In response to the recent cholera outbreaks in South Africa, the University of the Free State is at the forefront of developing a ground-breaking solution that aims to revolutionise low-cost domestic wastewater treatment and transform the country’s water infrastructure in rural areas. Led by the team at the UFS Centre for Environmental Management (CEM) in collaboration with the Council for Scientific and Industrial Research (CSIR), this innovative approach is centred around ecological engineering and offers a promising solution to the pressing water security concerns and increased pollution risks facing the nation.

South Africa has faced significant challenges in integrating water resource management and environmental preservation, leading to compromised water security and escalating pollution risks. Traditional wastewater treatment methods have struggled to cope with the deterioration of infrastructure, institutional capacity limitations, and rising hydraulic loads, resulting in the discharge of pollutants into rivers. This has raised concerns about the environmental and public health risks of heavy metals, emerging contaminants, and ‘forever chemicals’ (chemicals have an exceptionally long lifespan and do not naturally break down over time).

Natural-based solutions to address issues

Prof Paul Oberholster, Director of the CEM, says to address these critical issues, the centre has introduced a range of natural-based solutions, including phycoremediation, phytoremediation, and microbial bioremediation. Phycoremediation, a cutting-edge biological clean-up technology, uses indigenous micro or macro algae to remove contaminants from wastewater effluents.

“Phycoremediation effectively transforms pollutants such as carbon, nitrogen, phosphorus, sulfates, and salts into benign substances by harnessing nutrient enrichment. This process offers multiple advantages, including tackling various pollutants simultaneously, creating commercially beneficial compounds, sequestering CO2, and producing biohydrogen. Furthermore, phycoremediation is a cost-effective and resilient process that can accommodate varying substance quantities and consistencies.

“Microbial bioremediation, another pioneering technique, utilises microorganisms to naturally break down and degrade soil, water, and air pollutants. By leveraging the natural metabolic processes of microorganisms, microbial bioremediation reduces harmful substances to non-toxic or less toxic forms,” Prof Oberholster says. “This environmentally friendly method has shown success in cleaning up contaminated sites, including industrial areas, agricultural fields, disaster-stricken areas, and wastewater treatment plants.” 

This phycoremediation technology for domestic wastewater, developed in collaboration with the CSIR and the African Development Bank, is suitable for small to medium rural plants. It does not use electricity or any dangerous chemicals, and can be used on the assisting infrastructure. The technology has already been rolled out in the Western Cape, Limpopo, and Malawi.

According to Prof Oberholster, implementing these ecological engineering solutions provides transformative opportunities for small to medium-sized wastewater treatment works in South Africa. By incorporating these technologies, local communities can enhance treatment capacity, create employment opportunities, and recycle materials, while benefiting from cost-effective and environmentally conscious solutions. Upgrading existing treatment works becomes feasible, reducing the need for significant infrastructure investments.

Dr Yolandi Schoeman, a postdoctoral student in CEM, says cholera, a severe diarrheal disease caused by the bacterium Vibrio cholerae, has been a significant concern in South Africa. Understanding the causes, warning signs, and preventive measures is crucial in combating this deadly disease. Cholera outbreaks often occur in areas with poor sanitation, inadequate access to clean water, and overcrowding. Contaminated water sources, such as rivers or wells, become breeding grounds for the bacterium, which is then transmitted through contaminated food and water. Early identification of warning signs, including severe diarrhoea, vomiting, and dehydration, is essential for timely intervention.

Causes of cholera

Contaminated water: Cholera outbreaks often occur in areas with poor sanitation and inadequate access to clean water. The bacterium Vibrio cholerae thrives in contaminated water sources such as rivers, lakes, or wells.

Contaminated food: Cholera can also be transmitted through consuming contaminated food, especially raw or undercooked seafood, or produce irrigated with contaminated water.

Poor sanitation: Improper waste disposal, lack of proper sewage systems, and unhygienic conditions contribute to the spread of cholera. When human waste containing the cholera bacterium contaminates water sources or food, the disease can spread rapidly.

Warning signs of cholera

Diarrhoea: Cholera is characterised by profuse watery diarrhoea. The stools are often described as "rice water" due to their appearance.

Vomiting: Along with diarrhoea, cholera may cause vomiting, leading to rapid dehydration.

Dehydration: Cholera can cause severe dehydration due to losing fluids and electrolytes. Signs of dehydration include dry mouth, excessive thirst, decreased urine output, rapid heart rate, and low blood pressure.

Preventive measures to combat cholera

Access to clean water: Ensuring a clean water supply is crucial in preventing cholera. Communities should have access to safe drinking water sources, and measures should be taken to prevent contamination of water sources.

Hygiene practices: Promoting good hygiene practices, such as regular handwashing with soap and clean water, can help prevent transmission of cholera. Handwashing should be done before handling food or eating, and after using the toilet.

Sanitation improvements: Proper waste disposal systems, improved sewage systems, and sanitation facilities are essential in preventing the contamination of water sources and the spread of cholera.

Health education: Conducting health education campaigns to raise awareness about cholera symptoms, transmission routes, and preventive measures is crucial. Communities at risk should be educated on safe water practices, proper hygiene, and the importance of seeking medical help if symptoms occur.

Surveillance and rapid response: Establishing robust surveillance systems to detect cholera cases early and respond rapidly is vital. This includes improving laboratory diagnostics, training healthcare workers, and enhancing communication between health authorities and communities.

Vaccination: Vaccination against cholera can be an effective preventive measure, especially in high-risk areas or during outbreaks. Oral cholera vaccines can provide protection against the disease. It is important to note that vaccines alone may not be sufficient to control cholera. Improving water and sanitation infrastructure, disaster anticipation and response, promoting good hygiene practices, and implementing appropriate public health measures are also crucial in preventing and controlling cholera outbreaks.

“To prevent cholera outbreaks, a multi-faceted approach is required,” Dr Schoeman says. “Individuals and communities must prioritise access to clean water by ensuring a clean water supply and promoting hygiene practices such as handwashing with soap. Sanitation improvements, including proper waste disposal and improved sewage systems, are essential in preventing the contamination of water sources.” 

She says health education campaigns should raise awareness about cholera symptoms, transmission routes, and preventive measures, targeting communities at risk. “Establishing robust surveillance systems and emergency response teams, improving laboratory diagnostics, and enhancing communication between health authorities and communities is crucial for rapid response to cholera cases.” 

In addition to these preventive measures, nature-based systems offer innovative approaches to cholera prevention by harnessing the power of natural ecosystems. Conserving and restoring wetlands, which act as natural filters, can help purify water and reduce the presence of pathogens like Vibrio cholerae. The integration of ecological engineering solutions, such as phycoremediation and microbial bioremediation, into wastewater treatment processes not only addresses pollution concerns but also contributes to preventing the contamination of water sources and reducing the risk of cholera outbreaks.

The CEM's pioneering work aligns seamlessly with South Africa's commitment to sustainable development and the United Nations' Sustainable Development Goal 6, which aims to ensure universal access to clean water and sanitation. By integrating ecological engineering solutions like phycoremediation into public sector service delivery efforts, the CEM is driving positive change, improving quality of life for South African communities, and protecting precious water resources.

“The challenges we face in wastewater management, water security, and preventing cholera outbreaks require innovative solutions that prioritise ecological engineering and sustainability. Through our research and collaboration with local health authorities, we aim to develop preventive measures to combat cholera outbreaks and create a resilient water infrastructure for South Africa,” Prof Oberholster says.

The CEM's work has already demonstrated its efficacy and potential by piloting these advanced treatment technologies in the Southern African Development Community (SADC) countries. “Further research and capacity-building efforts within South Africa will enable the widespread implementation of these solutions and address the unique challenges small and medium municipalities face,” Prof Oberholster adds.