Water Access, Reliability,

and Use in Mkonze

Jessica Brumbaugh, Jackie Fili, Maddie Taylor

Global Health Minor Fieldwork: Tanzania, June 2017
Background & Demographics
● Community 8km outside of Dodoma
● Consists of 8 villages
○ Our attention focused on five villages:
Miganga, Chidachi, Chinyika, Mkonze A & B
● 6,456 people (as reported in 2012 census)
● Language spoken in the home: Kigogo
○ Kiswahili known by most members
○ Little to no English spoken
● 1 Health Center, 1 Dispensary
○ 3 doctors, 2 nurses, 2 community health
workers at health center
● Physical Environment: Dry season
Objectives
● Gather information about Mkonze’s water
access, use, and reliability through
in-person surveying in order to
understand:
○ The role that water plays in children’s
lives, both at school and in the home
○ The perceived disadvantages that are
present because of unreliable water
systems
○ The role that these disadvantages play
in causing inadequate health
outcomes
Methods
● Information was collected from community members in the form of survey styled questions
pertaining to water use, access, and reliability. Because of the informal nature of our work,
settings and questions varied as we carried out our project.

● Every morning before beginning fieldwork, we recapped any developments in information or ideas
from the previous day, as well as solidified how we intended to move forward.

○ This included setting objectives for the day and dividing question asking amongst us.

● The Muhimbili nursing students provided additional insight and translation from English to
Swahili.

● Community Health Worker Selina acted as our point of contact in the community, identifying
people to talk to, translating to Kigogo when necessary, and building our rapport within the
community.
Who We Talked To
● Families in Homes
● Village Leadership
○ Elders
● Public Primary and Secondary School Staff
○ Leaders
○ Teachers
○ Children
● Health Center Staff
○ Nurses
○ Community Health Workers
Broadly, What We Found:
~ “Water is a Priority.” - Everyone ~

Everyone we talked to agreed that water is a priority: for all

people of Mkonze, in all settings.
What We Found: Village Leaders & Elders
● Interviewed the Mkonze community elder
○ Estimated age greater than 100 years old
● Historically, water was collected from springs and caves in Kiromonjiro
○ Very far away
● Humans shared water with their cattle
○ Risky health implications
● Today, they retrieve water from the tap
○ He said: “Science is too complicated now, why should I boil water?”
○ What influence does this have on the community?
● Thankful for Western provision of education in Mkonze, but rejects Western
lifestyle influences
○ How does this inform future interventions regarding behavioral changes?
What We Found: Home Setting
● Local Taps
○ Government installed, privately operated
○ Inconsistent availability ranging from 3-4 days a week
○ Price rose from 50 to 100 Tsh in the last few years
● Local Springs and Rivers (1km-3km away)
○ Price is free
○ Water quality unknown
● Cleaning Routines
○ Inconsistent boiling practices across homes
○ Kept in large gallon plastic containers
● Uses
○ Cleaning clothing and home
○ Food preparation
○ Personal hygiene
○ Consumption
○ Bathroom cleaning
● Transported
○ By hand or head
○ Bicycle
○ Occasionally motorized vehicle
What We Found: School Leaders & Teachers
Chidachi Primary School
● 1028 Students
● 128 Students per toilet
● Water Source: Tap shared
with Secondary school and
nonfunctional
Chinyika Primary School
● 1000 Students
● 83 students per toilet
● Water Source: Tap located on
premises but nonfunctional
Chidachi Secondary School
● 393 Students
● 50 Students per toilet
● Water Source: Near by tap
but collapsed and unusable

● Priorities: 1. Water 2. Electricity 3. Facilities

● Students expected to bring water with them from home or near by taps
● Handwashing programs only at one school but no reference to if students had water for bathroom use
● No specific health classes available, instead health taught in Biology class along with disease information
● Nurse visits twice a year if called upon for service: Immunizations, Outbreaks, Check on student pregnancy
● First Aid service available
● Largest Medical Problems:
● Malaria
● UTI
● Dermatological issues
What We Found: School Children
● Different grade levels (standards) bring water to school on different days of the week
● Uses
● Mopping, cleaning classrooms, teachers’ toilets, making tea for teachers
● Not used for: students’ toilets, hand-washing
● Consumption
● None of the water that the children bring to school is used for drinking
● Children do not drink water until they return home after school
● Perceptions
● Parents are not happy that they are spending money and taking water for school uses when
it is meant to be used for home uses
● Teachers do not care about the broken water tap or unsanitary toilets; “they are
comfortable”
● The bathrooms are unclean and “stinky”
● Who do they think they should talk to?
● Some students said the headteacher, others said the regional commissioner
***Note: This information was gathered from a large group of school children all at once, there may have been several factors
influencing their answers (e.g. shyness, group mentality, etc)
Chinyika Primary School 12 toilets for 1000+ students (7 Boys/ 5 Girls)

Hand washing bucket Hallway of the male

(Empty and no spout) restroom
Chidachi Secondary School

8 toilets (4 Boys/ 4 Girls) for 393 Students

1 of the 2 teacher toilets Example of the student toilets
What We Found: Health Center Staff
● Monthly outreach to primary and secondary school is their goal
○ Last visit was in February
○ They don’t often make this goal
■ Understaffed, nurses are too busy, CHWs and Doctors are not trained to do this work
■ Wish they could visit more
● Educational programs for schools
○ Communicable disease prevention, typhoid, malaria, HIV/AIDS
○ Also teach proper hygiene
● Female teens a key population for outreach
○ Common for girls not to come to school if they are menstruating and don’t have sanitary pads
● Increased risk of disease outbreak in school if there is no water to wash hands
● Lack of water means buckets become unsanitary for hand-washing and wiping
○ Need water to clean bathrooms
● They suggest installing tanks that collect rainwater for school use
● No serious disease outbreaks in Mkonze schools recently
Why is Change Needed?
● Main concern is inadequate health outcomes for school children in the community
● Disadvantages manifest in the forms of :
○ Poor sanitation
○ Unreliable source of safe drinking water
○ Personal hygiene
○ Possible dehydration
● Lack of water adds unnecessary complexity to a child’s educational and social
experiences
○ Time spent worrying and fetching water rather than studying
● Preventing disease outbreaks
● Squatting → splashing → no water to rinse toilets → UTIs
● Dirty hands → contaminated water buckets → cross contamination
● Show students that they can advocate for themselves and how
○ A life skill
○ Children are the future!
What Can Be Done?
Listed Proximally to Distally

● Buckets with spouts

○ They are used in health centers but not seen
in homes
○ Educate on preventing cross-contamination
● Empower students to make change in their
communities
● Address barriers to limited school and health
center interaction
● Water bladders for backpacks (CamelBak model)
● Fix the broken water sources
● Build more toilets
What’s Next for Us?
● Goal: Bring attention to the situation
● Questions to Answer
○ Are people and students sufficiently hydrated?
○ Does this community want to be empowered?
○ How can we make potential interventions sustainable?
● Action Points
○ Reaching out to water NGOs across Tanzania to understand what efforts
are already in place and in what capacity they work with the Tanzanian
government
■ Email correspondence started with SAWA Tanzania and TWESA
(local NGOs)
○ Brainstorming possible funding sources
○ Keeping in touch with our points of contact in Mkonze
Acknowledgments and thanks to Dr. Dana Naughton, Dr. Sebalda Leshabari, Mr. Masunga Iseselo, Mr.
Francisco Alejandro Montiel-Ishino, the MUHAS nursing students: Hamza, Sarah, Hanifu, Heavenlight,
Matson, and Jackie, and Mkonze’s Community Health Worker and our point of contact, Selina. Our time in
Mkonze would not have been possible without you!
Thank you!