Land of the Disability Grant

Despite my love of clinic days, Orthopaedic Clinic Days are proving extremely demotivating.

On a clinic day we see more than 200 patients. We are an extremely stretched department but we try extremely hard to keep our patients functional. By far the majority of South Africans are reliant on their hands and feet for their daily work, and so it is important that we preserve their ability to make a living. And we make a massive effort to do so.

Susan Dorothea White, "Right Hand" 2010
Susan Dorothea White, “Right Hand” 2010

And yet on clinic days every second patient tells me that they want a Disability Grant. A measly grant that brings 1,1 million South Africans at the most ZAR1,400 (USD112) per month. Hardly a worthy income.

Today again, a young man presented to me seven months after an assault. He had several damaged finger flexors and certainly some difficulty in his non-dominant hand’s range of motion – but he didn’t even come to clinic asking for help. He came to us asking for a Disability Grant.

He was so angry when I started talking about Occupational Therapy and analgesia. He had no interest in them. He kept telling me how he could not possibly work again. I was honestly afraid at one point.

But I will not become a rubber stamp.

Every month, 40% of my salary goes straight to tax. And this is partially what it goes towards: disability grants that are so small that they keep their recipients in the claws of poverty.

I won’t be one of the voices that claims that social grants are inherently bad, because I certainly agree that they have their place. But I know that MANY doctors around the country do fill out Disability Grant applications for patients who don’t qualify for them, and many patients have come to expect that. I don’t entirely blame them. Today I spent half an hour explaining to a patient why he did not qualify for a DG; and I’m pretty sure he left thinking that the stupid white doctor just didn’t want him to be happy. It would certainly be easier to tick a few boxes and send the patient on his merry way, thinking I’m the best thing since Polio drops.

Why? Why would people be so eager for a measly grant? Sometimes I think that South Africans haven’t been grown to have hope. To struggle isn’t easy, but so many people have become so used to poverty and pain. It is what people know.

There are amputees who surf. Blind people who work in IT. People without limbs who drive tractors. Young women with CP who fight for their independence every day. And I have to ask myself: what was plowed into their lives that we have not offered to millions of others? Sure, many people simply have the quality of perseverance; but SURELY part of it must be instilled, inspired, cultivated? We triumphed over Apartheid but we forgot to teach people to triumph over the little voice that says “I cannot. It is too hard.”

And this I have come to know: the many who would rather have a DG than attend Occupational Therapy, than seek a job that is disability friendly, than TRY, are really just pathognomonic of our failure to instill hope in our countrymen. We get angry with them, but we should be angry with the system that created them.


  1. BakedintheCape says:

    Meg! You hit the nail right on the head, omw! My friends sister who is 27 like myself, was in and out of the day hospital claiming she had cholesterol then it was high blood pressure, she even went to the disability doctor, my word all for a grant and she was never sick, someone actually told hospital personnel she was smoking close to half a packet of cigarettes before entering the doctors consultation room so her chest could be tight, this from someone who is perfectly healthy.

    1. barefootmegz says:

      That’s so sickening. Not only does the country not have money to give DGs to people who don’t need it, but the effects are so far reaching. Every time she goes to the hospital with false reasons she wastes resources. And while she could be an economically active individual she is just making life hard for herself too…

  2. Nancy says:

    The hill is steep and long. So easy to be discouraged. 😦
    – Nancy

  3. harveylisam says:

    Thanks for sharing, M — very well articulated. And can I also express how INSANE it is that you see that many patients a day? Like, honestly. Mind blowing. You’re a trooper.

    1. barefootmegz says:

      Thanks Lisa! It’s a little frustrating too see that many, to be honest, because I feel like a) I’m not giving them the care I’d like to and b) I’m not getting enough practice with doing the right thing in an examination sense.

      1. harveylisam says:

        I can only imagine! I definitely understand that feeling for both those reasons.

  4. Gennie says:

    Hey Missy! I am trying to invite you to view my blog (I made it private) but your username isn’t working. Is it something different than barefootmegz?

    1. barefootmegz says:

      Hey! Try barefootmeds or barefootmedstudent?

  5. wavygirl27 says:

    It’s the same in the USA. I work in physical therapy and I honestly feel that they don’t want to either find a career they can do, or they simply don’t want to work. Some people, yes, are disabled, but what about that 26 year old with chronic back pain. As soon as we hear they are going to try for disability benefits, we know one thing for sure. They aren’t going to get better. They are running through their PT because it looks good to the judge.

    1. barefootmegz says:

      It’s so sad and demotivating 😦

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