SA’s grandmothers are breadwinners in their old age, and their inability to access decent healthcare quickly impacts on their children, grandchildren and their entire communities. Health-e News’ Kim Harrisberg reports.Six elderly women sit inside a corrugated iron shack in the Ngangelizwe township in Mthatha, a region with among the highest poverty rates in the Eastern Cape, to share their stories. An analysis of the 2015 General Household Survey data shows that the heads of households are predominantly male up until the age of 60, after which women begin to take over the role of breadwinners. Almost 1.5 million – or 11% – of all South African households are now run by women of pensionable age. Nozukhile Hadi (60) maintains the vegetable patch of the Sinovuyo Disabled Children’s Centre in Tabase. Picture: Kim Harrisberg Like many townships in South Africa, the roads between Ngangelizwe’s shacks are narrow and untarred. In the more rural areas, such as the mountainous Tabase region, traditional homes are often difficult to reach without a 4x4. This, together with a shortage of ambulances, means accessing medical attention urgently is often difficult, if not impossible. The same data reveal that, for households earning less than R10 000 per month in the Eastern Cape, one in five residents needs to travel between 30 and 90 minutes to access their nearest healthcare facility. ECHOED COMPLAINTS The investigation included a two-day provincial hearing where residents testified about their health horror stories. Eventually using their mother’s old age grant, they were able to pay the R600 for a private car to take them, but Tumeka died at the hospital a day later. These included promises of 11 new ambulances, 157 replacement ambulances and 10 planned patient transport buses. The department also committed to achieving, among other fulfilments, a fleet of 667 ambulances leading up to 2021. Eastern Cape health spokesperson Sizwe Kupelo listed the following actions taken by the department: Marvellous matriarchs: The grandmothers of Ngangelizwe township use their social networks to care for their grandchildren, share groceries and provide emotional support to one another Picture: Kim Harrisberg A report by the Rural Health Advocacy Project published last month explores the gaps in the public health sector in the Eastern Cape, both in terms of emergency medical services, medicine stock-outs and medical staff. (See data analysis by Daniela Q Lépiz from Code for Africa.) His motorised buggy does not get him far on the rough terrain, and taxi drivers refuse to carry the buggy in their vehicles. She complains of swollen ankles and knees from these trips, but, as he has epilepsy, she knows the importance of these check-ups. He developed cerebral palsy as a result of untreated fits when he was younger. RURAL ISOLATION She is one of many grandmothers who support both their grandchildren and their children when they struggle to find jobs in bigger cities. The 13-hour round trip made by elderly matriarch Nolibele Debe from Nqileni village, about 100km south of Ngangelizwe, to Madwaleni Hospital, captured this well. Suffering from chronic arthritis, Debe would walk over hills with her joints grinding against each other. She would then catch a boat across the Dludla river, the only means of transport out of the village. In the rainy season, she would be unable to access her urgent chronic pain treatment. “The pain makes me feel as if the parts of my body are separating,” she said. GRASS ROOTS COMMUNITY CARE In Tabase, the elderly women have come together to support both one another and local disabled children at the Sinovuyo Disabled Children’s Centre. They work closely with Happy Homes, a home for disabled children in Mthatha, run by disability activist Vivian Vuyelwa. Sinovuyo has also become the place where the elderly women share food and money – and emotional support. A shortage of accessible water and electricity makes it difficult for them to pursue their dreams of sewing, baking and selling vegetables, although they hope to do so in future. Gogo’s in charge: Nozukhile Hadi (60) alongside her community’s grandchildren whom the grandmothers feed, clothe and raise as their parents seek work. Picture: Kim HarrisbergIt is this shared suffering – and the response of the elderly women of Tabase and elsewhere in Eastern Cape – that has helped to hold these communities together. This innovation is also cited in the Rural Health Advocacy Project report, where they reflect on the innovation of the Mankosi region where residents, frustrated by the void of medical services, decided to pool money together and build their own clinic. The mountains also make access to healthcare a painful and difficult journey for the elderly matriarchs, as well as their dependents.