The Popular Disability Grants

The government acknowledges the ongoing poverty in South Africa and tries to accommodate the citizens who are willing to work. The average income for a person (and more or less for the family) in rural South Africa is 500 rand (~$80) a month. When that provider is unable to produce an income due to disability or old age (males 55 y.o. and females 60 y.o.), the government puts out a helping hand of 700 rand (~$110) a month. All patients with chronic disease process like HIV/AIDS and epilepsy receive a grant. All employed patients with acute injuries interrupting their work duties receive temporary grants.

Physicians hold the gateway to a disability grant. Everyday a crowd of patients come in Outpatient Department for reasonable, deserving, or sometimes laughable requests for grants. The government provides short term grants for TB to reduce exposure of the individual to the workforce. Currently all ARV treated patients receive grants, but that might change as the number of ARV patient increases beyond the slim government budget. Also epilepsy patients collect a lifetime grant. Single mothers with children under twelve years of age may receive a grant. Name a condition or situation and a grant probably exists for it. However, every five years, all patients must renew their grant.

With high unemployment rates, large families, and poverty, people must find strategies to survive. Grants have become a viable option to improve their financial situation. As a consequence, physicians have become cynical about the motives of patients. Many come with ridiculous stories and ignorance of how the grant process works. Physicians must sift through the fake and the justifiable stories. Here are some cases:

1) 14 y.o. child walks in without assistance behind his mother. The mother says the son needs a grant for paraplegia.
2) 35 y.o. male comes with supposed epilepsy. There is no documentation of CT scans and EEG to work up the epilepsy. We check his anti-epileptic drug levels in his blood, but the levels come back as barely detectable. Is he not taking his meds? If not, why not?
3) 23 y.o. female comes in to test for HIV/AIDS. Two HIV rapid tests are negative. She cries out frustration because she really needed the grant to feed her kids.
4) 45 y.o. male successfully completes his treatment for TB and assumes his grant continues the rest of his life.

One private clinic took advantage of this grant frenzy by offering grants to every breathing patient. This increased their patient population and then their pocket books. Fortunately the government noticed the innumerable grants at this clinic and subsequently, shut down their practice.

Again this trend parallels poverty and unemployment. I believe as the South African economy improves and begins providing feasible jobs, people will choose to contribute to society rather than take from society. Most South Africans are kind and hard working citizens. I just happen to see the more dishonest ones more often.