October 2016

Engaging Delft in Heart Health

On the 15th of October, our Heart of the Matter (HOTM) project reached its conclusion at a community engagement event held in the Delft Civic Centre in Cape Town. The Delft residents who participated in the project rose to the occasion with terrific enthusiasm to showcase the photobook and two films that they had been working hard to produce since the beginning of the year.


Enthusiastic engagement of community members in question and answers sessions focusing on heart health at the Heart of the Matter community engagement event : Delft Civic Centre, October 15th 2016 .


The HOTM brought together nineteen dynamic Delft community members in a unique partnership with a group of cardiovascular disease (CVD) research scientists from Stellenbosch University, led by Professor Hans Strijdom.


In the first phase of the project a team of 11 community members – who chose to name themselves the Delft Health Ambassadors—participated in a photovoice process. Through this process the group developed a novel photobook, using images and narratives to describe accessibility to different types of food in the urban township of Delft, key factors influencing their food choices and their perspectives on what healthy eating means.


During its development, the HOTM photobook was shared at several stages with the scientific team, providing them with first-hand and grounded information regarding the diets and lifestyles of people who live in a place that has a particularly high rate of cardiovascular disease. The Stellenbosch researchers contributed to the book with many comments about what they had learned through the photographs, and by providing essential public health information about cardiovascular disease. So far, 150 copies of this colourful and unique photobook have been disseminated, mainly into the Delft community with some also being given to medical scientists with an interest in community engagement, at Stellenbosch.


In Phase 2 of the project, eight younger community members – who ranged in age from 18 to 25 and called themselves the Delft Youth Ambassadors – collectively, designed, scripted and shot a short film entitled Your Health is Your Wealth. The film illustrates the ways in which heart attacks, strokes, high blood pressure and diabetes have impacted the lives of these young people. Your Health Is Your Wealth also describes what the youth participants think can and should be done to address the heart disease epidemic that is ‘’tearing families apart’’.


The 3rd phase of HOTM enabled the Delft Health and Youth Ambassadors, and the CVD research group, to work together in making the film For a better life. The film further explores the Delft participants’ knowledge about what is driving the high prevalence of heart disease in the community, and illustrates how their regular engagement with the group of CVD research scientists over nine months has augmented their awareness about the health implications of food and lifestyle choices.


Phase 4 was all about the HOTM community engagement event which took place on a windy but sunny spring day in October after 3 months of detailed planning by the Delft Health and Youth Ambassadors. The Ambassadors and the SLF team all arrived early and with much excitement and anticipation to set up and prepare for the arrival of the audience. All guests had been personally invited by the Ambassadors and were warmly welcomed by them at the door. The first 45 guests received a copy of the HOTM photobook. The CVD team from Stellenbosch University also arrived in good time to help welcome guests and catch up with the Delft participants before the start of the programme.


The Delft Health and Youth Ambassadors’ ownership and enjoyment of the day was evident from the very minute they arrived at the Civic Centre. The event was MC’d in Afrikaans, English and isiXhosa and all of the Ambassadors took a turn on the stage. As well as showcasing the book and films that they had produced together, the two Delft groups had designed the packed programme to encourage audience engagement, including energetic dancing and singing performances by local artists. The day’s activities also included some question and answer sessions to gauge and amplify the learning that was happening in the room as the event progressed. Many questions about heart disease that had been asked by the Delft participants throughout their engagement with the project were given carefully prepared and thorough answers by the scientific team, with the intention of sharing this knowledge with all in attendance. The lively audience of 120 guests were entertained, informed and well fed throughout the afternoon! Their sustained engagement and positive responsiveness indicated that the event was a success and the Ambassadors and scientific team received fervent applause at its closing.



We hope that the HOTM project has helped to raised awareness among the Delft community about the ways in which food and lifestyle choices influence the risk of developing CVD. The scientific team commented on their experiences of participating in the project in the following ways…


It brought me back to earth in a way, and made me realise that our research must always be to the benefit of society. Having said that, I must also state that this project confirmed that we, as a group, are doing relevant research, and it has strengthened my resolve to continue with what we are doing’.

Hans Strijdom


I have realised the value of having our research ultimately translated to our communities in an understandable manner. At the end of the day, these are the people we are doing it for’.

Shantal Windvogel


Gaining knowledge and understanding from the perspective of the community members themselves renders insight that the laboratory cannot offer. A unique opportunity is created where the two ‘worlds’ can interact and gain better perspectives and understanding through the exchange of information’.

Frans Everson


It is vital for researchers to communicate their research to the general public, be it through workshops or media outlets. These forms of communication and interactions may help educate not only caregivers but also children, thus giving the knowledge to make better choices regarding their own health’.

Nyiko Mashele


Although this engagement did not affect how we conduct research, it has helped broaden our knowledge with regard to cultural and social issues that may influence heart health’.

Mashudu Eva Mthethwa


More than anything it reaffirmed my ambition to continue with research that can have large-scale positive impacts on the communities such as Delft’.

Sana Charania

 The Heart of the Matter project has received accolades from both the Dean of the Faculty of Medicine and Health Sciences, and the Vice Dean of Social Impact, at Stellenbosch University. The project was supported by an International Engagement Grant awarded by Wellcome to SLF director Gill Black in November 2015.

Spotlighting Shebeen Struggles

This is the second blog in the ‘Livelihood Struggles’ series. It highlights livelihood struggles specific to the liquor sector in townships, one sector of several core sectors SLF has identified in the course of its research. This is a staff blog, written by Caitlin Tonkin, with research additions from Andrew Hartnack.


 “(1) A Person may not micro-manufacture or sell liquor unless authorised to do so in terms of a licence… (3) A person who… micro-manufactures or sells liquor in contravention of [subsection (1)] is guilty of an offence…” (Western Cape Liquor Act of 2008)

In the Western Cape, these are the (basic) laws which determine who can and can’t sell liquor and where they can and can’t sell it. Passed about eight years ago, the way these laws have hit the ground in townships amounts to prohibition. Prohibition, in townships, threatens the economic survival of thousands of people.


Quincy is one of those people. A South African living in Delft, Quincy opened a shebeen (an illegal liquor outlet) to try to make ends meet. Of obtaining a licence so that his sales would be legal, he explains: “I tried to get a licence, but it was too much. The bar was too high. I tried three separate times to apply, and I paid around R 28 000 in all for the applications… The process was so bad and there were lots of excuses from the liquor board, so I gave up.”



Click on infographic to see in full.


Click on infographic to see in full.

In brief, the township/liquor picture that Quincy is part of looks like this: there is a demand for liquor and spaces of liquor consumption (this demand is created as much by a desire for alcohol as it is by a desire for spaces of recreation and sociability ekasi). In response to this demand, people desperately needing an income to put food on the table start selling liquor. A handful of these people make money enough to surpass the day-to-day needs of families and to start secondary businesses, like hair salons or spazas; many, however, make minimal incomes and sell liquor because alternative options do not exist for them. Either way, liquor becomes the staple of micro-enterprises of varying sizes, and forms an important part of the township leisure economy.


Enter into this picture the requirement of the Western Cape Liquor Act that liquor traders must be licenced. The problem isn’t so much with the requirement that liquor traders are licenced – SLF’s research has found that many traders, like Quincy, want to enter into the Act’s regulatory framework. The problem is that the requirements to get a licence are nearly impossible to fulfil from a position of poverty and informality.


requirements-sketchIn researching the liquor sector in townships, SLF recorded story after story of people hitting a stonewall of requirements when trying to legalise their liquor micro-enterprises. One shebeen owner tried to get a licence through an agent, but the agent was fraudulent (a common occurrence) and the owner was cheated out of R 300. Now she will not apply for a licence anyway because she thinks that people who live in shacks are not considered. A similar view is held by another shebeen owner who says: “… the Liquor board said if you are doing business (shebeening) in a squatter camp you are not supposed to get a licence, but if I add two toilets and make my place better then they would reconsider it.”


“The problem is that the requirements to get a licence are nearly impossible to fulfil from a position of poverty or informality.”


Unable to acquire licences and formalise their businesses, township liquor sellers must either operate illegally and endure (or be broken by) police harassment, or close and forgo the income (albeit minimal) brought in by liquor sales. Noma, a domestic worker from Delft, has experienced both sides of that particular coin: “When I was raided, they used to take me away and lock me up overnight. Although I knew I could make the money back, there was now nobody to look after my children while I was away… this could not go on as my kids were young. So I closed the shebeen… The income (from domestic work) does not compare at all… If it weren’t for the licence I would go back to selling alcohol tomorrow.” Not all shebeeners are as successful as Noma was, earning R 1000 or less a month – and yet the persistence of even these small-scale shebeeners in the face of police harassment and imprisonment speaks to the lack of alternative income options in townships.


Quincy, Noma and others’ experiences indicate that the Western Cape Liquor Act is not in fact working to regulate the township liquor sector – on the ground, it is operating as a prohibition act, with detrimental effect to the many township micro-enterprises dependent on selling liquor. What is needed is a liquor policy which recognises the potential of the township liquor sector to play a developmental role in townships. In the words of one shebeener: “Shebeens should not close at all, because people are making a life out of it. The government must channel the money into development…” Should the Western Cape government remain intent upon eliminating township shebeens, then it is incumbent on them to create and support other employment options.

Socio-Ecological Urban Regeneration

In November 2015, the Sustainable Livelihoods Foundation (SLF) joined the Making All Voices Count (MAVC) initiative. MAVC is a global initiative that aims to promote communication, transparency and, ultimately, accountability between citizens and their governments. MAVC programmes hope to achieve this change in relationship by using technologies to improve communication, and help describe and capture tensions that may exist between citizens and government. Once captured and described, these tensions can be brought to the attention of the relevant government bodies, policy-makers, funders and other interest groups.


SLF is conducting four case studies as part of our MAVC project, each of which address a different sphere of governance. One of these cases focuses on in-depth retrospective and real-time research into the experiences and opinions of Rastafari bushdoctors (or herbalists) and conservation officials on the future use of public spaces for planting and harvesting traditional medicines. This ‘socio-ecological urban regeneration’ programme, as we have termed it, emerged out of a larger SLF-lead project called Herbanisation.


Herbanisation arose from SLF director Leif Peterson’s PhD that investigated the trade of fynbos in Cape Town, and the Western Cape more broadly. Leif’s research showed that the largest population group harvesting plant material in the City of Cape Town are Rastafari bushdoctors. He estimates that a total of 1, 100 tonnes of biological matter are traded annually within Cape Town, of which 262 tons of which grow in the Cape Town city area. As most of the plants are harvested in the Cape Floristic Region, an area home to many protected indigenous plant species, it is perhaps not surprising that bushdoctors’ harvesting activities attract hostility from conservationists, police and other interest groups. These tensions are precisely what the Herbanisation project aims to address. Through planting open-access gardens that are unfenced and free to harvest, the project has successfully brought bushdoctors, conservation professionals and other stakeholders of Cape Town biodiversity together to plant gardens in previously degraded and unused public areas. Not only has the project facilitated the strengthening of linkages between the various stakeholders involved, but it has also helped regenerate Cape Flats Sand Fynbos in open spaces—promoting conservation and contributing to the physical, psychological and emotional health and wellbeing of the local community.


However, the growing bushdoctor population along with an increasing demand for medicinal plants continues to raise concerns, and in some cases, legal action from conservation professionals and other stakeholders. More than a once-off engagement between conservationists and bushdoctors, this project, titled ‘Translating Complex Realities through Technology: Lessons about Government Responsiveness in South Africa’, builds on the Herbanisation project by bringing the voices of bushdoctors to conservation authorities through personal storytelling captured in short films. The bushdoctors designed and created six videos among themselves, and another was created by Leif. Leif’s story reflects on how the Herbanisation project has developed over time, his own positionality within this conundrum and how it provided an opportunity for bushdoctors and conservationists to interact and contribute to the creation of a sustainable medicinal plants garden. While the bushdoctors were given the freedom to tell their own stories, they we20160420_100702re prompted: ‘tell us a story about when you felt free or when you felt unfree during your work as a bossie dokter, and what do you do about it?’ Some of these stories reflected instances of conflict that arose when the bushdoctors were harassed by the police or were hounded by conservationists for illicitly harvesting traditional/medicinal plants in nature reserves. Others told of how the bushdoctors came to be bushdoctors, and provided a broader context of their everyday lives.


The stories have already been presented to an audience of more than a hundred key stakeholders, at the annual Fynbos Forum for conservation managers and scientists which was held in Port Elizabeth from 25-28 July 2016. The Forum was attended by Leif and fellow co-founder of the Herbanisation project, bushdoctor-Elder Neville van Wyk. The proposition of presenting the stories, along with being accompanied by a bushdoctor was enthusiastically received by the Forum organisers, who subsequently gave Leif a double-session—a concession rarely given—in which to present the films and open the floor up for questions and answers.


During the questions and answers, many members of the audience expressed great appreciation for the alternative perspectives presented via the digital stories. Conservationists, in particular, acknowledged how the stories effectively portrayed the bushdoctors’ worldview and everyday circumstances, which the conservationists had not understood before. One of the audience members went so far as to say,

 “I am a scientist, but in those stories I learned something that science cannot teach me”.

Another said,

The digital stories had a real way about driving a message that showed who [bushdoctors] are and why they do what they do”.


Neville’s story left such an impact that he was given a special commendation at the end of the workshop. The session also provided an opportunity for SLF to raise reflexive questions and concerns about bushdoctors, the relationship of accountability in the area of conservation and land management, and the use of digital story-telling as a means of engaging with policy makers and government role players.


A number of audience members expressed concern about how to engage with bushdoctors at a policy level, because they are, ideologically and in practice, an informal group that is currently not organised. This means that while some bushdoctors might agree to terms and conditions stipulated in a wild harvesting permit, others might not. Moreover, some audience members viewed bushdoctors as stubborn and unwilling to make any compromises about where and how much plant material they harvest. What is clear is that while the digital stories provide a valuable contribution to shifting perceptions about bushdoctors, much more work needs to be done in terms of addressing the fundamental differences in the positions of the conservationists and the bushdoctors.


One of the issues for effectiveness in the case of digital storytelling as a method for greater accountability is that the topic is morally charged on all sides of the debate—meaning that presenting the bushdoctors’ points of view, whilst compelling, does not invalidate the conservationists’ concerns pertaining to ecological impact of wild harvesting. In order for real shifts in accountability that lead to effective and sustainable change, the digital stories need to be embedded into a longer, multi-dimensional campaign to exchange ideas, beliefs and values between nature conservationists and bushdoctors. On their own the stories illustrate an important perspective that has been missing from the policy debate, but the fundamental concern of conservationists of the impact of wild harvesting on plant life in the Cape Floristic Region remain unresolved. Over the course of the next six months, SLF will use these stories as a lever to lead to more discussion with policymakers and the public about how to address these issues. The bushdoctors are also developing plans for how to make use of their own stories and screen them, accompanied by facilitated dialogue, to broader audiences.


Words by: Dillon Wademan

Economic Exclusion in Action

The following blog is the first in the series ‘Livelihood Struggles’,  and is the work of guest-writer, Gideon C. du Toit, a freelance writer based in the Garden Route region. The experiences described and opinions expressed are those of du Toit himself, and do not necessarily represent the views of the Foundation or its collaborators.


The Western Cape is an area known for its rich natural and cultural diversity. To the periodical visitor this seems like the ideal place to live. Little do they know that this area is also host to the atrocity of economic exclusion, something that I have experienced firsthand.


Earning my keep as a freelance writer, my wife and I were facing financial ruin as our combined household income steadily declined. Drawing on the spirit of entrepreneurial initiative and with months of planning, we decided that my mother’s winning Jaffle recipe was the way forward, so we purchased Jaffle pans, a gazebo, utensils, aprons, a menu and a small gas stove.


Mosselbay hosts two municipally-approved, demarcated areas for flea market trade. Since these areas have a lot of passing traffic, we approached the municipality and applied for a stand where we could sell our Jaffles. Even before I had the application papers in my hand, the municipal official informed me that the current stands were all occupied by the same tenants who have been renting it for years, and that no additional stands will be allocated. As I read through the papers it became clear to me that these demarcated areas where meant for occupation by at least the middle-class, as the requirements were grossly out of reach of the poor. The requirements to prepare food in a stall required an outlay of at least R15 000, not including health certificates and additional approvals.

The cave in Mosselbay in which du Toit and his wife lived.

The cave in Mosselbay in which du Toit and his wife lived.


When I pointed this out, I was advised to apply for a stand at either the Goods Shed, or at the annual Diaz festival. The Goods Shed is a former railway shed turned indoor flea market that enjoys the majority of its commercial traffic during December, while for the remainder of the year isn’t conducive for sustainable trade.


With no stalls available for lower income groups, no additional stalls identified in the existing areas, the high costs of obtaining a stall and boundless array of red tape to acquire a stand, we simply had nowhere to legally bring our product to market. Despite our best efforts to push through financially, we ended up homeless on January 12, 2016. Together with our pets, we took shelter in a cave from where we attempted to earn money by washing cars in one of the public parking areas but this was abruptly ended by the local traffic officials chasing us from the area, and once again denying us the right to earn an income.


On the 19th of January 2016, we decided to sell our remaining belongings, buy a lethal drug overdose and commit suicide. On my way back to the cave I was picked up by a stranger, who took pity on us and offered to take us to another cave, this time in Wilderness where homeless people have been squatting for years. This area was more “informal trade friendly” so I took to washing cars in the public parking areas, and on rainy days I worked on a novel, while my spouse found work as a waitress.


Once able to earn a small income without hindrance it took exactly one month for us to move into a small Wendy Hut in someone’s backyard. Systematically we worked ourselves back up. I decided to call the local DA before the municipal elections, and discuss the possibility of identifying areas from which less privileged people can bring products to market. I was assured that this issue was at the top of their priority list.


After months of saving, I managed to construct a biltong and droëwors manufacturing unit that cure products in a clean and hygienic environment faster than conventional methods. I figured that if I sell pre-manufactured products like biltong, I would stand a better chance of acquiring one of the new stalls, promised before the elections.


Early September 2016 I decided to follow up on the progress relating to the development of these additional trade areas. After my first four attempts to initiate correspondence with Mosselbay local government went unanswered, I escalated my enquiry to provincial level. Several failed attempts to get feedback from provincial government forced me to contact the office of the Premier, after which I was repeatedly referred to different offices, without receiving replies.


Weeks later, Carlin Petersen from the Mosselbay municipality responded, by telling me exactly what they told me a year ago. The promises made by local government with regards to additional facilities that would enable the poor to take part in the local economy, simply didn’t materialize. Any attempts to question this, are simply ignored and swept under the carpet, thus keeping the poor permanently excluded and without a voice.

The new entrepreneurial endeavor in which du Toit's future rests.

The new entrepreneurial endeavor in which du Toit’s future rests.


Why would a government proclaiming that they are encouraging entrepreneurial endeavors, avoid the issue when questioned? Why haven’t they done a thing towards devolving areas where poor people can trade? The initiatives implemented by the DA are clearly designed to serve the middle class. Despite my best efforts, I have been unable to enter the local economy, kept out of trade by bureaucratic rule, municipal bylaws and a financial bar set so high that the poor will never realistically reach.


As for me, I have no idea what my future will bring.


Read the subsequent blog in this series here.

‘Livelihood Struggles’ Blog Series Launch

Experiences of Exclusion from the Formal Economy


“The law is sometimes too tough for us.”

These may sound like the words of a criminal, encountering the workings of due justice. In fact, they are the words of a woman who runs an Educare centre in Ivory Park, Johannesburg, but struggles to achieve compliance with all the regulatory criteria. This woman, anonymised for her safety, was moved to start an Educare when she saw street-children in her area going hungry. She has correctly registered her Educare with government as a non-profit organisation, yet she receives no assistance from them and has to borrow money or use her pension to buy food for the children in her care. Although her Educare centre is rooted in her goodwill towards her community, it is also her only source of income – so the failure of “the law” to support her is a problem for her.



Police harassment for failure to meet unsupportive regulations is but one obstacle for the poor to building livelihoods.

In response to the need of people struggling on the economic margins for livelihoods, the Sustainable Livelihoods Foundation is launching a series of blogs titled ‘Livelihood Struggles’. The series will feature lived encounters with economic struggle, such as experienced by the Educare owner introduced above. Some blogs will be written by participants of the informal economy themselves, others by SLF researchers and collaborators. The series highlights the great difficulty poor South Africans face in gaining access to the formal economy and attaining regulatory compliance. Poor people face a range of challenges in accessing formal markets and building livelihoods for themselves: these challenges include legal restrictions around where businesses can operate, high fees for trading licences, lack of start-up finance options, unchecked crime, and unhelpful or corrupt officials. Often, when people attempt to work through these challenges legally, they are stone-walled by bureaucracy or red tape. If they bypass these challenges extra-legally, for example through trading without a licence, they face high risks of police harassment and criminalisation. But what options do unemployed persons have in an environment where there are few jobs in general and even fewer for persons lacking skills?


From years of research with the communities who face these challenges, the Foundation has come to understand that the difficulties faced by poor people in accessing the formal economy are neither random, nor befall only the unlucky. The obstacles are systemic. Economic exclusion is widespread; an outcome of a government which works better for the rich than for the poor. Thousands of South Africans are marginalised and prevented from building sustainable livelihoods because of government policies which make gaining access to the formal economy from a position of poverty almost impossible. This blog series will spotlight a handful of cases which come from communities surviving at the economic margins, where “the law is too tough for us” is indeed a personal truth for many. Highlighting the systemic nature of this truth, rather than the individual details of each case, is the purpose if this series. We hope that through these insights we can impress the need to strengthen rights for the poor to pursue livelihoods through informal economic activities in a way that promotes economic inclusion as a priority development objective.


Read the first blog in this series, ‘Economic Exclusion in Action’, here.