A boy jumps over a drain flowing with waste water from the leather tanneries into the river Ganges in Kanpur, India, May 3, 2018. Picture taken May 3, 2018. REUTERS/Adnan Abidi

Managing the supply of safe drinking water, ensuring access to safe sanitation and practicing good hygiene are key in limiting the spread of outbreak diseases. As we find ourselves amid the COVID-19 outbreak, global governments’ ability to ensure access to safe drinking water and sanitation will also be tested over and above the health care system that will be stretched to the limit.

Global Water & Sanitation Facts [2019 publication https://washdata.org/]
The World Health Organisation (WHO) recommends that its prescribed guidance on the safe management of drinking-water and sanitation services will be enough without additional requirements during the COVID-19 outbreak.   Disinfection of the treated water will provide for rapid die-off of the COVID-19 virus.  This gives relief that most of the widely used wastewater treated technologies coupled with disinfection will be adequate during the outbreak.

As of March 2020, there is no evidence about the survival of the COVID-19 virus in drinking-water or sewage (WHO/2019-nCOV).  The document confirms that faulty plumbing and poorly designed air ventilation systems were implicated as contributing factors to the spread of the aerosolized COVID-19 virus in a high-rise apartment building. Therefore, as part of an integrated health policy, the WHO makes the following recommendations:

  • Treatment of wastewater at well designed centralized facilities with disinfection to remove disease causing bacteria.
  • Sanitation facility workers to wear appropriate personal protective equipment (PPE) which includes protective outerwear, gloves, boots, goggles or a face shield, and a mask.
  • Risk assessment must be done to determine the adequacy of the plumbing and collection systems and the treatment and disposal of sewage in order to determine the critical points and formulate a mitigation plan.
  • Emptying of pit latrines and septic tanks of suspected or confirmed COVID-19 cases should not be done unless if at capacity.

Inadequate sanitation challenges

It is likely that around the world, 80% of wastewater is released to the environment without adequate treatment (UNESCO,2017). In addition to this, over 50% of the global population lacks access to safe sanitation.  Governments with lacking sanitation facilities will have to put in place mitigation plans to improve sanitation services and also have a long term view on permanent solutions.

Kenyan slum dwellers dump a drum of excrement into a river of sewerage in the Kibera slums, 5 km (3 miles) south-east of city centre Nairobi, November 25, 2005. The Kibera slums are the most populated informal settlement in East Africa, housing more than one quarter of Nairobi’s population. There is an average of one pit latrine for every 50 to 500 people. Froggers are employed to manually clean out the sludge from latrines but they often have no protection when doing their job and suffer various illnesses as a result. Froggers are stigmatized by their community because of their job and are often threatened as they work. Picture taken November 25, 2005.

South African sanitation challenges

In South Africa, 56% of all the wastewater treatment facilities are in a poor state and require rehabilitation and skilled operators.  In addition, most of the sewage collection infrastructure is old and in need of replacement and in some cases upgrades to accommodate the increase in urbanization in the major cities and towns.  This has resulted in leakages from the collection systems due to broken and blocked pipes and non-operational pump stations.  A strategic risk assessment will be required to contain and mitigate the risks associated with the poor standard of some of the treatment facilities and collection systems.

Rapid urbanization has led to the development of informal settlements in major towns and cities.  These settlements are often overcrowded with limited emergency response accessibility, access to safe water and sanitation services.   The nation-wide lockdown requires that all citizens should stay in their homes and only leave to purchase essential items.  The challenge with informal settlements is that most people must walk quite a distance to get drinking water and, in some cases, most use a shared toilet facility with other families.  WHO recommends that suspected or confirmed COVID-19 cases should use a dedicated toilet.  This would be near impossible to achieve in settlements that have 5 to 10 families sharing a toilet facility.

Impact on Gauteng Province

Gauteng Province in Numbers [Gauteng 2030 and Beyond]
Fourteen (14) days into the nation-wide lock down, the number of confirmed COVID-19 cases in South Africa is 1 749.   Gauteng Province which is considered as the economic hub of the country, has the most cases at 41% (713) of the total cases.

About 70% of Gauteng’s 12.3 million population lives in 152 townships and informal settlements which are scattered across the province.  The province is also the most densely populated at 675 people per square kilometer compared the nation-wide average of 42 people per square kilometer.

8.6 million people in Gauteng Province who reside in townships and informal settlements who face the following challenges:

  • Some communities need to walk and queue so that they can access safe drinking water in order to practice the hand washing hygiene. This limits their ability to stay indoors for extended periods of time.
  • Communal sanitation facilities with no access to water nearby will further impact their ability of practice safe hygiene when using toilet facilities.
  • Communities with low income and those who will be unable to earn an income during the lockdown period may not be able to afford things like protective masks and hand sanitizers in order to protect themselves when they must leave their homes.

What is South Africa doing about it?

South Africa embarked on a strict 21-days lockdown period which started on 26th March 2020.  The lockdwon conditions include confinement to homes, prohibition of jogging, walking dogs, and the purchasing cigarettes and alcohol.  In addition, the country is conducting door-to-door screening of COVID-19 symptoms.

The Department of Human Settlements has identified 27 densely populated townships and informal settlements across the country.  Some families will be relocated to alternative sites in order to reduce the densification of the settlements and ensure that social distancing is practical. The communication has been facilitated through the help of 12 NGOs.  This emergency relocation is part of a long-term permanent solution since living with the virus may be the new norm until a vaccine is found. Our government’s decisive reaction to curbing the spread of the virus is commendable.

The success of mitigating the spread of the COVIC-19 will be largely determined by the behaviour of our citizens in understanding the gravity of the matter and adhering to all the conditions of the lockdown. To this extent there has also been massive advertising campaigns by the South African govern on all available media platforms.

What can we do about it?

In the end we can only influence what is in our control.  We must do the best we can with what we have. We must practice social distancing and safe hygiene related to coughing and sneezing and washing our hands frequently and after using toilet facilities.  In doing so, we project our loved ones, our neighbors, our healthcare professional and give our nation a fighting chance to reduce the number of people we will lose to the pandemic.

A focused and prioritized effort will be required by governments to address the short falls sanitation services and sustainable water supply to complement what civil society can do to limit the spread of the virus.

Teboho Mofokeng

MSc Wastewater Treatment | Pr Eng ECSA | Passionate about our water future