The sanitation crisis is a growing pandemic in most developing countries, globally, including in South Africa. It is exacerbated by increasing urbanization, poverty, lack of political will, poor institutional response and limited financial resources to address the increasing demands. The sanitation situation in Inanda in Durban is no different. This study examines a ‘trialogue’ of governance, sanitation and service delivery in Inanda. It investigates the approach to sanitation delivery, capturing the impact of policy implementation through the real experiences of communities in Inanda. The theorisation for this study is built on debates relating to governance as an analytical lens. It also draws on Foucault’s theory of governmentality to understand how government functions in an environment internal and external to itself to manage and distribute public resources as a service to the governed. Government employs the ‘art of governing’ through regulation and the rule of law to achieve its service delivery goals. In the delivery of sanitation in South Africa the government adopts a multi-stakeholder governance approach, requiring inter-spheral and inter-department synergy, together with cooperation from the local communities and other sectors. The predominant qualitative account of sanitation governance is achieved through utilising a case-study design as a methodological approach. The case-study design allowed the researcher to delve deeper into smaller cases employing multi-method data gathering techniques. Triangulation increased the reliability and credibility of the findings presented. The empirical investigation of this research concentrates on the experiences of local communities in Inanda, exploring the impact of policy choices for sanitation delivery. In addition, it captures the application of governance principles by practitioners to meet sanitation demands in the varying geo-spatial formations, different housing typologies and absence of bulk infrastructure in the peri-urban and rural settings in the study area. The study paid special attention to imperatives such as local governance and participation; access to basic services as a Constitutional right; access to sanitation to advance a better quality of life through adequate facilities, improved hygiene education and access to water to complement sanitation goals. The study revealed that sanitation delivery in Inanda was fraught with developmental challenges. The eThekwini Municipality’s Water and Sanitation Unit, responsible for the provision of sanitation to the communities of Inanda is challenged with increasing populations, unplanned settlements, weak institutional response to operations and maintenance, limited financial resources, inadequate integrated and spatial planning, and moving targets due to increasing demands for sanitation services in Inanda. Poor sludge management threatens environmental integrity and community health. The Municipality’s interim response to the sanitation needs of informal/unplanned settlements had little impact on user satisfaction as the high cost of infrastructure limits the quantity and quality of facilities provided. Communities find it difficult to utilise governments’ choice of sanitation facilities provided to them due to poor quality infrastructure, inadequate of maintenance and care of facilities, lack of effective sludge evacuation strategies for ventilated improved pit toilets, and inability to use and maintain the eco-san innovations instituted by the eThekwini Water and Sanitation Unit. Inadequate sanitation facilities exposed communities to the hazards of crime, disease, indignity, perpetuation of poverty and discrimination as well as a perception that, approximately 18 years into the democratic era, government has failed the people, as majority of the households in Inanda still do not have their own toilet facility. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2012.

Introduction: Inadequate water supply and sanitation adversely affects the health and socio-economic development of communities. Since 2003, more than 40 000 households in peri-urban and rural areas within eThekwini Municipality, South Africa, have been provided with urine diversion toilets, safe water and hygiene education. eThekwini Municipality have requested that these interventions be evaluated to monitor their effect on health outcomes. Aim: The aim of the study is to describe the baseline situation in respect of sanitation, safe water and hygiene behaviour in Intervention Areas in eThekwini Municipality and compare these to Control Areas. Methods: An observational analytic cross sectional study design was undertaken. A multi-stage sampling procedure was followed and six study areas were randomly selected. Three Intervention Areas (urine diversion toilets) were matched with three Control Areas (no urine diversion toilets). A total of 1337 households, comprising of 7219 individuals, were included in the study. A Household Questionnaire a and an Observational Protocolb was administered by fieldworkers. Data was entered onto a custom designed EpiData database, processed and analysed using SPSS version 13. Results: The baseline characteristics revealed that Intervention and Control areas were very similar other than the provision of urine diversion toilets, safe water and hygiene education in the Intervention area. The Intervention area scored higher than the Control area (2.31 vs. 1.64) with regard to having a cleaner toilet, with no flies, no smells, having hand-washing facilities and soap provided close to the toilet. Some of the collected data from questionnaire responses were not consistent with the fieldworkers observations. It was reported that 642 households in the Control and 621 in the Intervention areas washed their hands with soap, whilst only 396 households in the Control and 309 in the Intervention areas were observed to have washed their hands with soap. Conclusion: Households in the Control area are at a greater risk of developing diarrhoeal and other related diseases. The provision of safe water, urine diversion toilets and hygiene education in the Intervention area has proved to be successful. Recommendations: eThekwini municipality must expand the package of services c to the Control areas. Sustainable hygiene education programmes must continue to be implemented and be evaluated over time. Plate 1: Inside view of the UD Toilet Plate 2: Ground tank providing 200 litres free water Plate 3: Hygiene education material Plate 4: External rear view of the UD toilet / Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2007.

The effect of different types of sanitation facilities on soil contamination with geohelminth eggs and the associated risk factors were assessed in three informal settlements in Durban, South Africa. Adult members of 30 households in each settlement were interviewed to determine their knowledge, attitudes and perceptions on risk factors associated with geohelminth transmission. Two hundred soil samples were collected in each study settlement from areas considered potential sources of infection such as houses, pathways, sanitation facilities and washing areas. Of the total 600 soil samples collected, 190 (32%) were positive for geohelminth eggs with the eggs of Ascaris lumbricoides, Trichuris trichiura and Taenia spp. being recovered. Quarry Road West, where open defaecation was the most common (80%), sanitation coverage the lowest (11%) and lack of knowledge on geohelminth transmission high (97%), showed the highest levels of soil contamination (mean = 102.55eggs/100g). Stool samples were also collected from 135 children aged 1-16 years living in the three study areas. Children were found to be infected with A. lumbricoides and T. trichiura with prevalences of 33.4 and 6.5%, respectively and corresponding geometric mean intensities of 5.6 and 0.87eggs/g faeces. Some children (9.6%) also harboured dual infections. No hookworm or tapeworm infections were recorded. The results show a direct link between high levels of soil contamination and increased prevalence and infection rates. Indiscriminate defaecation by community members is recognised as the main contributing factor of geohelminth eggs in soil. The type and the number of toilets provided to a community greatly influence the success of a sanitation facility. In order to effectively control geohelminth transmission, health education and antihelminthic treatment need to accompany sanitation programmes in these areas. / Thesis (M.Sc.)-University of KwaZulu-Natal, Westville, 2011.