SPOTLIGHT

Delays in disability grants take a heavy toll

By Elri Voigt for Spotlight 27 August 2020

Elderly people queue for their Sassa payouts at Makhaza Mall in Khayelitsha, Cape Town (Photo: Gallo Images / Roger Sedres)

During the strictest phases of South Africa’s Covid-19 lockdown, the South African Social Security Agency effectively stopped accepting new disability grant applications. Spotlight explores what happened and speaks to two applicants about the impact the disruptions have had on their lives.

People who needed to apply or reapply for disability grants were in for a nasty surprise when the South African Social Security Agency (Sassa) decided to stop accepting applications at the beginning of the Level 5 lockdown. 

Sassa at first attributed this decision to the lockdown itself – and later to the lack of access to healthcare facilities, which is necessary since, as Sassa explained in a press release in July, a medical assessment forms part of the application process.

Sassa says they have since resumed the disability grant application process using a “phased-in approach”, where Sassa offices set aside two days a week for disability-related matters. It also said grants that “were supposed to lapse from March 2020 have been extended to the end of October to cushion affected beneficiaries”.

But various civil society organisations and some members of the public are questioning whether Sassa has done enough in recent months to ensure that people eligible for disability grants can, in fact, receive the grants.

Minister of Social Development, Lindiwe Zulu, in an answer to a recent parliamentary question, said that by 29 June, Sassa had 19,053 bookings for medical assessments for disability grants. 

Zulu said local Sassa offices “strive to ensure all bookings are assessed within a month”, but lockdown restrictions impacted this. With just under 5,000, Western Cape has the highest number of assessments on the waiting list, followed by North West.

Impact on DR-TB patients

The Doctors without Borders (MSF) team in Khayelitsha first learned about the situation from their Drug-Resistant Tuberculosis (DR-TB) patients in May.

Dr Jen Furin, a TB doctor working for MSF Khayelitsha, explains that their DR-TB patients qualify for a temporary disability grant as they cannot work because DR-TB is a “critical and highly debilitating disease which is also airborne”.

For Furin, one implication of effectively suspending disability grant applications is that it can reverse many of the gains the country has made in DR-TB treatment. 

“The short and long term health implications of this decision are potentially disastrous,” she says.

“We felt that the measure to suspend disability grants altogether could not be justified, as it resulted in some of society’s most vulnerable populations being further exposed to hunger, deprivation and ultimately (in the case of DR-TB patients) treatment failure and death,” says Vinayak Bhardwaj, MSF’s deputy head of mission in South Africa.

CSOs and government

Given their concerns, MSF approached government about the matter. Then, in a letter to MSF dated 10 May and signed by Dianne Dunkerley (and seen by Spotlight), the executive manager of grants administration at Sassa explained that: “Sassa has had to suspend the taking of disability grant applications during lockdown.”

“Initially, it was because our offices were closed, as the administration of social grants is not seen as an essential service. However, under Level 4 lockdown restrictions, we are unable to send potential applicants for medical assessments, as access to health facilities is extremely limited,” she wrote.  

On 14 May, MSF, together with Black Sash and other organisations, sent Sassa a proposal on how to deal with the problem of limited access to healthcare facilities. According to Bhardwaj, the initial response to their proposals was positive. 

“We were told that these measures would be deliberated upon by Sassa’s executive committee. However, subsequent attempts to get a reply to our emails were unsuccessful for well over a month,” he says.

With little apparent progress, SECTION27 was roped in and in July wrote to the Minister of Health, the Minister of Social Development and the Chief Executive Officer of Sassa. A flurry of letters followed.

But by the time SECTION27 initially wrote to Sassa, plans for restarting services were already well underway. On 8 July, Sassa announced that it would again allow new disability grant applications, using a phased-in approach where certain types of applicants would be prioritised.

Sassa also informed MSF that 475 medical officers were contracted to address the backlog in disability assessment applications, and that they were looking into alternative channels to do medical assessments.

Bhardwaj admits that Sassa has done much of what was requested. However, he says that none of MSF’s DR-TB patients have received their disability grant yet, and that more could have been done to assist them and other applicants.

“Sassa could have gone further and taken into consideration the suggestion that, for example, a diagnosis for DR-TB automatically qualifies a patient for a disability grant without further assessment,” he says. 

Ektaa Deochand, an attorney at SECTION27, says that while the extension of temporary disability grant applications is welcomed, it isn’t sufficient by itself. 

“They have also not provided us with definitive time frames for implementation of their plan, and they have not given us details for alternatives for the processing of the grants,” she says.

Sassa responds

Kgomoco Diseko, national spokesperson for Sassa, told Spotlight the backlog of disability grant applicants and the timeline to deal with them is unique to each Sassa office.

He says that Sassa considered the impact the decision to suspend disability grant applications would have on these applicants. “Yes, the impact was looked at and that is why they (applicants) had to be protected through the decision Sassa made during levels 4 and 5 of the lockdown.” 

He says Sassa has made efforts throughout the lockdown period to help applicants whose grants expired in that period, by automatically extending or reinstating temporary disability grants.

The most recent development was at the beginning of August and concerned temporary disability grant recipients whose grants had expired in July. Diseko explains that these recipients’ grants will be systematically reinstated; they will receive a double payment in September, and will continue to receive this grant until the end of December 2020.

Despite Sassa offices reopening after undergoing safety assessments, Diseko says that services at some offices continue to be disrupted by Covid-19.

“The major challenge being that certain offices close from time to time for disinfection purposes due to staff members getting infected with the Covid-19 virus,” he says.

The situation is further complicated by the role of organised labour. In response to a letter sent by SECTION27, Sassa’s CEO Busisiwe Memela cautions that there may be “interruptions in our ability to provide disability-related services”. She adds that the unions claim Sassa staff are being exposed to additional risk.

When asked for more information about this, Diseko explains that it is Sassa’s duty to provide a safe working environment for its staff, and that unions “raised this undisputed fact as a concern”.

He says that so far, however, the only disruptions to Sassa’s offices came from decontamination processes, and not from actions by unions.

The struggle to access grants

Meanwhile, some grant applicants have been struggling to get their applications through the system.

“I should have been receiving money since 1 May… I mean, it’s not fair,” says *Maratha Abrams, 47, a disability grant recipient who was due to reapply in March. She received a temporary disability grant last year because she has gout, which she says makes it impossible for her to work.

“I depended on that money to help with food and stuff,” she says. “I can’t work properly. I’m a machinist so I must use my arms to work, but due to this gout, I can’t. I’m constantly in pain.”

After getting the necessary medical assessment confirming she qualifies for the grant, Abrams drove the 12 km from her home in Delft to the Sassa office in Bellville on 19 March. She says she was then told that because of the 21-day lockdown, due to come into effect the following week, she could only reapply on 16 April when lockdown was set to ease.

But all Sassa offices were officially closed by the Minister of Social Development, Lindiwe Zulu, on 30 March. At the beginning of May, the country moved to lockdown Level 4, and Sassa announced that their offices will start “progressively opening again”. 

At 04:00 on Tuesday 12 May, Abrams says she again joined the Sassa queue in Bellville, and was turned away once more. 

“I was there from early in the morning until 14:00, and they still refused to help me,” she says. Abrams repeated this exercise again on 26 May, once more taking the futile trip at 04:00.

When the country officially moved to lockdown Level 3 on 1 June, she tried again. “I slept there at the Sassa office in Bellville in front of their office in a bakkie until the next morning,” she says. At first, it seemed she could be helped that day, when people were divided into two lines – one for pension applications and another for disability applications. But only the pension applicants were helped, says Abrams.

“I was there until they almost closed down. They let the security lady come out with a paper and pen to write down our names and cell phone numbers. They never called us back,” she says. 

On 13 August, Abrams told Spotlight she received a message from Sassa. It stated that Sassa will deal with “backlogs for people who applied (for the disability grant) from 15 January to 28 February”.

While she only applied in March, Abrams went to Belville the next day to find out when her application could be processed. She received another disappointing answer. 

“I must go back (on) 15 September and see if I qualify. Then, if I do, I will only get paid on 1 October,” she tells Spotlight afterwards.

“I’m sad and disappointed because my family is suffering at this moment…  that (grant) helps a lot.”

Making ends meet

Chantel Smith, 57, a farmworker from Stellenbosch, says she has been struggling since January to help her 58-year-old husband reapply for his disability grant. He developed epilepsy due to brain trauma following an assault. Smith has since then been the sole breadwinner for her family of five, and without the grant she says they are struggling to make ends meet.

“We weren’t rich (before the attack), but we could work well with our money. We can’t keep up anymore. I can’t break even the way I used to,” she says. “The grant would really help at this point.”

Smith tried to get her husband’s application processed again in June, with no success. “When the government announced on TV that the Sassa offices would open again, in June, I think, we went again with new hope that it will work this time. But it did not.” Instead, Smith says, her husband was sent from one Sassa office to the next. The explanation they were given was they were in the wrong office for the area in which they stayed. Smith is at her wits ends about what to do.

“Everyone in the house needs to eat. It’s cold, it’s winter, you eat more. The food prices are so high that you can’t keep up. You can’t afford to ask your neighbour for something because everyone is struggling,” she says.

Smith and her husband tried to reapply early in August but were again shunted between Sassa offices, with no one able to assist them, except to inform Smith that her husband’s medical assessment has now expired. 

She is tired and frustrated and pleads with Sassa officials to simply do their jobs properly and help applicants. 

“All we want is for them to do their jobs… How do they sleep at night? When you know that you didn’t treat that person well? What kind of conscience do you have?” she asks.

Applicants should have been informed

Spotlight contacted Sassa’s Western Cape head office about Smith and Abrams’ difficulties. Shivani Wahab, Sassa’s senior communications manager for the province, explains that when disability grant applications were suspended during lockdown, applicants could receive a Covid-19 Social Relief of Distress (SRD) grant. She adds that an automated process is used to apply for this grant, and disability grant applicants should have been told this by management at the Sassa offices.

“The clients you make reference to, who accessed the Sassa offices on numerous occasions, should have rightfully been informed of the process from the outset,” she says. “The disruption caused by the lapsing of the temporary disability grants is sincerely regretted.”

But accessing the SRD grant has its own challenges.

The minister said earlier that by 15 June, the department had received 6,9 million applications for the SRD grant, of which about 3,2m had been approved. Only about 1,09m of those approved had been paid by that date.

Zulu, in her reply to a parliamentary question on disability grants, acknowledged the challenges in the Western Cape.

The number of assessments booked per assessment schedule has been reduced to 20 from 40 to ensure compliance with the Covid-19 protocols related to sanitation, social distancing and hygiene,” Zulu said. 

“Sassa Western Cape has been granted authority to deviate from normal tender processes by [the] National Treasury to appoint doctors in the George and Boland areas through a closed bidding process by approaching all doctors listed on the HPCSA [Health Professions Council of South Africa] database as a fairness measure.”

Sassa uses both contracted medical officers and those in the Department of Health. At present there are 475 doctors across the country contracted directly by Sassa to perform these assessments, in addition to doctors from the health department. DM/MC

*Not their real names 

**Note: SECTION27 is mentioned in this article. Spotlight is published by SECTION27 and the Treatment Action Campaign, but is editorially independent – an independence that the editors guard jealously. Spotlight is a member of the South African Press Council.

This article was produced by Spotlight – health journalism in the public interest. Sign up for our newsletter.

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