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Siyayinqoba Beat It! 2006 Episode 10 -

Water and Sanitation

In this episode of Siyayinqoba Beat It! the support group discussed water and sanitation and how it affects our lives. If we don't have toilets or running water in our homes, we are at risk of contracting cholera, typhoid and other diseases caused by contaminated water. What can we do to protect ourselves against these diseases? To the support group and viewers to understand this matter, Limpho Klu from Mvula Trust explained the importance of teamwork in communities to get clean water.

Shalom Ncala: Molweni, namkelekile ku-Siyayinqoba Beat It! support group. Igama lam ngingu-Shalom Ncala. Ku-Beat It! support group, sonke siphila ngegciwane le-HIV. Uma uphila negciwane le-HIV noma unesithandwa, ilunga lomndeni noma umngani onegciwane le-HIV, u-Siyayinqoba ungowakho. Manje ngifuna ukwamukela isivakashi sethu u-Limpho Klu. Kulelviki sibheka indaba yamanzi nokuchithwa kwendle nokuthi iyithinta kanjani impilo yethu. Uma singenazo izindlu zangasese noma amanzi ahlanzekile emakhaya, singabasengozini yokuphathwa yi-cholera yi-typhoid nezinye izifo ezingabangelwa ngamanzi angcolile. Yini esingayenza ukuze sizivikele ezweni? Iqembu le-Siyayinqoba lihambe laya e-Limpopo futhi lahlangana no-Nokuthula Khoza ophila negciwane le-HIV ositshela ukuthi impilo yakhe ithuthuke kangankananani selokho i-Mvula Trust yafaka oompompi endaweni engama-metre angu-200 ukusuka emzini ngamunye. {IsiZulu} [Hello and welcome to Siyayinqoba Beat It! Support Group. My name is Shalom Ncala. In the Beat It! Support Group, we are all living positively with HIV. We are happy to have you here again today. Now I would like to welcome our special guest, Limpho Klu, the Regional Manager of the Limpopo Mvula Trust. Welcome Limpho, we are happy to have you joining us today. Each week we get together to discuss issues that affect our lives, from sex and the positive person to overcoming stigma and denial. Siyayinqoba is your guide to better living with HIV. If you are living with HIV or you have partner, a family member or a friend who is HIV positive, Siyayinqoba is for you. This week we are looking at water and sanitation and how it affects our lives. If we don’t have toilets or running water in our homes, we are at risk of contracting cholera, typhoid and other diseases caused by contaminated water. What can we do to protect ourselves against these diseases? The Siyayinqoba team travelled to Limpopo and met Nokuthula Khoza, a person living with HIV, who tells us how her health and lifestyle have improved since the Mvula Trust provided taps within 200 metres of every home.

Justicia, Limpopo – “Clean water has improved my health”

Nokuthula Khoza: {Setswana}[My name is Nokuthula Khoza. I live in Justicia. In 2004 I started feeling ill, I was mostly coughing. I decided to go to the clinic, they tested my mucous and told me that I have TB. They ran more tests and decided to keep me overnight at the hospital for blood tests. The results showed that I am HIV positive. Every morning I have to wake up early to get water that I will need for the day, for cooking, cleaning and bathing. The river water is not clean so it has to be boiled to avoid cholera infection. You have to walk a really long distance to find clean water.]

Modjadji Letsoalo (Mvula Trust): {Sesotho}[Mvula Trust came back to Justicia to do a project called WHELL. WHELL stands for Water Health and Livelihoods. This project looks at water, HIV, general living conditions and sanitation. Looking at these issues in relation to each other, we realise that firstly, a person who doesn’t have proper sanitation will suffer more from water related disease such as cholera, diarrhoea and others. These are issues we can overcome if people have clean water.]

Nokuthula Khoza: {Setswana} [It’s better now with the help of Mvula Trust. The water is clean and the distance to walk is not that far.]

Modjadji Letsoalo (Mvula Trust): {Sesotho} [If we look at the water project in Justicia in relation to the project on water, livelihoods and sanitation, and then try to determine how people living with HIV/AIDS will benefit from this project. The conclusion is that people have easier access to clean water, even though the water is not in their houses, but at least they don’t have to walk long distances to access it. This makes it easier for them to prepare home cooked meals and improve their living standards.]

Jane Mathebula (Community Garden Advisor): {Setswana} [There have been many changes since working with Mvula Trust. It is now possible to make a food garden. We’ve started a food garden at the school. It yields vegetables such as spinach, beetroot, cabbage, onions. Our garden is here provide for the children at the school. Some are HIV and TB patients and come from poor families. The garden is vital to the school and to the community.]

Support group

Shalom Ncala: Uma sabuya emakethe sizokhuluuma futhi ngamanzi nokuchithwa kwendle. Ungayi ndawo. {IsiZulu} [We talk more about water and sanitation after the break. Stay with us.]

Shalom Ncala: {Sesotho} [Welcome back to the Siyayinqoba Beat It! Support Group – the programme for everyone infected and affected with HIV. Limpho, what I would like to know is in the rural areas people are poor and they don’t have access to water] and things like these make it very hard for people to live normal lives, especially if there’s HIV involved. How does Mvula Trust help these particular people in terms of accessing water?

Limpho Klu (Mvula Trust): When it comes to Mvula work, we work mainly in rural areas and semi-urban areas and our main work is that we try to equip communities not only to bring in water to them but for them to be involved in the actual project implementation, whereby communities would be involved in purchasing pipes and laying them down and even deciding where they want the pipes to be. And it would be from the engineer’s side to say where do you want your stand pipe, for instance, is it within the 200 metres that have been assigned and also would you have enough pressure for the water to flow? So we get as much as possible for the community to be involved. {Sesotho} [And our scheme is designed in such a way that every person will have access to 25 litres of water per day.]

Lihle Dlamini: Since you say its 25 litres per person per day, in an area where there’s 37% of HIV infection, how does that affect the 25 litres a day? What impact does that have on that minimum litres you give a person a day, taking into consideration that some of them are unemployed and can’t afford food, let alone pay for the water that they need. Some of them can’t walk that distance because they are sick. How does it affect the situation of 25 litres per person a day?

Limpho Klu (Mvula Trust): Like I said, that is the basic but there are exceptional cases and each and every case should be taken on its own to say: “What is the problem and how can it be addressed?” And right now I can’t say this is how you go about it. But for instance, a community could even approach the municipality and say: “You know what, we have a serious case, we have these people who are being infected who would need, over and above, what has been put in this policy.” And in that case, that particular village needs special intervention and therefore you have to look into it and say: “Mobilise.” And that is why I say that is the role of civil society, because it’s people on the ground and they know what the problem is. They need to look at the different parameters they can approach for their problems to be solved.

Vuyani Jacobs: With all the togetherness of the municipalities and their people and so on, they want to be elected every year, they talk about access to water so my question is how many people need water in South Africa and are we reaching the target of 2008? The second part is do you work in other areas because when we look into issues like what happens in the Eastern Cape, of people using water in the river where cows are drinking, where people are walking through to go to another school, but those are the same places people go and drink water. They don’t have choices based on those things, we can’t say that people can meet together and make a solution. I think government needs to make a priority to make sure that there are going to be pipes, there are going to be taps. Is that really happening, can we clap hands on ourselves and say that is happening?

Limpho Klu (Mvula Trust): It has been acknowledged that municipalities are under-resourced. In some cases there are about 87 municipalities without technical managers. There has been acknowledgement and one of the things that has been done is that the old people who were in technical division need to come back and help the youngsters and help wherever there are any technical issues. The backlog is there, it’s not something that we can run around, and I think the Department of Water Affairs and the different municipalities would be in a position to give the exact percentage of what the backlog is like today. It differs from province to province, from municipality to municipality. By the year 2008, each and every person in South Africa should have access to basic water.

Shalom Ncala: Uma sabuya emakethe sizokhuluuma futhi ngamanzi nokuchithwa kwendle. Siyabuya. {IsiZulu} [We will talk more about water and sanitation after the break. We’ll be right back.]

Shalom Ncala: {Sesotho} [Welcome back to the Siyayinqoba Beat It! support group – uhlelo lwabo bonke abaphila negciwane le-HIV nabanezihlobo ezinalo. Iqembu le-Siyayinqoba lihambe laya e-Limpopo futhi lahlangana no-Nokuthula Khoza ophila negciwane le-HIV. {IsiZulu} [ - the programme for everyone infected and affected by HIV. The Siyayinqoba team travelled to Limpopo and met with Nokuthula Khoza who is living with HIV.]

Justicia, Limpopo – Building better pit toilets

Nokuthula Khoza: {Setswana} [My toilet is far. And at night I could run into a thief, a snake or something dangerous. It can be really dangerous. It’s not safe and there’s no fence around Skukuza Game Reserve. Some wild animal could come out while you are on your way to the toilet. Sometimes we have visitors and we are embarrassed to tell them that the toilet is outside. The toilet must be kept clean all the time to reduce the chances of falling ill.]

Ken Vinson (Mvula Trust Programme Manager): Pit toilets are in reality the only practical sanitation option for the majority of people in South Africa. There isn’t a sufficient water supply and not a sufficiently reliable water supply to operate systems like water borne sewerage in rural areas.

Joanne Barnes (Stellenbosch University): The pit latrine is, for instance, a low tech solution that can actually work very well but one, even with a pit latrine, needs to be careful where you install it. If you install it in sandy soil, the walls of the pit can cave in. and if you install it in places where there’s a clay layer very close to the bottom of the pit, then some of the drainage and sea pitch of that latrine can actually travel quite a distance.

Ken Vinson (Mvula Trust Programme Manager): The principle of a ventilated pit toilet is that your pit is sealed, pit to the atmosphere is obviously not sealed at the bottom so it can drain out but it’s sealed to the atmosphere so that a fly that goes into the toilet cannot get out and then spread diseases. This is why we have the vent pipe with the fly screen on the top.

Esther Phokungwana: {Setswana} [Before we had this toilet, we used a wooden toilet that didn’t have a roof or door, we only used it because we couldn’t do otherwise. We realised that with this type of toilet, the kids would also be safe, because the other type exposed them to diseases. This one has a door and a roof so there’s more privacy to relieve yourself. The children don’t get cholera anymore because it’s safe. You can close it and it doesn’t smell.]

Joanne Barnes (Stellenbosch University): Improving sanitation for people living in chronically depressed areas and impoverished areas, would be the single biggest public health step forward we can take to help people living with chronic infections such as HIV/AIDS. I think it would be the single biggest improvement for them to reduce all of the infection pressure that is caused by poor sanitation. And it would greatly aid the health service in reducing all of these opportunistic infections for these people, by keeping their environment so much cleaner.

Support group

Shalom Ncala: I would like to welcome Professor Dave Sanders from the School of Public Health at the University of Western Cape. Welcome Professor Sanders, how are you sir?

David Mark Sanders (School of Public Health, UWC): Thanks very much, I’m fine and yourself?

Shalom Ncala: Professor Sanders, I would like for you to explain to us all the water-born diseases and the types of bacteria that we find in the water.

David Mark Sanders: As the film clip showed, most of those diseases are actually related to poor sanitation and most of those bacteria, parasites etc, are actually in human waste. And water can get contaminated with them but also hands can get contaminated. And hands, in turn, can contaminate food which we eat and therefore we can get the diarrhoea. So essentially it’s those bacteria, virus, parasites, getting back into our mouths and into our upper intestines but those actually come from unsanitary conditions.

Lihle Dlamini: How much impact can those illnesses have on a person who’s already infected with HIV? Let’s say for instance, a person from Denmark suffers from Bilharzia and is HIV positive, how much impact will that cause on the immunity of that person?

David Mark Sanders: Everyone gets diarrhoea, whether they are HIV infected or not. But people who are HIV infected, because their immunity is down, are more likely to contract diarrhoea from getting infected with one of those organisms. And more importantly, they are more likely to suffer more from that diarrhoea, in other words, their body resistance won’t get rid of that problem so quickly. So they might end up with what we call Chronic Diarrhoea, which is diarrhoea that lasts for a long time and leads to loss of nutrients. So the people get thin and iller and so a vicious cycle is established.

Lihle Dlamini: Would you then agree with me if I said that could then lead to a person getting to an AIDS stage earlier than the person could have without those infections.

David Mark Sanders: Yes, I think that’s quite right because as we know, even in a person who’s not immuno compromised, who hasn’t got their immunity affected, even those people can lose weight and get under-nourished as a result of diarrhoea. So in a person who’s already got HIV, it can accelerate; weight loss, poor nutrition and therefore vulnerability to other infections. But remember what I said before, it’s not just through water that people are going to get gut infections. They have to also observe proper hygiene and that requires hand washing, usually with soap if you can afford it, it’s much better with soap and especially before preparing or eating meals.

Shalom Ncala: It used to surprise me when I was sick and my mother was taking care of me, that she would insist on washing her hands every time she had to do something for me; making breakfast, cleaning the clothes that I wear as well as cleaning the bedding I slept on because I would get night sweats or pneumonia. So she used to make sure that everything has to be clean, she emphasised cleanliness whenever she took care of me.

David Mark Sanders: The problem for poor people who are living in areas where there isn’t piped water, is firstly they might not have the knowledge that your mother has but I think they also won’t have the volumes of water so easily which will allow them to do that so often. You see, that is one of the problems.

Limpho Klu: But do you know when it comes to hand washing, it’s not also the volume. In our area, we deal with cases where there is no portable water and you come and see people have to wash their hands. It might not be a priority but it’s to say: “How do you wash your hands?” For instance, if you take a bucket, in our area there are a lot of mangoes so there’s a lot of archar, in every house there’s an archar bucket. When you buy five litre wine, those taps make good washing water facilities. You just take your bucket, you make a small hole and you put in the tap from the wine and you seal it. And the quantity of water that comes out is very minimal. Also, it means it’s clean water. We started buying those things, it’s about 50 cents.

David Mark Sanders: Vuyani is smiling again.

Limpho Klu: We contacted the person who is manufacturing those wine taps, 50 cents. And in the projects where we have been implementing sanitation, we say: “Here is your wine tap, you have a free archar bucket, now start filling in clean water.” If you put a bowl underneath and look at the quantity of water that is needed to clean that hand, it’s almost less than a cup but you would have done a good job.

Thami Mthembu: If I were a person that lives in a rural area and my main water supply is still from a dam or from a river, is there something I can do to disinfect that water myself?

Limpho Klu: When it comes to disinfecting using bleach, you need a 25 litre that you have, you just need a teaspoon of bleach, you put it in there and you wait for at least 45 minutes for it to disinfect the whole thing. Then after that the water is clean, it can be used. But also that is not the only way. Somebody else could say: “I don’t have money for the bleach, what else can I do?” If you take that same container and you put it out in the sun for the whole day, the UV light is going to disinfect that very same water.

Shalom Ncala: Namhlanje sifunda ukuthi kunezifo ezihambisana namanzi ezibangela isifo sorhudo esibi futhi abantu abaphila negciwane le-HIV kudingeka baqiniseke ukuthi amanzi esiwaphuzayo ahlanzekile futhi awanawo amagciwane. Oomama abancelisa abantwana babo ubisi lwamabhodlela futhi abangakwazi ukuthola amanzi ahlanzekile, kufanele babilise amanzi ngomzuzu owodwa abangasogwini noma imizuzu emithathu uma ungekho ogwini. Uma singekho isimiso sochitha indle, kudingeka sakhe izindlu zangasese ezingcono ukuze sizivimbele amanzi. Kufnele sikhulume namakhansela ethu nomasipala bethu ukuba basisize kulokhu manje. Oomasipala kudingeka baqinise ukuthi amanzi nesimo sokuchitha indle kusebenza kahle. Ningasishayela ucingo kulezinombolo ezilapha. Sithemba ukuthi niyijabulele le-show futhi niyawuzwa umoya we-Siyayinqoba, Sisonke singayinqoba. Yiba nathi futhi ngeviki elizayo ku-Siyayinqoba Beat It! support group, kuze kube ngalosikhathi, hlalani ninempilo, hlalani ninethemba. {IsiZulu} [Today we’ve learnt that there are water borne diseases which cause diarrhoea and that people living with HIV need to make sure that the water they drink is clean and free from bacteria. Mothers who use formula feed for their babies and don’t have access to clean water, have to boil the water for at least one minute at the coast and three minutes in-land. Where there are no sanitation services, we need to build better toilets to prevent dirty water from getting into the drinking water. We must speak to our councillors and municipality so that they can help us. Municipalities need to ensure that water and sanitation systems work properly. Each week we receive many letters from you, our viewers. Please keep them coming. We value your comments and questions. Join us again next week in the Siyayinqoba Beat It! Support Group. Until then stay healthy, stay positive.]

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