Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
International Federation of Red Cross and Red Cresent Societies - 23 July 2003
John Sparrow and Selma Bernardi in Silele, Swaziland
Wednesday
12.00 Noon
Poverty brings its own problems. Mother-of-six Nelsiwe depends on Red Cross food distributions of maize, beans and oil to feed her family and the clinic has provided corn-soy blend for the youngest to improve their nutritional intake. Today she has brought her two-month-old baby for a check up. Like all her children it has scabies.
Scabies comes from poor hygiene. Where there is a shortage of clean water and soap, or a reluctance to use them, scabies thrives. And, as Nelsiwe has discovered, it spreads like wildfire.
Poor access to safe water and adequate sanitation in Swaziland has wider and more troubling health consequences. Last December cholera broke out and the clinic dealt with a stream of cases from the surrounding Kaliba area. Mduduzi Nkonyane, the Red Cross water and sanitation officer, is in no doubt why the population is vulnerable.
"Just take a walk with me," he says. "Most households have no latrines. People defecate in the bush. They do not cover their faeces, and do not wash their hands because water isn't close. When it rains the faeces is washed into the rivers.
"People drink from the rivers. The water is dirty, it is kept in dirty containers, and nothing is done to purify it. Often homesteads do not have refuse pits. You find cow dung all over the yard. Food like vegetables isn't washed before cooking or eating, and flies are everywhere."
He is busy changing things. In the hills close by, streams are fed into filtration and purification tanks and a pipeline carries water down to the clinic. Outside, a mountain of coiled pipe reveals other plans: to take the clean water into 385 homesteads.
The digging of trenches started yesterday. Sanitation pits are also being dug, cement slabs constructed to place on top. Before water is laid on, homesteads must agree to a sanitation package.
It is the first such project in the area, and requests for similar schemes are coming from other communities. Health information campaigns would seem to be paying off although Mduduzi has no illusions. There is a long way to go yet. As he climbs the hill to inspect the trenches, he is blunt. "We still have a lot of people to educate. I mean there are these beliefs. People just won't sit where someone else has sat. They say: if that woman is going there, I am going to the bush."
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