Bill Gates funds ground-breaking sanitation research in Durban, but in the communities living under pollution from oil refineries just a short drive away – run by companies in which Gates is invested – asthma and cancer rates are high

It was standing room only in the darkened hall when Cyril Ramaphosa, a former miners’ union leader-turned-mining magnate and South African deputy president, walked to the podium at Durban’s deluxe International Convention Centre. He was to address a “National Sanitation Indaba”, a conference dealing with the outrage that more than one in 10 of South African households still lack adequate sanitation in the 21st century.



“It is a tale of daily humiliation for many of our people,” Ramaphosa told delegates. “The lack of adequate sanitation encourages the transmission of many infectious diseases, including cholera, typhoid, hepatitis, polio, cryptosporidiosis and ascariasis. Diarrhea – a disease directly related to poor sanitation – it is said, kills one child every 20 seconds. This is more than 4,000 children every day worldwide. This amounts to more deaths than Aids, malaria and measles combined. This is a tale of diseases that are easily spread and young lives that are needlessly lost.”

Diarrhea kills more than 4,000 children every day worldwide .. more deaths than Aids, malaria and measles combined Cyril Ramaphosa



It is the kind of health cause that Bill Gates relishes. In 2011, his foundation launched the Reinvent the Toilet Challenge, offering grants to the 2.5 billion people on the planet in need of sustainable sanitation. In the room next door to Ramaphosa’s audience, various organisations had set up stalls to display their prototypes. South Africa’s water research commission was showing off the “Earth Auger”, which does not flush or require connection to a sewage system, replaces toilet paper with sawdust and turns excrement into pathogen-free compost. It is due for testing by communities in the next three months.



Stuart Woolley, assistant research manager at the commission, said: “Sanitation is a massive issue and it’s not just the health aspect, it’s dignity. You go to the rural areas and see toilets people have to use and it’s a stark contrast for those who live in suburbs with porcelain toilets. The fact that Gates put funding up front really did accelerate the programme and create a lot of innovation where there really wouldn’t have been before.”

Facebook Twitter Pinterest Stuart Woolley (L) and Chris Buckley (R), toilet experts at the Sanitation conference at the ICC in Durban. Photograph: Khaya Ngwenya/Khaya Ngwenya/Demotix for The Guardian

The Gates Foundation awarded $1.6m (£1m) to the University of KwaZulu-Natal in Durban to become a hub for sanitation researchers and product developers. Professor Chris Buckley has a business card with the university’s logo and the job title “shit manager”. Engaged in the field for more than 20 years, he explained cheerfully: “I’m known as the shit manager across Africa.”

Buckley, 66, recalled that Gates had visited Durban – where a million people, nearly a third of the population, have no formal sanitation – to look at pit latrines and “saw there’s a better way of doing things”. Buckley was then one of three researchers who sat down with the Microsoft co-founder at his foundation to convince him that toilets are a global health multiplier. “His comment was, ‘The data sucks’. None of us could disagree.

“The Gates Foundation is the best research organisation I’ve ever worked for. They’re completely goal driven and empathetic to the researchers. They believe in cooperation rather than competition. In my experience, money has never been the scarce resource. Bill Gates describes himself as an impatient optimist.”

Reinventing the toilet could improve lives on an “almost unimaginable scale”, Buckley believes. “The whole point of sanitation is public health. That is the reason for doing it. All the other things are nice-to-haves.”

The Guardian’s Keep it in the Ground campaign is calling on the Gates Foundation to move its investments out of fossil fuel companies. Climate change is thought to be the biggest threat to global public health of the 21st century.

Asked if there was any contradiction between the Gates Foundation’s investments in fossil fuels and its world-class work on improving sanitation, Buckley paused before replying:

“I wouldn’t want to defend Gates Foundation’s investment policy. Considering all the other aspects – and Bill is a very engaged person – I’m sure he’s aware of it, there’s a reason for it. Nutrition and sanitation and neglected tropical diseases are the major disease burden in the world. I don’t know where fossil fuels fit on that scale. Since he is aware of burdens of disease, he wouldn’t be doing something not logical.

“There’s a certain pragmatism you have to have. You can’t make an omelette without breaking eggs. You can’t solve all the problems of the world so you have to choose which you want to.”

Not everyone in Durban feels this way, however. A 15-minute drive south are the giant tanks and stacks of the biggest petrochemical complex in Africa. One of the main nodes is Shell and BP South African Petroleum Refineries, or Sapref. The Gates Foundation has a $372m stake in BP and $5.5m in Shell.

Is it any coincidence, ask local campaigners, that the cancer risk in this part of the city is so high that it has been dubbed “cancer valley”?

A scientific link to cancer has never been proven, although a 2007 study led by the University of KwaZulu-Natal found an increased risk of the disease in certain areas.

Last week, beyond scenic palm trees, the entrance of Sapref was patrolled by G4S security guards as gardeners mowed lawns beside the boom gates. An inflatable archway, with a cartoon image of a tortoise wearing blue overalls, proclaimed: “It’s turnaround time. Let’s delivery it safely.” Last month a fuel line explosion here claimed the life of a worker and left two others seriously injured – one of many accidents over the years.

Within sniffing distance of the refinery in the Isipingo Beach suburb, widow Zakiya Kikia-Khan has asthma. “I can’t smell very well but I can feel it in my chest when Sapref is flaring. It’s very scary: I feel choked up, I feel my lungs can’t get air, I feel starved of oxygen. I get panic attacks. My husband died last July and I now feel even more vulnerable. I will not be able to shout for assistance. I fear I will die alone.

Facebook Twitter Pinterest Zakiya Kikia-Khan lives near Sapref in Isipingo Beach. Photograph: Khaya Ngwenya/Demotix for The Guardian

“I know my asthma would be better if I wasn’t exposed to it. I use my inhaler more often on days they’re flaring. They attack us at night: most of the flaring is under cover of darkness. There is also noise, almost like jet engines, that comes out of nowhere and goes on and on. I used to phone Sapref’s PR person at 2am and I would say, ‘If I can’t sleep, why should you?’”

Kikia-Khan said her daughter Naadira, 18, suffers bad allergies and has had her sinuses drained twice. The 51-year-old is also worried about other children living in the area. When she visited a school close to Sapref, “the first thing I noticed was how black the roof was. If that’s the roof, what are the kids’ lungs like? What kind of future generations are we rearing?”

Asked about the Gates Foundation’s links to Sapref, Kikia-Khan replied: “I think, as much as a philanthropist, Gates is also a businessman. He’s a shrewd investor and refineries make money. I’d like to tell him, ‘Your investment in Sapref is undoing all the good work you’ve done and is associating you with a company that doesn’t care’.



“Bill Gates is throwing money at the symptoms. It’s no good mopping up constantly when you don’t fix the tap. Zakiya Kikia-Khan

“Bill Gates is throwing money at the symptoms. It’s no good mopping up constantly when you don’t fix the tap that’s leaking. I’d like them to come here and see what’s happening. This area has got gangsterism, crime, unemployment – surely that burden is enough without industry having to add to it.”



A spokesperson for Bill Gates’ private office said: “Bill and Melinda Gates wrote in their recent annual letter that ‘the long-term threat [of climate change] is so serious that the world needs to move much more aggressively – right now – to develop energy sources that are cheaper, can deliver on demand, and emit zero carbon dioxide.’ Bill is privately investing considerable time and resources in this effort and the breakthrough innovations needed and will continue to speak out about it. We respect the passion of advocates for action on climate change, and recognize that there are many views on how best to address it.”

Sapref did not respond to requests for comment.

Facebook Twitter Pinterest Bill Gates and his wife Melinda during the session ‘Sustainable Development: A Vision for the Future’ in the Swiss mountain resort of Davos, January 2015. Photograph: Ruben Sprich/Reuters

In the suburb of Merebank, where paint is peeling off the walls of blocks of flats, Lutchmee Perumar, 52, and her husband Krish live within sight of both Sapref and a refinery owned by Engen. One of their four children has a chronic thyroid problem. “It affects our breathing,” Perumar reported. “If it’s raining, the odours are very strong in the air. My husband is asthmatic so it affects him terribly.

“Cancer has been very common in our community. My mother died from it and my sister has been diagnosed with it. I have half-siblings with it too. People are frustrated, but the companies just think we’re making a big noise. We are the ones living right in the midst and no one listens.”

It would be such a good thing if Bill Gates himself came here to see what has happened to the people. Lutchmee Perumar

She joined in the condemnation of the Gates Foundation. “They should withdraw because these investments are creating major problems here ... It would be such a good thing if Bill Gates himself came here to see what has happened to the people.”

Facebook Twitter Pinterest Inthirin Naidoo, principal at Settlers Primary School in Merebank. Photograph: Khaya Ngwenya/Demotix for The Guardian

Settlers primary school in Merebank is sandwiched between the Sapref and Engen refineries. A 2002 study found high levels of asthma among its pupils. Its principal, Inthirin Naidoo, arrived 17 years ago and says Sapref has been by far the more helpful of the two neighbours, for example outfitting a library. But he noted: “When I first came here I got a sore throat that has never gone away. There’s no doubt the kids’ illnesses in terms of coughing are probably pollution related.”

Lawrence Vartharajulu, 51, a teacher at the school, remarked: “If you asked the children how many of them are asthmatic, you’d be amazed how many of them would say yes, they do have pumps. Many residents have moved out of the area because of air pollution. They don’t find it viable to stay here.”

The area is uniquely vulnerable. The stacks at the refineries are said to have been built much lower than the industry norm to avoid aircraft from the city airport that, until recently, was nearby. South Durban sits in a bowl so that cloud cover traps pollution like a lid. Wind from the adjacent coastline is another contributory factor.

Facebook Twitter Pinterest Asthma levels in children at Settlers Primary School in Merebank are high. Photograph: Khaya Ngwenya/Demotix for The Guardian

The University of KwaZulu-Natal sudy showed that children with pre-existing asthma were profoundly affected by their exposure to the pollution with more symptoms and lung function losses. Another study is currently under way to investigate whether the pollution is directly causing asthma.

Lead researcher Rajen Naidoo, associate professor of occupational medicine at the university, said: “Sapref has been extraordinarily defensive about it. Rather than recognising this is a problem, they’ve behaved in ways that try to undermine the report. If they accepted the findings, there could theoretically be a legal responsibility.

“The communities in Durban and worldwide have rallied against Shell and I would have thought philanthropic organisations like the Gates Foundation would be more circumspect about who they invest in. They should pull out of Sapref. It’s a question of perception around these things and you want these organisations to be seen as neutral.”

Facebook Twitter Pinterest Desmond D’Sa, coordinator of the South Durban Community Environmental Alliance. Photograph: Khaya Ngwenya/Demotix for The Guardian

Perhaps the most outspoken critic of Sapref is Desmond D’Sa, 58, coordinator of the South Durban Community Environmental Alliance and winner of last year’s Goldman Environmental prize. His office contains a map showing pollution incidents in the south Durban basin and a poster that declares: “People united will never be defeated by Shell!!!”

D’Sa describes Sapref, more than half a century old, as “like a rusty bucket”. He recalled a big explosion there in 1998 – “That opened our eyes to the dangers we’re facing,” – and cited further accidents in 2001 and 2006. The alliance takes bucket samples to measure chemicals in the air and is bringing a legal application against the refinery to obtain monitoring data and information about leaks and explosions.

D’Sa’s brother Patrick died from cancer aged 59 and his granddaughter is asthmatic. “Every night we struggle. She can hardly breathe sometimes so we have to rush her to hospital. The industries have absolved themselves of all blame.”

“On the one hand [the Gates Foundation] invests in healthcare and say they’re helping us, on the other they’re taking profits from an industry that’s killing us ...Gates could have his legacy doing the right things but investing in fossil fuels is no legacy at all. It will destroy African lives.”

