Service delivery protests may pose next ‘most imminent threat to SA’

SA has emerged from a two-year health disaster and continues to battle with the fallout of the coronavirus and economic disaster brought about by lockdowns.

With a global monkeypox outbreak threatening many countries, SA health experts are contemplating whether to brace for another major health crisis.

The disaster that poses the most imminent and devastating threat, however, is that of mushrooming service delivery protests.

That is according to disaster management experts in the health sector, who spoke this week at the Hospital Association of SA conference in Cape Town.

Wayne Smith, head of disaster and emergency medicine at Metro EMS in Cape Town, said: “If you ask me about the threat of monkeypox versus that of civil unrest, I would say the latter is the biggest problem and my biggest fear.”

This week, at least four people have been killed in service delivery protests in Thembisa, while several buildings, including the Ekurhuleni call centre, have been gutted.

Though police later reported the area to be calm, service delivery protests sometimes catch and spread.

The protests follow a recent spate of severe disasters including the pandemic, floods, rolling blackouts, drought and the July riots that rocked the country a year ago.

Disaster and emergency experts said the protests arise out of the country’s disastrous inequality and put more pressure on several systems including health, security and economics, and make other disasters worse.

Mande Toubkin, head of emergency and disaster management at Netcare, is no stranger to a sudden crisis that can cripple a country.

She is also aware of how disasters play out in expected and unexpected ways.

“On one level we were prepared for Covid-19 and in 2012 when we were looking at the SARS health concerns, I had worked on a pandemic plan of action and that has stood us in good stead. Disaster management is a grudge purchase though, and it was hard to tell people what to do. We didn’t know what to expect,” she said, adding that with an earthquake or fire, for example, you know what to expect. 

“Covid was an undercover agent. We didn’t know what we were dealing with. In hindsight we didn’t know what misery the lockdowns would cause, but with a disaster you make a decision and work from there,” she said.

Two years later, she, like Smith, worries about “civil unrest” but is equally worried about blackouts and the impact a full blackout could have on the health system.

Looters not only targeted big retailers and malls but also looted medical centres.

—  Sophie Smit of the Helen Suzman Foundation

With climate-related disasters such as floods, droughts and rising sea levels also becoming more common, disasters can strike simultaneously, amplifying the effects of both.

According to a paper by legal researcher Sophie Smit of the Helen Suzman Foundation, the July riots last year put extreme pressure on the health system.

She said the vaccine rollout had been affected by the riots and they had “also had an impact on access to other types of chronic and lifesaving medication for TB, HIV and diabetes”.

“Although these medications are necessary for many of the individuals, the risk posed by riots and looting to staff members and patients was too great to continue their provision in that climate,” she said.

“Lifesaving medical care was further compromised due to the torching of ambulances needed to transport patients to medical facilities and the prevention of the much-needed delivery of medical supplies such as oxygen for patients in a critical condition. Looters not only targeted big retailers and malls but also looted medical centres, pharmacies and, horrifically, the SA National Blood Service.”

Melanie Stander, emergency medicine manager for Mediclinic Southern Africa, is feeling more positive than other emergency experts because of what was learnt during the pandemic.

“Whatever the next disaster may be, I am not worried. I am not fearful, We have what it takes and we have so many things in place that we did not have two years ago,  before Covid. It came at an enormous price, but we have also benefited from this experience,” she said.