C19 People’s coalition is outraged to learn of the shooting of Community Health Workers in Bhisho, Eastern Cape.

17 July 2020
For Immediate Release

On Thursday evening, 16 July, at 7:35pm, Community Health Workers (CHW) who occupied the Eastern Cape Provincial Health Department’s Head Office were met with rubber bullets, forced out the building, and left stranded in the freezing winter night to walk many kilometres to find shelter and assistance. The occupation followed the refusal of the Department’s Superintendent General, Dr Thobela Mbengashe, and the MEC for Health, Sindiswa Gomba, to respond in good faith and on time to a memorandum handed over by CHW’s a week earlier.

CHW’s have been at the forefront of the health response to the COVID-19 pandemic in South Africa. CHW’s are predominantly older women workers who work long hours, with little pay, providing vital health services to their community. Yet they remain casual workers, often earning as little as R3500 per month. The struggle by CHW’s to become permanent employees, to earn a living wage and to be provided with safe work conditions and equipment did not start with the COVID pandemic. It is a struggle they have waged since 2002 throughout the country. While the National Department of Health (and the President in his recent public address to the nation) has lauded the work of CHW’s who have screened millions of people for COVID-19, while it claims to centre health provision on a community based, primary health care approach, it has continued to abuse and exploit this most vulnerable part of the health workforce. This labour system sets up a culture of organisational harm where lower levels, usually women, bear the brunt with little support and recognition. This is the face of gendered burden of care, which mostly black women endure and have endured for far too long.

The most recent phase of the struggle for recognition and permanent employment has been ongoing for weeks, culminating with the handing over of the memorandum on Wednesday 6 July. Numerous attempts at communication and requests for meeting have been systematically ignored. CHW’s have limited access to the normal processes of labour dispute and their organisations are often not recognised by the national bargaining council. In large unions who organise in the health sector, CHWs have limited representation due to their casual status and lack of formal recognition. In addition, CHW organisations are being undermined. In the Eastern Cape, NUPSAW was excluded from the bargaining council despite meeting the requirements and the bargaining council refused to recognise CHW’s as workers. All other organisations of CHW’s are also consistently denied access to representation and bargaining at a national level.

On 16 July, with few avenues for normal labour dispute processes and in frustration at the lack of any communication, CHWs went to the Department’s offices to meet directly with the MEC and the Superintendant General. They waited there from 8am in the morning, but were not received by them. As afternoon and then evening fell, they elected to stay the night as many could not afford the transport money to return from far flung villages again the next day. In the evening, this peaceful occupation, really a long wait for a promised meeting, was met, not by representatives of the Department, but by police in riot gear shooting rubber bullets, sending the community health workers running in panic out into the night. This is not the first time CHW’s have been met with a heavy hand by the state. In 2014, over 100 middle aged and elderly CHW’s were arrested in Bloemfontein after protesting the collapse of the health system and their conditions of work.

We can no longer tolerate a situation where our state, far from being an example of good labour practice, is responsible for the casualisation of work and the exploitation of the mainly women workers leading healthcare provision in our communities. We note the recent permanent employment of CHW’s in Gauteng as a step in the right direction and hereby demand an end to regional disparities in the pay, recognition and national integration of CHWs into the workforce of the Department of Health. We demand that CHW’s calls, in the Eastern Cape and in the rest of the country, for secure employment and a living wage, be met with immediate effect. Further, we call on all workers, CHWs and all Extended Public Works Programme (EPWP) workers to join forces in a coordinated national campaign against this casual employment and exploitation by the state. We specifically call on other healthcare workers, including doctors, nurses, pharmacists, social workers, physiotherapists, occupational therapists and audiologists, to stand in solidarity with our CHWs.

We cannot build a people-centred health system or a people-centred response to COVID-19 without CHWs.

Finally, in regard to the shameful actions that took place in Bhisho on 16 July, we demand accountability for this gross abuse of power through the immediate suspension of the MEC for Health and the Superintendant General, until a full investigation has taken place into the decision to deploy police to arrest and shoot at CHWs.

Issued by the C-19 People’s Coalition

For comment please contact:

Sibongile Tshabalala +27 74 471 6318

Tinashe Njanji +27 78 831 5809

This statement was further endorsed by the following organisations:






EPWP Gauteng Provincial Workers Forum

Treatment Action Campaign


Rural Rehab South Africa

Triangle Project

People’s Health Movement of South Africa

Cancer Alliance

City of Tshwane Community Health Workers


Studies in Poverty and Inequality Institute

Rural Health Advocacy Project




TB Proof

South African Care Workers Forum


Southern African Alcohol Policy Alliance in SA



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