Health status of hostel dwellers: Part IV. Immunisation of children

The immunisation status of children (0 - 5 years) living in the Zones, an urban migrant council-built hostel in Langa, was investigated to examine the effect of migrant labour and related to this, the effect of circular or oscillating migration between Cape Town and the eastern Cape (Transkei/Ciskei) on access to this preventive health care measure. 'Road-toHealth' cards were available for 69,4% of subjects - 78,8% for those born in Cape Town and 50,8% for those born in Transkei. Immunisation Of 'Road-to-Health' card holders ranged from 71,8% to 95%. The range dropped to 41 - 79,1% if it was assumed that children without 'Road-to-Health' cards (i.e. without positive proof of immunisation) had not been immunised. Children born in Cape Town have a significantly higher immunisation coverage than children born elsewhere (Transkei accounted for 82,7% of these children). Immunisations administered in Cape Town numbered 80,6%, while 62,6% of subjects were born in Cape Town. In Transkei, payment is required for immunisation, in Cape Town it is free. By implication, cost appeared to be an important reason for low coverage in Transkei. The findings of this study suggested that hostel migrant children who had access to the Cape Town health services through working parents had better immunisation coverage than children at the home-base who seldom or never reached the city

A survey of the physical health status of pupils aged 10 - 14 years in Standards 3 - 5 at three schools in New Crossroads, near Cape Town in the Western Cape

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Editorials

Biko revisitedSyncopeAn integrated healing approac

Health status of hostel dwellers: Part I. Introduction, methodology and response rates

A health status survey (October - November 1987) was carried out among the residents of the urban migrant council-built hostels outside Cape Town at Langa, Nyanga and Guguletu, at their request. The project is introduced and the basis for the interpretation of the findings is provided.Migrant labour and the resultant material and physical impoverishment provide the social context for this study. The hostel dwellers as a migrant or mobile population presented certain research challenges. The working concepts, including the notion of the 'bedhold', employed in this study to address the mobility of the population are outlined. The methodology describes how the range of criteria selected to measure health status was investigated in a single survey. The response rates suggest that surveys carried out in the urban location of a migrant labour situation do not access the poor in the broader migrant labour situation. Findings are treated with caution for what they infer for the broader migrant population

Health status of hostel dwellers: Part V. Tuberculosis notifications

Cape Town tuberculosis notification rates for the hostel dwellers of Langa and Guguletu emphasise the severity of the problem among the poor in the city. But the enormity of the problem for the broader dependent migrant population can only be surmised from these figures. It is not possible to compile a comprehensive tuberculosis profile for a geographically divided mobile population nor provide the necessary continuity of treatment under the present politically contrived disparate health care system. Control of tuberculosis cannot wait for a political solution

Health status of hostel dwellers: Part VI. Tobacco smoking, alcohol consumption and diet

Smoking, alcohol consumption and diet were among the criteria selected to screen health status among the residents of the urban migrant council-built hostels of Langa, Nyanga and. Guguletu outside Cape Town. Smoking patterns fell within the range found elsewhere. Problems associated with alcohol consumption were exacerbated by the overcrowded hostel living conditions. Dietary patterns were not examined against the concept of an 'ideal diet'. They are understood in the context of the poverty of the hostel dwellers and in the context of limited space available in the hostel environment for cooking and storage. In comparison with a home-based migrant population, the urban migrant hostel dwellers eat more frequently, more regularly and have more variety in their diet. In the light of the findings on the lifestyle indicators of the hostel dwellers, it is concluded that improved living conditions, rather than health education that focuses on individual behaviour, will have a greater impact on improvements in their health status

Health status of hostel dwellers: Part II. Infant mortality and prevalence of diabetes, hypertension and syphilis among adults

The range of biomedical criteria selected to measure the health status of the residents of the urban migrant council built hostels of Langa, Nyanga and Guguletu were investigated in a single survey. A single survey method screens health status and provides the opportunity to examine the interrelationship between findings on the different health criteria. Here a high infant mortality rate is examined against a low prevalence of diabetes, hypertension and syphilis and some of the effects of migrant labour on the health status of migrant hostel dwellers are identified. The low prevalence of disease among the Cape Town hostel residents suggests that migrant labour, by sifting out the able-bodied and employable, reproduces a 'healthy worker effect' among the migrant population with access to the city. The high infant mortality rate, in contrast, suggests that the disease burden of the migrants is being carried by the home-base population

Health status of hostel dwellers: Part III. Nutritional status of children 0 - 5 years

The standards laid down by the National Center for Health Statistics in the USA were used to assess the nutritional status of children (0 - 5 years) in the Zones, an urban migrant council-built hostel complex in Langa, outside Cape Town. Of the children, 5,7% were below the 3rd percentile of weight-for-age (acute undernutrition). There was a significant difference between age categories and an increase in age was associated with an increase in proportion of children below the 3rd percentile. Acute undernutrition was significantly higher for children born outside Cape Town. There was a significant difference between age groups and percentage of children below the 3rd percentile of height-for-age (chronic undernutrition). Chronic nutritional levels were also significantly higher for children not born in Cape Town. Yet there were no significant differences between proportions of children under the 3rd percentile of height-for-weight (current nutritional status) for age category or place of birth. These results suggested that while in town children were adequately nourished, this was not the case at their home-base. Chronic undernutrition findings indicated an incremental negative effect of the poverty of the home-base on the long-term health status of hostel migrant children