Caring for the elderly during lockdown was ‘wasteful expenditure’, says Eastern Cape social development department

The Eastern Cape Department of Social Development has refused to pay for the services of 25 non-profit organisations that continued to provide food, medicine and care to almost 1,500 elderly people in the province during lockdown, saying that the caregivers had broken lockdown rules by helping.

In a scathing affidavit, filed to oppose an urgent application to force the department to pay R1.5-million for services rendered by the organisations between April and August, the head of the department, Ntombi Baart, said paying for the services rendered to the elderly would amount to “irregular and wasteful expenditure”.

Imbumba Association for the Aged, a group of 25 caregiver organisations operating service centres in the former Transkei and Ciskei homelands, will apply for an urgent court order at the Makhanda High Court on Tuesday 22 September to force the department to honour its service level agreements that it would look after 1,452 elderly people.

Advocate Ori Ben-zeev said in papers before court that the application was one of great urgency as the organisations had depleted their reserve funds to look after the elderly during a lockdown. He added that without the daily interventions of caregivers, “the older beneficiaries they serve would die” as they were entirely dependent on caregiving that included two meals a day, medicine and nursing.

He said most of the beneficiaries had no family in the Eastern Cape as their relatives work in the Western Cape and Gauteng.

Melumzi Hubert Sauka from Imbumba said they are a group of organisations that run service centres for the elderly.

They have valid service-level agreements with the Eastern Cape Department of Social Development to do so and run their facilities from 8am to 4pm. During this time they offer programmes for the elderly, including tending vegetable gardens, sewing, beading, handwork and physical exercise, with special care provided to those suffering from Alzheimer’s disease. He said about 75% of those attending their care centres were women.

Sauka explained that after President Cyril Ramaphosa declared a National State of Disaster in March, one of the first regulations imposed was that the elderly should remain at home.

He said the caregivers at Imbumba had decided to continue their assistance to the elderly at their own homes by providing two meals a day, helping with cleaning the home and doing laundry, fetching medication from clinics, buying groceries, basic essentials and linen and nappies where necessary and bathing and washing those unable to do this themselves. 

“The lockdown did not do away with older persons’ need of care,” he said. “It also did not suddenly have other adults materialise to undertake this work.”

He said that in June they received a letter from the department saying they would not be paid for their home-based care services as “people couldn’t travel and service centres had to close”.

Sauka said this decision was irrational and unlawful as their duties continued “notwithstanding the pandemic and government’s response to the pandemic”.

He added that they firmly believed that if they did not continue with their assistance to the elderly, those in their care would have died as most were over 60, many were unable to care for themselves, were impoverished and could not manage their own finances.

“[The department] knew that our services were critical and that our beneficiaries’ survival depended on it,” Sauka said.

He said the elderly had the greatest risk of developing severe Covid-19.

“[Cancelling the service level agreements] immediately deprives older beneficiaries of their access to healthcare services, sufficient food, social security and social assistance. It places their dignity and their lives at serious risk.” 

He said while the department had undertaken to continue paying a stipend to caregivers, “they haven’t done this either” and 120 caregivers were now not receiving any payment, leaving them to “struggle for food themselves”.

Baart, however, said that when the caretakers started looking after the elderly at home, “it completely [went] against the grain of our business funding model”.

She said if she paid any of them it would be considered as “unlawful and wasteful expenditure”, adding that the decision had been taken with “no malice or unlawful intent”.

She argued in papers before court that it was impossible for caregivers to render a “lawful” service during hard lockdown. She said that the elderly who attended service centres “are independent and capable of taking care of themselves. They are not frail or ill”.

She said services provided by caregivers such as cleaning, going to the clinic and shopping were in any event not allowed.

“The elderly were not left without food,” she said, explaining that ward councillors were told to make sure the elderly received food parcels, that there were many other organisations distributing food, and the old-age pension had been increased by R250.

She said the province had no model for home-based care.

Nomalinge Mlindi, the chairperson of Imbumba, said no food parcels were provided to the households by the department during lockdown.

“The department refuses to recognise the humanitarian outreach work of Imbumba’s members under the extraordinary conditions imposed during the lockdown. The department’s position is that the decision by Imbumba members to render home-based care was implemented without consulting them, is unlawful and wasteful expenditure of public funds and a breach of the terms of their service level agreements.

“This is a matter of significant public interest. By early July the Eastern Cape Department of Social Development had not paid a single subsidy to any NGO in the province providing social care services. This was reported by various media outlets, as well as a document detailing the effect of the lockdown on NGOs. 

“While some payments were made by the end of July, the MEC for social development was still explaining away unpaid subsidies to the provincial legislature on 13 September. The department’s failure to honour their legal obligations causes hardship and suffering not only to NGO staff, but the beneficiaries of NGO services whose rights are being disregarded.

“The Imbumba matter has the potential to bring this to an end. Its decision also has implications for subsidy cuts affected by other provincial departments of social development.” 

The Imbumba Association is represented on a pro bono basis by Webber Wentzel. DM/MC