Gauteng’s poor to bear the brunt of contagion
“However, maintaining basic preventative hygiene and social distancing is not equally feasible for all people in all communities,” said a team of researchers at the Gauteng City-Region Observatory (GCRO).
Last week, it published its map of the month, left, charting the vulnerability to Covid-19 in Gauteng “to aid an understanding of the localised risk factors that might contribute to the spread of Covid-19 and might amplify its health and socio-economic impact in Gauteng communities”.
The mapping, write the researchers, focuses on the spatial distribution of “some salient risks and vulnerabilities” at a ward level, as drawn from its Quality of Life V survey (2017/18).
The first map is based on an index of risk factors to maintaining social distance and preventative hygiene per ward. It combines six variables: the percentage of respondents per ward who live in crowded dwellings, have no access to flush toilets, have no access to piped water, use public healthcare facilities, have no access to electronic communication and rely on public transport.
The second, complementary map, is based on an index of risk factors that will likely increase health and socio-economic vulnerability during an outbreak or broader shutdown. It also combines six variables: the percentage of respondents per ward who have poor or very poor health, have no medical insurance, face hunger, have pre-existing health conditions, find it difficult to save money and previously failed to find healthcare when they needed it.
“While the government has thus far focused on critical measures to prevent the spread of COVID-19 in the immediate term, its responses will need to evolve over time to consider how the pandemic will have significant effects on the economy and livelihoods, especially given existing poor health conditions in many areas.
“Once again, these impacts are likely to be felt unevenly. Poorer communities are likely to bear the brunt of the dire health and socio-economic consequences as COVID-19 spreads.
"In addition, with various shutdown measures already in place, they will be the most vulnerable to these dramatic changes in the patterns of social functioning, and the downturn in economic activity that will inevitably result,” write the team..
Crowded living conditions make it difficult to maintain social distancing and isolate sick people and often include high likelihood of sharing ablution facilities - 14.4% of respondents live in crowded circumstances.
“In addition, we considered those who do not have clean running water in their homes or yards, and are therefore either accessing water from alternative sources such as streams or rainwater tanks or from shared points such as stand pipes or street taps.
“In many circumstances, this may be combined with shared toilet facilities or toilets such as pit latrines and the absence of running water. In these situations of less than ideal water and toilet facilities, it may be more difficult for people to ensure appropriate levels of hygiene and to practise social distancing.”
About 66% of respondents usually use public healthcare facilities.
“During this time, public health services and professionals are going to do everything in their power to manage the spread of COVID-19 but the usual high volumes and long queues in public health facilities are more likely to be an impediment to containing the spread of the virus.”
The researchers note how it is extremely difficult to maintain social distancing with the use of public transport and some 44% of respondents in the Gauteng City-Region rely on public transport. “Many people working in essential services will still need to use public transport to work in hospitals, pharmacies and supermarkets.”
The second map highlights that the risks which increase health and social vulnerability are relatively higher in some wards (shaded dark purple) in Gauteng than in others (light pink).
“Importantly, although there are various wards to be concerned about at this time, it indicates that health and social vulnerabilities are not as spatially clustered compared to the risk distribution in Map 1, and suggests a much broader group of residents in the Gauteng City-Region might be affected by an outbreak or broader shutdown.
“This is partly because respondents’ lack of access to medical insurance, experience of pre-existing relevant health conditions and difficulty to save money is widespread throughout the province, even in middle and upper class areas.”
Wards of concern include Stinkwater, Atteridgeville, Mamelodi, Ivory Park, Soweto, Katlehong, Tsakane, Bekkersdal, Khutsong and Sebokeng where 45% to 60% of respondents experience various risk factors, which “increase their health and social vulnerability”.
The maps reveal how challenges to maintaining social distance and preventative hygiene are “spatially clustered” but limited ability to cope with health and social shocks is more widespread in the Gauteng City-Region. The latter, too is significantly influenced by the challenges in maintaining social distance and preventative hygiene measures.
The maps, says the GCRO, can help the Gauteng provincial government direct communication strategies, as well as health and social support “to areas experiencing the greatest risk first”.