In a country named by the World Bank as the most unequal place on earth, the coronavirus has ripped open old wounds in South Africa.
Despite the end of white minority rule more than two decades ago, some experts suggest a recent lockdown has highlighted how urban areas are still divided along racial lines.
As predominantly white South Africans isolated themselves in suburban compounds with gardens and space, community advocate Edward Molopi says many black people didn’t have that luxury.
“Data from the Western Cape demonstrates that black townships have endured a higher rate of infections than more affluent areas in the province,” the research officer with the Socio-Economic Rights Institute said.
“South Africa remains a country where extreme wealth exists alongside widespread poverty — this inequality is borne disproportionately by black people.”
According to report, the government tracking at the time showed nearly 12 per cent of all infections in the Western Cape were in Khayelitsha, the largest township in Cape Town, even though it has just 6 per cent of the province’s population.
By contrast Stellenbosch, known for its winelands and a university town, has just 1 per cent of Western Cape’s cases and makes up about 4 per cent of its population.
And now, 26 years after the end of the country’s apartheid system of oppression, the pandemic is once again highlighting lingering economic and racial inequality.
“The virus has done the country a ghastly favour by exposing the unsustainable foundations on which it is built … that must be urgently fixed,” Archbishop Tutu said.
Like almost everywhere else in the world, the coronavirus was brought into South Africa by returning overseas travellers.
The country’s ‘patient zero’ is believed to have been a man who picked up the virus during a holiday to Milan in March.
Since then, cases have been steadily rising. And Health Minister Zweli Mkhize warned this week that: “We have now reached the surge.”
“The storm that we have consistently warned South Africans about is now arriving,” he said.
South Africa has recorded the highest number of confirmed infections on the continent.
Although that could partly be because it has rolled out mass testing unlike other countries in Africa.
Testing levels remain low on the continent with the World Health Organisation warning shortages of test kits are a challenge in Africa so the real number of cases are unknown.
The growing COVID-19 numbers come after South Africa imposed one of the toughest lockdowns in the world, even going so far as to ban alcohol and cigarettes.
Currently the epicentre of the outbreak is Gauteng, which includes Johannesburg and the capital Pretoria, and accounts for a third of the country’s cases.
“We have densely populated areas within that province where social distancing is almost impossible,” he told the ABC.
“People are living in deprived circumstances in often one-room or if they’re lucky, two-room houses and social distancing becomes an almost impossibility.
“Not only that, the people themselves have not taken to the idea of wearing masks and social distancing and of course this is leading to a dramatic increase in the number of cases that we currently are seeing.”
Mr Molopi says about 3 million people live in informal settlements throughout the country and “the vast majority are overcrowded and rely on shared water points and sanitation facilities”.
“This makes it especially difficult to observe any physical distancing and practise the strict hygiene regimen recommended to curb the spread of the virus,” he said.
Mr Molopi says it is also more likely that people in these townships hold blue-collar jobs and are unable to work from home, putting them at further risk of becoming infected as they have little choice but to catch public transport that is often crowded.
Despite this, human rights defenders have reportedly said security forces were deployed to enforce lockdowns, mainly in poor black areas like townships.
South African health experts even suggested early on that a contributing factor to their lower case numbers was a youthful population, with just 3 per cent of people above the age of 60.
Experience with other health crises, including a tuberculosis outbreak, also helped, with tens of thousands of community health workers with experience in tracking contacts of tuberculosis patients now doing the same for positive cases of COVID-19.
But problems began to arise once South Africa began easing restrictions last month. At the beginning of June people were allowed outside for work, worship, exercise or shopping.
Mines and factories were told they could run at full capacity to try to revive the economy.
South African President Cyril Ramaphosa acknowledged at the time that this didn’t come without risk.
“The risk of a massive increase in infections is now greater than ever,” he said.
It proved true just weeks later. The daily case numbers are now rising by more than 10,000 a day, after less than 1,000 in April.
There are more than 250,000 confirmed cases and there have been more than 3,860 deaths, according to data compiled by John Hopkins University.
That is only expected to get worse ahead of what authorities reportedly predict will be an August/September peak, and as the country struggles with shortages of test kits, healthcare staff and hospital beds.
The World Health Organization’s Africa regional director Matshidiso Moeti warned last month that “until such time as we have access to an effective vaccine, I’m afraid we’ll probably have to live with a steady increase in the region”.
As cases grow, South Africa is doing its best to brace for a worst-case scenario.
Helen Rees, the founder of the Wits Reproductive Health and HIV Institute at the University of the Witwatersrand in Johannesburg, says there have been some successes.
“That hard lockdown did allow us to get quite a lot of things in place, so we have got surge beds,” Ms Rees, who is also on the South African ministerial advisory committee on COVID-19, said.
“We are putting in [and have put in] lots of extra beds with oxygen, we have had a ventilator project where engineering industries have rediverted their efforts to make easy-to-use ventilators for high-flow oxygen.
“So we’ve done a lot of that. We’ve also really had a massive push on trying to get people to wear masks and distancing and so on. All of that’s in our favour.”
But Ms Rees warns that Africa might be about to follow Europe’s early COVID-19 experience.
“I think we’re going to see in many settings like South Africa where you have large numbers of poor populations who are unable to have the comfort of middle-class isolation, and rubbing shoulders with your neighbours is inevitable we’re going to find the same across many other African countries,” she said.
“It’s just that we are behind Europe and the US, for example, in terms of the scale-up of the epidemic.”