Gathering Water Worries in Zanzibar.
Water, water, everywhere, but not enough to drink. “No matter where you are here, you literally see water,” says MPH student Sayeli Jayade, who spent July in Zanzibar, a semi-autonomous group of islands off the coast of Tanzania in the Indian Ocean. “But before anybody even talks about the quality of their drinking water, the first thing they say is they just don’t have enough.”
In a practicum supported by the Santander University Scholars Program, Jayade designed and led a qualitative study to assess Zanzibar’s drinking water needs.
She and two students from the College of Engineering held focus groups and interviews with Zanzibaris in the capital and in rural communities, asking them about their drinking water: “‘Do you feel like your water is safe? What are your concerns around water? How do you get water?’” She also interviewed government officials at the Zanzibar Water Authority (ZAWA), from the director general to the lab technicians.
The assessment is an early step in a collaboration between the State University of Zanzibar (SUZA) and the lab of Muhammad Zaman, professor of biomedical engineering and international health at the College of Engineering. Zaman’s lab, Partners in Global Health Technologies, creates devices to tackle a range of global health issues, including a simple device for a refugee camp in Lebanon: It floats in a water tank, lighting up a green LED when the water is safe and lighting up a red LED—and dispensing just the right amount of chlorine—when it detects contaminants.
Zaman was considering doing something similar in Zanzibar, where he brings a group of undergraduates each summer to work on a range of projects, when Jayade approached him.
“I have a background in biomedical engineering, and I worked at L’Oréal for two years doing product evaluation,” Jayade says. “That’s where I fell in love with the idea of evaluation—not just making something and hoping it works, but the idea that you need to invest time and money to make sure that whatever you’re putting out there really does what it’s supposed to be doing.”
Jayade wanted to do more with that passion. “Makeup is cool, but it doesn’t save lives,” she says. So, she enrolled at SPH, where she is completing the certificate in Global Health Program Design, Monitoring, and Evaluation as part of her MPH.
When she told her advisor, Andrew Stokes, that she particularly wanted to evaluate global health technologies, “he pointed at Dr. Zaman and said, ‘That’s literally what he’s doing right now,’” she says. Once Jayade and Zaman had a plan, she says Stokes next pointed her to Lora Sabin, associate professor of global health and “the wiz at qualitative data,” she says. “I knocked on her door and I said, ‘I have a study. Help?’” Sabin shared her expertise, and encouraged and helped Jayade to get IRB approval so that she would be able to publish her results. “If it wasn’t for the incredible mentors that I have at BU, this wouldn’t have happened,” Jayade says.
She says she is thrilled to get to help with the first steps of the project, a key time for evaluation. “Before you just go out and make things—whether that’s an intervention, whether that’s a device, whether that’s a policy—you need to know who it’s affecting, who’s your target audience, and what they really want.”
As it turned out, Jayade says what Zanzibaris want is not what she was expecting.
She expected to mainly hear concerns about contamination. She heard about how people take special care to avoid fecal-borne diseases like dysentery and cholera when the rainy season increases runoff, and that saltwater sometimes gets into freshwater sources. Based on previous research, she thought lead would be a concern, but it barely came up.
Instead, community members and officials mostly told her about the lack of drinking water, a problem Jayade is finding may have less to do with supply, and more to do with the systems in place to provide it.
“The government is saying, ‘We need you to pay for the water so that we can supply more water,’” she says. “But people don’t want to pay for their water because they feel that they shouldn’t have to, and they’re getting water themselves by digging their own wells.”
That, in turn, raises concerns for the government—not only because of losing water buyers, but also because unregulated well-digging could mean unsafe water, or even destabilizing the soft island soil. “The houses around the hole might sink in,” Jayade says ZAWA has claimed, although she says there are relatively few cases of house-sinking, compared to the rapidly-increasing number of unregulated wells.
Jayade is now analyzing all of the information from her interviews, to inform the work Zaman’s lab will do next—whether a device should test for bacteria, or chlorinate water, or even just monitor the water supply.
She will also give ZAWA her findings in a policy brief, with recommendations on how to address Zanzibaris’ complaints and concerns. “I love being at the grassroots, understanding what people want and giving them that megaphone,” she says. “That has probably been the most empowering thing for me, and really kept me going during this hard month of just vigorously collecting data.”
Jayade says the experience has felt like a dream. When she and Zaman realized during the first week that the issue was more complex than water contamination, he reassigned two of his undergraduates who had originally planned to start working on a water safety device. Instead, the students assisted Jayade in the study she designed—one she now hopes to publish. “If you were to tell me a year ago that I’d be running my own study? It’s too good to be true.”
Sayeli Jayade is taking over the SPH Instagram account from August 6 through 10 to share photos from her practicum. Follow along at Instagram.com/BUSPH/ and with the hashtag #BUSPHSummer18.
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