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Water and Health in Limpopo

Project History

In 2006, UVA was awarded one of the first Framework Programs in Global Health offered by the National Institutes of Health (NIH) Fogarty International Center with the intention of developing a global health curriculum, interdisciplinary educational and research collaborations, and a transnational partnership. Representatives from both UVA and UNIVEN held joint faculty workshops to explore the possibility of expanding the existing collaboration around shared research and educational goals. Based on the group’s expertise as well as the needs articulated by communities near UNIVEN, collaborative efforts were focused on developing sustainable strategies to improve access to water and sanitation while monitoring health outcomes in real time.

In 2009, the first team of UVA and UNIVEN students and faculty conducted baseline community assessments including a complete census, water quality testing, and GIS mapping of water sources, sanitation facilities, and households. Univen faculty members from nursing, public health, microbiology, hydrology, GIS, and planning have been and remain engaged in these efforts. The outcome from the first WHIL research projects highlighted that the community’s priority was access to a greater supply of water. Therefore, research activities focused on the development of an improved water supply system by collaborative engineering teams. This initial work established significant community trust that has been the foundation of WHIL.

While water supply was a first priority, initial investigations had also established that access to clean drinking water was necessary for our partner communities. This led to the pilot project for what would become PureMadi and the ceramic water filtration technology. The ceramic water filters led to research activities involving HIV+ individuals using the ceramic filters to determine efficacy in reducing diarrhea, along with acceptability and desirability in the community. The filters are now produced by two factories, one in Ha-Mashamba and the other in Hammanskraal. The filters are used by many families in rural South Africa.

In 2010 the opportunity emerged to create an agent-based model of early childhood diarrhea in our partner communities in an effort to capture the complexity of ECD. The creation of the computerized agent-based model allowed researchers from different disciplines to combine their experiences and data. The resultant “insilico” model allowed the team to more rapidly test strategies to improve water, so that the most likely to succeed could be chosen for further testing in communities.

In 2012 the WHIL Innovations Fellowship program began accepting fellows from the US and South Africa. Fellows with backgrounds in Chemistry, Anthropology, Microbiology, Architecture, Nutrition, Psychology, Engineering, Epidemiology, Molecular Virology, Environmental Sciences, and Rural Development have come together to share innovative solutions to the challenges around access to clean water. The WHIL Innovations Fellowship provided mentored postdoctoral training in collaborative research and research implementation targeted at accelerating the development of sustainable strategies to reduce the devastating costs of Early Childhood Diarrhea (ECD). This training program focuses on the closely related issues of poor access to water and sanitation in rural areas of Southern Africa and unacceptably high rates of morbidity and mortality associated with ECD. The goals of the program build upon the initial Framework program of building sustainable and innovative global health research collaborations that are specifically tailored to the needs of the local community. 2017 saw the culmination of the WHIL Innovations fellowship program with a symposium “Global Health Research in Africa: Inspiration, Innovation, and Implementation” at the University of Venda. This Pan-African symposium brought together the D43 Framework programs from within Africa to share research and to build new research collaborations.

This model of a sustainable, collaborative, organized, and integrative approach to student and faculty engagement in global health research supported our robust postdoctoral training program. The WHIL Innovations postdoctoral training program has in turn supported pre-doctoral Global Infectious Disease Research Training (GIDRT) trainees along with undergraduate trainees as part of the Minority Health International Research Training (MHIRT) program through both research activities and mentorship. This generational mentorship and research evolution highlights the sustained, trans-disciplinary, and trans-institutional research collaborations that are characteristic of CGH partnerships.

 

Location

The University of Venda is located in Thohoyandou, Limpopo Province, South Africa. Limpopo is the northernmost province in South Africa and is roughly the size of Pennsylvania. Limpopo Province is made up of five Municipalities: Vhembe District, Capricorn District, Mopani District, Sekhukhune District, and Waterberg District. Much of the work conducted by WHIL occurs in the Venda region. In 1962, the South African Government “created” Venda as a bantustan, or homeland, for the Venda-speaking people. Its capital was Thohoyandou and it was the smallest of all the homelands. The homelands were supposedly created to “allow“ Black South Africans to govern themselves and to preserve their culture, but in reality they denied their residents any opportunity to participate in South African politics. As a direct result of Apartheid, high levels of illiteracy and poverty, as well as poor service to the people in particular water, electricity and sanitation continue to challenge the entire province. These conditions significantly affect the local population’s general health and wellness.