Southern Medical Program student Soren Meeuwisse recently had her scoping review Water fetching and musculoskeletal health across the life-course in Sub-Saharan Africa published in the PLOS Global Public Health Journal.
What is the focus of your research?
Although water has been declared a fundamental human right by the United Nations, many households in Sub-Saharan Africa (SSA) do not have adequate water accessibility and it is socioculturally women’s responsibility to walk far distances carrying water to provide for the household. This practice, performed by millions of women worldwide every day, is predicted to persist for many years due to deeply ingrained sociocultural gender norms and increasing water insecurity, as a result of climate change and population growth in SSA. The review outlines how women in SSA endure the harmful MSK impacts of water fetching through the many stages of life—from childhood and childbearing years to old age. As a result, they face gender disparities in health outcomes and opportunities for personal and economic development. This paper aims to inform future studies and interventions in MSK healthcare, aiming to prevent, reduce, and rehabilitate poor MSK health, ultimately improving both individual and societal well-being.
What did you learn?
I gained a deep understanding of my specific topic through the rigorous research process, but just as importantly, I learned a great deal about conducting research properly. This experience has greatly enhanced my appreciation for high-quality, impactful published studies. The main take-aways that I learned from my research are:
(1) The MSK issues reported in this review are preventable and this is a global public health problem that is socially normalized, under-measured, and underrepresented in the literature
(2) Despite elderly women commonly fetching water, there is very minimal literature on their MSK health, which has significant implications for the well-being of their household as well. Many grandparents are the primary caretakers of their grandchildren, as the middle generation in SSA has sadly been largely impacted by HIV/AIDS. Therefore, the grandparents’ physical ability to fetch water directly impacts child health and school attendance.
(3) Men or younger boys who fetch water have preferential access to tools (such as a bicycle or cart) that ease the burden of water fetching, illustrating gendered access to innovative devices that may be developed to assist the health of water fetchers. Further, it is understood that women play a crucial role in household water accessibility, yet women are largely excluded from water management, decision-making, and implementation processes which are often led by able-bodied men. Addressing the challenges of MSK pain and dysfunction in SSA require consideration of societal, cultural, behavioural, infrastructural, and ergonomic factors.
How has the research impacted your training as a future physician?
This research has deepened my understanding of the intricate connections between social determinants of health and physical well-being, particularly in the context of musculoskeletal health. It has reinforced the importance of viewing patient care through a holistic lens, prioritizing cultural safety, and considering not just the medical issues but also the social and environmental factors that shape health outcomes. As a future physician, this experience has emphasized the value of interdisciplinary and cross-cultural collaboration, public health perspectives, and evidence-based interventions in addressing complex global health challenges. It has also sharpened my research skills, which will be critical in staying current with evolving medical knowledge and improving patient care.
What are the next steps for your research?
The next steps involve building on the findings of this review to explore targeted interventions that can mitigate the musculoskeletal impacts of water fetching. Future research should focus on developing culturally appropriate, ergonomic tools and community-based strategies to reduce the physical burden on women and the elderly. Additionally, addressing the gendered barriers in water management and decision-making processes is essential. Collaborating with local communities and stakeholders in SSA will be key to implementing sustainable solutions that promote both physical health and gender equity.