Chances are, in South Africa, if you’re suffering from a serious mental illness you will struggle to see a psychiatrist. City Press reports that at 1.52 psychiatrists per 100,000 population, the reality is that many patients will rarely be seen by one. If you’re a parent of a child who needs psychiatric evaluation, you will struggle even harder because, according to the newly released World Health Organisation (WHO) country profiles on mental health, there are only 0.08 child psychiatrists per 100 000 population.

The report says added to that, the profile shows that despite there being policy framework on mental health – the Mental Health Act 17 of 2002, as well as the National Mental Health Policy Framework and Strategic Plan 2013/2020 – there is still no suicide prevention strategy. This is despite the number of high-profile suicide deaths in the country last year alone.

The report says with a total expenditure of less than R100 per person per year on mental health and government spending only 3% of the total healthcare expenditure on mental health, experts agree that these figures point to a dire need for the renewal of focus and a change in strategy.

“There are definitely not enough psychiatrists and even more so not enough child psychiatrists. The reality is that many patients rarely see a psychiatrist, unless they are admitted to a psychiatric ward (of a public facility),” Bonga Chiliza, a professor and president of the SA Society of Psychiatrists, is quoted in the report as saying. “It also means that many people with complex illnesses will not be managed as they should be and that is why we find so many who are undertreated or ‘missed’ in terms of diagnosis.”

More than 150 country profiles of mental health resources were published by the WHO, based on data given by the member states. The report says they are intended to provide a national-level snapshot of the existence of policies, plans and laws for mental health, human and financial resources available and the type of facilities that provide care.

The South African profile reflects that per 100,000 people, there are 16.56 mental hospital beds and 4.33 general hospital psychiatric beds. While the profile noted that it did not have the total number of healthcare workers specifically tied to mental health in both governmental and non-governmental facilities as it wasn’t reported, the SA Federation for Mental Health (SAFMH) said those “blank spaces” pointed to poor record-keeping, as well as monitoring and evaluation on the part of government.

Nicole Breen, spokesperson for SAFMH, is quoted in the report as saying: “Unfortunately a large portion of the profile is accurate. The plight of mental healthcare patients in our country is severe. Under-resourcing, in particular, is a problem, as well as an astounding lack of qualified professionals.”

“The profile illustrates the low numbers of beds, wards and forensic units in relation to the number of people it captures as having a mental illness, (which is) a challenge for many mental healthcare patients who require urgent and intensive attention. The profile, however, fails to note the contributions made by non-governmental organisations (NGOs), which play an important role in caring for people with mental illnesses and intellectual disabilities within community care settings.”

The report says while Chiliza was loathe to criticise the fact that the country didn’t have a suicide strategy, Breen said having a policy would be important as it would set out a road map towards effectively tackling the issue of suicide and diminishing its prevalence.
“Policies generally bring law to life, making it implementable. Enacting a policy that is issue-specific and in line with other national and international imperatives, and steeped in research will enable state departments, NGOs, citizens and other parties to understand what their role is in ameliorating the plight of those who are suicidal, as well as in supporting those left behind when a loved one has committed suicide.

“Suicide is a specialised issue that requires a specialised response,” she explained. On this basis, she said, a separate strategy or policy would be extremely positive.

The report says both, however, agreed, that a lot still needed to be done in the country in so far as mental health is concerned. “What we are pushing for is a mental health programme fund, wherein which money will be set aside by government just for mental health,” Chiliza said, adding that “they did it for HIV and it worked very well. We would like something similar … right now.”

“I think the provinces themselves aren’t even sure how much they spend towards mental health. We think they spend even less than 1%, so a lot more can really be done.”

Breen said in the report that there also needed to be a concerted effort in investing in community-based care, alongside the hospital setting. “Quality community-based care is out of reach for the vast majority of mental health patients. Facilities are often unable, owing to more effort being put towards funds for food and operational costs, to offer proper rehabilitation programmes or equip their residents with skills so that they can either live completely independently or in a less restrictive environment. This becomes another form of warehousing.

“Investment is needed to ensure that mental health patients are able to not only survive in these facilities, but thrive, leading lives of dignity and accessing all of the services they need.”

See the 8th Modern Wonder of the World

Free entry for African citizens every Wednesday

Need fun holiday ideas this Easter for you and your family? It may help to revive memories for a family member with dementia, as well as being a very pleasant day out.

High on the list of places to visit will be the V&A Waterfront and particularly the Zeitz Museum, the largest museum of contemporary African art in the world. With 100 galleries spread over nine floors and containing more than 30 000 exhibits, it was hailed as the 8th Modern Wonder of the World when it opened in September 2017.

There is free entry for African citizens (not just South Africans) every Wednesday between 10am and 1pm, and for under 18s it is free all-year-round. The usual cost is R190 for a single-day entry.

On the first Friday of the month, Zeitz stays open until 9pm (normal closing is 6pm) and visitors get a 50 percent discount on entrance fees from 4pm onwards.

More discounts at the V&A Waterfront

Before leaving home for the V&A Waterfront, please remember its Especially for You seniors discount, which offers South African pensioners free parking anywhere at the V&A from Monday to Friday between 9am and 12 noon.

The City Sightseeing Pensioners’ Special is a wonderful opportunity to experience the Cape Town sights at reduced rates.

Park in the Portswood Parking Garage at the V&A Waterfront and take a short stroll over the road to the City Sightseeing Tour Office situated outside the Two Oceans Aquarium, where you can purchase the City Sightseeing pensioners’ tickets for half the normal price.

You must register with the V&A Waterfront at its information centre to access the Especially For You special offers.  Please note that the City Sightseeing Pensioners’ Special Tickets cannot be bought online and cannot be combined with any other specials, and you must show your SA bar-coded ID book.

For more information on the City Sightseeing tours, visit or telephone 
021-511-6000, where you can confirm the current prices and discounts.

For pensioners who prefer to leave their cars at home, Metrorail runs a pensioners’ special on Tuesdays, where the over 60s can travel free by train from any station to any destination within the Metropolitan area.

This discount applies only on weekdays during off-peak times (9am to 2pm) and remember to bring your ID book. To get to the V&A Waterfront, go to Cape Town station and catch a bus.

Activities for the over 60s in the Cape

The Western Cape offers plenty in the way of things to do and see for the over 60s, and a number of them offer discounts if you show your ID book.

With the warm sun on your face and the soft wind in your hair, you can enjoy the following:

Safaris and Nature Tours

Cape Town Tourism says that scenery and nature are the top-ranking attractions for visitors to Cape Town. These range from bush life to scenic coastal, wetlands to woodlands, forests to mountains, and from sand dunes to semi-desert.

Useful information can be obtained from Come to Cape Town on or or tel 021-300-0777. It says it has the lowest rates online, and will beat any written quote.

Beautiful Beaches

Cape Town offers a wide range of beaches, from the Clifton and Camps Bay busy beaches to the more peaceful ones at Hout Bay, Fishhoek and Noordhoek.

Boulders Beach and its penguin colony in Simon’s Town is a popular attraction.

Wine Tasting

A morning on the beach is often combined with a trip to one of the many wine-growing areas to enjoy a lunch which can range from simple but highly enjoyable cheese and wine to a full-blown restaurant meal with all the trimmings.

Come to Cape Town is also helpful here, because it can arrange a half-day or full-day wine tour.

Museums and Galleries

Back in the city there are many museums and galleries within walking distance, such as the South African National Museum and Planetarium and the South African National Art Gallery. as well as the Jewish Museum and the Castle of Good Hope museum, plus a host of others.

If you feel like a breather after a hot day in a museum, you will get lungfulls of fresh air on top of Table Mountain and at Table Mountain National Park, Robben Island, Kirstenbosch National Botanical Gardens, Cape Point and Lion’s Head with its panoramic views of the city.

For a full list of attractions and upcoming events, Cape Town Tourism has information desks with skilled consultants and plenty of leaflets and brochures. The head office is situated in central Cape Town at the Pinnacle Building on the corner of Burg and Castle Streets. Tel 021-487-6800 Fax 021-487- 6859

By Fred Roffey

Early each year we see the super-rich and their companies attending the World Economic Forum in Davos, Switzerland. It is splashed across world media.

And each year we get the same platitudes, with some exceptions, from speaker after speaker and they still come up with no real plans for the future.

A big exception was billionaire Bill Gates, who made the case for governments and individuals to fund global health initiatives in developing countries. One of the many initiatives of his own foundation has been to spend about $10 billion on the Global Fund to Fight Aids, Tuberculosis and Malaria.

However, during the conference time the collective wealth of those attending increased by $2,5 billion a day, but the super-rich and companies are paying lower rates of tax than they have in decades, according to anti-poverty charity Oxfam.

And during that time thousands of people around the world, many of them women and children, paid the ultimate price of poverty with starvation, pain or death.

All this has led to growing calls for a wealth tax. In its latest report, Oxfam said inequality was at record levels and called for a wealth tax to level the playing fields.

It pointed out that the wealth of the world’s billionaires increased by $900 billion last year, while the wealth of the poorest half of humanity, 3.8 billion people, fell by 11 percent.

“Billionaires now have more wealth than ever before. Between 2017 and 2018, a new billionaire was created every two days,” said the report.

It added that last year 26 people owned the same as the poorest half of humanity.

The People’s Health Movement (PHM) in Cape Town has joined the call for more effective taxation of individuals and companies as a way of helping to create global health care.

Karen Meyer-Borochowitz, Executive Director of DementiaSA, has signed – on behalf of DementiaSA – a statement by PHM which appeals to national governments to review public health systems to ensure they meet the needs of their populations. (See DementiaSA Signs Global Health Care Statement in this issue.)

In the statement, PHM urges effective taxation to ensure that all individuals and corporations pay their fair share of taxes to enable the funding of services beneficial to health.

It also urges the regulation of tax havens and evasions.


It is time the world had an annual conference to focus attention on the appalling state of global health care and to urge the introduction of a wealth tax.

The extreme gap between rich and poor is undermining the fight against poverty and damaging economies as well as fuelling public anger across the globe, according to Oxfam South Africa spokesperson Jabulile Buthelezi.

She said recent reports were important as they highlighted the plight of millions living in poverty, and showcased the difference between the haves and the have-nots.

“People are dying because we do not have enough doctors, medicines and nurses servicing the public health care system, which is underfunded. Poor women and children are hit the hardest. Women spend hours caring for children, the sick and the elderly when public services fail.”


To make matters worse, chronic diseases and conditions are on the increase. According to the World Health Organisation, chronic disease prevalence has shown regular growth over the past decade.

An ageing population and changes in societal behaviour, such as negative health habits, are contributing to a steady increase in common and costly long-term health problems.

The middle class is growing, automation accelerating and people are adopting a more sedentary lifestyle. This is pushing obesity rates (with all the related conditions) and cases of diseases such as diabetes upward.

Dementia is very much included in these problems. About 3% of people between the ages of 65-74 have dementia, nearly 20% between 75 and 84, and about half of those over 85 years of age in the Western World. Every three seconds, someone in the world develops dementia.

Hardest hit are developing countries with poor health care facilities for dementia, shortage of doctors and nurses, and slow diagnosis.

The time for an annual conference on world health care is now overdue.

Recent accusations of elderly neglect at several care centres in the Western Cape have focused attention on the Older Persons Act of 2006.

This is intended to protect, promote and maintain the status, rights, well-being and security of elderly people. It is an Act that aims to prevent the abuse of frail older persons, including giving them 24-hour care and support services in residential facilities.

Also required are “care and supervision services for older persons who are suffering from dementia and related diseases.”

Other services at residential facilities include:

  • Counselling services for residents and family members who need these services.
  • Implementation and monitoring of outreach programmes
  • Provision of beds for the temporary accommodation of older persons at risk
  • Respite care services
  • Training of volunteer caregivers to deal with frail older persons
  • Recreational and sport facilities

Older persons in residential facilities have the right to:

  • Appoint a representative to act on his or her behalf
  • Have reasonable access to assistance and visitation
  • Have access to basic care
  • Privacy
  • Participate in social, religious and community services of his or her choice
  • His or her own physician if he or she can afford it

Full details of the Older Persons Act of 2006 can be found online at Google. It also has a useful summary of the Act.

DementiaSA has taken a major step in recognising the important role the People’s Health Movement (PHM) in Cape Town plays in achieving health care for all people in every country.

On behalf of DementiaSA, the Executive Director, Karen Meyer-Borochowitz, has signed a statement by PHM which appeals to national governments to review public health systems in various ways to ensure they meet the needs of the population.

Karen joins well over 155 organisations from 45 countries who are signatories, plus more than 265 individuals from 40 countries.

The statement refers to the Astana Declaration on Health Care held in Astana, capital of Kazakhstan, on October 25 last year, when representatives of UN member countries met to reconfirm their commitment to world health.

Karen points out there is a reference to NCDs (non-communicable diseases)  and the WHO (World Health Organisation) has declared dementia an NCD, yet in South Africa dementia is not recognised as an NCD.

The Astana Declaration regards primary health care (PHC) as a cornerstone of universal health coverage (UHC) , whereas the PHM believes PHC is broader.

The Declaration recognises that it is “ethically, politically, socially and economically unacceptable that inequity in health and disparities in health outcomes persist.”

However, the PHM says “nowhere are the fundamental economic and political causes responsible for this as well as for widening inequalities worldwide explicitly stated.”

The PHM statement continues: “Attaining the highest possible standard of health is a fundamental right of every human being, as stated in the Constitution of the World Health Organisation .

“In 1978, world leaders made the historical commitment to achieve health for all through Primary Health Care in the Declaration of Alma-Ata.

“We express the need for urgent action by all international agencies and governments, all health and development workers, and the world community to protect and promote the health of all the people of the world.”

Included in the PHM statement are the following:

  1. Attainment of the highest possible level of health is a most important worldwide social goal whose realisation is the responsibility of governments and requires the action of many other social and economic sectors in addition to the health sector. People’s health depends on working and living conditions that promote flourishing lives and a healthy and protected environment.
  2. Equitable economic and social development will require rejection of the currently dominant neo-liberal paradigm and establishment of a sustainable and equitable economic order globally and nationally. Among other interventions, regulation of financial flows and of tax havens and evasions are urgently needed.
  3. Effective and accountable global governance for health is required to realise PHC. The statement says this should include means of effective taxation to ensure that all individuals and corporations pay their fair share of taxes to enable the funding of services beneficial to health.

DementiaSA would like to introduce you to our amazing brand ambassadors Bradley Fortuin and Trevor Abrahams, who drive for dementia at various biker rallies.

Dementia and those affected have many friends in the biking fraternity, and the Brand Ambassadors for DementiaSA were well received when they were introduced at the CMA Rally and distributed some brochures.

Bradley Fortuin, who was at the rally, said he chose to partner with DementiaSA because he wanted to make a difference by touching people’s lives.

He pointed out that CMA is also a Motorcycle Ministry. “If God can use Trevor Abrahams and I, it would be pleasing to my heart, because for me it’s the awareness and support for the family and, most importantly, the person with dementia.”

Trevor said it had been an amazing awakening for him to attend his first Dementia Awareness course. “My grandmother was a dementia sufferer and lived with me and now it’s my mom who is diagnosed with an aggressive type of dementia. She also lives with me.

“This time around I wanted to be more prepared to firstly cope with this disease and also be a better help to my mom.

“Also, I thought I could spread the word about what I would come to know about those who could need that help, especially among the biking fraternity.

“We did a little promo about dementia awareness at the CMS Rally and going forward, we would like to broaden our presence at these rallies – Bradley has some good thoughts about this – and hence spread the awareness wherever we go.

“Lots of people have heard the term dementia and they know of someone, through conversation, who has family or friends with dementia. I met someone the other day whose family member was diagnosed with dementia at 47 years young.”

If you are a biker and attend rallies, please look out for our Ambassadors.

We would like to encourage all readers to get involved and help us spread the word about DementiaSA and what we do.

Feel free to invite us to your events, church meetings or any awareness opportunity you may have that would allow us to educate people about dementia.

DementiaSA focused on caring (and love) for the many people with dementia for the month of February.

Families, hospitals and clinics were approached during the month to give more care than usual to dementia-affected people.

“During February we gave an extra-strong focus on the loved ones with dementia, and on the people who care for family members,” said Karen Borochowitz, Director of DementiaSA.

The aim was to let people know how much we appreciate the love and care they give to people with dementia.

Karen was interviewed on Smile FM, GHFM and CCFM, just to name a few. DementiaSA radio advert was played on over 10 different radio stations. This helped create awareness about what it’s like to live with a dementia family member.

Staff members visited dementia patients at their facilities and gave them little gifts.

“Others called at doctors’ offices and waiting rooms and left brochures about dementia for patients, plus small gifts of appreciation for allowing us to put our brochures in their offices.”

Statistics show the severity of the dementia problem. About 3% of people between the ages of 65-74 have dementia, nearly 20 percent between 75 and 84, and about half of those over 85 years of age in the Western World. It is the 8th leading cause of death for the elderly in the USA.

Every three seconds, someone in the world develops dementia. Developed countries have budgeted for a big increase in spending on retirement centres and health clinics with dementia treatment facilities. In developing countries there is some improvement in treatment, but diagnosis problems and lack of facilities are in many cases hampering progress.

In South Africa, DementiaSA has created a steadily increasing network of support groups, social workers and facilities where nurses and other medical personnel are trained. Space at its offices at 79 Roeland Street in Cape Town was recently increased to allow for a big demand for its training services.  Tel 021-421-0077/78