Reacting to the rapid spread of cholera in Limpopo in particular, the South African government made equally vociferous efforts to deny that the rising number of cholera incidents were indicative of gaps and failures in the health system and the inability of current social policy to address the demand- and supply-side factors that militate against access to information, sanitation and health services for the most poor. In its vintage style, the government has chosen to ignore the structural conditions that provide fertile ground for disease, and has instead opted for the convenient excuse of blaming the outbreak of disease solely on the ignorance and negligence of the poor.

The message we are bombarded with from radio, television and government newsletters is that all we need to do is wash our hands before we eat and boil drinking water, and cholera and other diseases will be a thing of the past. While cleanness and neatness, personal hygiene and individual choices comprise critical health factors, simply harping on about these at the exclusion of addressing socio-economic conditions and structural issues is tantamount scratching the wound instead of addressing the primary problem. The fact of the matter is that there is an escalation in the prices of goods, including electricity, paraffin, and coal. A significant number of people still have no access to electricity, own no stoves and still have to walk thousands of kilometres to hew wood and gather cow dung for fire. It is therefore unlikely that the rural and urban poor will have the luxury of having their stoves on all the time. Given these realities, the poor are more likely to put their stoves on or light their braziers once or twice a day only when they cook meals.

This simply means that even if the rural and urban poor know that boiling drinking water will help to avert cholera and other waterborne diseases, their socio-economic situation is such that they simply cannot afford to boil water every time they have to drink it. In any case, having burning braziers and coal-stoves on all throughout the day will also mean the poor will inhale flames and polluted air every minute of their lives. It is therefore critical to acknowledge the social policy and economic path – based on commercialising and commoditising basic services such as water and electricity – and the urban-centred developmental trajectory that are central to the spread of disease. The long and the short of it is that we cannot address health issues appropriately without moving towards pro-poor social policy and insisting on an economic-growth path focused on improving the income, livelihood, and capability of the most poor and indigent, especially the rural poor and the urban proletariat.

* Mphutlane wa Bofelo is a South African writer–activist and contributor to kagablog.
* Please send comments to [email protected] or comment online at http://www.pambazuka.org/.