Water Shortages: Cause of Water Safety in Sub-Saharan Africa

Abstract

This chapter highlights a high rate of water crisis across sub-Saharan Africa (SSA) despite its huge hydro-potential. Factors contributing to water stress include rainfall deficit and drought, increased water requirements, population growth, urbanization, and poverty. Coupled with the uneven distribution of water resources and mismanagement of water facilities, the gap between the demand for water and available supply has deepened. This has led almost half of the SSA population to drink water from unprotected sources. Moreover, many millions travel far distances and spend several hours daily to collect water. Children and women are mainly involved in water collection. The growing scarcity of water in Africa has a negative impact on economic growth. Besides, water shortages are at the heart of many social crises in SSA and have become directly or indirectly the first cause of death in Africa linked to waterborne diseases. The prevailing water-related diseases include malaria, typhoid fever, cholera, poliomyelitis, etc. To attain the African agenda 2063, national governments in SSA need a multidisciplinary approach integrating, supervising informal settlements of the population in urban and peri-urban areas; improving water storage capacity; increasing irrigation potential for agriculture; and having a good understanding of the epidemiology of waterborne diseases.

1. Introduction

Water is the most basic human need that is required to sustain life on earth. Water is central to plant, animal, and human life. Providing safe water and adequate sanitation is used as a standard indicator to achieve economic development and good health [1]. Therefore, good management of its resources is crucial to the development of every nation. Apart from its vital functions in human life, water is indispensable for the crop, animal, and fish production [2]. However, natural (climate change, rainfall deficit, and drought) and human factors (rapid population growth, urbanization of major cities, agriculture, and tourism) contribute to its scarcity [1, 3, 4]. Water scarcity, defined as lack of sufficient water, or lack of access to safe water supplies, is a global issue [3]. Globally, more than 2.7 billion people face water shortages, and 663 million people in the world lack access to safe water [3]. Unfortunately, half of the people who drink water from unsafe sources live in Africa with 319 million people in sub-Saharan Africa (SSA) [5]. The causes of water shortages may differ in various regions of the world with respect to variations in climatic conditions and socio-cultural realities. Generally, Water shortage can be a limiting factor in poverty alleviation and is associated with negative impacts on the health of the population. It is therefore imperative to understand the driving factors that contribute to water scarcity in SSA and to evaluate its real impacts on the socio-economic development and health of the African sub-continent. Understanding the aforementioned parameters will help to devise appropriate strategies and policies to address the water shortage in SSA. Moreover, a good understanding of how waterborne diseases are affecting the population in both rural and urban areas is necessary to attain the African agenda 2063.

2. The water shortage scenario in Africa

2.1 Water sources in Africa and water shortages: what a contrast

Water scarcity is when water demand exceeds water availability and refers to lack of sufficient water, or lack of access to safe water supplies [3]. There are four dimensions of water scarcity: (i) the first-order water scarcity describes limited available water resources for both current and future needs; (ii) the second-order scarcity highlights lack of financial resources needed to make improved water resources available to the people; (iii) the third-order water scarcity results from the failure of institutional setup or inadequate infrastructure; and (iv) the fourth-order water scarcity is induced by social disparity with the less privileged people experiencing difficulty to have access to safe and sufficient water [6]. These four forms of water scarcity exist in different areas of SSA.

The water crisis is a global issue worldwide. Even though 80% of the Earth's surface is covered by water, fresh water supply has increasingly become a crucial global problem [3]. This global problem received the attention of the United Nations to adopt the Sustainable Development Goal (SDG) target 6 in 2015 [7]. Despite the relative success of the Millennium Development Goals (MDGs) water target in different parts of the world, half of the people who drink water from unsafe sources live in Africa. Specifically, in SSA, 319 million people still live without improved drinking water sources and only 27% of SSA’s population has access to basic sanitation [5]. Apparently, Africa seems to be endowed with abundant water resources. The relationship between the abundance of water sources in Africa in general and in sub-Sahara in particular and water scarcity is contrasting. This is why water shortages are experienced even in countries where freshwater is in abundance. Therefore, water scarcity does not mean the absence of water in the natural environment. Actual Africa’s hydro potential is irrefutably huge; the continent disposes of 17 major rivers, close to a hundred lakes, coupled with sizeable groundwaters [8]. In addition, Africa has abundant rainfall and relatively low levels of withdrawals of water especially for use in community water supply and agriculture [8]. Inspite of this potential, water sources are unevenly distributed between different zones of the continent [8] with SSA having the greatest part of the water blessing. While the Central Region is endowed with 48% of the continent's water, the Gulf of Guinea claims 24% of the water potential of the continent. At the country level, the Democratic Republic of Congo alone holds 23% of African water [8]. Additionally, natural factors such as rainfall deficit and drought cause significant reductions in the overall availability of water due to the geographical location of several African countries [9]; the present threat on the disappearance of Lake Chad is symptomatic of the growing scarcity of water in SSA. The Lake Chad basin has drastically been reduced by 90% in its surface area [9].

2.2 Factors favoring water shortages in SSA

One of the factors that limit access of the community to safe water in Africa in general and in SSA, in particular, is poverty. The level of poverty is such that half of the extremely poor people live in SSA [10]. It is the main driving force behind the rural migration of the population into the big cities. Due to poverty, many youths back out of school earlier to embrace any money-earning activities in towns. Except, mismanagement and lack of policy prioritization, insufficient infrastructure limiting water supply in SSA has a direct link with the prevailing poverty [11]. Unfortunately 96% of the poorest countries in the world are located in SSA and poverty is projected to increase in this part of the world even in the next 10−12 years [12, 13]. On the other hand, anthropogenic factors including increasing water requirements resulting from irrigation, population growth, and increased urbanization have deepened the gap between the demand for water and available water supply in SSA [4, 14, 15]. The insufficient coverage of potable water in urban areas is particularly attributed to the population growth that has almost doubled over the past 10 years. Consequently, the demand for water supply equally increases. Therefore, the rapid demographic growth together with climate change constitutes a serious challenge for water authorities in SSA. Efforts put in place by the African government often do not yield appreciable outcomes to cope with the ever-growing population. Localities that experience water seizure for over many years rely on alternative sources for water supply. Common alternative water sources used by the population in SSA include wells, boreholes, streams and the rivers. While boreholes can be private or public, streams and rivers are open water sources and are thus owned by local authorities. The correlation between the rapid population growth and the demand for water supply will not be better in the near future as the population is expected to triple by the year 2050 and likely to reach 1.2 billion in SSA [4, 16]. As such, most countries in SSA will be in a state of water stress or scarcity [17]. Moreover, increased demand for water supply can also be induced by the growth of a middle class of citizens in large agglomerations with high water needs. However, the Africa Water Vision 2025 will be based on the principle of service differentiation. The growth of a middle class of citizens with greater water needs will be addressed following this aforementioned principle. Therefore, different socio-economic groups in different parts of an urban area or of a country in Africa will be able to obtain the types and levels of water services that they want and are willing to pay for [18]. Last but not the least, another contributing factor to water shortage in SSA is inadequate water-resources development. Despite a growing demand for water in response to population growth, water scarcity is partly due to low levels of exploitation of water resources. Presently, the entire sub-continent uses less than 2% of its renewable groundwater and irrigates less than 2 MHa (or about 1% of its cultivable land) of groundwater [19]. The current SSA land irrigation capacity is far less than that of the States of Texas in the US. SSA must use modern technologies as other regions such as India do to steer up its agricultural development based on sustainable groundwater development.

Some African towns such as Bamako (Mali), Kampala (Uganda), Lagos (Nigeria), Niamey (Niger), and Ouagadougou (Burkina Faso) will be the most affected by water stress due to their geographical locations coupled with their unprecedented urban growth [7, 20]. Another arising issue that complicates the water crisis in SSA is that the concentration and distribution of formal water outlets is a constant in relation to the consumer demand and the quality of supply that are variables. This phenomenon is most obvious in small towns and peri-urban areas [21].

The stress in the water supply-demand relationship is aggravated by insecurity or socio-political crisis that may cause a shift of a significant influx of the population from crisis areas to other localities. In this case, refugees and internally displaced people constitute the most vulnerable group experiencing water shortages. For example in Cameroon, since 2014 we have witnessed a significant influx of the population from the Far North and, a massive exodus of the population since 2016 from the northwest and southwest to other cities such as Yaoundé, Douala, Bafoussam, etc., because of the insecurity perpetrated by the Islamic sect Boko Haram and the Anglophone crisis. These phenomena have caused the swelling and concentration of populations in certain areas of Yaoundé such as Akok-Ndoe, located in the sub-division of Yaoundé 7. With a population of around 6000 people, this locality does not record any drilling or water supply provided by the public service. Similarly, Mayo-Tsanaga division, located 80 km away from Maroua has been experiencing a significant population growth resulting from the relocation of refugees and displaced persons from Boko Haram attacks. As direct consequences, the population of Mayo-Tsanaga must gather around a single water point to fetch water as seen in Figure 1.

Figure 1.

Women and children struggling to fetch water in the Mayo-Tsanaga Division (Cameroon).

On the other hand, the overpopulated area of Akok-Ndoe either dig wells on rocky soil or obtain water from the private water vendors at an exorbitant price ($10 per m³). Sometimes, the quality of such water is doubtful and is unsafe for the consumers’ health. Unfortunately, this situation may depict the reality of many other consumers throughout the sub-continent. The services of the private water providers may compromise the affordability and quality of water, two key criteria for water safety [22].

2.3 Socio-economic impact of water shortages in SSA

There are several dimensions of access to safe water. These comprise proximity, accessibility, reliability, quality, quantity, and affordability [23]. Each of these aspects is almost violated in many countries in SSA. For example, if by standard a water point should preferably be within 200 m, many million across SSA travel for several miles to find a water source. Sometimes at the water site, people wait in a line and carry dirty water into containers to bring home for drinking and cooking. About three-quarters of the households in SSA collect water from a distance far beyond the WHO recommendation [24]. Unfortunately, the burden of water collection and storage usually falls on women and girls [4, 25]. Water fetching is a woman or child-dominated activity in Africa. The impact of distance between the water source and the point of its use goes beyond the physical burden. A study carried out in rural Kenya indicated a relationship between water fetching times and a risk factor for moderate-to-severe diarrhea [26]. In the middle of the year 2020, two children from Tokombere, a sub-divisional headquarter in the Far-North region of Cameroon were found dead on their way to fetch water, due thirst and trekking. Other dangers such as snake and scorpion bites are permanent threats to those that venture to fetch water during hot and cold weather. According to the United Nations estimates, women and young girls spend about 40 billion hours per year transporting water [27]. This corresponds to a complete year’s worth of labor by France’s entire workforce [28]. This comprises the time for traveling to the water collection point, waiting at the water source, transporting the water, and storing it.

Even in big cities where water facilities are available, the reliability dimension of water is not always ensured. The high water demand in contrast with the limited water supply reduces the pressure of water flow in the water pipeline (water not flowing in some taps) leading to a lack of water, especially in the morning hours. This may cause water shortage for days or weeks in some countries like Cameroon. Sometimes, a rupture of water tank can lead to a lack of water supply to hundreds of people. Unfortunately, it takes many days for water authorities to be aware and to address the situation.

In addition to their public health impact, waterborne diseases can have a significant impact on the economy of endemic countries [29]. Water appears to have an economic value and should be recognized as an economic good. Providing clean water and a healthy environment is used as a standard indicator of achieved development as highlighted in the SDG water target. Otherwise, water shortage constitutes a serious setback to sustainable development. Water shortage can be a limiting factor in poverty alleviation resulting in low productivity, food insecurity, and constrained economic development [18]. This is because inadequate water resources can restrain improved agricultural development given that agriculture is the largest user of water in Africa. Water stress is particularly a serious threat to irrigated agriculture leading to food insecurity.

The water crisis is at the heart of many social tensions in SSA. Water shortages have plunged several countries in SSA into major social crises. For instance, the crisis in Darfur (Sudan) and recently the tribal conflicts between the Musgum and the Chua Arabs in Logone and Chari (Northern Cameroon) stem in part from water disputes [30] as seen in Figure 2. In Darfur, the conflict resulted from competition over water and grazing land between two groups of nomadic farmers, in the same light, in the Logone and Chari division of the Far-North of Cameroon, the Musgum (mainly farmers and fishermen) are competing with the Shua Arabs (herders) over increasing scarcity of water and land resources resulting from the reduction of water bodies in the Lake Chad Basin. Other water-based conflicts in SSA include violent conflict between Senegalese and Mauritanians over the introduction of the irrigation systems, conflicts in the Niger Delta resulting from the struggle over access to limited wetlands due to the decrease of the level of the Niger River, etc. [30].

Figure 2.

A: Displaced Musgum in Kousseri. B: Darfur conflicts in South Sudan.

2.4 Water shortages a threat to water quality and cause of waterborne diseases in Africa

Apart from its negative socio-economic impacts, inadequate access to safe water remains a high risk for communicable diseases that in return reduce vitality and economic productivity. The serious water shortages in SSA has forced communities to rely on unsafe water sources. Unfortunately, the water of these sources is often used without any form of treatment [31]. Almost half of the people drinking water from unprotected sources live in SSA [32]. This explains why more than 70−80% of diseases on the African continent are related to poor water quality [32].

Even in the presence of water availability, water management practices at the level of households have also a great responsibility in spreading water-borne diseases [33]. For instance, lack of awareness, knowledge, and hygiene practices could therefore be barriers to safe water use. Poorly managed sanitation facilities expose water resources to contamination [4]. For example in Cameroon, recurrent ruptures of septic tanks dumping their content on the main roads connecting working-class neighborhoods in cities like Yaoundé are recorded daily [34]. Such human wastes are carried by rainfall and sometimes end their course in a river or any other water source thereby exposing the community to serious waterborne diseases. Other wastes that contribute to polluting water sources in our major cities in SSA include plastic bags and plastic bottles. As they accumulate in the rivers, they can divert the direction of the water flow into the community. This may explain why the quality of the water sources often correlates well with the prevalence of water-related diseases in the community [35]. Additionally, lack of waste treatments in urban areas, insufficient water treatment facilities, as well as mismanagement of the existing water facilities are among the factors that contribute to the deterioration of Africa's water quality [34, 36, 37]. In addition, the use of chemical contaminants in the cultivable areas of our cities represents a source of risk of contamination of water from wells, boreholes, etc. The presence of these products might result to heavy metals in various water sources across SSA and poses as much a public health problem as microorganisms [31, 38, 39]. In addition to the questionable quality of water due to water shortages, urbanization and population growth also contribute to the disposal of more wastes into water bodies in many countries in SSA [38].

Worldwide, the annual loss of human life associated with the consumption of unsafe water is estimated at 30 million people. It thus appears that, for lack of proper access to the resource, water has become directly or indirectly the first cause of death in Africa [8]. Water-related diseases constitute a significant proportion of the burden of disease in SSA.

Diseases resulting from the use of unsafe water or water stress can be grouped into (i) waterborne diseases (e.g. cholera, typhoid, etc.); (ii) water-related diseases (e.g. malaria, yellow fever, river blindness, sleeping sickness, etc.), (iii) water-based diseases (e.g. guinea worm and bilharzia etc.), (iv) water-scarce diseases (trachoma and scabies, etc.).

Diarrheal diseases be of viral, bacterial, or parasitic origin are the leading cause of human mortality in Africa. Our continent alone contributes to 53% of the diarrheal cases reported globally, with contaminated drinking water being the main source of transmission [40]. In 2016, more than half a billion deaths in SSA were attributed to diarrheal diseases with contamination of drinking water identified as one of the leading risk factors. Mortality due to water stress coupled with poor sanitation and hygiene is projected to substantially increase by 1.5 deaths per 1000 annually by the year 2050 [41]. This is true for countries with high mortality rate such as Angola, Burkina Faso, Burundi, Central African Republic, Chad, DRC, Ethiopia, Guinea Bissau, Liberia, Mali, Niger, Sierra Leone, and Somalia [41] (Figure 3). The most devastating waterborne diarrheal disease on the African continent is cholera, which is caused by Vibrio cholera. Cholera is a deadly diarrheal disease that decimates tens of thousands of people annually. Approximately, more than one million cholera cases are reported in Africa [42]. This may explain why 83% of the total deaths due to cholera were from the SSA region [43]. Additionally, a curated database of cholera incidence in SSA from 2010 to 2020 identified 999 suspected cholera outbreaks across 25 SSA countries [44]. Most of the major outbreaks of this disease occurred in countries such as Nigeria, Cameroon, the Democratic Republic of Congo, Kenya, Ethiopia, and Sudan [42, 43, 44]. Notably, the collective outbreaks in four countries alone (Democratic Republic of the Congo, Ethiopia, Cameroon, and South Sudan) represented 65% of total outbreaks that occurred in the entire SSA [44]. Besides poor sanitation and hygiene, floods have been recognized as one of the major contributing factors of cholera outbreaks in SSA [45]. This occurs when floods hinder supply of or access to safe water sources, thereby introducing Vibrio cholerae even to areas that are usually not affected by this pathogen [46]. The coastal regions of SSA remain the focal areas. Curiously, most of these cholera foci are in densely urbanized areas of Africa with limited access to safe water and adequate sanitation [42].

Figure 3.

Projections of WASH mortality rates for SSA countries and South Asia [41].

The most frequently reported parasitic waterborne diseases in SSA are malaria (95%), schistosomiasis (44.8%), giardiasis (23.4%), soil-transmitted helminths (23.4%), and amoebiasis (21.3%) [27, 47]. Recently in 2020, Malaria infected more than 200 million people in SSA indicating its exponential increase attributed to the interruption of malaria-control services during the awake of Covid-19 pandemics [47, 48]. Parasitic infections via water can be acquired while bathing, washing, drinking water, eating food exposed to contaminated water, or being bitten by an infected vector. Interestingly, the prevalence of important parasitic diseases in several regions of SSA is still high in recent years given that most of these diseases circulate in poor water supply areas [29].

Among bacterial waterborne diseases, typhoid fever features as an important cause of morbidity and mortality with an estimated 12−33 million cases leading to 216,000−600,000 deaths annually [49]. Apart from Benin, Equatorial Guinea, Eritrea, Namibia and Somalia, which did not provide any report on typhoid fever, this bacterial disease is highly prevalent over the whole SSA as highlighted in Figure 4 [50]. The highest incidence of this disease occurs in areas of high water contamination with human feces, limited water supply due to increased population, urbanization, and weak health systems [51]. An updated data on the burden of typhoid fevers from 2010 to 2013 show that this waterborne disease continues to be high in SSA (Table 1), and illustrate the need for control measures such as vaccination, and improvements in water quality, sanitation, and hygiene [52]. Gastroenteritis caused by non-typhoidal Salmonella is another important waterborne disease that prevails in SSA. Close to 80% of all the reported cases in 2017 occurred in SSA alone, affecting mainly children under 5, adolescents, and active young people under 50 [53].

Figure 4.

Prevalence of typhoid fever in sub-Saharan Africa [50].

Published disease burden		Updated disease burden
	Adjusted*	Adjusted^*	Unadjusted
SSA	3056589	3243643	4328528
LMICs	1188304	12070102	20811469

Table 1.

Typhoid fever burden in SSA estimated from 2010 population data.

SSA, sub-Saharan Africa; LMICs, low-income and middle-income countries [52].

*Adjusted for water-related risk.

Many studies across Africa suggest that coliforms, Escherichia coli, Streptococcus, Salmonella, and Shigella spp., Vibrio cholera, etc. are major contaminants of alternative sources of water in SSA [31, 37, 39, 42].

In the light of its devastating impacts on health and socio-economic developments in Africa in general and in SSA in particular, water crises come immediately after weapons of mass destruction [16]. Consumption of unsafe water thus poses a major challenge to population health in many countries of SSA.

3. Conclusions

Addressing water shortage in SSA needs a multidisciplinary approach integrating environmental policy, innovative technologies, and socio-economic dimensions. Preserving and restoring water ecosystems such as wetlands and forests to collect, filter, store, and release water appears vital to reducing water scarcity. Additionally, the reuse of wastewater is another strategy to improve both water availability and quality [3] Implementing a tax on heavy water users such as the industries and agriculture would help avoid wasteful water consumption. Moreover, policies like organic farming practices should be encouraged to reduce water pollution. Improving water storage capacity via the construction of more dams, the storage of water in shallow wells, rainwater collection and storage, drip irrigation for crops is of paramount importance to fight against water shortage. To attain the African agenda 2063 based on inclusive growth and sustainable development, it appears crucial to have a good understanding of how waterborne diseases are affecting the population both in urban and rural communities. Therefore, governments in SSA should supervise informal settlements of the population in urban and peri-urban areas in view to reducing the disease burden resulting from waterborne diseases via improving access to safe water. In this case, future research should be redirected towards environmental determinants of waterborne disease outbreaks, and the relationship between waterborne diseases and water resources development in the context of climate change in SSA.

There is a need for in-depth research with a focus on cross-context and cross-cultural comparisons that can generate important lessons and insights for effective water policies and that take into account different conventional and alternative water uses at different scales. There is also a need for optimal use of groundwater since SSA is currently underusing its renewable groundwater and irrigable cultivable land. National governments should provide adequate investments in water facilities.

Acknowledgments

We register our thanks to AGAPAO, non-governmental organization that gave information about the internally displaced people of Kok-Ndoe in Yaounde 7. We are grateful to the Norwegian Church Aid for the pictures of water crisis in Mayo-Tsanaga and those from conflicts in the Logone and Chari (Far-North Cameroon) and Darfur (South Sudan).

We are equally thankful to the Institute of Medical Research and Medicinal Plants Studies for granting me time for this research.

The corresponding author is also grateful to his darling Irene Assiam for her tremendous encouragement while putting together this chapter.

Conflict of interest

The authors declare no conflicts of interest.

Acronyms and abbreviations

GIZ

Internationale Zusammenarbeit

LMICs

low-income and middle-income countries

MDGs

Millennium Development Goals

PACN

Pan Africa Chemistry Network

SDG

Sustainable Development Goal

SSA

sub-Sahara Africa

UN

United Nations

UN-DESA

United Nations Department of Economic and Social Affairs

UNDP

United Nations Development Program

UNEP

United Nations Environment Program

UNHCR

UN High Commissioner for Refugees

UNICEF

United Nations International Children’s Emergency Fund

WASH

Water, sanitation and hygiene

WHO-UN

World Health Organization United Nations