“You know that's a rip-off”: policies and practices surrounding micro-enterprises and poverty alleviation in South African township tourism

Supporting the development of small tourism businesses has been seen by policy-makers as a valuable means of alleviating poverty in South African townships. This perspective has been endorsed by several ‘responsible’ tourism businesses and academics. Following a review of the literature, this paper reports the findings of an empirical study that examined the practices of micro-business owners and the factors that shape their behaviour in two South African townships. In spite of significant visitor numbers, it finds that their narrow social networks and the imbalances of power between them and intermediaries such as travel agencies and tour operators prevent them from developing their businesses and sharing in the material gains that become available because of tourism. This analysis has important implications for local policy-makers and those advocating responsible tourism. For the former, it suggests a cessation of current initiatives in favour of greater regulation and alternative forms of investment. For the latter, it implies the need to reassess the utility of advocating responsible tourism to consumers in a context where they do not understand the dynamics which fashion what is on offer or the full implications of their choices

Citizenship, Community Participation and Social Change: The Case of Area Coordinating Teams in Cape Town, South Africa

Social change does not roll in under the wheels of inevitability On the contrary; we have to organize for it, mobilize for it, struggle for it and indeed, plan for it. This is especially so in a country such as South Africa, where centuries of colonial-cum-apartheid thought and practices have led planning bureaucracies to create and perpetuate socioeconomic patterns of uneven development and neglect. Amidst the geographies of largely "white" affluence, fear and collective "othering", those others, i.e. predominantly "black", unemployed, homeless, destitute, angry and alienated, are increasingly demanding their basic rights, rights that are enshrined in the post-apartheid Constitution (RSA 1995). One of the many structures that have been created in order to make available constitutionally guaranteed opportunities for participation in governance has been Areas Coordinating Teams (ACTs), established in the late 1990s as a vehicle through which government agencies could engage local communities in development planning. The ACTs were established in order to encourage consensus among politicians, bureaucrats and communities with regard to specific planning issues such as housing, health care and overall infrastructure at grassroots level. This article addresses the question of whether the ACTs, as spaces for participation in development planning available to the local communities of Cape Town, do indeed contribute towards grassroots- oriented, bottom-up programmers in post-apartheid South Africa. It draws on two complementary studies. The first consists of informal interviews with councilors and officials. In these interviews, the politicians and the bureaucrats expressed their views and understanding of ACTs. The second study was based on a structured questionnaire directed at community-based organizations (CBOs) attending the ACTs initiated/coordinated meetings. My focus here is on the relationships between the official, "invited" spaces of the ACTs and other spaces within the community and on the relationships that officials and elected representatives have with these spaces, in order to assess their potential for democratizing the development planning process.International Bibliography of Social Science

Concurrent partnerships in Cape Town, South Africa : race and sex differences in prevalence and duration of overlap

Introduction: Concurrent partnerships (CPs) have been suggested as a risk factor for transmitting HIV, but their impact on the epidemic depends upon how prevalent they are in populations, the average number of CPs an individual has and the length of time they overlap. However, estimates of prevalence of CPs in Southern Africa vary widely, and the duration of overlap in these relationships is poorly documented. We aim to characterize concurrency in a more accurate and complete manner, using data from three disadvantaged communities of Cape Town, South Africa. Methods: We conducted a sexual behaviour survey (n = 878) from June 2011 to February 2012 in Cape Town, using Audio Computer-Assisted Self-Interviewing to collect sexual relationship histories on partners in the past year. Using the beginning and end dates for the partnerships, we calculated the point prevalence, the cumulative prevalence and the incidence rate of CPs, as well as the duration of overlap for relationships begun in the previous year. Linear and binomial regression models were used to quantify race (black vs. coloured) and sex differences in the duration of overlap and relative risk of having CPs in the past year. Results: The overall point prevalence of CPs six months before the survey was 8.4%: 13.4% for black men, 1.9% for coloured men, 7.8% black women and 5.6% for coloured women. The median duration of overlap in CPs was 7.5 weeks. Women had less risk of CPs in the previous year than men (RR 0.43; 95% CI: 0.32-0.57) and black participants were more at risk than coloured participants (RR 1.86; 95% CI: 1.17-2.97). Conclusions: Our results indicate that in this population the prevalence of CPs is relatively high and is characterized by overlaps of long duration, implying there may be opportunities for HIV to be transmitted to concurrent partners

Tuberculosis in persons with sudden unexpected death, in Cape Town, South Africa

Background Globally, tuberculosis (TB) remains one of the leading causes of death from a single infectious agent, but there has been little work to estimate mortality before the diagnosis of TB. We investigated the burden of diagnosed and undiagnosed TB in adult and child sudden unexpected deaths (SUDs) evaluated at Tygerberg Forensic Pathology Services, South Africa. Methods In a retrospective descriptive study spanning 2016, we identified all SUDs where active TB was detected at post-mortem and matched with routine health service data to differentiate decedents who were diagnosed or undiagnosed with TB before death. A patient pathway analysis of the health service activities preceding SUD in adults with active TB was conducted. Results Active TB was identified at post-mortem in 6.2% (48/770) of SUDs and was undiagnosed before death in 91.7% (44/48). The prevalence of active TB was 8.1% in adult SUDs (90.1% undiagnosed before SUD) and 1.8% in children (none diagnosed before SUD). Patient pathway analysis was possible for 15 adult SUDs, and this documented primary health care clinic attendances and hospital admissions in the six months preceding death and missed opportunities for TB investigations. Conclusion The prevalence of TB among SUDs in the Eastern Metro of Cape Town is high. Most active TB at post-mortem was undiagnosed before death, and multiple missed opportunities for TB investigation and diagnosis were noted. The systematic evaluation of all SUDs for TB could improve the reporting of undiagnosed TB and support risk mitigation for healthcare workers involved with the post-mortem process

Therapeutic recreation as a developing profession in South Africa

South Africa experiences socio-economic challenges with a high prevalence of poverty resulting in disability and non-communicable diseases affecting the health and welfare of communities. Health services are not always accessible or available to citizens, especially those of previously disadvantaged or rural communities. The South African National Plan for Development 2030 aims to address these inequality and health issues. One focus area of this plan is the inclusion of recreation, leisure and sport as an important service sector to improve the health and well-being of all individuals. Therapeutic recreation could play an important role in this regard. In South Africa, therapeutic recreation is in its developmental stages. This paper aims to provide the reader with an overview of therapeutic recreation in South Africa as a developing profession. An overview of the current status of the profession is discussed in terms of standard of practice and as it relates to health professions and recreation service providers, programmes with therapeutic value and training needs. The study concludes that there is still groundwork to be done, calling for interested parties to embark on an aggressive advocacy and strategic planning process to develop therapeutic recreation as a profession in South Africa.Scopu

Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town

Background: Chronic non-communicable diseases (CNCD) have become the greatest contributor to the mortality rate worldwide. Despite attempts by Governments and various non-governmental organisations to prevent and control the epidemic with various intervention strategies, the number of people suffering from CNCD is increasing at an alarming rate in South Africa and worldwide. Objectives: Study's objectives were to explore perceived challenges with implementation of, and adherence to health messages disseminated as part of a CNCD intervention programme; to gain an understanding of participants' expectations of CNCD intervention programmes;, and to explore the acceptability and preference of health message dissemination methods. In addition, participants' awareness of, and willingness to participate in CNCDs intervention programmes in their community was explored. Methods: Participants were recruited from the existing urban Prospective Urban Rural Epidemiology study site in Langa, Cape Town. Focus group discussions were conducted with 47 participants using a question guide. Summative content analysis was used to analyse the data. Results: Four themes emerged from the data analysis: practical aspects of implementation and adherence to intervention programmes; participants' expectations of intervention programmes; aspects influencing participants' acceptance of interventions; and their preferences for health message dissemination. The results of this study will be used to inform CNCDs intervention programmes. Conclusions: Our findings revealed that although participants found current methods of health message dissemination in CNCDs intervention acceptable, they faced real challenges with implementing and adhering to CNCDs to these messages.DHE

Is small beautiful? Understanding the contribution of small businesses in township tourism to economic development

The increased importance attached by policy-makers to the anticipated developmental effects of tourism in developing countries has been insufficiently examined by academic researchers, particularly in the context of the contribution of small firms in urban areas. This deficiency is addressed by providing a review of existing research followed by an analysis of interviews with 90 tourism business located within and outside the townships of Langa and Imizamo Yethu, Cape Town, South Africa. The findings reveal tensions between the different actors involved in township tourism. While the involvement of small, locally owned, businesses is beneficial, it is limited by conflicts of interest, lack of trust, limited social networks and little attachment to the township locality. The discussion highlights the complexity of tourism's role in economic development, which has significant implications for local policy-makers

Priority focus areas for a sub-national response to climate change and health: A South African provincial case study

Introduction: The intersection of health and climate change is often absent or under-represented in sub-national government strategies. This analysis of the literature, using a new methodological framework, highlights priority focus areas for a sub-national government response to health and climate change, using the Western Cape (WC) province of South Africa as a case study. Methods: A methodological framework was created to conduct a review of priority focus areas relevant for sub-national governments. The framework encompassed the establishment of a Project Steering Group consisting of relevant, sub-national stakeholders (e.g. provincial officials, public and environmental health specialists and academics); an analysis of local climatic projections as well as an analysis of global, national and sub-national health risk factors and impacts. Results: Globally, the discussion of health and climate change adaptation strategies in sub-national, or provincial government is often limited. For the case study presented, multiple health risk factors were identified. WC climatic projections include a warmer and potentially drier future with an increased frequency and intensity of extreme weather events. WC government priority focus areas requiring further research on health risk factors include: population migration and environmental refugees, land use change, violence and human conflict and vulnerable groups. WC government priority focus areas for further research on health impacts include: mental ill-health, non-communicable diseases, injuries, poisonings (e.g. pesticides), food and nutrition insecurity-related diseases, water- and food-borne diseases and reproductive health. These areas are currently under-addressed, or not addressed at all, in the current provincial climate change strategy. Conclusions: Sub-national government adaptation strategies often display limited discussion on the health and climate change intersect. The methodological framework presented in this case study can be globally utilized by other sub-national governments for decision-making and development of climate change and health adaptation strategies. Additionally, due to the broad range of sectoral issues identified, a primary recommendation from this study is that sub-national governments internationally should consider a “health and climate change in all policies” approach when developing adaptation and mitigation strategies to address climate change

Competing coalitions: The politics of renewable energy and fossil fuels in Mexico, South Africa and Thailand

This paper analyses why middle-income countries incentivize renewable energy despite inexpensive domestic fossil fuel resources and lack of international support. We examine the politics of renewable energy programs in Mexico, South Africa and Thailand. All three countries hold abundant local fossil fuel and renewable energy resources. We argue that renewable energy programs become implementable policy options in fossil fuel resource-rich middle-income countries when coalitions of powerful political actors support them. This study presents an analysis of the domestic coalitions in support of and those in opposition to renewable energy policies from a discourse network perspective. Discourse networks reflect actors and the arguments they share to advance or hamper the policy process. The analysis draws on a data set of 560 coded statements in support or opposition of renewable energy from media articles, policy documents and interviews. Findings show similar structures of competing coalitions in all three countries, with the discourse in all three countries revealing strong linkages between environmental and economic considerations