The case of cholera in SA cannot be viewed as an isolated event

Medical staff wait to treat patients at a cholera centre set up in the aftermath of Cyclone Idai in Beira, Mozambique, on March 29, 2019. Picture: REUTERS/Mike Hutchings

Medical staff wait to treat patients at a cholera centre set up in the aftermath of Cyclone Idai in Beira, Mozambique, on March 29, 2019. Picture: REUTERS/Mike Hutchings

Published Mar 23, 2023

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By Ratidzo Makombe

South Africa is viewed as the “America of Africa”. Its status as a Second World country in a Third World continent is slowly dwindling as they were greylisted regarding being investor friendly earlier this year. Beyond their external reputation, the government has been underperforming, and the state of state-owned enterprises is one way to judge its performance.

South Africa’s case shows an underperforming government with the collapse of several state-owned enterprises, such as the Passenger Rail Agency of South Africa (Prasa), and the bailouts of South African Airways (SAA) and the SABC. In addition, Eskom, the largest electricity producer in Africa, has been experiencing service provision challenges with load shedding up to 12 hours a day at its worst state thus far. All these state failures are linked to the mismanagement of funds and “big-man politics”. Sadly, the poor pay for the realities of these state failures.

In the first week of March, South Africa recorded six cases of cholera. According to the National Institute for Communicable Diseases, three cases were from external exposure, two were from South Africa, and one is still under investigation. It comes as no surprise that there are internally original cases of cholera within the country with the frequency of water shedding in Johannesburg, Nelson Mandela Bay and smaller towns. In the case of Cape Town, it has been reported that the city system is in danger of collapsing due to dilapidated ageing water infrastructure resulting in sewage spills. Cholera breeds in places with poor water, sanitation and hygiene infrastructure.

What is more, South Africa’s water systems run on the provision of electricity.

According to the Water Reticulation System in South Africa, water processing and distribution all include using an electric water pump. However, this process has been impacted greatly by the lengthy power cuts. This impedes good hygiene and sanitation practices at the household level, especially in households that cannot afford water. In addition, small businesses in the food industry are also affected as hygiene practices are compromised due to limited water resources. Thus, the state failures of Eskom have a ripple effect that will affect the country’s poorest.

Beyond South Africa’s mismanagement of Eskom cascading into water supply interruptions, the country faces threats of a cholera outbreak from its neighbouring countries. The World Health Organization has graded the cholera outbreak in the Southern African Development Community a stage 3 emergency. This is the highest level of internal grading due to fatalities, potential spread and limited vaccines available. Within the SADC region, Malawi has the highest recorded cases at about 51 000, followed by Mozambique with approximately 7 300 cases, Zambia with 212 cases and South Africa with the least documented cases thus far. Cases of cholera within the region make it difficult for South Africa to contain the spread of the disease because of the free movement of people within the region and the internal problems mentioned above.

To curb the spread of cholera within South Africa, Ramaphosa’s government must take drastic measures to eliminate water shedding. Problems within Eskom cannot be resolved as the new minster of electricity rightfully stated. However, mitigation measures can be implemented to ensure a continuous water supply. Firstly, there is a need to use renewable energy supplies to pump water into reservoirs, water towers and then to consumers.

This way, the problems facing Eskom do not affect the water supply. Cape Town’s water supply issues include ageing water infrastructure. They need to prioritise replacing this infrastructure over repairing it as this is a short-term fix to a long-term problem. Moreover, prioritising the replacement of the structure is critical because Cape Town is a significant tourist destination, bringing in about R800 million from December alone in 2021. The spread of diseases such as cholera has a negative impact on any economy, and South Africa’s case will be no different if Ramaphosa’s government does not take action.

Lastly, at the regional level, SADC countries need a start actioning their Hygiene Strategy of 2021 to 2025 launched in Malawi. That strategic plan has three focus areas:

Priority Area 1: Political leadership, commitment, and accountability;

Priority Area 2: Strengthening the enabling environment for hygiene practices;

Priority Area 3: Increasing supply and demand for hygiene services and focusing on behaviour change.

These strategies can all potentially change the trajectory of the SADC region’s state of affairs with the cholera crisis. However, they need to act on these priority areas sooner rather than later.

Overall, South Africa’s state of affairs is in a precarious position due to mismanagement, corruption and big-man politics, which most African countries struggle with. However, they still have a good window to resolve these issues if they start investing in long-term action plans rather than short-term mitigation measures that do not solve the root causes of the problem.

* Ratidzo Makombe is a doctoral candidate in development studies and a researcher at the University of Johannesburg’s Institute for Pan-African Thought and Conversation.

** The views expressed do not necessarily reflect the views of Independent Media or IOL.