By Sarah Schaub

Sitting on the dirt floor of the family’s home, Dr. Anita Hunter, WSU Vancouver College of Nursing Clinical Professor, graciously accepted the refreshments that were offered to her, though hesitant. Eyeing the sediment that had collected on the bottom of the glass, she knew the water used to make the fruit beverage was likely contaminated with heavy metals and other toxins from their local water source. She knew the porridge that was offered to her was likely made with that same water. Even more frustrating was accepting this meal would reduce the amount of food this family would eat that day, but to refuse would have been a grave insult. The Ugandans are very hospitable and are always willing to share what they have with visitors – it is a cultural expectation.

“I’ve been invited into the homes of many villagers in Uganda, especially by families I have cared for or worked with at the hospital,” said Dr. Hunter. “Our mission all along has been to help improve the health and well-being of the people in the Mbarara District as well as across the country. What my colleagues and I have found over these past eight years is a country plagued by poverty, joblessness, preventable infections, and now contaminated water sources that almost 80% of the population of Uganda uses.”

This family and so many others who do not have access to clean water is the reason for Dr. Hunter’s research. Dr. Hunter and two WSU Vancouver DNP-Family Nurse Practitioner students, Stephanie Gardiner and Kinda Tyler, in collaboration with researchers and students from the University of San Diego, spent two weeks in January 2016 in the Mbarara District that stretches from Masaka to almost the Tanzania and Rwandan borders, approximately 1,846 hundred square miles. The objective for this trip was to determine if the child-bearing health of women and the development of children in that region were impacted by consuming water from the local water sources; both governmental filtered water and water from natural sources such as rivers, streams, bore holes (wells), and swamps. It is these sources where the presences of heavy metals such as arsenic, iron, lead, cadmium, selenium, and others have been found.

The contaminated water in this district and other communities with the same topography is a direct result of a natural phenomenon where water from the underground aquifer moves upward through lava rocks to replenish surface water lost to global warming. The lava rock is the storehouse for the heavy metals. The effect of heavy metals on human health is significant causing cancer, neurological problems, cardiac problems, and kidney damage in the adults; pregnancy loss, low birth weights, congenital birth defects and prematurity for women of child-bearing age; and developmental delays, reduced cognitive functioning, neurological defects, behavioral problems, and poor school performance in the children.

“When I first began my journey to Uganda in 2007, I wanted to help find a way to prevent the deaths of the 13,000 children who die in this community annually from preventable conditions,” Dr. Hunter said. “Over the years, my work has gone from caring for these sick children in hospitals, to uncovering what is causing them to be hospitalized.”

Anita-Hunter-DNP-and-StudentsDr. Hunter, Stephanie, and Kinda assessed the health of 273 women and children from five villages, two of which did not have access to clean water. They discovered that people living in villages without access to clean water suffered serious health and development issues while displaying dismal health outcomes:

  • The water sources tested in these two communities had toxic levels of arsenic, lead, and fluoride and neither community had access to clean water.
  • 70% of the women and children tested positive for heavy metals and arsenic.
  • Women in these communities had twice the incidence of neurological problems (memory loss, numbness, gait imbalance, headaches, unusual smells and tastes), and cardiac problems (palpitations and chest pain); and had three times the incidence of fetal/neonatal losses and premature infants than the women in the three villages with clean water access.
  • Children had 10 times the incidence of developmental delays, especially in the area of cognition and speech/language development, compared with children in communities with access to clean water.
  • Malnutrition and malaria rates were the same across all five villages and were not statistically significant in the incidence of neurological and cardiac symptoms in women or the developmental problems in the children.

Dr. Hunter will return to Uganda for a 10-day trip in July to gather more data on the child-bearing health of approximately 100 women and the cognitive health of approximately 100 school-aged children. The data collected from the July and January trips will be disseminated to the Public Health and the Water Quality officials in the District in hopes that it will then be addressed at the national level.

“Such contamination has the potential to affect the future generations of Uganda,” Dr. Hunter said. “We hope that the data gathered will provide the evidence needed for the government to take action and increase the access of clean water to the people living in rural Uganda and that international partners may express an interest in helping.”