South African President Cyril Ramaphosa has announced Sunday she will soon visit Hammanskraal, where she was last May 21st declared a cholera epidemic. Hammanskraal is a city north of Pretoria, the capital of South Africa, in the Gauteng province to which both Pretoria and Johannesburg belong in the northern part of the country. At the moment people died from the epidemic it was 23.
The national government had confirmed on Tuesday 41 almost, the majority of them in the province of Gauteng, among the most populous areas of South Africa, which has about 60 million inhabitants, like Italy. The first two cases of cholera had been identified in February of this year, more than ten years after the last cholera epidemic in South Africa, which occurred between 2008 and 2009, with about 12,000 cases. However, it is not clear whether the February and current cases have the same origin: the two patients of early February had contracted the virus outside the country, while the current cases concern people who fell ill in South Africa.
The spread of cholera is on the rise in different countries of the worldespecially from sub-Saharan Africa. The data ofOMS of April report the presence of outbreaks in 14 countries and 3,412 deaths in 2023, the majority of them in Malawi, the Democratic Republic of the Congo and Mozambique.
Cholera is an intestinal infection caused by the bacterium Vibrio cholerae and, in the majority of cases, it is transmitted by the intake of contaminated water or food. It is a treatable disease, but can lead to death if not treated promptly. Lack of access to safe drinking water and adequate sanitation facilities is among the major factors in the spread. But other economic, political and environmental factors can affect the spread of the infection.
The case of Cyclone Freddy in Malawi and Mozambique, for example, shows how the increase in extreme natural phenomena is also causing problems for some countries in terms of public health. Both countries already had an outbreak of cholera when the cyclone and the resulting floods severely damaged water infrastructure, displaced more than 700,000 internally and weakened the health system – three aspects that increased the risks of contamination and spread of infection.
The current epidemic in South Africa is instead an example where political choices have had an impact on citizens’ health. In Hammanskraal, the water supplied by the municipal aqueduct comes from the river that crosses the Gauteng region. Before being distributed, the water is collected and purified in the treatment plants. For more than ten years, the residents of the area – supported by various organizations – have criticized the water management system and say they have get sick due to local water consumption.
In 2011, the South African Department of Water and Sanitation declared the river polluted by sewage and non-potable water for the poor plant maintenance of treatment. In 2013 and 2019 the government had allocated funds for the renovation of the plants, but in both cases the works were never completed: without any transparency on how the money was spent or on the progress of the works. OUTA, a South African anti-corruption organization, claims that despite tests confirming the contamination of the water, local and national authorities have not never communicated the real health risks. Most citizens of Hammanskraal feel like they are victims of a system corrupt where none of the responsible political figures has ever suffered consequences for missed interventions.
Since 2019, the city administration has started distributing drinking water in Hammaskraal through the use of tankers, but this does not seem to have produced concrete improvements. How has explained university professor Jo Barnes – who works in the department of global health, health systems and public health at the University of Stellenbosch, in South Africa – polluted water is discharged along the road, contaminating containers or surfaces. In some cases the waters of the river are used by the residents for religious ceremonies or to irrigate the cultivation land.
The water crisis is also exacerbating social inequality by making the most marginalized or vulnerable people more likely to contract viruses and diseases. Water is not only needed for food, but also for cleaning, sanitation and irrigation. Considering that many people can’t afford to buy extra cans, the common advice is to boil the tap water.
The water is distributed to the houses through pumps powered by electricity: when there is no energy, for example due to frequent blackouts, the houses do not receive water. South Africa has been going through an energy crisis since 2008, in the last two years the blackouts in the country have increased and lasted even 10 ore. People would therefore have to boil large quantities of water in a few hours, but not everyone has the means to do so or suitable environments to store it. Not to mention the costs of using energy for families often in fragile economic conditions.