Alexandra residents live on the edge of a health hazard

by | Nov 28, 2022 | Indepth2022

Dump sites come back to bite the residents of Alexandra, north of Johannesburg, as air-borne and vector-borne diseases rise and living conditions deteriorate. 

 Construction rubble piled up in a heap, 

disused household items and office furniture,  

branded cardboards ripped out of their commercial life, 

crinkled-up paper carrying designs of ink from one end to another.  

Empty takeaway containers greased with oil from an indulged meal,  

plastic and glass bottles weighted by the last drops of fizzy beverages in all their funky colours. 

All of this basking in the sun as though waiting to restore their purpose… 

This is and has been the back-yard view of thousands of residents living in Alexandra township, proudly referred to as Alex or Gomora, north of Johannesburg, for several years. Within 10 minutes of riding the Gautrain from Park Station, many privileged people overlook this toxic wasteland from the comfort of an air-conditioned express commuter train shunting through a system worth more than R30 billion. 

If lucky, one can even spot an element of the waste cycle in action. It’s either a resident throwing out a bucket filled with rubbish without a second thought, or a truck offloading construction rubble and industry debris right outside the rusty shacks as children, some as young as two years old, play on the dumps.

Depending on what time of day it is, one could also watch as a scattered group of recyclers sifts through waste to collect what will be their bread and butter at the end of the week or month. These are normalised day-to-day activities in the informal settlements of Setswetla, Jukskei View and the new EFF settlement.

The dire state of dump-living 

Densely packed shacks in these settlements now form a guard of honour on the banks of the waste-clogged Jukskei, the narrow 50km-long river feeding the Hartbeespoort dam in North West. Nurtured by apartheid spatial planning, Sandton (Africa’s richest square mile) neighbours one of the continent’s poorest communities, while the ever growing waste in illegal dumping sites remains unacknowledged. An area of 144km2 in Sandton is home to 220 000 people, as found by the 2011 census report, while 180 000 people occupy the land in Alex’s 6.8km2 – which means every square kilometre houses about 26 000 people. Simply put, one Sandton resident has the same sized space as 17 Alex residents.  

“When we started working on cleaning the river and its banks in August 2021, the river was flowing. It does not anymore [it’s clogged with rubbish].”

This inequality, South African human rights commissioner Philile Ntuli contends, is “continually reproduced and sustained [by] the apartheid social and political order [as] the hostels, ghettos and tight corners are an endless confrontation with colonial perceptions of the incompetence and sub-humanity of African people”. To date, the sub-humanity Ntuli speaks of explicitly plays out in two ways: trucks unloading building rubble right outside people’s houses in Alex, when the nearest construction site from which it is collected is in Sandton; and the multitude of municipal service shortcomings. These shortcomings include raw sewage, poor sanitation, inadequate housing and abundant refuse that is neither collected nor catered for with the provision of refuse bags and containers. This is according to a SA Human Rights Commission report prompted by the township’s “devastating” service delivery protests in 2019.  

During these protests, former Gauteng premier David Makhura promised to urgently stop the building of “illegal structures” – people’s houses being made of concrete palisades or rusty corrugated metal sheets. Typically, this call for an urgent halt to illegal land occupation was not accompanied by strategies for the housing backlog, which has persisted since the early 2000s when the township began seeing an influx of residents. 

Not only have things remained largely unchanged, but more people have occupied the vacant land near illegal dumping sites. This has brought on the growth of the illegal dumping economy. On the day Wits Vuvuzela visited the area in October 2022, truckers could be seen unloading waste and then paying an unemployed male resident R50 to unpack the waste, shovel it out and dump it in the Jukskei River. All the while, patient waste recyclers watched, marking their next haul which they would attempt to rescue from drowning.

The newest settlement in Alexandra stretches across the river from Jukskei View. Photo: Keamogetswe Matlala

Making a living from the dump 

For waste recycler Seijo Joaquim-Neves, collecting plastic bottles from the riverbank dumps is “ukukhereza (hustling)”. “Ngikala amasaka ngenyanga. iR2 000 ngiyay’thola noma ngikhereze kahle (I recycle about four sacks a month. I earn R2 000 when I say I’ve hustled well)”, the Mozambican national said. From his earnings, Joaquim-Neves is able to “bhatal’irent, theng’ukudla (pay rent, buy food)” and “qash’imoto (hire a van to transport his bottle-filled sack to the recycling depot)” for R200. Although he collects a haul of waste every weekday on the Jukskei banks, Joaquim-Neves does not work oblivious to the health threats. He wears a face mask and hand gloves to protect himself from microorganisms that could potentially carry viruses. Less than a year since he took a leap into waste recycling, the young recycler admits this is a lucrative livelihood in Alex. 

It is not only plastic bottles that carry the livelihoods of Alex residents. Used bricks are also recycled in the bid to put food on the table. Bongiwe Msimanga collects such bricks to sell at R1 each to people to build houses within the informal settlements that sprout like mushrooms across the township. She says, “Work is scarce and food is expensive.” The 50-year-old mother of one claims that living in Jukskei View is cheaper and she has easier access to the dump site from which she makes a living. Although dumped bricks alleviate the struggle of raising her now 21-year-old child, Msimanga admits it was wrong of them to occupy land so close to the Jukskei River and contribute to its dire state with illegal dumping.  

Seeing that people rely heavily on these dump sites to put food on their tables, will illegal dumping ever end in this community?

Although he is deeply involved in efforts to ensure an end to it, chairperson of the Alex Water and Sanitation Forum, Janky Matlala, admits the problem of illegal dumping is getting out of hand. “When we started working on cleaning the river and its banks in August 2021, the river was flowing. It does not anymore [it’s clogged with rubbish],” he says. Matlala adds that there is still a lot to be done, in addition to their cleaning project (Water Warriors), which runs for two to three days each week at seven points of the river cursed with dump banks.

The health effects of living near a dump site 

In a forum lecture titled ‘Climate change: the greatest global health threat of the 21st century’, Stellenbosch University head of the family and emergency medicine department, Professor Bob Mash, tabled pollution, biodiversity loss and climate change under the ecological drivers of the growing burden of diseases on the country’s healthcare services. The possible causes of this burden include compromised air quality, no access to fresh water, infectious disease exposures and natural hazards, while factors mediating it are, but not limited to, governance as well as the culture and behaviour of a community. Unlike many theoretical assertions, this tabulation is evident. 

Given the fact that informal settlements are hardly ”recognised” by municipalities because the residents are considered illegal occupants, they do not receive basic services such as electricity, water supply and sewage systems. As a result, it is normal to have residents of Jukskei View resorting to relieving themselves in buckets and throwing the waste into the river. Meanwhile, in the new EFF settlement, a woman with a crying child strapped to her back cooks pap on an open fire near that same river bank. It is the only space where she can do this, as shacks are packed so close to each other. This screams ”health hazard”. This not only explains why, in the afternoon, it starts smelling like “sun-baked faeces that have dried up after rain has fallen,” as Msimanga describes it, but also why another resident, Shelly Mohale, battles so much with house flies. Mohale says she has to clean pots right after cooking and transfer the contents to plastic containers to avoid having house flies contaminate the food.  

Commonly known as “filth flies” for their infamous diet, which includes animal waste, faeces and rotting organic waste, these flies release pathogens – microorganisms categorised as viruses, parasites, worms and bacteria that cause diseases and illnesses. These range from common cold, flu, meningitis and measles to yellow fever. A senior health sciences student from Sefako Makgatho University, Lighton Sombane, confirmed that these ailments (together with typhoid fever, cholera and tuberculosis) are a few of the 65 diseases flies can transmit to humans. It is therefore reasonable to attribute this to what another Alex resident, Jeffrey Mashigo, whose gate is less than seven metres away from the dump banks, says is an all-year-round flu. “They [children] always have the flu and taking them to the clinic doesn’t help because every two weeks, the flu comes back,” the father of four said. Since warm temperatures exacerbate house flies, Gauteng’s frequent heat waves have residents needing to close the doors and windows of their homes to avoid the flies, hindering ventilation in the process. 

According to Mashigo, it becomes unbearable at around 3pm, when the smell of all the dumps becomes worse. At this point in the waste cycle, the greenhouse effect takes charge as a consequence of gases from the dumping contents such as methane, carbon dioxide and nitrous oxide concentrating in the atmosphere. As found by the Natural Resources Defense Council, this concentration “absorb[s] sunlight and solar radiation that have bounced off the earth’s surface”. Instead of escaping into space over time, these pollutants “trap the heat and cause the planet to get hotter”.  

All the while, people inhale this toxic air and many more residents like Msimanga, who cough all year round, blame the dust that sweeps through their yards for their dry throats. Even though carbon dioxide is the most common greenhouse gas people are generally exposed to, research that nitrous oxide is 300 times more potent as it depletes the ozone layer, exposing humans to UV radiation which could potentially cause skin cancer and permanent damage to eyes. Additionally, “UV radiation causes a decrease in immunity and makes the body more susceptible to infection with viruses or parasites,” says environmental journalist Sabrina Shankman. Nitrous oxide can also live for an average of 114 years in the atmosphere. Methane, on the other hand, is 80 times more potent than carbon dioxide, according to the United Nations environment programme, and is naturally released by decomposition, a common dump feature. It also reduces the amount of oxygen available for people to inhale, consequently causing headaches, vision problems, nausea and a change in heart rate. Although these were not revealed in interviews with Alexandra residents, the potential is not ruled out.  

In some instances, as accounted for by an academic look into the effects of landfill human exposure in Thohoyandou, Limpopo, pollutants form acidic moisture in the atmosphere which results in acidic rainfall. Falling victim to this, people stand the risk of “reduced lung function, asthma, ataxia, paralysis, vomiting, emphysema and lung cancer when heavy metals are inhaled or ingested”. As research found illnesses such as high blood pressure and anaemia to be caused by heavy metal pollution, Msimanga’s confusion seemed to have cleared. Before moving to Jukskei View, Msimanga says, she was never as sickly as she is now, with constant foot aches and chronic hypertension.  

While cleaning the Jukskei River in Alexandra as part of the Water Warriors’ initiative, Mandla* also collects plastic bottles to cash in at a recycling depot. Photo: Keamogetswe Matlala.

What now?

Without the greenhouse effect, the average temperature of Earth is scientifically proven to dip as low as -18 degrees celsius from 14 degrees celsius. Furthermore, almost four trillion metric tons of ice from glaciers in Antarctica have melted since the 1990s. This is not only a significant loss of the world’s fresh water but also an indication that sea levels are gradually rising. In the next rainfall season, the Jukskei could potentially break its silence by washing away hundreds of homes that stand in its way. The occurrence of devastating floods used to be something far from South Africa’s reality, but it has become evident with floods this year in the coastal provinces – KwaZulu-Natal, Western Cape and Eastern Cape – that they are closer than it was thought.  

Water Warriors volunteer Betty Mano, who was born in 1971 and has since lived in Alex to witness the deterioration of it, believes the problem of illegal dumping would not have grown as bad if the government had provided the community with waste containers. Despite the fear that aborted human embryos – the worst ”waste” they have found dumped – would be found more often, Mano says direct human exposure to toxic pollutants would be kept at a minimum. 

When you disembark at the Marlboro Gautrain station and walk into the township, you are met with two clean open fields: the Water Warriors’ attempt to put vacant land to good use. In the next few months these fields will become recreational parks, and not places where traditional healers and churches perform their rituals as they were a year ago.

*Not their real name

FEATURED IMAGE: Mandla* fills a sack with recyclables after a day of cleaning the Jukskei River. Photo: Keamogetswe Matlala

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Life after death in the time of covid-19

by | Dec 26, 2020 | Indepth2020_Health

The covid-19 pandemic, and corresponding health restrictions placed on hospitals and funerals in South Africa, have completely changed the way we grieve and say goodbye to our loved ones. 

“Standing there in the cemetery, looking at the deep holes all around me, I just remember being overwhelmed with anxiety,” recalled Margarida Khadhraoui about the day of her brother’s burial.

“They’re probably all filled now,” she reflected.

Khadhraoui, a 50-year-old mother of two young boys, is just one of the many South Africans who have experienced loss during the covid-19 lockdown period, which began in March. The nationwide lockdown was characterised by various health restrictions, with one being a ban on all hospital visitations to prevent new coronavirus infections. These health restrictions compromised people in different ways, but for many it affectedtheir last moments with their loved ones, along with their grieving process.

Lost final moments

The ban on hospital visitations remained throughout the duration of South Africa’s strictest levels of lockdown, being levels five, four and three. In August some hospitals began to allow visitations, with News 24 reporting that covid-19 patients at the “end of life” stages would be allowed visitors, but still in line with strict safety protocols.

Khadhraoui was not so lucky. Her brother, Alvaro Jose Oliveira Goncalves, passed away right before such exceptions were established, so she was unable to visit him before he died.

“The most difficult part of it all was that when my brother was admitted, we weren’t able to visit him. Usually when someone is ill, you go see them and it almost gives them that push to fight and carry on, but we couldn’t,” said Khadhraoui.

Khadhraoui remembered her brother having flu-like symptoms a few days before he was admitted to hospital, but he had not thought a covid-19 test was necessary. He assured Khadhraoui that he was fine and, because he had no pre-existing issues that would put him at a higher risk for covid-19, she let it go.

Early one Friday morning in late July, Khadhraoui received a distressed phone call from her sister-in-law, who exclaimed, “Margi, Alvaro can’t breathe!”

Khadhraoui told Wits Vuvuzela, “It was all so sudden. He had some symptoms, but he was fine, and then her couldn’t breathe two days later. We managed to get the paramedics to the house that morning.”

She added, “His oxygen level was at 56, which is really bad. Your normal level should sit at 94 or 95, so they immediately put him on oxygen and rushed him to the hospital.”

Goncalves was first diagnosed with bacterial pneumonia, which is an infection in the lungs caused by bacteria. It was later confirmed that he had tested positive for the coronavirus as well. Goncalves stayed in Linksfield Hospital for two weeks, and remained on a ventilator throughout.

The day before he passed, he was intubated and placed in an induced coma.

“I knew he wasn’t going to make it. I could feel it. I told my husband, ‘my brother’s leaving us,’ and I got the phone call 10 minutes later,” said Khadhraoui.

While rummaging through her bag for tissues to conceal tear-filled eyes, she said, “I couldn’t be there to hold his hand, tell him that I’m there for him or tell him to not be scared. I don’t think he necessarily needed it … I was the one that needed it.”

Stefanie Bove, a clinical psychologist of 16 years, explained that the covid-19 restrictions, and new circumstances created by the pandemic, will have an effect on the grieving process experienced by individuals who have lost loved ones.

“Grieving under these circumstances will definitely affect one’s general mental wellbeing, more so than usual. And the restrictions will play a role in the prolonged grieving process,” said Bove.

Bove, who consults for Saheti School in Senderwood and has her own private practice in the Bedfordview area, confirmed that she has had more people coming in for grief counselling than before the start of the pandemic.

Bove told Wits Vuvuzela, “I think that most grief now will result in complicated grief because there are so many new factors that have come into play. For example, not being able to have contact with loved ones or not really being able to say goodbye.”

Complicated grief refers to a prolonged grieving process, as described by Mayo Clinic, an American academic healthcare company. It is associated with, for example, difficulty in recovering from loss and resuming one’s normal life.

While psychologists may have different versions of what a normal grieving period is, Bove explained that a normal grieving period usually lasts three months. With the new circumstances created by the pandemic, however, Bove believes new factors have made it more complex and difficult to predict.

Khadhraoui recognised the covid-19 health restrictions, which prevented her from seeing her brother, as a big challenge for her.

“I needed that comfort,’’ she said. ‘‘I still struggle to come to terms with the fact that he is gone. And I don’t know if I’ll ever get over it.”

Rushed goodbyes

Another area disrupted by the covid-19 pandemic and lockdown restrictions in South Africa was the funeral industry.

The health restrictions placed on funerals denied many South Africans control over the way in which they laid their loved ones to rest. Funerals play a big role in how we say goodbye to our loved ones and so, according to Bove, can also have implications on ones grieving process.

“Rituals are so important because it’s essentially saying goodbye officially. Covid has meant that those rituals are thwarted, resulting in an even deeper sense of loss of control, and death already has that effect,” said Bove.

In many religions, white candles are often lit during funerals or after someone has died, as a symbol of remembrance for the soul that has passed on and in order to strengthen prayers. Photo: Catia De Castro.

The first restrictions placed on funerals began before lockdown, on March 15, when President Cyril Ramaphosa announced a national state of disaster. Restrictions included a limit of 50 attendants at funerals. When lockdown began, further restrictions were added to the government gazette, such as a one-hour limit on funeral services and a ban on night vigils.

South Africa is known for its cultural diversity and so naturally there are many different funeral rituals. Consequently, health restrictions have disrupted these rituals.

Nelisiwe Makaringe, a 19-year-old first-year student at the University of Johannesburg, studying public management and governance, was affected by these restrictions during her nephew’s funeral.

Makaringe and her nephew, Sifiso Mo’koena, were the same age and grew up together. She often referred to him as her brother when talking.  Mo’koena passed away suddenly in May from an unknown cause.

“He became really sick one day and started having cramps in his stomach, so he went to Thelle Mogoerane Hospital [in Vosloorus]. We still don’t know what his cause of death was because the hospital records say, ‘natural death’, but he was negative for covid,” said Makaringe.

Although Mo’koena did not pass away from the coronavirus, Makaringe disclosed that the family was still affected by the pandemic due to the funeral restrictions, as some of their African and Christian rituals were not allowed.

Makaringe told Wits Vuvuzela, “With African homes, the deceased usually comes home in the casket a day before and stays overnight at the home. We then have the funeral and memorial the next morning, and afterwards people usually cook and have a celebration. We weren’t able to do any of that.”

Makaringe said the inability to bury Mo’koena the way they had hoped to, had an impact on the way she and her family have grieved.

“The funeral was so rushed. We weren’t even able to have a memorial service. How can you have a funeral in one hour?” exclaimed Makaringe, an air of frustration in her voice.

“I was very close to him and I feel like I wasn’t able to say goodbye. We weren’t able to grieve properly.”

“Afterwards, I felt like he hadn’t died,” Makaringe added.

Funeral home workers have been on the front lines during the lockdown, so they have witnessed the way in which families have been affected by funeral restrictions.

Willem Schuwte, an assistant manager at AVBOB Funeral Parlour for the Johannesburg Central Business District branch, has been involved in funeral arrangements during the lockdown period and has had to interact with, and assist, families throughout.

AVBOB is one of the few funeral parlours that offer grief counselling to the families they assist.

Schuwte told Wits Vuvuzela, “A lot more people have requested [grieving counsellors] during lockdown. I definitely think that families have been affected by these restrictions.”

Dealing with families during this time has been extremely challenging for Schuwte due to the families’ reluctance to accept the new health restrictions. Schuwte explained that the body should go straight from the mortuary to the grave site, as outlined by covid-19 health regulations in South Africa.

“[The new process] doesn’t fit in with some beliefs, and families don’t always understand or want to comply when they are told that their loved one can’t be transported or buried the way they want,” said Schuwte.

Bove reiterated the importance of funerals in relation to grief. She said, “When you’re not given a chance to attend or pay your last respects correctly, it complicates the grieving process.”

 

Technology: A saving grace

Technology has proved to be helpful in many ways amid the pandemic. One such way has been through the ability to livestream funerals when family members or friends have been unable to attend.

Schuwte has seen many families utilise technology to livestream funerals via Zoom, Facebook and other online platforms. He said, “A lot of families have been livestreaming. It’s become the new norm, and I think it’s a trend that’s going to stick around.”

Livestreaming funerals has not only provided a way for those who cannot attend to say goodbye to their loved one, but has also eliminated the high risk of being exposed to the coronavirus when attending physically.

The high risk of funeral gatherings has been continuously seen throughout the lockdown period in South Africa. During the initial level-five lockdown period, three funerals in Eastern Cape accounted for more than 200 covid-19 cases, as reported by News 24.

Sumentha Naidoo, a 45-year-old mother of three and logistics manager at Whirlpool (a home appliances company), personally experienced the benefits of technology when she was able to attend her uncle’s funeral online.

Naidoo’s 71-year-old uncle passed away from the coronavirus in August. He had previously attended a family member’s funeral and his family believes he was exposed to the virus there. Due to the unfortunate circumstances, the family decided it would be best to have the funeral via Zoom.

“The family did it over Zoom because they didn’t want to put anyone in that position, especially since my uncle had gotten the virus from a funeral,” Naidoo told Wits Vuvuzela.

She added, “We would’ve been scared too, because we (Naidoo, her husband and children) had just recovered from the virus ourselves.”

Sumentha Naidoo acknowledged the difficultly of not having, or being able to give, physical comfort following the death of a loved one during the national lockdown in South Africa. Pictured: Sumentha Naidoo and husband, Jogi Naidoo. Photo: Catia De Castro

Naidoo explained that, although technology had been extremely useful, she wished there was no need for it, as physical support and comfort are important when grieving.

“With Christians, but especially in our Indian culture, friends and family come together the very same night someone dies. There are always people around, and that support is so important. The family was missing that embrace of a loved one, and it’s a big part of mourning,” said Naidoo.

Bove highlighted the way covid-19 restrictions have changed the expected behaviour at funerals and prevented people from conveying compassion during the sensitive period after loss.

“Social distancing makes it so difficult when you’re not able to extend normal gestures of love and care. And even afterwards, there’s no celebration. This could all prolong the normal grieving process,” said Bove.

Many South Africans have experienced loss under the already stressful context of the global pandemic, but all have been unique in their own personal way.

Khadhraoui struggled to hold back tears and subtly wiped her nose as she described her experience.

Tearfully she said, “We were only a year apart but, being the oldest, I was almost like a mother to him. Whenever there was a crisis, he knew, ‘Margi will fix it’. I felt like it was my responsibility to look after him, and I couldn’t even be there to hold his hand.”

FEATURED IMAGE: The Braamfontein Cemetary in Johannesburg remained quiet over the weekend of October 31, despite the rise in deaths during the covid-19 pandemic. Photo: Catia De Castro.

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