Health clinic gardens in North-West Province, South Africa, as complex social-ecological systems Susanna Francina Cornelius 22787976 Dissertation submitted in fulfilment of the requirements for the degree Magister Scientiae in Environmental Sciences and Governance at the Potchefstroom Campus of the North-West University Supervisor: Prof S.S. Cilliers Co-supervisor: Prof T. Elmqvist Assistant supervisor: Dr. M.J Du Toit Mei 2016 2 Health clinic gardens in the North-West Province, South Africa, as complex social- ecological systems Ancia Cornelius 3 PREFACE AND ACKNOWLEDGEMENTS Living in South Africa gave me the opportunity to grow up with diversity – diversity of cultures, diversity of personalities and beliefs, diversity of rich and poor, diversity of flora and fauna and an incredible amount of different biomes. Having this privilege, I learned many life-lessons I believe I would not have learned growing up in a different setting. It taught me the value of diversity and species richness and its crucial role in adaptation and survival. South Africa has a fascinating wealth, not measured in economic status but measured in a unique mix of fauna and flora, human races and cultures, geology and biomes. It is also a great pleasure and privilege to be part of studies on the intricate ecology and sociology associated with this country. A large number of people participated in this study and made a contribution to its success and even though I may not have the opportunity to thank them personally, I would like them to know my sincere appreciation for their involvement, enthusiasm and support. Dr Andrew Robinson - Acting Head of Department and Deputy Director-General: Health Services - for his involvement in the initiation of this project and his role as mediator between the academics and Department of Health Ms M. Rakau - Chief Director of Bojanala Health District - and her entire management team for giving consent to do the survey All facility managers, groundsmen and other stakeholders – for making time to answer my questions My supervisor, Prof S.S. Cilliers, for his guidance, enthusiasm, constant support and encouragement throughout the study My co-supervisor, Prof T. Elmqvist, for his insights and for hosting me at Stockholm Resilience Centre, Sweden My assistant supervisor, Dr M.J. Du Toit, for her continual hard work, endurance at field trips and guidance throughout the study Prof S. Siebert and Mr D. Komape of the AP Goossens Herbarium (NWU) for their time and effort in identifying the plant species of this study. Dr S. Mishra for his assistance in the data collection and fieldwork Ms Elsa Esterhuizen for her assistance and guidance regarding my bibliography My family and friends for their love and support during all stages of my study All the researchers at Stockholm Resilience Centre – for their warm welcome, original ideas and friendship Dr S. Barthel, Dr E. Andersson and Dr M. Tëngo of Stockholm Resilience Centre for their guidance and perspective on my study 4 National Research Fund (NRF) for their financial support The North-West University for financial support and hosting me as a student 5 ABSTRACT The world’s urban population (54%) is currently increasing. The fastest growth rates are expected to occur in urban areas of Africa and Asia. Since urban areas will continue to expand, ecological studies should also take social influences into consideration. Changes in social- ecological systems are often studied by using a resilience thinking approach. The diversity of biophysical and social factors can play an important role in maintaining resilience of a social- ecological system. Complex or “wicked” problems can occur at the interface of social and ecological systems which contain many interacting factors making it difficult to solve. Poverty, food and nutrition security and biodiversity loss are some of South Africa’s main “wicked” problems. Although food is available in most parts of South Africa, the nutrient content of the food consumed is not sufficient. Health clinics were established across South Africa (in urban and rural areas) to provide free health care, but their gardens may also have several advantages. The first aim of this study was to determine the plant species composition, floristic and functional diversity at each health clinic garden and to compare it to home/domestic gardens in the North-West Province as well as over the different local municipalities of the Bojanala District Municipality. The second aim was to determine the resource diversity (social and physical) of these gardens and to compare them over the different local municipalities. The third aim was to determine the perceptions of the different stakeholders on ecosystem services and disservices at health clinic gardens. A subset of best practice clinics was also identified which can contribute towards developing a management framework to ensure a more resilient system of health clinic gardens in South Africa. Results showed that health clinic gardens are similar to home/domestic gardens in the North-West Province regarding dominant families, dominant genera and species representation except for the greater diversity of exotic ornamental species and endangered species present in home/domestic gardens. No clear difference could be found between local municipalities according to plant species composition. There was greater physical and social resource diversity at Moses Kotane and Moretele Local municipalities than at Rustenburg (physical) and Madibeng (social) Local municipalities. Although the individual perceptions of the stakeholders differed according to their role at the clinic garden, results showed that food and sense of place (as well as the spiritual value of the garden) were overall perceived as the most important ecosystem services of clinic gardens. Damonsville, Leseding and Reagile clinics obtained the highest score in comparison with other health clinic gardens in the Bojanala District Municipality and are good examples of best practise regarding diversity of natural, social and physical resources as well as perceptions of ecosystem services. It is suggested that the health clinic gardens should be managed using a step-by-step approach, starting with the limitations at the best practice (highest ranking scores) health clinic gardens. Communication between all stakeholders involved at the clinic gardens as 6 well as with the community is one of the key factors that can contribute to successful management of health clinic gardens. Key words: Urbanisation, social-ecological systems, resilience, nutrition security, urban gardens, health clinic gardens 7 OPSOMMING Die stedelike wêreldbevolking (54%) is tans besig om toe te neem. Die vinnigste groeikoers word in Afrika en Asië verwag. Aangesien stedelike omgewings besig is om uit te brei, moet ekologiese studies ook sosiale invloede in ag neem. Veranderinge in sosio-ekologiese sisteme word dikwels bestudeer deur van die veerkragtigheidsbenadering gebruik te maak. Die diversiteit van biofisiese en sosiale faktore kan ‘n belangrike rol in die handhawing van veerkragtigheid in ʼn sosio-ekologiese sisteem speel. Ingewikkelde, moeilik oplosbare (“wicked”) probleme wat baie interaktiewe faktore bevat, kan by die koppelvlak van sosiale en ekologiese sisteme voorkom. Armoede, voedsel- en nutriëntsekuriteit asook biodiversiteitsverlies is sommige van hierdie probleme wat tans in Suid-Afrika heers. Alhoewel voedsel in meeste dele van Suid-Afrika beskikbaar is, is die voedingswaarde van die voedsel wat ingeneem word, nie voldoende nie. Gesondheidsklinieke is in stedelike en plaaslike dele van Suid-Afrika gestig om gratis gesondheidsorg te verskaf. Die tuine van hierdie klinieke kan ook verskeie voordele vir die gemeenskap inhou. Die eerste doelwit van hierdie studie was om die plantspesiesamestelling, floristiese en funksionele diversiteit by elke gesondheidskliniektuin te bepaal. Hierdie aspekte van gesondheidskliniektuine is ook met huistuine in die Noordwesprovinsie sowel as oor die verskillende plaaslike munisipaliteite van die Bojanala Distrikmunisipaliteit vergelyk. Die tweede doelwit was om die hulpbrondiversiteit (sosiale en fisiese) van hierdie tuine te bepaal en om dit oor die verskillende plaaslike munisipaliteite te vergelyk. Die derde doelwit was om die persepsies van die verskillende deelnemers aan tuinboupraktyke op ekosisteemdienste en -nie-dienste by gesondheidskliniektuine te bepaal. ʼn Versameling van “beste praktyk” klinieke, wat kan bydra tot die ontwikkeling van ʼn bestuursraamwerk, is geïdentifiseer. Hierdie klinieke het die potensiaal om ʼn meer veerkragtige sisteem van gesondheidskliniektuine in Suid-Afrika te verseker. Die resultate het getoon dat gesondheidskliniektuine baie ooreenkomste toon met huistuine in die Noordwesprovinsie in terme van dominante plantfamilies, -genusse en -spesies. Die enigste verskille is ‘n groter diversiteit van uitheemse ornamentele spesies en bedreigde spesies wat in huistuine teenwoordig is. Geen duidelike verskil kon tussen plaaslike munisipaliteite volgens plantspesiesamestelling gevind word nie. Daar was ʼn groter fisiese en sosiale hulpbrondiversiteit by Moses Kotane en Moretele Plaaslike Munisipaliteite as by Rustenburg (fisiese) en Madibeng (sosiale) Plaaslike Munisipaliteite. Alhoewel die individuele persepsies van die deelnemers volgens hulle rol by die kliniektuine verskil het, het resultate getoon dat voedsel en “sin van plek” (asook die spirituele waarde van die tuin) algeheel as die belangrikste ekosisteemdienste