Academic journal article Bulletin of the World Health Organization

Drawers of Water: Assessing Domestic Water Use in Africa. (Public Health Classics)

Academic journal article Bulletin of the World Health Organization

Drawers of Water: Assessing Domestic Water Use in Africa. (Public Health Classics)

Article excerpt

The public health classic reproduced on the following pages is an extract from the first thorough study of water use in a developing country from the consumer's point of view. It was a seminal starting point for many of those professionals, gradually increasing in number during the International Drinking Water Supply and Sanitation Decade (1981-90) and beyond, who devoted their careers to extending water supply and sanitation services to the unserved millions in the developing world. In awakening the appetite of many of its readers to the excitement of interdisciplinary research in this field, Drawers of water (1) has done more to improve water supplies for the poor than any standard engineering or social science textbook.

Although more than thirty years have passed since the fieldwork was conducted, Drawers of water is still relevant and informative. Numerous studies have deliberately imitated its approach (2-4). According to Sydney Rosen & Jeffrey Vincent of Harvard University (5): "Knowledge of household water supply and productivit? ... is limited to a handful of original studies, which continue to be cited and recycled in the literature. Foremost among them is Drawers of water ... Drawers of water remains the most comprehensive and compelling account available [of] ... water use in ... Africa."

East Africa was chosen as the study location because the diversity of landscape, climate, hydrology and geology allowed for analysis of domestic water use under different environmental conditions. The region also possessed dispersed settlements in which many people lived in scattered compounds or households. This allowed for analysis of individual decision-making in domestic water use. Finally, it was home to a wide assortment of ethnic groups, which provided an opportunity to analyse the different cultural dimensions.

The data reported in Drawers of water were acquired between 1966 and 1968 by interviews and observations at 34 study sites in Kenya, Uganda, and the United Republic of Tanzania. Thirteen field workers (students from East African universities) assisted in collecting the information in over 740 households. Twelve of the sites were in rural areas, while the other 22 were in and around towns and cities; water was piped to the houses at 15 urban sites, but carried to the houses at all the other sites.

The researchers examined the use of water for basic consumption, hygiene and amenities in domestic life. They also assessed the social cost of obtaining water in terms of direct monetary costs as well as less readily measured costs in energ3, and time. Quantities of household water use were recorded and the factors affecting variations in use were assessed.

Drawers of water was to yield important findings that influenced water policy and practice on a number of fronts. First, a typology of water-related diseases was presented in Drawers of water that was based on their transmission routes in the environment, rather than on the taxonomic or clinical characteristics of the pathogens as is more traditional in medical texts. The strength of that classification system (Table 1) is that it indicates almost immediately the types of intervention that are likely to be effective in reducing the incidence of water-related diseases. As a result, a modified version of this typology has by and large set the agenda for thought about water interventions and diarrhoea for the last 30 years, precisely because it focused on the objects of such interventions.

Second, it suggested that increasing the quantity of water used per capita could be more important for a household's health and well-being than improving its quality. Because faecal-oral diseases have multiple transmission routes -- hands, food, utensils and flies as well as drinking-water-- they are more likely to be water-washed than waterborne. If a household has only a small quantity of water to use, it is likely that all aspects of hygiene -- from bathing and laundry to washing of hands, food and dishes -- will suffer. …

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