Water shortages and failing municipal infrastructure are disrupting healthcare services across the Eastern Cape, with facilities in both urban and rural areas struggling to maintain basic hygiene and patient care.
In Makhanda, images of women carrying buckets of water at Settlers Hospital this week sparked public concern, while in the rural Alfred Nzo district, staff and patients at the Meje Community Health Centre have been forced to fetch water from tanks for months.
At Settlers Hospital, the provincial health department moved to clarify the situation after photographs and videos circulated on social media showing women carrying containers of water inside the facility.
The department said the women were not patients but boarder mothers — accommodated at the hospital to support admitted children — and insisted that no patient had been instructed to carry water.
It said the water in the containers had been supplied from the hospital’s internal reserves as part of contingency measures during municipal outages in Makhanda.
According to the department, a small number of caregivers briefly moved containers themselves after using their allocated water, before staff intervened.
“The actions shown were voluntary and not instructed by staff,” the department said, adding that the incident was short-lived and did not affect clinical services.
It maintained that patient care continued uninterrupted and that sufficient water remained available for essential functions, including medication preparation and kitchen use.
However, residents and civil society organisations said the incident reflected a deeper and more persistent crisis linked to the collapse of water infrastructure in the Makana Local Municipality.
If there’s water in the pipes, it’s brown. It’s sewage coming out of our taps
Devon Waldick of Grahamstown Deserves Better said the situation at the hospital was symptomatic of broader failures in municipal service delivery.
“We don’t have water for months,” Waldick said.
“If there’s water in the pipes, it’s brown. It’s sewage coming out of our taps.”
He said unreliable supply was affecting households, businesses and public institutions alike.
The impact is even more severe in rural areas.
At the Meje Community Health Centre in Mbizana, staff and patients have been without running water for months, relying on buckets drawn from tanks located hundreds of metres away.
The Public Service Association (PSA) said conditions had deteriorated to the point where basic healthcare delivery was being compromised.
“We were informed that nurses have to fetch water in buckets and the tank is more than 400 metres away,” PSA provincial manager Thami Makuzeni said.
“Sometimes patients resort to relieving themselves in nearby bushes because of this situation.”
The union warned that the lack of water, combined with staffing shortages and poor sanitation, posed serious occupational health and safety risks.
In a letter to senior health officials, seen by the Dispatch, conditions at the facility were described as “dirty and unhealthy”, with the absence of running water making it impossible to properly clean the premises or maintain infection control standards.
The health department said the intermittent supply at Meje was linked to a declining borehole, which had run dry.
Health MEC Ntandokazi Capa’s spokesperson, Camagwini Mavovana, said a new, deeper borehole had been approved, with implementation expected to begin this week.
In the interim, water deliveries had been made to backup tanks, while the existing borehole had resumed limited pumping to parts of the facility.
Despite these measures, the PSA said no meaningful intervention had been implemented over several months, prompting the matter to be escalated to the SA Human Rights Commission.
Political parties said the crisis reflected a wider collapse in infrastructure and governance.
The EFF said ongoing service delivery failures were undermining the dignity and safety of residents.
Meanwhile, DA MPL Mogatosi Kabelo said the crisis highlighted the dependence of healthcare facilities on functioning municipal services.
“Hospitals depend on municipalities for basic services to function, and when these collapse, hospitals and clinics can’t function,” Kabelo said.
As water outages persist across parts of the province, health facilities are increasingly forced to rely on contingency measures, raising concerns about the long-term sustainability of services.
Daily Dispatch
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