When water is scarce: how drought damages health outcomes

When water is scarce: how drought damages health outcomes

During a recent trip to visit some of our doctors placed at Hlabisa and Mseleni Hospitals in the uMkhanyakude district, the reality of the continued drought struck us in full force.

AHP Mseleni-drought-rogan ward

This photo, in particular, brought home the daily difficulties in accessing water. This woman was collecting water from a hole over a meter deep, whereas you can see in the distance the natural bank of the dam that is very nearly empty. She told us how each week the water level drops, and she worries that the rains are not due for months.

KwaZulu-Natal officials officially declared drought conditions in December 2014, and then again a year later after spring rains failed to materialise in September. It is not the only province affected: Eight of the nine South African provinces have been declared disaster areas, with 2015’s rainfalls the lowest since records began 112 years ago.

AHP Mseleni-drought-uMkhanyakude rogan ward

These weather patterns wreak havoc, affecting not only the provision of water, but also of food, as many rural communities rely on subsistence farming and livestock to supplement their nutritional needs. Rising food prices in times of drought force families to implement drastic coping mechanisms such as skipping meals or eking out water for consumption, forgoing hygiene practises such as bathing. It can make chronic respiratory illnesses worse and increase the risk for respiratory infections like bronchitis and pneumonia.

The drought has not only caused food and nutrition insecurity, but also means that children frequently don’t attend school, having to help fetch water or are too tired to get to school.

A month ago, a new report was released, detailing how around three million children and 14 million women in Sub-Saharan Africa spend more than 30 minutes a day collecting water.

AHP Hlabisa - drought - roganward

Over sustained periods of time, this causes muscoskeletal damage, soft tissue damage and can lead to early arthritis. People also have to contend with water-borne diseases like schistosomiasis, an infection causes by parasitic worms. The most commonly reported adverse effect in South Africa was spinal pain. In rural areas, higher rates of poverty, chronic malnutrition, and poor health are likely to lead to more injuries. And since they often have to walk long distances to collect water, women and children are at higher risk of sexual abuse.

While acute conditions are easy to attribute to the drought, such as increased incidences of diarrhoea in children, there are more sinister and longer term effects that may play out. In conversation with one of the AHP doctors, she explained that she worries about ARV adherence rates slipping. “When it’s a choice between making it to the clinic to get your meds, or having to fetch water for your immediate needs, water wins every time.”

Leila Gharagozloo-Pakkala, UNICEF Regional Director for Eastern and Southern Africa, warned earlier this year that  “The El Niño weather phenomenon will wane, but the cost to children – many who were already living hand-to-mouth – will be felt for years to come.”

It’s all the more reason that it’s so important that we continue to plan for, find and keep the health workforce needed to deliver health for all.

AHP Mseleni-drought children_ rogan ward

You can access the full report: An Analysis of Water Collection Labor among Women and Children in 24 Sub-Saharan African Countries here.