Words: Abonge Chiya / GroundUp
Members of the National Union of Public Service and Allied Workers (NUPSAW) will hold protests with community health workers (CHWs) across Cape Town this month, demanding permanent public sector jobs.
The Western Cape Department of Health and Wellness (WCDHW) says it recognises and values the important contribution made by community health workers but has made no decision to permanently absorb them.
Last week, about 50 union members and community health workers employed by The Caring Network organisation in Bishop Lavis picketed at the police station.![]()
They say that because they are employed by organisations and not the state, they only get a stipend and do not get benefits such as medical aid and pension.
‘We are demanding to be permanently employed by the Department of Health,’ said Jabu Khanyile, NUPSAW provincial organiser.
‘We’ve been talking to the government several times. We’ve been marching, we’ve done everything. We are going to picket until someone with eyes and ears listens to us,’ said Khanyile.
He said they chose to picket outside the police station because they wanted a safe place to demonstrate as ‘Bishop Lavis is a red zone.’
Salaama Abrahams has been a community health worker for eight years. ‘I visit approximately ten households per week through door-to-door visits. I also attend to patients who are referred to us by healthcare facilities,’ said Abrahams.
‘We want to provide the best possible service to our communities, but it becomes difficult when the necessary resources are not available,’ said Abrahams.

‘One of the biggest challenges is gang violence … It is not always safe for us to walk around or visit households. Despite these challenges, we continue trying to reach patients because many community members depend on the services we provide,’ she said.
Abrahams said she is a single parent, and she battles to meet her monthly expenses with the stipend she gets.
‘Having a proper and sustainable wage would make a significant difference to my household. It would provide greater financial stability, help us meet our basic needs with dignity, and allow me to contribute more meaningfully towards my family’s future. I believe the work we do in our communities should be recognised and fairly valued,’ said Abrahams.
‘We work every year without a salary increase … and there are no benefits,’ said Hennah Idas, who is employed by The Caring Network.
Western Cape an outlier
In January 2025, the Johannesburg Labour Court ruled that community health workers, who for years were employed by the health department on recurring fixed-term contracts, must be deemed permanent government employees.
The Western Cape is the only province not included in the ruling because community health workers are employed through health organisations and not directly by the provincial department.
But NUPSAW has argued that the Western Cape department still has a responsibility to community workers in the province.

Dwayne Evans, spokesperson for the WCDHW, told GroundUp that the province operated with a different, long-standing service delivery model in which community health services are contracted through organisations.
‘The WCDHW’s position remains that the Labour Court matter concerning the permanent employment of certain CHWs does not apply to the Western Cape in the same manner,’ said Evans.
‘Employment conditions, remuneration and benefits are matters between the employing organisation and its employees and should be confirmed by the respective employer.’
He said the department ‘takes concerns about the wellbeing and working conditions of people delivering healthcare services in our communities seriously.’
The Caring Network did not respond to GroundUp.
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Picture: Abonge Chiya / GroundUp





