South Africa: COVID-19 Hygiene Necessities Hit Rural Areas

Residents in remote rural villages who have long had to manage the daily reality of no access to running water are anxious about coping with the coronavirus.

The simple act of washing his hands after using the toilet is a luxury for 55-year-old Kgutsana Heisi Molefe, who hails from Mondlo, about 20km outside Vryheid in KwaZulu-Natal's Zululand District Municipality.

Apart from not having running water, Molefe has to dig a hole to relieve himself because there are no flushing toilets in the former farming community of Jimane, situated about a kilometre from Mondlo, where he lives.

The village of about 380 households does not receive basic government services such as running water, electricity, flushing toilets and tarred roads. The impoverished residents fear that as more areas begin to be affected by the coronavirus, they will be rendered helpless.

"What I understand about the virus is that we must wash our hands after using the toilet, but how can we do that when we don't even have water?" asked Molefe, who is living with a disability after suffering a stroke that partially paralysed his left shoulder and arm.

He and his neighbours, who depend largely on radio and television for information about Covid-19, are beginning to feel anxious as the number of confirmed cases around the country continues to rise.

South Africa had reported more than 400 cases at the time of writing, with the numbers increasing daily.

President Cyril Ramaphosa announced a national state of disaster on 15 March 2020 in a bid to stem the growing number of Covid-19 cases in the country. Some of the stringent measures the government has put in place include closing schools and universities, limiting gatherings to under 100 people, restricting travel and cancelling official events.

KwaZulu-Natal had recorded its first case on 5 March when a Hilton man, who had travelled to Italy with a group of 10 people, including his wife, was diagnosed with Covid-19. He was reportedly the country's first case too.

Plight of rural residents

As the virus continues to extend its reach around the country, the residents of small rural villages wonder how they will cope if and when it reaches them.

Molefe's neighbour, who asked not to be named because he fears being victimised, said the community receives water from Vryheid, which supplies the entire AbaQulusi Local Municipality.

"We have to pray or really beg for water... There is nothing certain because most of the time they [the people who deliver the water using municipal water tanks] choose who is going to get the water, and yet water is a right."

The man, a member of the local traditional council, has rubbed local political leaders the wrong way for voicing the residents' concerns. He explained that when residents call the municipality to ask for water, sometimes the truck cannot reach their homes because of the bad terrain.

Pointing at open land in the scenic landscape, the man said the dams are dry and cows and other livestock are dying because of the drought. "To be honest, there is nothing that we can do as a community to stop the spread of the virus once it comes here in Jimane.

"We don't even have toilets. We dig holes to relieve ourselves. Some cannot afford to build seats on the existing blocks covering the pit latrine. We wash our hands with the little water that is available. We cannot even do the things that the government is asking us to do during the outbreak because of the water situation. We also need the water to cook, you know.

"If we get the virus, some people will get help, but most will die in the line at the clinics or hospitals. Even if the government does bring awareness, there is nothing that they can do for us or to protect us from the virus."

He said the best way to access information was listening to the radio. "If you don't have a radio, people think you are talking about a Toyota Corolla," the man quipped.

Another neighbour, Mzwakhe Ngema, 63, said he fears for his two children, who are two and nine years old, respectively. "I walk to C section of Mondlo with a wheelbarrow to get water from a tap for my children. I do this especially when the water truck has not come," said Ngema.

"It is not clear how we can keep ourselves safe [in terms of the virus]. I have to think twice before shaking people's hands. We have to be careful how we cough and I now have to shout at someone who coughs recklessly."

Extending a helping hand

The World Health Organization has urged people to regularly and thoroughly wash their hands with an alcohol-based hand rub or soap and water. People have also been encouraged to keep a safe distance from one another in order not to spread the virus. Touching one's face, particularly the eyes, nose and mouth, is also not recommended.

New Frame visited Khethelihle Primary School in A section in Mondlo, where teacher Bongumusa Mdluli is a beacon of hope for the 1 095 learners in grades R to 4.

"I kept hearing about the virus on the radio and on the news on the TV, and I went to school to test how well the learners understood the virus," she said. She discussed the symptoms of Covid-19 with her learners, and how they could work together to prevent its spread. "We practised how to wash hands... We used [the bleach] Domestos to wash the surfaces of the desks in every classroom."

Asked why she went beyond the call of duty to do this, Mdluli responded: "I work with many kids and it's scary, and we need to clean where we work. We have not heard from the department of health, but we have gone ahead to encourage cleanliness. There is an issue of water in Mondlo, but at least at the school we have JoJo tanks." She has also reached out to local businesses for help.

Wracked with fear

Favorite Phenyane, 67, and her neighbour, Jabu Kunene, 60, were sitting on the veranda of her house when New Frame visited. Phenyane was having sleepless nights thinking about her granddaughter, S'thembile, 25, who is working in China.

"Luckily I think S'the is in a different region to Wuhan, where the virus originated. I don't sleep wondering if she is okay. She is there working as a psychologist and teaches English to the children. It has been a year since she left. She said they wear masks but she is okay," said Phenyane, who also worried about her Easter church activities.

Kunene said, "I am not saying anything. I am just scared."

At the Mondlo taxi rank, Sipho Mabaso, who speaks for the local taxi association, said even though the virus has not yet reached the area, commuters and drivers are afraid. "In our line of work, the virus can enter and spread quickly because we work with commuters and money. When a commuter enters the taxi, you do not know what they might have. Money also exchanges hands [and] we drive different taxis and pour petrol."

Mabaso said the association's members are still unsure exactly what the virus is, which means they would not know how to warn people against spreading it.

The KwaZulu-Natal Department of Health spokesperson, Noluthando Nkosi, said it would engage the province's Department of Cooperative Governance and Traditional Affairs to provide JoJo tanks for Mondlo and communities facing similar challenges.

On healthcare workers raising awareness of the virus in rural areas, Nkosi said the plan had to be cancelled following Ramaphosa's announcement of a state of disaster.

Nkosi said health member of the executive council Nomagugu Simelane-Zulu visited the Amajuba District Municipality, under which Mondlo falls, and urged district and local task team officials to educate people about the virus.

Caring for all

Dr Mosa Moshabela, dean and head of the University of KwaZulu-Natal's School of Nursing and Public Health, said that although he hopes the virus does not reach remote Mondlo, residents are not completely defenceless.

"People in rural areas have means with which to cope with disasters and disease," said Moshabela. "We need to help them come up with a way that works for them. If you start telling them about hand sanitisers, it is not going to work."

Moshabela said it is vital that rural citizens be well informed about Covid-19. "If we are serious, we need to make sure that even people in remote areas start to talk about the virus. Unfortunately, when people in cities start to get sick, that is where they are going to go. People go home and they will take it there, and that is why we need to restrict movement so that people do not spread it to people who do not have means."

Mthandazo Ndlovu Hlahla, the manager of Oxfam South Africa's democracy, governance and strategic alliances programme, said the virus hit the country at a time when the social burden of care on women is increasing.

"The required prevention measures include heavy reliance on water. The ongoing water crisis in parts of South Africa places a huge burden on women, which this pandemic will worsen, especially in peri-urban and rural areas. In addition, women play a significant role in home-based care for the sick and indigent. Extra care and checking in on the elderly and indigent become critical with the coronavirus."

Ndlovu Hlahla called on the private sector and private healthcare providers to contribute to the national response through interventions such as testing, technology and tracking tools, and raising awareness.

"We commend the different civil society formations who have launched actions to assist. We must build on this momentum to mobilise our collective power in communities, building circles of support and solidarity that leave no one not knowing what to do or feeling alone and abandoned."

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