The quality and availability of water have been a major issue at two hospitals in Kwa-Zulu Natal (KZN). At Montebello Hospital in Ndwedwe families have to bring water when visiting sick relatives because the tap water at the hospital is “muddy and discoloured”. 

Last week, a patient who asked not be named, told Health-e News that, when she was admitted in 2020 the hospital didn’t have running water at all. She and other patients had to use buckets to collect water from a Jojo tank on the hospital premises.

“I was so surprised when I came back to the hospital at the end of July [2023] to give birth and found out that the water crisis is still an issue,” she says. 

Around 344 kms away at Bethesda Hospital in Ubombo the situation is much worse. According to the trade union, Public Servants Association (PSA) the hospital has been experiencing consistent water shortages since 2018. Healthcare workers recently wrote to the South African Human Rights Commission asking for an intervention. 

PSA manager in KZN, Mlungisi Ndlovu, says the prevailing water shortages have reached a critical level, directly impacting Bethesda hospital’s ability to function effectively.

“Imagine healthcare workers having to use small bottles of water to wash their hands before and after surgery. This is so inhumane and no one is supposed to work under such conditions. It also places the health of patients at risk,” says Ndlovu.

The video below was shared with Health-e News by hospital staff. It was filmed recently at Bethesda hospital. The video shows healthcare workers at the facility using bottled water to wash their hands after having performed a surgical procedure on a patient. The video was taken by disgruntled healthcare workers with the aim of showing the public the difficulties they have to go through due to shortages of water at the facility. 

Disrupted care

A health worker at Montebello Hospital, who did not want to be named because she is not authorised to speak with the media, says things are very difficult at the hospital and they are working under a lot of pressure because of the water shortage and water cuts. 

“It saddens us to be asked by patients to bring them water from our homes because they fear that what comes out of taps is unsafe to drink. Water is a basic need at the hospital; therefore, we are pleading to those who are in power to fix this crisis at Montebello Hospital so that we can do our job in serving the community without any stress.”

At Bethesda, the water shortage has led to disruptions at the facility theatre, kitchen and laundry services. The lack of water is not only affecting the hospital as it also extends to the surrounding communities. 

“This exacerbates the hardships faced by residents. This creates an atmosphere of great distress as people struggle to fulfil their basic needs and to maintain proper hygiene,” says Ndlovu from the PSA.

 Importance of having water

Clean, running water is essential for healthcare delivery. But a 2021 World Health Organisation (WHO) report estimates that a quarter of health facilities globally have no water services. This puts patients and staff at risk of infection. The situation is particularly dire in low- and middle-income countries, like South Africa, where 15 out of every 100 patients in acute-care hospitals, will get at least one infection during their stay. 

According to Ndlovu, the dire shortages of water at Bethesda hospital has resulted in a range of problems. These include inadequate sanitation standards, inefficient service delivery, and unacceptable living conditions.

Safe drinking water, sanitation and hygiene (WASH) are crucial for public health beyond the facilities. 

“Our members who reside within the hospital residential houses say that, sometimes they do not even bathe or shower due to lack of water. They have to drive to the nearest towns to get bottled water for drinking and other household purposes,” says Ndlovu.

In a recently published opinion piece, Dr Husna Ismail an epidemiologist at South Africa’s National Institute For Communicable Diseases (NICD) writes that water is the cornerstone of all infection prevention and control programmes in hand hygiene.

Hand wash stations with water, soap, clean towels or alcohol-based hand rub should be available in key areas such as the toilet and at the points of care. “Standards for water quality, sanitation, and environmental health should be met. Hand sanitisers must have at least 70% alcohol by volume,” writes Ismail.

‘Public hospitals have back-ups’

But KZN Department of Health spokesperson Ntokozo Maphisa says that all the public hospitals in the province have standard contingency plans for the provision of water when they experience shortages from time to time.

“According to [Montebello] hospital management, there was indeed a disruption in the water supply from Ilembe Municipality from the 17th July 2023. Contingency plans were subsequently made, which entailed  sourcing water from the private providers and also from Ilembe water using water tankers. Currently, water is available, and the institution is using a generator to pump it from Ilembe water reservoirs to the hospital reservoir tanks.”

With regards to Bethesda hospital Maphisa says reports of water shortages are not true. 

“UMkhanyakude District Municipality has three water tankers which assist local health facilities with water supply when there are interruptions.”

The KZN health department also notes that, ultimately, municipalities are the sole providers of water.  – Health-e News.