The Karoo has always been parched — it means land of thirst in the language of its earliest inhabitants, the Khoisan hunter gatherers. Yet nothing prepared residents of its oldest town, Graaff-Reinet, for their worst drought in more than a century.

As the dry spell entered its fourth year, tap water turned brown and smelled like rotting fish. When the water behind the Nqweba Dam dried up, depositing tens of thousands of dead fish onto cracked earth, queues began forming at municipal boreholes and farm animals died in their hundreds.

The bleak choices facing people living in the drought-stricken Eastern Cape region — whether to flush toilets or not, or to keep animals alive or let them die — could soon be faced by other places on a warming planet with shrinking water supplies.

“This area is dry but our taps have never been completely empty,” says Bukelwa Booysen, who has had to send staff in search of borehole water for her school for disabled children, and send the children home when they can't find any.

An abnormally hot summer with rainfall 75% below average, according to the US National Oceanic and Atmospheric Administration, has struck the region.

‘When it runs out’

Bushes and trees clinging to the Karoo’s rocky ravines are withered and grey. Even hardy acacia thorns are dying. Signs mark rivers that are now dry beds.

At one farm, Gerrie Snyman, 65, feeds grain to sheep and goats that cannot find pasture.

More than a third of his couple of thousand goats and sheep have either died or been sold this year. His 80 cows are now 15. He loads a calf that was starving — its mother had stopped producing milk — onto his truck to take home and shoot.

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“We are grateful to the Almighty for our borehole water,” he says. “We don’t know what we’ll do when it runs out.”

When Cape Town’s reservoirs nearly ran dry 18 months ago, it made international headlines and authorities rationed water. Yet the Karoo is long past water rationing.

For Valentia Esho, 45, an unemployed mother of seven in the township of Umasizakhe, it means letting her toilet fill up instead of flushing, never washing clothes and only washing plates that stink. Water is just for drinking.

“The house is really smelling,” she says, inside her one-room brick-and-tin home. “Everyone is paining from stomach aches and diarrhoea.”

In another township, Asherville, where wind kicks up dust devils, school headmaster Basil Vaaltyn is overseeing water distribution from a truck. He has done everything to cut down on his usage: “I’m down to a minute showering instead of two.” His wife saves dirty dishwater to fill the cistern.

A spokesperson for the municipality says it is drilling boreholes, installing pipelines and building an 18-million litre reservoir, adding: “Usage of water is still high. The community is requested to use water sparingly.”

‘There's water here’

With municipal authorities overwhelmed, charity organisation Gift of the Givers is trucking water to townships and drilling boreholes.

Gideon Groenewald, a geohydrologist for the charity, uses science and spirituality to look for groundwater. When he was growing up on a farm, he used to dowse with wet twigs. Nowadays he prefers magnetic detectors.

“I open Google maps and look for the lines of trees. I ask God in prayer which lines hold water, then I go down to that GPS location,” he says while a forked stick turned in his hand over an arid patch of shrubs.

“You see the stick moving where the magnetic field is? There’s water here,” he says. “It’s pure science.”

The charity has drilled 1,800 boreholes in the past three years, Groenewald says, only a third of them dry.

But Louise Stafford, water director for the Nature Conservancy, urges caution with boreholes, because groundwater is a finite resource.

Water-intensive agriculture such as citrus farms can make droughts worse, she says, and leaky pipes are losing a billion litres a year, problems national water minister Lindiwe Sisulu has pledged to tackle in a new water master plan.

One Sunday, as clouds form over Graaff-Reinet, its Assembly Church prays. The clouds spit but do not pour.

“We pray for God to open heaven and send rain,” Pastor Dolan Cochrane says. “Lord, we know that, in your time, you will come to our rescue,”  he says.