.
This soup I make for people taking HIV treatment and those suffering from TB mostly, but even the elders who collect pension come and ask for some soup and I don’t chase them away, I accept them. Even now I have an elderly lady and an elderly man living in my house. They don’t have children, they don’t have anything, they are ill with TB, so I take care of them. I want to be trained to work with HIV positive people, I want to be educated so I can be able to help, to get in and find them and make them feel free when they are sitting with me, so they can tell me that they have the virus. Maybe if an individual has discontinued their treatment I can be able to encourage them and accompany them for their treatment myself. What gave me an interest to work with HIV positive people is that I saw that no one cares for them, people discriminate against them. I wish I had somewhere I could care for them. A person with HIV is the same as I am, as I too, as fat as I am, can die from high blood pressure. I love that I help people who are ill because I too don’t know when my day will come. Even though I have nothing I feel very motivated because I am helping my people. People must help each other in the community. Those who can should help those who are unfortunate and unable to help themselves. And those who can’t help themselves must reach out to their helpers. Social capital is to build each other, similar to ubuntu. It is similar to the work that I do of bringing together people who don’t have people to care for them. It is humanity in other words.
Leanne Stellenberg - Kuils River, Cape Town I am originally from the Eastern Cape and I am always very proud to say that I am from there because the Eastern Cape has got many, many special people that have done so much for our country. I am very proud to be a South African woman because of our history. Women have played such an important role in the development of our people. I have been inspired by women who have never set foot in a school, nor had any education, but they were smart, well-learned and very wise women. One of the problems we are sitting with in South Africa is abuse. Abuse is the shame of our nation and it happens in all homes, and it is the best kept secret. One of the groups I work with is the Kuils River Women’s Support Centre. When I facilitate training I start with a healing process because you cannot develop skills without some healing first. Because every time there is a betrayal of trust it causes another hairline crack until everything cracks. And when everything is broken you are not in a position even to care for your children, and if you can’t even feed your children then you feel you are a useless human being. So I look first at how to help that person gather herself and care for herself and from that point I move on to skills development. When you are very impoverished, the most important thing for you is to put bread on the table. It’s so important that we empower women to be able to go out there and care for themselves and not be so economically vulnerable.
Social exclusion aggravates poverty and poverty is misery, ill-health, missed opportunities, it’s a negation of humanity and it’s the worst form of terrorism. If we develop the rural areas and invest in the people there then we will have less problems in urban areas. Because of the apartheid regime many of our people are not used to doing things for themselves. Also we were taught as children that it’s disrespectful to be assertive and that is creating a lot of problems. If we assist people to develop themselves, so that instead of being job seekers they can employ one person, you can imagine the ripple effect. We need to create a closed-loop economy so that the money generated by the poor stays in their community. To do this we need facilities, premises and equipment in the townships and rural areas. If you look at any community there are so many people with so much knowledge. If they can just give what is the greatest gift that God gave us: a little bit of time and their mind, to assist other people. We grew up with ‘ubuntu,’ and in the Eastern Cape, we grew up with a saying ‘umntu ngumntu ngabantu’ that means: you are a person through other people.
Pastor Makili - Khayelitsha, Cape Town I started working in Johannesburg where I first encountered the word of God and I became a preacher and work with the word of God. Then I came to the Western Cape and started this project of working with HIV positive people. I made a decision that I am interested and I can really help someone who is HIV positive as I have seen the way it affected me in my family and other people close to me. I then took a decision to work with the community. We work in Site C in a clinic in Khayelitsha, where we decided as Christians to work in clinics to pray with the people so that the church can also play a role in helping people with HIV, because church people are supposed to play a big role in the HIV problem. We try to have people speak about HIV whether they are Christians or members of the community, but as preachers we are trying to get people to be open about it, so we help them spiritually, and emotionally and with food. Jesus never just preached the Bible but He also taught people to help other people with actions and not only by words. People in church have a problem that when you are a preacher or a member of the church, if they find that you are HIV positive, they will automatically assume that you lead a promiscuous life and they will discriminate against you in the church. That is why we are trying to have people understand that it is possible to get HIV even when you are a Christian. That’s why we have decided to start workshops and training preachers so that they may be able to help their congregations, to know that HIV is just like any other disease.
We get a great response from the people now because they feel free to speak about their HIV status and the people also appreciate it very much that the church is speaking about HIV. We speak about their way of living and what affects them in their homes as well as ways they can help themselves to deal with their problems. We don’t work with those people who are already on anti-retrovirals, but those who have just found out, maybe today, that they are HIV positive. We try to calm them down when they are still shocked, because they look up to us as pastors. If we get something, for example from Social Services, we are able to give people food parcels but we are trying to train people as well to give them skills to do things for themselves and not rely on the benefits of the support group. So that when that person leaves the group they will be able to work for their family. On Mondays, Wednesdays and Fridays we operate the soup kitchen for the people who are taking treatment. Before they get their treatments, we give them soup to eat. People who are HIV positive and those who have TB and other poor people are given soup on those days at Nolungile Clinic. I see social capital as a way of communicating with people in high places so that they can see our work on the ground and also for the community to come together. We need a good platform from government level to the people.
Monica Duda - Philippi, Cape Town I grew up in Transkei in a family filled with love, a home of hard workers. We farmed in the fields most of the time. Having grown up and completed my studies, I moved to Cape Town where I started working in the community of Crossroads in a crèche. After Crossroads was destroyed and burnt in 1996, we became squatters and then we got the land in Brown’s Farm, Philippi. I started working as a community health worker with community development. Seeing the plight of women at home, jobless, I started food gardening. We started by planting in our back yards, but as RDP (Reconstruction and Development Programme) houses were built, the spaces were small so we started approaching schools for land to use. Now we are farming vegetables at Siyazakha School. Each person joining pays R20-00. We work everyday, some work in the morning, and those who have jobs work in the garden in the afternoon. We water the garden using water from the school which we can’t even afford to pay for, so that is our problem. We also eat from this garden, we sell vegetables and get more seedlings. We were helped and trained to farm here by agriculturists, giving us seedlings and equipment to work. We started this as a group of ten women and now we are five. The name of our project is Masibambane Women’s Development Group. I feel women need to participate a lot in gardening, and doing projects like the soup kitchen. They should learn to do things for themselves and make their own money. The problem we have in my community is scarcity of jobs. Our people are unemployed. No work for the community means children end up falling victim to drugs as they loiter, then by using drugs, they end up not working. You will find children coming to school having not eaten, and they faint. So we help those children by making a pot of soup. We thought the pot of soup would only feed a select few students but we end up feeding the whole school.
The rate of TB and HIV/AIDS is very high in the communities we live in. We do Directly Observable Treatment Support, DOTS in the community to give TB patients their medication in their homes. We help at the clinic by giving health talks dealing with TB, HIV/AIDS and teach people how to garden for themselves. What we teach people, starting with the young ones is that TB is an illness on its own and it can be healed, and AIDS can be avoided by using protection, and treated at the clinics. Whether one has TB or AIDS it is important to eat the right nutritional food and take the right medication. At our clinic there are children and adults who are HIV+ and some have TB, there are also support groups, we help them sometimes by giving them vegetables from our garden. What I would like to say to the community is that people must use land they get to help themselves and other people in the community so that we may never sit with nothing to do because that causes the ill situation in our community to be worse. I can never see someone else suffer, I love to support people. What encourages me in the work that I do is seeing that I am of help to others. Social capital is a way of building each other and helping each other, sharing ideas and thus, by helping each other, knowing that whatever you are doing will have a good result by doing team work.
Nomalizo Pikashe - Nomzamo, Cape Town I’m born in Eastern Cape, in the vicinity of Lady Frere. I came here to Cape Town in 1975. I was a school child, but due to the illness of my father, I couldn’t carry on, he had TB. When I left school I was sixteen. I struggled to get work, at that time they were asking for your pass. I wasn’t interested in being a domestic worker but I was forced to be a domestic worker. I worked for one year but the second year I told myself I am going to get a training whatever I do and that’s how I became a pre-school teacher. I know the health of the community through the children. My community is one of the very disadvantaged communities. We are still staying in shacks and in some areas, no water, no toilets, 80% is unemployed. I can say that they are suffering from depression. The community health workers struggle to get sick people to go and see the nurses at the clinic. Sometimes they ignore the visits, they don’t want to be visited, they don’t want to be seen. They are not actually bed-ridden but they are lonely, malnourished, poverty-stricken people and they hide themselves away. We have got a lot of children being street children because they don’t get that love at home. I really feel very sad about AIDS. My people don’t want to accept it, they don’t want to understand it, they don’t admit it. I was trying to organise the pre-schools to come together and educate our parents, but all of a sudden you find that other educators are also still in the dark. That is the hardest part in my community, to find other teachers don’t want to speak to parents, they don’t want to speak about this to children. The main priority is education, for adults as well as children. Some of the children’s parents at our school have died of AIDS. I try to link up with their families and keep them at school and I help them with their homework, with reading, with everything. I don’t want them to feel just because their parents died that they have nobody else, that this is the end of their future. We are still their parents also. I act as their mother. Children must know that if their parents have died, there are still parents left. I was one of the government’s pilot site schools when they did a survey of what the pre-schools are doing in the communities, what the educators are doing in pre-schools. The government trained us, a three year course, but we were not awarded certificates because the course was not accredited. Last year we were trained again, the same course, funded by the government and this year we were awarded the NQF Level 4 certificates.
Now I am organising food gardening in the school and in a local clinic and in the community, empowering other women to start their own. The one side of the garden is medicinal plants. The garden in our local clinic was started by the children from my crèche. So, if I’m educating the children, I’m educating the parents. If those who have skills can come forward, it’s not about money all the time. If you can just think of what you can do for the community, you have invested. If we can work together, share what we have, we can brighten our future.
Polly Jacobs - Belhar, Cape Town I come from a gangster family but I did not become a gangster for the simple reason that my very family members that were gang members, they make sure that I did not follow in their footsteps. If they needed to give me a hiding, then they give me a hiding in order to keep me away. And the other thing is that both my grandfather and my dad were alcoholics, but today I am 60 years old and I still don’t drink and smoke. I wasn’t reared by my own mother and father, although both of them were still alive, I was reared by my grandma and my grandfather. And being very poor, they taught me values that no money in the world can buy like respect for elders, respect for your fellow human beings, and also to be concerned about your fellow human beings. There were times that they went to bed without food and I wasn’t aware of it just so that I could have bread for the next day to take to school. Because they believed you cannot think straight on an empty stomach. I’m bearing the fruits of my grandmother’s labour. I started with the Belhar community and I served on the Belhar Health Committee for 11 years. The biggest frustration I have is our social economic conditions because people are not able to provide for themselves, mainly because the unemployment rate is so high. That is also part of the reason why the TB rates in some of our areas are so high. In some homes there are ten to twelve families living in one house. In Belhar also, at one stage, there were 12 different gangs operating. I greet them, I talk to them, but I’m not involved with their gangster activities. I don’t look at them as gangsters, I look at them as residents of the community and as a resident, “What is your contribution to improving the status of our community?” If you look around our communities it’s mostly the women that do all the hard work. Most times they are the pillars of strength in our communities, without them our men are lost.
I cannot perform miracles and I cannot tell people what to do, but I’m creating the opportunity for communities to empower themselves, to take ownership of their own health, social and economic development. I take community Health Committees through the induction process, teach them the role and function of community health committees, teach them about active community participation. Basically whatever affects your livelihood then you need to be part of that decision because it’s your life. We must remember all of us, we only have one health and we only have one life and we need to take good care of it. The nurses and the sisters and the doctors, they are there to render a service, not to take care of our own health, that is our responsibility and that is lacking in communities. In different ways and in different forms my mentors all taught me the same thing: develop values and try to live by them. Maybe that is what is coming out in me and that is why I always challenge the authorities. Whenever the authorities of bureaucracy make empty promises it’s always motivated me to challenge them more. If you don’t put pressure on the authorities then they won’t change. I am the eyes and the ears of our respective communities and it is up to me to ensure that whoever is in authority delivers the services that are promised.
Richmond Dontsa – Khayelitsha, Cape Town I grew up at Eastern Cape in the district of Tsolo and I came here to Cape Town in 1990. I set up this organisation called Agency for Community Development. The area I am working in Khayelitsha is Site B South area. There are people in need. The people need information, the people need capacity-building. There are people who need to be helped to look after children, some of those children are orphans because of HIV/AIDS. I‘m working in those nutrition centres but it’s difficult to do the job because we don’t get enough volunteers because the people are eager for compensation in whatever they do. So, that makes my job very difficult, even to co-ordinate those centres. You’ll find that there are two volunteers which is not enough because you’re working with sixty children. And another thing, some of those children take medication, they should take it in the morning, in the afternoon, and in the evening. Fortunately, in the morning, their guardians or their parents give it to them, but at midday we have no-one qualified to give it to them. But we are trying because there is a need for those children to be catered for. We don’t have funds even to compensate some volunteers in my area. Imagine, you can volunteer for the whole year without any compensation, you are becoming down, down, down, until you decide to do something else because there is no payment in what you’ve done. But it is good work that is being done by those people. This thing of HIV/AIDS, it’s a hidden thing to the people, the people don’t want to talk about it and the people are dying because of it. If you say nothing about it, you won’t be helped. I would say to my community: Please speak out about HIV and AIDS in your relationship; speak to your boyfriend, speak to your girlfriend about it so that you may not fall into this epidemic. Use a condom to prevent AIDS and also encourage those who are already infected, they must take the medication. If you continuously take the medication, tomorrow you will be better than you are now. Another thing with the youth; we started up a literacy project in which the kids at tertiary level can help to teach the adults in the community to read. Because if they are unable to read and write then even if you go to spread a message door to door by handing out a pamphlet, they can’t read it. In the area of Khayelitsha there are places where you find they are dumping things amongst the shacks, which is unhealthy especially for the children because it is smelling and the children are playing in those piles of dump. As a result I’ve got a project that I am starting now, a recycling project in order to cater for those people who have no bins, so that is another way of trying to make good health in those informal settlements because it’s in my area, it’s where I am based.
Even if you are hungry in your stomach but if you do a good thing, you feel happy in life. And even if the people knock on my door, I feel very happy when someone comes and asks for help because that’s what I am there for. I don’t need to be paid by them but I need a thank you from the people, that’s what makes me feel good. Social capital is about what you are doing as a community worker. What you are doing is the social capital. Keep up your good work!.
Sandra Ambrose – Mitchells Plain, Cape Town I got into being a community worker through Bradley, I gave birth to a child who’s mentally challenged and taking him to clinics and hospital you speak to other parents, speak to other mothers that’re going is through the same motions, the same things you are. Eventually we said, why don’t we start something where on a Friday I will look after your children and we would rotate, and that is how it started. In time we started a little centre called ‘Joy Day Care Centre’. We felt it was a joy, these children were given to us and it’s a joy to have them. I don’t think I had it in me to become an activist but it must have been there all along. We met up with Disabled People South Africa, DPSA, they were a movement that was into having the rights of people with disabilities seen to. They felt strongly that you don’t look at the disability but you look at the ability. As parents we affiliated to that group and that is where Disabled Children’s Action Group, DICAG was born. We also felt that as parents we have a voice. We could say, “This is what we want for our children”. Yes we respect professionals but we wanted to talk for our children ourselves and that’s where the slogan comes from ‘Nothing about our children without us’. If you are doing a policy for disabled children, we want to know what that policy is. We want to give input into that policy because these are our children and this is about our children’s future. A big problem we have is inaccessibility of the roads and daycare centres, difficulties in accessing health services. At our hospital in Mitchells Plain, because I’m a very vocal person I would say, “Listen, I can’t be number 300 with Bradley who is hyperactive and mentally challenged, I need to see get assistance fast”. But a parent who is very passive is going to wait there all day, running up and down with this mentally challenged child, and she’s not going to speak up. Bradley has really opened a lot of doors for me. I never thought I had it in me to challenge government, I never thought I had it in me to challenge anybody! I didn’t have much education, I was also intimidated by people who were very learned, and I only went as far as Standard 7 so it was difficult for me to understand the doctor’s terms. You know I would say, “Can you break up that word for me so that I can understand it?” and that is how I learned.
I love people, I love working with people, I love talking to people, I would speak to gangsters, I was never afraid of gangsters, I would involve them in the community, say: “Listen, you are just standing there on the corner doing nothing. Come here, come clean the garden here for the children“. They would warn me, “Mams, don’t come in tomorrow with the children, there’s going to be a lot of shooting here”. And they had that respect that they didn’t want the children to be hurt in the gang fight. People inspire me, I’m proud when I see other parents developing. Today another woman is running the day care centre, I’ve started there but I’ve moved on. It’s those little things that sustain you, that make it worthwhile. It’s a great thing to work in the community. I believe what you put in is what you get out.
Shaheemah Baatjies – Salt River, Cape Town I was actually born in Claremont and then with the Group Areas, on my tenth birthday, we moved out of Claremont. Of course at that time I didn’t really know what was happening. Well we had no other place to go than to go to Garden Village, Maitland, which was very raw and it took a lot of adapting, getting used to coming out of a big home into this little place with the stable doors. It was very hard. Actually I think it’s good to start off having a bit of hardship because when you start off the other way round, that is where the non-caring attitude comes in because you don’t appreciate what it’s taken to get there. Later on, during my married life fortunately somebody offered us a place in Salt River and that is where I still am. Around 1999 a non-governmental organisation was started in Salt River and a call went around that they need people to help them with their survey and I offered. But believe me, when I did the survey, and you go to each and every person’s home, that is where the need really hit me. You know we found one lady that was lying dead for 4 days and nobody knew. And when the survey was done and we saw where the need really was, that is what made me decide to join Salt River Health Committee. I know what it is to be downtrodden, I know what it is to be hurt, and I know what it is to have hunger for love. So, that is why I want to give what I have. I’ve always had a soft spot for the elderly. You know the way young people are today, young people are discarding the elderly, it’s a very sore point in my life and, we are all going to get old I wouldn’t like someone to discard me one day. So, I’m actually investing in my own life by putting into the community what I am doing now. I feel there is a lot to be done as far as the elderly is concerned and I also feel the government is shirking their responsibilities by trying to put everything onto home-based care. The majority of those young people have left school, they might not have the money to go and further their education, they might have parents who need their help. Fine, let them volunteer but pay that person, just enough to give them some sense of achievement, so that they don’t turn to drugs. If you have nothing, you’re tempted to steal.
Sometimes I wish God gave me the power you know, honestly, just nobody needs to know, but just to be able to put my hands on you and to heal you. I’ve always had that longing in me because I feel other people’s pain. Compassion and love, nothing can actually replace that, no money in the world can actually replace that. You know if you’re rubbing somebody’s legs and to see the satisfaction on that person’s face. It’s like a circle man, they’re getting the satisfaction of being massaged, but it’s actually coming back to you. And this is something you can’t put into words. I want to tell the ladies especially in the Muslim community, we’ve all been put on this earth for a purpose, I know this is a delicate issue, but don’t let your home life tie you down. There is a great need out there, even if you spend one hour a week giving your time in the community, it’s something. Shereen Marlie – Salt River, Cape Town I started working with the City Council in 1976 as a family planning advisor, we had to motivate people to use family planning and it was not an easy task. We had to do house-to-house visits. My area was District Six, I know the area, the Seven Steps, the Bloemhof Flats, and it was actually nice to work there because there was a mixed variety of people. Some people didn’t have food and here you come with family planning, how were they going to listen to you? In the 1980’s, there was an attempt to start a health committee in Salt River but it was very difficult to work there. The people think, man, if something doesn’t affect me, I’m not bothered. So it collapsed. In 2002 it was rekindled again and fortunately up till now we are going very strong but for these four years, no funding. So each and everything has to come out of our pockets. Through our cake stalls once a month we generate money, besides going to the people in the community. Our main problem in Salt River is our drug-trafficking. Next to Spencer Road Clinic there’s a building, it used to be the Baths. But that building was closed down and at the moment it’s being used for drug trafficking. And I said to the committee, “Why don’t we approach the City Council for a multi-purpose centre for that piece of ground?” We will be able to cater for the youth; we will be able to cater for our aged. I hope and pray this will go up very soon because this will benefit a lot of people. With the new legislation the community must be aware that they have got ownership as far as the health centres are concerned. The community makes the health committee, they are the people that can make decisions, and if they feel this is what they want, it can be done. The health committee covers a broad, broad spectrum. It is about the drugs, it is about our youth, it’s about the aged, the drains, the streets, all those things. It is huge. It is there to give them a broader power to see what they can do as far as the community is concerned. Where I grew up, a place called Queenstown, we care for one another and we greet one another, we talk to one another. That is also one of the reasons why I can speak Xhosa as well, because I used to listen and talk to everyone, it wasn’t because of your colour that I’m not supposed to talk to you. There was always a love for other people as far as I’m concerned, especially if I see something is not cosy and something is not right, I will make it my business to go to that person and say, “Are you alright? Do you really feel alright?” I am married, I’ve got children, I’m looking after my grandchildren but I’ve got time for the community. If one person can do it why can’t another person do it?
Social capital starts right at the bottom it’s what the ordinary what the ordinary people are doing. There are a lot of us that are doing things without having money. At the end of the day I’ve done it without a cent in my pocket and it’s been done. That is what I understand by social capital!
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"I can never see someone else suffer."
