DEPARTMENT: WATER AFFAIRS

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DEPARTMENT WATER AFFAIRS FORESTRY Cholera
Outbreak Response in Limpopo and Mpumalanga
Provinces

• Presentation to the Portfolio Committee of Water
  Affairs and Forestry
• Date 04 February 2009
• Presented by DG Water Affairs Forestry Ms Pam
  Yako

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CONTENTS OF PRESENTATION

• Background
• Status of the outbreak
• Cholera Protocol
• DWAF InterventionsZimbabwe,Limpopo and
  Mpumalanga and
• Mpumalanga and Limpopo Case Studies
• Conclusion
• Action Plan

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BACKGROUND

• In 2003 DWAFs role moved from that of provider
  of water and sanitation services to communities
  to that of a supporter and a regulator
• The role of the Department of Water Affairs and
  Forestry is to work with local government support
  municipalities in executing their constitutional
  mandate
• Due to challenges faced by this sphere of
  government, Dwaf role has not been confined to
  the above- in most cases the Department had to be
  directly hands on in resolving service delivery
  challenges
• The Department of Health is the lead Department
  in epidemics like cholera with sector support
  from other departments

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BACKGROUND Cont

• Cholera outbreak reported in Zimbabwe in August
  2008
• First cholera cases reported on 15 November 2008
  South Africa Musina. Has since spread to all
  provinces.
• At that time, three deaths and 132 cases of
  affected people were reported and received
  treatment in hospitals, clinics and temporary
  centers
• In response to this threat Dwaf regional office
  intensified monitoring of water quality in rivers
  and within affected municipalities
• Dwaf also participated in the National Cholera
  Response Plan which covers (inter alia)
• Health interventions
• Water Sanitation
• Community Mobilisation

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Cholera Protocol Role of DWAF

• Support intergovernmental Coordination structures
• Initiation, representation, functions, strategies
  
  
  
  
  
  
• Internal co-operation and communication
• Identification of high risk areas
  
  
• Surveying of infrastructure
• water quality monitoring (all sources taps,
  plants and rivers of affected areas)
• Ensuring Operational efficiency of water services
  infrastructure
• Provision of water purification materials to
  treatment plants
• Support on Water Services Infrastructure
• Survey and ensuring compliance
• Provision of temporary/Emergency water and
  sanitation infrastructure at emergency and
  strategic points
• Influence and Support short and long term
  rehabilitation of infrastructure
• Control over authorized users by management of
  compliance and authorization conditions

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WHY THE 2008/9 OUTBREAK IN LIMPOPO

• Movement of affected people from Zimbabwe into
  RSA
• Polluted water resource, i.e. rivers from
  untreated effluent eg BeitBridge into Limpopo
  river,Ngoaritsane river in Mpumalanga
• People without access to water and sanitation
  services drinking unsafe water
• Inadequate awareness on health and hygiene

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Institutional Arrangements National
co-ordination

• Dwaf reports on water quality and status of water
  supply and health and water education and
  physical interventions National Inter-sectoral
  Committee hosted by DOH (weekly)
• In the Province DWAF participates in the
  Mpumalanga and Limpopo Provincial JOCs.

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DWAF RESPONSIBILITIES DURING OUTBREAK

• According to the National Cholera Outbreak
  Response Plan for South Africa
• Community mobilisation
• Environment Safe Water supply
• Environment Sanitation

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STATUS REPORTED CHOLERA CASES

• According to the National Department of Health
  (NDOH) cholera cases have been reported in all
  nine provinces- a total of 7580 cases and
  51deaths indicating a Case fatality ratio (CFR)
  of 0.67 .

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Updated Cumulative Statistics(AS AT 12H00 ON
27JAN 2009, SINCE 15NOV 2008)
Notes1. CFR CASE FATALITY RATIO2. Wolrd
Health Organisation (WHO) GUIDELINE IS THAT IT
SHOULD BE BELOW 1
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Initiatives at SADC Level

• DOH chaired SADC Troika meeting on health and
  water 11 December, 2009
• Troika officials recommended
• Establishment of inter-sectoral Task Team which
  was done
• Fact-finding mission to Harare- to be undertaken
  on 15th February 2009
• Assistance to Zimbabwe on water and sanitation,
  materials and infrastructure (Zimbabwe indicated
  a need for US85million requirement, this need
  will be verified on the fact finding mission
• Mobilisation of resources through Secretariat

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Interventions in Zimbabwe

• Through the SADC protocol, Dwafs interventions
  in Zimbabwe around the Beitbrigde and other
  strategic areas can be summarised as follows
• Refurbishment of Water Treatment Works- including
  disinfection of systems
• Water Tankering to affected areas
• Refurbishment of Waste Water Treatment plants
• Drilling of new boreholes and refurbishment of
  dilapidated ones-30 x 10kl tanks and new
  boreholes
• Water Quality monitoring
• Repair of Water and Sanitation Distribution
  Systems
• Health and Hygiene awareness including provision
  of soap, jik and educative material

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DWAF INTERVENTIONS in Limpopo

• DWAF initiated mapping of vulnerable areas using
  GIS with DOH and SAMHS (SA Military Health
  Serves)
• Intense Monitoring of raw water and drinking
  water-normally raw water is monitored once a
  month and drinking once daily. During the
  outbreak, raw water was monitored once in 4days
  and drinking water about 6 times a day or during
  every shift
• Ensuring compliance by water treatment and sewage
  works that are run by municipalities- a total of
  6 treatment works in the affected areas
• Assistance with operations maintenance
  practices where necessary

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Interventions MUSINA

• Estimated Expenditure for Musina / Beitbridge
  (until May 2009 R12 million)
• Water quality monitoring
• Limpopo River
• Water works (raw water, treated water)
• End user points (Home Affairs centre at the
  showgrounds, civic centre) Municipality provided
  temporary ablution facilities and water points
• Health and Hygiene materials distributed at key
  transit areas

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Musina Cont..

• DWAF Community Development Officers (CDOs)
  deployed
• Health and hygiene materials distributed to
  communities
• Working with PDOH identify potential outbreak
  areas using GIS mapping

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Interventions MUSINA-Madimbo

• Supply of water tanks (3x10kl, 1x5kl and 4x2.5kl)
• Temporary toilets 50 No. supplied
• Water quality monitoring in local rivers
• Drill and equip 5 boreholes
• PDOH supply of water buckets
• Improvement of operations and maintenance of
  local infrastructure

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CASE STUDY OF DWAF SUPPORT (VHEMBE)

• Since declaration of cholera in Musina, DWAF has
• Attended the municipal and medical JOCs (led by
  Musina municipality!)
• Supplied personnel to co-ordinate water,
  sanitation, and health hygiene(HH)
• 5 x Community Development Officers for HH
• Artisans and drivers

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CASE STUDY OF DWAF SUPPORT(VHEMBE)

• Anti-cholera activities
• Water quality testing water supply (5no. sites
  every three days)
• Water quality testing river water (5 no. samples
  per day)
• Drill new boreholes
• Water tanks
• Temporary toilets

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DWAF SUPPORT(VHEMBE)

• Other ongoing support
• OM budget
• Regional bulk water grant
• Refurbishment budgets
• ISD Institutional capacity building
• Planning and implementation

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CASE STUDY OF DWAF SUPPORT(VHEMBE)

• Dwaf has allocated R49,2m for operation and
  maintenance and R8,7m. This funding just covers
  only the schemes transferred by Dwaf, there is no
  contribution from the municipality to maintain
  other schemes
• VDM regularly underspends OM/Refurbishment and
  Regional Bulk Infrastructure funds
• Minister issued two Directives (Nov Dec 2008).
  In response, VDM indicated that they require
  support from that DLGH
• Ineffective O and M leads to disruption of
  supply this increases the likelihood of
  transmission (due to ingress of contamination,
  communities reverting to unsafe sources)

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Vembe Case Study

• For sanitation R60m has been budgeted in the MIG
  allocation and to date R36,6m has been spent.
  There is currently a backlog of 139622 households
  without sanitation and the current allocation is
  less than what is required to address the backlog
  in 2014
• R15m has been allocated for bulk infrastructure
  and R10,3m has been spent
• For schools and clinics they have been allocated
  R3,4m

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MPUMALANGA Bushbuckridge Case Study

• Some cases originated from Limpopo
• Lack of access to safe water and sanitation
  facilities
• Lack of operation and maintenance of water
  services infrastructure
• Not enough investment in refurbishment and OM

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Interventions MPUMALANGA

• Installation of temporary sanitation facilities
  in strategic points of affected communities
• Intervened by chlorination of Water in certain
  areas
• Conducted Operations Maintenance works when
  necessary
• Mapping of affected communities
• Daily Testing of borehole and tap water
• Enforcement of water quality /sewage discharge
  standards
• Health and hygiene education

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The Bushbuckridge Case Study

• BBR LM has a population of 743653 people a figure
  which is the highest in the Province
• BBR LM has 143839 households, coming second only
  to Mbombela Local Municipality which has 157465
  households
• BBR LM has the highest number of villages in the
  Province, listed as 143 villages, the second
  highest is Emalahleni with 84 villages.
• The population water services needs in BBR LM is
  (water) 534626 and (sanitation) 580564
• The water services project list in BBR for the
  year 2007/08 and 2008/09 is dominated by water
  projects.
• The sanitation backlog in BBR LM is 114272 which
  is the highest in the Province and yet sanitation
  has not been equally prioritised by the district

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Analysis

• There are 18 Water treatment works and 10 waste
  water works managed by the municipality and yet
  only R49,8m is being spent on operation and
  maintenance.- a big proportion of that coming
  from DWAF through the transfers programmes

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Budgetary Information 08/09

• Municipal Infrastructure Grant R 152.7m
• Operations Maintenance R 49.8m
• Refurbishment R 22.7m
• Bulk Infrastructure Grant R 3.0m
• Total R228.5m
• BBR LM has spending R1,5M towards the provision
  of sanitation for the year 2008 from a budget of
  R3.338m
• Overall MIG expenditure is R73.m out of R152.7m

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Support provided

• Support
• Development of specifications and terms of
  reference for the installation of a chlorination
  system
• Assistance in the training of plant operators
• R10m funding for sewage works and boreholes,
  supplementary to the refurbishment budget
• Registration of water works in terms S26 of the
  National Water Act
• Facilitated process to secure funding through the
  Mpumalanga Provincial Cabinet

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• Corrective Action (notices) issued in response to
  non-compliance
• Sewage overflow into a public stream College
  View 05/10/2006
• Operation of Thulamahashe Sewage Works 31/01/2007
• Operation of Mangwazi Biodisc 04/12/2006
• Operation of Dwarsloop Sewage Works 31/01/2007
• Operation of Mkhuhlu Sewage Works 13/12/2006
• A notice of non-compliance will be issued to BBR
  LM by Friday 06 February 2009

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Other Corrective Actions In Mpumalanga

• Emalahleni Local Municipality (notice deadline
  06/02/2009
• Tubatse Local Municipality (responded within
  their 7 day notice to take remedial action)
• Mbombela Local Municipality in process of
  issuing notice for non compliance in White River
• Delmas Local Municipality in process of issuing
  non compliance notice for Delmas sewage works

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PROGRESS REPORT OTHER PROVINCES

• Gauteng/Western Cape, North West, KZN in control
  in co-operation with Provincial DOHs
• Other provinces DWAF on alert, but there are no
  reports of confirmed NEW cases.
• The Department is however continuing with
• Co-operation with Provincial DOHs
• Water quality monitoring
• Health Hygiene education

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Conclusion

• Strengthening the Regulatory function of DWAF
  will help manage cholera incidents much more
  effectively in future
• There is a need for a much proactive-
  preventative and well resourced strategy to
  manage disasters of this nature- DWAF is working
  on the implementation
• The fundamental challenges like the powers and
  functions will have to be addressed in order to
  deal with capacity of LG to discharge its mandate

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WAY FORWARD

• Short Term
• Intensification of Health and Hygiene Education
• Refurbishment of infrastructure in Zimbabwe and
  in affected Districts
• Availability of health services in Zimbabwe to
  prevent people from having to come to RSA
• Medium Term
• Speeding up water and sanitation infrastructure
  development
• Development of a National Intervention Unit for
  cholera and other related services in Dwaf to
  ensure a proactive and speedy response to prevent
  loss of lives

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THANK YOU