During the strictest phases of South Africa’s Covid-19 lockdown, the SA Social Security Agency effectively stopped accepting new disability grant applications. Elri Voigt explores what happened and speaks to two applicants on the impact the disruptions have had on their lives.
People who needed to apply or re-apply for disability grants were in for a nasty surprise when the SA Social Security Agency (Sassa) stopped accepting applications at the start of South Africa’s level 5 Covid-19 lockdown.
Sassa at first attributed this decision to the lockdown, and later to the lack of access to healthcare facilities. Access to healthcare facilities is needed since, as Sassa explained in a press release last month, a medical assessment forms part of the application process.
Sassa said it has since resumed the disability grant application process using a “phased-in approach”, where its offices set aside two days a week for disability-related matters. It also said that grants that “were supposed to lapse in March this year, have been extended to the end of October to cushion affected beneficiaries”.
But has Sassa done enough to ensure that people eligible for disability grants can receive the grants?
Minister of Social Development Lindiwe Zulu, in an answer to a parliamentary question said by June 29 Sassa had 19 053 applications awaiting medical assessments for a disability grant. Zulu said local Sassa offices “strive to ensure all bookings are assessed within a month”, but the lockdown restrictions impacted this. With just under 5 000, the Western Cape has the highest number of assessments on the waiting list followed by the North West.
Impact on DR-TB patients
The Doctors without Borders (MSF) team in Khayelitsha first learnt about the situation from its drug-resistant TB patients in May.
Dr Jennifer Furin, a TB doctor working for MSF Khayelitsha, explained that their patients qualify for a temporary disability grant as they cannot work because drug-resistant 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 that the country has made in drug-resistant TB treatment.
“The short-term and long-term health implications of this decision are potentially disastrous,” she said. “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 drug-resistant TB patients] treatment failure and death,” said Vinayak Bhardwaj, MSF’s deputy head of mission in South Africa.
Civil society and government
Given their concerns, MSF approached government about the matter. Then, in a letter seen by Spotlight to MSF dated May 10 and signed by Dianne Dunkerley, 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,” Dunkerley wrote.
On May 14, 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,” Bhardwaj said.
With little apparent progress, Section27 was roped in and last month wrote to the minister of health, the minister of social development and the CEO of Sassa. A flurry of letters followed.
But when Section27 initially wrote to Sassa, plans for restarting services were in fact already well under way. On July 8, Sassa announced that it would again allow new disability grant applications, using a phased-in approach where certain 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 other alternative channels.
Bhardwaj admitted that Sassa had done much of what was requested. However, he said that none of MSF’s drug-resistant 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 drug-resistant TB automatically qualifies for a disability grant without further assessment,” he said.
Ektaa Deochand, an attorney at Section27, said that while the extension of temporary disability grant applications was welcomed, it wasn’t sufficient. “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,” Deochand said.
Kgomoco Diseko, the national spokesperson for Sassa, told Spotlight that disability grants backlog and timeline to deal with the applications was unique to each office.
He said that Sassa considered the impact the decision to suspend the 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 said.
The most recent development was early this month and concerned temporary disability grant recipients whose grants had expired last month. Diseko explained that these recipients’ grants would be reinstated and they would receive double payments next month. They would continue to receive this grant until December.
Despite Sassa offices reopening after undergoing safety assessments, Diseko said that services at some offices continue to be disrupted by Covid-19.
“The major challenge is that certain offices close from time to time for disinfection due to staff members getting infected with Covid-19 or succumbing to it,” Diseko said.
The situation was further complicated by the role of unions. In response to a letter sent by Section27, Sassa’s CEO Busisiwe Memela, cautioned that there may be “interruptions in our ability to provide disability-related services”. She added that the unions claimed that Sassa staff were being exposed to additional risk.
Memela said that so far, the only disruptions to Sassa’s offices came from decontamination processes, not from actions by unions.
The struggle to access grants
Meanwhile, some grant people have been struggling to get their applications through the system.
“I should have received money on May 1 ... I mean, it’s not fair,” said *Maratha Abrams (47), a disability grant recipient who was due to re-apply in March. She received a temporary disability grant last year because she has gout, which she said made it impossible for her to work.
“I depended on that money to help with food and stuff,” she said. “I can’t work properly. I’m a machinist so I must use my hands to work, but due to this gout, I can’t. I’m constantly in pain.”
Abrams, after getting the necessary medical assessment confirming she qualified for the grant, drove 12km from her home in Delft to the Sassa office in Bellville on March 19. She said she was then told that because of the 21-day lockdown coming into effect the following week, she could only reapply on April 16 when the lockdown was set to end.
But all Sassa offices were officially closed by Zulu on March 30. In May, the country moved to lockdown level 4, and Sassa announced its offices would start “progressively opening again”.
Abrams joined the queue at 4am on two occasions, and on another slept in a bakkie outside the Sassa office in Belville.
“I was there until they almost closed. They let the security lady come out with a paper and pen to write down our names and cellphone numbers. They never called us back,” she said.
On August 13, Abrams told Spotlight she received a message from Sassa. The message stated that Sassa would deal with “backlogs for people who applied (for the disability grant) from January 15 2020 to February 28”.
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] September 15 and see if I qualify. Then, if I do, I will only get paid [on] October 1,” she told Spotlight afterwards.
“I’m sad and disappointed because my family is suffering at this moment because that [grant] helps a lot,” she added.
Making ends meet
Chantel Smith (57), a farmworker from Stellenbosch, said she has been struggling since January to help her husband reapply for his disability grant. Her husband (58) developed epilepsy due to brain trauma following an assault. Smith has been the sole breadwinner for her family of five since, and without the grant she said they were 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 said.
“The grant would really help at this point.”
Smith tried to get her husband’s application processed again in June, with no success. “When government announced on TV that the Sassa offices would open again, in June I think, we went with new hope that it will work this time. But it did not,” she said.
Instead, Smith said, her husband was sent from one Sassa office to the next. The explanation was that they were in the wrong office for the area they live in. Smith was 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 said.
Smith and her husband tried to reapply early this month but were sent from one Sassa office to the next with no assistance, only to be told that her husband’s medical assessment had expired.
She was tired and frustrated.
She pleaded with Sassa officials to 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’s difficulties. Shivani Wahab, Sassa’s senior communications manager in the province, explained that when disability grant applications were suspended during lockdown, applicants could receive a Covid-19 social relief of distress (SRD) grant. She added that an automated process was used to apply for this grant, and 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.
But accessing the SRD grant has its own challenges.
The minister earlier said by June 15 the department had received 6.9 million applications for this grant and about 3.2 million had been approved. Only about 1.09 million of those approved had been paid by then. Zulu, in her answer to the parliamentary question, acknowledged the challenges in the Western Cape.
* 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.