The sustained interest in river health reflects our reliance on rivers and connected waterways not just for fishing and food but for our health and wellbeing as the lives of humans and more-than-human depend directly and indirectly on the life flows of the river systems. Few areas do this become more apparent than when considering the microbial world. The degradation of river environments creates conditions for the propagation of resistant pathogens such as E. coli and Cholera.

River health represents an ongoing sustainability challenge and topic of concern in the South African context, as illustrated by recurring reporting.

2002 State of Rivers Report – uMngeni River and neighbouring rivers and AmanziEthu Nobuntu report of April 2021

…consequently,

These microbial flows come to extend to the spread of pathogens resistant to current antimicrobials, thus exasperating the emerging sustainability challenge of antimicrobial resistance (AMR) as naturally occurring resistances have been part of the microbial world for at least 30,000 years.

Dcosta et al., 2011 Kashuba et al. 2017

In the recurring reporting, considerations are made for how the Umgeni River in Kwa-Zulu Natal affects the health conditions of life in the region, opening the way for research to explore how rivers and their health can be conceptualised as streams in which the health of humans, animals and the environment intersect as the three components of One Health.