If there is one thing I have learned in life, it’s that small towns are pretty much the same wherever you go. I’m currently living in Lwak, Kenya which is located in the Nyanza province and is about 5 km from the shore of Lake Victoria. It’s a beautiful area and the Luo people are some of the most gracious I’ve met. Like many other small towns, the people lead relatively simple lives, are friendly and outgoing although somewhat suspicious of outsiders, the food is predominantly local, and the kids are curious and interested in new things.
I’m living in Lwak as part of a research project on water access. Our study is an interdisciplinary collaboration between 3 professors (Jenna Davis, Civil & Environmental Engineering; Eran Bendavid, School of Medicine; and Roz Naylor, Food Security Institute), a fast-tracking Post-doc (Amy Pickering, CEE), and the Kenya Medical Research Institute/Centers for Disease Control-Kenya (KEMRI/CDC). The project aims to understand the complex relationship that exists between water access (both quality and quantity), food security, and health. We have selected to focus our study on children under 5 years old and women of child-bearing age (18-49 yrs) and will be measuring growth and disease outcomes to help answer the question if it is more important to have access to higher quality water (less microbiological contamination) or higher quantities of water. Water, food security and health are linked in many ways; contaminated water can cause waterborne disease, water can be used to grow food to sell or eat, nutritional status can affect the progression of diseases like HIV.
Our collaborators at KEMRI/CDC have established an intensive health and demographic surveillance system (HDSS) in this region that visits every household within the study area quarterly to maintain a current census of the people and their major health issues. KEMRI/CDC also operates the International Emerging Infections Program (IEIP), which is a more targeted program within a subset of this study area that visits households every 14 days to learn more about the infectious disease burden among this population, which has been plagued with high child and adult mortality rates. The 33 villages enrolled in IEIP are located within a 5 km radius of the local hospital, St. Elizabeth Lwak Mission Hospital. All households enrolled in this program receive free (subsidized by KEMRI/CDC) medical care for any infectious disease at the hospital. Our research team selected this area to conduct our research due to the amazing infrastructure and wealth of pertinent data currently collected by KEMRI/CDC. In addition, last year the government constructed a water treatment plant that provides chlorinated water for a small fee at several public taps throughout the community.
The project is being implemented by 3 different field teams. First, we are utilizing the quarterly HDSS survey team to administer a household Water Access Survey that includes questions about the water source and type of food household members consume. The water questions cover topics such as what type of water source the household uses (spring, borewell, public tap, shallow well, pond, river), the time it takes to walk to the water source, how much/if they have to pay for water, if they treat the water, and how much water they use for different purposes (cooking, drinking, washing clothes, bathing, water crops or gardens). The food security questions include what foods the mother and children have eaten in the past day, how often the family goes to sleep still hungry, what type of crops the family grows, and if they sell their crops, consume them or both. The second team consists of 6 community interviewers that are visiting households to take body measurements (height, weight, and arm circumference) on mothers and children under 5 that will help us to assess nutritional status. The final team is the water team (with whom I primarily work with) and they are responsible for conducting an inventory and sampling water sources within the study area and also collecting samples of stored water used for drinking, cooking and other domestic purposes from select households.
I’ve been here for almost 2 months now and have trained the water team on how to conduct a brief questionnaire, how to measure chlorine residual in the water (when it is from the public tap or a house reports using chlorine to treat the water), and also how to collect and analyze microbiological samples. They are measuring 100 mL of water for total coliforms (a general class of indicator bacteria) and E. coli(a type of bacteria found only in feces and indicative of fecal contamination). I’ve gained a lot of insight into the issues surrounding water access, started to develop some interesting research questions to pursue in the future, and have been asked by more than one person if Obama sent me from America to help them (his grandmother lives about 25km from here). Several of the children are enamored with my hammock, called “suore” (swing) in the local language Luo, and I’ve worked out an agreement where they can use it all day in return for giving me a 1 hour Luo lesson. I’ve been renamed Jessica Adhiambo, the Luo name for people born in the evening (I was required to contact my mother to confirm my time of birth) and am often greeted by those who know me as just Adhimabo as I ride my bicycle through the study area. This morning when I looked at the small notebook that I carry, I realized that one of the children had written “Jesika Adhiambo” on the front of it for me!