Health; Human Settlements; Water and Sanitation; Home Affairs 2017/18 Annual Reports; with DWS Minister

NCOP Health and Social Services

13 November 2018
Chairperson: Ms L Dlamini (ANC, Mpumalanga)
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Meeting Summary

Annual Reports 2017/18

The Committee took advantage of an opportunity to raise further questions with officials from the National Department of Health. They asked how the Department would assist provinces which were struggling, specifically Mpumalanga and KwaZulu-Natal. They were worried about the ability of the country’s health facilities to attend to people who were critically ill, the accessibility of vaccines for children, and the infant mortality rate. The preferential treatment given to private ambulances in the Free State, North West and Gauteng came under scrutiny, with the Department being asked if those who had benefited would be held accountable.

The National Department of Human Settlements had to respond to Members’ concerns about the programme to provide adequate housing for military veterans. They said that the beneficiaries had received housing that did not comply with the agreed square metreage. The Minister had agreed that there was a discrepancy, but beneficiaries had not been adequately compensated. Members commented on the high staff turnover in the Department, the issuing of title deeds in all of the provinces, and health and safety aspects in the transit camps.

When the Department of Water and Sanitation presented their report, Members highlighted the increase in irregular expenditure, and asked the Department how they were going to deal with the consequences. How would officials be held accountable for maladministration and corruption? Members wanted to know the way forward, and how it planned to pay its debts so that municipalities could deliver services. The Committee agreed to meet again to discuss the issues of leaks, sewerage challenges and the necessity for water boards in rural areas. The Minister, who was in attendance, said a focused written report would be given to the Committee on the issues raised.

The Department of Home Affairs was the last entity to present their report, and Members raised concern about the limitations of the DHA’s offices and the shortage of staff affecting the services it was able to offer. Other topics discussed included the entry of illegal foreigners into the country, the registration of birth certificates for foreigners, and identity theft. The issue of a private terminal at the OR Tambo airport was raised, and whether the Department had approved its operation. The Chairperson expressed concern that the Department was making important decisions without informing the Committee, such as its recent decision to relax visa requirements.

Meeting report

National Department of Health: Q & A session

The Chairperson thanked officials from the National Department of Health (NDOH) for being present and allowing Members more time to raise questions with them. There were a number of issues which had already been raised. On finances, the Department had been sitting with a qualified audit opinion for the last seven years. The impact at national level should also be felt at a provincial level. In certain areas, people were not feeling the impact on the ground. People who were critically ill were having to wait long hours to see a doctor, and facilities were not serving the people. The problem of facilities was one of management, and was not because of a lack of resources. On the issue of TB, children were using drugs made for adults. She asked for the names of the particular medicines. Private ambulances were clearly a problem in the Free State.

Ms Precious Matsoso, Director-General (DG): NDOH, apologised for arriving late.

The Chairperson accepted her apology, and added that in health facilities in the Free State, the appointed facility managers had still not been paid their allowances. In the Free State and the North West, there was a shortage of oncology machines and that those which were in use were not of good quality.

Ms L Zwane (ANC, KwaZulu-Natal) asked what the Department’s plans and strategies were to assist provinces which were struggling, especially Mpumalanga and KwaZulu-Natal. Had the first phase been evaluated and what were the outcomes? Was there a budget to ensure that things went smoothly? She said that the Compensation Commissioner for Occupational Diseases (CCOD) had not submitted a report for years. How was the Department assisting in this? What did the Traditional Health Practitioners Bill seek to achieve? On the issue of vaccines for children, she said there was a problem of accessibility in KwaZulu-Natal. She personally had gone to the clinics and found that vaccines were available only if one could afford them. What about ordinary people? People who came from other countries who had not yet been vaccinated were going to bring diseases into the country, and children would not be protected from them.

Ms T Mpambo-Sibhukwana (DA, Western Cape) asked the Director-General to explain what happened to the nine infants who had died at a hospital in Gauteng. What was the mortality rate for each province? What had the NDOH done with the Department of Water and Sanitation (DWS) to mitigate problems? She said that there was a shortage of staff in the Free State. What was the Department was doing to prevent ebola? People from other countries were bringing ebola into South Africa, and this comprised the health of ordinary people.

Mr C Hattingh (DA, North West) asked for clarity on the Departmental oversight of provinces. On the issue of Mediosa, the mobile clinic service provider, had there been interference from the Department, or had it looked the other way? This issue was in the public domain and it should have been well known in the Department what was going on. The private ambulance services had been allowed preferential treatment with no consequences. This had been done with impunity and the Committee had not been prepared to get to the bottom of it. He was concerned that the Minister boasted about the successes on the Multi-Drug Resistant (MDR) and Extensively Drug Resistant (XDR) anti-tuberculosis treatment. It was a very important anti-TB treatment, and he asked what was being done to address the continued abuse of treatment. What was being done about counseling ordinary people who had not advanced to MDR and XDR treatment? What was being done to maintain infrastructure? He added that the allocated budget for maintenance was not being put to fruitful use.

The Chairperson said that some of the questions were not coming directly from the Department’s report but were coming from oversight. The Committee agreed that they wanted a full report on private ambulances in all of the provinces. Since 2014, people had been agitating for a 24-hour service clinic, and asked the Director-General to deal with this issue.

NDOH’s response

Ms Matsoso replied that the Department had established a team of technical and administrative staff. The Department had visited 50 hospitals in various provinces, and its report would be sent to the secretary of the Committee. The report highlighted multiple problems. The Department wanted to change how grants were being used, and this would solve the problems. Provinces send their business plans to the Department, but there was no link between the plans and the problems.

On the issue of private ambulances, she said that in the Free State, North West and Gauteng there were a number of ambulances which were parked but were not being used. The Department had been following up on this. The mortality rate had increased since the privatisation of ambulances.

Regarding qualified audit opinions, she said that some of the provinces had improved and the Department was close to getting Mpumalanga unqualified.
Ebola was rife in the Democratic of Congo (DRC) because of the conflict. There was a vaccine available, but rebels had started attacking the border that was close to Rwanda and Uganda. Where rebels were arrested, the disease would not spread.

She said that the Chief Financial Officer (CFO) of the Department would comment on the issue of redirecting the budget for maintenance. The Auditor General (AG) had recommended routes but that this would only make the Department a compliance-driven one and this would impact on their ability to deliver.

She said that the Traditional Health Council regulated products. The Department had been moving from one province to another and had come up with guidelines for a proper system of regulation. These guidelines would be presented to the Committee.

An official from the Department said that they have done a review on the infants who had died in the hospital. There had been 41 infants, and there were a number of causes which had resulted in their deaths. He listed these as significant overcrowding, premature births and exposure to HIV. As a consequence of overcrowding there had been inadequate bacterial infection control. On the issue of premature births, he said that this was a result of more teenagers having babies. There had been a large influx of undocumented minors that had contributed to the issue of overcrowding. Maternity wards and ante-natal wards were particularly overcrowded.

The Chairperson asked Ms Matsoso and the Chief Financial Officer (CFO) to respond to the rest of the questions in writing.

National Department of Human Settlements: Annual Report

Mr Mbulelo Tshangana, Director-General: National Department of Human Settlements (NDHS), said that in the last financial year, the Department’s finances were in good shape but the provinces of the North West, Limpopo and Gauteng were still struggling. When Gauteng did not perform, it affected the entire country. Grants had been introduced last year to address the title deeds problem. The affordable housing programme had not performed. The biggest challenge was that the Department was dealing with a highly indebted market who earned very little.

The structure of the presentation was aimed at addressing what the Department had achieved, what had not been achieved, and the expenditure report. The Department had taken funds away from Johannesburg and Cape Town because they were not performing, and had shifted them to the metropoles which were performing.

Mr Neville Chainee, Deputy Director General (DDG): Strategy and Planning, NDHS, explained the Department’s plans to improve the implementation of its programmes. On the programme of delivery support, he said that the AG had indicated that in many of the provinces there was an inability to meet the targets. There had been a qualified audit opinion for the Western Cape. On the programme of military veterans’ housing, there had been a problem with the verification of the lists of veterans and units.

Ms Funaneng Matlatsi, CFO: NDHS, said that the Department had had to take money away from Gauteng, Limpopo and the North West because they were not performing. The Department had lost housing opportunities in Gauteng. Most of the provinces had spent 100% of their grants. On the issue of the AG’s report, she said that the Department would consult with the Department of Planning, Monitoring and Evaluation (DPME) and engage with municipalities that required attention. The challenge of title deeds would be solved with a specified grant.

Mr Tshangana said that the last page of the report was important and that the Department had been working on pieces of legislation. He added that Members could expect the Bills to come their way soon. He also noted an apology from the Minister.

Discussion

Mr D Stock (ANC, Northern Cape) referred to the Department’s programme 2 (Human Settlements Policy, Strategy and Planning), and said that it had not been performing for three years. How did they intend to deal with this situation? In the Northern Cape, military veterans received houses but they were not built according to the agreed square metreage, and asked for clarity on this.

Mr Hattingh noted that money was being taken away from certain provinces and given to other metropoles. What criteria were being applied in doing this?

Ms Mpambo-Sibhukwana referred to the issue of military veterans’ houses that did not comply with the agreed square metres. How far was the DHS with the process of compensating them with an extra room? What long term plans were being implemented to reduce costs? What was the long term vision in respect of electricity, housing and water and sanitation? During a visit to the Free State, she had seen flats which had been incomplete for four years. How far was the process of that project? On the issue of title deeds, she had previously asked the Minister to provide written information on each province -- how far were they in issuing title deeds in each province?

Ms Zwane referred to the human resources plan, and asked what mechanisms have been put in place. She asked for clarity on the assessment of service delivery in the municipalities. Under programme 4 (Housing Development Finance), what was the subsidy for fees? She commented that there was a very high staff turnover, and asked why there was a mass movement of staff in the Department.

The Chairperson said said the Committee appreciated the leadership of Mr Tshangana for keeping the Department stable. In the catalytic project, why had the report omitted Mpumalanga? Where money was transferred to provinces to build houses and all of it was spent, was the Department able to check how the money was spent? In Mpumalanga, one could not see the performance based on the money spent. On the issue of personal expenditure, how did this affect the projects that were not achieved? Was expenditure in line with performance? Regarding the one bedroom houses, she said the biggest challenge had been that people in the community had been promised they would be given an opportunity to be a part of the project, but they had not been appointed. They were promised they could participate and a small percentage would be allocated to them. She asked the Department to indicate which boards still needed to be appointed.

Referring to transit camps, she said that KwaZulu-Natal had a problem with sewerage. How was the Department following up on this? This was also a problem in Khayelitsha, and people had been in transit camps for up to 10 years. There were high levels of crime in transit camps, where people had to share toilets and were not given decent accommodation. She asked how far the backlog had been reduced. There had been much discussion on the Urban Settlements Development Grant (USDG). Secondary cities were not being assisted, and they were affected by urban migration. Was the title deeds strategy working?

She asked Mr Tshangana if the Department could respond to the issues raised in writing.

Mr Tshangana replied that the Department would submit reports to the Committee by Monday.


National Department of Water and Sanitation: Annual Report

The Chairperson welcomed the Minister and officials from the Department, and asked the Minister if some people had left the Department, and if it was related to corruption.

Mr Gugile Nkwinti, Minister of the National Department of Water and Sanitation (NDWS), replied that the internal audit department had produced a report, and action would be taken. He added that Mr Sifiso Mkhize, the Acting CFO of the Department, had resigned.

Ms Deborah Mochotlhi, Acting Director-General: NDWS, said that the ground water level trends showed that resources had deteriorated. Regarding organizational environment, the single Catchment Management Agency (CMA) decision had been reviewed, and the focus was now on establishing the remaining seven CMAs.

Irregular expenditure had increased from R4.179 billion in 2016/17, to R6.156 billion.  and there was now a net interest compared to the previous financial year. Under fruitless and wasteful expenditure, a total amount of R52.574 million was resolved during the year, and R2.682 million had been transferred to receivables for recovery. An outstanding balance of R16.175 million was still under investigation.She noted that the operating expenditure had a decline because of reducing its projects to curb the overdrawn account. The Department had received a qualified audit opinion and the water trading account was one of the issues raised.


Discussion

Ms Mpambo-Sibhukwana said the issue of irregular expenditure was a cause for concern. Was there monitoring and evaluation on this aspect? What criteria were used for the allocation of bursaries? What were the time frames for filling vacant posts? Municipalities in the Free State were affected, and she asked when their debts would be paid. She said that municipalities were unable to deliver, and asked the Minister to ensure that they were assisted. How far was the Department with the eradication of the bucket toilet system? She asked the Department to attach time frames to dealing with irregular expenditure. On the issue of leaks, she asked if the Department was reaching out to the people and communicating in isiXhosa.

Mr Stock said that the Department had previously presented listed projects. What was the status of the implementation of these projects? How did it deal with challenges to make sure projects were successful? He asked for clarity on the performance bonuses given to the Department’s employees. On the qualified audit opinion, what measures have been put in place to ensure that the Department could perform new projects in the next financial year? He asked for further information on the current financial status of the Department. What steps had been put in place to deal with irregular expenditure? Had officials been held liable for missing money?

Ms Zwane said that the Department had inherited major problems. How would they recover money that had been taken out of the Department wrongfully? She commended the project that was going to begin in Clanwilliam. She asked for an explanation for the reduction in the number of entities in the remaining CMAs. She asked for clarity on the use of private expenditure, and asked how this was being dealt with. How was the Department dealing with people who continually flouted the supply chain management (SCM) regulations?

Mr Hattingh said that the Committee was seeing a department in regression. He asked why bonuses were paid, with no consequences being enforced. He observed that there had been some involvement from the National Prosecuting Authority. What investment was being made in international participation? He asked for more clarity on the Department’s way forward.

The Chairperson said that the protests about water had a direct correlation with the performance of the Department. She asked the Minister if there was a commission of inquiry into its financial performance. The challenges had not changed since 2014, and Members wanted to know the way forward. Was there a need for water boards in rural areas?

The Chairperson asked the Department to respond to the issues raised in writing, and gave the Minister an opportunity to comment.

Minister’s response

Mr Nkwinti replied that the Department would produce a focused report for the Committee. Issues of corruption and maladministration had been raised in the internal audit report, and some officials had left the Department. Corrective measures had been implemented and the Department was busy with the process now. Officials were facing disciplinary processes. He reassured the Committee that internal capacity would be used, and outsourcing had been abandoned.

 
National Department of Home Affairs: Annual Report

The Chairperson welcomed officials from the National Department of Home Affairs (NDHA) and asked them to report on their performance in the last financial year. The main issue was whether the Department had been able to achieve within its budget. She noted an apology from the Minister and Deputy Minister.

Mr Thulani Mavuso, Acting Director-General: (NDHA), said the Minister had an appointment with a doctor in the morning and would be at Parliament in the evening. The Deputy Minister was on leave and would be back in office on Monday to resume her responsibilities. He had been requested to present the report to the Committee.

The Chairperson replied that the Minister should send a letter to the Committee indicating his appointment. She said there were time constraints, and asked Members to comment.

Ms Mpambo-Sibhukwana said that one of the officials should call the Minister and ask him to email a letter of appointment before the meeting could resume.

Mr Hattingh said that the Committee had been confronted with a similar situation in the past, and it could not continue. It was a waste of valuable time to send officials back.

Ms Zwane said that the Committee was under time constraints, and asked for the irregularity to be corrected.

The Chairperson requested the officials to contact the Minister as the meeting proceeded.

Mr Mavuso began the presentation, and said that 14% of their targets were not achieved. The Enhanced Movement Control System (EMCS) could not be finalised. Offices were overcrowded with long lines of clients. The Department’s footprint was inadequate, and Pretoria had only one office. There was a challenge because of the constant reduction in the budget, and there had been a loss of 450 internal positions. They had not been able to fill the positions. The main responsibility of the inspectorate was to enforce applications for permanent residence, but it remained under-capacitated.

Mr Gordon Hollamby, CFO: NDHA, said the Department had maintained an unqualified audit position, and were very close to getting a clean audit. The irregular expenditure was related to old cases in 2010 and they were waiting for condonations to come through. Should they come through, it would reduce the amount significantly. The Department still had audit risk.

Mr Mavuso said that the Department wanted to continue to develop the Home Affairs Bill and that their focus was on governance and administration practices.

Discussion

Ms Zwane said that the Committee anticipated a clean audit so long as the Department adhered to the suggestions in the audit opinion. With regard to Information Communication Technology (ICT), what was the Department doing to ensure its technology was in order? They had not achieved their target of issuing three million “smart” identity document (ID) cards. How were they going to increase the issuing rate? Was the Minister capable of addressing the challenges the Department was facing? Had they started the process of forming public-private partnerships to improve land ports,? What were they planning to do to achieve the target of the EMCS piloted at one port of entry?

Ms Mpambo-Sibhukwana said that DHA centres in Gauteng were very small, and it was difficult for doctors to work in them. When was the Department planning to implement the Committee’s proposal for renovations? Foreigners were allocated time to stay in the centres for up to 180 days, and this had cost implications for the taxpayer. What efforts had the Department made to mitigate the challenges when people exceeded their stay? There was a testimony from police saying that there were illegal people crossing Beitbridge from Zimbabwe. She highlighted the problem of illegal people entering the country. On the issue of registering birth certificates for foreigners, how many did the Department deal with? What was the effect of births when the mother was South African and the father was not? She said there were people who were marrying South Africans for the sake of citizenship. What was the Department doing about people who had had their ID’s confiscated, or used in the wrong manner?

Mr Hattingh said that when he had visited a school in Gauteng, he had been informed by the principal that there were problems of undocumented foreigners applying to enroll at the school. In hospitals, more than 50% of patients were undocumented foreigners. Referring to the DHA offices, he had seen four people sharing one office and one vehicle. The vehicle had been taken away and was not replaced. How many inspectorates would there be and how would they be resourced? He said there had been an increase in xenophobic attacks and it was the duty of the Department to know who was in the country legally and illegally. What was the way forward on this? In the same office he had visited, no one was being assisted because the computer was down. What was the way out of this? He noted that the passport and ID system was being maintained by South African Revenue Service (SARS) technicians -- was it true that the Department was going to take this over, and if so, what was the rationale behind it?  He said that the fingerprint system was giving problems, and wanted to know why.

The Chairperson asked if the private terminal at the airport had been approved by the Department, and if it was operational. What had been the implication of the court judgment? She said that the Committee could not process the Bill when there were outstanding matters. If the Border Management Authority (BMA) was in operation, what had the Department done about those who had confessed to taking bribes? This was the responsibility of the DHA, and not SARS. On the issue of airports, she asked the Department to explore systems used in other countries, like Singapore. She had received letters from people who had valid South African ID’s, but had been told they had become invalid. She would forward these letters to the Department so that they could assist the people. She asked about the appointment of the Director-General. She said that one official in an office could not assist the number of people that needed help.

On the issue of social cohesion, she said the Department could not wait five years before they started implementing. She asked the DHA to form a working relationship with the Department of Basic Education (DBE) to solve the issue of children who were without birth certificates. In the Eastern Cape it was not an issue related to foreigners, but rather an issue of parents who chose not to let their children have birth certificates. She explained that children were planting and using dagga, and parents did not want this to be traced back to them. The Department sometimes made big decisions without informing the Committee. For instance, Members had heard that visa requirements had been relaxed on the radio. She asked the Department to brief the Committee on decisions they took.

DHA’s response

Mr Mavuso said that the Department had reached an agreement with the National Treasury to allow them to generate their own revenue and be self-funding. The funding of the Department was inadequate. An office which was fully fledged and could offer adequate services required at least 20 to 25 people. There were 412 offices and this meant that 10 000 people were required. The Department already had 9 000 people. It needed to create centres of excellence, but this meant that their footprint would be reduced.

On the issue of ICT, he said that of the 412 offices, there were only 84 where one could apply for smartcards. Certain offices were difficult to expand because of their physical infrastructure. They had had a meeting with the Department of Public Works (DPW) and asked them to provide purpose-built offices. It had been agreed that the Department would submit designs to the DPW. The ICT challenge was the main reason they could not expand their footprint. He explained that in cities, the private sector invests in ICT because they need it, but in certain towns no one was investing in it. The DHA was working with the State Information Technology Agency (SITA), but SITA was not responding fast enough. SITA was not coping because they had too many clients.

Regarding the BMA, he was not aware it had been referred back to the Minister, and he would talk to him about dealing with it. In the border environment, they wanted the BMA to have one commanding control, but there were multiple stakeholders and the lack of integration created a problem.

He would personally visit and do his own assessment of the clinic that was meant to stabilise people before they were transferred to a hospital in Krugersdorp. He explained that when a child was born in South Africa, as long as one of the child’s parents was South African, the child would be South African. There was a continuing problem of people entering into marriage for the sake of citizenship.

Regarding identity theft, he said that the Department assisted with an online verification process and they were looking to expand it. The Department wanted to bring down the age of applying for an ID to nine or 10 years old, and would report to the Committee once they were ready with a policy proposal on this.

On the issue of hospitals, the Department had met with the MEC of Health in Limpopo and she said her budget was depleted before the close of the financial year. People were coming from the Southern African Development Community (SADC) region and attended ante-natal classes in hospitals. He explained that hospitals did not require identity documentation for people to be treated or to birth in the country. The issue of illegal migration had to be dealt with at a political level. The border and points of entry must be isolated sterile areas, but they were business and contaminated areas. Multiple stakeholders were involved and there was no single control. He added that a child could receive a grant from the South African Social Security Agency (SASSA) without a birth certificate.

Regarding deportation, he said that the White Paper on International Migration tried to deal the issue of illegal migration.

He said there was no approval for the private terminal at the airport. The Minister had indicated at a meeting that it had sounded like a good idea, but there had been no processes of approval.

The Chairperson asked how long it would be operating for.

Mr Mavuso replied that the Department was going to regulate their relationship with Fireblade Terminal Operations. The issue would have to be taken up with Cabinet because he was unsure whether the responsibility lay with them or the Department of Transport. If it was assigned to the DHA, a policy would have to be drafted. Its purpose was to operate as a port within a port, and not as a port of new entry.

Ms Zwane asked if it was already operating. On what basis was it operating, if there had been no approval? She raised concern that it was being governed by the courts, and not by Parliament.

The Chairperson said that it was a serious matter, that the Minister had not approved it in writing. She did not know whether it would be challenged in a court of law.

Mr Mavuso replied that there was no letter of approval, and only a letter signed by the Minister who had rejected it in October 2016. He would report back to the Committee with a full presentation on this matter. Regarding the matter of airport systems, he said the Department had already looked at the Singapore model. There was a Memorandum of Understanding signed for next year, where a new model would be implemented as well as an e-pass system.

Where people had an ID but then it was later blocked, the Department investigated these cases and the Minister could make an exemption on humanitarian grounds.

The DHA would like to finalise the post of Director-General, but the position had not yet been advertised because there was going to be a reorganisation of government, so the position would not be filled until after the election. He said there was no money to fill the other vacant posts.

On social cohesion, he said the Department had a working relationship with the DBE. There was a constitutional imperative for children not to be denied education even where they had no documentation.

Mr Hollamby said that the DHA had achieved an 86 % performance against its targets, and expenditure had been 99% against budget. Money had been spent on targets which were not achieved.

The Chairperson asked if the Department had spent money on the BMA, and it had not been achieved.

Mr Hollamby replied in the affirmative, and said that the Department had appointed six shortlisted companies to take the process forward. They had to go to the market with a form of proposal and this would be done in the new financial year. Vehicles for the inspectorate had been deployed already.

The DHA’s Acting Chief Information Officer (CIO) said that on the issue of points of entry, the old system was still running and had been developed through SARS. The Department had completed testing of a new biometric system and were now doing the integration testing. It was intended to test the system at Lanseria and then at Cape Town International Airport by the first quarter. The e-gate system would be used in Cape Town first, and then all other points of entry. It would replace the current system.

On the issue of migration from SARS, he said that SARS had indicated they could no longer assist the Department. They were speaking to the National Treasury about appointing IT technicians. The system would hopefully be launched by April next year and it would be run by the Department and not SARS.

The Chairperson said that some systems had the potential of being upgraded.

Mr Mavuso replied that the Department had tried that option, but it was too expensive to upgrade.

The Acting CIO said that the new national identity system would replace the national population register. There were processes which had never been, and they were developing them on to the new system.

Ms Zwane asked for clarification on babies who were born in South Africa, where the mother was a foreign national and the father was unknown. If the mother claimed the father was South African but had no proof, how did the DHA handle the situation?

Mr Mavuso replied that the mother would have to register the child in the country that she was from.

An official from the Department said that men were abusing the system. Where a mother gave birth in the country, the child would not be regarded as South African unless one of the parents was South African. Where someone claimed they had been raped, a paternity test would be used.

Mr Mavuso said that if the child remained in the country, they could elect to assume South African citizenship.

The meeting was adjourned.

 

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