Chair, the Select Committee on Women, Children and People with Disabilities undertook an oversight visit to the Limpopo and Gauteng provinces from 26 to 28 January 2011, informed by the NCOP's key strategic priorities, as well as the committee's five-year strategic plan.
In Limpopo province the aim was to investigate allegations of neglect and inhumane living conditions for mentally disabled patients; interventions by the department of health and their plan of action for disabled persons in the province; and the accessibility and disbursement of social support grants and support provided through the Department of Social Development and the SA Social Security Agency.
In Gauteng the aim was to meet with the Commission for Gender Equality and get a briefing on work done in the province and progress made in respect of its turnaround strategy; and to meet the Tshwaranang Legal Advocacy Centre for Women to discuss the work of in relation to the implementation of the Domestic Violence Act, Act 116 of 1998.
The Limpopo oversight visit was specifically conducted in response to allegations of neglect of mentally ill patients at the old Nkhensani Hospital at Giyani and the department of health's response to these allegations.
Discussions with the hospital psychiatrist at the Evuxakeni Hospital revealed the need for a mental health review board to ensure that the care, treatment and rehabilitation of persons who are mentally challenged conform to the Constitution and the Bill of Rights.
The Limpopo department of health services are divided into three levels of care, namely tertiary, secondary and primary. It has three specialised hospitals and only one with a high level of security for convicted criminals and acute patients. The province is struggling with limited capacity in regard to psychiatrists and registrars. It is embarking on an intensive retention programme to attract and retain qualified psychiatrists and registrars in the province. Outreach is done at secondary level and district hospitals. The department is in the process of bridging the gap between institutional and community services. It is also in the process of training psychiatric nurses to conduct follow-up services in communities and particularly in rural areas. The department is working closely with educational technical colleges in this respect.
Psychiatry is a specialised service and is not available at all hospitals. With three hospitals in the province dealing with this specialised care for acute patients, many patients from rural areas have to travel great distances to get the services they require. There are not sufficient psychiatrists, physiotherapists and nurses deployed to these hospitals.
One of the major challenges in the province is the absence of a provincial mental health review board. The department acknowledges that it is contravening legislation by not having any and plans are under way for the department to fast-track the process. The board was expected to be fully operational by 1 April 2011.
The following key points are based on our own observations and on the presentation of the provincial department of health in Limpopo: the skills retention strategy of the department of health in Limpopo; concerns over the absence of a mental health review board; the extent of family involvement in the lives of these patients; poor referral systems; and the poor condition of facilities.
While no commitments were made in respect of the department of health in Limpopo, the delegation mentioned its intention to have further follow-up engagements with the department in respect of the accommodation for mentally disabled patients at the Evuxakeni Hospital at Giyani, Limpopo.
The committee conducted a site visit to the head office of the Commission for Gender Equality, CGE, to receive a presentation from the CGE on its plan of action in provinces; to receive a followup presentation from the CGE on its turnaround strategy as presented to the committee; to discuss issues relating to gender-based violence with the CGE; and to receive a progress report from the CGE on key recommendations emanating from the strategic report on the public hearings on gender-based violence.
In respect of monitoring and service delivery as far as the Domestic Violence Act is concerned, the CGE noted the lack of training of law enforcement officials, most notably police, in the handling of cases of domestic violence and the issuing of protection orders. In most cases, the protection order comes too late to take the victim of domestic violence out of immediate danger. This is further exacerbated by law enforcement officials trying to mediate the situation while not being trained to do so. Training of law enforcement officials is provided in regard to the correct procedures, contact details of places of safety, and worksheets.
The CGE's Eastern Cape office is leading a consortium of the commission, including the National Prosecuting Authority and the Human Rights Commission, in an attempt to collectively lobby and challenge the issue of ukuthwala [forced marriages], which is rife in that province in particular.
In Mpumalanga an awareness programme for men regarding gender-based violence, and facilitating public awareness of domestic violence and HIV infections related to rape and sexual assault are in place.
In the KwaZulu-Natal office, regarding such harmful cultural practices as ukuthwala, virginity testing and male initiation, focused interventions include raising public awareness, as well as dialogues held to determine whether traditional practices still hold relevance and whether or not these practices are still followed within the ambit of culture. Specific focus is on whether or not cognisance is taken of the Bill of Rights on these issues.
As a national office, the CGE makes representations on legislation tabled in Parliament and lobbies in regard to gender issues. It addresses legal issues relating to chieftaincy cases, performs court monitoring in respect of gender functionality, and champions issues of inheritance in respect of the recognition of customary marriages and intestate succession.
The delegation raised the following concerns: the accessibility of CGE provincial offices, particularly in rural communities; the poor enforcement of maintenance orders and the CGE's role in this; the need for the CGE to have more qualified attorneys so as to play a more effective championing role in legal processes; and the need for the CGE to actively work to change the negative image created by its past poor performance. Positive performance and results will result in positive publicity.
The Tshwaranang Legal Advocacy Centre was established to end violence against women, to eradicate the victimisation of women by the legal system, and to make the law a vehicle of social change for women. It promotes the rights of women to live free of violence and have access to adequate and appropriate services, through the provision of free legal services and litigation, public education, research and advocacy.
The delegation resolved to conduct follow-up meetings with the Department of Justice and Constitutional Development and the SA Police Service in regard to the issues emanating from the oversight visit. The select committee noted the manner in which the provincial department of health and social development in Limpopo, the SA Social Security Agency and the Commission for Gender Equality have organised themselves to work towards implementing policy directives and programmes in improving the lives of women and the mentally disabled.
The committee has furthermore observed the challenges faced by these institutions on the ground, particularly in regard to capacity, infrastructure and resources, and the negative impact that these have had on service delivery. After conducting the site visits and observing first- hand the dynamics prevalent in all the facilities visited, the committee is in a better position to understand these challenges. [Applause.]
Debate concluded.
Question put: That the Report be adopted.
IN FAVOUR: Eastern Cape, Free State, Gauteng, KwaZulu-Natal, Limpopo, Mpumalanga, Northern Cape, North West, Western Cape.
Report accordingly adopted in accordance with section 65 of the Constitution.