[Media Watch] Impact of COVID-19 measures in rural South Africa

The book COVID and Custom in Rural South Africa: Culture, Healthcare and the State was born out of research commissioned by a government development agency in the Eastern Cape province of South Africa, during the first and second waves of the COVID-19 pandemic. It tells the story of how marginalised communities in the rural periphery of South Africa experienced the constraints placed on their funerals and customary practices during one of the world's longest and most restrictive lockdowns.

In the book, authors Leslie Bank and Nelly Sharpley argue that the South African government, encouraged by the private sector and in an urge to lead Africa in its response to COVID-19, opted to follow a Global North middle-class biomedical response model that was poorly adapted to the vast majority of the South African population, outside of a small minority of people in the suburbs of the main cities. The authors suggest that the government purposefully overlooked the contradictions in its policies and the challenges of their implementation in a country with widespread poverty and inequality, to the enormous detriment of the poor, rural populations who have little access to the benefits of biomedicine, and who as a result died in large numbers without dignity, and who were systematically marginalised and silenced.

In the first chapters of the book, Bank and Sharpley explain that in the rural areas of South Africa, community traditions underwent a great period of restructuring in response to colonisation and later in response to apartheid, with rituals being at the centre of the people of the Cape colony's struggles to retain some form of autonomy and control over their lives. Poor rural communities placed great importance in particular on funeral and burial rituals, with the afterlife being seen as a type of “freedom in death” from the oppression and lack of dignity imposed on them during their lives. Funerals were family and community matters, and were not usually managed by funeral directors, local government officials, hospitals, or the state. Rural communities were thus accustomed to having relative freedom to bury their dead as they saw fit, in dignified ways, and in accordance with religious beliefs and traditions.

As the COVID-19 crisis began to unfold and the virus spread throughout the country, the South African government declared a State of Disaster in March, 2020, and funerals and customary practices were viewed as super-spreader high-risk events. New regulations were introduced that sought to restrict travel between provinces, limit interactions with the bodies of people who died of COVID-19, enforce physical and social distancing, shorten rituals, and restrict attendance at funerals. Customary practices were also banned during the lockdowns. Because the majority of these practices take place in rural settings, the communities there quickly became the target of law and police enforcement. This repression created a culture of fear, and a feeling that the state was “fighting with our traditions”.

Furthermore, because the biomedical model was so poorly adapted to these settings, provincial COVID-19 mortality rates in South Africa were among the highest in the world, with rates in excess of 200 deaths per 100 000 people in the two main metropolitan areas of the Eastern Cape province, Nelson Mandela Bay and Buffalo City. In a chapter entitled Disposable citizens, the authors posit that these excess deaths could be directly attributed to government oversight and failure of the state's public health approach. Between April and August, 2020, hospital staff shortages, lack of preparation and equipment, fear, closure of government departments, and the total absence of community engagement brought health systems to a halt. Rural families were scared by the government's harsh efforts to control funeral practices using police force. When infections finally reached a peak in July, 2020, rural populations were deeply shocked at the increased number of improper funerals that were carried out in chaos and confusion, including denying families the right to see the bodies of their loved ones and the wrapping of bodies in several layers of thick plastic. These practices removed all spiritual and social closure and dignity in death.

The final chapter of the book focuses on the exhumation of bodies that eventually began to take place as the COVID restrictions were gradually lifted. In rural areas of the Eastern Cape between December, 2020, and January, 2021, local populations began to slowly resist the restrictions that had been placed upon them and customary practices returned. Exhumation and reburial was a process that was supposedly governed by legislation, but after months of harsh restrictions families began to defy government rules, and many secretly informally reburied the bodies of their family members at night.

Covid and Custom in Rural South Africa is a powerful exposure of how the South African government failed in its duty to care equally for all communities during the COVID-19 pandemic, with disastrous consequences, and a reminder of the widespread inequality and legacy of oppression that is still deeply entrenched in the nation.

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