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Limited access to water and sanitation is a risk to health, dignity, and ability to engage in occupations. This article aims to: 1) discuss the current and historical factors affecting access to water and sanitation in rural South Africa, and 2) explore the occupational implications of water access, particularly for older adults and people with disability in rural South Africa. A literature review was carried out through searching JSTOR, Scopus, and MEDLINE databases and using framework analysis to interpret the retrieved documents. This paper also reports a thematic analysis of semi-structured interviews, conducted in 2012 in a rural area of South Africa. Environmental, political, social-economic and attitudinal factors were identified as impacting water access and occupation, in both the documentary analysis and the semi-structured interviews. Due to South Africa’s history, injustice has occurred in the forms of occupational apartheid and occupational deprivation. We argue that supply systems must enable people to easily access more water than is essential for survival, so that people can participate in meaningful and productive occupations. Therefore, access to water should be considered part of an occupational right. Recognising this right will be an integral step in ensuring that water supplies are improved to support better livelihoods, and to achieve economic and social empowerment, and quality of life for all, in line with many of the United Nations’ new Sustainable Development Goals

The ICF framework facilitates the communication of children's perceptions of health and of relationships between health and water carrying. The model thus derived from their views incorporates not only commonly accepted conceptualizations of health condition, body structure and physiological function, but also of functioning through activities and social participation. Children's accounts suggest a possible association between water carrying and symptoms typical of musculoskeletal disorders. However, further research into the strength of association between water carrying and musculoskeletal disorders is needed.

Abstract. Cyanobacteria produce toxins which are hazardous to the health of people who are using water that is contaminated. The hazard quotient suggested by United States Environmental Protection Agency (USEPA) was used to assess the human health hazard of using contaminated water containers. There was no statistically significant difference (P = 0.5511) in the level of microcystin between blooming and decaying seasons. Findings show that all treated water samples in the containers were below the 1.0 µg/L level, which underscore this important issue: drinking water from treated water in containers has no adverse health effect when compared to drinking water from non-treated water containers, whether used by adults or children. In conclusion, collecting and storing of either pre-treated or non-treated water using containers needs post-treatment before drinking.

Most conventional water treatment plants are not sufficiently equipped to treat both intracellular and extracellular Microcystins in drinking water. However, the effectiveness of sodium hypochlorite in removing Microcystin in containers at the point-of-use is not yet known. This study aimed to assess point-of-use water container treatment using bleach or sodium hypochlorite (NaOCl) and to assess the health problems associated with microcystins. Thirty-nine percent (29 of 74) of the total selected households were randomly selected to receive and treat their stored container water with sodium hypochlorite. The level of microcystin in the container water was measured after 30 min of contact with sodium hypochlorite. Microcystin concentrations in both the blooming and decaying seasons were higher (mean 1.10, 95% CI 0.46–1.67 µg/L and mean 1.14, 95% CI 0.65–1.63 µg/L, respectively) than the acceptable limit of 1 µg/L in households that did not treat their water with NaOCl, whilst in those that did, there was a significant reduction in the microcystin concentration (mean 0.07, 95% CI 0.00–0.16 µg/L and mean 0.18, 95% CI 0.00–0.45 µg/L). In conclusion, sodium hypochlorite treatment decreased microcystin s to an acceptable level and reduced the related health problems.

Plastic containers in the range of 5-20 L are widely used - especially in rural African settings - to collect, transport and store water for domestic use, including drinking, bathing and hygiene. The pathogen content of the waters in these containers has not been adequately characterized as yet. This paper presents the primary findings of a synoptic survey of drinking water quality samples from these containers and involved collection of bacterial indicator and pathogenicity gene data. In total, 571 samples of a variety of waters were taken in rural communities in South Africa and the Escherichia coli numbers measured. Of the E. coli positive samples, 46% (n = 148) were screened for the presence of E. coli pathogen gene markers. Though synoptic, the survey provided many insights into the issues that drove the study. Container use markedly degraded water quality as judged by indicator counts, even where improved water supply services were in place. Household container use also appeared to promote regrowth or contamination of containers with pathogenic E. coli strains. Polymerase chain reaction (PCR) analysis also showed that the diversity of potential pathogenic E. coli carrying virulence genes was great. All seven genes screened for (Ial, Stx1, Stx2, EaeA, Eagg, ST, LT) were found in the waters, alone or as mixtures (number of different combinations = 31) including those characteristic of the more dangerous invasive and haemorrhagic E. coli strains. Given the central role of containers in the management of water supply to rural communities, it is clear the microbiology of these waters requires much further characterization.

The study investigated the effects of cyanobacteria toxins such as microcystins in water sources and water stored in containers during its blooming and decaying seasons. Samples from water sources and containers near the Hartbeespoort Dam in South Africa were analysed using a microcystin ELIZA test kit. Microcystins were present in water sources used by the community, with an average of 4.3 μg/L in communal tap water and 4.8 μg/L in the water stored in tanks. The concentration of microcystins was lower in groundwater in the decaying season (0.38 μg/L) than in the blooming season (1.4 μg/L). Although microcystins were present in the storage containers, the average levels in all water samples were below the acceptable limit of 1 μg/L. The present study confirmed the presence of microcystins in the water storage containers. Therefore, it is suggested that water used for drinking from community water sources should be treated before storage to eliminate microcystins.

Author Contributions: Both (Mokoena MM. and Mukhola MS) authors were the one who conceptualized; develop the methodology; including the software to be used during data analyses as well as validating it. The investigation and formal data capturing, cleaning coding and analysis were done by Mokoena MM. Mokoena MM wrote the original draft and Mukhola MS contributed on review and editing it.