In Focus: Water shortages in parts of Free State affecting health servicesNot one child surveyed in the Grow Great study had access to piped water in their homes in Mqanduli, Eastern Cape. PHOTO: Black Star Images/Spotlight

In Focus: Water shortages in parts of Free State affecting health services

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Qwaqwa, situated in the Maluti-A-Phofung Municipality is close to the Sterkfontein Dam, which is one of the four biggest dams in the country. Yet, hospitals and clinics in and around Qwaqwa have for years struggled with dirty water, dry taps, and constant water interruptions.

A medical technologist at the National Health Laboratory Service (NHLS) at the Mofumahadi Manapo Mopeli Regional Hospital says there are still many water problems in Qwaqwa which is affecting operations at the Manapo Hospital. The hospital services about 500 000 people in the municipal area which includes Qwaqwa, Kestel, and Harrismith.

“The scarcity of water here at Mofumahadi Manapo Mopeli Hospital affects us very badly as workers. “Each and every pipe in the laboratory requires water for the purpose of rinsing. Each day we have about 300 patients whose blood samples need to be tested. A week will never go past without running out of water. This is an inconvenience that we all have to live with,” she says.

Another health worker in emergency medical services stationed at Manapo Hospital says the hospital is unhygienic. He says toilets are dirty and muddy. “I never use the toilets at the hospital because there is no water in the toilets. For me to use a toilet I have to wait to be called into the community where I will ask the patients to offer me a toilet at their home,” he says.

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A recent report from Ritshidze, a community healthcare monitoring project, found that cleanliness and infrastructure remain a major concern in Free State health facilities, including clinics. Observations at clinics monitored found that toilets were in bad condition. Some of the biggest concerns flagged were “no toilet paper, no soap, and no water at all”.

Provincial Chairperson of health worker union Hospersa Peggy Motlokoa says she has been pleading with the municipality management to treat the issue of water at Manapo Hospital as an emergency.

“Working conditions for our members are not taken seriously at the Manapo Hospital. It is unhygienic for a hospital to not have running water,” she says. “How are they supposed to work if toilets are dirty, muddy, and smelly? It is not fair for the patients and the workers.”

Water shortages and poor maintenance create various challenges at some health facilities in the Free State. PHOTO: Ritshidze

An old problem

Former CEO of the hospital Dr Balekile Mzangwa tells Spotlight that water problems at Manapo Hospital have remained unchanged during his term. Mzangwa was heading the hospital from 2013 until the end of August this year.

He says despite several service delivery protests and interventions from the provincial and national government, problems of water shortages and clean water persist.

Mzangwa recently started in a new position as CEO of Universitas Academic Hospital in Bloemfontein.

“What I can tell you is that nothing at Manapo Hospital has improved, nothing whatsoever. The water challenges that we were facing before the service delivery protests and the challenges that we faced after the protests are still the same.”

The water challenges in Qwaqwa date back to at least June 2016 when the community went without water for days forcing them to rely on unreliable water trucks and fetching water from streams and rivers.

In January last year, eight-year-old Musa Mbhele drowned while collecting water from a stream. Her death fuelled a three-day service delivery protest over the shortage of water in the area. Shops were torched, government vehicles overturned, and the provision of health services came to a halt.

people fetching water from a stream. a
The scarcity of potable water causes people to seek alternative sources of clean water that may be unsafe and could prove to be costly for health. PHOTO: Black Star Images/Spotlight

Water shortages in perspective

Senior Lecturer and Head of Zoology and Entomology in the Faculty of Agricultural Sciences at the University of Free State, Dr Patricks Otomo who has been researching the quality of water in Qwaqwa says the real problem underlying the water crisis is the lack of proper infrastructure.

According to a report by the Department of Water Affairs and Sanitation on interventions in Maluti-A-Phofung, three dams supply Qwaqwa with water, Fika Patso, Sterkfontein, and Metsi-Matso dams.

Otomo points out that South Africa is a water-stressed country. “Water shortages are not unique to the Qwaqwa region. However, the contradiction in the case of Qwaqwa is the fact that the region is located at the foothills of the Maluti-Drakensburg, in the heart of a water catchment area comprising more than half a dozen perennial rivers. The river network forms part of the Vaal River Basin whose waters are used for the domestic, agricultural, and industrial needs of part of the Free State and the adjoining provinces of Gauteng, Mpumalanga, and North-West,” says Otomo.

“There is water in Qwaqwa. What is lacking is the proper upgraded infrastructure to harvest, treat, and redistribute this water to the community,” he says.

“That being said, climate change has been identified as a compounding factor decreasing precipitation rates in the region,” he says, referring to a water and sanitations department report on Free State dams, which last year stated the Fika Patso Dam on average was filled to only 45.8% of its 29.5 million cubic metres capacity. The dam was established in 1986 as a water reservoir for the domestic and industrial needs of Phutahditjhaba (Qwaqwa).

“And in a rural community such as Qwaqwa, the scarcity of potable water causes the people to seek alternative sources of clean water. However, this could prove costly and prompt the neediest in the community to rely on unsafe and unsanitary sources of water for domestic, recreational, and agricultural uses. These are typically surface waters from rivers, lakes, and boreholes.”

Otomo says hospitals beset by water shortages are likely to see their operational costs increase significantly because of the need to find alternative sources of clean water. This, unfortunately, could translate to increased treatment costs to the patients and reduce medical services and procedures due to budget reallocation or unsafe and unhygienic work conditions.

“In such establishments (health facilities) water is useful for personal care, consumption, surface cleaning, and certain medical procedures in dentistry, among others. Having limited access to clean water in a hospital is certainly precarious to the health practitioners and patients alike,” he adds.

Toilets at some clinics in the Free State are not working due to water shortages and poor maintenance. PHOTO: Ritshidze

Government response

There have been various government interventions to address the water crisis in the area, although the effectiveness of these interventions is hard to gauge.

The National Department of Water Affairs did not respond to Spotlight’s questions by the time of publication and the province’s health department declined to comment.

During the 2018-2019 financial year, the Free State Department of Cooperative Governance and Traditional Affairs spent R22.5 million on water tankers for the Qwaqwa community. In 2020 after the death of Mbhele, the (then) Department of Human Settlements and Water Affairs injected R220 million into the municipality which was ring-fenced to address the water challenges.

When Spotlight spoke to Fanyane Moloi, the new acting CEO of Manapo Hospital he could not provide much information yet about progress with the water challenges at the hospital. Moloi is the former CEO of Thebe District Hospital in Harrismith which also falls under the Maluti-A-Phofung Municipality.

“However, I did get a report about the water situation at the hospital,” Moloi said. He started his new job at the beginning of September. “So, from the report that I received, we no longer have water problems at Manapo Hospital but what I can confirm is that currently there is a construction of a new reservoir being built at the hospital,” he said.

According to the acting communications manager at the municipality Tebogo Kwakwa the municipality has not had any water challenges since the beginning of the year unless there is a power failure.

“All our hospitals are receiving water from their taps except when there is a burst. We all know that Qwaqwa has frequent power cuts and this has a huge impact when it comes to the pumping of water as we use electricity to pump. Most of our pump stations are affected by this,” she said.

An elections issue

As local authorities insist there have not been any water problems this year, some political parties campaigning for the upcoming local government elections in the area aim to make the water crisis an election issue.

Leader of Dikwankwetla Party of South Africa Moeketsi Lebesa says, “This is not just a Manapo Hospital crisis. This is a Qwaqwa crisis. If it is not dirty water coming out of our taps, we can go days without water and even electricity.”

Lebesa is also the party’s mayoral candidate in the municipality.

“Our solutions to the water crisis in the area include the reconnection of Metsi-Matsho bulk supply to Fika Patso distribution network. The reconnection will supply the entire Southern Qwaqwa area with clean, drinkable water. We will also do the commissioning of UFS (Qwaqwa Campus) reservoirs. There are three reservoirs on top of the hill opposite the UFS of which two are incomplete and there is a pipeline from Sterkfontein Dam opposite the university. We will complete and reseal these reservoirs and connect the Sterkfontein pipeline to these reservoirs which will feed the Greater Phutaditjhaba, the industrial area, the CBD, Kestell, and Qwaqwa North.”

The Democratic Alliance (DA) in the Free State has been vocal about how the water crisis affects the operations of hospitals and clinics in and around Qwaqwa.

“We are in the middle of a global pandemic, which automatically confirms water as a basic need,” says Mariette Pittaway, DA member in the provincial legislature.

“They have placed Jojo tanks at clinics and at the Manapo hospital but they do not fill up the tanks, as a result, the hospital and clinic operations are terribly affected,” she says.

The party’s provincial leader Roy Jankiehlson says infrastructure in the municipality is something his party will work on.

According to provincial ANC spokesperson in the Free State Oupa Khoabane, the organisation intends to improve the service delivery that he says has largely been affected by political instability and disturbances in the area.

“Our main focus is to ensure that water is accessible for the residents of Qwaqwa. The municipality has been suffering for a long time and now is the time to get the institution in order. We have to stabilise the institution, which is what we are currently busy with so that when we retain the institution in the local government elections that are coming up, we will be able to ensure that residents have access to water without any difficulties.”