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22 April 2025 | Story André Damons | Photo Supplied
Dr Tafadzwa Maramura
Dr Tafadzwa Clementine Maramura is a Senior Lecturer and NRF-Rated Researcher in the Department of Public Administration and Management at the UFS.

With roughly half the world’s population experiencing severe water scarcity for at least part of the year, according to the UN World Water Development Report 2024, a researcher from the University of the Free State (UFS) seeks to understand how South Africa and the rest of the African continent can ensure that every person has access to water.

Besides Dr Tafadzwa Clementine Maramura, Senior Lecturer and NRF-Rated Researcher in the Department of Public Administration and Management at the UFS, research focusing on service delivery, especially delivery of water to the most vulnerable and poorest households, her work also focuses on the water-health nexus. In February she was appointed the Secretary for the Institutional Governance and Regulations Framework – a sub-specialist group for the International Water Association (IWA), becoming the first black African female to be appointed to this position.

According to statistics quoted by Greenpeace, 5.52 billion people out of a population of 7.78 billion in 186 countries face water insecurity, of which, 1.34 billion are Africans, accounting for more than 90% of the continent’s population. The United Nations World Water Development Report 2024: water for prosperity and peace; facts, figures, and action examples state that as of 2022, 2.2 billion people were without access to safely managed drinking water.

 

Research focus

With this, and with the Sustainable Development Goals (SDGs) – especially Goal 6 (clean water and sanitation) – in mind, Dr Maramura seeks to understand how South Africa and the rest of Africa can ensure that everyone gets access to this particular resource. “My research focuses on water governance and sustainable service delivery, public policies, and the green economy in the African, as well as the South African, context. What I found is interesting and really saddening at the same time. When you break it down, you realise that one in every three people in Africa don’t have access to potable water.

“Water is a basic human right, you can survive without electricity and other luxuries, but not without water. Each time you brush your teeth or flush your toilet with at least 15 litres of clean water or you are watering your garden with clean water, there are people that actually don’t have access to basic drinking water,” says Dr Maramura.

She is also investigating what the government is doing to ensure it delivers on this service it is mandated to, as South Africa has all the policies in place, and the best constitution in the world, but still the poor and most vulnerable communities do not have water.

“Access to clean water is not just a basic need; it is a matter of dignity, equality, and survival. As a young African woman, through my research, I see first-hand how the burden of water scarcity falls disproportionately on women and girls, robbing us as women, of education, economic opportunities, and health.

“But we are not just victims – we are leaders in this fight. By empowering women and investing in sustainable water solutions, we can transform our communities and break the cycle of poverty. The time for action is now because water is life, and every African deserves it.”

 

The water-health nexus

Dr Maramura has book chapters coming out in June this year that focus on the water-health nexus in failed states, thereby merging SDG 3 and 6 on health and water respectively. Water plays an indispensable role in the world as it is important for accomplishing several other SDGs, such as zero hunger, poverty eradication, good health and well-being, and affordable and clean energy. It all depends on the achievement of goal 6.

Says Dr Maramura: “You cannot solve problems in isolation; you cannot look at the water problem in isolation. If you have a water problem, you have a health and education problem because kids can’t go to school if there is no water. Hospitals can’t function when there is no water.

“SDG 3 speaks to health and SDG 6 speaks to water and that is where the nexus is, nexus meaning connection between water and health. How can we ensure that we merge the two together and ensure researchers working on health and water can find common ground to address any challenges arising from the lack of water so that we don’t have these health issues?”

South Africa is an upper-middle-income country but still struggles to deliver potable water to everyone and many communities in the country still rely on ventilated pit latrines due to limited access to modern sanitation facilities. With the deadline for achieving the 17 SDGs only five years away, South Africa is at risk of failing to achieve the SDGs.

 

Solving the water problems

According to Dr Maramura, there is no magic wand that can be used to solve all the country's water problems, but a collaborative and comprehensive effort is needed. “There is work that needs to be done. The government, private sector, the communities, as well as other role players need to work together. South Africa is a water-stressed country with rainfall below the global average. We realised that we have scarce groundwater resources.

“The community needs to understand, participate, and be aware of how much damage we can do by just drilling boreholes and digging wells. The private sector needs to know what it is that they can do to ensure that they also play a part through their corporate social responsibility and philanthropic dimensions in assisting the community.”

From the government side, she says, the policies are there so the government needs to consult with the communities, the private sector, and all other relevant stakeholders. They need to involve affected communities and after consultations, they need to engage these communities because they understand their problem best.

News Archive

Higher than expected prevalence of dementia in South African urban black population
2010-09-22

 Prof. Malan Heyns and Mr Rikus van der Poel

Pilot research done by University of the Free State (UFS) indicates that the prevalence of dementia, of which Alzheimer’s disease is only one of the causes, is considerably higher than initially estimated. Clinical tests are now underway to confirm these preliminary findings.

To date it has been incorrectly assumed that dementia is less prevalent among urban black communities. This assumption is strongly disputed by the findings of the current study, which indicates a preliminary prevalence rate of approximately 6% for adults aged 65 years and older in this population group. Previous estimates for Southern Africa have been set at around 2,1%.

The research by the Unit for Professional Training and Services in the Behavioural Sciences (UNIBS) at the UFS and Alzheimer’s South Africa is part of the International 10/66 Dementia Research Group’s (10/66 DRG) initiative to establish the prevalence of dementia worldwide.

Mr Rikus van der Poel, coordinator of the local study, and Prof. Malan Heyns, Principal Investigator, say worldwide 66% of people with dementia live in low and middle income countries. It is expected that it will rise to more than 70% by 2040, and the socio-economic impact of dementia will increase accordingly within this period. 21 September marks World Alzheimer’s Day, and this year the focus is on the global economic impact of dementia. Currently, the world wide cost of dementia exceeds 1% of the total global GDP. If the global cost associated with dementia care was a company, it would be larger than Exxon-Mobil or Wal-Mart.

The researchers also say that of great concern is the fact that South Africa’s public healthcare system is essentially geared toward addressing primary healthcare needs, such as HIV/Aids and tuberculosis. The adult prevalence rate of HIV was 18,1% in 2007. According to UNAIDS figures more than 5,7 million people in South Africa are living with HIV/Aids, with an estimated annual mortality of 300 000. In many instances the deceased are young parents, with the result that the burden of childcare falls back on the elderly, and in many cases elderly grandparents suffering from dementia are left without children to take care of them. “These are but a few reasons that highlight the need for advocacy and awareness regarding dementia and care giving in a growing and increasingly urbanized population,” they say.

Low and middle income countries often lack epidemiological data to provide representative estimates of the regional prevalence of dementia. In general, epidemiological studies are challenging and expensive, especially in multi-cultural environments where the application of research protocols relies heavily on accurate language translations and successfully negotiated community access. Despite these challenges, the local researchers are keen to support advocacy and have joined the international effort to establish the prevalence of dementia through the 10/66 DRG.

The 10/66 DRG is a collective of researchers carrying out population-based research into dementia, non-communicable diseases and ageing in low and middle income countries. 10/66 refers to the two-thirds (66%) of people with dementia living in low and middle income countries, and the 10% or less of population-based research that has been carried out in those regions.

Since its inception in 1998, the 10/66 DRG has conducted population based surveys in 14 catchment areas in ten low and middle income countries, with a specific focus on the prevalence and impact of dementia. South Africa is one of seven LAMICs (low and medium income countries) where new studies have been conducted recently, the others being Puerto Rico, Peru, Mexico, Argentina, China and India.

Mr Van der Poel says participating researchers endeavour to conduct cross-sectional, comprehensive, one-phase surveys of all residents aged 65 and older within a geographically defined area. All centres share the same core minimum dataset with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non-communicable risk factor questionnaires, disability/functioning, health service utilization and caregiver strain).

The local pilot study, funded by Alzheimer’s South Africa, was rolled out through an existing community partnership, the Mangaung University of the Free State Community Partnership Programme (MUCPP).

According to Mr Van der Poel and Prof. Heyns, valuable insights have been gained into the myriad factors at play in establishing an epidemiological research project. The local community has responded positively and the pilot phase in and of itself has managed to promote awareness of the condition. The study has also managed to identify traditional and culture-specific views of dementia and dementia care. In addition, existing community-based networks are being strengthened, since part of the protocol will include the training and development of family caregivers within the local community in Mangaung.

“Like most developing economies, the South African population will experience continued urbanization during the next two decades, along with increased life expectancy. Community-based and residential care facilities for dementia are few and far between and government spending will in all probability continue to address the high demands associated with primary healthcare needs. These are only some of the reasons why epidemiological and related research is an important tool for assisting lobbyists, advocates and policymakers in promoting better care for those affected by dementia.”

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za  
21 September 2010

 

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