Thelma Abu wants her research to make a difference. For her, this starts with ensuring everyone has access to a human right and necessity: water.
The global health researcher – one of nine recipients of the Black Research Network’s inaugural IGNITE grant – is driven by her lived experiences in her home country of Ghana to improve water access, sanitation and hygiene, also known as WaSH, in the Horn of Africa.
“We know that our health and well-being are determined by the conditions in which we are born, raised, work and play, as well as age,” says Abu, a post-doctoral researcher in the department of geography, mathematics and environment at the University of Toronto Mississauga.
“Global health equity is about how everyone, everywhere, can attain their full potential.”
Abu co-authored a research article that was published last year in the Journal of Water, Sanitation & Hygiene for Development. It highlights the experiences of health-care professionals in Kenya and the management of WaSH in health facilities. The work responded to a global call by the United Nations in 2018 to ensure that WaSH is implemented in universal health coverage, which was piloted in the country.
Abu conducted research alongside Community Health Support (COHESU) – a local NGO – in Kisumu County, which is located in western Kenya and is one of four counties to launch a universal health-care pilot. The research was conducted in three health-care dispensaries that provide preventative curative, maternal and childcare services, but are only open during typical working hours. This means that many community members need to visit local private health facilities or government hospitals during nights and weekends – places where malaria, respiratory diseases and eye and ear infections are highly reported.
The group found that water quality, economic resources and ecological factors were the top barriers to local health promotion efforts.
“These are challenges in households and health-care facilities where infection prevention and safety is supposed to be optimum,” Abu says.
“We cannot talk about water insecurity without acknowledging the intersection of climate change, health, gender, development and how they link to policy, which is shaped by social and ecological factors and processes within places.”
The Kisumu Water and Sewerage Company (KIWASCO) has been responsible for the Kisumu County’s piped water system since 2001, but it is the responsibility of the health ministry to provide plumbing works to health facilities. Health-care workers often construct tippy taps – equipment to ensure running water, due to limited plumbing – with the help of non-governmental and philanthropic organizations.
Health facility managers control water availability to avoid high water costs by locking pipes. Only one person was responsible for all cleaning per facility amid funding shortages that lead to staffing issues. All were factors that caused concern among the study participants’ when it came to poor water quality and availability.
Abu notes that systemic and governmental change is crucial to ensure communities receive access to clean water. To secure access and availability of safe water, she says health-care facilities need to be adequately funded by the government. This also means the government needs to prioritize access to safe water in households and health-care facilities by providing sustainable water infrastructural options and investment in expanding the piped water system.
At the same time, Abu is using her research to highlight injustice, push for policy change and garner support for NGOs like COHESU who work to support communities.
“My goal is to have evidence to advocate for the necessary resources that facilities need to provide safe services to patients,” Abu says.
Closer to home, Abu is also exploring how Black communities in the GTA navigated the COVID-19 pandemic. Currently in its data-collection phase, her project – which received $7,000 in support through the BRN’s IGNITE grant – will fuel pathways to build resilient health-care systems. After talking to community members, the team plans to connect with local grassroots organizations that were instrumental during the pandemic. The researchers have partnered with Peel Public Health and Trillium Health Partners, a hospital system that serves Mississauga and western Toronto.
“The pandemic exposed structural inequalities in various places and we know that Black and racialized communities were disproportionately impacted,” Abu says.
“We’re interested in learning from the community about their experiences and how to best shape and strengthen community resilience and inform future public health messages and care to address their needs.”
Her advice for aspiring post-doctoral scholars? Find a unique spot in research and seek opportunities to build a supportive network.
“As graduate students, we should be able to incorporate research questions into our mentors’ programs that are of interest to us. And in that, we create a niche for ourselves as emerging scholars,” Abu says.
“It’s important to build that supportive environment as we grow in our field to fall back on when we need support during our career trajectory.”