Impact of scarcity of water on public health in rural Eastern Cape, South Africa

South Africa is one of the few countries in the world that enshrines the basic right to sufficient water in its Constitution. However, much remains to be done to fulfill that right. After the end of Apartheid, the South African newly elected government inherited huge service backlogs with respect to access to water supply and sanitation. In 1990, about 15 million people were without safe water supply and over 20 million without adequate sanitation services. According to the WHO/UNICEF Joint monitoring program, the share of the population with access to an improved source of water supply only increased from 83% in 1990 to 88% in 2004. After the cholera outbreak in 2000, the African National Congress promised free basic water. In 2001 a revised tariff structure was suggested that included 6 “kilolitres” (cubic meters) of free water per month (4 liter/capita/day for a family of five or 25 liter/capita/day for a family of 8). Putting the policy of free basic water in practice proved a challenge. Pre-paid meters were introduced in Johannesburg in other cities which cut off water supply above the 6 cubic meter monthly limit if no payment was made thereby denying the poor access to adequate water. In April 2008, the South African High Court stated that the practice of shutting off water was unconstitutional. However, because of the privatization of basic services such as water and sanitation in South Africa, the actual impact of service delivery by the government is seen as questionable.