Knowledge and perceptions of schistosomiasis, a water-borne disease, in two semi-arid rural areas of South Africa (Ndumo) and Zimbabwe (Ntalale).

Schistosomiasis is a serious water-borne disease of public health importance in southern Africa and is characterised by high morbidity and negative socio-economic repercussions. Limited knowledge on the mode of transmission and treatment contribute towards increase in the risk of infection. This study assessed community knowledge levels, perceptions and the co-constructed realities of social actors with regards to schistosomiasis in rural resource-poor communities of Ndumo in South Africa and Ntalale in Zimbabwe. We hypothesised that there was association between community knowledge level on schistosomiasis and location of residency and socio-demographic factors. Two-hundred and eight questionnaires were used to gather quantitative data on socio-demographics and knowledge levels while 18 focus group discussions were used to collect qualitative data on perceptions and social constructs. The Fisher's exact and Chi-square tests were used to determine the differences in community knowledge levels based on localities, gender, religion and age. Results showed that awareness level of schistosomiasis was assessed as 'good' in both Ndumo (91%) and Ntalale (81%). Majority of the respondents identified schistosomiasis as a water-borne disease with significantly higher proportion in Ndumo (89%) compared to Ntalale (68%) (p = 0.005). A significant proportion of participants in both localities were aware of the symptoms of schistosomiasis especially the passing of urine with blood (82.5% in Ndumo and 77.0% in Ntalale; p = 0.039). However, presence of schistosomiasis eggs in human stool apart from urine as a sign of infection was highly acknowledged in Ntalale (57.4%) compared to Ndumo (11.7%; p < 0.001). Knowledge on the body parts affected by the infection was low in both localities with 36.9% in Ntalale compared to 1.0% in Ndumo (p < 0.001). In both study areas, local understanding of schistosomiasis was limited to passing urine with blood, a symptom only seen in cases of urinary schistosomiasis. All the participants associated schistosomiasis with being water-borne, but had divergent perceptions on the symptoms, lifecycle and treatment of the infection. Trends of schistosomiasis and at-risk populations were perceived differently in Ndumo and Ntalale. Although respondents from the two localities acknowledged schistosomiasis as water-borne disease, the study showed lack of in-depth knowledge on the life cycle of the diseases. We therefore recommend that health education be implemented together with other strategies such as improvement in access to water and sanitation in the two study areas to achieve effective control and prevention of the disease.

The political ecology of stakeholder-driven climate change adaptation: Case study from Ntalale ward, Gwanda district, in Zimbabwe.

Vulnerable rural communities face climate change-related shifts in rainfall patterns, particularly droughts and floods. The study investigated how Ntalale ward households in Gwanda district of Zimbabwe interpret climate change and adapt to its stressors in the context of the Zimbabwean political economy. Focus group discussions and interviews collected qualitative data. The community has experienced the following climate change-related risks: droughts, floods, heatwave and intra-seasonal rainfall variability. Droughts were reported to be occurring more frequent in the past 25 years as compared to the period before 1991. Ntalale area experienced floods in the 2002-2003 rainy season only. Respondents generally perceived that the rainy season had changed in the past 5 years, with the season now beginning in December and ending in March. The households have resorted to shifting cultivation practices, replanting, use of wetlands in preference to upland fields, changing of seed varieties or crops, selling of livestock and informal trading as coping strategies. Although non-governmental organisations have assisted the community to set up irrigation schemes, a few selected community members have benefited from the initiative. The Ntalale community has experienced four climate change-related risks and institutions have assisted the community. It is recommended that cooperation between households and institutions is key in developing stakeholder-driven adaptation strategies.

The relationship between HIV and AIDS and water scarcity in Nyamakate resettlements land, north-central Zimbabwe.

HIV and AIDS and water variability have been studied separately, yet, they impact on rural households simultaneously in an interactive manner. The study provide narratives on various realities from a study in the Nyamakate community that illustrates the dialectical relationship between HIV and AIDS and water scarcity. A qualitative research methodology was employed, and the following data collection tools were used: semi-structured interviews, focus group discussions (FGDs) and participant observations. The study showed that in the Nyamakate area, HIV- and AIDS-affected households utilise more water if there is a bedridden patient. Such households utilise an average of 145 litres per day and reported a water shortage of 103 litres per day. Although community rules and customs stipulate that water should be accessible to everyone, exclusion of HIV- and AIDS-affected households is underlined by cultural issues, scorn at poor levels of hygiene, infectious opportunistic infections and labour shortage, which limited access to water points by households directly affected by HIV and AIDS. In cases where women were overwhelmed with caregiving roles, men fetch water. We conclude that HIV and AIDS and water scarcity are dialectically related and hence should be considered in an interactive manner in order to understand the challenges faced by affected households.