Community perceptions of South African Police Service responses to substance use and the impacts on health and well-being of community leaders and substance users in a peri-urban community in Cape Town.

Erasmus, Jodilee Jade

Community perceptions of South African Police Service responses to substance use and the impacts on health and well-being of community leaders and substance users in a peri-urban community in Cape Town.

Thesis / Dissertation

2025

Publisher

University of Cape Town

Department

Department of Public Health and Family Medicine

Faculty

Faculty of Health Sciences

Abstract

In South Africa, high levels of drug-related crime, including drug dealing, theft, and possession alongside widespread substance use and a history of violent police interventions in communities, reflect ineffective policing. Reports frequently highlight corrupt policing and police involvement in crime syndicates within communities, particularly in low-income areas. These challenges and dynamics exacerbate socio-economic and health disparities and social malaise. This complex dynamic between law enforcement, substance users, and community leaders is poorly understood, contributing to a climate of distrust and conflict, conditions which perpetuate these disparities Research Aim: The study aims to explore and understand the relationship and the dynamics that exist between substance users and police officials in community settings where many substance users live, informing strategies to enhance health and well-being. Methods: Participants were recruited from a peri-urban suburb in Cape Town characterised by economic disadvantages, high rates of unemployment and a high prevalence of substance use. This exploratory qualitative study made use of three groups of participants: people who use drugs (PWUD) (n=27) (Group one), Community leaders identified by PWUD's (n=6) (Group two), and members of the South African Police Service (SAPS) (n=8) (Group three). Purposive sampling methods were used. Data were collected through focus groups for Group one, followed by in- depth one-on-one interviews for Groups 2 and 3. Data were analysed using thematic analysis using NVivo12 software. Findings were interpreted using the Social Determinants of Health Framework and the Socio-ecological model. Results: PWUD's highlighted daily dangers like high crime rates and poverty. Many felt trapped by displacement from drug use or government relocation programs. They expressed fears and frustrations about police violence, corruption, and distrust, likening officers to gang members. PWUD emphasized the need for reliable policing, as they too are victims of crime while facing poverty, unemployment, and inadequate housing. On the other hand, community leaders viewed themselves as an underutilised resource. They emphasized the need for resources and support systems, especially for the youth, and highlighted challenges such as police corruption and lack of cooperation. Engaging community leaders can improve health by fostering trust, enhancing outreach efforts, advocating for local needs, and facilitating access to resources and support services to the community. The implications for police-community relations and policy were significant. Police officers highlighted the strong connection between gang activities and substance use, noting their powerlessness due to changes from a 'police force' to a 'police service'. Officers expressed frustration over the community's lack of respect and support, corruption within their ranks, as well as inadequate resources and leadership, all of which hinder effective policing of substance use. To improve trust and restore faith in SAPS, new organisational processes are required to address and investigate illegal activities within the SAPS stations. Conclusion: Applying the social determinants of health and socio-ecological perspective allowed for the exploration of risk factors which contribute to substance use, criminal involvement and lack of trust, ultimately perpetuating cycles of poor health. By integrating the perspectives and experiences of PWUD's, community leaders and police officers, it became evident that to effectively address health inequities requires a comprehensive, integrated approach that considers complex social, economic, and environmental influences on well-being.