In the first part of this research project in Tanzania, it emerged that a large part of the population doesn’t have clean water. The causes: climate change leading to droughts, combined with poor water management. In this second part, we explore how the lack of water affects people’s lives.

DAR ES SALAAM – Health and the environment are closely related. “It’s inevitable, the environment provides us with everything we need, from water to food – says says Aloyce Urassa – We depend on plants and nature, so it’s imperative to understand how much environmental changes affect our health and well-being “. Aloyce Urassa is a physician and promoter of various climate change and global health initiatives[1].

Water is life. But this water is harmful.

Despite its complexity, the problem of water scarcity in Tanzania is cyclical and easy to understand: rising temperatures threaten the country’s already precarious water supplies in both major cities and rural communities. There is a shortage of water, and where it’s available, it’s of poor quality. Aloyce explains that the rise in temperature affects the proliferation of bacteria and the development of pathogens, causing diseases such as cholera, typhus, dysentery, and hepatitis, which are linked to the insecure water supply. This happens because drought reduces the amount of water and increases the concentration of bacteria. At the same time, decreasing water flow leads to stagnation, which encourages mosquito breeding and the spread of vector-borne diseases such as malaria, of which “at least 90% of cases in Tanzania are associated with environmental problems.” 4.1% of all global malaria deaths occur in Tanzania, where 93% of the population lives in areas at high risk of transmission. Adding to the risk of infection is the lack of water: according to WHO, only 24% of the population has access to adequate sanitation.

“People here are forced to drink water that shouldn’t even be used to wash the legs. They don’t know how diseases develop, and when symptoms appear, most people cannot afford treatment. ” The government offers health insurance (NHIF) at a relatively affordable cost, that increases with age: basic insurance for 18-to 35-year-olds costs TZS 192,000 per year [2], equivalent to one or two months’ salary, but it does not cover everything and not everyone can afford it. Even the more comprehensive coverage is subject to limitations, including a 60-days limit on hospitalization, and its cost more than double that of basic insurance, and doubles further for adults over 60 [2]. Citizens voices are unanimous: “It’s for the rich!”

Against this background, it’s better to prevent. But how? The most efffective means is education. Aloyce argues that people are willing to learn: “We, the health professionals, realized one thing. At the beginning of the pandemic, when the government was actively promoting hygienic measures, the number of hospitalizations related to poor sanitation dropped significantly. Citizens quickly got the message, learned hygiene rules and implemented them to reduce the spread of the virus! In this sense, this experience has shown us that it takes very little to get people to adopt a healthier lifestyle.” In addition, education must be inclusive: “We can’t educate people with brochures, because many can’t read” and although literacy has improved in the last decade, reaching almost 80% of the population, “we are a country of young people; therefore, you have to be creative in communicating these concepts ”Aloyce adds .

“Maisha na maji salama”: Bottom-up efforts give hope for “safe life and water”

People are really inquisitive, you can see it in the eyes of the children and teens in the schools when Anicet teaches them about hygiene practices. Anicet Theobald is a young Tanzanian who got in touch with a European volunteer organization in 2018 that trained him on hygienic practices. When the association stopped its activities because European volunteers could no longer reach Tanzania due to the pandemic, Anicet started its own association, Youth & WASH (Water And Santitation Hygene), to support the implementation of the 6th UN Sustainable Development Goal (SDG).

The 2030 Agenda aims to achieve 17 SDGs, of which number 6 refers to ‘providing access to clean water and sanitation for all’. To give more to this goal and accelerate initiatives to achieve it visibility – which would otherwise be unattainable, given the expected 40% decline in clean water over the next 10 years – the United Nations launched the Water Action Decade (2018-2028 ) in 2018. Indeed, the impact of the projections would be devastating if we also take into account the steady increase in the world’s population.

In Africa, individual and ‘bottom-up’ efforts have exponential value, especially when they involve young people, who make up the majority of the continent’s population: About 60% of Africans are between 0 and 25 years old. For this reason, Anicet teaches in schools, to make hygiene practices transferable and sustainable: “The children go home and teach their mothers what they’ve learned.” Anicet shows elementary school children how germs are transmitted by getting their hands dirty with flour to show that even the child sitting at the desk farthest from the one initially ‘infected’ by Anicet will have flour on his or her hands at the end of the games.

“When there isn’t enough water and the water that’s available is dirty it’s important to know how to better manage it so that you don’t have to choose between drinking and carrying out hygiene practices. Children learn not to waste the water, to boil it before they drink, and to filter it with cloths. These are daily actions that save lives.”

Anicet and his team understand that there are villages, like Msanga, where the water supply is inadequate, even if it’s well managed. For this reason, Youth & WASH will launch a new campaign in 2022 called “Maisha na Maji Salama”, which means “safe life and water”. The project aims to provide villages with clean water tanks, install pipelines and filtration machines and bring ‘mobile clinics’ to villages that will allow specialized doctors to visit residents. It’s an ambitious project, that needs funds, as Anicet says: “If we maximize our capacity, we can implement the project in four villages the next year”.

This shows that while the actions of associations like Youth & WASH are important, an approach based solely on civil society efforts clearly falls short: for a problem of such magnitude, the solutions must be structural, otherwise too many people will fall by the wayside. However, Careen Joel Mwakitalu, Tanzania’s representative to Youth4Climate in the run-up to COP26 and UNOPS communications manager, notes that the government is focusing resources and energy on centers of tourism and foreign investment. As a result, coastal areas, which already benefit from the nature of the territory, the fertility of the soil and the abundance of fish in the sea, are much more developed than inland regions. Moreover, corruption is strong and deep-rooted, cutting off the legs of all those young Tanzanians who, with few resources and many ideas ready who are willing to shut loudly not to give up their ambitions.

[1] President of the African Leaders Malaria Alliance (ALMA) Youth Advisory Council, member of the Board of Directors of Rotarians Against Malaria Global, national coordinator of NextGeneration Global Health Security and World Youth Summit, and co-chair of the SADC Youth Forum on the committee for the environment and climate change.

[2] Source: Insurance paper brochure

Lucrezia Ducci

All the pictures ©Lucrezia Ducci