Bathing without water

New publication on everyday practices of sanitation and hygiene in the low-income areas of Lilongwe, Malawi

Hygiene matters to people!

This post has been written by Maria Rusca, Cecilia Alda-Vidal and Nienke Kral

What do good smell, personal cleanliness, a spotless environment, clean clothes, and tidy appearance have in common? This is what matters to people living in Area 56, a low-income area of Lilongwe, the capital of Malawi. Despite high poverty levels, persistent water shortages and the lack of infrastructures, residents do their best to keep up with their hygiene practices; to “look smart” and “smell good” (Anna, resident). As most of the hygiene initiatives are focused on health education and hand-washing promotion, we were surprised to find out that most residents have clear priorities, preferences, and motivations when it comes to practicing hygiene.

Derita, a resident from Area 56, explains that one of the most important hygiene practices is bathing: “the elderly here they take a bath in the morning and in the evening, but for the kids it is in the morning, in the afternoon and in the evening”. Vanessa adds that babies are the priority: “dirty children are disgusting and also bad because other people are going to talk about you”. Residents are concerned with eliminating bad odours, as “bad hygiene is when you have smelly babies” (Eve, resident), and project an image of cleanliness: “dirtiest practice […] is dirty clothes” (Vanessa, resident). From walking through the area it is evident that doing laundry is an embedded practice and a common routine. In the morning, women fetch water and wash their clothes, and for the rest of the day, they hang from ropes in front of their houses to dry in the sun.

Photo 1
 A typical laundry-hanging scene in Area 56 © Nienke Kral (2016)

Having a clean house is equally important to project a positive image of the household and their space. If the floor around the house is not swept, the neighbours may label people of that household as dirty and say they are unable to take care of their own space: “good hygiene means that you clean the surrounding around the house because you do not want to look shabby” (Derita, resident).

Practicing hygiene when there is no water to spare

Yet, very often residents are unable to smell good, enjoy clean environments, wear clean clothes and, ultimately, feel well, clean and tidy. This has much to do with water availability and affordability. The water utility provides water through kiosks that are open 4-6 hours a day. A resident reminds us of the costs of the irregularity of the service and how this frustrates people living in this area: “the bucket is not something cultural, it is everyday life[…]. If we had water the whole day we would not need to have buckets, then we could go straight to the source”. They explain that with reliable supply and an in-house connection they could practice hygiene as they do in higher income areas: “you have a better life with your own tap because you can only use the water right there. For kiosk water, when you have for example three buckets you have water but you cannot cover it. Flies can come. And that is something I find bad hygiene” (Monica, resident).

To make it even more difficult, water, buckets, toothpaste and soap are expensive. Steve, a resident, explains what is called for to properly carry out locally preferred hygiene practices. “The way I understand hygiene, is, if you have buckets, you should have one for laundry and one for bathing, buckets for keeping your water, like drinking water, then you have a special bucket for that, if you want to have a bucket for cooking, you should have a bucket for that. And a mopping bucket, they should only be used for mopping.” For many residents, this is far too expensive; Anna expressed a common sentiment when she said, “the difference in hygiene between households is because some cannot afford so many buckets or can’t go to the shop to buy soap”.

Photo 2 different buckets for each hygiene practice © Nienke Kral (2016)

Residents often trade-off between soap or water and toothpaste, which is an expensive product: “sometimes we use [toothpaste], but it is not frequently because of income and then we use ash and sometimes when we don’t have a toothbrush, we use our hand, so that is how we clean our teeth” (Vanessa, resident). For many households, even toilet paper is unaffordable. Many have to use leaves or newspapers, or when these are not available, they scratch their buttocks against the wall to clean themselves: “Leaves are not good, only people with low income are using these. Using the wall we find really dirty, but what can we do if you don’t have the money” (Resident, focus group).

What are the implication for WASH projects?

Our research shows that in the low-income areas of Lilongwe residents are well aware of the health risks they experience on an everyday basis and of how hygiene practices can mitigate these. Despite the high poverty levels and the constant water shortages in the area, a number of water-intensive hygiene practices are consistently undertaken by residents. These practices are socially grounded and deeply embedded, and are often passed on by family members, mostly mothers, or institutionalized in religious practice. 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. 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.

References

Here you can read the details of our research and the implications of our findings for urban WASH projects and health risk reduction in low income neighbourhoods:

• Rusca M., Alda Vidal C., Hordijk M., Kral N., Bathing without water, and other stories of everyday hygiene practices and risk perception in urban low-income areas: the case of Lilongwe, Malawi, Environment and Urbanisation, doi: 1177/0956247817700291)
• INHABIT Cities. Investigating Natural, Historical, And Institutional Transformations – Cities

Aknowledgments

This research has been undertaken in the framework of the collaboration between INHAbIT Cities (Investigating Natural, Historical and Institutional Transformations in Cities) and UNHIDE (Uncovering Hidden Dynamics in Slum Environments). INHAbIT Cities is sponsored by the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 656738 and is implemented by King’s College London. UNHIDE is sponsored by the Dutch Ministry of Development Cooperation (DGIS) and is implemented under the memorandum of understanding between the University of Amsterdam and the UNESCO-IHE Institute for Water Education.