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Maternity Benefits in South Africa - a measure of gender equality

By Liesl Orr, of the SACP Gender Commission and who works for NALEDI

Maternity benefits are good for women and society because childbirth and parenting is for society as a whole.

An essential element in maternity protection is a legal guarantee to pregnant women and young mothers that they will not lose their jobs as a result of pregnancy, absence on maternity leave or the birth of a child.

Important objectives of parental rights include giving women and men equal access to paid work; enabling women and men to combine workplace and family responsibilities; achieving equal representation of women and men at all levels of organisations; and making women's and men's family and work roles equally visible, legitimate and valued.

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Present policy and practice does not reflect pregnancy as a different but 'normal' worker experience and workplace concern. Pregnancy is treated something than cannot be reconciled with anticipated experiences of a 'normal' worker.

South Africa has huge inequalities between men and women and between women of different races. It is lower wage earners that will be most affected by the rate and duration of maternity leave and pay, and will gain significantly from good benefits. Maternity benefits (and childcare) assist in facilitating and increasing female labour market participation rates and thus have a positive impact on gender equality.

We need to challenge the common approach to maternity benefits, which tends to focus on costs and draws on economic arguments and motivations rather than focusing on the actual needs of mothers and infants. Maternity cash benefits give substance to the right to maternity leave. If women do not have access to cash and health benefits, many would not be able to afford to take maternity leave or may be forced to return to work despite their own and their child's health needs.

The Maternity Protection Convention of the ILO calls for a minimum period of leave of 12 weeks, although a 14-week leave period is recommended. According to an ILO Report Maternity Protection at Work (1997), more than 120 countries around the world provide paid maternity leave and health benefits by law.

In South Africa maternity benefits are covered through a social insurance scheme - the unemployment insurance fund.

Maternity benefits should be provided at full pay. The qualifying period should be as short as possible. Higher-income earners should not be excluded from the fund but there should be a ceiling on the benefits payable.


Fighting evictions and for decent housing in Durban

During February, poor residents in a Chatsworth block of flats squared up with Durban Metro Council and police fighting evictions of poor residents who could not pay council rates. Here we summarise a court affidavit by Thulisile Manqele, one of the affected residents who successfully appealed against the Durban Metro Council decision to cut her water supply during March 2000. This case was heard by the Durban High Court.

I am an adult female who is 35 years old, unemployed and a South African citizen


The Respondent has cut off the water supply where I stay. I explain my personal circumstances in some detail below. My circumstances are similar to those of approximately forty other households.

I have resided in a flat owned by the Respondent for about seven years in Unit 3, Chatsworth, Durban. Unit 3 has 150 blocks of sub-economic two roomed flats. These flats were constructed in the 1960s for persons who were removed under the Group Areas Act, and who were too poor to afford regular and more substantial houses built in other areas of Chatsworth.

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I worked as a domestic worker for a Mrs. Cilliers from 1983 to 1995. In 1995 I got sick. I became very tired and suffered intense abdominal pains lasting three or four days. I could no longer work and I was forced to resign. Doctors could not determine the cause of my illness. I was placed on medication to regulate high blood pressure.

Since February, I have been given charity cleaning work to do on Fridays for which I receive R15.00 and R5.00 to buy bread. This is my only source of personal income. I rely on neighbours for food. I assist with cooking communal meals and my family are able to partake in these meals. From time to time I receive food and clothing hand outs from concerned members of the community, religious organisations and social workers.

I have four children - a girl aged 16, a boy aged 14, a boy aged 6 who suffers from asthma and another boy aged 4. They all reside with me. There are three other children who permanently reside with me - a nephew aged 1, a nephew aged 7 and another nephew suffering from kwashiokhor, a disease caused by malnourishment.

While I was working, I could afford to pay my rent, electricity and water accounts. Since I became unemployed I have fallen behind in payment. In August 1999 the electricity supply was cut because I could not afford to pay the consolidated account. As at 31 January 2000 my arrears amounted to R9 879,34. The reason I was in arrears was simply because I am unable to pay.

Around the 10th February 2000, I received a bill from the Respondent relating to the consolidated charges payable by me. I have difficulty reading English and the bill appeared to me to be in the same form as the bills I received previously. It was only later in the month that my daughter BONGIWE drew my attention to the fact that the Respondent was threatening to cut off the water supply.

I then attempted to telephone the Respondent to bring my circumstances of indigence to the Respondent's attention and to request that my water service not be restricted or cut off. The number in question was never answered and after several attempts I gave up trying because the process appeared to be hopeless.

On 29 February 2000 I discovered that the pipe which had been used to bring water onto the property had been cut. Another section of pipe had been put in place of the section that had been removed and the new section of pipe completely blocked any flow of water onto my pipe.

I was in peaceful possession of the pipe and utilising it to obtain water for domestic use. The My use of the pipe, and thus access to water was ended unilaterally by the Respondent without obtaining an order of court. This conduct amounted to an act of total destruction.

Since the water supply has been cut off, my living conditions have become unbearable. During the first few days I was able to beg a few buckets of water from neighbours. Many of these have also had their water supply cut off and those who have not are too scared to use more water than that for which they can pay. I am unable to pay for water. I have accordingly not been able to bath since the beginning of March.

My children are suffering even more than I am. Five of my seven children are below the age of seven. Not having access to water is unhygienic. Zamani is still in nappies and I am unable to properly clean him when the need arises.

Each night we leave pots outside hoping for any rainwater that may fall. The little rainwater that we are able to gather as been of little use. It is barely sufficient to quench the thirst of the children and is certainly not enough for cooking. My children frequently complain of thirst. The situation is a source of extreme humiliation and despair for me, and my children suffer unduly.

In desperation on one occasion I collected water from a still standing stream about fifty metres from my flat. There is garbage in the stream and the water seems polluted. I do not believe that it is hygienic for me to use the water. It is so dirty that it cannot be swallowed.

Therefore I pray to the court that an urgent order be granted against the Respondent and for the restoration of my water supply. I argue that the facts explained above show that the Respondent committed an act of total destruction by cutting my water supply. The by-laws under which the Respondent operated violate the 1997 Water Services Act and deny me the basic human right.

Activists mobilise against the high price of AIDS medicines

Every time Dorothy Zwane came home to Standerton, it was like Christmas. Working as a domestic worker in Pretoria, she made more than anyone else in her family, including her brothers, who work as farm workers. She would bring her mother dresses, her two sons books and toys, school fees for her nephew, furniture for the house, and food for everyone. Her family-three generations gathered together in a room lit by a single candle, remembers the last time Dorothy came home. She was so tired, and then the headaches began. She said she feld drunk and confused, and then she started seeing things that weren’t there. The pain in her head got worse, and when she began to fall down, they took her to the hospital for the last time.

HIV/AIDS weakens the immune system

At some point, Dorothy had inhaled spores of the cryptococcus fungus. Healthy people control the infection, but HIV had ravaged Dorothy immune system, so the fungus was able to pass into the blood, which carries it to the brain. There it sets up colonies-pearly, glistening spheres along the blood vessels of the brain, most abundant on the wrinkled surface but also present deep in the brain's core. The fungus does not kill neural cells, but it makes them swell, squeezing the brain inside the skull and turning the grey matter into "a big bag of mush. When the skull is cut open at autopsy, the brain bulges out like toothpaste out of a tube.

Sicknesses caused by HIV/AIDS can be cured but drugs are too expensive

This is cryptococcal meningitis, one of the most feared opportunistic illnesses that kill people with AIDS. It can be treated, but one of the key drugs-fluconazole, which also works well against thrush, an extremely common ailment among HIV patients-costs the equivalent of about R58.00 for a standard dose, far too much for South Africa's health care system. Pharmaceutical giant Pfizer holds the patent for fluconazole and sets the price in almost every country. But in Thailand, the government permits local companies to make a generic form of the drug; the price for the same dose is only about R4,20.

Local and international campaign for access to cheaper drugs

During March and April, the South African Treatment Action Campaign together with the MŽdecins Sans Frontires and ACT UP campaigned to pressure Pfizer to match the Thailand price, or to give TAC a license so that it can find a company to manufacture a generic version of the drug. In mid-March, the activists delivered letters to Pfizer offices in 18 different countries, giving Pfizer one week to agree to their demands. But the deadline passed and the company did not agree. Following more letters Pfizer released a statement which said that "Pfizer will offer fluconazole for free to those people who cannot afford it".

The TAC welcomed this as a great victory for people living with HIV/AIDS in South Africa and demanded that the offer be extended to all poor countries.

The health system is in a serious crisis

At Standerton Provincial Hospital, where Dorothy Zwane died, there is a desperate need for fluconazole and a lot of other drugs. In 1998 alone, a shocking 51 percent of women attending public prenatal clinics in Standerton were infected with HIV. The hospital is supposed to stock 169 so-called essential drugs, but it is completely out of 38.

In AIDS, there are two conditions that are absolutely critical to treat: tuberculosis, because it probably kills more HIV-positive South Africans than any other opportunistic infection and because it imperils the general population; and sexually transmitted diseases, because people who have them are more likely to contract and transmit HIV. But despite being fairly cheap, drugs to treat these problems are often unavailable. For example, according to a report by the provincial government, TB drugs were out of stock between 15 and 30 percent of the time. As for STD drugs, at least one is unavailable most of the time. "If we send patients to a private pharmacy, they can't afford the drugs.", says a nurse at the hospital.

Mpumalanga Province is worse than the norm and in rural clinics around the country, drug shortages are not uncommon.

Activists hope something else will become clear: the fact that there are life-prolonging treatments. The government has not yet issued national treatment guidelines.

Certainly that is true for cryptococcal meningitis. A few large hospitals do treat this disease. When HIV patients arrive with cryptococcal meningitis, they are stabilized, given painkillers for the headache, and sent home to die.

"You're not going to see enthusiasm in doctors who haven't treated people with the drug-not because they don't care but because they don't know," says Zackie Achmat of the TAC, who has HIV himself. "This shows the amount of work we have to do in this country. Treatment literacy, even among doctors, is very bad."

It's worse, of course, among patients. "Since there are no treatments, people are always hopeless," continues Achmat. "The minute they know they're positive, they deteriorate fast. It's psychological. They despair."

Ultimately, this is what the fluconazole campaign is trying to do-inject hope into the bleakest of epidemics. That's more than a sentimental gesture. People avoid getting tested, say doctors and AIDS workers, because what can they do if they're infected? And if they don't know they carry the virus, they often are not as careful about protecting their partners. If parents could live an extra year or two-which has been proven possible even without drugs that target HIV itself-their children might get a better start in life before being orphaned. Drugs like fluconazole would inspire hope, says Achmat, "because we wouldn't be saying anymore, 'Go home and wait for your time.' "

  • This article was adapted from an article in Village Voice, a US newspaper.