Don’t blame Zim for cholera

South Africa’s cholera crisis has nothing to do with Zimbabweans or cross-border contamination.

Health and water experts insisted this week that the widespread outbreaks in central Mpumalanga and southern Limpopo are too far away from Zimbabwe to be linked and are instead the result of chronic under-investment in rural sanitation and water services by often incompetent or clueless rural municipalities.

”Municipalities are simply not doing enough to provide clean water and safe sanitation in this country. Rural communities are being forced to use water that has been contaminated with human waste. Human faeces are landing up in our rivers and, because municipalities are failing to provide piped water, communities are forced to drink river water,” says Mvula Trust spokesperson Jonathan Timm.

”The cholera outbreak is directly linked to this problem. And even if we beat the outbreak this year, cholera will keep recurring unless government starts dedicating real resources and technical expertise to the root causes in rural municipalities.”

Mvula is South Africa’s largest NGO focusing on water issues and has spent R300-million on grassroots water infrastructure projects in rural communities.

Timm is unable to estimate, though, how much is needed to build proper sanitation facilities to prevent future outbreaks.

”It is a massive amount. The problem is so big that I simply cannot even guess how much we’d need to spend,” he says.

The more militant Coalition Against Water Privatisation (Cawp), however, projects that government will need to spend a minimum of R80-billion — the projected cost of the Gautrain project — just to address the ”hotspots” in Limpopo, Mpumalanga and the Eastern Cape.

”Government is quick to point fingers at Zimbabweans or ‘unclean’ rural villagers when in fact it is government that is responsible for the cholera outbreaks. Government has failed to keep up with sanitation or water needs in rural communities and has instead wasted taxpayer money on unnecessary luxuries such as the Gautrain,” says Cawp national organiser Patrick Sindane.

”Safe water is a basic right. If government had focused on the basics, we would not be in this situation. But instead they try shifting the blame to the victims, saying people should not use river water. If villagers have no piped or other water, what must they use?”

Authorities confirm that all rivers flowing through the Kruger National Park are already contaminated, while other key rivers in Mpumalanga and Limpopo are also testing positive for the E.coli and Vibrio cholerae bacteria that cause cholera.

Department of health statistics confirm that the sprawling peri-urban settlement of almost one-million people at Bushbuckridge on the Kruger Park’s border is the epicentre of the outbreak.

Up to 3 454 cases and 29 deaths had been reported in Mpumalanga by Thursday morning, with an additional 3 202 cases and 16 deaths reported in neighbouring Limpopo.

More than 66% of the Mpumalanga cases are women, with a further 10% being children.

The Limpopo statistics include the initial outbreak further north, on the province’s border with Zimbabwe at Musina and Beit Bridge, to which Zimbabwean refugees initially fled.

”Nationwide we have recorded a total of 6 202 cases of cholera but, as you can see, the majority of them are in Limpopo and Mpumalanga. In Mpumalanga more than 90% of cases are from Bushbuckridge, which has extremely poor access to water and sanitation” says Barbara Manzi, the regional disaster response adviser for the United Nations Office for the Coordination of Human Affairs (Ocha).

Ocha is helping coordinate a response to cholera throughout the Southern African Development Community (SADC) region. There have been small outbreaks reported in Zambia (508 cases) and Malawi (312 cases) and possible outbreaks in Namibia and Swaziland.

”Socio-economic and political factors [in Zimbabwe], growing urbanisation right across SADC, population movement and lack of appropriate response have been aggravating factors of the cholera epidemic.

”The World Health Organisation is also concerned that onset of the rainy season will spread the outbreak to other regions,” says Manzi.

”As the situation is not expected to improve in the immediate future, partners (NGOs, WHO and health departments) increasingly feel the need for a proper analysis of the risk factors, plus a definition of possible scenarios and identification of regional priorities for preparedness and response interventions in the short, medium and long term.”

Bushbuckridge municipal spokesperson Matumi Malatji conceded on Wednesday that almost all cholera patients in his district were residents without proper water or sewerage connections.

”People are getting sick by drinking or washing in river water. We have not ruled out the possibility that pit toilets may also have contaminated the water table and our boreholes. The only way we are going to stop this is to build proper sewerage systems with flush toilets,” Malatji said.

The national department of water affairs and forestry has allocated R20-million for temporary measures to supply clean drinking water, while Malatji says Mpumalanga’s provincial government has made a ”principled” commitment to a focused ”RDP” housing and infrastructure programme to build proper sanitation and water infrastructure in the area.

”Addressing the cholera outbreak as a short-term solution won’t be that expensive. But the real problem is sanitation — and it will take huge resources to fix. Sanitation is a rural competence, but the reality is that most rural municipalities simply do not have capability and have not been able to employ the kinds of technical skills necessary to deliver either sanitation or, often, even water,” says Janet Love, former chair of Parliament’s committee on water affairs and forestry.

”The Constitution requires national government to step in when either provincial or local authorities fail. That has not happened when it comes to water and sanitation.”

Love is the national director of the Legal Resources Centre, which is suing government on behalf of community and environmental groups in Belfast for lapses in local water quality.

National health spokesperson Fidel Hadebe and his provincial counterparts in Limpopo and Mpumalanga were unable to say this week how much the cholera outbreak was costing the taxpayer, or how much would be needed to prevent future outbreaks.

Hadebe confirmed that the initial response remained focused on providing clean water and hygiene products to affected communities, as well as boosting the ability of local hospitals and clinics to treat victims.

A more detailed analysis of the root causes and steps necessary to prevent future outbreaks would happen only after the crisis has passed, he said. — African Eye News Service

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