Water Cuts & Cholera situation in City of Cape Town: City, Departmental & civil community responses

Meeting report

Opening remarks by Chairperson
The Chairperson noted that the Portfolio Committee had done a legacy report some weeks previously, based on submissions from organisations about water cuts in Cape Town. She noted that there had been several disturbing reports, including reports on a woman who, during her pregnancy, had no direct access to water. Everyone had a constitutional right to water, and it was part of the Committee’s oversight role to enquire about this. The City of Cape Town Municipality (CCT) and the Department of Water Affairs and Forestry (DWAF) would be called upon to answer on water devices installed without people’s permission.

City of Cape Town (CCT) presentation
Councillor Clive Justus, Mayoral Committee Member, Utility Services, City of Cape Town, affirmed a commitment to ensuring the Constitutional right to water, and to sound intergovernmental relations conducive to that.

He noted that the Water Scorecard reflected a 26% savings on unconstrained water use. Collection rates had risen from 67% to 92%, indicating people’s willingness to pay for service. He noted that the cost of water in Cape Town was the cheapest in the country, possibly in the world.

A leaks programme had been instituted, schools and 32 000 indigent properties were visited, and leaks were repaired at no cost. A water pressure reduction scheme had been instituted in Mitchells Plain, to prevent leaks. 40 kilometres of water pipe replacements were planned, of which 18 had been completed. 30 000 water management devices had been fitted, and 20 000 more would be fitted during the current year. He noted that other achievements included ten DWAF awards being earned, as well as achieving ISO accreditation. There was compliance with water access as a constitutional right.

Mr Trevor Blake, Director: Revenue, City of Cape Town spoke to legal obligations. Monies had to be collected, and there had to be a credit control policy. Such a policy had to accommodate poor people and senior citizens. It had to spell out approaches to people who were financially able to pay but did not, and those who were willing to pay, but were unable to do so. The position of child-headed households also had to be considered. A decision had been reached to classify households with an income below R2 880 per month as indigent. These would receive free benefits. Properties valued at under R88 000 did not have to pay rates, and those valued at under 199 000 received a R30 indigent grant.  Also classified as indigent were people aged 60 years and older, and child-headed households. There had been a once off debt write-off to the tune of R2 billion, and a R1,5 billion write-off of parked arrears from the previous administration.

He stated that the water supply of domestic users was not disconnected. Flow management devices were installed to make water flow more slowly. This was not a prepaid water meter.

Mr Lungile Dlamini, Director, Water Services, City of Cape Town said that debt management and cost recovery required a technology that complied with access rights. All inputs had to be paid for, to sustain water and sanitation operations.

Flow management devices were installed where no payment had been received for three months. Officials engaged with households before installing of such devices, but they were installed in all new housing developments. They were initially set at full flow, but could, over time, be adjusted to the customers budget. Old plumbing had been repaired, as well as leaks. R50 million in debts had been written off. Registered indigents who wanted the device would get 10 620 liters of water per month. This was a flexible device; unused water could be transferred to the next day or customers could request more water. They would in future be installed in all properties.

Environmental Monitoring Group (EMG) and Water Caucus (WC) submission
The delegate from EMG stated that the Phiri case ruling in Johannesburg was related to water device management. There was another side to the coin of leak repair. People were receiving summonses, and being evicted in respect of unpaid amounts. The EMG believed that the water devices had the effect of ignoring personal circumstances. Use of these devices did not consider the realities of large African families, nor the water needs arising from the Aids epidemic. It was essential to stop the operation of the device, and first evaluate the impact on customers. Installation of such devices was a de-humanising instrument, as they isolated the individual. They flew in the face of a belief in community and society.

The Mazibuko case in Johannesburg showed similarities to the position in the Western Cape. When people could not pay, the officials would be sent in. In the Phiri case ruling, a water flow device had been declared illegal, yet currently a modified device was showing itself. People in Khayelitsha were getting water at a trickle. Such a device was not installed in affluent areas. This was dehumanising. There had to be negotiations with the Council to revise the system.

Ms van Zyl submission
Ms van Zyl submitted that her water supply had been cut for 4 months during her pregnancy. Her child had never tasted water from a tap in their home. Water had to be obtained from neighbours, who eventually complained that this was water for which the neighbours were paying. She had eventually been assisted in the restoration of water supply, but during the current year there were interruptions of the water supply occurring every day for an hour. This also occurred in neighbouring houses. Ms van Zyl did not trust the device.

Khayelitsha and Wesbank residents’ submission
A resident from Khayelitsha noted that in her neighbourhood, there was one tap shared by many. On weekends there was no water. There was a pre-school centre in the area that was affected. People had to relieve themselves in the bushes. This device was not helping the community.

Another resident from Wesbank submitted that when the blue meter was installed, there had been a promise to fix leaks, but this was not done. Her whole bathroom had been flooded. She had to pay for unused water. Only one leak had been fixed, and officials refused to attend to others. In a neighbouring house, sixteen people had been left without water for a week, following the installation of a meter, and they had also not had leaks fixed. The residents were forced to make expensive telephone calls, but there was no response.

South African Municipal Workers Union (SAMWU) presentation
Mr Lance Veotte, Branch Chairperson, SA Municipal Workers Union (SAMWU) described the flow device as a vigorous cost recovery mechanism. The City had said that it would be tested as a pilot project for six months, followed by monitoring. However, he questioned what had been established by the pilot project, and noted that these devices had been installed only in the poorer areas, among others Delft, Macassar, Retreat, Gugulethu and Langa. This was discrimination.

Three meetings had been held with communities in Wesbank, to which the Council was invited. It turned out that officials themselves lacked knowledge about the device, and the policy behind it. They said that it had been installed to save water. The community responded that they lacked the showers, baths, hot water devices and pools that used up water in large quantities and queried whether such devices were installed in the more affluent areas. There was intense community frustration. The devices cost R700 apiece, and were powered by a lithium battery that had to be replaced, at cost, within two years.

Mr Veotte quoted excerpts from community meetings in various areas. He noted that in Wesbank there were reports of water cuts every Monday, responses were frequently only forthcoming after three days; water would be switched on, causing pipes to burst; a meter had been installed without permission; a resident received a summons, with both water and electricity being cut; a meter had broken down and a resident was without water for a month; officials would not inform a resident about the purpose of the meter, and jumped over a wall to install it, violating privacy.

Wesbank residents protested that they did not use water for luxuries.

Witsand residents reported water cuts during the day, with water only turned on during the early morning hours. Residents had to walk to informal settlements for water.

Mitchell Village, Tafelsig residents reported a promise of 350 litres of free water per day, yet enormous water bills had been received. One woman with a baby had had her water cut the previous Saturday evening, and it was not yet turned on again. During the previous week, water had been cut in four houses where elderly people lived. Residents complained that they were not in the habit of watering lawns so this was unnecessary.

A Tafelsig resident, John Kivedo, reported a water cut on 5 January that lasted for three days. His neigbours had the same problem. Furthermore, the meter box batteries were flat. These meters were wasting money. Bills were received that were based on estimated readings. Officials did not come out to do direct readings. The bills were often exorbitant. No workshops had been conducted about these meters, and they had only been installed in poor areas.

Discussion
Ms P Tshwete (ANC) asked who had been consulted about the installation of devices. It was clear that most did not want them. She further asked what had happened to the promised evaluation after six months.

Mr J Arendse (ANC) remarked that reports of total water cuts had been received for some time now, and he questioned whether the last resort should not be the trickle system. He said that the problem was that Members did not live in the affected areas. The Council had made a good presentation, but situations on the ground had so often been found to be different to reports about them. He was disturbed by frequent reports about complete cut-off.  Whilst it was true that water saving was indeed a priority, South Africa being a water stressed country, he questioned whether there had been a breakdown of water savings and how much was really saved by cut offs.

Ms E Lishivha (ANC) wondered if Council bylaws took people into consideration at all. Water cuts were not the same as electricity cuts. Water was needed for the processes of birth and death, and for treating illness. It seemed that the Council looked to residential areas for water savings, when it could direct itself more properly to business and industry.

Ms S Maine (ANC) concurred with Mr Arendse about reports of cuts.  She queried whether communities were informed about water flow devices. The council spoke of providing the cheapest glass of drinking water in the world, but it seemed that communities were perhaps only having access to one glass of water per month. Community leaders could at least have been informed. To leave women and children without water was totally unacceptable. If the water flow device was such a good one, it should rightfully have been installed everywhere.

Ms N Mathibela (ANC) asked if the Council had instituted Batho Pele principles, and if there was a monitoring and evaluation unit to monitor citizen satisfaction.

Mr A Madella (ANC) said that the facts presented by the Council were impressive, but he too would like to know what was actually happening on the ground. The health implications of water access for the poor were massive. In New Tafelsig, people had moved in and then received bills that did not correlate with their tenure. Developers had used water on the site that was eventually charged to the occupants of houses. The poor received free houses, only to be driven from them. He asked if recipients of the hi-tech water flow device were consulted, how the devices worked and who was expected to pay for battery replacement.

He thanked community representatives for their submissions. The cholera epidemic had reached the Western Cape, and water access problems compounded the problems of preventing and containing the disease. Cholera was a water-borne disease that could take hold where good-quality running water was scarce.

The Chairperson expressed the conviction that all parties had to appear before Parliament, in cases where community issues were involved. The City of Cape Town had spoken of a need for governing bodies to find each other.

She was outraged by the report about the baby who had never known water from a tap in its own home. This pointed to a situation where the Constitutional right to water did not exist. It could not be said that the whole city was represented in the meeting. However, there was definitely a crisis. She had received estimated water bills herself. It was true that water had to be conserved, but she said there was no reason why an estimated bill should run to R800, and she questioned how it was possible to have a R7 000 water bill.

The Chairperson said that DWAF had to assist in defining the meaning of the Acts regulating water supply. Everyone had to have access to water and sanitation and water services authorities had a duty to ensure efficient and economical access. The Water and Water Services Acts had been drafted to redress past inequalities. Equity had to be a top priority. The Minister had developed a strategy pertaining to this. With reference to equitable access, she questioned why there was an emphasis on the poor areas when it came to saving water, and whether there had been savings in, for instance, Constantia and Plattekloof. She asked whether it was really a case of protecting the water resources, wherever they might be situated, or whether the poor were being told that they were the only ones whose access had to be controlled by a device.

She stated that the Committee was awaiting a response from the City of Cape Town.

Mr Justus replied that the spirit of the engagement was to alert the water authority to community experience. There had been insightful questions. He was there to hear, not to defend. The Department of Water Affairs had to address all complaints. There had to be immediate and effective remedial action. The City was committed to the Constitution, the Bill of Rights, and Batho Pele. There was a sincere desire to intervene. He could only, as yet, make commitments, but specifics could not yet be addressed.

The City of Cape Town was committed to the best water at the lowest price. It did not desire to have a situation like the one pertaining in Sedgefield and Knysna. It had to ensure that water was made available. The Committee had lauded the City policy, but policy had to be effective in practice. Practice was based on human intervention, and this was prone to human deficiencies. A customer satisfaction survey was indeed in place. This matter was taken seriously. Previously disadvantaged groups indicated that service had improved, whereas formerly advantaged groups experienced decrease. The City pursued an equitable policy. Integrated Development Planning (IDP) documentation was employed, and the budget was based on customer satisfaction surveys.

Ms September stopped Mr Justus at this point. She said that there were questions that could be answered on that day.

Mr Justus answered that he was dealing with the matter of consultation. Concerning the specifics of water devices, eight forums had engaged with communities. Water management device contractors were trained strictly about policy and practice. They would be disciplined. The City would not impose what people could not bear.

Ms September repeated that people in the room expected direct responses, and so did the Members of the Committee. She proceeded to spell out clear guidelines for such a response. The issues that had been raised today had to be dealt with. The question remained whether the Municipality was adhering to the existing legislation. In regard to the ruling about water management devices, there should be evidence of consultation, and ideally statistical evidence. She asked whether the City could point to specific meetings, held at specific venues. The City would be held to its own commitments. She asked the City, within one week, to come up with a plan of recovery and restoration.

The same would be required of the DWAF, with specifics of what was being done and how the Department would restore what the legislation required.

She noted that the City of Cape Town had to enter into partnership with the Department of Social Development, on behalf of the poor. Costs had to be recovered. The City had a revenue base to retain, but some people simply could not pay. Intervention was needed. It was not necessary to deal with everything within a week, but she did expect a response. She then asked whether the Department and City could commit to appearing before the Committee again within a week.

Ms Pam Yako, Director General, DWAF, replied that the DWAF would do its homework and return.

Mr Justus answered that it was hard to respond to specifics.

The Chairperson said that she wanted a simple yes or no answer as to whether the City of Cape Town could return within a week with responses conducive to taking the process forward.

Mr Justus remained equivocal. He again referred to specifics.

Ms September persisted with her request for a definite commitment.

Mr Justus asked what day of the following week the meeting would be scheduled.

Ms September replied that it would be on Budget day.

Department of Health presentation on the cholera outbreak
Dr Thami Mseleku, Director General, gave a brief explanation of how cholera was transmitted. He emphasised that it was a waterborne disease, and commended Mr Madella for the definition he had provided earlier. He stressed that it was spread through the contamination of water.

Dr Frew Benson, Department of Health, then addressed the Committee on spread factors, responses, challenges and recommendations (see document). He noted that cholera was spread through a bacterium, and followed the faecal-oral route. The spread was via contaminated water, but food could also become contaminated in the process. The symptoms manifested were sudden watery diarrhea. The incubation period varied between two hours and seven days, with a median of two days.

South Africa had experienced cholera epidemics before, with the previous one in 2003. The poor were mostly affected. Access to water and sanitation were determining factors.

The disease was recorded from 15 August 2008 in Zimbabwe, and had spread to Mpumalanga by November. By mid-December it had spread down the N1 route, especially to Capricorn and Sekhukune. The movement of people from Zimbabwe contributed to the spread down into Gauteng and the Free State.

Regarding the status of the disease, he remarked that the fatality rate, in the absence of treatment, was 50%. With proper treatment, this figure could be as low as 2%. The outbreak had commenced at Musina, which was only 10 kilometres from the Beit Bridge border. Capricorn, Sekhukune and Waterberg were affected, with many affected in Vhembe. Limpopo had been the first province to be seriously affected, with 3 680 recorded cases. For Mpumalanga the figure was 4165, with 30 fatalities. Three people had died in Gauteng. Two cases had been reported from KwaZulu Natal, one of them a fatality. Nine cases had been recorded in the Western Cape, the most recent being on the previous day.

In Limpopo, the contamination of rivers had caused a flare-up. The occurrence of rain had caused contaminated faeces to be washed into rivers, exacerbating the situation.

In the Bushbuckridge area, rivers were shared with Limpopo, which contributed to the spread. There were few cases initially, but these had escalated to around 200 cases per day.

In Mbombela district, cases decreased due to the availability of trucked-in water.

The migration of infected people, and easy travel, especially over Christmas, had contributed to the spread. Another problem was that those mildly infected did not seek help, but could still contribute to the spread.

The response in South Africa had been to activate a national plan, with the Health Minister mobilising Cabinet, to collaborate with the DPLG and the DWAF. A national multi-sectoral Outbreak Response Committee was established. International health partners were mobilised, and alert messages were posted to the provinces. Outbreak response teams were established in all provinces. These met on a weekly basis.

Medical operatives were trained to cope with the specifics of the disease. Notably, cholera was treated through aggressive rehydration.

The DWAF formed part of the multi-sector response team. There had been door to door community mobilisation, general mobilisation of resources and involvement of role players like the Red Cross. Tent treatment centres were erected.

Water and sanitation challenges consisted in the fact that many depended on contaminated sources or containers. Formal water was often not sufficiently chlorinated. Interrupted water supplies and overstressed water systems contributed to spread. Water stored at communal taps could be contaminated.

Challenges to the health system proceeded from the fact of nine countries being affected. Health systems were unprepared, weighed down by the existing burdens of tuberculosis (TB) and HIV. Treatment was hampered by inadequate medical supplies and personnel.

Dr Benson recommended that Department of Health should co-ordinate with DWAF and DPLG to identify risk areas. There had to be health promotion drives. Institutions had to be alerted and medical stock levels maintained. Escalation had to be anticipated. Local authorities should look to water and sanitation. The provision of safe water was crucial. There had to be a preparedness to truck in water to affected areas. He stressed that the Department of Health (DoH) could not deal with the matter on its own. As with other diseases, the most vulnerable were affected. No province could be at ease. The disease could spread to all provinces.

Dr Mseleku added that, because of its waterborne nature, it would be incorrect to blame foreigners for the spread of cholera. In Mpumalanga it had spread down the N1 route, but also through our own contaminated rivers. Spread of the disease could not be stopped through closing of borders. The solution lay in the provision of safe water supplies.

DWAF presentation: Cholera outbreak response in Limpopo and Mpumalanga
Ms Pam Yako, Director General, DWAF, noted that her presentation had been prepared before liaising with the Department of Health.

Ms Thandeka Mbassa, Deputy Director General: Regions, DWAF, pointed out that the role of the DWAF had changed from provider to that of supporter and regulator.

The DoH had chaired a Southern African Development Community (SADC) Troika meeting on health and water in December 2008. Through the SADC protocol, the DWAF intervened in Zimbabwe. It also intervened in Limpopo, Musina and Musina-Madimbo.

Ms Mbassa drew attention to a case study of DWAF support in Vhembe, and challenges experienced there. The municipality regularly underspent on Operation and Maintenance (O&M) refurbishment. Ineffective O&M lead to disruptions of water supply, which increased the likelihood of transmission.

A case study in Bushbuckridge, Mpumalanga, likewise pointed to lack of access to safe water and sanitation facilities. Here also, there was inadequate investment in refurbishment and O&M. The sanitation backlog in this area was the highest in the province, and yet sanitation had not been equally prioritised by the District. Municipal non-compliance had emerged as the most serious challenge, as it hampered the development of water and sanitation infrastructures. Pro-active strategies were needed. Some municipalities were clearly unable to cope with their existing resources.

Ms Yako added that the DWAF had to review its own protocols, especially with regard to water and sanitation challenges. The Department could strive for more accuracy in its predictions. She noted that the outbreak had tested DWAF capacity. The Department had to respond to a crisis, but it also had to carry on with its tasks of continuous oversight and support. Laying criminal charges against a municipal director did not solve problems related to continuous regulation. More than just money was needed to improve municipalities. There was also a shortage of skills. In its role as regulator, the capacity of the DWAF infrastructure was stretched. Resources were invested in regulation, but it seemed that infrastructures had been established with a smaller number of people in mind than were currently affected. There were thus ongoing challenges.

Discussion
Ms September commented on the “people factor”. She suggested that the Department keep track of the number of community workers and councillors involved. The Department could encourage people on the ground to bring their own skills into play, especially as regards prevention. A ripple effect could be set in motion.

Ms Tshwete commented on inadequate human resources. She enquired about the persistence of insufficient health promotion, and the state of materials made available.

Mr Madella expressed appreciation for the DOH and DWAF response and co-operation. He said that without their actions, the situation could have been much worse. He asked if more could be done to contain and eventually eliminate cholera, and what plans were in place to address water quality challenges. He referred to the sanitation backlog related to the bucket system, which contributed to the problem. He then enquired to what extent the backlog had been addressed. Contamination through rivers could not be dealt with at the source, but the symptoms could be dealt with. He called for a concerted effort to stop the disease in its tracks, to prevent a future resurgence.

Dr Mseleku replied that stakeholders were being mobilised for health promotion at the community level. Communities were being educated and involved for prevention. People had been trained in Mpumalanga, and trained communities could train others. The escalation that Dr Benson had referred to created a need to increase production materials, and the process had to be taken into different languages. Independent Electoral Commission (IEC) informational materials had to be increased in a crisis. Health promotion campaigns were up and running. The current emphasis was on community cure of TB and AIDS. The same numbers and resources did not yet exist for other health promotion areas.

The provision of medical supplies was related to provincial budget issues. Adequate supplies of re-hydrants to treat cholera might not be available at a given place and time. Intervention in Zimbabwe had proved that the solution had to be a political one. Supplies were inadequate in neighbouring states, and this was an issue to be negotiated.

Dr Mseleku said that there was also a need to step up the education campaign. There was a lot of water moving around in the country, and people had to be educated to stop the spread of the disease. Collective resources had been mobilised for intervention in Mpumalanga and KwaZulu Natal, but he warned that if there had been simultaneous cholera outbreaks in five provinces this would not have been possible.

Ms Tshwete said that the outbreak seemed to have caused comparatively fewer deaths in Swaziland than in South Africa.

Ms X Makasi (ANC) commented on the state of medical care in Mpumalanga. The high death toll suggested that this was inadequate. 

Dr Benson replied that the incidence of cholera in Swaziland might be higher than supposed. In Mpumalanga, deaths had occurred because cholera was not recognised quickly enough. The diarrhea that marked the onset of the disease had been taken to be of the common variety.

Dr Mseleku concurred that it had not been health-care problems that caused death in Mpumalanga. The Red Cross was mobilised, and emergency care centres set up.

Ms Mathibela wondered how long the complaints about capacity would continue. In Sekhukune, a nodal district, there had been capacity problems for the preceding 10 years. Long tendering processes were obstacles to progress. District councillors had been tasked, but improvement was not forthcoming.

Dr Mseleku responded that in Mpumalanga there was indeed a pattern of re-occurrence in certain areas. In Bushbuckridge talks would be held with local government, and a year later the same problems would still be apparent. There was a stubbornness in Mpumalanga that was disturbing.

Ms Yako said, in regard to Mpumalanga, and particularly to Bushbuckridge, that initiatives had been presented, and plans for quality water put in place. A municipal indaba had taken place in September 2008, on which the Department could still report. In regard to regulation and compliance, there was the possibility of setting up a single unit to deal with that. This could take the form of an investigative branch, headed by a Deputy Director General.

Ms Makasi pointed out that in Bushbuckridge, there was an inadequate water supply at some clinics. Councillors were disempowered. There had to be better integration of local and provincial government.

Ms Lishivha added that people were still getting water from streams in Bushbuckridge, and she asked what could be done to make the municipality take up sanitation as a priority.

Mr J Arendse (ANC) referred to the KwaZulu Natal outbreak and the role of unsafe water sources, especially after floods had occurred. A watch campaign was needed to educate people about hygiene, so that there could be preparedness before the next rainy season.

Ms Yako said that the monitoring of raw water quality could best be undertaken by a DWAF branch specifically devoted to that. It had become a question of river management. The Department needed funding to build bulk infrastructure, and to implement that at the municipal level.

The Chairperson suggested that the rollout towards water and sanitation targets be reviewed, especially with respect to clinics and schools. In certain provinces, the water and sanitation needs were particularly urgent. The existing state of water and sanitation provided an opportunity to get involved with the river project. The DWAF, DPLG and DoH could establish a partnership towards this end. It had emerged from the meeting that flooding of rivers created the potential for disease. There was also waste contamination of rivers by industry. This may have been related to a 38 year old woman dying of cholera that was contracted on a chicken farm in Kliptown, in May last year, as reported upon by Drum magazine.

The Chairperson noted that she was impressed with DOH and DWAF interventions. She could supply Mr Mseleku with documentation on the Delmas issue. There were still municipalities bent on going their own way. She reminded the Department of Water Affairs that it must still provide a plan for Bushbuckridge to the Committee, as this region was vulnerable to disease.

SADC interventions were likewise appreciated.

The Chairperson also thanked community representatives for being the eyes and ears of the Committee, and for their submissions.

The meeting was adjourned.