South Africa: Older People Lack Basic Care, Support

Many face risks to their physical well-being and safety and experience profound distress and fear at the prospect of being forced to live, and die, in an institution.

The 68-page report, “‘This Government is Failing Me Too’: South Africa Compounds Legacy of Apartheid for Older People,” details the government’s failure to effectively carry out the Older Persons Act, a post-apartheid law that guarantees the rights of older people and provides for community- and home-based care and support services.

These services would enable older people to continue to live in their own homes with the support they are entitled to. “Older people have been overlooked by a government that has neglected their rights,” said Noma Masiko-Mpaka, South Africa researcher at Human Rights Watch. “The South African government should act promptly to make the Older Persons Act meaningful, not just words on paper. Older people have a right to live with dignity.” Between September 2022 and May 2023, Human Rights Watch interviewed sixty-three older people in Eastern Cape, Gauteng, and Western Cape provinces, seven non-profit service providers, three volunteer community organizers, one non-profit community caregiver, two family caregivers, and one government social worker. Human Rights Watch also consulted forty-five South African researchers, academics, lawyers, non-profit service providers, human rights experts, and members of older people’s organizations and two international academics, and reviewed national legislation and reports by governments, academics, international bodies, and local groups. Older people in South Africa today spent at least half their lives under an apartheid regime, whose racial segregation policies denied the majority of black African, coloured, and Indian/Asian people a good standard of education, decent work, and the ability to save for older age.

The cumulative impact of that racial discrimination still affects older people today. Human Rights Watch found that current government policies are compounding this legacy. South Africa has more than five and a half million people age 60 or older. Many of them do not have adequate financial and other support to live a dignified life. Ben Zolile, 75, lives in River Park, Johannesburg. He says his health goes “up and down.” He used to eat lunch each day at a service center for older people but now cannot make the trip due to bad knees. “No one comes to my house,” he said. “There are no other services that come to my home.” Human Rights Watch found that the Department of Social Development has failed to allocate sufficient resources for community- and home-based care and support services and for the non-profit organizations contracted to deliver them. Furthermore, the government’s current targets for delivering services leave hundreds of thousands of eligible older people without access. “Every week, every month [older people] come and apply,” said Nosiphiwo Tetana, who manages a service center for older people in Dimbaza, Eastern Cape. “And we have to turn them away as we can’t overload the budget.” The situation is further exacerbated by the government’s restrictions on how funding can be spent, the lack of a system to determine who is entitled to care and support, an over-reliance on family members to provide support, disparities in provincial governments’ service plans, and insufficient numbers of social workers. Human Rights Watch found that the situation was particularly bleak for people requiring full-time care and support at home.

The Grant-in-Aid, the social security entitlement designed to cover the costs of full-time home-based care and support, is woefully inadequate. Under the grant, older people receive R500 (US$27) per month, which would cover less than the R610 (US$32) cost of a single day of care, based on the national minimum wage. Moreover, few older people interviewed even knew about the grant. Of those who did, some wrongly thought they did not qualify.

The family of Nozala Ndoyana, 84, was unaware of the Grant-in-Aid. Ndoyana lives in Gwaba village, 36 km from East London, with her youngest daughter, Pamela, who washes her mother, cooks her breakfast, and leaves for work, for up to 12 hours a day. Pamela, 47, constantly worries about her mother when she is at work. “Even though I make her food, she may not think to eat it, and go without food all day,” she said. Sometimes Nozala wanders away from their house. If the neighbors see her, they will assist her, but there is no one to be with her all day. Pamela said they would apply for the grant. “But,” she said, “I don’t think I can find someone who can look after her for R500 a month.” Older people require adequate housing to live independently in the community. Yet Human Rights Watch found that older people are often unable to afford private rent or repairs, including to make their housing more accessible. Some feel unsafe in their homes. Others have waited decades for state-subsidized housing. Bahija J., 75, has been on the waiting list for 40 years and has been renting a house in disrepair and with no hot water in Cape Town since 1996. “The previous government failed me, and now this government is failing me too,” she said. South Africa is obligated under national and international human rights law to ensure that older people, including those with limited mobility and those requiring support with daily activities, can live independently in the community with access to community- and home-based support services and adequate housing to enable them to remain in their homes. “Government policies are failing older people and sending a strong signal that the dignity of those who sacrificed so much for South Africa’s freedom no longer matters,” said Masiko-Mpaka. “The Department of Social Development should allocate sufficient funding to deliver community- and home-based care and support services so that older people can live independently in their homes and communities.”.

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References:

• https://www.hrw.org/africa/south-africa
• https://www.gov.za/documents/older-persons-act
• https://www.hrw.org/report/2023/06/27/government-failing-me-too/south-africa-compounds-legacy-apartheid-older-people
• https://www.gov.za/services/social-benefits/grant-aid
• https://www.gov.za/sites/default/files/gcis_document/202302/48094gon3069.pdf