Water Accessibility and Health of Refugee Communities in Rhino Refugee Settlement in Arua District- Uganda
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Water supplies must be both safe and acceptable to users, although quantity may take precedent over quality in terms of delivering a wide range of health benefits, including those that are mostly linked to hygiene. This study aimed to assess the community accessibility of domestic water sources and its relationship with prevalence of diseases at Rhino refugee camp; water sources from Ofua and Tika zones were map out, secondary data on water accessibility and disease prevalence was reviewed, Key informant interviews and focus group discussions were conducted in both zones, 200 Refugee households were randomly selected and interviewed using structured questionnaires; and water samples were collected from the mapped water sources and a sample of households in the two zones of the camp. Water sampled was analyzed for physico chemical and microbial status. ArcGIS 10.22 software was used to generate maps of the water source distribution and population densities, qualitative data obtained were analyzed by contextual interpretation, Wilcox rank tests, Chi square and regressions tests were performed on the quantitative data. The physico-chemical and microbial data were subjected to log linear regression with poison distribution test and zero-inflated regression; the physico-chemical parameters were compared to the WHO and UNBS drinking water standards using single sample t-test. Results showed Few water sources were distributed around the densely populated (>280 people/source) communities, Available water source is Tank reported by 40.20% and 26.63% in Ofua and Tika zones whereas, 76.27% and 100% in Ofua and Tika said available drinking water source was Tank. Four parameters on choice of a source showed significant associations (p= 0.00, p= 0.000, p=0.02 and p<2.2e-16). About 12.1% of the refugees have 7 to 8 people per a household and accessing 2 (20 L) jerrycan/household/a day. Accessibility to domestic water is low 10.1 liter/person/day and regression models showed high significant interactions effects (p= 0.00088, p= 1.29e-05, p= 3.30e-07) among all the parameters. Households and tanks showed high microbial contaminations (households= 58.35 TC, 50% TTC and 46% enterococcus; whereas, tank= 80% TC, 60% TTC and enterococcus). Two boreholes in Tika zone showed high levels of TDS (926 and 806 NTU) and EC (1850 and 1629 µs/cm); one borehole showed higher turbidity (8 mg/l) than the WHO and UNBS permissible levels set in the standards. Whether the refugees boil water or not is significantly associated with microbial contaminations of water, amount of water collected and children fetching water in the camp were associated (p<0.00) with diseases reported in the camp; diarrhea, malaria, URTI and Hepatitis A were reported to be the diseases in the camp. In conclusions, water coverage was low in the two zones and accessibility of water for domestic use was compromised with the influx of the refugees. Despite quality being low at the sources, Tanks and households presented high microbial contaminations.