The outbreak of cholera in Hammanskraal, Tshwane, which claimed more than 20 lives, is an indictment on government’s failure to provide basic water and sanitation services in the affected communities. It is also a stain on our society, which has tolerated unacceptable living conditions for too many South Africans.
After Hammanskraal, cholera infections spread to the Free State and Limpopo. But before that an earlier outbreak claimed one life in Ekurhuleni in February, which should have raised a red flag and galvanised the authorities to mount an intensive preventative campaign in vulnerable areas.
This is especially concerning because we are not dealing with a new, less understood disease. Cholera has been with humanity for the ages, and we know that it thrives in conditions of poor sanitation and an absence of clean water.
The National Institute of Communicable Diseases (NICD) has warned of the potential for larger, localised cholera outbreaks because of unsafe water supply. It also observed that the question of poor sanitation, which drives the disease in our country, has not been addressed for decades.
Despite the often-promised better life for all, many of our fellow citizens live in settlements with poor or no sanitation, with an absence of, or a dire scarcity of safe water to drink and use.
This is a growing problem that requires a determined effort to prevent and contain.
The World Health Organisation recently warned that cholera is resurging in many parts of the world, including in our neighbouring states in the sub-Saharan region. This represents, in a sense, a reversal of progress previously made in fighting the disease.
Despite the often-promised better life for all, many of our fellow citizens live in settlements with poor or no sanitation
The global health body urged countries in the region, including South Africa, “to enhance readiness, heighten surveillance and institute preventive and control measures at the points of entry to prevent and mitigate cross border infection”.
It has also pointed out that wherever cholera has been eliminated, it has been thanks to improvements in basic water, sanitation and hygiene — access to which is, in fact, a recognised human right. The tragedy in Hammanskraal, the WHO said, underlined the problem of inequality and lack of social development in many parts of South Africa.
What makes things worse in our case is that the disease has been circulating in some of our communities for a while now, but the government has not shown any urgency in alerting citizens or mounting any meaningful public education programme. Unchecked, the disease is bound to claim more lives. Not unjustifiably, the UN has described the latest cholera episode in our country as “tragic and avoidable”.
Broadly speaking, it must concern us that contaminated water spreads not only cholera, but other water-borne diseases.
The arsenal to fight cholera is well-known. To contain the disease and prevent future surges, we must provide safe drinking water, sanitation and promote hygiene not only in the affected communities, but throughout society. This will require investment in the relevant infrastructure.
Meanwhile, government’s mishandling of the water provision to poorer communities has spawned a whole industry which provides water in tankers, in effect substituting the authorities’ responsibility modernise water provision and sanitation — thus minimising the chances of outbreaks of diseases such as cholera.
The outbreak underlines how, as a country, we have allowed a discriminatory regime where some communities enjoy superior public services such as water and sanitation while others remain the forgotten people, yet to enjoy the rights promised in our constitution.
In the short term, government must institute programmes to provide affected communities with good sanitation and clean, safe water. In the long term, it must review its strategy on human settlements, which has failed to eliminate the spread of unplanned settlements without necessary, even lifesaving, public amenities.
The latest resurgence of cholera in our country should serve to remind us that the enduring inequalities in access to adequate public services will make our challenge of eliminating diseases more difficult.
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