South Africa: Tackling the Cholera Challenge

While government has admitted to having missed the mark in adequately resolving water challenges experienced by several communities around the country, action is being taken to ensure access to clean water for all, writes Neo Semono.

South Africa reported its first case of the cholera disease in February.

The disease is usually spread through contaminated water and according to the National Institute for Communicable Diseases, cholera causes severe diarrhoea and dehydration and can be fatal if left untreated.

The country has recorded a total cumulative number of 1045 suspected cases of cholera in 15 of the 52 districts across five of the country's nine provinces. Of those cases, 197 were laboratory-confirmed.

Data from the national Department of Health confirmed that 43 lives have been lost to the disease which according to the World Health Organization's (WHO) Weekly Regional Cholera Bulletin, has affected 13 other African states.

In its May 2023 bulletin, the WHO characterises the South African outbreak as a "combination of cluster and sporadic cases."

Gauteng accounted for most of the cases at 176 from three of its districts followed by the Free State with 11, North West with five, Limpopo four and a case in Mpumalanga.

Of the regrettable cholera fatalities, 35 were in Gauteng, two in the Free State, four in Limpopo and two in Mpumalanga.

While this is grim, government has always been forthcoming with information related to the outbreak seen through the frequent updates in the number of cases and fatalities to the public through the media.

Hammanskraal which is located north of Pretoria, was reported as the epicentre of the outbreak.

Responding to this, government set up a temporary field health facility, the Kanana Cholera Treatment Centre. The centre has assisted over 200 people. Concerned with saving lives and stopping the spread of the disease, national, provincial and district outbreak response teams were also activated.

These teams have been able to reach over 300 contacts as part of case finding and contact tracing activities.

Concerned with developments in the Hammaskral area, President Cyril Ramaphosa visited the City of Tshwane's Rooiwal wastewater treatment works plant. He also interacted with residents of Hammaskraal.

Cognisant that government does not always get things right, the first citizen apologised to residents for government's inability to provide clean drinking water. The apology was a clear indication that the administration is acutely aware of its shortcomings.

While some paid the unfortunate ultimate price in the outbreak, government is taking accountability and working to address water and sanitation issues in Hammanskraal.

And just what are those plans that government has put in place?

An improved wastewater technology solution will be installed at the Rooiwal plant between August this year and March 2024. According to the Department of Water and Sanitation, the solution will treat the sewage better and increase the quality of discharged effluent into the Apies River, reducing the levels of E. coli in the treated sewage.

Government will also improve drinking water provision to residents and Magalies Water will install a portable water treatment plant (called a 'package plant') at its Klipdrift Water Treatment Works near Hammanskraal.

This will produce treated drinking water, which will be fed into the Hammanskraal piped water distribution system.

While some may feel that government always has a "plan" and implementation is elusive, the package plant will be implemented in a phased approach and Magalies Water will start installing the plant from July 2023. It will be completed by March 2024.

At its completion, it will provide sufficient drinking water to supply the residents of Hammanskraal with drinking water from their taps.

When the package plant is completed, the City of Tshwane will be able to stop supplying residents with water from the Temba Water Treatment Works, until the quality of water from Temba meets the required standards.

Yes, it is true that sometimes tenders to build critical public infrastructure are awarded to unskilled individuals and this ultimately undermines service delivery efforts.

Prior to the outbreak, the City of Tshwane had terminated the tender for the repairs and extension of water works and disciplinary steps against city officials implicated in the matter were underway. The city also announced its resolve to blacklist the companies that were awarded the Phase 1 contract to upgrade the Rooiwal plant following long delays and non-performance in the project.

These companies have been given time to respond to the intention to blacklist them. Should these companies fail in this endeavour, they will be listed as restricted suppliers that cannot do business with the state for a period of five years.

The maintenance and expansion of Rooiwal Wastewater Works and Temba Water treatment will cost R4 billion, with the final completion of work expected to take three years. While the maintenance and expansion of Rooiwal Wastewater and Temba Water Plants is underway, the City of Tshwane will continue to provide tankered water for residents.

According to the Department of Health, interventions taken have resulted in the transmission of the disease declining. It is regrettable that the outbreak has resulted in the loss of life. What is clear is that government has been responsive and proactive in the matter.

Our job as citizens is to maintain strict compliance with personal hygiene particularly when it comes to preparing food at social gatherings and funerals since the majority of cases and fatalities had causal links with funeral service attendance in outbreak communities.

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