Uncollected waste often serves as breeding grounds for rodents and other disease carrying vectors, particularly in informal and squatter communities. Open waste has been associated with injury, suffocation, poisoning and death amongst waste pickers and children playing in the vicinity.

The current housing backlog is estimated to be in excess of 150 000 units. As a result many people in the CMA live in inadequate, unsafe and unserviced housing often in overcrowded conditions. These adverse living conditions contribute to the spread of communicable diseases.

Inappropriate provision of housing in flood plains, on unstable soils and steep slopes and in transport corridors has increased the environmental health/hazard risk to the host communities.

In 1995, an average of 2.9% of people in the CMA did not have access to water supplies within 50 metres of their place of dwelling. In areas such as Khayelitsha, this proportion increased to over 5%. The utilisation of insufficient quantities of water has a negative impact on domestic and personal hygiene practices, with the potential for spread of disease.

11% of dwellings in the CMA did not have on-site waterborne sanitation in 1995, with 1% of the population reliant on pit latrines. 78% of households had flush toilets within the house but only 24% of households within black communities had such facilities.

In 1995, 94% of dwellings had access to refuse removal services. 72 000 dwellings were without operational stormwater drainage.

In 1995, 8% of the CMA population used paraffin for cooking, with 40% of these being black. Wood is also used as a source of energy in informal settlements. Research has shown that acute respiratory infections are the main ill health symptoms in informal settlements and an important cause of childhood morbidity and mortality.

There were 79 cases of Meningococcal Meningitis recorded between January 1998 and August 1998. In 1997, there were 367 deaths due Tuberculosis in the Cape Metropolitan Region.

Between July and December 1998, 27 432 cases of acute respiratory chest infection in children under six years of age were recorded throughout the CMA.

• Percentage of population with safe and accessible drinking water.
• Percentage of population served with safe and adequate sanitation.
• Percentage of the population with adequate refuse removal.
• Meningococcal meningitis rate.
• Tuberculosis rate.

See a summary of all Indicators on this website

• An informal housing study is being undertaken, focussing on unplanned and un-serviced squatter settlements in order to identify the worst off in terms of housing provision and basic services.
• A district health system is being developed to integrate provincial and local government community facilities to ensure more responsive and effective local services.
• A planning and co-ordinating unit has been set up within the Directorate: Protection, Health and Trading to assist in determining where health facilities should be located and to liase with relevant communities regarding their needs.
• A public awareness and education programme about safe waste disposal and minimisation is being undertaken.

The CMC is also involved in the following initiative:

• A CMA Healthy Cities/Local Agenda 21 Initiative, which aims to select environmental health indicators.

• Lobby your local Councillor to place the provision and improvement of basic services on your Council’s agenda.
• If your drinking water comes from an informal source, treat it before consuming it e.g. through filtration, boiling and chlorination.
• Get involved in neighbourhood clean up campaigns.
• Do not make fires in confined, poorly ventilated spaces.
• Do not swim or wash in stagnant water or urban canals.
• Do not allow your children to play on waste sites.
• Do not build your house in the flood plain of a river or on unstable, steep slopes.
• Be aware of the symptoms of Tuberculosis and Meningococcal Meningitis and encourage people who show signs of having these diseases to undergo tests and treatment.