It’s Yellow, Let It Mellow, If It’s Brown, Let It Drown”: Examining The 2 Health Effects Of Drought-Induced Water Rationing For Sanitary Needs

This paper focuses on the impacts of water stress on health outcomes. It specifically investigates the health effects of insufficiency of water for 22 sanitary needs in drought-affected households. A Focus group discussion that drew medical experts from such fields as medicine, virology, and 23 microbiology was conducted to collect data. The findings of the study show that there is a possibility of vulnerability to negative health outcomes 24 such as Cholera, Diarrhea, and respiratory problems by households that lack the necessary levels of water for domestic, sanitation and hygiene 25 uses. It is therefore important that individuals and households susceptible to the vagaries of drought be aware of this relationship so that they 26 may forge necessary adaptive measures such as the use of purifiers, hand and surface sanitizers, and disinfectants to mitigate the health effects 27 of a drought that are related to inadequate water use for sanitary purposes.


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South Africa is a drought-prone country. The first known and widely reported drought episode in South Africa occurred in 1921.

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It was a severe drought, and it is used as a yardstick for measuring the severity of the droughts that have occurred after it 34 (Rouault and Richard, 2003). Since 1921, there have been several episodes of drought with untold hardships on households, 35 homesteads, and industrial activities (Kilimani et al., 2018;Azadi et al., 2018). The water crisis was so acute in Gauteng Province 36 in 2014 that substantial water needs in Johannesburg were met by water imports from Lesotho -a sister country to South Africa 37 (Mellisa, 2020). In Western Cape Province, water stress is a well-known phenomenon. In Cape Town, Western Cape, for 38 example, dry spells and intensely low rainfalls necessitated the need for the promulgation of a bylaw that strictly regulated water 39 use by households and agro-allied and industrial businesses. These regulations became expedient as the city geared up to the 40 possibility of being the first city to experience the anticipated Day Zero -a day that water would stop flowing from taps. As

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In terms of population composition, roughly one-half of the population in the Province is of mixed ethnicity (previously 82 referred to as "colored" under the apartheid regime), while one-fourth is black, and one-fifth is white. The remainder of the 83 population is Asian of mostly Indian descent. Most of the people in the Province reside in urban centers of which most of the 84 people reside mostly in the city of Cape Town. The most widely spoken language in the Province is Afrikaans, and this is followed 85 by Xhosa (Dyer, 1999), and English -which bridges the language gap in the Province existing between indigenous languages 86 spoken by South Africans and many other African languages spoken by a relatively small percentage of the population.

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Western Cape has a strong and thriving agricultural sector which has contributed significantly to South Africa's Gross 88 Domestic Products (GDP) (Conradie et al., 2009;Sirami et al., 2013). The Province boasts the production of a chunk of South 89 Africa's wool, wheat, alfalfa (lucerne), hay, and fruit (including apples, pears, apricots, and peaches), and almost all its wine 90 (Takadi and Moraba, 2018;Venter, 2018;Kemp and Burns, 2016;Burger, 2018;Visser, 2016). Owing to high productivity, the 91 Province has a thriving export trade system for fresh fruit,

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pesticides, and pharmaceuticals. The Province also boasts of marine engineering and ship repair services along the coastline.

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The study adopted qualitative methods of data collection and analysis. Focus group discussion (FGD) was conducted 99 to elicit an expert opinion from experts from the fields of medicine, microbiology, and virology about the effects or otherwise of 100 water rationing for hygiene purposes. A total of six discussants covering the above fields of study were selected for the study.

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The participants -three doctors, two microbiologists, and one virologist -were purposively selected for this study from Cape 102 Town, South Africa. The FGD was conducted using the telephonic feature of WhatsApp.

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In this section, the extant literature on drought impacts and vulnerability, drought drivers, and other relevant nuances will be 106 reviewed.

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Rainfed agricultural activities remain the principal source of livelihood for more than 70% of the population.

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In South Africa, a study was undertaken by Theunissen (2005)

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The exposure to health hazards occasioned by drought may just have more wide-ranging impacts than one may be 248 able to account for. For instance, there is scholarly evidence in the literature that finds that in utero exposure, that is exposure 249 of yet-to-be-born children -to environmental hazards may negatively affect their health when they are born, and educationally, the vagaries that women, children, refugees, and the displaced are exposed to as they are the most severely impacted as far 274 as the rising food prices are concerned. These communities and groups, according to the Report, suffer serious losses to their 275 human security as they consume fewer and less nutritious foods, and the frustrations over food insufficiency and/or insecurity 276 have also led to socio-political instabilities in some communities in as many as 30 countries.

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The findings elicited from the experts who participated in the focus group discussion will be presented and discussed under the

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Another consequence of inadequate and/or rationed water use in toilets highlighted by two of the discussants is that it may lead 299 to respiratory diseases. They had posited that the toilet environment is where organic particles such as bacteria, fungal spores,

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In closing, some of the discussants made some suggestions that could help water-stressed households -constrained to ration 307 water for hygiene needs -to lessen their exposure to health challenges. One of the discussants recommended the use of purifiers 308 in their toilets and the entire house. According to the discussant, purifiers help to eliminate bacteria and improve air quality.

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Another discussant recommended the continual use of hand and surface sanitizers so that bacterial infections that can cause 310 Cholera and Diarrhea may be avoided. Homes that lack the required amount of water for toilet use should not lack hand and 311 surface sanitizers; said the discussant. Purifiers have been found to be effective in improving air quality in the home (Cheek et