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Waste stabilization ponds (WSPs) are widely used for wastewater management owing to the simplicity of their design, low cost and the use of low-skilled operators. This study was carried out to assess the efficiency of a WSP system in reducing the levels of contaminants in hospital wastewater in a rural area of South Africa and to evaluate the current management of the WSP system. Sampling was conducted monthly from January to June 2014. Physicochemical and microbiological parameters were monitored using standard methods. The microbiologi