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Western Cape gears up for 'Day Zero' diseases

Hospitals in Cape Town are gearing up for the diseases Day Zero could bring, while private hospital groups are acting to ensure their own water supplies.

“Healthcare workers have been put on high alert to be vigilant and maintain an elevated index of suspicion when evaluating all patients,” Western Cape Health Department spokesperson Marika Champion is quoted in a Sunday Times report as saying. The province’s central medical distribution centre was “adequately stocked” with medication to deal with outbreaks, she said, and stock levels at clinics and hospitals were being electronically monitored regularly.

A province-wide “early warning system” was in place, provision had been made for emergency orders “should it be required”, and couriers were available if a hospital needed medication at short notice. New boreholes were being drilled and older ones reactivated at several hospitals, while a project to “boost the mains supply pressure” at Lentegeur Hospital in Mitchells Plain was under way “to enable us to fill the 700 000-litre water storage tower”.

Dr Che Linderts, an expert in public health at the University of the Witwatersrand, said water scarcity brought “a higher risk for disease caused by ingestion and contact with contaminated water”. The report says examples included skin diseases, and diarrhoeal diseases which spread through faeco-oral transmission – when germs from faeces enter someone’s mouth – and “inadequate or absent food preparation practices”. An example was fruit and vegetables not being washed properly before being eaten. Linderts said informal settlements were particularly vulnerable because of poor water and sanitation infrastructure.

The report says other major risks were heat stress and dehydration as a result of dry weather conditions. “High temperatures could lead to morbidity and mortality, especially in infants and the elderly.” According to Dr Harsha Somaroo, Linderts’s colleague, another area of concern is mental illness, which could take the form of anxiety, emotional distress and depression. These could result, for example, “from a loss of financial livelihood as a result of crop or livestock failure” or businesses going under because they rely heavily on water. Food insecurity and general “uncertainty about the future” could also lead to mental health illnesses.

Dalene Meyer, who queues for water at the Newlands spring four times a week, said: “My life is already stressful. I am a single mom with three children and a full-time job. This week, when the temperature was in the mid-30s, I felt close to a nervous breakdown. I asked myself: ‘Is this how it is going to be? Are the easier days going to be once in a blue moon after the taps run dry?’”

Mncedisi Twala, of the Cape Town branch of NGO Abemi South Africa, said those living in shacks in or around Cape Town had noticed a decline in the quality of tap water. “The colour keeps changing, and we are not the ones who can get to that clean mountain water you find at the springs.” Many shack dwellers were in a state of panic about transport to the distribution points the city council was going to set up after day zero, he said.


Meanwhile, private hospitals are not taking any chances regarding Western Cape premier Helen Zille’s promise that water supplies will be maintained to their facilities in the event of Day Zero. Business Day reports that the three biggest hospital groups – Netcare, Mediclinic and Life Healthcare – are investing heavily in alternative water supplies from the sea and underground so they can run independently of the municipal grid in an emergency. Many of the measures they are taking in Cape Town are being rolled out in other water-scarce regions, such as the Eastern Cape.

"We are very concerned, hence our investments in water conservation and augmentation," said Jacques du Plessis, MD of Netcare’s hospital division. Netcare is installing a desalination plant in its flagship Christian Barnard Hospital on the foreshore, which will yield enough fresh water for the group’s five Cape Town hospitals, its Medicross primary healthcare facilities and its renal dialysis units, he said. The plant could also provide sufficient water for staff showers and drinking water in the event of Day Zero, he said. "Our first priority is service continuity," he said.

Netcare had also drilled boreholes on the grounds of three of its Cape Town hospitals, and was investigating using black water he said. Black water comes from toilets. Netcare had cut water consumption at its Cape Town hospitals by 44% since 2015, Du Plessis said.

Mediclinic’s GM for infrastructure, Kobus Jonck, said the group could not risk relying on promises that hospitals would be guaranteed water if Day Zero arrived. "We are all nervous as Day Zero gets closer," he said. "We have started drilling boreholes and will transport water between facilities if need be. We are also looking at the need for extra security and are considering providing water to our personnel," he said.

Ten of Mediclinic’s hospitals were directly affected by the water crisis in Cape Town, he said. Mediclinic had steadily reduced its water consumption by, on average, 3.5% per year over the past eight years, and its Western Cape hospitals currently used 13% less than other hospitals in the group, he said.

Life Healthcare had sunk boreholes, which would be able to supply water to its Cape Town hospitals – Vincent Pallotti and Kingsbury – as well as its renal, rehabilitation and mental care units by mid-March, said its Southern Africa CEO Lourens Bekker. "In partnership with provincial and local government authorities, special contingency measures will also be in place to allow Life Healthcare to assist in case of emergencies and to mitigate the risk of water resources being plundered during the crisis," he said.

The Saldanha Bay municipality had undertaken to tank water to Life Healthcare’s hospital in Vredenburg should the municipal water pipeline be compromised in any way, he said.

The report says Zille had assured residents that public and private healthcare facilities would be prioritised should the city fail to avert Day Zero. Even so, the provincial government intended to make sure 18 priority public hospitals could turn to borehole water should the municipal supply fail, she said.

[link url="https://www.pressreader.com/south-africa/sunday-times/20180204/281505046664599"]Sunday Times report (subscription needed)[/link]
[link url="https://www.businesslive.co.za/bd/national/2018-02-02-cape-hospitals-ignore-zilles-promises-and-invest-in-own-water-supplies/"]Business Day report[/link]

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