A son reflects on his mother’s 20-year career as a Community Health Worker and the implications of her retiring without a pension or recognition.
It is deeply unjust that many Community Health Workers – including my mother – who have dedicated decades to our communities, have been overlooked for permanent positions in the Department of Health.
I recall the early 2000s, when my mother would leave my infant brother for weeks to attend training courses far away, to improve her knowledge and skills. My mother and her colleagues were on the frontlines of HIV-AIDS, TB, COVID-19 and other public health crises. They went door to door collecting information on orphans in need of assistance, ensured the elderly were registered for social grants, helped families obtain children’s birth certificates, and alerted social workers to those in need. Community Health Workers are the unsung heroes of our communities, and they continue to play an indispensable role in the Department of Health.
Today, I am a 34-year-old police officer with the South African Police Service, a graduate of a Bachelor of Laws and Master of Laws in labour law from the University of Johannesburg – all thanks to my single mother, who showed strength even when the system rejected her for not having a Grade 12 certificate.
All those years of dedicated service mean nothing. All those courses she attended mean nothing.
My mother will be 58 years on 28 June 2026, a reminder that her time in the Limpopo health department is drawing to a close. When she signed her renewed contract last month, she was told that the department was doing her a favour by extending the contract, and that she should not report for work once she reached 60, as her services would no longer be required.
This is an injustice. My mother began this work through an NGO. They would receive funds and food parcels through the support of international organisations to sustain them while under NGO employment. The Department of Health has repeatedly acknowledged the importance of Community Health Workers as frontline workers. Access to primary healthcare has long depended, and continues to depend on Community Health Workers’ referrals. Since the conclusion of resolution 1 of 2018 at the Public Health and Social Development Sectoral Bargaining Council (PHSDSBC), the department has failed to implement the provisions of clause 5.5. This prompted the National Education, Health and Allied Workers’ Union (NEHAWU) to approach the Labour Court for relief on behalf of Community Health Workers who have been exploited for far too long.
Accountability failures
How is the government permitted to deviate from fully implementing the labour court judgment on the permanent absorption of all Community Health Workers? What has become of respecting court decisions and honouring collective agreements? Do we still have unions that fight for workers’ rights? What precedent does the government set by failing to respect and implement court decisions and collective agreements? Should the constitutional rights to dignity, fair labour practices and freedom from unfair discrimination not apply equally to these workers?
In 2022, NEHAWU, DENOSA, HOSPERSA, NUPSAW, PSA and the Department of Health signed a further resolution extending the 2018 arrangement for another three years.
Now Community Health Workers holding a Grade 12 or NQF Level 4 qualification are supposed to be absorbed, to the exclusion of 16,687 long-serving skilled workers who founded this work. NEHAWU characterised this as a victory for Community Health Workers who had been subjected to renewable fixed-term contracts without job security, decent wages or the benefits afforded to permanent government employees. The parties agreed to finalise the absorption of Community Health Workers who did not meet the “eligibility criteria” by 31 January 2026.
Six months later, there is still no agreement on the absorption of those workers. It is concerning that the unions accepted the Grade 12 or Level 4 requirement without hesitation, a requirement that was never mentioned during the hiring of Community Health Workers. It is equally concerning that the Mpumalanga Department of Health advertised and filled Community Health Workers’ posts despite ongoing discussions about absorbing those who were excluded.
An eligibility criterion as a tool of exclusion
The Grade 12 or Level 4 qualification requirement is being used as a tool of exclusion. This criterion has not only divided colleagues but also created profound uncertainty for those without the required qualification. Although the department has indicated that such workers can be absorbed through Recognition of Prior Learning, which accounts for skills, experience and a portfolio of evidence, it shows no intention of initiating this process. The National Health Council is instead proposing that Community Health Workers without a Grade 12 be placed in posts such as cleaner, porter or general worker. This disregards years of skilled work. A salary level 2 position in the public service requires the relevant skills and knowledge, not a Grade 12 certificate.
Resolution 1 of 2018 did not distinguish between Community Health Workers with and without a Grade 12, and neither did the Labour Court judgement. The court held that Community Health Workers are essential and their jobs should be deemed permanent. The court further found that the Commissioner in the PHSDSBC erred in concluding that renewable fixed-term contracts were justified under the Labour Relations Act. The majority of those now excluded are women who volunteered when no one else would. This constitutes indirect unfair discrimination.
The road ahead
In less than two years, my mother will be shown the door, without a pension or a farewell befitting decades of service.
A woman who spent her working life ensuring that the elderly in her community were registered for social grants will likely have to join that same queue at SASSA.
A woman who raised her children alone, who sacrificed years of her life to a government that never fully employed her, will, in her old age, depend on those children to survive. That is the human cost of this failure — a mother’s dignity, deferred and then denied. She is not alone. There are thousands like her, facing the same ending: a lifetime of care work repaid with erasure.
The November 2025 agreement was important but still incomplete. Trade unions have demonstrated commitment to care workers’ rights by securing this agreement. The next step is to see it through, ensuring that every remaining Community Health Worker is absorbed with the dignity their decades of service demand.
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