Why South Africa was able to deploy a ready-made army of coronavirus hunters
Alexandra Township, Johannesburg — Instead of waiting for the coronavirus to do it's awful, inevitable work, South Africa has taken its fight against COVID-19 right into some of its poorest of communities, before they're completely overwhelmed. Already more than 20 million people across the country have been screened for COVID-19, with health workers often going door to door to check for symptoms and test suspected cases.
The South African approach relies heavily on an army of community health workers deployed in small teams. But unlike other countries that have had to quickly hire thousands of people to do screening and contact tracing, South Africa's teams were in place long before this pandemic.
South Africa's past adversity has become its greatest advantage: Nearly 3 million people died in this country at the height of the HIV epidemic, and tuberculosis has claimed more than half a million lives over the past decade alone.
Now, teams of health workers armed with years of experience fighting those two national killers have been re-deployed for this new battle.
We went out with health care worker Xola Dlomo as she got a chilly start to her day, screening early morning commuters at a Johannesburg road block. She has a routine set of questions:
"Have you been in contact with someone who has COVID-19?" she asks a driver. "Are you coughing, do you have a sore throat, difficulty breathing?" she continues.
Her work hasn't changed much. She spent more than a decade tracking down patients with TB and HIV. Now she's using those skills to detect the coronavirus.
"The only difference is that this one, we have to be more conscious when it comes to health and protecting ourselves, compared to what we usually do," she says.
Think of Dlomo as a medical detective; hot on the trail of the virus, screening for symptoms, testing suspected cases and tracing the contacts of those infected.
Her next stop is an inner city residence where she's checking up on a man who tested positive. Now Dlomo is trying to find everyone he came into contact with at the vegetable farming depot where he works.
It's a tall order, as most of those workers have limited access to the internet and seldom have enough minutes on their cell phones to receive calls. So most of the work is conducted face to face with contacts, to ensure they receive the necessary health warnings and screening. Their details are then entered into a national database, to cross check in the event they test positive for the virus. When that happens, the detection work starts all over again.
The rapid deployment of these health workers initially bought the country valuable time, with experts saying it helped slow the spread of the virus. Although cases now number over 110,000 in South Africa, the death toll is still lower than many countries with similar size epidemics at just over 2,000.
With the higher overall figures, the teams of health workers are being deployed to target "hot zones," where there are known clusters of infections.
Fighting the coronavirus may not have been what Dlomo envisaged when she qualified as a community nurse, but the oath she took then still stands true today.
"We swore that we will be there for our community," she says proudly, "Our first priority is saving the human life."
Health experts in South Africa were under no illusion that this country might not be hit hard by the virus, but the country's old battles with TB and HIV have given it a powerful weapon to fight the spread of the disease as winter begins to bite in the Southern Hemisphere.