Prof Jude Robinson is a social anthropologist and HORN Co-Investigator, and has recently led the development of a series of collaborative, interdisciplinary projects collectively called ‘Everyday Clean’, or Usafi kila siku in Swahili, to research One Health and Water, Sanitation and Health (WaSH) issues. Working closely with Dr Olivia Howland, (anthropologist and HORN Post-Doctoral Research Associate), the collaborative HORN team on Everyday Clean, includes microbiologists, veterinary scientists and public health specialists: Dr Dismas Ongore at the University of Nairobi, Prof. Nicola Williams at the University of Liverpool and Dr Annie Cook at ILRI; with three HORN Training Fellows, Dr Thigu Stephen Gatitu, Ann Munene and Danait Solomon.
Background
Human and animal health are intertwined with local ecologies, and research has identified hygiene as a One Health issue. Around 60% of human pathogens are zoonotic, and the World Health Organisation (WHO) notes that the impact of many neglected zoonotic diseases (NZDs) is,
‘… most severe on poor households in developing countries… Poor people are least likely to be currently diagnosed and treated against NZDs.’
Shifting environmental conditions and poor or insufficient hygiene facilitates the transmission of bacteria and viruses between and within species of animals; between humans; and between humans and animals. Around a third of the world’s population lives without regular access to adequate sanitation and even good hygiene practices can be compromised so many people struggle to stay clean. Although many people in East Africa spend time every day in environments where animals are present, much of the research into WaSH issues does not take account of the presence of animals and related hygiene practices in their study design. Over 50% of people in Sub Saharan Africa live in urban or peri-urban settings often with rapid population growth and many bring animals with them to the cities to keep as a source of food and income. Across East Africa, many farmers keep livestock and a high number of people are directly involved in routine aspects of animal husbandry. This includes feeding, watering, assisting with births, treating sick animals, milking, and the slaughter, butchery and disposal of dead animals, and each of these everyday encounters presents hygiene risks to animal and human health. Everyday clean practices can benefit the health of people and animals by creating productive and healthy environments that minimise the risk of zoonotic and other infections.
Everyday clean/ Usafi kila siku
Through interdisciplinary One Health projects, we will explore how people manage to keep clean in low income environments in Kenya, where people live in close proximity to animals and wildlife. Our approach is informed by theories of capabilities, risk and gender and aims to better understand people’s ideas, beliefs and practices around cleanliness and hygiene. We take a participatory approach to data collection and analysis and participants and communities will be involved throughout the research.
This interdisciplinary project aims to:
- explore the everyday hygiene practices of people who live alongside animals within two contrasting one-health contexts in Kenya, to identify what could facilitate people achieve better standards of hygiene and so improve their health and reduce their risk of infection;
- explore issues of age, gender and hygiene with women and men to identify potential barriers and opportunities for improving health;
- gain an insight into how people use and access soap and water in the context of changing economies, rainfall patterns and rapid urbanisation;
- critically evaluate the potential to use interdisciplinary teams to co-operate on data gathering and analysis to research hygiene and one health;
- assess whether the audio-visual intervention and storytelling approaches we develop and discuss at four community workshops helps to stimulate community thinking around hygiene practices that lead to improved health.
Our objectives are to: establish a participatory, interdisciplinary approach to improving hygiene practices in one health contexts; establish the use of storytelling to deliver complex health messages; and to identify issues for further One Health WaSH research.
For our fieldwork we propose to combine ethnographically informed observations and interviews with scientific structured observations and microbiological sample collection to undertake two complementary studies to critically assess (methodologically) the best way to positively engage with people to discuss hygiene and health in a one health context.
Study 1: researchers will identify 20 household environments in two contrasting low-income communities in (a) Nairobi and (b) Oloitokitok, Kenya, where rates of everyday human and animal interactions are high. The anthropologists, microbiologists and veterinary scientists will form a co-operative interdisciplinary team, working alongside one another at the same sites, with the same households. After conducting a brief community mapping of the two research sites, researchers will interview people at each of the 20 households, taking photos and microbiological samples to record their observations of human and animal interaction, noting who does what and why.
Study 2: developing a more gendered and age-sensitive approach the team will use interviews and photography to explore everyday washing practices with (a) 20 women and with (b) 20 men of different ages across wider geographical areas in Kenya and focus on personal hygiene in relation to their occupation and contact with animals inside and outside their homes.
Following a synthesis of our data analyses we will create a short audio-visual intervention and use local storytellers and members of the research team to highlight clean practices and opportunities to optimise human and animal health and hygiene, presented to communities via workshop discussions. This will provide an opportunity for researchers, and participants/community members to reflect on ideas of ‘clean’, and to collaborate on further ideas for research or interventions going forward.
Expected results
By taking a gendered and intersectional approach, we will assess how successfully women and men access and use resources they need to stay clean and this impact of this on their past, current and longer term health and the health of their animals.
Building on the success of A Bitter Pill that used photography to explore the use of traditional medicines in one health contexts, Everyday Clean, Usafi Kila Siku will work with local people to use photography, film and storytelling to explore communicate the findings around one health WaSH issues to wider communities.
Photos courtesy of Biko Wesa.