Not a single person in Inanda’€™s Congo area, some 30km from Durban’€™s city centre, lives in a formal house with running water ‘€“ let alone a flush toilet.

Sam Khumalo, 34, lives with his wife and two young children in Congo. He buys his water for 25c for 25 litres from the “head of the queue” ‘€“ the person in charge of the stand pipes in his area.

“The problem is the stand pipes are not near my home, and we need 50 litres every day,” says Khumalo, who either strains up the hill with the water containers or begs the use of a wheelbarrow from his neighbour.

But things are slowly improving since 1988 when Khumalo first moved in the area.

“When I arrived, it was more than worse,” says Khumalo. “But we got electricity in about 1994, and about two years after that they started removing the rubbish.”

Near the sprawling informal settlement’€™s main taxi rank, workers are busy constructing a big reservoir to improve the delivery of water to Inanda’€™s people.

Khumalo says that roads are also being improved and there are council plans to build formal houses.

But the biggest problem is the fact that less than 20 percent of residents are employed ‘€“ and council statistics reveal that a staggering 29 percent of households have no income whatsoever.

Crime is high and gangs operate in many areas. “In most areas, the houses don’€™t have numbers so criminals can easily hide,” says Khumalo.

Healthcare is also a problem, and people are frustrated by the long queues while nurses feel overwhelmed by the number of patients.

Sivanda Clinic treats about 3 700 per month ‘€“ with only 14 nurses.

Scabies ‘€“ a highly infectious bacterial skin disease ‘€“ is one of the biggest health problems. The disease spreads easily in the overcrowded settlement where hygienic conditions are difficult to maintain.

The biggest category of health complaints is sexually transmitted infections, say clinic staff. Remarkably, the clinic has no facilities for testing for HIV, and patients have to go to KwaMashu Clinic to be tested. As a result, many HIV infections remain undetected ‘€“ although clinic sisters report an increase in infections often associated with HIV, such as impetigo and shingles.

Respiratory infections, including tuberculosis, are a serious problem. Clinic sisters again blame overcrowded conditions and poor housing for the spread of these diseases.