Community Health & Well-being

Bringing health to eThekwini’s residents

Striving to ensure the health and well-being of eThekwini’s residents is key to fostering an engaged and productive citizenry, who are looked after with compassion and capable of driving economic growth.

The modern delivery of health services is overwhelmingly based on a medical or curative model of care. While this model does improve prognosis and prolongs survival it is not economically sustainable in the long term. What is required for the future is a combination of both the curative model together with community-based disease-preventing strategies and healthpromoting activities. This model places greater emphasis on recognising the social determinants of ill-health and will allow for critical prevention strategies to improve the overall health of citizens.

Challenges The City aims to provide services of high quality towards achieving the National Core Standards through the Ideal Clinic Status, yet faces numerous challenges in this regard. This is due to various factors that include subprofessional-standard practices, insufficient supervision, a lack of implementing tools, a shortage of staff and inadequate infrastructure. To rectify this situation, the next steps entail addressing the challenges of infection control, risk management, improving the adherence to policies and processes, better management of pharmaceuticals, improving infrastructure, data management, and ensuring the adequate management of patient records.

It is no secret that HIV/Aids and TB are major health challenges faced across South Africa. The high rates of infection of these communicable diseases contribute sharply to reduced

City empowers traditional healers to improve safety

The City’s Health Unit equipped traditional health practitioners on the management of diseases. This aimed to improve the safety of the sector’s approach to treating illnesses. This training is in line with the Traditional Health Practitioners Act (No. 22 of 2007) whose focus is on the professionalisation of the practice. Earlier this year, the City held a Traditional Health Practitioners’ Seminar at the Ntuzuma F Community Hall. The seminar recognised the role played by traditional health practitioners while also allowing for the City to receive feedback on its initiatives to empower the sector. Councillor Ntokozo Sibiya, chairperson: Community Services Committee, said the City recognises the important role of traditional healers in society. She said it was therefore important to strengthen support to improve safety and compliance of legislation within the sector.

“We understand that some people prefer to consult with traditional healers. Therefore, government must continue to work with the traditional sector to ensure healers are equipped with the latest information to manage diseases and protect themselves from being infected,” said Sibiya. The City’s Health Unit also visits practices to assess the state of hygiene and hosts workshops to educate traditional healers about the storage and measurement of medicine dosages. Neziswa Ndaka, deputy secretary of the Provincial AIDS Forum and a traditional healer, recognised the strides made in the professionalisation of the traditional healer sector. “We appreciate the progress that has been made. This includes being able to refer patients who are ill to hospitals. We are following guidelines to also protect ourselves from being infected when treating patients, and are open to working and learning from government and other sectors,” said Ndaka.

life expectancy and the collapse of socio-economic conditions for individuals, households and communities, resulting in a greater number of orphaned and vulnerable children.

The City’s programmes focus on attaining viral suppression in patients on ARTs and ensuring those patients who have started on treatment are retained in care. The importance of testing and ensuring individuals know their HIV/Aids status is also of paramount importance. Exacerbating the HIV/Aids epidemic, tuberculosis is recognised as the leading opportunistic infection amongst HIVpositive persons, with just under two thirds of HIV infected persons co-infected with TB.

Through the District AIDS Council, the municipality is focusing its five-year TB management plan on coordinating stakeholders whose work has an impact on TB risk factors, such as housing, workplace, environmental pollution, etc. as a mechanism to reduce and end TB new infections by 2030.

Towards a healthy environment The City is also focused on improving the compliance monitoring of environmental programmes in accordance with Environmental Health Norms and Standards. These contribute to the City’s efforts to promote an environment that is conducive to a healthy environment and improved quality of life for residents. Programmes that address environmental health include the following: • water quality monitoring • food control • waste management • health surveillance of premises (control of the built environment) • surveillance of communicable diseases, excluding immunisation • vector control • environmental pollution control (air, water, noise, soil) • disposal of the dead • chemical safety.

Upgraded clinics In its endeavours to provide premium healthcare, between 2016 and 2020, eThekwini Municipality upgraded six clinics. Among the facilities that were upgraded is the Savannah Park Clinic, where refurbishments were completed in 2020. The clinic expanded from three rooms to an 18-room structure that features a covered waiting area. The Savannah Park Clinic services two wards and attends to about 7 000 patients a month. Other health facilities in the City were upgraded through a collaboration by the National Department of Health in partnership with the United States President’s Emergency Plan for AIDS Relief.

Intensified vaccination drive In eThekwini, under the guidance of the KwaZulu-Natal Command Council, an intensified social mobilisation and Covid-19 vaccination drive has been rolled out. This initiative will target communities and districts where there has been a low vaccination uptake.

Through the vaccination roll-out, government aims to achieve herd immunity. As more people are vaccinated, fewer people remain

vulnerable and there will be a reduced chance of the virus being passed from person to person.

There has been a gradual but steady decline in the number of new Covid-19 infections, hospitalisations, and deaths. This is due to measures introduced by government such as lockdown regulations and the vaccination programme that is currently under way.

Although many people have been vaccinated, the eThekwini district is not where it should be in terms of its vaccination numbers. Dr Musa Gumede, deputy city manager: Community Services, eThekwini Municipality, said the greatest challenge currently is to ensure that the City does not experience a surge in infections.

“This is not the time to let your guard down; people must continue to observe safety protocols and I urge them to vaccinate. The vaccination programme is under way, and government has made it easy for the public to access vaccines through mobile vaccination outreach programmes near their homes,” said Gumede.

Gumede also reminded the public that vaccination for children aged 12 years and older is open. “Our children are the future, and they deserve to be protected against Covid-19. It is recommended that a parent or another adult accompany eligible children when they present for vaccination,” he said.

Community projects drive well-being

One of the City’s mandates is to create an environment where people interact creatively to stimulate economic growth, learning, sustainability, social cohesion, and unity. To achieve this, the Parks, Recreation and Culture (PRC) Unit through its various departments has worked to deliver integrated environmental, cultural, heritage and leisure services in the municipality. Over the past five years, the Unit has spent over R120 million to support community-initiated programmes in the creative arts through the delivery of signature programmes. The City has 97 libraries and two mobile libraries. The PRC rolled out free Wi-Fi at City libraries to ensure residents have access to information. The libraries are equipped with Wi-Fi, a computer lab, study rooms and, depending on the location of the library, can accommodate 120 visitors. An example is the Amawoti Library, which was built and opened in 2020. It boasts Wi-Fi, an outdoor gymnasium, basketball court, a garden, and an open space for socialising and parking. The City’s efforts to promote literature resulted in Durban being recognised as a UNESCO City of Literature in 2017. To address environmental challenges, the City’s 10 park districts are required to plant 500 trees each year. This promotes urban forestry. In 2019, the City was named the Greenest City in the World in a survey by Husqvarna. This has resulted in eThekwini being recognised as winners of several Arbor Day city awards and, of late, the international Greenest City Award. To transform the heritage landscape of the City, Council took the decision to expand its heritage footprint by adding more historical and cultural sites related to the liberation history of South Africa. EThekwini Municipality has more than 10 cultural and heritage museums. Each site is unique in its content and characteristics. The City is expanding its local history museums to include sites that were previously disregarded as insignificant historical sites when, in fact, they helped shape the historical landscape of the City. In its mandate to protect the environment, promote recycling and enhance the health of the community, the Cleansing and Solid Waste (CSW) Unit’s operations include 32 operational centres, seven transfer stations, and two landfill sites. The Unit also has 22 recycling plants, three landfill gas projects, and two leachate plants. These assets enable CSW to provide a full range of services to 3.4 million residential, industrial, and commercial customers. The City, through CSW, has created over 3 000 job opportunities through the engagement of community-based contractors. The City has won the Greenest Municipality Competition for four consecutive years. The winnings for the competition were used to employ 170 Expanded Public Works Programme staff in the north of the City.

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Ticketing and fare management systems The fare collection (FC) system, via automatic fare collection or ticketing, includes the distribution of travel documents, their subsequent validation, and fare payment. It can be combined with access control based on turnstiles. An important component is the follow-up processing of obtained data, its evaluation, the optimisation of connections, and their interconnection with any related systems.

Almex’s wide product portfolio allows the company to create FC systems tailored to every customer, according to the type of transport, payment habits, tariff policy, and numerous other factors.

Emv bank cards bring a new freedom of travel The EMV-based open loop payment system brings a new freedom dimension to passenger travelling experience. It is no longer necessary to buy a travel ticket before taking public transport,

No propriety travel card required. Simply pay for your fare directly on board the vehicle by tapping your standard bank card, mobile phone, or QR code. The same card can be used in various public transport providers in your country or abroad.

The usage of the bank card to pay for public transport is very popular with passengers. This payment method allows the passenger to travel across multiple transport modes much easily with one payment card.

Transport operators have seen an increase in revenue and passenger count by simplifying the payment method.

SANRAL ABT account system We will be launching a new ABT account system that will be accepted by multiple transport operators.

The new suite of products will be launched supporting the ABT card from POS units, Fare Validators, on-board ETM devices and Mobile ticketing devices.

Vehicle movement awareness With the AVL (automatic vehicle location) system, you will have a perfect awareness of your vehicles’ movement. The system automatically monitors and evaluates all the required parameters – vehicle route, speed of movement, timetable deviations, etc. In case of any deviations, the system will warn you, so that you can react to any nonstandard situations. Everything can be monitored in real time, while driving performance can also be retrospectively analysed and evaluated. The transport company thus obtains a useful tool for checking on work activities, statistical outputs, or resolving passenger requests or complaints.

EMV/ NDoT installed projects to date EThekwini Municipality: Muvo Card To provide a complete e-ticketing solution for the Municipality of EThekwini. Price Waterhouse Coopers were responsible to provide Change management. Standard Bank supply the day-to-day settlements of the card.

The project went live in 2012 and continues to evolve with new ticketing ideas and we currently have around 300 000 bank smart cards in use which can be used for daily travel as well as purchases in Retail Stores.

We maintain the Municipality AFC systems daily with on-site personnel.

GO GEORGE Standard Bank in conjunction with Almex have developed a web-based ticket warehouse system for the George Municipality. This means that the commuter can top-up his transit card at any third-party vendor using a Standard Bank credit card machine. This has increased the footprint of convenient top-up stations. The project went live in 2018 and Standard Bank have rolled out a number of these credit card machines in registered spaza shops whereby the owner makes a commission on every single transaction.