The SA Human Rights Commission’s “State of Human Rights in Gauteng” report describes the Organisation for Economic Development and Co-operation’s “broken social elevator” analysis, which outlines how wealthy families in unequal societies retain their privilege and disadvantaged families have little chance of improving their financial positions.

“Lack of upward mobility implies that many talents are missed out, the tax base and social welfare systems become overburdened, and which in turn undermines potential economic growth. It also reduces life satisfaction, well-being, and social cohesion,” said the SAHRC in its report released on Friday, 20 March 2020.

“These are the realities that define a majority of South Africans and Gauteng residents who reside on the periphery of main economic opportunities due to poor spatial planning, and a collapsing water and sanitation infrastructure denying them their rights as enshrined in the Bill of Rights.”

The 2018/19 SAHRC report analysed the provision of healthcare and housing in Gauteng, the country’s most populous province, and found that marginalised residents were left behind due to systemic and structural inequality.

“The human rights violations that were found by the Commission demonstrate that the state is still falling far short of meeting its human rights obligations to protect, promote and fulfil the enjoyment of the right to healthcare for the majority of Gauteng citizens,” reads the report, while admitting that Gauteng is “relatively better” than some other provinces.

It described how the wealthy in the province have access to private healthcare while the majority continue to use the public system: 

“In Gauteng, the deeply entrenched unequal health care systems are no exception, despite the province being the most developed with the highest GDP per capita in the country.”

Citing figures from Stats SA’s General Household Survey, it said only 55.8% of Gauteng’s public healthcare users said they were very satisfied compared to 92% of private healthcare users. Taking data from the Office of Health Standards and Compliance (OHSC), it said of 52 clinics inspected in the province the majority failed to meet the required standard of care. The SAHRC said only 24% of clinics meet Ideal Clinic Realisation and Maintenance (ICRM) standards.

The report also cited the Gauteng City-Region Observatory’s 2018 Quality of Life Survey, which measured residents’ views on the provision of a broad range of services. In Johannesburg, it found the responses continue to reflect the city’s duality, “where the highest levels of deprivation are in the south (notwithstanding some affluent areas) compared to high levels of affluence in the north,” said the SAHRC.

The SAHRC launched an inquiry into conditions in Alexandra and the Alexandra Renewal Project after a series of protests in the area in 2019. The report used the area as an example of the province’s persisting problems:

“The backlog in the low-cost housing provision, poor coordination between local, provincial and national governments and the rising tensions in communities that are left behind when projects of this magnitude are promised and not delivered,” it said.

“This further perpetuates a culture of violent service delivery protests as communities in the province feel neglected and their rights trampled upon by political office bearers.” DM