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Covid-19: a World Gone Mad

23/6/2021

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During lockdown, South African students wrote a book about ‘a world gone mad’

GORDWIN ODHIAMBO/AFP via Getty Images
Peet van Aardt, University of the Free State and Brian Sibanda, University of the Free State

South African student voices have largely remained unheard in formal discussions around COVID-19. A pandemic that should not be put to waste, COVID-19, on some podiums, is seen as laying the groundwork for germination of seeds of change.

The students in this collection of stories by the Initiative for Creative African Narratives (iCAN, a project within the Academy for Multilingualism at the University of the Free State in South Africa) have refused to be silenced amid this pandemic.

A World Gone Mad is a collection of 15 stories written by the students. All come from rural villages or low income, highly populated settlements on the edge of metropolitan areas (also known as “townships”). Some of them wrote their stories on their cell phones.

In March 2020, when South African president Cyril Ramaphosa announced the country’s first lockdown, students had to evacuate campus and return to their homes. During this lockdown, citizens were not allowed to travel, shops had to close and people had to remain indoors.

The strict rules created fear in people from densely populated areas such as townships, and within the first week the country saw a 30% increase in gender-based violence compared to the previous year.

The students reflecting on the experiences of this life in lockdown are predominantly undergraduate students from all disciplines at the University of the Free State. The project is a decolonisation initiative by the university that motivates students to write short stories that can be published and then used in a transformed curriculum.

A book colour with the title 'A World Gone Mad' on a blue background that is made up of line drawings of a virus and of people interacting with it.
iCAN/University of the Free State

The iCAN, now in its fourth year, has published five anthologies. The majority of texts are based on real life experiences, but many students submit purely fictional stories. We decided to include the COVID-19 stories in a separate collection.

Writing can be used as a coping mechanism, a way to digest the world around us. We found that the stories have drawn attention to the experiences of students during the COVID moment.

The stories

In one story, My COVID-19 Nightmare, the writer illustrates the anxieties and prejudice encountered in a small village. When the main character experiences strange behaviour from her neighbours, she learns why on Facebook:

One of the Maswanganyi daughters has Corona. She was seen a few days back in hospital coughing to death and she was admitted by the doctor. Now she is back and has infected her whole family. Be careful around them, guys. #staysafe #covid19 #stayathome.

The writer was shocked. She had gone to hospital due to a cough she developed the night before when she wanted to clear her room from mosquitoes with pesticide.

Internet connection and device access has highlighted the gap between the rich and the poor students in South Africa. In the story The COVID-19 Stumbling Block the protagonist is forced to return to the densely populated township of Diepsloot, Gauteng.

She thought she saw her future jumping out of the window when the university introduced an online learning system. She saw it as a waste of time; she had no electronic device other than her cell phone.

Other themes include greeting a loved one at a rushed funeral (The 60 Minute Farewell), one’s belief in God being challenged (Faith is Not Under Lockdown) and having to abandon campus life (A Story of House Akasia).

One student relied on his imagination, painting a bleak picture of a post-COVID world where virtual reality has become safer than real life (Death of the Human Race).

The students also addressed the pandemic within the pandemic: gender-based violence. In Ngenxa Kamama the story is about a mother and daughter trapped inside their house during lockdown with a violent father.

Hope

In A World Gone Mad, the students speak for themselves, presenting the world with an authentic expression of the lived experience. It’s one that negates a Western, canonised form of thinking that views the philosophies and literatures of the global North as the only intellectual authority.

It is our aim to ensure these stories make a considerable contribution to the curriculum and the ongoing efforts to reconstruct knowledge and a sense of being in an effort to decolonise higher education in South Africa.

Some of the texts will form part of the extensive reading component of the English Academic Literacy courses at the university, where students will do online quizzes on the stories. The idea is that students will learn about each other and from each other.

The stories are also a contribution to decolonising languages. In the English language written stories, students have tamed the language to their advantage; they have used it to carry the weight of their experiences. The one written in isiZulu also tells us that these indigenous languages, which are often marginalised and tokenised, are equally valid in carrying lived experiences and have space in higher education.

Lastly, the stories give hope in surviving the pandemics and gesture towards a post-COVID future that is socially and cognitively just.The Conversation

Peet van Aardt, Coordinator: Initiative for Creative African Narratives (iCAN) & Lecturer: Academic Literacy, University of the Free State and Brian Sibanda, Lecturer/Researcher: Centre for Teaching and Learning at the University of the Free State, University of the Free State

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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COVID-19 DIARY MARCH 2020

27/3/2020

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some pics taken Today 1 during Lock-Down:
South Africa Lock-Down Day 1

I do not consider myself a writer per se, but like many of us who do dabble in writing, we find healing in words and sharing info. So here goes.

Eerily quiet this morning when we woke up this side…. after a hectic night of waiting for all to get back from last minute shopping before locking gates at midnight, and staff getting drunk and calling for assistance around 02h00 in the morning…Hubby will go and check out possible/reported structural damage to the living quarters later this morning (I really hope everyone exhausted all their alcohol last night already and No, I am not going to hand out paracetamols this morning. Stupidity has natural consequences and then you have to live through it).

We this side, will be functioning during the lock-down on various levels, being exempted as one of the essential services. Our lock-down pertains to people and families living with the borders of the ‘farm’ itself.  With of course, lots of disaster regulations and safety measures at work.

It was quite a mission the last couple of days to put in place arrangements & measures, such as paying salaries earlier, to do monthly staff rations [for at least 130 staff - and their families] delivered in time (for at least 2 months), arranging additional security against possible increasing crime, getting staff back earlier from leave (those who wanted to come back instead of rather spending time across provincial borders with their other families) and to make sure immunity compromised staff obtain all their relevant medications for this lock-down or more lock-down time to come.

One thing I am extremely grateful for, is: living in the technological era (well, industrial revolution IV, or AI). We are SO  fortunate to still able to stay in contact with family and friends! I get chills simply thinking about what the people went through during i.e. the Black Death/Bubonic Plague Pandemic (which decimated about 60% of the world population). Not being able to know where your family or friends are, not having any contact, not knowing whether they’re alive or dead…. No wonder so many of them rushed off to check each other’s wellbeing…. Which we now understand had disastrous, deadly consequences.

Once again I urge everyone to make use of still available communication methods, to stay in contact especially with your parents, grandparents, children, grandchildren; those who now are in total isolation; alone. And far from you. They will need to hear your friendly supportive voice during this time. While various measure have been put in place (such as lowered internet fees to enable scholars to use internet to continue education, lowered airtime fees, etc.) There will be over-using of communication systems …We are already starting to experience this. The last couple of days while we have sufficient signal – servers do not respond to the overload already.

My heart goes out to those people only receiving their salaries only today. And tomorrow. Or at March month end. Not all companies are/were able to pay salaries at short notice of a Disaster Shut-down plan. And the SASSA (grant dependent) people in SA, who will have to venture out as from 30 March on the streets…. With limited transport. If calculations are correct, we are looking at, at least 19 milj of the 59/60 milj people in SA, who will have to go out during the lock-down to obtain their monies, and to purchase basic food items.

Not all people were or will ever be, able to stock up for the minimum 3 weeks (And don’t get me going on the absolutely crazy, havoc shopping the last couple of days!!! I still have a bruised check bone due to some lady who wanted all of the sweet corn tins in the shopping mall)

The above people especially, are the people we need to worry about. (Not whether you have enough cigarettes or booze in your pantry during the lock-down). They will get sick, they will spread the Covid.

Not all in SA have access to water. Not all have access to decent ablutions. Sanitisers have long ago disappeared, as well as the ingredients to make them at home. No masks, no gloves…

My personal opinion, as I have stated quite often for some time now, 3 weeks will not be enough to ‘curb the curve’. It might, hopefully,  grant the Government a bit of a breather to put more tests etc. in place….possible infrastructures….more safety measures…..and to figure out how many people actually, already have contracted the Covid.  And what to do.

The fact that pharmacies and some supermarkets, and Spazas, will be open during the lock-down for ESSENTIAL foods… (Times still tba) does not mean we can freely roam the streets and still do shopping.  These places will be open only, in particular for the people who have real need therefore.

Use your brain cells, people!

some Pics taken today, Lock Down Day 1 - 
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Beyond washing hands - Psycho-social & other effects of Covid-19

23/3/2020

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Covid-19, the infection caused by the novel coronavirus detected in December 2019 Wuhan, China, has rapidly spread to just about all countries worldwide; raising concerns also of widespread panic and increasing mental health issues in individuals subjected to the (real or perceived) threat of the virus.
 
Media coverage –real as well as fake information - has highlighted Covid-19 as a unique threat rather than one of many; which has added to panic, stress, and the potential for global hysteria.
 
 I am not going to repeat here the yet known Covid-19 symptoms, possible a-typical symptoms, and possible preventative measures. By now you should be familiar with this and hopefully practice it as a responsible citizen and decent human being. (That’s to say if you’re fortunate enough to have water and soap - which most rural areas in South Africa especially do not have, due to decline of maintenance services, health services, and funds. While this can be “blamed” on poor infrastructure and social inequity, the question should rather be how infrastructure became so absolutely lacking, why social inequity broadened, and why or where allocated funds disappeared, since the 1993 democratization and the country’s government since then. A topic for another day).
 
Psycho-Social concerns
 
Pandemics are not just a medical phenomenon; they affect individuals and society on many levels, causing severe disruptions (We are also not going to discuss economic implications or consequences here).
 
 Stigma and xenophobia are only two aspects of the many societal impact of pandemic infectious outbreaks. Panic and stress have also been linked to outbreaks. As concerns over the perceived threat grow, people start to collect (and hoard) masks and other medical supplies, foods, and as we already discovered, especially toilet paper. Foreign nationals are shunned, and at times physically attacked in the street.
 
A pandemic is often followed by anxiety-related behaviors, sleep disturbances, overall lower perceived state of health, and psychotic breakdowns. Individuals with mental illness may be particularly vulnerable to the effects of widespread panic and threat.
 
Chronic disease, including chronic infectious diseases such as TB and HIV/AIDS, are associated with higher levels of mental disorders as compared with the general population, as well as higher vulnerability. Studies show depression rates usually soar after infections (e.g, herpes exposure and anthrax scares). Although the effects of Covid-19 itself on mental health have not been systematically studied [obviously] it is anticipated that Covid-19 will have rippling effects, especially based on current public reactions.

Distrust in the systems

Then there is medical mistrust.

“Medical mistrust” refers to a lack of trust in medical treatment and advances. It results in a lower use of health care resources and poorer management of health conditions (coupled with potential misuse at times of crisis). Moreover, medical mistrust has been used to explain some racial and ethnic health care disparities. It has been linked to a variety of diseases and conditions.

During infectious pandemics medical mistrust has also been linked to conspiracy theories. In one US study, up to half of those surveyed endorsed belief in at least one health-related conspiracy theory. At its extreme, medical mistrust can lead to movements such as anti-vaccination trends. This morning when discussing Covid-19, staff shared their belief that China has actually created this virus, has the antidote in their back pocket, simply waiting to share this with the rest of the world pending the right amount, so why worry….(thanks to fake news).
 
In South Africa, we do not have sufficient funds, manpower, or even hospitals to address a pandemic. (We might have, if the Government decides to stop funding SAA and SABC or the Gupta’s. What was the amount mentioned yesterday? R385 Bilj+? We can live without local television stations, and we can make use of other Airplane services besides SAA. But we have to stop Covid-19, or don’t you agree?)

 We also have a massive, massive percentage of the population struggling with HIV (one of the possible reasons the WHO issued serious warnings to Africa this past weekend) – but not mentioned on TV/in the media yet (possibly due to the recent gagging order).

Anxiety and obsessive-compulsive disorders

We anticipate the effects of infectious disease threats to manifest as sheer anxiety and panic: worry about getting an infection, worry about loved ones getting ill, and worry when related symptoms—even minor—are present. The absence of a definitive treatment for coronavirus easily exacerbates anxiety. In most cases, these anxiety symptoms do not reach diagnostic thresholds for a DSM-5 diagnosis; however, patients are often not able to continue with their “new normal” lives.

Because a “new normal” is what a pandemic means.

Contamination obsessions—unwanted, intrusive worry that one is dirty and in need of washing, cleaning, or sterilizing—are very common in patients with OCD. Perceptual experiences (e.g, feeling dirt on skin) understandably would amplify obsessions. Sensory experiences (but not necessarily full tactile hallucinations) have been found in up to 75 % of patients with OCD patients. More intense sensory experiences (pseudo-hallucinations) are related to worsened control over compulsions and poorer insight. Biased information processing is associated with a tendency to overestimate threat in individuals with OCD. This may increase sensitivity to the panic associated with pandemic threats and further destabilize patients and increase functional impairment.
Cleaning and washing compulsions, also a core feature of OCD, can easily be exacerbated by the threat of infectious pandemics. Complications of excessive cleaning include dry, chapped skin (which can lead to super-imposed infections) and contact and atopic dermatitis; similarly, overuse of toxic cleaning supplies can lead to inhalational injuries. Fear of acquiring a new, sensationalized disease may worsen negative behaviors.

Psychotic disorders: an extreme of medical mistrust?

Anecdotally, the most glaring (and maybe the most interesting) examples of medical mistrust conspiracy theories concern patients who experience psychotic disorders. Typically, repeated media exposure to an alarming fact (in this case, spread of Covid-19), coupled with a distrust of organizations and government as well as misattribution of physical symptoms can result in delusions. Similarly, fears can quickly lead to clinical decompensation and must be carefully monitored.

Adding fuel to the fire are discussions of conspiracy theories related to infectious outbreaks in the mainstream media. The lack of knowledge about epidemics, the increase of zoonotic infections, and the fairly complex effects of climate changes can affect patients as well as confuse even an overall healthy person.

At the intersection of psychosis and obsessiveness is delusional parasitosis, also referred to as monosymptomatic hypochondrial psychosis, Ekbom syndrome, and delusional infestation. Essentially, the patient believes that he is infected with an organism that evades detection and treatment and, thus, causes continuous suffering. This syndrome was described as early as 1636 by Sir Thomas Browne, who referred to it as Morgellons disease. A concerning clinical feature of delusional infestation is its occurrence in multiple family members (eg, folie a deux).

Delusional infestation development in the context of pandemics has not been studied. Conceivably, increased cases may develop as more individuals focus on far-fetched, unlikely infections because of easy access to unverified information on the internet. To address delusional parasitosis, clinicians should rule out organic causes and reassure the patient that there is no infection or infestation.

No particular research data has been provided yet [or could be found] with regard to schizophrenia patients, or Bi-Polar patients; during the experience of a pandemic.

Impact on Children
 
Younger children, though they at present might be at lesser risk to develop the more serious symptoms of the disease; might start to show regressive behavior, become aggressive or destructive and disobedient, often clingy and scared to leave the parent’s presence (in general cases I would have added, perform weaker at school but since schools are closed….). Always remember children are susceptible to parents’ and adults’ stress levels. When they don’t have sufficient information relevant to their development stages, they make up their own stories which is often more scary than reality. The human brain abhors a vacuum – it will fill up with lies if no truth is available. It is not the time for overprotection. Kids simply worry more when kept in the dark. Make time to talk. Be sure children know they can come to you when they have questions Consider reducing the amount of screen time focused on Covid-19. Too much information on one topic can lead to anxiety. Teach children everyday actions to reduce the spread of germs. And while they are “stuck” at home, why not use the time to teach them basic life and survival skills. (See the links underneath for more information, how to talk to children regarding the Covid-19.)

Fear, Fear mostly

The current Covid-19 outbreak is spurring fear on a societal level. On an individual level, it may differentially exacerbate individual anxiety and psychosis-like symptoms as well as lead to non-specific mental issues (eg, mood problems, sleep issues, phobia-like behaviours, panic-like symptoms). In various African cultures, it could also lead to traditional group psychosis behaviour.

Increased Crime
 
Crime increases as well, during pandemics (as we have already seen in the increased SA crime stats the last couple of weeks). At present South Africa has been declared a State of Disaster. Once a State of Emergency follows, it may well be that prisons might be opened and prisoners released (which will amount, in total anarchy). Be vigilant, and stay safe.
 
Social isolation and its Impact

The main thing is staying inside, staying in the house, not going out, avoiding large crowds—the things you're hearing everywhere from everyone.

But – Here the biggest challenge for us is convincing young healthy people to realize that even though they are at lower risk, they may not even know they're infected. If they visit an elderly friend or parent or go to a store or someplace where other people are that are higher risk, they could be the transmitter of the virus. And we all saw this virus is transmitted exponentially. Take Italy for example.

That is going to be one of the biggest challenges—convincing the young and the healthy to flatten the curve and prevent more infections regardless of their own risk. The impact of self-isolation and everybody working at home, well that might be difficult to some (And impossible for others – especially the person who works for a daily wage, the ones who will be on unpaid leave. Such people really need their income, and might simply hide symptoms   in order to continue working, until it’s too late).

Households where one or both of the primary adults are usually working and out of the house during the day, children and adolescents are at school, and young adults are working or in college—all of a sudden everyone is home taking virtual classes or working in virtual environments. So now you have a whole new kind of family culture that has developed literally overnight. Instead of everybody having schedules and a lot of time away or me-time, everyone is in a small contained area, probably fighting for the computer screens or tv-remote. Everyone is trying to do things virtually.

In rural, lower income communities, there will be no virtual classrooms. There will be no school or education. Not even home schooling, as often such lower income parents have no education themselves. What to do with the children, how to keep them occupied, is a totally different concern.

Not to mention the educational delay children now will experience.

It is going to be a good opportunity here for family self-therapy, learning to work together and cooperate and how to re-experience the core family just being with itself all the time. This will be a huge adjustment. Also to those living on their own, and dependent on visits from family or friends – they have to live and cope being alone. It is going to be very stressful and we still don't know how long this will continue, which will add even more stress on people.

My Job – And Yours

I don’t have answers for Covid-19, I fear no-one does. Yet. If you are struggling with a mental health problem, please take your medication regularly, make sure you have sufficient to last through the coming months, and take care of your health.  If you are fortunate enough to be a healthy individual, respect social distancing and prevent spreading the virus to the more vulnerable populations. Call single parents or grandparent regularly. Ease their loneliness. Take care of children especially – they may very well be the only future.

It is really the action or inaction, for all of us to protect each other. We need to think beyond our own needs and expectations and take care of the country as a whole. This is a whole new virus the experts know little about. This virus did not need a passport to quickly cross international borders, yet it seems to be a slow learning process to some of us. It is trying to tell us of how precious our health is and how we have neglected it through eating nutrient poor manufactured food and drinking water that is contaminated, or simply abusing it with alcohol, nicotine or drugs. It is trying to remind us how materialistic we have become, and that now during crunch time - it’s the essentials that we need (shelter, food, water, medicine) as opposed to the luxuries that we sometimes unnecessarily value.

And it now also tells us, it is down to each and every individual to save his/her own life, and their countries.

https://childmind.org/article/talking-to-kids-about-the-coronavirus/
https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/talking-with-children.html
www.psychiatry.org
www.apa.org
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Corona Virus -Covid 19

5/3/2020

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Background: 
A ‘Pneumonia’ of unknown cause detected in Wuhan, China was first reported to the WHO Country Office in China on 31 December 2019.

The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020 as a pandemic.
 
A pandemic, normally is a highly contagious disease, regularly resulting in death, AND where the disease is spread in multiple countries and continents [world] at the same time.  

A pandemic normally also has severe financial and economic implications for countries worldwide and its people (travelling, tourism, postage and deliveries, businesses – not to mention individual income, inflated taxes, etc).

What is COVID 19, or, the commonly termed Corona Virus? 
Covid 19 seems to be actually a cluster of viruses, also known sometimes as super viruses, which does not respond to known medication or antibiotics.
 
Covid 19 is also Zoonotic, meaning transmitted between animals and people*.  
 
Common signs of infection include respiratory symptoms, fever, a cough, shortness of breath and breathing difficulties. However, a-typical symptoms are increasingly reported.
 
 In general, Covid 19 causes pneumonia, severe acute respiratory syndrome, kidney failure (shut down of organs) and eventually death.

Why is this disease so dangerous? 

There is currently no vaccine to prevent Covid 19. 
It will take according to latest research, between 18 – 24 months to develop a vaccine, and succesful treatment.
 
There is at present no known specific, treatment for Covid 19.
 
On 3/05/2020 as reported, Covid 19 has mutated into 2 strains: the original (L strain) and another (S strain) which might make treatment and developing a vaccine even more difficult.
 
Mortality rates of reported cases at present, are between 3% and 4%. Which is rather high considering other mortality rates in our advanced countries.
 
People with a-typical symptoms, and especially children; are considered as silent carriers of the virus. A silent carrier, is someone who is totally healthy and stays healthy, but they ‘caught’ the virus and are now simply passing it on to other people without getting sick themselves (I do presume at some stage, governments will try to 'catch' these people in attempts to develop vaccines).
 
People with possible Covid symptoms, might consider this as standard flu; others might run and/or decide they have this Covid and really clog the already over loaded Medical systems.
 
Most countries, such as South Africa, do not yet have in place the necessary Laboratory and Research facilities [nor funds] for coping with Pandemics or Epidemics; medical manpower,  required tests, diagnoses, or for quarantining infected patients.

COVID 19 in South Africa (where I live): 
At present, South Africa has only one definite, positive case of Corona virus (3/3/2020) with some medical staff in quarantine (people returning from holiday in Europe, Italy).
 
The possible reason, why countries such as Africa/South Africa, has not shown/been ‘infected’ yet, might be because we are not on the primary well-traveled routes (from China etc)  or, as we might not have in place yet proper screening and testing procedures (which obviously means, no reports).Also TBA I presume.
 
Quarantine normally lasts 2 weeks, although the WHO has put forward extended quarantine periods (to be advised) due to a-typical symptoms, also as some people seem to be carriers only without necessarily contracting Covid 19 itself (I.e. people released from quarantine after 2 weeks, only to return afterwards and testing positive).

High risk Populations: 
Adults, older people, the elderly, people with already, possible/underlying health problems such as auto-immune diseases, heart problems, high blood pressure, cholesterol, TB, asthma, diabetes, HIV/AIDS, smokers, addicts, drug users, etc. Such people are considered as vulnerable, and high risk.
 
Gender differentiation: Men and women can contract Covid 19 equally; however, men are more likely to die from this virus as per present statistics. No medical explanations supplied yet.
 
Children under 12 years of age, at present, do not seem to ‘show’ the live virus directly (no stats/medical explanations supplied yet).
 
No particular statistics available on teenagers.
 
Both children and adults can be silent carriers and there is emerging evidence that the disease can be passed on even when people do not show any symptoms/test negative. For this reason also, plenty countries have closed down schools till further notice.
 
How is the Covid spread? 
There is no definite proof that Covid 19 is not airborne, yet; however, that might also change with the different mutations.
 
Actually, there is no known answer to this question yet! Which leads to basic guidelines at present.

Present Guidelines for prevention: 
  • Social isolation. Do not needlessly enter large populated areas such as shops or malls.
  • Stand at least 6 Feet from people during conversations.
  • Stay away from people who exhibit any cold of flu like symptoms.
  • Do not spit carelessly!
  • Cover Mouth and Nose when sneezing. Immediately wash hands afterwards.
  • At present, no particular type of soap or disinfectant is suggested for cleaning or disinfecting surfaces or environment.
  • When using toilets – place the lid down when flushing. While toilet lids are regularly disinfected (in  public places)  flushing can cause infected particles to spray the air, infecting people especially where you might have a cut, injury, or even to your mouth when breathing.
  • Do not use the ‘air blower’ in public toilets. Rather use the paper towels, or rather – take your own toilet paper or tissues with, to use.
  • Never touch your face, mouth, nose or eyes before washing your hands properly.
  • Good personal hygiene is extremely important.
  • Routinely clean and disinfect all surfaces in your house regularly, especially kitchen surfaces.
  • Also clean telephones, computers and technical equipment; also in the work place.
  • Also make sure your working environment is properly cleaned, when used.
  • Do not share food, food containers, cups, mugs, glasses, water or cold drink bottles or utensils, etc.
  • Do not eat food prepared by a person with any cold or flu-like symptoms.
  • When you feel ill, quarantine yourself until you obtained medical assistance and received a bill of clean health.
  • Alcohol should be avoided as it lowers the body’s natural resistance.
  • Stop smoking, as this virus also directly attacks the lungs.
  • Ensure you are fully aware of the infection control hazards in your workplace, i.e. people working in abattoirs/ working with meats (Particular risk population)..
 
Cause of Covid 19? 
At present, the virus/s seems to be related [origin] to consuming foods of various origins in China*. Such foods, include i.e. pangolin, monkeys, dogs, cats, and various other species not standardly ‘prescribed’ for normal human consumption (also plenty animals on the Endangered Lists…..).
 
Please note as this is a Zoonotic disease, you might also pass it on to your animals/pets/herds. It is here, we have to work with it. 

In general, causes for not responding to medications –
 
Internationally, people seem to struggle to adhere to medication regimes. I.e. not completing antibiotics. Or, adhere, to TB/HIV medication. Above now as example, assisted in developing ‘super strains’.
 
Please take care out there!!

​ I do realise, this now Blog is not extensive of all items/actions to take; or all relevant data. For more information to your particular circumstances, check the WHO pages.
 
It is scary trying to write about Covid 19/Corona Virus.  I am thinking, Wow, now everyone will run to their medical practitioners claiming possible Corona (Covid)...
 

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Why use Rhino Horn? Vietnam Feedback

2/1/2020

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​Vietnam is one of the world’s largest consumers of rhino horn, contributing to the continued poaching of rhinos in the wild. Last year in Africa 1,100 rhinos were killed by poachers. And today there are only about 29,500 left in the world.
Considerable efforts have been devoted to reducing the demand for rhino horn in Vietnam. In 2015, the Government of Vietnam increased sanctions on the illegal trade and use of rhino horns. And, through a variety of campaigns, conservation organisations have tried to educate Vietnamese consumers about Africa’s rhino poaching crisis and the uselessness of rhino horn in medications.
We conducted a study to shed light on why people use rhino horn. To do this we interviewed consumers who admitted to using rhino horn in Vietnam.
We found that people used rhino horn for a number of purposes, principally as a medicine and as a status symbol. The most prevalent use was for treating hangovers. Other uses included using it to honour terminally ill relatives.
We also found that consumers preferred wild rhino horn over farmed rhino horn. And that they weren’t affected by stigma or concerns about rhino populations.
Our findings suggest that the demand for rhino horn is unlikely to fall because people’s beliefs are firmly entrenched. Our hope is that our findings help reshape the focus of future conservation campaigns by targeting the prevalent reasons for its use and the values associated with it.
Health and wealthWe interviewed 30, self-confessed, recent users of rhino horn and one rhino horn trader. They came from the upper income bracket of Hanoi, the capital of Vietnam.
The people we interviewed said that they used rhino horn to treat various ailments including hangovers, fever, gout and potentially terminal illnesses, like cancer or stroke. Some people also gave it to terminally ill relatives to console them and show that they had done everything in their power to help them.
Our findings confirm that the idea that rhino horn has magical healing properties is deeply rooted in Vietnam.
Aside from being used as medicine, rhino horn is considered a status symbol. Consumers said that they shared it within social and professional networks to demonstrate their wealth and strengthen business relationships. Gifting whole rhino horns was also used as a way to get favours from those in power.
StigmaWe found that the use of rhino horn doesn’t attract a stigma in Vietnam. The consumers we interviewed said they weren’t concerned about poaching or the plight of rhinos. The killing of rhinos in Africa was seen as a remote issue, something that happened far away, out of their influence because they didn’t kill the rhinos themselves.
They were also not concerned about the legal repercussions of buying it. The penal code of Vietnam prohibits illegal trade and use of rhino horn. However, all interviewed believed that the police would not pay attention to rhino horn use and that law enforcement efforts only focused on illegal trade in large quantities. And they’re not wrong.
And it’s not just the consumers who aren’t worried. A former trader of rhino horn said that potential profits from the trade far outweighed any risks.
Inform campaignsOur findings shed light on why current campaigns against rhino horn purchases aren’t working. For example, they tend to highlight the plight of rhinos, suggest that rhino horn doesn’t have medicinal properties or emphasise the legal consequences of purchasing it. Some campaigns also compare rhino horn to human nails (because they’re both made of keratin).
From our research it’s clear that people who buy rhino horn won’t be won over by any of these arguments.
In addition, our finding that consumers prefer rhino horn from wild animals has implications for the suggestion made by some observers that a controlled legalised trade could reduce poaching. We conclude that in fact such a trade would simply increase demand for poached rhino horn.
We hope that our insights will lead to campaigns that promote behaviour change. And campaigns that are better informed about the values associated with the use of rhino horn and that target the most prevalent types of uses.
Whether or not the legalisation of trade in rhino horn will be a solution to the poaching crisis is the focus of an ongoing study that we’re doing.

https://theconversation.com/we-asked-people-in-vietnam-why-they-use-rhino-horn-heres-what-they-said-116307
​

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Divorce in South Africa – No easy answers – What do we do with the kids?

18/6/2019

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Divorce in South Africa – No easy answers – What do we do with the kids?

We, in South Africa, have some of the highest statistics in the world, when it comes to divorce rates. The increasing concern is, divorce happens all the more, and, it happens so much more where people are married ‘young’ (early tweens, 20’s, and more).

It might be because of getting married too young, too much random sex resulting in unwed babies, innocent love, who knows; but it being so easy to divorce around here or for various other reasons, fact is, we can get married quickly and get divorced even more so.

So around here, since we get married so easily, we get divorced easily as well; as mentioned. 

The issue afterwards is, what do we do with the kids, and all the financial claims arriving afterwards?

I always ask, why do you want to pop out babies at that early age,  when you only got married (or even before getting married)  before you and your husband even have settled and know you future planning ( We probably never will receive an answer).

A recent question on a FB group Page I belong to, kick-started me thinking again (after neglecting my Blog for so long).

If you don’t mind, I am going to randomly address only some of the questions posted here –
  • Who pays maintenance?
  • Does the Dad also have to support the Mum until, whenever?
  • What is Mum’s contribution?
  • What happens if it is Infidelity?
  • What is Dad’s role, if any?
  • Maintenance vs Alimony?
There’s no easy answers on single/individual question/s re divorce (SA related). Divorce has so many questions, and, trying to address only some of them in one post, already is a challenge.

 Each household and marriage agreement, might also differ. And then of course, we have several laws playing a role here.

Divorce proceedings and maintenance have changed quite a lot since the ‘new’ Children’s Act of 2005/6 in SA (If I recall the dates correctly). Basically, all children have the right to still be kept in the same/similar lifestyle they were accustomed to when their parents’ divorce (however the Court will surely not grant them DSTV if no parent can afford this!) and of course, if it is not possible anymore to keep up Emily’s private horse riding and Kosie’s private lessons in Kaia Kwon Du (if such a thing exists) – no Court will and should enforce this.

Children always will according to Law, be allowed to still see both parents, and still receive parental love and visitations/ see both parents (as well as grandparents and extended family) regularly (if in case of abuse, social welfare stories and supervision).  
The focus has shifted to the rights of children, not those of parents. None of us have the ‘right’ of being a parent and I presume the reasons are self-explanatory – doing the beast with two backs and biological  insemination does NOT make you a parent – though so many people mistakenly still might believe since they sired a child, they have so many rights.

(It’s heart breaking also, that so many parents turn to false accusations in order to claim maintenance and alimony, in SA especially, but this is not the topic of conversation here).

Parents have equal say in the upbringing of the child/ren, does not matter who is the primary custodian (where the children stay). The courts recognise the rights of both parents with regards to decisions affecting children that are minors. This means that, even if i.e. the father is not the custodian parent, his consent is still required along with that of the mother in certain matters, including: which school, religion, the child getting married; application for a passport; and especially - removal of the child across provinces, or national borders.

The biological dad always has to pay maintenance – unless it is the mother who earns more and the dad takes primary custody of the children, etc and then various other situations.  Since 2012 I think? custodian parents can also start claiming ‘back pay/maintenance’). (My dates may be out of sync).

Then Dad has to keep in mind, every year due to economy & inflation, Mum can go back to court and ask increased maintenance as well (and here I wish to add to whether it might be Mum or Dad, do not stop claiming maintenance – here we also have sufficient cases to prove both Mums and Dads filing for bankruptcy, in order to sidestep paying maintenance). I do not agree with any parent getting away without paying required maintenance.

Now, a couple of other laws also come into play. Amongst others, if parents were married within community of property, the wife might get away even with claiming half of the husband’s pension fund (and yes, it still happens today where people make this mistake when getting married) – or, the husband can claim his half of the wife’s pension.

 Maintenance is strictly towards the children, and then both parents have to contribute, preferably 50% each, or percentage wise according to their particular income per month. The Court will determine the percentages, according to your income/payslips.

In practice what happens is (what is wished for) Dad pays medical fund, Mum pays school funds, etc. If both are trying to play fair (which also seldom happens).

Infidelity does not play a role, the courts follow a ‘No Fault’ system, meaning that couples could site irreconcilable differences as grounds for divorce - though you are allowed to proceed with a civil case against the ‘other person’ should you so wish. I might be out of place adding this, but even if one of the partners turn gay or claim gay as consequence of the marriage, there is no financial compensation.

Alimony is a different story – depends on how good your attorney is, and I suggest you get a good one. Most of the times the Mum (in SA according to stats) claims that Dad also has to pay her own lifestyle.

Here, it depends how good your attorney is. Because, if your wife were a ‘housewife’, a  little known fact might be the Courts could grant her a year of alimony only, with the understanding she has to use that year to ‘school’ herself and get out to get a job (this could extent to another year or more). This also applies to Dads claiming alimony.

 Once again, the Law can be on your side if you have a good attorney, or at least, Know your Rights!
 

 

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Fun in the animal world – Adari has a girlfriend!

14/2/2019

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Those following Adari’s excursions (YouTube or other), you know by now Adari recently turned 6.  And you also know by now, Adari appears as cover model and ideation for some published Cozies (Amazon books).

Adari is very much adult (middle-aged in human terms). But not always knowing what to do with female company! and with limited duck-social-experience.

2019, it seems to be still bird/ducks breeding season for this year with our variety of weather patterns. During the last couple of weeks, we (Adari) experienced a stream of shifty, skittish, visitors normally very early in the mornings, or very late in the afternoon. To such an extent that of course, Mum is not allowed to hug or give kisses (I am now grown-up, Ma, Uggh!) As long as Ma still provides food, water, a nice sleeping spot and protect against danger, of course.

There is one Nonnetjie (white-faced whistling duck) who increasingly (at least 3 weeks+ already) comes to visit. Normally after the other random visitors have left. Jeezz, talk about living with an in-love teenager!! When this little one whistles, off speeds Adari. Whether it is 05h00 in the morning, or midnight.

I have come to call this little one (presumably female): ‘Skinny’. Typical mother, I also wonder whether this little one suffers from anorexia, and/or what other problems…. (in comparison with Adari’s full body and beautiful white face and obviously, perfect everything else!)

 And why she can’t at least clean herself before visiting my boy!

 If this were the human world, I also would have sat her down and interrogated her with questions such as, why are you interested in a guy still living with his mum, and you know of course, he has no money or pending inheritance. What is his prospects, and your idea around this? What can you, deliver to the relationship? Who are your parents, what are they doing, why do they allow you to without supervision, court my boy?  (LoL again).

Instead, I think she wants his food and water? (Of course, I believe no other Nonnetjie is as beautiful or intelligent as my own Nonnetjie, but, still! And if possible, I would have subjected her to a variety of psychometric evaluations to screen whether she is really a suitable match).

Lately, they my son and seemingly girlfriend share water bowls outside, and they swim together. She (Female, I still think) turns her back on him and constantly wiggles her behind invitingly, but as soon as he tries to jump her*, she coquettishly jumps [hopspringe’] away… but come back for more of these activities.  (In the human world we also have a name for than LoL). Part of the mating rituals, I presume. I really need to do some more research re Nonnetjies and ducks in general.

For some reason, this all also, sounds like parenting. We constantly feel we have to stay on top of what our children/teens do,  and try to learn more, 
of whatever research/advice out there, what are we maybe missing practices, and adjust to our own lives.


Some days before already, Adari and Skinny were cooing in an unknown language to Mum’s understanding (while Mum thought she understood most of the duck language by now), each on the other side of the fence, while pecking each other’s beaks through the fence.

They are very skittish, together. Mum has to lean over the kitchen counter and peer through the window, climb and hide over and behind walls; when she attempts to take pictures. Even then, these little buggers tend to  disappear behind a tree or bush. Mum can’t see what they are up to! (Videos also seem to fail. These little buggers seem to know exactly when I am in the vicinity trying to capture them!)

Probably needless to mention, we all try to stay away from the swimming, cordoned area, which Adari ‘owns’ during Skinny’s visits. There is a lot of tip-toeing going on in the household in general, to not disturb this possible, blooming relationship…

As I am writing, Skinny is still here this morning. We now go for an at least ongoing 4 hour visit today only. This is exceptional.

I am thinking, it would be great to have Adari’s genes out these somewhere… As long as I myself, don’t have to raise them! (Otherwise, they will al probably also, end up in my bedroom LoL)


*I am very greatful Adari has after all the years, finally figured out there is some ‘jumping’ involved, somewhere!)

Some Previous Adari blogging -
https://www.goodpsychology.net/blog/duck-loves-mum-best-a-question-of-imprinting
https://www.goodpsychology.net/blog/unique-bonds-human-animal-relationships-duck-loves-mum-best-part-11
Picture
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Encourage Literacy for improved communication and education

5/1/2019

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How to encourage literacy in young children (and beyond)

File 20170704 13632 caakrr.jpg?ixlib=rb 1.1
Ask your child what their toys did while they were out today or invite them to help you read the mail. Evgeny Atamanenko/Shutterstock
Louise Phillips, The University of Queensland and Pauline Harris, University of South Australia

How can parents best help their children with their schooling without actually doing it for them? This article is part of our series on Parents’ Role in Education, focusing on how best to support learning from early childhood to Year 12.


Literacy involves meaning-making with materials that humans use to communicate – be they visual, written, spoken, sung, and/or drawn. Definitions vary according to culture, personal values and theories.

We look to a broad definition of literacy as guided by UNESCO to be inclusive for all families. Children learn to be literate in a variety of ways in their homes, communities and places of formal education.

What research tells us

New research in three-to-five-year-old children’s homes and communities in Fiji, has revealed that children’s regular engagement in literacy across many different media has supported good literacy outcomes.

There were ten main ways of engaging in literacy-building activities. These included print and information, communication and entertainment technologies, arts and crafts, making marks on paper, screens and other surfaces like sand and concrete, reading and creating images, and talking, telling and acting out stories that were real or imagined.

Children also engaged with reading, recording and talking about the environment, reading signs in the environment, engaging in music, dance, song and, lastly, with texts and icons of religions and cultures.

These activities were enjoyed and valued by children and their families as part of their everyday lives, and were further bolstered by creating books with children in their home languages and English.

Parents and communities include their children in daily activities, encouraging their literacy experiences. ChameleonsEye/Shutterstock

This research can be used to add to our discussions on how parents can help develop their children’s early literacy.

The Melbourne Institute of Applied Economic and Social Research found daily reading to young children improves schooling outcomes, regardless of family background and home environment.

The OECD Program for International Student Assessment (PISA) results also indicate a strong correlation between parents reading and storytelling with children in the early years and reading achievement at age 15, with those students performing one to two years above their peers.

However, it is not just being read to that matters. The adult-child interactions are also very important.

These interactions need to be lively and engage children with the text-in-hand. Alphabet toys and phonics programs alone offer little to develop literacy, as they focus on a code without contextual meaning. Words, and their letters and sounds, are best understood when seen and applied in everyday experiences, driven by children’s motivations.

How to be a talking, reading, writing, viewing, and listening family

There are several practical things parents can do to encourage broad literacy and learning in early childhood years.

  1. Don’t wait. Read what you are reading aloud to your newborn. Children become attuned to the sound of your voice and the tones of the language you speak as their hearing develops.

  2. Share stories at mealtime. Provide prompts like: “Tell us what your teddy did today”. Alternatively, randomly select from ideas for characters, problems, and settings, for example: “Tell us about an inquisitive mouse lost in a library”. Oral storytelling provides a bridge to written stories.

  3. Record on your phone or write down your child’s stories. Turn them into a book, animation, or slide show (with an app). Children will see the transformation of their spoken words into written words. These stories can be revisited to reinforce learning of words, story structure and grammar.

  4. Talk about their experiences. For example, prompt them to describe something they have done, seen, read or heard about. Research shows children’s oral language supports their literacy development, and vice-versa.

  5. Guide literacy in your children’s play, following their lead. For example, help them follow instructions for making something, or use texts in pretend play, such as menus in play about a pizza place. Children will engage with various texts and the purposes they have in their lives.

  6. Books, books, books. For babies and toddlers, start with durable board books of faces, animals and everyday things with few words that invite interactivity (e.g., “Where is baby?”). Progress to more complex picture books with rhyming language. Talk about personal links with the stories and ask questions (such as “I wonder what will happen next or where they went to”) as these will support comprehension. Look to the Children’s Book Council for awarded quality children’s literature.

  7. Talk about words children notice. Be sure the words make sense to children. Talk about what words look like, what patterns, letters and sounds they make. This builds children’s word recognition and attack skills, and understanding of what words in context mean.

  8. Involve your children in activities where you use literacy. For example, if you make shopping lists or send e-cards, your children could help create these with you. Explain what you are doing and invite children’s participation (e.g., “I’m looking at a map to see how to get to your friend’s house”). Children can meaningfully engage with and create texts and see the place these texts have in their lives.

  9. Use community and state libraries. Most offer interactive family literacy programs. Early Years Counts and The Australian Literacy Educators Association has a range of resources for families.

Above all, be sure the experience is enjoyable, playful, and encourages children’s active involvement. Literacy should be engaging for your children, not a chore.The Conversation

Louise Phillips, Lecturer, School of Education, The University of Queensland and Pauline Harris, Research Chair in Early Childhood, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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THE PROBLEM WITH [CHRISTMAS] GIFTS

30/10/2018

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I love gifts. Whether it be a bar of soap, chocolates, nuts, or a bottle of wine (preferably the type I love)

I love any gift. You bring a salad when 30+ people are gathering at my place? That is a gift from heaven. You wrap me a chocolate bar for Christmas (preferably fruits & nuts, or dark chocolate...) This means you were thinking about me when you bought this gift, because you took the time to find out what chocolates I like or love.

Does this sound strange? (Well, I do live in South Africa…)

So why do I also believe, Gifts can be a terrible thing?

Every year at Christmas, I get extremely excited. I hobble around in shopping malls attempting to two-step and ramba and samba on the ‘Deck the halls with ...’ or ‘Santa Baby’ and other Christmas tunes, even falling over my own prosthesis in the process, I cause fatty smooshing stains at shop windows for pushing my nose flat against all the windows to ‘absorb’ the decoration ideas; I decorate my own christmas tree and lounge at home (sometimes even a month or so in advance) and drive everyone around me crazy for coming up with wayward ideas to celebrate and share gifts; and oh, why don’t we do...xyz this year?!

(Also still trying to find the perfect eggnogg adjusted recipe for Africa temperatures and tastes, my previous atempts sent everyone immediately to bed LoL. And then myself, too!)

Someday, once I’m a real grown-up, I even might experience an European or American Christmas full of snow and all the possible coloured lights and decorations you can even think of.

In the meantime, lo-ong before any event, I start drawing up ideas of whom should be on my annual gift lists and what to give them. That does not necessarily mean my list is perfect, however. The list seems to be an ever, ongoing process.

Some of the standard dilemmas I encounter, is; we seem to be socially conditioned and expected to hand out gifts. Gift-giving has become a serious commercial activity, and we all, seem to buy into this.

We especially, seem to be expected to hand out gifts to everyone around us. We also seem to hand out gifts we think, ‘belongs’ to women, and gifts we think ‘belong’ to men. And then, obviously, more expensive also seems to be the norm (expensive equals apparently, better?)

Personally, I am getting a bit tired of all these expectations.

And when we don’t have ideas we give crappy gifts -  for example, please let this one [3 years in a row…] never be repeated: I do not want oven gloves for christmas or even my birthday! (What are you trying to tell me – as a woman I belong in the kitchen? Have you ever put any thought into, who I actually am or trying to do?)

 In this regard, I seriously want to make a recommendation – get to know the person before you simply buy random gifts. Even expensive gifts, could be not-so-ok.

 A good gift does not necessarily equal expensive. Sometimes a simple delicious bar of soap in the person’s favourite flavour which says ‘I was thinking of you’, is better than an expensive gift which relates nothing to the person at all.

I repeat, gifts can be a terrible thing.

Might I make a suggestion….?  

Just take some time selecting the gift for each person.  Make it personal and think of the person you buy it for! It really does not have to be expensive. 
(But I still would like you to wrap all my gifts nicely, colourful with a bow!)
 
 

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South Africa's intended health care plan - No clear answers yet

23/10/2018

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South Africa's universal health care plan falls short of fixing an ailing system

File 20180627 112604 12nm7oq.jpg?ixlib=rb 1.1
A patient collects her medication at a clinic in Khayelitsha, South Africa. MSF/Sydelle WIllow Smith
Laetitia Rispel, University of the Witwatersrand

South Africa’s Health Minister Aaron Motsoaledi has finally gazetted the bill detailing an ambitious plan to roll out universal health care in the country through a National Health Insurance.

The bill responds to a global campaign spearheaded by the World Health Organisation and linked to the UN’s sustainable development goals to make sure that no-one is left behind in accessing quality health care.

There’s no dispute that South Africa’s health care system needs major reforms. There are considerable inequities in health care between urban and rural areas; between public and private health sectors and between primary health care and hospital care. And the country has a complex disease burden with heavy caseloads of HIV, TB and non-communicable diseases.

South Africa has poor health outcomes compared to other middle-income countries such as Brazil with similar health spending as a percentage of GDP. It spends more than R300 billion – or around 8.5% of its gross domestic product – on health care. But half is spent in the private sector catering for people who are well off while the remaining 84% of the population, which carries a far greater burden of disease, depends on the under-resourced public sector.

The health system performs poorly due to a combination of factors including the poor management of public sector hospitals, health professional shortages (particularly in rural areas), low productivity levels among staff, escalating private health care costs and poor quality of care.

But in its current form the proposed legislation won’t be a silver bullet. There are still too many inconsistencies and unanswered questions for it to be the final roadmap to universal health care in the country.

For example, the bill focuses on curative services, missing an opportunity to take a public health approach that focuses on disease prevention, health promotion and health protection. In addition, it doesn’t address the relationship between the public and private health sectors which is seen as a major impediment to fundamental change.

How it will work

The bill is informed by a vision of ensuring equitable access to quality health services, regardless of a person’s ability to pay or whether they live in an urban or rural area. The proposed insurance fund envisages the consolidation of public and private revenue into one funding pool.

The idea is to enable a more equitable system through, for example, cross-subsidisation and ensuring that essential services are made available.

All people will have to register as users of the fund at an accredited health care establishment or facility (whether public or private). And the fund will decide on the health benefits that the facilities will have to provide. This will depend on what resources the facility has. People will be able to pay for complementary health service benefits not covered by the fund.

To be paid, health care providers, such as general practitioners and hospitals, will have to register with the fund. They will have to claim for each patient that they treat and will have to keep a record of diagnosis, treatment and length of stay.

Governance

The structure that’s been proposed for the fund is raising concerns on two fronts: it appears unnecessarily cumbersome and there’s a lack of clarity on lines of command.

The bill makes provision for the fund to establish an independent board that will report to South Africa’s Parliament. But it makes no mention of how the board will engage with the health minister (political custodian) and public servants in the health department. Nor does it explain how the performance of the fund will be evaluated.

The bill also introduces two additional management layers: district health management offices and contracting units for primary health care. These units will provide primary health care services in specific areas. It includes a district hospital, clinics and community health centres as well as ward-based outreach teams and private primary care service providers. They will be contracted by the fund.

National, provincial, and municipal health departments will still exist.

But the bill fails to explain the relationship between the district health management offices and the contracting units and how they will engage with the national, provincial and municipal health departments.

Given that there are ten health departments operating in South Africa – a national department and one in each of the country’s nine provinces – these additional offices and units could result in a more cumbersome bureaucracy. This could lead to more inefficiency and greater opportunity for corruption.

The new structure will also change the responsibilities of provincial health departments. Some of the proposals don’t make sense such as the idea that municipalities should take control of managing communicable diseases. Ideally this should be a national function, given the serious threat that is posed by some infectious diseases.

Many questions

Other parts of the bill are also unclear. These range from financing to how complaints will be managed.

Health financing and management: The bill doesn’t explain what the tax implications of the national health insurance will be for citizens. It also doesn’t set out the mechanisms that will be put in place to strengthen financial planning and monitoring systems, particularly in the public health sector. These are very important given current chronic overspending, inadequate financial management and corruption and lack of accountability in many provincial health departments.

Service provision: The bill says everyone is entitled to a comprehensive package of services at all levels of health care. But it doesn’t spell out what these packages will include. Given budgetary constraints, it’s obvious that there will inevitably have to be trade-offs and difficult choices.

The health workforce: South Africa doesn’t have a comprehensive health workforce strategy with detailed norms and standards. This remains the Achilles heel of health sector reform in the country. The lack of detail remains a serious omission in the bill.

Complaints mechanisms: The bill introduces a new separate complaints directorate – the investigating unit. But it’s unclear whether this will be the first level of complaints or whether it’s a duplication of the complaints directorate in the existing Office of Health Standards Compliance. There also isn’t clarity about where the Health Ombud fits in.

Ensuring that South Africa has a quality affordable health care system is critical. And the bill presents an important opportunity to think systematically about what needs to be done to fix the current health system. But there is still a long way to go.The Conversation

Laetitia Rispel, Professor of Public Health and DST/NRF Research Chair., University of the Witwatersrand

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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