2. REASONS FOR ABANDONING AND DUMPING OF CHILDREN WITH DISABILITIES
2.4. SOCIO-POLICAL TENDENCIES THAT INFLUENCE PEOPLE TO ABANDON AND DUMP
2.4.1. SOCIO-POLITICAL FACTORS
We have been discussing some socio-cultural factors related to children with disabilities, this part will further discuss socio-political factors that have also contributed to the human malaise of the children with disabilities. Socio-political factors in this regard imply the external factors and conditions that have had an impact on child disabilities. In this case, we will be discussing issues related to apartheid and how they impacted on children with disabilities, we will also discuss issues of infrastructures and the implementation of policies that directly affect children with disabilities in the region. Finally, we will also explore the Constitution of South Africa and how it stipulates on the management of issues related to child disabilities. South Africa as a nation has so far invested so much in the formulation of policies regarding how we can best take care of children with disabilities.399 Contrary to the ideals set up by the government and the provincial medical and health sectors, most families, particularly expectant mothers in rural areas or settings, have limited access to proper medical facilities.400 They resort to their own traditional ways which put the life of the child in danger. Traditional medicine and how it is administered is an issue of concern. There is no monitoring or controls on the effectiveness of traditional drugs on issues of physical and mental disabilities.401 Lois Laws, one of the researchers in the Parliamentary Liaison Office in the Catholic Bishop’s Conference, presented a case in which pregnant women consumed cow dung.402 Further to this reality, it was reported that most young girls who are pregnant
399 Department of Social Development, (2016), White Paper on the Rights of Persons with Disabilities: Official Publication and Gazetting of the White Paper on the Rights of Persons with Disabilities, No. 230, March 09, Government Notices. Quoting the Constitution, the gazette stated that everyone is equal before the law and has the right to equal protection and benefit of the law. This was the point of departure in the process of the promulgation of laws that inclusively takes care of children with disabilities.
400 Matthews, S., Martin, L., Scott, C., Coetzee, D. and Lake, L., (2015), Every Child Counts: Lessons Learned from the South African Child Death Review Pilot, A Research Brief, Cape Town: Children’s Institute, University of Cape Town, 1-8.
401 Ibid.
402 Law, L., (2011), Aspects of Pre-and Post – Natal Care, in “The Briefing Paper 278”, Pretoria: Southern African Catholic Bishop’s Conference: Parliamentary Liaison Office, December, 1.
consume drugs such as alcohol and Indian hemp, dagga or marijuana.403 This act is contrary to what medical expertise advocates. Drugs of that nature are most likely to have a serious impact on the development and growth of the child in the womb.404 Children born within such an environment are prone to exhibit multiple physical and mental disabilities and other health complications.
2.4.2. INFLUENCE OF APARTHEID
Under apartheid, black people were taught that they were inferior and that they should receive education only enough for their opportunities and status in society.405 The system created an atmosphere of crisis which resulted in black people being ill-equipped for any career and lacking the capacity for general self-employment.406 People residing in the so called black communities during apartheid were alienated, corporal punishment was administered, in violation of human rights.407 This became the culture of the time and it created a violent environment for the livelihood of the black person. Violence manifested itself in various forms and became the order of the day.
The current situation in which children with disabilities are being abandoned and dumped can be traced to have evolved within the context of apartheid.408 The black community had to fight for survival in their opposition to apartheid and they resorted to violent ideologies like sabotage as a form of political resistance.409 The rural black communities were severely tested, with insurgent attacks or its members by agents of the state.410 The current government has made efforts to reduce crime against some targeted minorities though the
403 Ibid.
404 Matthews, S., Martin, L., Scott, C., Coetzee, D. and Lake, L., (2015), Every Child Counts: Lessons Learned from the South African Child Death Review Pilot, A Research Brief, Cape Town: Children’s Institute, University of Cape Town, 1-8.
405 Tsele, M.S., (1991), Education for Democracy: A Case Study, in Numberger, K., (Ed), A Democratic Vision for South Africa, No. 3, Pietermaritzburg: Encounter Publications, 462.
406 White Paper on Integrated National Disability Strategy in http://www.independentliving.org/doc3/sa1997/wp, It states that people with disabilities are excluded from the main stream of society and have trouble in accessing fundamental rights. Partly such a situation has been attributed to the apartheid sentiments and perceptions whereby people with disabilities were marginalised some sectors particularly among the black communities.
407 Ibid. 462-463.
408 Lansdown, G., (2002), Disabled Children in South Africa: Progress in Implementing the Convention on the Rights of the Child, Pretoria: Rights for Disabled Children, 5. The legacy of apartheid per this report states that there is a gulf of difference in children’s experiences across the country. Its philosophy was to segregate and divide and since race determined social status, it also entrenched worlds of difference between those living in rural or urban communities, those with or without education (…….) and those with and without recognition of respect for their dignity and humanity. Black disabled children experienced exclusion and marginalised associated with their impairment. It would be unfortunate to distance this historical aspect of the experience of disabled children from the historical past of apartheid.
409 Ibid. 462.
410 Ibid. 468.
current dynamics still indicate that crime against children with disabilities remain a serious problem.411 Most black people in the rural communities were forced to reside in the informal settlements while others experienced imprisonment and even assassination.412 From the out- look of things as discussed above, the apartheid regime was characterised by gross human rights violations.413 People, especially in poor black communities, suffered from poverty and illiteracy making them incapable of taking care of their children especially those that needed extra care like children with physical and mental disabilities. Shooting of black leaders’
country-wide, forced removals, banning of groups and movements, detentions, torture and stoning, brutal hatred, division, fear, and suspicion became the norms of the time.414 The situation was not conducive for the poor people to seek medical care in the context where their rights were suppressed.
It was within this context that many families have raised their children with disabilities. The impact of apartheid in some sectors persists considering the different levels of people in the current democratic dispensation. The political situation has essentially changed, but people’s mentality is still largely affected by the past. This is manifested in various news reports of the abandonment and dumping of innocent children with disabilities in various parts of the country.415 The brutal act of abandoning and dumping children has so far raised ethical and moral concerns. The present project questions the morality of such inhuman acts. The apartheid regime created a situation of poverty that has imposed a negative impact on the
411 Gender, Disability, Children and Youth Programmes Unit of the Policy Coordination and Advisory Services in the Presidency, (2008), Background Report on Targeted Sectors for the Fifteen Year Review, Pretoria:
Legislative Framework, 37.
412 Ibid.
413President Jacob Zuma’s Speech on the Commemoration of the 2016 Human Rights Day, On March 21, 14:01:48.0 At Moses Mabhida Stadium, Durban said: ‘On this solemn occasion, we acknowledge all South Africans who suffered gross human rights violations during the period of apartheid colonialism including murder, torture or imprisonment. He further said ‘there is a cult of race superiority and of white supremacy is worshipped like a god. Few white people escape corruption and many of their children learn to believe that white men are unquestionably superior, efficient clever, industrious, and capable; that black men, are equally unquestionably inferior, slothful, stupid, evil and clumsy’. Within such perceptions and ideologies, children with disabilities especially among the black majority had limited chances to benefit from the state. They were experiencing gross violation of their rights by the state structures.
414 Ibid. 471.
415 South African Health Review, (2016), Thousands of Children Being Dumped in South Africa, Pretoria:
Health Systems Trust, November 17, in http://www.hst.org.za/news/information-authors-south-africa-health- review-2016, Posted on December 09, 2016. The article reported that more than 40 children are being dumped in the Free State every month. The spokesperson for the Department of Social Development said that 477 children were reported abandoned in the past 12 months. KwaZulu-Natal is also reporting high figures especially the new born babies. The report does not exclusively indicate the number of children with disabilities as such but it includes them as constituting the children being dumped. The number of children with disabilities may or may not be the driving factor alone rather there are also various factors that influence people to dump their children. From the previous discussions, we recognized that there is a strong tendency to dump children with disabilities than other reasons associated to it.
poor majority. It has put people in a situation where they have become hopeless when faced with the birth of a child with physical and mental disabilities.
2.4.3. INFRASTRUCTURE DEVELOPMENT VERSUS RATIONING OF MEDICAL PROFESSIONALS IN HEALTH INSTITUTIONS
South Africa is rated as one of the most developed nations in the SADC region.416 Despite this positive attribute, South Africa’s statistics on child mortality are shocking. For instance, statistics reveal that 7500 babies who are born alive die on their first day meaning that 21 babies die every day or one baby dies every hour.417 Although this is just a general view of the reality of child deaths, it points to something more specific that takes place in society.
The events that lead to early child deaths in the region are diverse. Although most children die of disease complications that are diagnosed by the medical profession there are other cases of children’s deaths with disabilities that are due to the negligence of parents in taking medical care of their children.418 Other children’s deaths are due to inadequate medical services available to serve the current large population.419 These are some of the cases that the causes of children’s deaths.
Studying the information on infrastructure development and rationing of medical professionals, some reports stated that the educational status of children with disabilities in the rural areas are hampered with widespread biases and exclusionary practices which more often affect possibilities for education facilities in the region.420 Children with severe disabilities often stay at home due to their physical condition hence placing additional burden on the family. Some children with disabilities do not access any services as they remain hidden by their close family relatives.421 To date, services to children with disabilities remain
416 SADC: This stands for Southern African Development Community originally known as The Southern African Development Co-ordination Conference (SADCC) which aims at addressing national priorities through regional action given to each member state.
417 Mkhize, V., (2013), Baby Death Shocker, in “The Star”, Wednesday, May 8, 1.
418 Lansdown, G., (2002), Disabled Children in South Africa: Progress in Implementing the Convention on the Rights of the Child, Pretoria: Rights for Disabled Children, 5. The legacy of apartheid per this report states that there is a gulf of difference in children’s experiences across the country. Its philosophy was to segregate and divide and since race determined social status, it also entrenched worlds of difference between those living in rural or urban communities, those with or without education (…….) and those with and without recognition of respect for their dignity and humanity. Black disabled children experienced exclusion and marginalised associated with their impairment. It would be unfortunate to distance this historical aspect of the experience of disabled children from the historical past of apartheid.
419 Ibid.
420 The Department of Social Development, (2015), White Paper on the Rights of Persons with Disabilities, Pretoria: Approved by Cabinet on December 9, 45-50.
421 McClain, C., Howell, C., Lagadien, F., Pretorius, L., Rantho, M. and Thompson, P., (1995), Integrated National Disability Strategy, White Paper to the Office of the President, Pretoria: Rustica Press, in this chapter, it is reported that it is commonly considered that the specific needs of people with severe mental/intellectual disabilities fall outside the ambit of development. Such people are likely to be regarded as ill and in need of
fragmented and unequal especially in the rural areas.422 It seems that the infrastructures that could have assisted parents to identify children with disabilities right from birth is crucially deficient. To this note, if no proper assessment, planning, designing interventions and the implementation of proper support mechanism is done, then no system could be effective in such an environment. This has yielded the scarcity of the socio-medical and political infrastructures that could have best addressed the issue of child disabilities in the region. To this effect, limited services are provided on paper while on the ground, there are no proper physical structures from where children with disabilities could access some basic services.
Communication barriers due to negative attitudes compromise so much on the realization of human rights for children with disabilities. Regarding human resource capacity i.e. rationing of socio-medical and political professionals in the field of children with disabilities, both government and non-government departments in South Africa have expressed that there is a serious lack of professionals, well trained for the task.423 Their distribution is uneven with the majority preferring to work in urban areas disregarding the rural areas hence putting the situation of children with disabilities at risk.424
One of the hardest hitting factors should do with infrastructure and rationing of medical professionals in rural areas. Sherry’s report revealed that there is a gradual decline in the number of nurses in the country, especially nurses with specialist qualifications who could register for intensive care units, operating theatres, advanced midwifery and psychiatry.425 In general, the shortage of medical and health professionals has affected almost all the provinces in the country, but the provinces where the populations are extremely high are the most affected.426 Most provincial primary health institutions lack skilled and professional nurses and doctors to deal with the current human situation facing children with disabilities.427 Rural health institutions and centres are the most seriously affected in the
constant care. Unfortunately, they are not provided with opportunities to participate in society to the best of their ability.
422 Ibid.
423 Ibid. 15.
424 Sherry, K., (2015), Disability and Rehabilitation: Essential Considerations for Equitable, Accessible and Poverty-Reducing Health Care in South Africa, in South African Health Review 2014/15, Durban: Health Systems Trust, 89-100.
425 Ibid. In her article, Sherry made a strong appeal saying that provision of healthcare as close as possible to where people live is an important step in making health care both more affordable and more accessible. Chronic care is particularly vulnerable to failure where access costs are unsustainable over time and these services should be prioritised for provision at community level.
426 Ibid.
427 Republic of South Africa, (2012), The National Development Plan 2030: The Provision of Affordable Access to Quality Health Care while Promoting Health and Wellbeing, in http://www.gov.za/issues/national- development-plan-2030. Cited on October 2, 2015.
Province of KwaZulu-Natal.428 The majority of nurses and doctors would certainly prefer to work in places where they can access basic human needs and resources of their own. They may also be needing better working conditions that ensure their human welfare. Rationing becomes one of the major and challenging realities when it comes to the allocation of health and medical professionals in the country. Some of the effects of poor rationing may be felt most by poor communities in rural areas.
Besides rationing, there is the problem of infrastructure in the country. Many provinces have tertiary health centres which are mainly in the big cities and are completely inaccessible for the poor majority.429 The country also has secondary health centres, where serious patients are referred for further treatment and admission.430 These institutions are normally very crowded and sometimes health professionals are overwhelmed by the number of patients in relation to the number of beds the hospital can provide at a particular moment.431 Doctor- patient relationships and contacts are crucial taking into account the number of patients admitted into such facilities. Providing adequate health care services in such contexts is difficult and challenging to the medical profession. Finally, there are primary health care centres in most residential areas.432 These are the clinics that are placed in proximity to the people, for easy access. The point is to make medical personnel accessible to everyone and make the essential primary care available to all. Unfortunately, most of these clinics face the challenge of lacking essential medical and health resources. Due to limited resources, they are usually not equipped fully to provide the necessary primary care needed in rural areas.
One of the crucial areas that is seriously lacking in the province is proper hospices, where, children with disabilities could be kept for the reception of primary health care befitting their physical and mental condition.
2.5. IMPLEMENTATION OF HEALTH POLICIES ON CHILDREN WITH DISABILITIES