Playing calamity’s concertina in Covid-19

An article from DGMT’s Annual Report, 2020
Normally, about 10 000 people die every week in South Africa. If they were all white – or rather, if they had the wealth and privilege of most white South Africans, that number would be 40% lower, as the age-standardised death rate for whites is less than half that of black Africans.[1] But, in the first week of 2021, official figures recorded almost 25 000 deaths as the second wave of Covid-19 took its grim toll. In just eight months between April 2020 and January 2021, the number of people who died in excess of the ‘normal’ was 125 000 – roughly a quarter more than our annual death rate.[2] In many homes, more than one family member died. While some of these deaths may have been only indirectly linked to Covid-19, as people avoided hospitals and struggled to access their chronic medications, many others died from undiagnosed coronavirus infection. No matter which, they all died as a result of the devastating pandemic, leaving communities across the country grieving and shell-shocked.

As with many other parts of the world, this is how 2020 ended in South Africa, and how the new year began. The second wave erased all doubts that Covid-19 was indeed a national calamity. The wounds are raw and painful – and we must acknowledge that as we begin to rebuild and restore – even as the pandemic is still with us. One of the positive effects of our common vulnerability was that we shed some of the pretences that keep us apart: civil society from government and commerce, junior managers from seniors – titles and positions that mask the fact that we are ‘all human’, as the Minister in the Presidency, Jackson Mthembu so poignantly tweeted a couple of days before his death.

This disruption of the social order also allowed voices from the ground to be heard, louder and more unsettling. Politicians were uncharacteristically quiet as ordinary people found ways to express their hunger, anxiety and anger at the greed and corruption which accompanied the procurement of personal protective equipment (PPE). It is too early to be sure, but it seems like Covid-19 shifted the power dynamics in the country – making people even more cynical of political parties and a state more reliant on the expertise distributed across all sectors of society.

Inevitably, grand schemes for national development were shelved or put on ice, shunted aside by basic priorities of food, income and life itself. Labour and consumer practices changed fast. The informal economy was decimated by the hard lockdown, but its dynamic nature confers resilience and it should be able to bounce back quite quickly. ‘Home’ became more important to all of us – as a place of work and of refuge from the virus. This sparked a wave of global innovation aimed at reaching people there – to connect, inform, teach and persuade. While it is still early days, and the overriding sentiment is gloom, these innovations open up new possibilities for strengthening social and economic connectedness where today, marginalised households experience poorer health and education and have access to fewer jobs.

Calamity loosens social hierarchies and accelerates change. It’s as if time itself speeds up, and problems and solutions become crystal clear. In her first novel called In Calamity’s Wake, Natalee Caple notes that “there are points where time accordions. It is as if the past, the present and the future are pressed together in a concertina, every minute toughing and then every minute open to be viewed.” John Kingdon describes these glimpses of new possibility as ‘policy windows’, when politicians suddenly get it; they grasp the problem and see the solutions – and are willing to implement them.

In South Africa, textbook cases of ‘policy windows’ emerged as the disaster laid bare the extent of inequality and, thankfully, stiffened the spines of our political leadership. The national ban on the sale of alcohol, applied at various times during the Covid-19 lockdown in South Africa, gave us glimpses of a better society: fewer trauma cases in hospital casualties, less domestic violence and less public money needed to offset the negative effects of alcohol abuse. The ban was instructive, but couldn’t continue forever, and would have become increasingly counter-productive as bootlegging gained hold. Still, there are ways to reduce excessive alcohol consumption without impinging on people’s right to drink in moderation, and implementing them now would vastly improve the rights to safety and well-being, particularly for children and women.

Another policy window was the zero-rating of digital educational content (i.e. no data cost to the user), intended to keep students learning through the lockdown. Inevitably, the wealthier universities, colleges and schools were able to make the best use of this disaster regulation, but it showed the critical importance of free digital services provided by public benefit organisations (PBOs) to children in informal settlements and rural areas. These insights no doubt contributed to the decision by the Independent Communications Authority of South Africa (ICASA) to make zero-rating of all digital content by PBOs and government a condition of licence for telcos seeking additional radio bandwidth for operations.

The DGMT team stepped into this space of uncertainty and flux. Concerns about the high levels of binge-drinking in South Africa had been on DGMT’s radar for the past three years, working closely with the Western Cape government, which is seriously considering policy options for alcohol harms reduction.

While most activists on both sides of the fence focused on the immediate effects of the ban on liquor sales, DGMT used the opportunity to galvanise a coalition of researchers and academics, petitioning government to accept the World Health Organisation’s recommendations for reducing the social and economic damage of excessive alcohol consumption. These policy ‘best buys’ have been shown to be highly effective, feasible and implementable at low cost. Despite this evidence, the South African government has never really taken issues of alcohol misuse seriously – until now. While this policy window is open, we must do everything we can to create a healthier society.

Similarly, ICASA’s inclusion of the zero-rating of public benefit websites as a condition of licence was the result of a submission by DGMT during the consultation process – in itself a simple submission, but actually the culmination of seven years of advocacy with government and the network operators! Assuming that ICASA and the network operators can resolve their other issues related to the spectrum auction, this neat policy solution will substantially increase digital access to information and reduce the cost of social innovation.

These regulatory changes to liquor and information & communications technology (ICT) practices could constitute massive breakthroughs for our society. But there also gains to be made by better implementing existing policies and programmes. In March 2020, the availability of food plunged precipitously due to the stringent lockdown regulations. Families shut indoors without access to the ‘piece jobs’ that supplement government grants simply ran out of food and had no way of replenishing it before the end of each month. For those foreign nationals excluded from any form of social security, there was no relief. For South African citizens, some relief would eventually come in the form of augmented child support grants and a once-off special Covid-19 grant of R350 (US$23), for which a full ten percent of the South African population applied.

In the meantime, hundreds of organisations, large and small, mobilised to provide food parcels. They part-filled a crucial gap at a time when families were desperate, but food distribution created risks to personal safety from restive crowds and coronavirus transmission. When the large food retailers opted to protect their own commercial interests ahead of that of communities – by refusing to participate in providing food vouchers redeemable at any store – DGMT and the technology companies servicing local spaza shops implemented an interoperable voucher system benefiting over 100 000 people across the country. It showed that the overhead and distribution costs of social relief of distress programmes can be substantially reduced – freeing up more money for beneficiaries and supporting the local economy at the same time.

This system also supported the reopening of early learning programmes, by providing food at a time when job losses had reduced the ability of parents to pay. DGMT and its early childhood development (ECD) systems partner, Ilifa Labantwana, then assisted the Department of Social Development in directing an employment stimulus package of nearly half a billion Rand to 110 000 ECD practitioners and social workers by the end of March 2021. At the time of writing, this complex undertaking is still underway. If successful, it will show how more of the informal sector – which provides early learning to most young children in ECD programmes – can be organised and supported to improve the quality of services.

While the events described above created opportunity for DGMT to accelerate a number of its long-term strategies, we also had to confront the acute crises linked to Covid-19 and implement new programmes in response. With the support of key funding and logistics partners and tapping into a network of 350 local nongovernment organisations, DGMT set up a procurement and coordination hub for the distribution of PPE to over 30 000 community level workers across the country. At the outset, we had predicted that community health workers, social workers and other paraprofessionals attending to people in their homes would not only be at great risk, but would likely be last in official lines for PPE. Over the course of six months, DGMT was able to procure and distribute over 300 tonnes of PPE, stimulating local manufacturing innovation and creating employment opportunities at the same. Against the backdrop of government corruption and inefficiency, this project showed the value of civil society in responding to national crises. Such value is often discounted by both government and the corporate sector.

One of civil society’s greatest contributions is its ability to ‘see’ and respond to people in need, to whom public services and commerce are often blind. Covid-19 created an urgent need for information to reach people without access to digital content, whose primary source of information is still radio. Working with the National Department of Health and public broadcaster, a team commissioned by DGMT and its close partners, Innovation Edge and Ilifa Labantwana, produced over 1 500 daily radio programmes broadcast in 12 languages on 15 public radio stations and 55 community radio stations between April and October 2020. This massive undertaking provided a source of accurate information to 20 million people, while creating a groundswell of engagement and community feedback.

Much of this feedback was distressing – expressing the hunger, fear, anxiety and loss of community members. It brought home the fact that both the material and psychological consequences of Covid-19 will be with us for a long time, even if the pandemic burns out naturally or is suppressed by vaccination. That sense of hope and aspiration – so crucial to human development – is now even more brittle. Even as we regroup in 2021, children are being born and starting to grow up, and it is up to us to define the new ‘with-Covid’ world. It is incumbent on all of us to offer leadership, to rebuild a sense of hope and possibility, and to use the pragmatism that emerges from crisis to forge a more inclusive society.

The world is still unsettled and there is still opportunity to bring about extraordinary change. There is no time to waste, and we must act boldly before time starts to stretch itself out again.


Dr David Harrison is the CEO of the DG Murray Trust. This article appears in our 2019 Annual Report.

Read DGMT’s Annual Report for 2020 here

References:

[1] Pillay-van Wyk, V., Msemburi, W., Laubscher, R. et al. (2016). Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease. Lancet (Global Health), Vol. 4(9): p642-653.

[2] South African Research Council (2021). Report on weekly excess deaths. https://www.samrc.ac.za/reports/report-weekly-deaths-south-africa