According to a new report, South Africans with HIV living in informal settlements and rural areas lack clean, safe water, which is placing them at serious risk of contracting potentially lethal waterborne diseases.

“They are particularly vulnerable to opportunistic waterborne pathogens. Exposure to these should therefore be prevented at all costs,” cautioned the Water Research Commission study. “Additionally, the absence of a safe drinking water supply has particular implications for HIV-infected breastfeeding mothers unable to ensure safe infant-feeding through the alternative of formula feeding.”

The report, “How Does the HIV and Aids Epidemic in South Africa Impact on the Water Sanitation and Hygiene Sectors?”, said that drinking water of good microbial quality was essential for the health of people living with HIV and Aids, particularly in rural and informal settlements.

The report noted the irony “in providing people living with HIV and Aids with advanced antiretroviral agents while they are forced to wash them down with water that may contain life-threatening pathogens”.
Caregivers, it said, should be provided with a safe water supply to promote antiretroviral treatment. “Not only is diarrhoea one of the many side effects of these drugs, but people on antiretroviral drugs require greater amounts of water for drinking.

“Diarrhoea is a common symptom of HIV and Aids. Diarrhoea affects 90% of HIV and Aids-infected people and results in significant morbidity, mortality, limited uptake of medicines and malnutrition. Morbidity from diarrhoea in HIV and Aids child patients is much higher than in adults.

“People infected with the disease also have to deal with waterborne pathogens that are known to cause eye and skin infections. “Diarrhoeal disease in these patients will compromise the absorption of the drugs and can even contribute to antiretroviral resistant strains of the HIV virus.

“HIV and Aids are changing the structure of African societies, hampering development progress and worsening poverty levels. Social factors such as gender inequality, human rights violations, stigma and discrimination are social drivers of the disease.”

But the report found that beyond water quality, inadequate quantities of safe water were a recurrent issue, highlighting the “inadequacy” of the free basic water policy for people with HIV and Aids. “This policy provides 6 000 litres of potable water supplied per formal connection per month per household in the case of yard or house connections. Current estimates of water requirements are highly variable (from 50 to 200 litres and more daily per person) but there are no tangible data to confirm this.”

Often the water supply system was not working. “Water interruptions are common in many of the smaller municipal areas and in townships. People have to store water or resort to using surface water if available, buy water, get water from sources far away from their home yards. Each of these scenarios poses some potential impact for their health.

“Storing water leads to in-house contamination and using surface water exposes people to waterborne pathogens,” said the report.

Source: iol