Exploring water-gender-health nexus in human settlements in Hopley, Harare

ABSTRACT

The study uses the case of Hopley, Harare, to reflect on the challenges of accessing water in the area and how this affects women and children regarding gender inequality. We argue that there is an intricate interplay between water, gender and public health as water takes on a gendered dimension. Through the lens of the Moser gender analytical framework and social justice theory, we analyse the interplay of water-gender health by examining gender roles and implications of water use and access and public health. This interplay is critical as it provides research and policy insights for enhancing the liveability of human settlements. A mixed method research design is adopted through which data is collected from both primary and secondary data sources. The findings reveal that water quantity and quality scarcity is prevalent in Hopley. This scarcity disadvantages women and girls are responsible for household water tasks. Subsequently, beyond the water-bone diseases, women and girls are more vulnerable to emotional, physical, and psychological stress associated with accessing water. We conclude that the gendered roles and perceptions rooted in patriarchal societal values and norms perpetuate social injustices among women and girls presenting an unescapable interconnectedness of water-gender-health.

KEYWORDS:

• Gender
• Hopley Farm Settlement
• Harare
• public health

Introduction and background to the study

The role of water in supporting the vitality and balance of human settlements has long been iterated (Sultana 2018, Cooper 2020). However, not all global citizens have access to adequate water, especially in fragile environments, including informal settlements (Dos Santos et al. 2017). According to the 2021 Global Statistics on water, in 2020, 2 billion people lacked access to safely managed water; including 1.2 billion people with basic services, 282 million with limited services, 367 million using unimproved sources, and 122 million drinking surface water (WHO/UNICEF 2021). The water security challenge is so dire in sub-Saharan Africa, where multiple factors exacerbate the water woes (Hannemann 2015, UNESCO and UN-Water 2020). In 2020, it was estimated that only 30% of the population in sub-Saharan Africa had access to safely managed water services (WHO/UNICEF 2021). These water challenges are identified as a ‘women’s crisis’ as women and girls are impacted significantly by the burdens of collecting water and their distinct water needs, unlike men (Gambe 2019, Radonic and Jacob 2021). Subsequently, the water-gender-health nexus has been illustrated through several issues on women’s health resulting from limited water access. For example, it is estimated that approximately 1 million people die each year from water, sanitation, and hygiene-related disease that could be reduced with access to safe water or sanitation (Water Aid 2019, UN-Water 2021).

Zimbabwe is not an exception to water crises. The country faces immense water quality and quantity problems that have persisted for the last two decades since early 2000s (Nhapi 2008, Musemwa 2010, Ndoziya et al. 2019). In 2020, it was estimated that 77.1% of households in Zimbabwe had access to improved drinking water sources (Government of Zimbabwe 2021). However, there are marked disparities in water access between rural and urban areas. Although 97.3% of the urban population is said to have access to improved drinking water sources compared to 67.9% of the rural household population, water scarcity challenges are rife in Zimbabwe’s major cities (Government of Zimbabwe 2021). For example, many emerging and informal settlements in Harare lack adequate water, forcing residents to access water from unconventional sources, including shallow wells (Ndoziya et al. 2019, Matamanda 2020, Matamanda et al. 2020). The magnitude of the urban water shortages has been evident from the recurrent cholera outbreaks that plagued most cities in Zimbabwe in 2008/09 and 2018, with the outbreaks prevalent in poor neighborhoods (Musemwa 2010, 2021, Youde 2010). Chigudu (2019) highlighted how the cholera pandemics have been widespread in urban areas where more deaths were recorded.

Zimbabwe is a patriarchal society where women and girls shoulder the domestic chores, a situation that compromises their well-being (Kambarami 2006). Consequently, women and girls in urban and rural areas are mainly responsible for household water collection and storage duties (Gambe and Dube 2015, Gambe 2019). In their report on urban health inequalities, Amnesty International (2011) revealed how urban health challenges are prevalent in poor neighborhoods and the vulnerability of women and girls bringing to attention the gendered-nature of the household water scarcity and vulnerabilities.

Previous studies on water shortages in Zimbabwe mainly focus on the severity of the problem at the city level (Human Rights Watch 2013, Kusena et al. 2017), the water and cholera nexus in urban areas (Youde 2010, Madzingamiri et al. 2014). In his study, Remigios (2011) explored the nexus on women-water-sanitation in Kadoma, Zimbabwe. Remigios (2011) only touched on cholera as associated with the water challenges, while health challenges were not the focus of his study. Gambe and Dube (2015) explored Harare’s water and gender nexus, but their work did not consider the health implications. Pahwaringira et al. (2017) investigated the water-gender nexus in Mabvuku, Harare, through the time-activity lenses. The focus of the studies mentioned above highlights the apparent research gap on urban medical geography in Zimbabwe that relates to the water-gender-health nexus in urban areas. Yet, this critical issue need to be probed to provide insights contributing to the aspirations of not leaving anyone behind as espoused in the sustainable development goals (SDGs). Specifically, SDG 5 focuses on gender disparities and SDG 6 on water which are critical in enhancing the liveability of urban human settlements (Matamanda 2020, Macheka et al. 2021). Furthermore, this study will provide insights into the situational analysis and bring to attention the issues that may stifle the City of Harare’s vision of achieving ‘World Class City Status’ by 2025 which is premised on a livable city where citizens have access to adequate water and healthy lives (City of Harare 2012). Overall, this study extends the focus of the water access and gender debate beyond the typical areas of focus on time poverty and unpaid care to a more holistic articulation of the health costs and risks borne by women and girls due to limited and compromised rights to clean water.

Adopting a gender lens to explore the water-health nexus in emerging settlements, we recognize that gender is not biologically predetermined, that is, based on sex where men and women are distinguished by their physical forms. Rather, gender is socially constructed and is defined by the roles and responsibilities assigned to men and women based on culture, values, and norms of a particular society (UNESCO 2003). Regarding water issues, gender may also be recognised as being learned through socialization processes and this explains why gender roles tend to change over time. Some social processes impact gender roles, for example, political status, class, ethnicity, physical and mental disability, age, race, religion and poverty (Blackstone 2003, Eisenchlas 2013). It is argued that the juridical system and notions of power have a bearing in regulating political life through limitation, prohibition, regulation, control, and protection (Butler 1999). In the same vein, gender is also constructed. This may be explained by the fact that the subjects (men and women) regulated by political structures are formed, defined, and reproduced following the requirements of these structures (Butler 1999, Mendelberg and Karpowitz 2016). Gender analysis is of utmost importance in discussions on the water-health nexus in human settlements. It helps determine the expectations and value of a woman or man within a particular context (Remigios 2011).

We argue that a clear understanding and proper safeguarding of water as an embodiment of complementary and conflictive social relations is crucial for the emergence of sustainable and healthy cities in Africa. Previous studies on the water-health nexus in Zimbabwe mainly consider cholera and typhoid as health implications (Lantagne and Yates 2018). Yet the health implications of water scarcity are complex and extend beyond the waterborne diseases. Therefore, the study takes a broader perspective in conceptualizing these health issues. The study’s main objective is to explore the waterscape-gender-health nexus in Hopley Farm Settlement in Harare, Zimbabwe. The study explores women’s lived experiences in accessing water and the associated health issues linked to women’s burden. Some of the questions to be addressed include but are not limited to: what is lived and narrated experiences of female-gender whose everyday life encounters and entangles with the violent waterscapes of Hopley? How are the encounters and the entanglements with the uneven waterscape reinserting hegemonic masculinity and reordering workloads, burdens, and health and school challenges of the female-gender? What affirmative action and policy options can alleviate the female-gender’s burdens and engender healthy water-gender nexus in the study area?

Water-gender-health nexus in human settlements

To promote the convenience of citizens, potable water must be as close as possible to the users (Graham et al. 2016). This is stipulated in most development plans which give so much value to the water supply. Human settlements should be developed so residents can easily access safe water for drinking. Such commitment is highlighted in SDG target 6.1, which envisages that by 2030, universal and equitable access to safe and affordable drinking water must be available for all. On the other hand, the NUA envisages cities and human settlements that fulfill social functions. Among these is to ensure universal access to safe and affordable drinking water and sanitation for citizens (United Nations 2016, p. 2). This is also buttressed by the need to achieve gender equality and empowerment of women and girls by avoiding discrimination in all spheres of life.

Regarding gender issues, SDG 5 commits to ending all forms of discrimination against women and girls worldwide. This commitment seeks to ensure gender equity in accessing and controlling resources such as water in human settlements. The burden of reproductive roles presumed to be women’s responsibility, as espoused by Moser (1993), means that women and children are quite disadvantaged. In this regard, SDG target 5.4 envisages that by 2030 there should be a recognition and value for unpaid care and domestic work through the provision of public services. This target seeks to recognize the utility of the reproductive roles mainly shouldered by women and children. At the regional level, African leaders in 2014, through the Africa Agenda 2063, committed to achieving gender equality in all spheres of life by 2063 by eliminating all forms of discrimination against women and girls (African Union Commission 2015). This commitment also applies to the water-gender-public health nexus, which seems to burden mostly women and girls through the tasks assigned to women and girls.

Water-gender nexus manifests in different ways in human settlements. The first issue to consider is the responsibility of collecting water at the household level. These responsibilities are not so complicated when water is accessible within the household compound. However, issues arise when the water has to be collected outside the premises. In such instances, more time is spent collecting the water; in some places, the citizens will have to queue for the water. In most communities in the Global South, especially in Africa, the responsibility for collecting water is for women and girls (Van Houweling 2016, Geere and Cortobius 2017). For example, in Cote d’Ivoire, it is estimated that around 90% of the women are primary water collectors at the household level (Graham et al. 2016). In many countries, women and children spend at least 30 minutes per trip fetching water (Graham et al. 2016). This figure culminates in an annual global total of 40 billion hours of unpaid work women spend collecting water (Abu et al. 2019).

Approximately 3 million children and 14 million women from sub-Saharan Africa collect water daily. In the process, they are exposed to several risks, including sexual abuse, disease, and dropping out of school (Taylor 2016, Pommells et al. 2018). Since the burden is mostly upon women and children (mainly girls), most women fail to earn any other income from paid work they might have engaged in had they not spent more time and energy fetching water. There are numerous examples of women and young girls waking up early and walking long distances to collect water, for instance, in India and most parts of Africa (Pickering and Davis 2012, Pahwaringira et al. 2017). This tends to expose women to dangers and risks of sexual abuse as they wake up before dawn to collect the water before others, and at times, it will often still be dark (Kwizera 2014, Pommells et al. 2018).

When the water-health nexus is examined, most proponents consider the waterborne diseases associated with inadequate water supply (Ablo and Yekple 2018, Kangmennaang et al. 2020). There is more to explore as women and children suffer beyond the risk of unsafe water. Different containers are used to store water, ranging from stainless steel jars and pots in Asia to plastic containers ranging from 2 to 20-litre capacity (Caruso 2017). In a study conducted in Limpopo, South Africa, women and children carried containers with a mean weight of 19.5 kg over a distance of 337 meters (Geere et al. 2010). In this context, the prevalence of spinal pain was 69%, while 38% complained of back pain. Wheelbarrows may be used at times to transport the water, but in most cases, these water containers are carried by the women and children balanced on their heads or strapped to their backs (Geere et al. 2018, Matamanda et al. 2022).

The strain of carrying the water in this manner results in untold suffering and pain which women and children bear in silence. First, the distance women spend carrying the water affects their health. This is explained by women’s prolonged and continued task of carrying water causes musculoskeletal and soft tissue damage and possibly early attacks from diseases such as arthritis (Taylor 2016). Carrying water for such long distances may compress the discs in the neck since the load will be too much (Hallet 2016). This is associated with strained backs, shoulders, and necks and other injuries when women walk on rough and undulating terrain and busy roads in urban areas (Caruso 2017). The health implications are even worse for pregnant women who risk miscarriages, early birth, and other pregnancy-related complications (Caruso 2017, Pommells et al. 2018). Women are responsible for child-caring, and they sometimes have to carry their babies on their backs as they engage in the tasks of collecting water, which also exacerbates the strain on their bodies. The aged, especially widows, have to shoulder the responsibility of collecting the water for long distances, making older women susceptible to backaches and constant headaches.

The other common water-health nexus challenges which affect women are associated with the quality of the water, which may cause some reproductive problems. Menstruation requires hygiene, and some girls attending school cannot afford to buy pads and use alternative materials like clothes that need to be washed constantly, but the lack of water complicates their menstrual cycles (Kwizera 2014, Sida 2015). Therefore, the challenges of women concerning water are framed as complicated due to mensuration, pregnancy, childbirth, and its aftermath (Sweetman and Medland 2017). Some water sources are unsafe and may be contaminated, especially when water is collected from shallow and unprotected wells. Such practices put women at risk of menstrual hygiene problems and discomfort. Mental stress is also considered one problem women must cope with as they constantly think through the daily ordeals they must go through in collecting water for the household (Workman and Ureksoy 2017, Collins et al. 2019).

Chronic fatigue, and spinal and pelvic deformities have also been attributed to water challenges among women (Hallet 2016). Incidences of anaemia are also identified as this water proves to have challenges for nursing mothers as contaminated water is hazardous to babies and causes infant mortality. The literature review presented on the water-gender-health nexus considers the theoretical underpinning that guides this study, focusing on how gender roles are constructed and the implications of the water problems on social justice. Thus, the theoretical framework focuses on the Moser Gender Analysis Framework (MGAF) and social justice theory.

Theoretical framework

The MGAF (also referred to as the Triple Roles Framework) and social justice theory inform this study. These two theories help to explain and provide theoretical insights and nuances for the water-gender-health nexus articulated in this study (see Figure 1). The MGAF was postulated by Caroline Moser and is premised on the concepts of gender roles and gender roles inherent in society. According to Moser (1993), the MGAF distinguishes between two types of gender needs:

• Practical gender needs that relate to women’s daily lives and these include the societal roles and burdens imposed on women and girls, such as cooking, fetching water and cleaning the house; and

• Strategic gender needs could transform existing gender subordination and include power issues and decision-making processes affecting socioeconomic development beyond the household level.

Figure 1. Theoretical framework guiding the study.

Source: Authors’ creation 2022

The MGAF also argues that gender-role identification is through women’s productive, reproductive and community roles in society (Moser 1993). The reproductive roles are categorised as those tasks which are basically referred to as the responsibility of women and mainly seek to promote the well-being of the household (Ludgate 2016). Although women spend a significant part of their time engaged in these reproductive tasks, there is a tendency among most societies that instead of being considered as ‘real work’ the reproductive tasks end up being identified as the responsibility of the women who are often assisted by the children, particularly the girl-child (Anant 2016). The productive roles are mainly considered to be the responsibility of men, although women also play a part in executing these tasks (European Institute for Gender Equality 2019). Productive roles include tasks aimed at producing goods and services for household consumption and/or trade. Lastly, community work outlines how society is organized and the roles of women and men in decision-making.

Figure 1 shows the three gender roles articulated by Moser (1993). These gender roles are nested in the context of social roles, responsibilities, and burdens that relate to social (in)justice, including the theoretical perspective articulated by proponents such as Rawls (1971). In his conceptualisation of social justice, Rawls (1971) focused on distributive justice, which refers to the fair distribution of burdens and benefits of social interaction among citizens. This perspective applies to this study as the distribution of water resources and the burdens on the different communities take a gendered perspective reflecting the disparities between men and women, thereby exposing the vulnerabilities of some individuals and groups. The burdens emanating from urban development, which according to Moser (1993) depict the productive roles relate to the unequal distribution of resources in certain neighbourhoods, where segregation is institutionalised such that reticulated water and sewer services may not be provided impacting on water availability and thus leaving these communities to source water from unsafe sources. This violation of the residents’ access to clean water illustrates the institutionalised injustice (what Sultana (2020) has termed water injustice) that affects the poor and is rooted in a capitalist form of urbanisation and power dynamics (Soja 2009, Harvey 2012, Mphambukeli 2019).

Therefore, social justice is critical in understanding Hopley’s water-gender and health nexus because the theory focuses on justice issues and how citizens access the city. Framed in this way, the social justice theory helps gain insights and explore the interplay between gender, water access and health. The water-gender-health nexus is greatly intertwined and emerges as a complex interplay that needs to be understood by exploring different issues that include water sources used, responsibilities for collecting the water, and the water’s implications on health among the users. These issues are answered by adopting a mixed-method research design explained hereunder.

Methodology

Study area

Hopley is located in the southern part of Harare, about 10 km from the central business district (CBD). From the last census, conducted in 2012, the population of Hopley was estimated to be 12,000, with an average of 7000 households. The government established the settlement in 2005 as part of Operation Garikai to accommodate the victims of Operation Murambatsvina (Matamanda 2020). Hopley has six zones that accommodate the residents (see Map 1).

Map 1. The layout map for Hopley showing the Mukuvisi River and the streams running through the settlement. Source: adapted from surveyor general research design and data collection.

This study uses a mixed-method approach guided by the case study design. Ethical clearance was obtained from the ethical committee of the University of the Free State with ethical number UFS-HSD2017/0808. Data has been collected using both primary and secondary methods. First, a document review was undertaken, which helped analyze policies and legislation relating to the water-gender-health nexus in the country. These documents include the National Constitution of Zimbabwe Amendment (No. 20), Water Act, National water policy, Public health Act, Regional Town Country and Planning Act, Urban Councils Act and Local Plan for Hopley. The document review provided the theoretical perspectives relating to the urban development and planning process and how it caters to the provision and supply of water in human settlements. The provisions for urban health have also been interrogated in these documents with a special focus on the gender nexus. The secondary data were analyzed using content analysis.

The secondary data were then triangulated with primary data collected from focus group discussions (FGDs), observations, photographing, and interviews with key informants. FGDs were conducted with women to gain insights into the daily lived experiences regarding water access and dimensions of health issues that affect women and girls. Interviews were conducted with key informants, including two NGO officials, four from the City of Harare, five planning professionals, and two from the Department of Physical Planning (DPP). The interviews sought to examine how the officials perceive the water-gender-health nexus and initiatives that may enhance gender parities and reduce the vulnerabilities among women. The survey method was used and included the quantitative component of the study, where 450 questionnaires were administered among the residents in Hopley to capture their lived experiences regarding the water-gender-health nexus. Thematic and textual analysis was used to analyse the primary data.

Document review

The study finds that the water-gender-health nexus is an intrinsic web that requires exploring a systems analysis approach. First, many pieces of legislation govern and regulate the water-gender-health nexus in Zimbabwe. By its nature, Hopley is an area that generally has abundant groundwater resources, yet residents lack access to safe water. The Constitution of Zimbabwe Amendment (No 20) of 2013, in its Declaration of Human Rights outlines the socioeconomic rights to water in Zimbabwe (Government of Zimbabwe 2013a). Section 77 (a) states that ‘Every person has a right to safe, clean and potable water and the State must take reasonable legislative and other measures, within the limits of the resources available to it, to achieve the progressive realisation of this right’.

In section 77(a), the State is mandated to take responsibility for water provision to the citizens. Section 80 (1) upholds women’s rights by envisaging that every woman should have the full and equal dignity of person with men, including equal opportunities in political, economic, and social activities. The provision and management of basic services in human settlements are espoused in section 194, which provides for the basic values and principles governing public administration. Providing basic services is one critical component that requires effective public administration. Local authorities must maintain such values as they administer affairs in areas of their jurisdiction.

The significance of water in human settlements is highlighted in the various statutes that mandate local authorities to ensure that properties have access to potable water. The Regional Town and Country Planning Act [Chapter 29:12] (RTCPA) requires local authorities to control development. Developers are enforced to provide basic services in settlements to make them habitable. This is in line with the provisions of the act that aspires to create sustainable spaces that are safe, convenient, and orderly and improve public health, efficiency, and the general welfare of citizens. Development control extends to promoting functional human settlements, which should have basic services to not pose as hazardous spaces for the inhabitants. The significance of water in human settlements is shown in Part XII of the Urban Council’s Act, which empowers and compels councils to provide water to residents in their jurisdictions. The utility of water is recognized as the UCA in section 184, which states that the council may require owners of premises within the council areas and not yet connected to the council’s water supply system to connect to the system to access water for drinking, domestic and sanitary purposes. Emphasis is on ensuring that all premises within the council area are connected to the water supply system, and they have access to the water supply at all times.

The Public Health Act [Chapter 15: 09] [PHA] guides and regulates public health issues in Zimbabwe, including the need to provide adequate water and sanitation facilities in human settlements. Part VI specifically outlines the provisions for water supply and water safety and empowers certain institutions to manage the provision of the water supply. In section 64 (1), local authorities must inspect and test water supplies in line with standards set by the Minister of Health to ensure that citizens have access to wholesome water for drinking and domestic purposes. The lack of water infrastructure and the use of unprotected water sources such as shallow wells is considered a nuisance to public health (Section 85 (c)). The welfare of citizens and their health are outlined in section 85 of the PHA, which discourages citizens from drinking water from unprotected sources or using it for domestic purposes. This section thus pays attention to the need to provide safe water which does not compromise human well-being. The main focus is on water quality and relates to waterborne diseases.

The National Water Policy (NWP) of 2012 recognizes the role of water and sanitation supply in promoting the sustainability of human settlements in the country (Government of Zimbabwe 2013b, p. 13). Concerning urban housing developments, the NWP envisages maintaining high standards and call for a moratorium on new housing developments that do not meet existing standards stipulated in the various national statutes and legislative guides (Government of Zimbabwe 2013b, p. 13). For this reason, developments will not take place or will not be approved by the council unless they conform to the regulations relating to water and sanitation supply. The logic is to promote the establishment of human settlements in which residents have access to critical basic services, thereby mitigating the burden on residents to access water and maintain high hygiene levels. The rationale for this moratorium confirms the argument postulated by Rawls (1971) that justice is recognized when primary goods are accessed by all citizens, especially the disadvantaged communities, in ways that enable them to function as normal and fully cooperating members of society over a complete life.

Results and discussion

This section presents the findings and discussion of the study, which are presented under the following themes:

1. The water situation in Hopley focuses on the everyday experiences of residents in accessing water.

2. Water-gender-health nexus in Hopley articulates the interplay between water problems in Hopley, gender dimensions and health issues.

Water dilemmas in Hopley

There is no reticulated off-site and on-site water infrastructure in Hopley. Since the settlement was established in 2005, little has been done by the City of Harare to provide water to Hopley residents. The water challenges overwhelming Hopley conforms to the situation in most parts of sub-Saharan Africa where citizens lack access to adequate water (Hannemann 2015). In an interview with an engineer from Harare Water, he highlighted that ‘[…] in as much as Harare Water is mandated to provide Hopley residents with water; the institution is currently overwhelmed and struggling financially. As a result, we have not provided water services in Hopley’.

Another engineer indicated that ‘the City of Harare has made initiatives to install community taps in the area’. Yet, upon the site visits and interviews with residents, this did not turn out to be true. The situation in Hopley contradicts the provisions of the various legislation stipulating the need to provide water services in settlements before their occupation. An official from the DPP explained ‘[…] the department is not supposed to approve the establishment of settlements before basic services are installed, the pressure to accommodate people in Harare has resulted in the Ministry succumbing to going against the statutes which seek to promote sustainable human settlements’. It was also revealed by an official from CoH that political pressure has also been responsible for the proliferation of settlements that are not serviced with reticulated water systems. As shown by Ndoziya et al. (2019), Hopley is a typical case.

Due to the absence of a reticulated water system in Hopley, a significant number of households rely on groundwater which is extracted in different ways. Figure 2 outlines the proportion of residents getting water from different sources. It emerges that 40% (n = 182) use protected wells, 31% (n = 141) who use the community borehole, 19% (n = 87) unprotected wells, 9% (n = 38) use other sources while 1% (n = 2) claimed that they use municipal water.

Figure 2. Sources of water used by Hopley residents.

Source: Authors (2017)

The description of protected well, according to the residents in Hopley, raises many concerns. This is so because even what they identified as being protected was a well that was dug and built but may not be covered on top (Figure 3). Moreover, some wells are susceptible to runoff entering when it rains as they are not covered (Figure 3). However, it was interesting to note that although there seemed to be a high number of respondents who highlighted that they collect their water from protected wells, their perception of water quality somehow indicated a different story.

Figure 3. A shallow which is left open and one which has a lid to cover it, both are referred to as protected wells by residents in Hopley.

Source: Authors (2017)

A respondent from an NGO explained that ‘Most areas in Hopley do not have access to reticulated water. Some organizations have come to help alleviate this problem, but their efforts have been futile. However, the water quality for those who can access it is very poor. Residents (those who can afford) are left with no option but to buy the water. This is an additional cost incurred by the residents considering that such water is costly’.

The 19% of the respondents who highlighted that they get their water from unprotected wells use infrastructure like the one shown in Figure 4. A solar-powered community borehole also serves some residents residing close to the boreholes, especially those in Zone 4. However, some of the residents raised concerns about water problems, that sometimes they are asked to pay for the water, yet they cannot afford a dollar per day for that. It was revealed by a resident that ‘[…] those who cannot afford to make the payment go to a “nearby” farm to fetch “clean” water. […] it takes an average of 45 minutes a trip to go there’.

Figure 4. An example of the unprotected wells used by residents in Hopley.

Source: Authors (2017)

The other issue was the reliability of the water among the residents in Hopley. Table 1 summarizes the survey’s responses regarding the reliability of water sources among residents in Hopley.

Table 1. Reliability of water among residents in Hopley.

Reliability of water source	Frequency	Percentage (%)
Very bad	51	11.3
Poor	180	40
Good	117	26
Excellent	96	21.3
No response	6	1.4

N = 450.

Water and burden of women and the girl child in Hopley

As explained earlier on, there is no reticulated water system that serves Hopley. It follows that for potable water, residents have to get it either from the community borehole or the farm; otherwise, they will have to drink the contaminated underground water. From the responses obtained through the household survey, 86% (n = 385) highlighted that women are solely responsible for collecting water with the assistance of children (mostly girls). These statistics confirm the reproductive roles (including fetching water) assigned to women by the Moser Framework (Ludgate 2016). A key informant indicated, ‘The preparation of meals in Zimbabwean society is heavily on the shoulders of women and the girl-child; hence, in one way or the other, the task for collecting water at the household level simply ends being the responsibility of women and girls’.

The conditions for accessing water in Hopley confirm the findings by Hallet (2016) that women carry 40-pound water containers. This was observed in Hopley where women and children carry water in 20-litre (approximately 20 kg) containers balanced on their heads (Figure 5). Most women complained that collecting water is their sole responsibility which men rarely chip in to assist. One woman lamented that ‘Life is tough for me. I have to make sure that there is enough water for all domestic uses. I do not have a shallow well, hence even the water for bathing and washing the dishes I get from my neighbors. The main challenge is getting the water to drink, which I have to endure the long distance every 2-3 days carrying the 20-liter bucket. My husband doesn’t assist in collecting the water and my children are still young’.

Figure 5. Young girls carrying 20-litre (approximately 20 kg) containers of water on their head.

Source: Authors (2017)

Unlike their male counterparts, women in Hopley spend more time collecting water. The burden of accessing water is thus on women and girls who travel long distances to access safe water. Although women and girls shoulder the greatest responsibility in collecting water, boys and men also participate in this task (see Figure 6). These findings contradict the common assumption that men and boys do not participate in such tasks.

Figure 6. Young men assisting with collecting water at one of the communal boreholes in Hopley.

Source: Authors (2017)

Some women said they must wake up at around 3 am to fetch water and carry out the other household chores. Unlike women and children from Limpopo who travel 337 meters while carrying water weighing 19.5 kg (Geere et al. 2010), the residents of Hopley, especially women and children, carry 20-litre containers for an average distance of 553.2 metres. The mean time required to perform this task is 52.54 minutes (survey 2017). This time is more than the 30 minutes estimated by the WHO and UNICEF (2017). This shows that much productive time is lost, which could have been used for other tasks. Besides the time spend walking to fetch there, there is also some time that involves waiting before one can fetch the water (Figure 7).

Figure 7. Off-peak situation at the community borehole.

Source: Authors (2017)

Water-gender-health nexus in Hopley

Many water-health nexus issues overwhelm Hopley residents beyond the traditional waterborne diseases, such as typhoid and cholera as popularised by most proponents. First, most residents showed dissatisfaction concerning the quality, taste, and colour of the water obtained in Hopley. Yet, despite such negative perceptions towards the water and its susceptibility to diseases, the residents still value the underground water as lucidly captured by Chirisa et al. (2014, p. 72) that ‘water is a precious liquid and colourless. This definition always made sense for urban dwellers because they always possessed a precious colourless liquid. Now they have a colourful but still very precious liquid’. The underground water in Hopley is contaminated mainly through the proximity of part of Hopley to Mbudzi Cemetery and the construction of shallow wells and pit latrines on the small stand sizes (approximately 150-200 m²). This contradicts the country’s RTCP Act and planning regulations prohibit using decentralised wastewater systems, such as septic tanks on stand sizes less than 2, 000 m². The study by Ndoziya et al. (2019) confirmed that the underground water accessed by residents in Hopley is contaminated. Yet, some residents continue to use this water for drinking and other domestic purposes. One resident (a widow) highlighted that ‘[…] I used to drink the water from my shallow well, but I have since stopped because it seems to be contaminated with the pit latrines that are almost everywhere and the cemetery. The water made my children sick, and it no longer tasted the same. […] The challenge I face is collecting the water for drinking and cooking, which is a task I am responsible for’.

Using such water sources contradicts the provisions of the PHA, which emphasizes that human settlements water must be extracted from safe sources. The use of such water shows the social injustice where residents in the settlements have to access water that is not potable. Officials from the City of Harare highlighted that such a situation results from health hazards, as illustrated in Figure 8. Although some residents are aware of the health implications of the water they consume, some are left with no option but to extract this contaminated water owing to sickness, old age, or simply for its convenience.

Figure 8. The close proximity of a pit latrine and a well.

Source: Authors (2017)

The use of contaminated water has also been linked to menstrual hygiene issues. Some women lamented that they often struggle when having their periods during the focus group discussion. It was highlighted that most women cannot afford to buy pads and instead use different materials that need to be washed regularly. This calls for potable water as the female reproductive system is more complex and sensitive than the male-system. A respondent (woman in the focus group discussion) elaborated that ‘[…] without adequate water, we are greatly disadvantaged and at-risk from menstrual hygiene problems. Despite the pain and discomfort of the period, one is still expected to collect water for the household […] the situation affects young girls more who even have to miss school when they have their periods’.

Another health dilemma relates to nursing mothers who need to collect more water for washing napkins. The use of disposable diapers is considered a luxury among most nursing mothers in Hopley, whose average household income is US$100 per month. The nappies used have to be kept clean. Otherwise, the family is put at risk from diseases such as diarrhea and typhoid. One nursing woman explained that caring for her toddler was daunting due to the lack of water. She iterated, ‘It just makes life hard for me. You see flies all over and my husband doesn’t even help as I grapple with the burden of fetching water. What even makes it worse is he asks me to take the baby when I go to fetch the water. Carrying the bucket on my head with the baby strapped on my back makes me so tired by the end of the day, but I have no alternative’.

Women end up suffering in silence, and men seem not to be bothered regarding the work as the responsibility of women. Another example of the strain on women is highlighted in the following quote from an interview with one lady. She narrated her ordeal: ‘I have to wake up early, around 4 am, so I have the chance to fetch the water. But the trickiest part is I can’t collect the water before the owner of the well. If I delay my arrival, I will find the water will have finished. Then I have to go further and be embarrassed as I ask for water from strangers. The distance back home is another nightmare as I have to carry the water uphill and by the time I arrive home, I will be exhausted, yet my day will just be starting. Of late, I have been experiencing excruciating back pains. The mental stress I endure is also another issue as the day ends. I will be pondering on the ordeal of the next day’. Considering the distance and time women and girls in Hopley travel, they are often exposed to the risk of violence or attacks, especially for those who wake up early in the morning to collect the water. Confronted with these realities, women and girls constantly fear, which translates to mental stress as they fear being attacked or raped. Most respondents described this emotional trauma in Hopley.

Conclusion

The utility of water in sustaining human settlements is highlighted in the provisions of the statutes and legislation. The legislation is somehow comprehensive in its mandate for ensuring that human settlements are serviced with safe water, which ultimately becomes convenient for women. Even the rights of women and men are upheld in the CoZ. The provisions of these legislation highlight the importance of water-gender-health nexus as articulated in the SDGs #5 and 6 while also recognising the value of water in upholding social justice through lessening the burden of water access among women and girls.

However, despite such provisions, Hopley has thrived since 2005 without a reticulated water supply. According to Harvey (2012) and Rawls (1971), this illustrates the distributive injustice where the processes of urban development have been to the disadvantaged of this poor community that has been burdened with water scarcity quality and quantity. This has resulted in residents resorting to alternative water sources (both safe and unsafe for human use). The experiences in Hopley confirm the events in most parts of sub-Saharan Africa, where women bear the brunt of collecting water amid its scarcity. This is in consistent with the patriarchal society where all reproductive roles are solely for women, thus illustrating how the gendered roles compromise the well-being of women and girls. Moreover, the financial implications of accessing water services are revealed and the urban penalty of the poor who struggle to access them, compromising their access to adequate water. This reflects the disparities in poor neighbourhoods where the residents’ rights to access water are evident, indicating water injustice (Sultana 2020).

Although there is abundant groundwater in Hopley, it is considered by the residents to be unsafe to drink. This leaves the residents with no option but to outsource water, especially for cooking and drinking. Collecting the water if it is not on-site, which is mostly the case, is mainly the responsibility of women and girls. This is socially constructed and strategic gendered role (Moser 1993, European Institute for Gender Equality 2019) as women are responsible for collecting water, and men, even if they are not engaging in any productive work, help collect water at the household level. The same is true for boys who just fetch water for personal use, mainly bathing but for domestic use. It remains the women and girls’ task. Therefore, more time is lost when women and girls travel to fetch water. This is a task they are not paid for and is associated with many untold health implications on their side. The burden of carrying a heavy load of water is just too much work for girls who make at least two trips a day to fetch the water depending on the size of the family. Women are also at risk from menstrual hygiene problems, mental stress, victims of rape and attacks, backaches, and headaches. Ironically, these health complications are rarely factored in human settlements where the emphasis is mainly on cholera, typhoid, and diarrheal incidences associated with water scarcity in emerging settlements.

The study concludes that since the statutes and legislative framework on human settlement acknowledge the importance of water-health nexus, women’s health concerns beyond waterborne diseases are not fully integrated into the human settlement plans. Thus, when human settlements are subject to spatial planning, urban policy, or improvements, time and energy spent collecting water must be considered and greatly minimized to not burden women and children. There is a need to adopt a holistic approach focusing on water-gender-health issues in human settlements. This approach must consider women’s roles and how spatial planning procedures in human settlements do not place women at risk of the health challenges mentioned above. Unless such an approach is undertaken, it will remain a fallacy to achieve the goals set by the African leaders in 2014 through the Africa Agenda 2063 committed to achieving gender equality in all spheres of life by 2063 by eliminating all forms of discrimination against women and girls. The COVID-19 pandemic has also shown how neglecting this nexus has dire consequences as the water scarcity has been attributed to the contigen of the virus, especially in poor neighbourhoods.

Further research may be undertaken, focusing on a systematic analysis of the urban water systems. Adopting a systems analysis to explore the water system in the informal settlements will provide insights into the critical leverage points in destabilising the water-gender-health nexus. This systems analysis may also be associated with developing a systemic model that will inform policymakers and urban planners on understanding the variables involved in the water system and how it implicates gender and health. A further study can be undertaken based on action research. Specifically, urban ethnographic action research may be conducted by spatial planners who will enable them to gain deeper insights by studying the water-gender-health nexus from ‘within the city’ as Verloo (2021) suggested. Employing Such a methodology will significantly help understand the intricacies of the water-gender-health nexus, which is critical in alleviating the challenges facing women in Hopley. Further research may be undertaken to enhance and improve the theoretical framework of the water-gender-health nexus. This further research may be quantitative and build on this existing study, where cross-tabulations can be done through multivariate analysis to identify the emerging patterns of the nexus.

Acknowledgements

The authors acknowledge that the manuscript is based on the PhD thesis by Abraham R Matamanda titled “Exploring emerging human settlement forms and urban dilemmas nexus: Challenges and insights from Hopley, Harare, Zimbabwe”, supervised by Professor Thulisile N Mphambukeli and Professor Innocent Chirisa. An earlier version of this manuscript was presented at the Water, Food and Health Nexus in BRICS Plus: Problems, Progress and Prospects BRICS-Plus International Conference, University of the Free State, Bloemfontein, South Africa. 2-5 August, 2018. The assistance from Professor Annette Wilkinson who reviewed an earlier draft of the manuscript is greatly appreciated. The comments from the two reviewers and handling editor have been instrumental in refinement of the article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Abraham R Matamanda

Abraham R Matamanda is an Urban and Regional Planner who has also been trained as a social ecologist. Abraham is currently a Lecturer in the Department of Geography, University of Free State. His current research focus on climate change adaptation, informal urbanism in the Global South, medical geography, planning for urban food systems and urban political economy. Abraham has published at least 30 articles, 20 book chapters, 1 co-edited book titled Urban Geography in Postcolonial Zimbabwe: Paradigms and perspectives for sustainable urban planning and governance published with Springer Nature in 2021. His recent publication is a book he coauthored titled Housing and technology: Special focus on Zimbabwe published with Springer Nature in 2022.

Thulisile N Mphambukeli

Thulisile N Mphambukeli holds a PhD in urban and regional planning, from the University of the Free State. Thulisile is currently affiliated with the University of Johannesburg, Department of Town and Regional Planning where she serves as an associate professor. She was a Fellow of The World Academy of Sciences in Italy (hosted at University of Konstanz, Germany) and a University of the Free State Rector’s Prestige Scholar. Dr. Mphambukeli is an alumnus of the Brown International Advance Research Institute (BIARI) at Brown University, USA, and the Public Affairs Research Institute, University of Witwatersrand. She is a recipient of many research grants and awards, such as the BRICS Think Tank Academic Forum Grant, NRF Knowledge Interchange and Collaboration (KIC) Individual Travel Grant (South Africa), the Herrenhausen Conference Travel Grant (Germany), and BRICS Think Tank Academic Forum Seed Funding (South Africa). She has published extensively in local and international journals.

Innocent Chirisa

Innocent Chirisa is a Full Professor in Environmental Planning and Management and Urban and Regional Planning. Has a keen interest in urban and peri-urban dynamics. Currently focusing on environmental systems dynamics with respect to land-use, ecology, water and energy. Holds a DPhil in Social Sciences. Prof Chirisa is also currently a Research Fellow with the Department of Urban and Regional Planning, University of the Free State, South Africa. He is currently the Pro Vice Chancellor, Academic Affairs at Zimbabwe Ezekiel Guti University (ZEGU).