/ 15 February 2002

The politics of cholera

South Africa’s water and sanitation policy fails to stem the tide of infection

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Edward Cottle and Hameda Deedat

The death of 260 people and the infection of about 150 000 others in South Africa makes the current cholera epidemic the worst in the history of the country. The prevalence of the water-borne disease, however, is specifically indicative of a serious failure of the government’s policy on water and sanitation provision.

From the onset South Africa’s post-apartheid water and sanitation policy and legislation was tied to a World Bank notion of cost recovery for services. This in a context where more than 78% of the water resources of the country were being [ab]used by industry and commercial agriculture, and rural people only consumed 1% of the 12% allocated to domestic consumption.

Instead of recovering the cost through subsidisation from those who profit from the use of water, the government chose to implement a reconstruction and development programme without the promised redistribution. We witnessed an austerity programme that, for example, saw the water and sanitation budget cut by R500-million in 1998.

This austerity approach also required tedious campaigns to ensure community “buy-in”, which only delayed project implementation and consequently, but not surprisingly, about two-thirds of all projects in the country proved unsustainable.

In KwaZulu-Natal we saw the suspension of 20 projects at the time due to budget cuts. Indeed, the water project for the Madlebe Tribal Authority, situated adjacent to the wealthy Ngwelezane/ Empangeni Transitional Local Council the official point at which the epidemic was noted was delayed by several months.

The Minister of Water Affairs and Forestry, Ronnie Kasrils, himself admitted that cost recovery had exacerbated the cholera epidemic as supply to people who could not afford to pay for services was cut, forcing them to seek alternative sources of water. The sources they found were contaminated with cholera.

Yet the Ngwelezane/Empangeni council, which cut the 17-year-old apartheid free-water supply through communal taps to the Madlebe areas adjacent to the Ngwelezane township, had a reserve of R98-million at the time, which Inkatha Freedom Party mayor Danny Moffat described as “a situation any business would be proud of”. While communities had to pay for cost recovery, this very same council offered various tax concessions to business for investing in the area.

Another and more striking revelation about the cholera outbreak has been the silence from government officials on the problems of sewage treatment at rural hospitals.

Research done between 1998 and early 1999 implicated at least two rural hospitals bordering Mozambique, which tested positively for cholera and were discharging effluent into streams, affecting the health of communities using these streams for domestic purposes.

The research also showed that rural hospital sewage works were in serious need of repair and maintenance and lacked the necessary chemicals for chlorination. Yet, the outbreak of cholera in the country in August 2000 was blamed upon a possible importation of the disease from neighbouring Mozambique.

The current attempt by the government to contain and prevent the spread of cholera has been taking place over the past 18 months. While the low fatality rate has been acclaimed as a sign of First-World intervention, there is still a serious problem with the preventative measures taken.

There has to be a fundamental change in water and sanitation policy that scraps the cost- recovery principle. As long as cost recovery exists the poor will seek alternative sources of water for domestic consumption.

Rural people in the newly formed Mhlatuze district municipality are still paying for water even though authorities are fully aware of the high unemployment within the area. The free-water policy of the government is benefiting the middle-class and the rich of Empangeni and Richards Bay, while the traditional black areas, such as Madlebe and Ngwelezane township, are paying water tariffs of up to 400% more than those of their white counterparts.

The extreme system of cost recovery is reinforcing the dualism of the past. The deepening of social inequalities, privatisation of health services and cost recovery will compel the poor into desperate measures for survival. Cholera and other water-borne diseases will continue to haunt South Africa for a long time to come.

Edward Cottle is the director of the Rural Development Services Network and Hameda Deedat is a researcher at the International Labour Resource and Information Group. This article is drawn from extracts from a research report on the cholera outbreak, which will be released later this month

ENDS