Bathing without water, and other stories of everyday hygiene practices and risk perception in urban low-income areas: the case of Lilongwe, Malawi

Abstract

Hygiene plays a key role in tipping the balance towards reduction of diarrhoeal and other infectious diseases. Yet it has often been overlooked, positioned as a “supporting rider” of water supply and sanitation services, or narrowly understood as handwashing. By focusing on handwashing infrastructure as proposed for the monitoring of Sustainable Development Goal (SDG) 6, development actors might miss the opportunity of capturing hygiene practices that are socially embedded and can act as a catalyst for change and risk reduction. We develop this argument by presenting an in-depth examination of hygiene practices in a low-income neighbourhood of Lilongwe, Malawi. Despite the high poverty levels and the constant water shortages in the area, a number of water-intensive hygiene practices are consistently carried out, proving that hygiene is central to residents’ everyday lives. Development projects should start by identifying these practices and by reflecting on the extent that these already work or can be made to work for reducing health-related risks.

Interdisciplinary Critical Geographies of Water: Capturing the Mutual Shaping of Society and Hydrological Flows

“…In the periphery of Maputo and Lilongwe, for instance, water is only supplied at night. Timing here matters perhaps even more than distance in shaping women's experiences of fear and violence with which water access becomes associated [92,93]. Concurrently, time of storage and discontinuity of flow fundamentally change the quality of water and, in turn, increase risks of its contamination [66,94].…”

Water insecurity and urban poverty in the Global South: Implications for health and human biology

“…The dense and overcrowded nature of these urban environments coupled with poor sanitation, open sewers, and pit latrines create multiple exposure pathways. Pit latrines routinely overflow and release of fecal sludge, contaminating soil, surface and ground water sources particularly during the rainy season (Carter, ; Rusca, Alda‐Vidal, Hordijk, & Kral, ). Environmental conditions may also expose households to the risk of injuries during water fetching while the social environment, known for exclusion, heterogeneous composition, and multiple stresses, may also complicate the impact water insecurity on psychosocial health.…”

A spectrum of methods for a spectrum of risk: Generating evidence to understand and reduce urban risk in sub‐Saharan Africa

“…Rusca et al (2017) used a household survey, semi-structured interviews and focus groups to understand preferences and motivations around hygiene in Lilongwe. Rusca et al (2017) used a household survey, semi-structured interviews and focus groups to understand preferences and motivations around hygiene in Lilongwe.…”

“…Surveys of this sort can draw out the risk implications of existing urban issues, such as hygiene and conflict. Rusca et al (2017) used a household survey, semi-structured interviews and focus groups to understand preferences and motivations around hygiene in Lilongwe. The use of these methods helped to build an understanding of both the direct benefits of hygiene practices and the co-benefits that they can produce for reducing health risk in low-income urban areas.…”