Evaluating water conservation and water demand management in an industrialised city: a case study of the City of uMhlathuze in Richards Bay

The objective of this study was to evaluate water conservation and water demand management in an industrialised City of uMhlathuze in Richards Bay. The City of uMhlathuze Local Municipality is the third-largest municipality in KwaZulu Natal (KZN) and is strategically placed to continue attracting investment as an aspirant metropolis due to the newly established Industrial Development Zone (IDZ) and the country's largest deep-water port. As an industrialised city, uMhlathuze's demand for water is already increasing and with the establishment of the IDZ, it is expected that water demand will escalate even further once the IDZ is fully operational. In line with the research question, this study has, therefore, sought to understand whether the industrialised City of uMhlathuze has developed and effectively implemented a water conservation and water demand management strategy and interventions in order to sustain water supply in anticipation of growing demand due to industrialisation and population growth. This objective was achieved by evaluating the city's current interventions and measures using a range of water conservation and water demand management solutions and guidelines. During this study, it was evident that the greatest threat facing South Africa's ambitious future economic growth, poverty alleviation and government's transformation agenda was the inefficient and unbalanced use of available and limited water resources. Thus, in order to avoid this imminent threat, the country as a whole must continuously reduce water consumption and demand from various sectors. This goal can be achieved through sustainable and improved water conservation and water demand management interventions. The study found that, in recent years, the issue of water scarcity had escalated in KZN. The province was in the grip of a drought, which was taking its toll on water supply in various municipalities around the province. The sparse rainfall in most parts of the province had caused the levels of rivers and dams to decrease to a point of crisis. Consequently, the KZN Provincial Government declared the province a disaster area in 2015. During the study, there was very little improvement as the City of uMhlathuze was still subjected to level 4 water restrictions. Evidently, the drought was intensifying the water problem in a municipality already grappling with poor and inadequate water infrastructure. A review of international and local literature was undertaken to theoretically position the objective of the research. An evaluation of the City of uMhlathuze water conservation and water demand management strategy and interventions was conducted using a questionnaire completed by city officials and part of the study included documentation review. This study investigated key elements of water conservation and demand management as well as interventions that were pertinent to achieving the desired outcome of efficient use of water. Respondents were required to answer questions focusing on several water conservation and water demand management related approaches and solutions. During the study, it was identified that there were inconsistencies in the implementation of water conservation and water demand management interventions even though the City of uMhlathuze had already taken the important step of developing a water conservation and water demand management strategy. It was recognised, however, that water conservation and water demand management remained relatively new for most municipalities. Consequently, it would take time for municipalities, together with communities, to implement effective interventions. The focus needs to be on the establishment of a combined team of staff and stakeholders, set up to finding solutions and interventions designed to maximise the most sustainable and efficient use of water. The conclusions drawn from this study and proposed recommendations indicated that wastewater reuse; pipe replacement; water pressure management; rainwater and stormwater harvesting; water sensitive urban design; leak detection and repair; joint planning and research team with the Industrial Development Zone; groundwater and aquifer recharge; stakeholder engagement, education and citizen awareness are feasible options for the City of uMhlathuze to consider in relation to water conservation and water demand management. These solutions should constitute the foundation of a revised and updated water conservation and water demand management strategy to be implemented incrementally with broad-based participation

Disclosure of HIV status: experiences of patients enrolled in an integrated TB and HAART programme in South Africa.

The convergence between the tuberculosis (TB) and HIV epidemics has led to studies investigating strategies for integrated HIV and TB care. We present the experiences of a cohort of 17 patients enrolled in the first integrated TB and HIV treatment pilot programme, conducted in Durban, South Africa, as a precursor to a pivotal trial to answer the question of when to start antiretroviral treatment (ART) in patients co-infected with HIV and TB. Patients’ experiences with integrated TB and HIV care can provide insight about the problems or benefits of introducing HIV treatment into existing TB care in resource-constrained settings, where stigma and discrimination are often pervasive and determining factors influencing treatment uptake and coverage. Individual interviews, focus group discussions, and observations were used to understand patients’ experiences with integrated TB and HIV treatment. The patients described incorporating highly active antiretroviral therapy (HAART) into their daily routine as ‘easy’; however, the patients experienced difficulties with disclosing their HIV status. Non-disclosure to sexual partners may jeopardise safer-sex practices and enhance HIV transmission. Being on TB treatment created a safe space for all patients to conceal their HIV status from those to whom they did not wish to disclose. The data suggest that the context of directly observed therapy (DOT) for TB may have the added benefit of creating a safe space for introducing ART to patients who would benefit most from treatment initiation but who are not ready or prepared to disclose their HIV status to others