1) DEATHLY EFFECTS OF NO TOILETS

She plunges her hands in and out of the drum and in one smooth movement removes a dripping item of clothing, wrings the water out and gives it a shake before gingerly making her way across her tiny yard where she stretches skyward to peg it to the washing line.

She repeats this a number of times, every time stepping on strategically placed rocks and a makeshift wooden bridge to reach the washing line. She stands on her tippy toes her fulsome frame in a brown shwe-shwe skirt and orange polo neck. Amid the fluttering, colourful washing drying in the south-easter, she cuts an attractive picture against the stark black and white of her shack and Table Mountain in the background.

However, the picture is far from pretty. Nozakhe Thethafuthi has good reason for not walking along the path to the washing line – her shack and yard is regularly flooded with raw sewage from a nearby pipe which blocks and then floods its contents into her surroundings.

Thethafuthi claims that sewerage first started flowing out from two manholes around her home in the winter of 2006. She has been forced to build a moat around her house in an attempt to relay the sewage to the swamp behind her shack. The effluent in the swamp is channeled to the ocean.

The stench is sickening, her living conditions inhumane. Thethafuthi nods her head when asked if the stinking sewage flows into the shack. “Yes, it often happens right throughout the year,” she says, pushing the black beanie away from her forehead.

“My daughter is at the clinic right now with one of my grandchildren because he has diarrhoea. The babies have had diarrhoea episodes every week since their birth (a year ago),” says Thethafuthi.

She settled in RR Section, a cramped informal settlement adjacent to Lansdowne Road in Khayelitsha outside Cape Town in 2004. “I came from the Eastern Cape looking for work, I have nowhere else to go,” she shrugs.

Who cleans the sewage when it spills into her year, at times a daily occurrence? “I must clean it myself and it makes me very stressed. My kids are sick all the time and it stinks, but we have no other place to go,” says Thethafuthi.

The family is one of only a handful that has access to a flush toilet a couple of steps away, but they share it with at least five other households.

Makhosandile “Scarre” Qezo lives in another part of RR section ,notoriously blighted by inadequate sanitation facilities. Despite his shack being relatively close to flush toilets, he does not have access to the ones that are working – they have been locked by those who were lucky enough to receive a key to the padlock. Those toilets that are not locked are beyond description – overflowing with sewage and other waste that runs on to the concrete floor.

Scarre was viciously attacked when he crossed Lansdowne to relieve himself during the early hours of May 1. The open veld adjacent to the N2 highway is used daily by hundreds of desperate community members as a toilet.

“I found a bush and was busy when two men approached me. A third one was keeping watch further away. I tried to stand and pull my trousers up when the one screamed at me asking for my phone.

“He swore at me and didn’t give me a moment to reply, but stabbed me in the face. I tried to grab him, but grabbed the knife instead and cut my hand. He then threw sand in my face. Other people saw what was happening and came closer to help me, so they ran way with my cellphone,” recalls a traumatized Scarre. He continues to return to the same spot everyday to relieve himself.

In another incident, a teenager was run over and critically injured. A year ago Zanele (she does not want to give her surname), who was born in RR Section, also crossed Lansdowne Road to relieve herself. It was the middle of winter and by 6.30pm it was already dark. As she tried to make her way across the busy double-lane road she was knocked over by a car.

“I did not see the car because I was in a rush to use the toilet,” she recalls. Zanele sustained several fractures and was in hospital for several weeks where she underwent surgery.

“I feel better now, but my waist hurts when it is cold and I cannot walk properly,” she says.

Zanele still doesn’t have access to a toilet in her neighbourhood, but after the accident a shop owner, a five minute walk away allows her to use the toilet. “I take my mom with if I have to walk there as I am scared,” she says.

The impact of the accident has been significant on the teenager’s life, leaving her depressed and absent from school for prolonged periods.

Gavin Silber, Coordinator of the Social Justice Coalition, said everyone in Khayelitsha’s informal settlements has either been adversely affected personally, or someone close to them who has, in the process of conducting the simple task of trying to relieve him or herself.

“It is pervasive, but considered part of everyday life. Residents are forced to relive their traumas – be it assault, violent robbery, or rape – multiple times each day,” he said.

Silber said the SJC and the community were committed to working with the City to improve this fundamental service, which would have a direct impact on contributing to one’s rights to health, safety, and dignity.

“However, the City must first acknowledge the problem exists. Their failure to do so to date is an affront to the hundreds of thousands of Capetonians in informal settlements who live with this considerable burden, and is not conducive to fostering cooperation and discourse,” Silber said.

The City of Cape Town declined to comment. A list of questions sent to the Mayor Dan Plato last week were not answered at the time of going to press. His office said they were busy with the World Cup.

2) RR SECTION: ALMOST NO TOILETS

RR Section is flanked by Lansdowne Road and Mew Way, both major arteries through the sprawling township of Khayelitsha. Ramshackle shacks are tightly knit with eroded and sodden dirt roads and footpaths cutting between the homes with a massive uninhabitable marsh right in the middle.

Lack of open space means that children from the 3 000 households congregate around the only real open spaces which are near the 58 communal taps and 129 flush toilets clustered on the outskirts – many of which are not functional. Preliminary laboratory tests show that the water that gathers under the taps is highly contaminated with ecoli and other contaminants.

Overflowing sewage from blocked and broken pipes, and leaking and overflowing toilets means that the often barefooted and unsupervised children play among the raw effluent which streams down the paths.

A senior health official who asked to remain anonymous confirmed that Khayelitsha had “a huge problem with diarrhoea”.

He added that Site B Clinic, where most of the RR Section residents would end up, had extremely high incidences of diarrhoea and death rates.

The City and Province have on numerous occasions placed the burden of blame on “vandalism”, but it is clear that it is very often other factors are to blame. “I know many will say that people vandalise the toilets, but we cannot get away from the fact that there are simply not enough toilets and that many, many people do not have access to the toilets,” he said.

“Tell 12 Rondebosch households to share one toilet and see if it copes.”

Figures from the City reveal that between July and September last year the death rate due to diarrhoea (in children under 5 years) was by far the highest in Khayelitsha – 111 per 100 000 population.

Sanitation has become a major focus area for the Social Justice Coalition (SJC) – an activist movement which was formed two years ago in response to xenophobic attacks. During this time the SJC provided material relief and legal support to the victims of the attacks.

SJC members established that one of root causes of attacks was lack of safety in poor informal settlements.

“The deficit in safety in informal settlements – exacerbated by the general vacuum of functioning and visible local government – contributes to frustration and anger which can in turn lead to vigilantism, which ultimately targeted the most vulnerable,” said SJC Coordinator Gavin Silber. The lack of safety was further illustrated in the failure of the State to protect foreigners after the attacks began.

Late last year the SJC consulted with RR Section community members about the primary challenges to safety. The number one concern was access to toilets and in January the “Clean & Safe Toilets Campaign” was adopted at its AGM as a primary campaign.

Shaun Reznik researcher and engineer at the SJC confirmed that RR Section currently had 100 chemical toilets (similar to those find on building sites), 129 full flush toilets, 144 Bi-pot chemical toilets and one communal ablution block (which is currently locked).

“We are not sure how many of the flush toilets are actually functional, but those that work are accessed by only a small group of people who share a key. The chemical toilets are also often locked while the Bi-pots are inside people’s shacks,” he explained.

Reznik explained that the water table levels in RR Section were high which meant that sewage had to be collected above the ground. Failure to do so meant that every time there were floods, which is a frequent occurrence, sewage flooded onto the roads.

Reznik said it was difficult for communities to report blocked flush toilets as most of the toilets were not numbered and the contact telephone number was not widely known.

“There are supposed to be Environmental Health Officers monitoring the toilets, but we do not think this is happening,” he said.

Silber said that at present RR Section had approximately 12households to each toilet. This however fails to take into account broken, dirty and dysfunctional toilets, of which there are very many.

The SJC has met with Cape Town Mayor Dan Plato where he described the SJC’s motives as dubious and their information as flawed. He also told activists to demonstrate elsewhere in South Africa. Minutes of the meeting also reveal that Plato also said people “squat there they shouldn’t squat” and in doing so “aggravate their own situation”. The SJC have however been working relatively well with Water and Sanitation personnel in RR Section, to fix long existing problems and identify shortcomings in existing policy and practice..

Efforts to get Plato to comment failed.

3) CAPE TOWN FAILS TOILET TEST

Most of the sanitation technologies provided to informal settlements in Cape Town do not meet the standards of basic sanitation. This is either due to the higher household: toilet ratios, the technology itself, the condition and location of the sanitation infrastructure, or the way in which it is serviced.

This is revealed in the Water Dialogues Report which aims to understand whether and how the choice by Cape Town to outsource sanitation service delivery in its informal settlements affected the quality of service delivery.

The report claims that the City of Cape Town does not currently have a strategic plan for progressive realisation of basic sanitation to informal settlements nor does it have an effective oversight function in place, and that little has changed in this regard since similar research was completed in 2007.

According to the report this has resulted in a haphazard, ad hoc approach to sanitation service delivery, strongly in favour of outsourcing its services. It has also led to private contractors providing services that are not properly regulated or monitored by the City – the City mostly relies on self-regulation by the contractors – which, in some cases has resulted in unacceptable service delivery.

“The status quo has thus resulted in human rights violations as stipulated in the South African Constitution) and legislative contraventions (e.g. the Occupational Health and Safety Act), as well as impacted on national and international commitments such as the Millenium Development Goals,” the report stated.

Based on the research and findings of the report several factors have contributed to this current situation. The first is the general perception by the City that informal settlements are temporary, and therefore not worthy of long-term investment or high priority either in terms of planning or resources.

A second contributing factor has been the political instability within communities, especially within informal settlements since 1994. With the City struggling to gain safe access to the informal settlements in the mid- 90s, it decided to outsource these services, without consideration to how it would be able to regulate the work of the service providers.

Based on the research, the City is clearly not fulfilling its role in regulating water service provision.“As a result, a number of legal and human rights contraventions are occurring that are either going undetected by higher levels of government, or the consequences thereof are not enforced,” the report said.

South Africa upholds the access to water and sanitation as basic human rights and sets certain standards for what constitutes basic sanitation. In most parts of the country, Ventilated Pit Latrines (VIPs) meet the standard of a basic sanitation facility. However, due to the high water tables in Cape Town, VIPs are not used in the City.

Instead, a host of different sanitation technologies and services are employed, including the unsuitable “bucket system”, (traditionally a 20 – 25litre black bucket distributed to households and historically serviced by municipal workers), which the City is trying to eradicate. There are only two informal settlements in the city that still have this technology.

There are also flush toilets, pour-flush toilets, container toilets, chemical toilets and Porta-Potti’s, to mention just a few.

The report noted that the City used the narrow definition of the 25 litre municipal black bucket to define the bucket system, while in fact promoting the container toilet, which is in reality a large bucket, with many of the same issues as the bucket system and an additional number of issues due to the fact that it is a communal toilet.

Therefore, the City has essentially substituted the black bucket system for the container toilet system, in this way creating a false impression that it is eradicating the bucket system, the report said.

According to the research, approximately 128 000 households out of the City’s 884 000 households (14.5%) live in informal settlements. Of these, approximately 37% do not have access to any sanitation system at all. Of those households that do have access, 68% are supplied with one of the four types of bucket sanitation technology, with container toilets supplying two-thirds of these households.

The report found that quality of service delivery differs significantly, with high user satisfaction for Porta-Potti’s, and very poor service quality for container and bucket toilets. In the latter cases, raw sewage spillage occurs frequently, and smells, flies and maggots were cited as common issues by community members.

Overall, the servicing of container and bucket toilets falls far short of the standards required. Thus more than 100 000 households in informal settlements do not yet have access to basic sanitation. “This figure is not reported in any of the official reports; only absolute sanitation backlogs are generally reported. It is clear from the research, that the data available is not being properly interrogated. This is leading to misreporting which has significant implications for planning,” the report said.

Articles by Anso Thom. 1 & 2 were published in the Cape Times on Thursday 10th June 2010. All articles are available on the Health e-News website