Safe Water and Community Health in Nairiri, Kenya
In Nairiri, Kenya, Mailiari Clinic provides healthcare for thousands of people. However, without safe water, the clinic can’t properly care for patients. A new water source might change that.
“Our biggest challenge here is water.” The woman says directly to the camera, standing outside the clinic where she works. “Most days we don’t have water in the dispensary; even if we need to use water we don’t have anyone to collect it for us... Most patients come and want drinking water, but the facility has no water to offer them.”
Jerusha Kariri is a cleaner at the dispensary in Mailiari Health Center, the main source of medical care for the area surrounding Nairiri, Kenya. A staff of four Registered Nurses, along with half a dozen auxiliary support members like Ms. Kariri, care for thousands of people in Nairiri and the surrounding villages. However, the staff at Mailiari Clinic often lacks the resources they need to provide proper and safe care for their patients. Due to the lack of safe water access in Nairiri, the staff at Mailiari have been relying on unsafe and unreliable sources of water — a problem which has had drastic consequences for the health center, its staff and its patients.
In one of this year’s initiatives, a new water source at Mailiari Health Center could change everything for staff and patients alike. Moreover, the installation of a safe water source could drastically improve the health and quality of life for everyone in Nairiri and the surrounding area.
Life in Nairiri
Nairiri, a village in Meru County in Central Kenya, is home to more than six thousand people and three hundred households, many of whom lead a nomadic lifestyle. The village also contains a mix of cattle and sheep farmers and subsistence farmers, all dependant on a common water source. Nairiri is in a hot, arid area; rain is only common for two months of every year. Partly because of this, water is hard to come by for most people — and safe, usable water is nearly impossible to find.
In two recent video interviews at Ntalami, a village near Nairiri, local women spoke with an interviewer about the difficulties of finding water in Meru County. Just like the staff at Mailiari, Rose Makena and Fridah Gaki Kimathi both agreed that “(Their) biggest worry has been water challenges.” With families to support and no safe water source in sight, both women have needed to rely on whatever water sources they can find.
This is a trip that can take up hours of every day, on top of a day’s work taking care of their families. Sometimes, even reliable water sources are unavailable; on those days, Fridah Kimathi says, “The children spend the night hungry.” With the neverending task of collecting water, combined with the uncertainty of finding a usable water source in the area, both women are constantly worried about finding water to keep their families alive.
Rose and Fridah’s predicament is normal for the community. As the nearest available water source is eight to ten kilometres away, most people in Nairiri and the surrounding area have to make daily trips to find water. These trips can take up hours of every day, a burden which, as in many water-stressed communities around the world, often falls on women and children. This often cuts into the work that local women have to do, and limits their opportunities in life. For children, the lack of safe water access in the area may hinder their education. Schools in the area also lack safe water access, and most children come to school carrying their own water. In addition, the task of collecting water take up hours of every day that should be dedicated to school or studying.
To make matters worse, the water from nearby sources in the area of Nairiri is usually not safe for human use. In addition to the problem of water scarcity, contaminated water has become a massive threat to community health in the area.
Unsafe Water and Community Health
There are few protected water sources in the area surrounding Nairiri, which means that the water sources that people depend on for survival are open to contamination. Since many of Nairiri’s inhabitants make a living through cattle or sheep farming, animal waste often contaminates the common water sources. As a result, waterborne diseases like polio, hepatitis B, and typhoid are rampant in Nairiri and the surrounding villages.
When something as essential as water becomes dangerous to people’s health, it can wreak havoc on a community. Many of the diseases that the community of Nairiri faces are virtually unheard of in developed countries, but Nairiri’s situation is far from uncommon. Millions of people still die of waterborne diseases every year, most of them in communities without access to a reliable safe water source.
When a community is vulnerable to waterborne diseases, children often suffer the most. The vast majority of fatal diarrhoeal disease cases are children; children have weaker immune systems than adults, making them more vulnerable to contagious diseases, and they may be more vulnerable to dehydration that comes with diarrhoeal disease. Diarrhoeal diseases are a leading cause of infant mortality in children under five, and one of the leading causes of childhood malnutrition.
Even nonfatal cases may do serious and lasting damage to a child’s health. Children who survive are often malnourished, which can lead to serious problems in the child’s health as they grow older. Children who grow up malnourished may suffer from stunted growth and weakened immune systems; they may struggle in school or miss school because they are too sick to attend. Contaminated water can damage a community’s health and its safety, and, because it endangers children, it can also harm the community’s future.
Water and Hospital Safety
With waterborne diseases rampant in the area, the people at Mailiari Health Center have their work cut out for them. However, the clinic is not immune to the area’s water access problems, which has left them without the resources to take care of their patients. As Jerusha Kariri noted, the hospital’s dispensary is frequently empty, leaving patients without water for drinking or bathing. In addition, the scarcity of water often makes hygiene at the health center difficult for staff members to maintain.
In the absence of a nearby safe water source, the staff at Mailiari Health Center relies on water vendors for most of their water needs. However, water vendors are often also using unsafe sources, including perennial rivers and open swamps. And since water vendors are not legally obligated to say where they collect water, the staff at Mailiari often have no idea where their water is coming from. As a result, the water at the clinic’s dispensary is frequently unsafe for use, which has put both the clinic workers and the community that depends on the clinic in danger.
The problem of unsafe water at Mailiari Health Center is a common issue for medical centers in water-stressed areas. Patients can’t enter a hospital without interacting with its water supply; even aside from drinking water or personal hygiene, anything cleaned on the premises of the hospital comes into contact with the hospital’s water supply. A safe, clean and steady water source is vital for the running of any medical center; however, in water-stressed areas like Nairiri, medical centers may have a hard time finding any water at all.
Worldwide, more than ten percent of patients receive a nosicomial infection, or hospital-borne infection, during a hospital stay. The rate of infection is two to three times higher in middle or low-income countries, and especially in countries where water insecurity is common. The use of contaminated water in hospitals may expose vulnerable patients to waterborne diseases. In addition, the scarcity of water may lead to a lack of adequate sanitation, making it easy for pathogens to pass from patient to patient or from patient to doctor. Without a safe and abundant water source, hospitals can become dangerous for staff and patients alike.
When unsafe water makes a hospital unsafe for patients, mothers and young children may suffer the most. Research shows that unsafe water is heavily correlated with maternal and infant mortality. In 2014 report by June Cheng et al. from United Nations University, 193 countries were analyzed for safe water access, infant mortality rates and maternal mortality rates. Countries that were ranked in the lowest quartile for safe water had significantly higher rates of infant mortality and maternal mortality.
The link between lack of safe water access and maternal mortality is largely due to postnatal infection. Worldwide, around 11 women per 1,000 live births suffer from a sever postnatal infection which led to an extreme outcome — death or near death. In low and middle-income countries, up to 15 women per 1,000 live births were affected. Places without reliable, safe water sources tend to suffer the worst danger of postnatal infection; contaminated water may play a role in causing infections. In addition, water insecurity may leave hospital staff without the resources to maintain proper sanitation, putting new mothers at risk of infection.
Every community deserves safe and effective healthcare, and places like Mailiari Health Center should be able to provide care and relief to people who need it without patients or staff having to worry about getting sick. However, without safe and available water, medical centers can become vectors for illness. With this year’s project, however, H2O4ALL may be able to change that.
H2O4ALL in Mailiari
Our initiative in Nairiri will provide Mailiari Health Center with a borehole, giving staff and patients access to a safe and reliable water source. This water source would provide for the entire center; staff will be able to maintain proper sanitation in order to protect themselves and their patients from infection, and patients would be able to receive water from the dispensary instead of having to bring their own. Moreover, patients and staff will no longer have to wonder where their water is coming from, or worry whether it is unsafe to use.
With a reliable safe water source, Mailiari Health Center can become a safer place for staff and patients alike. With the decreased risk of hospital borne infection, countless deaths and illnesses may be prevented in the future. And with the resources to keep their clinic a safe place for patients, staff will be able to provide cleaner and more effective medical care to people who need it.
In addition, the borehole would provide for the water needs of many people in the Nairiri community. More than 300 households and six thousand people in the immediate area would also have access to the well. For many people, the well at Mailiari would be closer than the source that they were using; this would allow them to avoid the long walk to an uncertain water source that dominates many women’s lives in the area. In addition, safe water access would drastically decrease the spread of waterborne diseases in the area, preventing countless illnesses and allowing children to grow up healthier and safer.
Aside from the borehole at Mailiari Health Center, our project in Nairiri will also provide safe water access to several public buildings in the Nairiri ara, including a police station in Nairiri and three primary schools in the area. With safe water available at schools, getting an education may become much easier for the area’s children. Not only will children be safer at school with a reliable source of safe water, but many children will be able to avoid the long trip for water by collecting water at the school. Without the risk of disease transmission or the burden of collecting water, children in Nairiri and the surrounding villages will grow up safer, healthier and more free to learn.
When a community lacks something as essential as a safe, reliable water source, a borehole at a health center can change thousands of lives for the better. With the help of H2O4ALL and our partners in Kenya, Mailiari Health Center can become a safe place for the community, with the resources to provide effective medical care. And access to safe water will massively benefit everyone in Nairiri and the surrounding communities, increasing the quality of life and allowing families to keep their children safe from waterborne diseases.
Thank you to Francis Mutua, our Kenya liaison, for providing information about the Nairiri area and the project. Thank you to Salphine Mithika, H2O4ALL’s commissioned photographer, for providing images.
