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Water insecurity in a syndemic context: Understanding the psycho-emotional stress of water insecurity in Lesotho, Africa

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  • Workman, Cassandra L.
  • Ureksoy, Heather

Abstract

Syndemics occur when populations experience synergistic and multiplicative effects of co-occurring epidemics. Proponents of syndemic theory highlight the importance of understanding the social context in which diseases spread and cogently argue that there are biocultural effects of external stresses such as food insecurity and water insecurity. Thus, a holistic understanding of disease or social vulnerability must incorporate an examination of the emotional and social effects of these phenomena. This paper is a response to the call for a renewed focus on measuring the psycho-emotional and psychosocial effects of food insecurity and water insecurity. Using a mixed-method approach of qualitative interviews and quantitative assessment, including a household demographic, illness, and water insecurity scale, the Household Food Insecurity Access Scale, and the Hopkins Symptoms Checklist-25, this research explored the psycho-emotional effects of water insecurity, food insecurity, and household illness on women and men residing in three low-land districts in Lesotho (n = 75). Conducted between February and November of 2011, this exploratory study first examined the complicated interaction of water insecurity, food insecurity and illness to understand and quantify the relationship between these co-occurring stresses in the context of HIV/AIDS. Second, it sought to separate the role of water insecurity in predicting psycho-emotional stress from other factors, such as food insecurity and household illness. When asked directly about water, qualitative research revealed water availability, access, usage amount, and perceived water cleanliness as important dimensions of water insecurity, creating stress in respondents' daily lives. Qualitative and quantitative data show that water insecurity, food insecurity and changing household demographics, likely resulting from the HIV/AIDS epidemic, are all associated with increased anxiety and depression, and support the conclusion that water insecurity is a critical syndemic dimension in Lesotho. Together, these data provide compelling evidence of the psycho-emotional burden of water insecurity.

Suggested Citation

  • Workman, Cassandra L. & Ureksoy, Heather, 2017. "Water insecurity in a syndemic context: Understanding the psycho-emotional stress of water insecurity in Lesotho, Africa," Social Science & Medicine, Elsevier, vol. 179(C), pages 52-60.
    • Handle: RePEc:eee:socmed:v:179:y:2017:i:c:p:52-60
    DOI: 10.1016/j.socscimed.2017.02.026
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    Cited by:

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    2. G. Mukwada & S. J. Taylor & D. Manatsa & P. Mahasa & G. Robinson, 2020. "Combating food insecurity in a rapidly changing mountain climate environment: insights from Lesotho," Climatic Change, Springer, vol. 163(2), pages 989-1006, November.
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    6. Rosinger, Asher Y. & Bethancourt, Hilary J. & Young, Sera L. & Schultz, Alan F., 2021. "The embodiment of water insecurity: Injuries and chronic stress in lowland Bolivia," Social Science & Medicine, Elsevier, vol. 291(C).
    7. Vica Marie Jelena Tomberge & Janine Stefanie Bischof & Regula Meierhofer & Akina Shrestha & Jennifer Inauen, 2021. "The Physical Burden of Water Carrying and Women’s Psychosocial Well-Being: Evidence from Rural Nepal," IJERPH, MDPI, vol. 18(15), pages 1-11, July.
    8. Brewis, Alexandra & Choudhary, Neetu & Wutich, Amber, 2019. "Household water insecurity may influence common mental disorders directly and indirectly through multiple pathways: Evidence from Haiti," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    9. Godfred O Boateng & Shalean M Collins & Patrick Mbullo & Pauline Wekesa & Maricianah Onono & Torsten B Neilands & Sera L Young, 2018. "A novel household water insecurity scale: Procedures and psychometric analysis among postpartum women in western Kenya," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-28, June.
    10. Achore, Meshack & Bisung, Elijah, 2022. "Experiences of inequalities in access to safe water and psycho-emotional distress in Ghana," Social Science & Medicine, Elsevier, vol. 301(C).
    11. Boateng, Godfred O. & Workman, Cassandra L. & Miller, Joshua D. & Onono, Maricianah & Neilands, Torsten B. & Young, Sera L., 2022. "The syndemic effects of food insecurity, water insecurity, and HIV on depressive symptomatology among Kenyan women," Social Science & Medicine, Elsevier, vol. 295(C).
    12. Carole D. Nounkeu & Jigna M. Dharod, 2020. "A Qualitative Examination of Water Access and Related Coping Behaviors to Understand Its Link to Food Insecurity among Rural Households in the West Region in Cameroon," IJERPH, MDPI, vol. 17(13), pages 1-12, July.
    13. Joseph Kangmennaang & Elijah Bisung & Susan J. Elliott, 2020. "‘We Are Drinking Diseases’: Perception of Water Insecurity and Emotional Distress in Urban Slums in Accra, Ghana," IJERPH, MDPI, vol. 17(3), pages 1-17, January.
    14. Mushavi, Rumbidzai C. & Burns, Bridget F.O. & Kakuhikire, Bernard & Owembabazi, Moran & Vořechovská, Dagmar & McDonough, Amy Q. & Cooper-Vince, Christine E. & Baguma, Charles & Rasmussen, Justin D. & , 2020. "“When you have no water, it means you have no peace”: A mixed-methods, whole-population study of water insecurity and depression in rural Uganda," Social Science & Medicine, Elsevier, vol. 245(C).
    15. Farooq Ahmed & Muhammad Shahid & Yang Cao & Madeeha Gohar Qureshi & Sidra Zia & Saireen Fatima & Jing Guo, 2021. "A Qualitative Exploration in Causes of Water Insecurity Experiences, and Gender and Nutritional Consequences in South-Punjab, Pakistan," IJERPH, MDPI, vol. 18(23), pages 1-14, November.
    16. Marlow, Marguerite & Christie, Hope & Skeen, Sarah & Rabie, Stephan & Louw, Jacobus G. & Swartz, Leslie & Mofokeng, Shoeshoe & Makhetha, Moroesi & Tomlinson, Mark, 2021. "Alcohol use during pregnancy in rural Lesotho: “There is nothing else except alcohol”," Social Science & Medicine, Elsevier, vol. 291(C).
    17. Boateng, Godfred O. & Balogun, Mobolanle R. & Dada, Festus O. & Armah, Frederick A., 2020. "Household energy insecurity: dimensions and consequences for women, infants and children in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 258(C).
    18. Bisung, Elijah & Elliott, Susan J., 2018. "Improvement in access to safe water, household water insecurity, and time savings: A cross-sectional retrospective study in Kenya," Social Science & Medicine, Elsevier, vol. 200(C), pages 1-8.

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