SOUTH AFRICA— A recent and alarming cholera outbreak has devastated communities in South Africa, resulting in the tragic loss of 15 lives and leaving 37 individuals in critical condition.
Residents of Hammanskraal, located north of the city of Tshwane have expressed their dismay regarding the handling of a recent cholera outbreak.
To address the situation, South Africa’s Water and Sanitation Minister, Senzo Mchunu, has activated a technical team to collaborate with the city of Tshwane and the Health Department.
Their main focus is to respond effectively to the cholera outbreak in Hammanskraal.
In addition, the Department has instructed the city to cease supplying water from the Temba Water Treatment plant to the residents of Hammanskraal for human consumption.
The community in Hammanskraal, under the City of Tshwane Metropolitan Municipality, has been grappling with unreliable and substandard drinking water supply for an extended period, despite the upgrade of the Temba Water Treatment Plant to a capacity of 120 megalitres per day (ML/d).
In light of the ongoing cholera outbreak, the Department has expanded the responsibilities of the existing technical team of water services and regulations experts.
Their objective is to develop an integrated model to address the current outbreak. The team will collaborate closely with the city, as well as the national and provincial Departments of Health.
Their tasks include conducting water quality investigations of sources, taps, and stationary tanks in households, and identifying the root causes of the disease outbreak.
The Genesis of the existing situation
The current working hypothesis suggests that the poor water quality issue in Hammanskraal is a result of the Rooiwal Wastewater Treatment Works failing to meet the desired standards for discharging effluent into the Apies River, which eventually flows into the Leeukraal Dam.
The Wastewater Treatment Works is located upstream of Hammanskraal and has impacted the water quality of the Leeukraal Dam, where the Temba Water Treatment Works sources water for purification and distribution as drinking water to residents.
Over the years, the Department of Water and Sanitation has issued directives and compliance requirements to the city of Tshwane to address the pollution caused by the Rooiwal Wastewater Treatment Works in the Apies River and Leeukraal Dam.
However, the city has failed to respond to these directives, leading the Department to initiate legal proceedings against the city.
The aim is to obtain a court order compelling the city to address the issues with the Rooiwal Wastewater Treatment Works.
The legal process is currently ongoing, and the city has contested the legal action.
To provide potable water to affected communities, Tshwane is currently supplying water through the use of water tankers, as these communities were initially served by the Temba Water Treatment Plant.
In 2021, the South African Human Rights Commission (SAHRC) conducted an inquiry into the sewage pollution of Tshwane’s rivers and the Roodeplaat Dam.
The SAHRC report recommended, among other things, that the National Government take over the water and sanitation function of the city in accordance with the law. However, these recommendations were rejected by the city of Tshwane.
The Department has engaged with the National Treasury to secure funding for the intervention recommended by the SAHRC.
The National Treasury responded by stating that the city had already received funding through its Urban Settlements Development Grant (USDG) allocations for the rehabilitation and upgrading of the Rooiwal Wastewater Treatment Works.
Consequently, the Department is pursuing legal action against the city to obtain a court order mandating the use of the USDG allocations for the rehabilitation and upgrading of the Rooiwal Wastewater Treatment Works.
The technical team will also conduct a thorough assessment of the various water supply systems, including those managed by the Magalies and Rand Water Boards, to verify compliance with current drinking water quality standards.
Amidst this critical situation, Deputy Minister of Water and Sanitation David Mahlobo, Deputy Minister of Health Dr. Sibongiseni Dhlomo, and Gauteng Province Lead for Health Nomantu Nkomo Ralehoko visited Jubilee Hospital.
Minister Mahlobo announced the establishment of a command center to address the cholera outbreak, with a focus on containing its spread within Tshwane and preventing its escalation to other parts of South Africa.
A call to action
UNICEF has issued a compelling call to action, urging the international community to mobilize a total of US$170 million to save the lives of 28 million individuals across 11 countries in eastern and southern Africa.
These nations have been grappling with a devastating cholera outbreak that originated late last year and continues to wreak havoc on vulnerable populations.
The gravity of the situation has been exacerbated by a severe drought in the Eastern African region, as well as heavy rainfall and floods triggered by Cyclone Freddy in Mozambique and Malawi.
Among these countries, Malawi has borne the brunt of the casualties, experiencing a fatality rate of 5.9%.
In contrast, other nations have recorded a fatality rate of around 2.2%, primarily due to the displacement of nearly a million people by the cyclone and the subsequent damage inflicted upon clean water infrastructure.
The current situation is dire, with UNICEF reporting a staggering 93,681 cholera cases and a tragic death toll of 2,023 individuals across the region.
Recognizing the severity of the crisis, the World Health Organization (WHO) has raised the alarm, highlighting that the world is facing the acute resurgence of the 7th cholera pandemic.
This resurgence is characterized by a significant number of outbreaks occurring simultaneously, accompanied by alarmingly high mortality rates.
To combat the outbreak, WHO recommends several crucial measures.
These include improving access to timely and appropriate case management for cholera patients, enhancing the infrastructure supporting such management, and strengthening infection prevention and control measures in healthcare facilities.
Additionally, effective risk communication and community engagement strategies are essential to promote behavioral change and encourage the adoption of preventive measures.
The utilization of the Oral Cholera Vaccine in conjunction with improvements in water and sanitation infrastructure is strongly recommended to control cholera outbreaks and prevent the disease’s spread in high-risk areas.
WHO emphasizes the need for member states to bolster and maintain cholera surveillance, particularly at the community level, to detect suspected cases early and ensure timely treatment, thereby minimizing the fatality rate to less than 1%.
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