Mothers and Fathers of the Nation: The Forgotten People

Report of the Ministerial Committee on Abuse, Neglect and Ill-Treatment of Older Persons

26 February 2001

Volume II
Provincial Reports

A. PROVINCIAL PROFILES
(1999 and 2000 Inter-Governmental Fiscal Review) 

Notes on the Table:

  1. While the gross national expenditure on welfare has increased from R14.5 billion in 1995/6 to R20.6 billion in 2001/2, there is a decline real value of the budget because of inflation. Based on a 1995 standard the budget for 2001/2 is R10.3 billion. Hence there has been a cut in the real value of grants and in the social services budget.
  2. The cost of social security grants as a proportion of gross welfare expenditure rose from 87.8% in 1995/6 to 92.5% in 1999/00.
  3. Based on the 1995 standard, the welfare services budget fell from R1.6 billion in 1995/6 to 1.2 billion in 1999/00.
  4. Poorer provinces have difficulty allocating more money to welfare services because of their commitment to the Child Support Grant. Disability and foster care take up in these provinces is also low and likely to rise.
  5. IDASA concludes that Eastern Cape and Northern Province spend a large proportion of their budgets on social services (welfare, health and education) but appear to be under-funded in terms of the equitable share from central government. Mpumalanga and North West allocate less of their budget to social services.
  6. Over the next 3 years provincial budgets for welfare programmes and subsidies are scheduled to increase by 3.8% in real terms. The increase will be 35% in the Northern Province and 29% in KwaZulu-Natal. But Free State (-.9%), Mpumalanga (-5.8%) and the Western Cape (-10%) continue to cut spending on social welfare services.

B. THE FREE STATE

REPORT ON COMMITTEE VISIT 9-10 MAY 2000

  1. PUBLIC HEARING MAY 9

The Public Hearing was held in Bloemfontein on 9 March. It marked the launch of the provincial visits by the Committee. The Hearing was attended by 600 people and was officially opened by the MEC for Welfare, Ms A. Buthelezi-Phori. There were desks to address pension problems and complaints about Home Affairs and IDs. After the opening some Committee members remained at the Public Hearings to listen to public submissions, and others sat in private rooms for people who wanted confidentiality.

In public speakers spoke of the problems they had with local councils, civil servants and the government. In private they told stories of abuse and ill treatment by their children, relatives and care-givers.

The following issues were raised:

Financial Abuse: 

Psychological Abuse:

Cases were reported of family members who either intentionally or due to the stress of care-giving, intimidated and humiliated older persons

Physical Abuse: 

Systemic abuse:

Official Response:

Officials of the Department of Social Welfare in the Mangaung admitted that the farms and rural areas of the Free State have not been mapped out and that farm workers must rely on their employers to bring them to town every month to collect their pensions. High rates of illiteracy among the elderly add to the problem. In Brandfort one social worker caters for 28,000 people. She speaks no African language and the farm dwellers speak neither English nor Afrikaans. She was not aware that water and electricity services to elderly people were being cut.

  1. VISITS TO RESIDENTIAL HOMES: MAY 10

2.1 Boiketlong Old Age Home, Thaba Nchu 

This institution caters mostly for people who are destitute. The building was undergoing renovation and the residents had temporarily all been placed in one dormitory-type building. This home was built by the NG Sending Church in Africa and was used by the Bophuthatswana homeland.

There were 26 residents, one of whom was in hospital after allegedly being assaulted by staff. We were informed that investigations into several cases of abuse were pending. Random discussions revealed the following:

2.2 Botshabelo Old Age Home 

This home is run by the Seventh Day Adventist Church. It was built from Development Aid funds. It looks beautiful. Some of the residents attended the Public Hearings and gave a confidential report. They asked Committee members to visit the home and “observe”. 

Residents raised the following issues with Committee members: 

2.3 Mooi Hawe Old Age Home, Bloemfontein 

Committee members met with the President of the Oranje Vroue Vereeniging, Mrs Potgieter. The Home had 148 residents and 22 vacancies. All residents were classified as frail. We were told that twelve residents had died the previous month. In 27 years there had not been a single case of abuse by outsiders or insiders: bruises resulted from falls. In this event all staff on duty were interviewed. Residents may claim that staff had caused the bruise but they picked them up from the floor. There was one case of a dead woman who was found to have a cut on her head but it was decided that this had happened at the funeral undertakers, Avbob. . Residents with Alzheimers disease had to be restrained and this did cause bruising. They also have to separate residents who fight. 

There were six black residents of whom four were young. Four others had died. Eight came to Mooi Hawe from Odendaalsrus and 2 from Alan Ridge. There were no black members of the Board but there were two possible candidates. We were told it was difficult to find people who had the time and qualifications. In discussions with the Welfare Department it emerged that Mooi Hawe got a life time top-up grant to take black residents from a home which was closing. Other white homes had refused.

Staffing consists of 48 nurse-aids and 19 nursing sisters. Nurse aids used to be trained by Mrs Potgieter and get a certificate from the Nursing Council, but she can no longer do this. Now they have to accept a poorer quality nurse and they only receive a little in-service training. They recognize they have to improve their training and supervision. There is no protocol but qualified nurses are always on the look-out for abuse. The home receives subsidies of R1185 for 142 places. Thirty residents pay fees ranging from R1941 to R2067.

The per capita cost is R1773 excluding VAT. 60% of this is staff salaries.

There is no outreach programme. 

2.4 Boikhutso Old Age Home, Mangaung 

This home was established in 1960 with revenue from beer halls for about 50 disabled and older persons. Then it became a Transit Camp for homeless people. When this closed in 1984 the community rallied and formed the Mangaung Society for the Aged which was registered in 1986 and received a low-interest loan of R2.8 million from the Housing Department to rebuild the home (it was one of the few black organizations to benefit from this scheme). It did not repay the loan - after prolonged negotiations with the Housing Department it was finally written off. 

Presently there are 76 residents. Assessment is done prior to admission and families are encouraged to keep in touch. Subsidies are paid according to the following scale:

They have started to address abuse and neglect in the community but, while luncheon clubs are subsidized there are no subsidies for the community based services: “We are told to develop services but we get no support”. Applications for poverty funds have been rejected.

The home offers the following services:

This is the only organization for the aged in Mangaung. Many cases of abuse in the community are reported to them - but they are not followed up by the police. The Society helps people get their pensions and retrieves IDs from loan sharks. They are concerned that the Government does not use them to communicate information about pensions to the community such as re-registration, increases in pensions etc.


C. GAUTENG

“I have been forgotten. All old people have been forgotten. We are the most neglected people.” Lebogang Kgaye.

In Gauteng a great deal of abuse takes place within the family and older persons seem to be the target for much of this. Services are not adequate to cater for their needs. Social workers lack capacity and training for this. The NGO sector does not appear to be well organised or coordinated or able to make a difference. It is not clear why organisations for the elderly do not work together. Health care services are also problematic. But the biggest issue for the elderly is unaffordable rates and taxes. The Indigent Policy is not being applied and is possibly too complicated.

  1. DELEGATION FROM KATLEHONG

Shortly after the Committee was established a group of pensioners from Katlehong traveled to Pretoria to meet them and present their concerns which were as follows:

  1. Unable to afford rent, arrears and service charges - plea to write off arrears
  2. Grand-children are robbing pensioners of their houses and putting them in the back yard
  3. When the husband dies the house is not allocated to the widow who has to find accommodation elsewhere
  4. CPS should tighten security at pay points 
  1. PUBLIC HEARINGS AT EERSTERUST 14 AUGUST

307 persons attended the hearings which were also attended by the Mayor and the MEC for Welfare Services. 56 complaints were reported to the Help Desks. 

Representatives of the following organizations were present:

Ga Rankuwa Hospital, Metheo ya Sechaba, Lodewyk Spies Old Age Home, Partners in Word, Pretoria Academic Hospital, Pretoria Council for the Aged, Andries Snyman Rusoord vir Bejaardes, Monument Diensentrum, Daveyton Old Age Home, Daveyton Zenzele, Sanco, Hlangani Club, Mabopane, Benoni Welfare, Eersterus Community Services, Golden Citizens Club, Mamelodi Care of the Aged, Mamelodi Senior Citizens Association, Mamelodi Old Age Home, Kwathema, Springs, Kwathema Care of the Aged, CCP Old Age Home, Jolly Group, Tsakane Care of the Aged. 

The following issues were raised:

Community Issues

Health care:

Housing

Pensions:

  1. Reports from Residential Homes

  1. PUBLIC HEARINGS VEREENIGING 15 AUGUST

Over 600 persons attended these hearings, which were held in a church. The Deputy Major and the MEC for welfare Services also attended. There was a lively atmosphere at the hearings and people expressed high appreciation for the Minister’s initiative in appointing a Committee and for the presence of the MEC. 68 people give evidence and help desks worked well. 

The following organizations were represented: Evaton West Development Forum, Vaal Seniors Club, Itsose Club Empilisweni, Vereeniging Youth Club, Bophelong Luncheon Club, Bazelibethu, West Rand Health Services, Baragrwnath Hospital, Bongani for the Aged, Kgotelopele Bophelong Project, Itsoseng Elderly Club, Mohlakeng Old Age, Avonrus Old Age Home. Soweto Civic Organisation, Senior Citizens of Soweto

Overall it appeared that the Vaal has been more neglected than other areas in Gauteng, has a high incidence of abuse in families and a high level of unemployment. The various social services are unable to respond to need. There is little funding or support of Clubs

A major concern is that local authorities and local councilors who are not responding to the needs of older persons. Masakhane is dead. Older persons with their meagre incomes were seen as a prime target for the collection of unaffordable rates. This resulted in extreme hardship.

Community Issues

Abuse:

Local Authority Services:

Pensions

Health

  1. RESIDENTIAL HOMES

  1. SOWETO PUBLIC HEARINGS 16 AUGUST

353 persons together with the Mayor of The Greater Johannesburg and the MEC attended the Hearing at Baragwanath Hospital. The high level of family violence was highlighted and the declining respect for older persons. Other issues raised were the unaffordability of rates and taxes, disinterested local councilors, and health and welfare services are unable to respond to the need. 

Community issues

Health

Housing

Pensions:

  1. RESIDENTIAL HOMES

  1. PUBLIC HEARING IN DAVEYTON, EAST RAND, 18 AUGUST

An additional hearing was held at Daveyton on 18 August at the request of a social worker who attended the public hearings at Eersterus. Two members of the Committee attended and found a hall packed with older residents. 

Three-quarters of the reports and complaints concerned local services and high arrears bills for water and electricity . People knew nothing about an Indigency Policy and blamed local councilors for the lack of information. Social workers were accused of not following up on cases of hardship reported to them. Many old people had had summons issued against them for bad debts. The other important issue was the cancellation of pensions and, when re-instated, non-payment of arrears. 

Local government officials agreed to address pensioners the following week on the Indigency policy. The Gauteng Department of Welfare agreed to call a meeting with social workers to address their indifference and invisibility.

  1. RECOMMENDATIONS BY THE COMMITTEE:

The Province should conduct an internal audit of welfare and health services in respect of older persons. This will enable it to develop an effective management system. It should give attention to the following problems: 


D. KWAZULU NATAL 

COMMITTEE VISIT 21 - 25 AUGUST 2000

  1. PUBLIC HEARINGS ULUNDI 22 AUGUST

“We are the mothers of the nation. They are President and Ministers because of us, yet we are treated so badly” Mildred Dlamini, Pensioners’ Committee member

The Hearing was opened by the MEC for Welfare who compared the Committee to sniffer dogs finding out what was wrong. “We have built many offices but it saddens me that in some people are not respected, no matter how much I plead with staff members.” He appealed to the audience to report to him so that he can act against staff who are not treating them properly.

The Hearing was attended by 623 people . The breakdown was as follows:

Mahlabatini 73
Nkandla 24
Monmouth 39
Ngoye 83
Babanango 49
Mondlo 26
Nongoma 33
Mseleni 12
Ulundi 10
Obombo 11
Vryheid 12
Eshowe 35
Hlabisa 33
Matubatuba 16

Smaller numbers came from 71 villages whose location is unclear

There were 106 submissions, 65 of them were in Zulu

Isikhalo/ Complaints

  1. Lists were handed in totaling 308 canceled disability grants and 99 pensions canceled without warning.
  2. There is a problem with procurators/proxys not being accepted - frail old people have to be carried to pay points. A list of the IDs of ten frail elderly and their ten proxies was handed in. However, on the other hand there were reports of proxies who did not hand over the pensions.
  3. There were three complaints that pensioner committees demand R2 from pensioners . 
  4. There were complaints about the long distances pensioners had to travel to pay points , the location of pay-points, the cost of transport and the lack of shelter and toilets. 
  5. There were reports of armed hold-ups at pension points and failure of the police to respond. There were five complaints of inaction by the police (who pleaded lack of transport).
  6. There are suspicions about CPS , a report that they do not pay pensioners their full entitlement and allegations of manhandling and their late arrival at pay-points.
  7. There were two complaints about Cornerstone Funeral Plan (for which premiums are deducted directly from pensions by CPS). One accused an official of using his own thumb print, presumably on an application form and the other accused the company of refusing to pay for a burial.

Proposals made to the Committee

  1. Shelter, food, seating and first-aid or mobile clinics should be provided at pay-points
  2. More pay-points should be provided so the distance pensioners have to travel is reduced and queues are shorter.
  3. Child Support Grant should be payable to the age of 18
  4. Security at pay-points would deter thugs and hawkers who prey on pensioners
  1. VISIT TO KWABADALA OLD AGE HOME, NKANDLA 

A Committee member and a photographer visited the home without notice, the only one in the Ulundi District. Both the Superintendent and the social worker were off duty. There were 69 residents, mostly elderly, and 70 staff (a record staffing ratio?). It includes groundsmen, security, kitchen staff and a mortuary attendant. Of the care staff there are 2 staff nurses, 2 nursing assistants (who have completed courses) and many “ward aids” who are untrained. Currently the home is not full but numbers fluctuate and there is no overall decline. Referrals come from social workers. 

The home was established by the Dutch Reformed Church in the 1970s. Initially the home was overcrowded, with people sleeping in the corridors. Currently, the physically frail occupy wards in the main block, separate for men and women. The wards are open plan with 5-6 beds in each of the four corners of the room and a dining area in the middle, with bathrooms , toilets and a sluice room leading off the dining area. There are no doors. Cupboards in each corner are shared by the occupants of the beds. There were no locks. Neither bathrooms nor bedrooms were particularly clean but the floors were very shiny. A builder was repairing the sluice-room.

Besides the wards in the main block there are 70 tiny tin-roofed rooms for the physically able - with shared toilet and ablution blocks, only one of which was operational. Both rooms and toilet blocks looked run-down. Many are occupied by staff. 

A few beds in the wards were occupied by bed-ridden people, some young. Most residents were sitting or lying in the sun outside. A group of men were working on fruit-bowls made from ice-cream sticks glued together and then varnished. They seemed cheerful and few complaints. One complaint was from a man who gardens and said the fences were broken and the cattle eat his vegetables. He was also trying to get a one-handed wheel-chair since having a stroke in December. Pensions are cancelled when residents are admitted and they get R2 a month pocket-money , paid three monthly. 

Food is outsourced to Mandate Meal Management in Durban. Lunch was about to be served and looked appetizing. We were told by residents that they like the food and get meat every day. Generally residents looked shabby but not unhappy. Many could not speak English. Nkandla Hospital is 7 km away. A doctor visits weekly.

The Manager, Mrs Samuels phoned the Committee member the next day. Her main problem seems to be that staff are occupying most of the little houses and she has asked the Department to separate them from the elderly but nothing has happened. She is unhappy with the building and the open wards and is trying to put up curtains.

  1. PUBLIC HEARING AMANZIMTOTI 23 AUGUST

“If we don’t stand on mountains how will you hear our cry?”

Mayor of Durban South Central Theresa Mthembu’s speech, read by Councilor Moodeley, called for strengthening of community structures to help older people cope better, for facilities to be opened to senior citizens groups and for a dynamic support system. She also called for more attention to be given to conditions at pension pay-points, at clinics and hospitals, where old people also had to queue for long periods, and for Home Affairs to give special attention to the problems elderly people had with birth dates and IDs. The old tradition of women being perpetual minors was still a problem for older women who lost their homes after the death of their husbands.

The hearing was attended by 367 people . 45 oral submissions were presented .

Written submissions were received from the following:

Department of Social Welfare, Province of KwaZulu-Natal
Health Services, Province of KwaZulu-Natal
South Local Council Forum for the Elderly
Durban Association of the Aged (DAFTA)
Aryan Benevolent Home Council
Northcroft Senior Citizen
The Black Sash
Umlazi Christian Care Society
Bill Buchanan Association for the Aged
Babithuba Women’s Project
KZN Association for Older Persons
South Local Council for the Elderly
Bahle Help the Aged Care
Kwamashu Christian Care Society
Osizweni Kwamashu Senior Citizens Club
Reports from Sunset Lodge Frail Care Home 
Beth Shalom old age home
The Association for the Aged (TAFDA)
Verulum Day Care and Frail Care Centres
Umlazi Welfare Society

The following problems were highlighted:

Residential Care

  1. There are disparities in conditions at white, coloured and Indian facilities and African homes because apartheid government only provided funding for the erection of the former. 
  2. Ongoing differences in the funding of African homes - based on unit cost - lead to inferior staffing with fewer sisters and qualified care-assistants
  3. Inadequate and inefficient staff, no training programmes and low staff morale
  4. Too few trained staff and lack of discipline, supervision and structured controls.
  5. Inadequate record-keeping and documentation, guidelines etc.
  6. Inadequate controls on distribution and administration of drugs
  7. No activity programmes for residents
  8. Abuse by untrained and uncommitted volunteers 
  9. The closure of category 1 homes which left destitute elderly without shelter
  10. An old age home built in Kwamakhuta in 1998 had not been opened
  11. Serious financial problems faced by old age homes face e.g. Zibambeleli, Claremont and 
  12. Ekanana Old Age Home in Umlazi were unable to pay salaries in August 2000.
  13. There have been no prosecutions for elder abuse
  14. TAFDA, which runs 3 frail aged homes, reported that between July 1998 and April 1999 they monitored abuse in one home. Of the 84 residents affected 69 were women with an average age of 82 years. 44% of incidents were physical abuse, 32% psychological, 23% financial and 33% active neglect. 82% of perpetrators were care attendants, 11% cleaners, 5% staff nurses and 1% a professional nurse. There were no reports of sexual abuse . They found the abuse to be endemic. Although they installed cameras they were unable to change the staff and finally closed the home.

Proposals made to the Committee

  1. Staff counseling to help them to handle stress
  2. Staff training in identification and implications of abuse
  3. Staff monitoring by professionals
  4. Encouragement to residents, family and visitors to report concerns and complain.
  5. Selection of staff who are people-centred as well as professionally trained.
  6. Setting up a register of nurse aids and care assistants so that when staff are dismissed for abusing residents they cannot find employment in similar settings.
  7. Government should subsidize salaries so trained staff can be employed
  8. Day care centres should be attached to homes
  9. Shelters were needed for destitute but not frail elderly

SOCIAL PENSIONS:

“They refused to pay me a pension. I am retired at home. The children did not go to school. I have got no water. The neighbours supply for me the water. The phone was closed down. I have got nothing.” ( A 66 year old pensioner at the Public Hearings)

  1. In July 2000 29,622 pensions were suspended - due to failure to re-register (Black Sash).
  2. Pension applications take 6 to 13 months to be processed. In the past it took 1-2 months.
  3. Transfers between districts take 4 months . 
  4. Back-pay not received - sometimes for years. When arrears are received it is not the full amount - pay-out officials seem to take a cut.
  5. Cheques often incorrectly made out and cannot be cashed
  6. Pensions are cancelled without explanation, or pensioners told they have died. Lengthy delays before pensions are re-instated.
  7. Pension payments summarily discontinued after review with advice received months later
  8. Problems with outsourcing pension payments - CPS systems not linked to Department so CPS cannot inform pensioners of the status of their application
  9. CPS toll-free number not functioning
  10. No Department help-desks at pay points
  11. Fraud unit/investigation team is not accessible to pensioners
  12. Transport availability and cost: difficulties in getting to pay-points and frail old people having to be carried in wheel-barrows or old blankets.
  13. Transport problems, muggings, assault and robbery and experienced at the Durban office of the Social Welfare Department. An appeal was made in 1998 for the transfer of all pension dockets to the Chatsworth office - the proposal was unanimously agreed but the Department has dragged its feet on the issue. (DAFTA)
  14. Too few district offices to administer pensions and long queues there.
  15. Long queues at pension pay points , no protection from the weather or facilities , late arrival of CPS officials and severe congestion.
  16. Funds run out at pay-points, pensioners having to return twice of thrice
  17. Officials are rude, impatient and unwilling to assist. They demand payment for services. “Pensioners have to pay bribes at every point in the pension application system” (Black Sash). Bribery and other abuses in the queuing system
  18. Pension applicants not informed when provincial budget depleted for the financial year, but told to inquire the following month. This results in needless cost and suffering.
  19. Problems with Smart Cards - pensioners are rejected because of worn finger-prints, cards get lost.
  20. Social Relief grants not publicized or budgeted for and difficult to access .Deducted from the pension when it is restored.
  21. Abuse by procurators - some are family members and others money lenders
  22. Direct deductions by CPS on behalf of Cornerstone Funeral Society and allegations of intimidation by Cornerstone agents. (However, this system seems to deal with the problem of the final pension payment being withheld on death and the lengthy process of re-claiming this - a serious concern of pensioners in other provinces).
  23. The pensions of people who own houses valued at over R150,000 were stopped without notice, forcing many owners to gift their houses to their children - thus putting them at their mercy. “What has your home got to do with the grant. The government doesn’t own your home” (clapping).
  24. The amount of the pension should be increased by more than R20 a year - often the pension supports whole families and the ending of the State Maintenance Grant has caused suffering. No programmes were put in place as were promised.
  25. The Child Support Grant should be paid to the age of 18 - it is more important in the years 7-18 than under 7.

Proposals made to the Committee:

  1. Staff should be trained in how to treat pensioners and monitored.
  2. Trade Union members or provident funds should contribute a percentage of salaries or contributions so the government can increase pensions .
  3. Standards should be set for those to whom pension payments are out-sourced to assess their competency. 
  4. The establishment of a Directorate of Elder Affairs or a Minister of Senior Affairs
  5. Pensioners should be given notice when pension is to be canceled
  6. Membership of a funeral society should not be linked to the administration of pensions.
  7. Temporary relief or food parcels should be provided (as happened from 1970-1973) where grants are awaited or have been suspended.
  8. Wheelchairs are needed for the frail elderly and younger physically challenged at pay-points 
  9. Pensioners should not be paid on the same days as recipients of Child Support grants and Disability grants as they get pushed around.
  10. Men should also qualify for a pension at the age of 60.

HOME AFFAIRS AND IDs

  1. Home Affairs take more than a year to issue an ID , often requesting additional documentation.
  2. Pensioners cannot produce birth or marriage certificates and spouses death certificates - they do not remember the exact dates and the induna/inkosi who performed the wedding ceremony is dead.
  3. There is a problem incorrect birth dates on IDs and shared ID numbers. 

Proposals made to the Committee

COMMUNITY CARE

Proposals made to the Committee:

  1. The formation of an Elder Protection Unit
  2. Collaboration between Departments in keeping records of the aged 
  3. Soup Kitchens and stoves , and refrigerators.
  4. More volunteers to visit, feed and wash the elderly and some form of payment.
  5. Sheets , disposable napkins and other home care products 
  6. Sewing machines for those who are not frail and small shelters where they can be trained
  7. Transport to get the elderly to day centres
  8. Flat rates to pensioners for rates and services
  9. Housing and shelters for the elderly

HEALTH

  1. High hospital charges - essential operations are unaffordable.
  2. Local clinics are congested so elderly patients have to wait all day.
  3. No routine reviews of chronic medication.
  4. Some clinics unable to supply medicines (KwaMakhutha).
  5. In hospitals elderly people are made to wait long hours standing or lying on trolleys without food or assistance. At times they go home without medication.
  6. Increasing volumes of patients and decreasing quality of care in hospitals (Prince Mahiyeni, King Edward and Addington)
  7. Health districts do not coincide with local government districts.
  8. The geriatric clinic at Kwadabeka has closed and now the elderly must wait much longer with the general patients

Proposals made to the Committee

  1. Specialized units for the elderly in hospitals
  2. More hospital services to address the AIDS pandemic
  3. Better inter-sectoral coordination
  4. Pensioners should be exempted from health charges.
  5. There should be transport to and from hospitals.
  1. VISIT TO RESIDENTIAL HOME : SUNSET LODGE: 

This is the home where the Carte Blanche programme was filmed. It is owned by the Salvation Army. It was visited by Committee members and appears to have been transformed. Physically it has been refurbished and the new matron seems well-organised and enthusiastic. There were 52 residents (40 women) but it will shortly have 74 places. The cost is R2600 per month but 70% of residents pay only R440. 47 subsidies of R1215 are received from the province. Community churches visit - which is how the management got wind of the abuse. Now there are comment and incident boxes. The four floors of the home cater for different groups and have dedicated staff. Staff do experience racial abuse but “at 80 or 85 it is not our place to try and change their perceptions,” (Matron). Staff needed to be tolerant and to be able to take a break when abused. Previously they were more regimented. This compounded their frustration and irritation. Management held discussions with staff away from residents and if necessary staff are moved to a different level. 

Transformation: Most of the staff are black - it is difficult to recruit white staff at the prevailing salaries, we were told. We saw only two black residents: a man and a woman. both of whom looked rather forlorn - the woman had become disorientated (and incontinent) since entering the home - her family seldom visited. We noted that the menu offered only “white” food. 

Activities : There was little sign of activity among residents, many of whom admittedly were confused. But we were told that knitting, cards and reading were provided. 

Outreach: The home has 13 home nursing assistants who give short term and long term help to AIDS and cancer patients.

  1. PUBLIC HEARING NORTHDALE, PIETERMARITZBURG 24 AUGUST 

Over 700 people attended the hearings. They came from Sobantu, Edendale, Howick, Greytown, New Hanover, Ixopo, Imbali, Elandspruit, Matumatolo, Kranskop, Bulwer, Nhlazatshe, Swayimane, Donnybrook, Mountain Rise, Kokstad, Mbumuza, Mpolweni, Matimatolo,, Slangspruit, Caliza, Richmond, Inchanga, 

The Hearing was opened by the Deputy Mayor, Mr Chetty who welcomed the opportunity for people to participate - which had never happened before.

The Regional Director, Hyacinth Dubazane, then listed the problems the province was facing including wrong birth dates, confusion over reviews and the non-payment of arrears. The introduction of machines had caused some suspensions and the machines sometimes broke. Pensioners problems are not taken seriously : “People who can no longer plough or plant because of age are asked how they survived before the pension.”

When Cornerstone Funerals were introduced they promised toilets and shelters would be built at pay-points. Nothing had happened. People also allege they are enrolled in the scheme without their approval.

Written submissions were received from the Community Workers Forum for the Aged representing 29 old age homes and community organizations and the Pietermaritzburg and District Council for the Care of the Aged (PADCA).

The following issues were raised at the Hearings:

Abuse by the Department of Welfare: 

Health care:

Abuse in the family: 

Housing: 

Rates and service charges:

Transport:

LADYSMITH PUBLIC HEARINGS 25 AUGUST

The Public Hearing was attended by 1,544 people. They came from Ezakheni, Msinga, Shalastone, Ngogo, Newcastle, Olivershoek, Singatha, Bergville, Tholeni, Madadeni, Driefontein, Moba, Qinisa, St.Charles, Dundee, Glencoe, Uitrecht, Embizeni, Pieters, Dengal, Itholeni,, Somsuku, Limeville, Kwawathi, Lucitania, Embuthu, Vaalkop, Ematiwane, Jononoskop, Steadville, Spunderkron, Nazareth, Charlestown, Sun River-Indaka, Ephumuleni, Ntokozweni, Manzabilayo, Msingatha, Ngobozana, Tafufu, Tshandatshe, Xhorana, Ngqoza, Modikane, Mtambalala, Goqwana, Mantlaneni, Mxhokozweni, Cornfields, Escourt, St Chads Mcitsheni, Wasbank, Mooi River, Sun Chets, Msinga, Brutville, Mzimkhulu Village, Highlands, Mount Frere. Dannhauser, Somsoek, Tugela Ferry, Kokstad

The following issues were raised:

Pensions:

Why are you taking away our grants? 

Home Affairs 

Corruption:

Abuse In The Community


E. EASTERN CAPE

  1. PUBLIC HEARINGS BY JOINT STANDING COMMITTEE

In February 2000 public hearings by the Joint Standing Committee on Public Participation and Petitions were held in many parts of the province around the issue of pension and grant suspensions. Many of the issues raised in the course of these hearings were echoed in the Public Hearings which this Committee held.

In spite of the recommendation that these problems be addressed urgently, very little seemed to have changed when this Committee visited in May. 

The following observations of the Joint Standing Committee are worth repeating here:.

  1. Long delays between application and payment of pensions
  2. Poor administration in the transfer of payments between the Welfare Department, banks and post offices and a lack of helpfulness by all three if a payment went astray, was not claimed or was paid out to the wrong person. The onus was on the rightful beneficiary to take action even though they were not informed where their pay-point was or the mistake was the fault of the bank or the department.
  3. A lack of grievance procedures, a shortage of staff and the frustration experienced in trying to find someone with whom to raise grievances and try to solve problems. 
  4. A poor system to review and track old age and permanently disabled people
  5. Inadequate administrative infrastructure and staff, a lack of computers or even telephones and fax machines in most offices in rural areas and small towns, yet the Department did not take up offers of help from civil society.
  6. Fraud was rife but the Department seldom took action

COMMITTEE VISIT 29 MAY - 2 JUNE

  1. LUSIKISIKI PUBLIC HEARINGS 30 MAY 2000

Public Hearings were held in the Teachers Training College , a new building now standing empty . About 800 people were bussed in from Pondoland , Umtata and many surrounding villages. The following issues were raised:

Elder abuse: 

20 cases of elder abuse were reported including assault , theft of pension and eviction by children , rape and robbery by young people known to the elders . Most cases had been reported to the police and other authorities but little or no action is alleged to have been taken against the culprits.

Pensions: 

In other parts of the Eastern Cape pensions are paid by the post office but here divisions between local headmen have prevented this so Department officials make cheque payments. They often arrive late. The next day pensioners must queue to cash or deposit their cheques at one of the two local banks. There is a fear that if they ask the Department to pay pensions direct into their accounts they may lose them again . Getting a pension or restoring one seems to be a major burden for many people. There is also fear that officials may retaliate against those who complain. Independent checks on officials were requested. It was also alleged that new pensioners have to give a commission to officials. Cheques continue to be issued to deceased and to be claimed when these names are called out by officials. There are often mistakes on cheques and sometimes cheques are stolen by officials.

Disability grants: 

Many younger disabled people attended the hearings (132 cases were reported to the help desk). The cancellation of disability grants is a big issue here. There is considerable confusion over the difference between this grant (temporary and permanent) and old age pensions. As one person pointed out: “Disability Grants are given if you are ill from starvation and taken away when you are well again!” But the main criticism was that recipients were not notified if a grant is rejected, suspended or canceled: “We are human beings!” declared one old man. Many problems are caused when this happens. No records seem to be kept of applications and social workers do not explain the appeals procedure (if indeed they know it!).

Funeral benefits: 

There was much criticism of cheques being withheld if the pensioner had died - this money would help to pay for the funeral. Instances were recounted of relatives applying for but never receiving this money. It was further alleged that burial societies were ripping off pensioners some of whom pay R100 a month for ten years and then receive only R2000 for their funeral. There was a request for a national scheme or some guidelines/controls on burial societies.

Conditions at pay points: 

There are no shelters or protection from the hot, wet and cold weather yet pensioners have to wait from early morning. Officials often arrive late without even offering an explanation.

Home Affairs: 

12 cases of ID/Home Affairs problems were reported: Affidavits are not being accepted as verification of age. Many old people are illiterate and do not know their birth dates. New IDs make the same mistakes as old IDs. Home Affairs offices are far away and they don’t give new applicants an exact date to collect ID - as is done in cities. Temporary IDs should take one week only.

Other problems: 

  1. VISIT TO ST. ELIZABETHS HOSPITAL:

Members of the Committee visited the hospital and spoke with a number of elderly patients. There were several empty beds. The wards were rather dilapidated and not very clean but rehabilitation of the hospital had started in other wards. There were no complaints about treatment at the hospital and several relatives were visiting and helping to care for patients.

  1. STERKSPRUIT PUBLIC HEARINGS 31 MAY

The Public Hearing was attended by about 600 people including the Mayor, the MP and the Regional Director. It was held in a Teachers Training College that has closed. The audience was mostly elderly and more positive about current policies than was the case in Lusikisiki. However, there was criticism of the emphasis being given to children’s rights and the effect this had on grand childrens’ behavior. When parents tell children to go to work one replied she had never seen an old cow sucking from a calf. The main concern over pensions seemed to be that when people die before being paid the cheque is withdrawn- “Ask the government not to neglect us when we are dead.”

The Chief of Herschell also focused on children: blaming the government for children overstepping their rights and showing disrespect. He wanted the government to see that the message reached remote areas - “To the blacks the elderly person is a god.”

Pemmy Majodina, NCOP member, raised the following issues:

  1. Long queues at pay points and no social workers to oversee treatment there. 
  2. Sometimes pensioners wait the whole day at banks without being served (clapping). FNB was the only bank in Sterkspruit and staff had a bad attitude . There were separate queues and tellers for pensioners. The bank deducted commission from withdrawals (although we were informed that the Standard Bank in PE accepts pensioners without charging commission).
  3. There should be an office in each town to advise on burial societies (clapping)
  4. Pensioners were pestered to pay high sums for furniture .
  5. Each town should have a welfare forum to attend to problems such as assaults by grandchildren.
  6. There is no computer in Sterkspruit welfare office so all forms have to be taken to Queenstown. This leads to lengthy delays.

OTHER PROBLEMS RAISED AT HEARINGS: 

  1. MEETING WITH SOCIAL SECURITY STAFF

  1. RESIDENTIAL HOMES

Huis van de Horst, Aliwal North: 

The Manager and Board refused to allow a visit by Committee members or to answer questions without an advance official request being considered by the Committee. This home receives a substantial number of subsidies. We were informed by local social workers that there had been reports of abuse and that the home did not admit any black elders. A full report was sent to the MEC with a copy to the Minister, calling for in investigation. We understand that the investigation is now complete. There are apparently a number of other homes in the area where the same practices apply.

  1. PUBLIC HEARINGS AT MDANTSANE, EAST LONDON JUNE I

Public Hearings were held in Mdantsane, attended by the MEC and local dignitaries and about 300 elderly people.

Private submissions included 2 reports of financial and one of physical abuse by family members and several reports of suspected theft of grants by officials . A representative of the Ministers’ Fraternity, Mdantsane indicated that poverty funds were not getting to this area, officials are not being punished and cheques for the deceased are stolen. He proposed that the government appoint ministers with commendations from the church to act as a watchdog.

The following issues were raised:

Pensions:

  1. Applications take too long to be approved
  2. Sometimes pensions are approved and paid out to the wrong person
  3. Forgery and robbery are common problems
  4. Notices for pay days are put on the notice board but most old people cannot read
  5. Arrears are not paid in full when suspended pensions are restored -break-downs of what is due and what has been paid are not given to pensioners.
  6. A complainant reported that a burial society had refused to pay the expense of burying his wife although she was a member.

Abuse:

Community services:

  1. SOCIAL SECURITY OFFICE, EAST LONDON: 

The main problem, according to officials, was pensioners being “taken off as deceased”. This is difficult to follow up with Home Affairs . If the system reinstates a pension, it will be stopped again the following month. No information on a cancellation is available at pay-points so claimants have to go to the office. The final cheque cannot be paid to the immediate family without a death certificate and a funeral invoice for the computer - then it takes at least a month before the payment is made. No benefits are paid if pensioner dies the day after receiving a payment - only unclaimed benefits are paid. Sadly, this policy has not been explained to pensioners. 

Officials saw the SOCPEN 5 program , in terms of which pensions are administered by the National Department, as very problematic - it was adequate in 1994/5 but is now a nightmare, said an official. They were unable to generate payment for unclaimed benefits and unable to enter cases onto system. It did not inform provinces of suspensions so they couldn’t inform beneficiaries. 

  1. RESIDENTIAL HOMES

  1. COMMUNITY CARE BY GOMPO WELFARE FOR THE AGED

Ms Kongisa of Gompo attended the Public Hearings in East London and this project was visited by committee members.

Gompo was established in 1982 to provide for groups not catered for in white old age homes. It now targets the aged in all population groups. It has a strong volunteer base and motivates aged persons to take charge and be involved in community projects which will improve their health and prolong and enrich their lives . This is done by means of a number of programmes:

Scope and Limitations of Gompo : 

Gompo operates in six districts of East London, including Duncan Village, Mdantsane and settlements between them. It has a total of 1897 active members and 852 housebound members. Each district team is headed by a social worker. Most of the resources to run the programmes have been raised from private funders as there has been little ongoing support from the Department of Welfare. Applications for poverty alleviation funds have been unsuccessful. This severely hampers the further development of the scheme.

  1. UITENHAGE PUBLIC HEARINGS : 2ND JUNE 

Housing

Abuse:

Pensions

Residential Homes


F. MPUMALANGA

  1. COMMITTEE VISITS 13 AND 27-29 JUNE 2000

On 13 June two members of the Committee visited Nelspruit to meet with traditional leaders and prepare for the Public Hearings. They also visited the Kabokweni Pension Pay-point where they found hawkers outnumbering pensioners, the absence of satisfactory toilets and a Departmental official who operated from inside his car. No priority in the queue seemed to be given to the frail elderly.

  1. PUBLIC HEARINGS 

KaMkhutshwa 27 June 2000

The Hearing was attended by 537 people from Buffelspruit, Daarnjie, Lekagi, White River, Kannamajare, Empageni, Phiva, Mzinti, Fig Tree, Komatipoort, Steenbok, Ngodini, Malekutu, Kabokweni, Stembiso, Mbangwane, Kamsogwaba, Goba, Mananga, Msogwana, Schoemansdal, Middelplaas, Jeppes Reef, Done Koppies. Mpakeni, Kamkushwa, Mbuzini, Langloop, Diekoppies Kenyemazana, Masogwara

Badplaas 28 June 2000. The Hearing was attended by 677 people from Balfour, Standerton, Ermelo, Badplaas, Machadasdorp, Embalenhle, Bethal, Emzinoni, Magason, Secunda, Wesselton, Amsterdam, Mayflower, Fernie, Elukwatini, Crisiesmeer, Carolina, Lothair, Breyton, Hlazatshe, Selvey, Emfeni, Piet Retief, Mhluzi

Kwa Phaahla on 29 June 2000. The Hearing was attended by 904 people from Siyabuswa, Moloto, Vals, Tweefontein, Pankop,Merapyane, Vaalbank, Ammeldrif, Middleberg, Witbank, Kenhouthood, Kwagga, Matieslop, Wakraal, Vaalbank, Enveldrift, Mogaeneng, Belfast, Dennilton, Elandsdoorn, B’Hoek, Almondrift, Klopper, Msindo, Tuolino, Leeuwkuil, Weltegrede, Moloto, Toitskraal, Bundu Inn, Tuis en Loop.

Issues raised at the Hearings are summarized under the following headings

COMMUNITY ISSUES

Abuse:

Clubs

Social workers

HEALTH

HOUSING

PENSIONS

PAY-POINTS

HOME AFFAIRS AND IDS

BANKS: 

Many pensioners would like to use banks but experienced the following problems:

  1. They were unable to withdraw all their money
  2. There was no local branch
  3. Bank charges should not be made
  4. They did not get the full pension from the bank - they were told the balance was saved but this was not shown in the bank book

LOCAL SERVICES

Water: 

Rent:

CRIME AND CORRUPTION

WITCHCRAFT

  1. VISITS TO RESIDENTIAL HOMES

  1. Herfsakker Outehuis, Nelspruit.

The home has 80 frail residents and is subsidized. All the residents are white as are management and members of the Board. The Committee was told that black elderly did not want to come into the home as they would forfeit their pension. The unit cost is R1,800 per month. There is an outreach programme which trains care givers in the community. No cases of abuse were reported but there were reports of residents “hurting themselves”. Families were blamed for giving them un-prescribed medication. The complaints box had never been used.

  1. Gugulethu St. Benedicts Home: 

The home was registered in 1984 but did not receive a low interest government loan. It is subsidized by the Catholic Church. It had 56 residents, 33 of them were frail. It receives a unit cost subsidy of R1,400 per resident.

  1. Huis Immergroen in Witbank :

Run by the SAVF, this home was established in 1964. It provides for 78 frail elderly and assisted living for 30 persons in self-catering units. There are also 22 flats housing 45 persons.

The home has an outreach program serving the township of Schoongezicht through a luncheon club. This club was approved for a subsidy, but it was never paid.

The home has a management committee which includes two black members. It appears to be well managed. The unit cost is R1800 per month for frail persons who are admitted irrespective of social or financial status , colour or creed . 58% of residents only get the social pension. There is strong emphasis on sharing and participation in community projects. This home was the first “white” home to admit black residents. 6 of the 58 frail residents are black.

Abuse protocol: The home follows the prescribed protocol. Staff are trained to be alert to signs of abuse - bruises, withdrawal, depression, changed habits etc. The home has a TV monitor system in all rooms, corridors, wards, bathrooms and lounges. The staff believe that this is essential to prevent abuse. There is some abuse between residents , especially married couples and from time to time family members abuse older persons, especially financially.

Facilities and care standards: The frail care ward is in a converted hall but the atmosphere is good , there are unacceptable odors, and communication between residents and staff is open. The assisted living facilities were basic. Residents undertake tasks like serving meals, washing up, cleaning etc. In view of subsidy changes this facility is very important. The housing units were well kept.

Problems experienced by the Home:

  1. St Joseph’s Home for the Aged, Middelburg 

The building was a school hostel for boys before 1977 when it was converted into an Old Age Home. Of the 51 residents, 24 receive a subsidy. 10 flats are being built. The organisation has outreach programs including a luncheon club and a shelter for homeless and abused persons 

Structure and Services:

The home is managed by a board of Management and Bishop Nkhumishe of the Catholic Church as the President. It is well managed with a unit cost of R1850-00 per month. Policy to admit all persons who require care, irrespective of religion or ethnic origins. 

DQ98 is observed and a thorough assessment is done at admission. The problem is that persons who were admitted in a state of severe neglect or abuse recover so well that they no longer qualify for a subsidy. However, if they have return to the community they might again suffer from abuse or neglect since there is little or no community based care.

Abuse Protocol:

The home does not have an abuse protocol but uses the Departmental guidelines. Staff are regularly briefed and train to ensure optimal protection for residents. There is a problem of children exploiting residents financially.

Abuse in the community is also a problem and SAPS are not able to handle cases of abuse. In one case where family members withheld food from an older person, SAPS did not want to intervene and no social worker was willing to investigate.

The manager believes that the following steps are necessary to combat abuse:

Problems experienced:


G. NORTHERN CAPE

VISITS TO THE NORTHERN CAPE

Public Hearings were held in Kimberley on 15 and in Upington on 16 May 2000. Following the hearings a number of visits took place to homes for the aged in Kimberley, the San community in Smithsdrift and Upington and Keimoes with the investigation into abuse at the ND Swartz Homes.

  1. PUBLIC HEARING IN KIMBERLEY 15 MAY

1.1 The Hearing was held in the City Hall and attended by 350 persons, mostly from disadvantaged communities. There was much appreciation for the initiative of the Minister in addressing abuse. In total 32 persons gave evidence in public, and 14 per sons in camera. The following issues were raised:

1.1.1 Decline of moral standards and respect to older persons

A number of people expressed the view that the younger generation shows no respect to their elders and believe they have more rights than the aged. The role and leader ship of the church in this regard was questioned and some church leaders accused of marginalising and abusing older persons. For example the churches hardly speak out against the problems facing older persons such crime, exploitation and pension problems.

1.1.2 Social Pensions

1.1.3 Family violence:

A substantial number of people reported on the high incidence of abuse in families. The following were reported:

1.1.4 Local authority services:

Local authorities do not show any sympathy when rates fall into arrears. There are no rebates for social pensioners. A number of persons informed the Committee that the local authorities are not interested in protecting older persons who have been exploited by unscrupulous landlords. Allegations were made that local councilors are involved schemes to force older persons out of their homes. Some older persons are living in hostels where they are at risk.

1.1.5 65 persons presented the plight of the 300 older persons from Smitsdrift.

Their main problems were.

  1. PUBLIC HEARING AT UPINGTON 16 MAY

Over 600 persons attended the hearing. 73 gave evidence. The older persons, officials and community leaders expressed their satisfaction with the appointment of the committee. The following issues were raised:

2.1 Family Violence dominated the hearings and evidence corroborated that given in Kimberley. Alcohol abuse appears to be a very serious problem in the Upington area, which is known for its wine production. The following are cases in point: Katowa Coetzee (85) is victimized by family in order for them to buy liquor; she is regularly caught up in family fights. Sophia and George , both in there seventies , live with their children. They drink excessively and at times her children have sexual intercourse with Sophia. The water and lights are regularly cut.

2.2 Loan sharks. The problem of alcohol abuse is linked to a very active micro/loan industry in Upington and Keimoes. A number of community leaders wanted this to be addressed but had found Welfare Department staff unable or unwilling to do so. A case in point is that of Jan Africa who owes to a loan shark R300 for as long as he can remember. He keeps on paying R300 per month.

2.3 Water and light accounts. 12 people complained that the local authority was not willing to intervene and stop the suspension of basic services when pensioners fall into arrears.

2.4 Extreme neglect was reported in 7 cases. All were frail persons living at home. A lady of 72 had been left unattended for 3 days and was dehydrated and filthy. . A number of people reported that many elderly do not have a satisfactory nutritional status. 

2.5 Discrimination: There were allegations that white homes discriminate against people of colour 

  1. VISIT TO RESIDENTIAL HOME

ND Swartz Homes for the Aged. 

Four staff members and two members of the public gave evidence in camera at the Hearings. The Committee then visited the home. The following allegations were made:

Staff of the Department of Welfare told the Committee they were unable to resolve the problems at ND Swartz. It was therefore decided to request the MEC for Welfare to intervene. Subsequently the Minister of Welfare and Population Development, Dr Skwiyeya, agreed that the Committee should undertake a full enquiry into the facility. This investigation has been completed and a report submitted to the MEC for Welfare.

  1. General Observations:

During the Hearings in subsequent visits, the following was evident:

4.1 Transformation:

Most of the Welfare services for the aged such as homes and service centres are concentrated in bigger cities and towns. The majority of these centres serve predominantly white people. It appears that transformation moves slowly. Very few white people attended the Hearings and no white organisation gave evidence. From information gathered after the hearings, NGO’s in this province appear to openly resist change.

4.2 Finance

Most homes for the aged are finding it difficult to cope financially, due to subsidy cuts. The Vuyo Old Age Home in Prieska was recently closed for this reason. Its residents were black and were returned to their families - a very unsatisfactory situation.

4.3 Legislative changes

As far as compliance with legislation is concerned, very few persons involved in services for the aged were aware of the Aged Persons Amendment Act of 1998 and the regulations which came into effect on 1st August 2000.

4.4 Clubs 

Very few of the clubs for the aged that has been in existence for as long as 8 years receive any Government funding. The functioning of these clubs needs to be evaluated.

4.5 Health Services: 

During discussions with local leaders and departmental officials it was clear that due to long distances and lack of infrastructure and resources, health care is not accessible to many elderly people.

4.6 Conclusion:

The Northern Cape’s elderly are plagued by extreme poverty, lack of adequate food, exploitation by moneylenders and family members and inadequate welfare and health services. There is a high incidence of alcohol abuse. The Department of Welfare functions mostly on its own as the voluntary welfare sector is declining due to shortage of resources and resistance to change. A transformation action plan is urgently required. There is no office of the S A Council for the Aged in the province, further hampering development and coordination. Of particular concern is the appalling situation at the ND Swartz Homes in Upington and Keimoes.


H. NORTHERN PROVINCE

REPORT ON PUBLIC HEARINGS 25-28 JULY 2000

  1. Thohoyandou: 25.07.00: -86 out of 650 persons testified
  2. Tzaneen: 26.07.00 :-28 out of 300 persons testified
  3. Pietersburg: 27.07.00 :-52 out of 700 persons testified
  4. Lebowakgomo: 28.07.00: - 101 out of 1250 persons testified

Total number of people who attended: - 2900
Total number of persons testifying: - 267
Number of persons in private hearings:- 94

Issues raised at Public Hearings in Northern Province:

(For break-down see Table at end of this report)

  1. Social Security:

Over fifty percent (52,7%) of complaints concerned this. They included the following:

  1. Health and Services (19,8% of complaints)

Health services from primary to tertiary level are problematic on the following grounds: 

  1. Social Welfare Services (16,10% of complaints)

Only in the Tzaneen area did there seem to be reasonable satisfaction with welfare services. In the other three areas over 17% of those testifying had problems with these services.

  1. Family and Community Care

  1. Conclusion


I. NORTH WEST PROVINCE

VISIT TO NORTH WEST PROVINCE 11-14 JULY 2000

Four Public Hearings were held in the province: Vryburg, Mafekeng, Klerksdorp and Rustenburg. People traveled to the Hearings from all corners of the province - not necessarily to the Hearing closest to where they lived. In general, the Committee experienced more problems in this province: management of the hearings was weak, the help desks did not function well and no printed referral forms were available.

Of special concern was the apparent lack of capacity in this Province to properly administer the pension system. This tended to confirm the concern expressed by that the Standing Committee for Social Welfare in the province which, according to newspaper reports, called for an urgent meeting with the MEC in May to discuss the renewal of a contract to a consortium involving people close to provincial government officials, and to address the problems pensioners were experiencing. 

In this province CPS entered into a joint venture with a company belonging to a former chief director of strategic planning and development, Bushy Maape. (City Press 21 May 2000)

  1. Evaluation of Public Hearings: 

A break-down of 103 cases recorded at Vryburg (41), Klerksdorp (30) and Mafikeng (32) revealed the following:

  1. Problems in respect of Social Security dominated the evidence with 70 cases (68%). Pay point problems were the most numerous (50%).
  2. Abuse, mostly by family members, was high (13,8%). In certain cases older persons alleged that their children treated them like animals. Young people showed little respect to older parents or grandparents.
  3. Transport (9,7%) and health care (7,7%) are areas of concern.
  4. Both in complaints about Social Security and abuse by family members there were problems with SAPS. It appears as if older persons are not a priority for the police.

(For details see Table at the end of this report)

  1. PUBLIC HEARING AT VRYBURG ON 11 JULY 

Pension pay-outs

Community Care

Residential homes:

Resoord Old Age Home was visited. 18 deaths were reported last year. Is this being investigated? Whereas the National Department’s Directory of Homes states this home has a capacity of 94, only 30 frail people were in the home at the time of the visit. Who owns the home? All residents are white. The black staff complained about poor wages. Apparently there is no outreach programme and there are no black members on the management committee

Transport

Lack of transport was a problem in Taung, social workers could not visit and they were told that the government did not have money for transport. Transport was also a problem in Bloemhof. A pensioner from Egron called for government subsidies for buses.

Health

  1. PUBLIC HEARING AT KLERKSDORP 12 JULY 

The following issues were raised:

Pensions

Disability Grants

There were many reports of cancellation of disability grants without reason - unfortunately few details of claimants’ disabilities were recorded . Many complained that they had not been informed their grant had been cancelled and were sent from pillar to post. A fifty-seven year old claimant from Ventersdorp explained that he suffered from polio and he walks with steel crutches. His grant was cancelled. A fifty-six year old man from Ventersburg had a limb amputated in 1995. He had been told his grant would be paid in August 2000.

Home Affairs

ID problems included wrong birth dates . An old lady from Ottosdal had her grant suspended because of a mistake in her ID number. She had to go to Lichtenburg where they were rude to her. Many people reported wrong birth dates on their IDs. An 62 year old lady applied for a pension two years ago but someone in Mpumalanga has the same name and ID number as her so she has not received her pension.

Residential Care

There was a written submission from Frail Care Centres for the Elderly in Potchefstroom concerning the irregular payment of subsidies and the mis-assessment of pensioners since the pension exceeded the R500 subsidy limit. 

Community Care

Local Council Services:

  1. PUBLIC HEARING AT MAFEKING 13 JULY 2000 

Pensions

Community Care

  1. PUBLIC HEARINGS IN RUSTENBURG 14 JULY 

Pensions/CPS

Residential Homes

  1. MEETING WITH THE HOUSE OF TRADITIONAL LEADERS , ZEERUST 1 NOVEMBER 

The attention of the Committee was drawn to the following:

  1. Traditional leaders favour the tackling of abuse and neglect in the home and community rather than through “foreign interventions” like homes for the aged.
  2. The pension payment system is a matter of serious concern to traditional leaders. The introduction of a new pay system using banks, post offices and smart cards was recommended.
  3. Means should be explored of stretching the social pension to ensure pensioners get value and the products they require.
  4. Traditional leaders need to investigate whether they are doing enough to protect older per sons both in the family and in the pension system. The meeting agreed to regularly place the item on their agenda. 

J. WESTERN CAPE

COMMITTEE VISIT 19-21 SEPTEMBER 2000

  1. INTRODUCTION: 

The Western Cape adopted its own constitution in 1998. In terms of the directive principles set out in Chapter 10 the Provincial Government must adopt and implement policies to actively promote and maintain the welfare of the people of the Western Cape, including policies aimed at achieving, among other objectives, an “environment in which all frail and elderly persons (i) have access to family care or appropriate alternative care when removed from the family environment (ii) are given basic nutrition, shelter, basic health care services, and social services; and (iii) are protected from maltreatment, neglect, abuse, degradation or involuntary seclusion.” This is unique.

However, the new national welfare financing policy requires a shift in funding from per-capita and post subsidies to programme-based subsidies and from institutional care to preventive services. Although older persons are identified as a “special focus group”, welfare services are expected to be integrated . Accordingly, the Western Cape Social Services Department has been re-structured. There is no longer a specialist section for the elderly who, with other groups, now fall under the Customer Services Division. All complaints are handled by this Division.

It is our impression that this has left a gap in the service to elderly people and to a loss of expertise and experience in this field. Fortunately, other provinces have not followed the same course thus far. The Committee was only able to visit a few homes during the period of the Public Hearing. It was the intention of one Committee member to visit other homes (where there had been complaints) with a representative of the Social Services Department but this could not be arranged.

The final section of this Report on the Western Cape deals with complaints received by the Committee. A common feature of complaints was difficulty in getting them investigated by the Department of Social Services and the Police. One qualified nurse in the Department of Health is tasked with oversight of the health of residents in 160 residential homes including 120 for elderly persons. She has no resources or forensic training. Nobody in the Social Services Department seems to be directly responsible.

  1. PUBLIC HEARING IN PAROW 19 SEPTEMBER 2000: 

The Hearing was attended by about 600 elderly people from Dunoon, Scottsville, Bonteheuvel, Ravensmead, Kraaifontein, Bishop Lavis, Eerste River, Elsies River, Atlantis, Bellville, Black Heath, Strand, Hazendal, Wallacedene, Wellington, Kuils River, Paarl, Happy Valley, Hazendal, Mfuleni.

Organisations represented: 

KSE Diensentrum, Scottsville
Multi-purpose Center, Bonteheuvel
Crown Cork Diensentrum
Tygerberg Service Centre
Shawco Advice Centre
Child and Family Welfare
Willoweg luncheon club
Sir Lowrys Pass Service Centre,
SA Council for the Aged
Leonsdale Senior Club
SANCO, Elsies River
Bonteheuvel Domestic Violence
Social Services Eerste River
Social Services, Bellville
ACVV, Cape Town
Nazareth House, Elsies River
Strand Care Service Centre
Russel Rest Eerste River
Christelike Vroue Alisie
CHSO Woodstock
Neighbourhood Old Age Homes, Woodstock (NOAH)
Vereenige Gereformeerde Kerk, Eerste River
Mfuleni Child Welfare
Gemoedsrus, Wellington
Focus on Elder Abuse
Kuils River Centre for the Aged
Paarl Welsyn Orginisasie
Rushof Oue te Huis, Paarl
Kraaifontein Diensentrum
Gammaka Womens Group

The hearing was opened by Mr Peter Marais, Western Cape Minister of Health and Social Services, who attended all three Public Hearings. He expressed his belief that a new world should be created for the elderly: “Hulle moet lewe, hulle moet nie net bestaan nie.” He gave an assurance that action would be taken to address the problems facing the elderly and announced a plan to train home care workers so elderly people did not have to go to clinics and hospitals. 

Abuse in the Community: 

Abuse in Residential Homes: 

  1. Written guidelines for home managers
  2. Labour laws should be amended to enable employers to take on casual staff and dismiss them during a six month probation period.
  3. The SAP Clearance certificate system should be modified to enable employers to apply for clearance without an employee’s permission. 
  4. Legislation should be amended to require staff to be registered with a national council.
  5. The reporting of theft and fraud by staff should be mandatory
  6. A special SAP unit should be set up for abuse of vulnerable adults.

Community Care: 

Pensions: 

There were a number of complaints about pension administration and All-Pay which has been contracted to pay pensions: 

  1. PUBLIC HEARING GUGULETHU 20 SEPTEMBER 

The Hearings were attended by 400 people from Gugulethu, Vietnam, Khayelitsha, Bonnytown, Silvertown, Kaalfontein, Macassar and other areas.. 

The following senior clubs were represented: Nombasa, Masimanyane, Monwabisi,Noncedo, Rainbow Lane, CPWOA Erica Place.

This hearing was also opened by the Minister, Mr. Peter Marais, who reported that his Department was building multi-purpose centers in Langa and Bonteheuvel and that centres were needed in Gugulethu and Khayelitsha.

The following issues were raised in public submissions:

  1. PENSIONS:

  1. ABUSE IN COMMUNITY: 

  1. Homeless, forgetful, needs care, children’s addresses unknown; 
  2. I am a cripple with a wooden leg, the other is also bad. I sleep outside winter and summer.
  3. Applicant’s friend gives her food and baths her as her daughter ill-treats her. She lives in a shack
  4. There is no-one to care for her. The door is kept locked so she cannot wander. Her home has a urine odor.
  5. She has two sons who are not prepared to assume any responsibility for her
  6. There is only one room and conditions are deplorable
  7. She is totally incontinent and is lying on a filthy mattress
  8. His young wife is disrespectful towards the applicant and has no compassion for his state of frailty
  9. People in her neighbourhood had taken her money and even her furniture
  1. COMMUNITY SERVICES

  1. PUBLIC HEARINGS GEORGE 21 SEPTEMBER 2000

The Hearing was attended by about 200 people from Plettenberg Bay, Stilbaai, Ilingelihle. Mossel Bay, Knysna, Dysseldorp, George, Kranshoek, Lawaaikamp, Parkdene, Themba Lethu, Beaufort West, Oudtshoorn.

Representatives came from New Horizon Pensioners Forum, Jagersbosch Diensentrum, Huis JJ Watson, ACVV, SANTA, Rosemoore Old Age Home and Service Centre, Benevolent Park Mossel Bay, Ons Huis, Mossel Bay, Rotary Home George, Rosemoore, Knysna Versorgingdienst, Swartberg Diensentrum, Knysna Versorgingsdiens Loeriehof, Ilingelihle Centrum, Masiqumane Pletterberg Bay, Dysseldorp Oord, Lawaaikamp service Centre, Eldorado Diensentrum, Black Sash Knysna, All Pay George,

The Hearing was opened by the Minister of Social Services, Mr Peter Marais. He called for a team of trained workers to regularly visit old people to collect their pills from the Day Hospital and get their pensions. These proposals were greeted with loud clapping from the audience. “We must make life for the old so comfortable that people start to look forward to getting old.” 

The following issues were raised in submissions:

PENSIONS: 

COMMUNITY CARE: 

HEALTH

  1. VISITS BY THE COMMITTEE TO RESIDENTIAL FACILITIES 

  1. EKUPHUMLENI OLD AGE HOME, GUGULETHU, CAPE TOWN: 

This home was visited by a member of the Committee in 15 May 2000 following press reports on the death of a resident after falling onto a fire. Both the Social Services and the Health Department had visited the home but the Manager complained that they only came when there was a problem. She was appointed shortly before the accident - there had been a long-standing dispute between the previous Manager and the Committee of the Home. Lack of qualified staff was a problem, especially at night.

Members of the Ministerial Committee again visited this home on 20 September. The home was full (166 residents) but there is a shortfall in subsidies The previous manager did not keep proper records of residents and Social Services had not been notified of new admissions. It took 4-6 months to get pensions transferred to the Home. The Manager welcomed the visit even though it was unannounced. There was still a shortage of staff, especially trained staff.

There continue to be problems with the Management Committee, two of whom are signatories of the bank account. They lack the necessary skills.. Thus in August there was an overdraft. The selection/election process needs to be strengthened. The Home is trying to involve the community and to raise funds.

  1. ROSEMOORE DIENSENTRUM, GEORGE

A complaint was received by the Committee in April about the neglect of residents in the housing scheme adjoining this center. There was some confusion as there is an old peoples home with the same name opposite the Centre. The M.P. for the area, Ms Baleka Mbete, visited the center at the Committee’s request. Later, when the Committee held Public Hearings in George, members visited all three facilities.

The Centre is run by a management committee and receives a monthly subsidy of R19,000 from the Provincial Social Services Department. It runs a clinic, provides meals and runs a shopping service. There are 130 houses attached to the center occupied by pensioners who pay a membership fee of R1 a week plus R2 for food. The cost per person of rent, food and water is R100. 

We were told that when the management had tried to increase the fees “Dit was oorlog!”. Many tenants came to the center following their eviction from farms. Many have drink problems. Self neglect is also a problem. They don’t get involved in programmes and when they become frail they don’t want to go to the old age home.

ROSEMOORE OLD PEOPLES HOME

98 residents, 48 staff, 2 of whom are trained sisters, 3 staff nurses, 3 assistant nurses. Monthly subsidies are R72,000. A Social Services staff member sits on all management committees, also on the Southern Cape Council for the Aged.

The old wing consisted of small double rooms, the new wing of six bed wards

We walked past two lines of residents seated along the sides of the L-shaped balcony: the CVAs and the senile, we were told. The former were responsive but were facing the wall. There was a small TV in the corner of the balcony. The matron seemed rather dejected. People didn’t want any activities. “Our community don’t volunteer”, relatives didn’t visit. Most residents are not in burial societies, their policies lapsed when they entered the home.

COMPLAINTS RECEIVED BY THE COMMITTEE OR REPORTED TO IT

A. Concerning residential facilities in the Western Cape

  1. ACVV Huis, Bergsig, Riebeeck West: A report of physical and emotional abuse.
  2. Altehar, Strand: A report of the neglect and confinement of a wheel-chair bound resident 
  3. Andante Retirement Village, Kuils River: A report of the extensive use of catheters and over-medication to sedate residents.
  4. Avonrust, Rondebosch: A report of the misuse of drugs , lack of regular medical examinations and deteriorating conditions.
  5. Beaconvale: A report was received that the home was dirty and elderly people neglected but inspections found nothing amiss. Apparently there are management problems.
  6. Carlisle Lodge, Fish Hoek: A complaint about neglect, force-feeding and rough handling by staff resulting in severe bruising. The resident concerned was transferred to another home and died shortly afterwards. The family laid charges at the police station but subsequently received a letter that the investigation had been halted due to lack of evidence.
  7. Chris Heunis Old Age Home, Somerset West. A report of the rapid deterioration in the health of an aged man following admission, and extensive bruising
  8. Ekuphumleni: A report that residents were ill-treated, not given enough food and did not have money for toiletries.
  9. Huis Andre van der Walt: A report that staff are rude and uncaring and that some residents are tied to their chairs, not taken to the toilet and not kept warm.
  10. Huis Disa, Tulbach: A report that the home was locked at night and residents could not get out if there was a fire.
  11. Huis Esperanza, Strand. A complaint about the slapping of residents by staff. 
  12. Huis Hesperos, Beaufort West: A report of abuse.
  13. Huis Marie Louw, Somerset West: A report of non-administration of medication and bruising of an elderly lady.
  14. Huis Protea, Goodwood: A report of emotional abuse and intimidation by management.
  15. Huis Sonnekus, Milnerton: A report that a ninety year old woman repeatedly fell out of bed, in spite of rails, resulting cuts and bruising. Also a report that the home is dirty.
  16. Huis Uitsig, Parow North: Reports of favoritism and complaints about the management committee.
  17. Huis Zonnekus, Milnerton: A report that medication was not given to a resident, of her falling unnecessarily , of the falls not being reported and of the resident being left for a long time on the toilet.
  18. Jireh Johanna Old Age Home: A complaint that the home is dirty and staff behavior towards residents poor.
  19. Kensington Old Age Home: Complaints that medication is not being given and that the home is dirty. Staff complains about family’s visiting hours.
  20. Kraaifontein Te Huis: A complaint that a diabetic resident who was partially blind was not adequately cared for. A full investigation into this complaint was conducted by the Social Services Department which, while it was unable to find evidence of neglect, made detailed recommendations for improvements and will review the situation in March 2001.
  21. Ladies Christian Home, Cape Town: A report of inattention to the cleanliness and comfort of a bed-ridden resident and problems with the administration of medication.
  22. Monte Rosa, Gardens: A complaint about abusive staff behavior.
  23. Nerina Place, Bishop Lavis Township: A report that family members could not visit a resident in her room, that visiting hours were restricted and that a gift parcel was stolen.
  24. Nerina Gardens, Fish Hoek: A report of family being prevented from visiting a resident with Alzheimers Disease because they had complained about her cleanliness.
  25. Noordhoek Manor: A complaint that the frail-care section was dirty and not properly staffed.
  26. Serepta Old Age Home: A report of lack of staff over-sight at night leading to the rape of an elderly resident (by another resident) who subsequently died. Also complaints about lack of activities for residents and misappropriation of finance.
  27. Zerilda Steyn, Pinelands: A report that an elderly lady, moved here from Sea Point Place (both facilities are owned by Cape Peninsula Organisation of the Aged) was unable to call for help because the bells were not working. Family also found the staff unhelpful. Also a report of theft of residents possessions.
  28. Zonnebloem (ACVV) Cape Town : A case of physical abuse.

B. Concerning abuse in the community

  1. A report of an elderly woman who was robbed by a boarder and left alone for three days.
  2. A report of an elderly man locked out by the landlord without notice who died of pneumonia. His nephew tried to take action against the landlord but the police sent him from pillar to post and didn’t seem to know how to handle the case.
  3. A report by her neighbour that an elderly lady was being neglected by her grand-daughter. Investigations by the police and social workers concluded that the neighbour was interfering.
1. EASTERN CAPE PROVINCE 
POSTAL ADDRESS: 
The Head of the Department 
Department of Welfare
Private Bag X0038 
BISHO 
5605
TELEPHONE NUMBER: 
(040) 609 3962
(040) 609 3939
FAX NUMBER:
(040) 639 1644
2. MPUMALANGA PROVINCE 
POSTAL ADDRESS: 
The Head of the Department 
Department of Social Services and Population Development 
Private Bag X11213 
NELSPRUIT
1200
TELEPHONE NUMBER:
(013) 752 4106/7/8
(013) 755 1591
FAX NUMBER:
(013) 755 3828
3. KWAZULU-NATAL PROVINCE  
POSTAL ADDRESS: 
The Head of the Department
Department of Welfare and Population Development 
Private Bag X27
ULUNDI
3838
TELEPHONE NUMBER:
(035) 874 3703/4
FAX NUMBER:
(035) 874 3710
4. GAUTENG PROVINCE 
POSTAL ADDRESS: 
The Head of the Department
Department of Welfare & 
Population Development 
Private Bag X35
JOHANNESBURG
2000
TELEPHONE NUMBER:
(011) 355 7878
FAX NUMBER:
(011) 836 6533
5. WESTERN CAPE PROVINCE 
POSTAL ADDRESS: 
The Head of the Department
Department of Social Services 
Private Bag X9112 
CAPE TOWN
8000
TELEPHONE NUMBER:
(021) 483 4730
FAX NUMBER:
(021) 483 4783
6. NORTHERN CAPE PROVINCE 
POSTAL ADDRESS: 
The Head of the Department
Department of Social Services and Population Development 
Private Bag X5049
KIMBERLEY
8300
TELEPHONE NUMBER:
(053) 830 0640
FAX NUMBER:
(053) 831 4917
7. NORTHERN PROVINCE 
POSTAL ADDRESS: 
The Head of the Department
Department of Health and Welfare 
Private Bag X9302 
PIETERSBURG
0700
TELEPHONE NUMBER:
(015) 290 9262
FAX NUMBER:
(015) 291 4135
8. NORTH WEST PROVINCE 
POSTAL ADDRESS: 
The Head of the Department 
Department of Social Services, Arts, Culture and Sport 
Private Bag X6 
MMABATHO
2735
TELEPHONE NUMBER:
(018) 387 3753
(018) 387 3752
FAX NUMBER:
(018) 387 5273
9. FREE STATE PROVINCE 
POSTAL ADDRESS: 
The Head of the Department
Department of Social Welfare 
P O Box 517 
BLOEMFONTEIN
9300
TELEPHONE NUMBER:
(051) 405 4444
FAX NUMBER:
(051) 403 3578

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