Protection of the vulnerable: Engagement with Department of Social Development & umbrella bodies

Meeting report

Western Cape Social Development Presentation

An official from the Department of Social Services stated that protocols have been put in place between the provincial Department of Social Development (DSD) and the Department of Health (DOH) with regards to the prevention and management of COVID-19 at old age homes:

-Western Cape Government (WCG) Response - roles and responsibilities between DOH and DSD in long term care facilities (LCTF)

-Practical Guideline of Western Cape Departments of Social Development and Health in the management of COVID-19 in LTCF

-Department of Health doing screening and testing on site at a facility with staff and residence

-Communication with facilities aligned with regulations issued in terms of the Disaster Management Act, 2002

-Awareness Information - according to World Health Organization (WHO) guidelines, R1.755 million has been made available for all 117 funded facilities for the management of COVID-19

-Appoint service provider to assist standalone facilities with assessments, training, guidance and support with preventing and managing COVID-19

-Facilitate a volunteer organisation to deep-clean facilities – with a focus on homes in vulnerable communities and hotspot areas

-DSD Regional Office Directors/staff members’ representation at Joint Operations Committee (JOCs) on district/local level and provide psycho-social support

-15 000 x masks and 2 340 x liters sanitisers have been distributed to funded facilities across the province

-5000 x face shields have been distributed to 117 funded facilities

-23 000 x cleaning products have been distributed to standalone facilities

 

Challenge:

-The challenge of Personal Protective Equipment (PPE) remains

 

Western Cape Social Development (Sub-programme): Services to Persons with Disabilities

An official from the Department stated that there were 39 residential facilities across the Western Cape, with a total of 1673 residents. Of the 39 facilities, five were designated specifically for children with severe to profound intellectual disabilities and these house a total of 92 children.

Geographic spread across the six regions:

Metro North - 13 Facilities and 541 residents

Metro South - 7 Facilities and 264 residents

Metro East - 3 Facilities and 54 residents

Cape Winelands - 10 Facilities and 581 residents

Eden Karoo - 4 Facilities and 193 residents

West Coast - 2 Facilities and 40 residents

 

COVID-19 Interventions by the Department

The following documents were circulated to residential facilities for guidance

-Protocol for Funded Residential Facilities where there are suspected positive or confirmed positive COVID-19 cases

-Guidelines for the prevention and management of coronavirus Infection in long term facilities

-Distribution of donations of masks, face shields and sanitisers for metro-based facilities

-Fumigation of premises of metro- based facilities by Non-Governmental Organisation (NGOs): Volunteer Ministers

-Distribution of masks and face shields for Eden Karoo and Cape Winelands facilities

-Financial Assistance of 15 000 per facility

 

BADISA Presentation

Ms Christine Quickfall, Chief Executive Officer, Badisa Charity, thanked the Committee for providing the platform in order to give feedback on certain issues that emerged as a result of the COVID-19 pandemic period.

Financial challenges

Government transfer < core cost of service < the full cost of service:

-No fundraising since middle March; donor fatigue

-Dramatic and sudden event: additional expenses not budgeted for

-Uncertainty: Monitoring and Evaluation targets; Service Level Agreements new targets and funding levels

-Budget reprioritisation?

 

State assistance/support:

-Stability: funding levels and administration of payments reassuring (letter 3 June)

-Support in providing PPEs, albeit not sufficient

-Responsiveness when enquiring

-Instruction on essential services 25 March; prevention and infection guidelines: 20 May; Badisa own Standard Operating Procedures and protocol

 

Communication and social cohesion:

-No recipe/best practice. Isolated opportunity for collaboration and mutual learning

-Practicing “big government” approaches: Department of Labour and Home Affairs

-Best practice: provincial government weekly engagements with faith sector

-Staff trauma, exhaustion and burnout

-General uncertainties about virus behavior; impossible medium/long term planning

-Implications: yet to be determined

 

Western Cape Older Person’s Forum (WCOPF) Presentation

Mr Vernon Hendricks, Chairperson, Western Cape Older Persons Forum, expressed his heartfelt condolences to all who had lost loved ones due to the COVID-19 virus. He also extended his gratitude to all the first responders, essential service employees, public health leaders, physicians and scientists who had been working tirelessly in order to treat COVID-19 patients, to protect vulnerable the populations and minimise the spread of the virus.

While COVID-19 affected everyone however, the critical issue was the rights and wellbeing of the vulnerable as they were disproportionately affected. The pandemic did not seem to ease off and therefore everyone had an obligation to respect the wellbeing of not just older people but the population at large. During this period, older people had come out of retirement in response to the virus and had been assisting in health facilities and running soup kitchens without assistance from any of the poverty alleviation organisations.

The challenges that older persons face:

-Job losses

-Loneliness

-Service centres being closed

-Savings being depleted

-Safety and security

-Food security

 

Engagements with a focus group of residential facility managers revealed issues with the following;

-Isolation facilities

-Transport

-Personal protective equipment (PPE)

-Mental ill-health (dementia)

-COVID-19 lockdown regulations

 

WCOPF’s Concerns

The re-evaluation of persons on disability grants could not take place due to staff shortages. This meant that the burden of households rested solely on the shoulders of older persons in whose care these people are often left while parents are working or occupied elsewhere. The recommendations by the forum were that the DSD interacts with DOH to facilitate a process whereby arising obstacles can be dealt with.

It was highlighted that the beneficiaries of social assistance do not qualify for food hampers although they are the ones who are mainly responsible for households. Arising concerns were also around the fact that the distribution of food hampers does not always reach where it is most needed. It is important to note that older persons put themselves at risk to keep communities stable out of a duty of care although it is not their responsibility.

Recommendations:

-Training of all staff

-Make funding available for proper PPE

-Counselling/debriefing sessions for staff members

-Regular information sessions to residents

-Home-based care givers who are at home due to the lockdown could be utilised to assist in residential facilities in their areas

-Intersectoral collaboration will be the key to all challenges and beneficial to older persons

 

Age-In-Action Presentation

Ms Irene Snell-Carroll, Provincial Director, Age-in-Action, stated that Age-in-Action was a developmental organisation which strived on collaborations with other stakeholders to uphold the rights and dignity of older persons, through advocacy, lobbying and improved access to care, support and protection, training and development and sustainable economic empowerment.

Age-in-action provides direct specialised integrated social work services that comply with provision, protocol and minimum standards according to the Older Persons Act of 2006 in order to promote the protection of older persons in the Western Cape:

• Early identification of older persons at risk
• Investigate alleged elder abuse
• Counselling
• Statutory interventions
• Placements in residential facilities
• Register alleged abuse older persons on the VEPOPAR system.
• Assisting alleged abused older persons with court proceeding by being a professional witness and moral support for them
• Establish an emergency fund and food bank for homeless and destitute older persons
• Assistance to legal services

 

Care-line

To maintain the older persons care-line for the protection, prevention of abuse and empowerment of vulnerable older person and ensure that services are accessible for older persons:

• Maintain the toll-free telephone system for older persons where they can call for help specifically focusing on abuse
• Promote this service
• Data capturing of alleged abuse case reported
• Keep trained staff online which can assist clients
• Establish legal support network

 

Training and Educational Programmes: To provide training and information regarding elder abuse and neglect of older persons to stakeholders, other government departments and older persons in the Western Cape:

• Provide training of the Older Persons Act 13 of 2006 and Elder Abuse to communities
• Support existing organisations in governance
• Mentor and support emerging organisations
• Provide educational programmes to all older persons in the Western Cape

 

COVID-19 and Older Persons: Transition from Crises to Routine

The COVID-19 pandemic has shaken the foundations of lifestyles and everyday routines, particularly for older people as society at large us collectively learning on how to live with the virus. This virus is not just threatening the lives and safety of older persons but is also threatening their social networks, their access to health services, their jobs and their pensions. This is mainly focused on those who normally receive care at home and in the community and are more likely elderly females.  

The current pandemic has affected the population at large, but especially those who are most vulnerable who reside under poor conditions and survive with just the bare minimal. The fear of the unknown is difficult to deal with because no one knows if there is ever going to be an end to the pandemic and older persons struggle to come to terms with the new routine that is enforced on them. Physical distancing is crucial but needs to be accompanied by social support measures and targeted care for older persons by increasing their access to digital technologies.

Challenges:  

• Living within the minimum puts a further strain to the most vulnerable
• Older persons had to stretch their pension to assist their children who had lost their jobs/working on short time, etc. and still have to pay their normal bills
• Communication (language barriers) and lack of understanding
• Low literacy level of some older persons and not to have the capability to assist grandchildren with schoolwork or activities has been a challenge
• 24 hour support system for frontline workers has taken its toll on older persons
• Older persons cannot come to terms with the loss of their loved ones during the pandemic as they did not have the chance to say farewell
• The fear of the unknown is difficult to deal with because no one knows if there is ever going to be an end to the pandemic
• Technology is a challenge for many older persons who wants to communicate with their children and grandchildren, specifically if they want to see their faces

 

Conclusion:

Older people are frequently overlooked in development and humanitarian strategy development and funding. In the context of COVID-19 and the risk posed to older people, they must be explicitly identified and considered in funding applications and decisions at all levels and in all settings.

Services Provided By Western Cape Association for Persons With Disabilities During Covid-19

Ms Erica du Toit, Awareness and Sensitisation Coordinator, Western Cape Association for Persons with Disabilities, stated that as of 26 March 2020, all services had closed, and staff members had to work remotely.

Support to Branches:

• Continued supervision of social workers to ensure service delivery and provide psycho-social support
• Daily contact to ensure compliance of regulations
• Distribution of 27 000 nappies from NCPD Nappy Run
• Distribution of PPE
• Development of home stimulation programme
• Lump sum to branches
• Preparation for reopening

 

Awareness of effect on Persons with Disabilities (PWD):

• Highlight effect on persons with disabilities through social media, radio interviews and articles
• Information sharing of current statistics and announcements from the SA Social Security Agency (SASSA)
• Recognition and thanks to donors

 

Branch services to PWD

Social Services:

 

• Telephonic contact with clients
• Offices opened on the 4 May
• Lockdown 4 – essential services: home and office visits, intake of new clients, no group work or community work and  11 of 13 branches used donations or partnerships

 

Special care centres:

• Began opening on the 17 April
• Most provided social relief to families using donations and partnerships
• Running home stimulation programmes

 

Protective workshops:

• Began opening on the 13 July
• Four of the five provided social relief to families – only one had external support
• Sanitising of premises

 

Challenges:

• Impact on client’s socio-economic situation
• Devastating effect on service delivery, organisational sustainability, job stability and general wellbeing
• Food parcel delivery not our core business
• No incoming donations caused budget deficits
• Subsidy dependent
• Retrenchment processes started

 

Discussion

Mr G Bosman (DA) asked if there were any specific statistics regarding the number of people who were struggling to access their disability grants through the South African Social Security Agency (SASSA) including the number of those who required assistance in getting their temporary disability grants renewed.

Mr C Dugmore (ANC) asked all represented organisations whether they received any additional funding from the provincial department of Social Development during the pandemic or the lockdown period.

He mentioned that one or two of the presentations had indicated that there were challenges with masks and needed clarity on whether there was any shortage experienced currently in any of the facilities referred to.

Mr P Marais (FF+) said that the backbone and real heroes of the Western Cape’s Health and Social Development was not the governing party but the NGOs. He was filled with emotion to see what was achieved despite the financial challenges and emphasised that these NGOs should not have to be concerned around how the new service level agreement would look like in order for them to function.

He asked whether there was a uniform message in terms of COVID-19 as it seemed that the plans put in place by the government were not consistent. Currently, a recovery plan had not been viewed by the Western Cape government as it is responsible for making a provision for the needs of NGOs post COVID-19. He asked whether the organisations had given the Western Cape government a list of their needs post COVID-19.

Ms Shariefa Darries, Provincial Coordinator, Western Cape Older Persons Forum, responded by saying that statistics and data were being collected. During a focus group that had been underway with managers from respective centres, there was no request for the information as data collection was not yet complete. However, she mentioned that the information can be sent to the Portfolio Committee. 

Addressing the issue of funding, Ms Darries added that there was no additional funding which had been requested as they were not service providers but rather a lobbying advocacy organisation. They were, however, looking at how they would respond with future business plans to the DSD to see whether they could incorporate this to the COVID-19 pandemic.

Ms Quickfall (BADISA) responded that their challenges were beyond masks but also included food and PPE, but they were working on making basic PPE available in hopes of resolving the issue by the following week. The organisation was also busy with an assessment of all their essential services facilities in order to determine if there were current needs or there would be arising needs in the next three months. As such they could not reveal the exact details but once all the work had been completed, the findings would be made available to the Portfolio Committee.

She mentioned that, as the organisation, they had not received additional funding from the Department.

The recovery plan was one of the issues that remained of concern as there is no sustainable recovery plan being currently worked on. She added that it would take three decades to recover to the level at which they were at.

Ms Snell-Carroll said that they had not received additional funding from the Department of Social Development.

Western Cape Social Development: Psychosocial and Bereavement Support Rendered During Covid-19 Disaster by WCG

Dr Robert Macdonald, Head: Western Cape Department of Social Development, in his opening statement explained that the psychological support to individuals and families was tailored to the specific needs of the client and could include debriefing, counselling, psychotherapy and cognitive behavioral therapy. The overall aim was to develop coping mechanisms and resilience of the client and/or family unit.

Role of Departments

In the context of the COVID-19 National Disaster, the Provincial COVID Coordinating Council determined that DSD should take on the role of providing psychosocial support to individuals and/or families affected in various ways by the virus. All services were rendered by either DSD social work professionals or NGOs funded by DSD. The Provincial CCC further determined Department of Cultural Affairs and Sport (DCAS) should take the lead in engaging the religious sector to strengthen bereavement support to families who had lost members to COVID-19.

Psychological support services – DSD

On 11 May 2020 the Departments of Health and Social Development agreed to a protocol whereby DSD would assist with:

• Counselling to persons referred by the Department of Health to quarantine and isolation facility
• Counselling and/or reintegration and/or mediation services when persons return to their families and communities following hospitalization or quarantine/isolation. The main need here related to overcoming stigma and fear around the return of previously infected individuals

 

During the disaster period, psychosocial support services were also required for a range of related vulnerabilities that occurred and/or were aggravated by the COVID-19 situation (for example, GBV, trauma, depression and anxiety).

Bereavement Support – Department of Cultural Affairs and Support

DCAS has worked with partners to provide relief to citizens through its sport, arts and culture relief funds and expanded access to psychosocial and bereavement support through:

• A partnership with the religious sector to scale up their ministry and support to families in need and offer bereavement support linked to funerals. The task team of religious leaders and WCG meets bi-monthly
• The launch of the enriched web portal, a well-being and resource portal, for after school, NGO and sport practitioners. A virtual training session on some of the resources on the portal was held in June and two further sessions are planned, one for 26 August and one in November
• Focusing residents on the importance of support with a call for a minute of silence at noon every Wednesday in memory of all those who have lost their lives and loved ones to COVID-19

 

Jelly Beanz Presentation

Ms Edith Kriel, Co-founder and Director, stated that Jelly Beanz created holistic African interventions which included:

• Therapeutic services for children that have experienced trauma, abuse or neglect and their families
• Training and mentoring within the child protection and child mental health sector
• Development of resources to improve services delivery

 

Childline South Africa quotations included:

• “When they announced that there was to be a lockdown, I freaked out because I felt like it was the end of the world and we’re all gonna die. Which is ironic since I’m home ALL day everyday but now, I feel trapped inside my house. Perhaps I’m claustrophobic?”
• “I think they should check on children more regularly, and make sure that when they talk to children, to allow children to give more honest answers, because most children are hurt and prefer to bottle up their emotions and so they should be free to speak because we do not know if they are being abused or if everything is okay at home or not or how they are feeling. They should communicate more with the children and visit them more often.”
• “I worry about my mom; she is in hospital”

 

What we learnt about children’s experience:

• Exposed to increased violence in the home

• Few COVID referrals, sexual abuse is still majority
• Many children traumatised by what is happening at community level (e.g. violence of army in initial lockdown) but few psychosocial services to deal with number of children
• Just ‘another thing’ to deal with, but has a significant impact on the neurobiological functioning
• Anxiety (illness and death of self and loved ones)
• Home-schooling was problematic
• Opening and closing of schooling was very disruptive for children emotionally
• Unsupervised/neglect

 

What Jelly Beanz was up to:

• Receiving and distributing donations of food parcels
• Develop messaging for radio broadcasts (in 12 different languages) with an audience of about 24 million.
• Participated in a national advocacy task team
• Continued to make contact with all clients
• (Telephone, WhatsApp or online platforms)
• Reporting of abuse of children and ensuring services were rendered during a time where there were very few statutory child protection organisations available.
• Developed training materials regarding telephone / online therapy and shared with colleagues
• Together with the NACCW and Children’s Institute we developed a 12-hour training programme for Child Care Workers, which is accredited with their board.

 

Closing thoughts:

• Anticipated increased disclosures of abuse and neglect once schools re-open
• Children that have experienced trauma use non-verbal communication of others to scan for safety issues. This poses challenges in terms of mask wearing by staff
• Teachers (ECD to high school) need to be trained and supported to manage the emotional impact of pandemic (trauma informed schools)
• Need to train frontline workers and community leaders on dealing with psychological first aid
• Increased number of children need access to psycho- social services
• More hands in dealing with child trauma issues in all communities and in rural areas (lay counsellors)
• Staff need emotional support
• Funding is precarious

 

Discussion

Ms L Botha (DA) asked how Lifeline or DSD had evaluated the extent in which the new norm further contributed to the manifestation of dysfunctionality and further aggravated domestic violence. With regards to face-to-face, online and telephonic counselling sessions, she asked for a breakdown of the number and types of sessions to be provided including the contrast between the Metro and Rural areas.

Mr Dugmore asked the representatives of Lifeline to give a breakdown of the number of staff members who engaged with people via the WhatsApp advice system, and whether it was an individual dealing with a client, or it was mostly standardised WhatsApp responses.

He asked about the staff complement available to Lifeline when dealing with work which required them to make direct visits into communities.

He also inquired about the composition of the faith-based forum which had been set up to assist with the bereavement counselling and whether it was the same forum which Dr Ivan Meyer had been involved in or it was a different forum.

Mr Marais said that Lifeline was a household name in the Western Cape and were an overall well-trained organisation. He wanted to know if they had been in consultation with the Department of Social Services in being part of the formulation of the recovery plan and emphasised that organisations cannot operate in isolation and therefore there should be established linkages between the various departments and organisations.

An official for Lifeline responded that regarding the COVID-19 deaths, there had been issues with people who could not find closure due to the restrictions of lockdown. The total number of volunteer counsellors available were approximately 80 to 90 people who dealt with all aspects of the programme which included face-to-face, online and telephonic consultations. Those responsible for face-to-face were a total of 12-15 counsellors, however, there was a waiting list of about two weeks. An available trauma team composed of 12 counsellors had been specifically trained to do debriefings.

The WhatsApp facility needs to be expanded and this requires money, and this is an obstacle since the organisation is largely self-funded.

Training courses had to be suspended and this was essentially the financial backbone. Although these courses had been launched online, this remained a huge challenge since the courses needed to be redesigned to accommodate the platform they were offered on. In the process, there were concerns around loosing the intimate nature and the depth of the of the courses, but necessary measures needed to be taken.  

The organisation had not been able to partner with any of the governmental departments, but this was being looked into.

Anger and abuse were fuelled by many reasons such as job losses and disappointments. The aim was to provide as much support in order to minimise or prevent the outbreak of anger and turn it into constructive pro-activeness.

Ms Kriel said that their relationship with the Department of Social Development meant that there was an opportunity to add subsidies and financial support to the services provided by Jelly Beanz. She mentioned that the organisation would also like to be able to expand and so far, the Child Protection Directorate within the DSD had been supportive of the work done.  

On the groundwork meant that social workers were now emphasising the need for more specific training on trauma issues and implementing the best means to assist children who were experiencing trauma. The issue was that the number of available social workers was not enough and there was a need to consider ways of expanding knowledge between workers. The organisation was in communication with the various departments regarding the issues affecting children.

Ms Jacqueline Boulle, Acting HOD: Western Cape Department of Cultural Affairs and Sport, addressed the question on religious forums. He highlighted that the same forum mentioned by Mr Meyer included organised formations, individual churches and foundations which were a part of the humanitarian forum hence it had been extended beyond just the formal organisations.

The Chairperson thanked the organisations for the presentations and feedback. Since the meeting had gone overtime, it was suggested and agreed to by Members that the considerations, adoptions and resolutions be put over to the following week’s meeting.

The meeting was adjourned