Evaluation of an Emergency Bulk Chlorination Project Targeting Drinking Water Vendors in Cholera-Affected Wards of Dar es Salaam and Morogoro, Tanzania.

In August 2015, an outbreak of cholera was reported in Tanzania. In cholera-affected areas of urban Dar es Salaam and Morogoro, many households obtained drinking water from vendors, who sold water from tanks ranging in volume from 1,000 to 20,000 L. Water supplied by vendors was not adequately chlorinated. The Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children and the U.N. Children's Fund, Tanzania, collaborated to enroll and train vendors to treat their water with 8.68-g sodium dichloroisocyanurate tablets (Medentech, Ireland). The Centers for Disease Control and Prevention (CDC) provided monitoring and evaluation support. Vendors were provided a 3-month supply of chlorine tablets. A baseline assessment and routine monitoring were conducted by ward environmental health officers. Approximately 3 months after chlorine tablet distribution, an evaluation of the program was conducted. The evaluation included a full enumeration of all vendors, an in-depth survey with half of the vendors enumerated, and focus group discussions. In total, 797 (88.9%) vendors were included in the full enumeration and 392 in the in-depth survey. Free residual chlorine (FRC) was detected in 12.0% of tanks at baseline and 69.6% of tanks during the evaluation; however, only 17.4% of these tanks had FRC ≥ 0.5 mg/L. The results suggest high acceptability and use of the chlorine tablets by water vendors. However, given variation in the water source used and longer storage times, dosing could be increased in future programming. Bulk chlorination using chlorine tablets offers an efficient community-level approach to treating water closer to the point of use.

Fostering children affected by AIDS in Richards Bay, South Africa: a qualitative study of grandparents' experiences.

Grandparents are increasingly becoming the primary carers of children orphaned by the HIV epidemic in South Africa. Traditional family roles are being reversed as aging family members take responsibility for the physical and psychosocial needs of children. This study uses qualitative research to explore the experiences of grandparents fostering children orphaned by AIDS in Richards Bay, KwaZulu-Natal Province, South Africa. The idea was born after a local HIV support organisation (Richards Bay Family Care) observed a trend within their organisation of grandparents increasingly becoming foster parents for orphans. An exploratory study was conducted in the organisation's three target areas (two rural villages and urban Richards Bay); the ultimate aim was to explore options for improving financial and emotional support for this group. The qualitative research methods included: four focus group discussions with foster-carers and community leaders (including two pocket-chart voting exercises); 12 in-depth interviews with grandparent foster-carers; and ten key-informant interviews, mostly with staff who provide support services. Data analysis was by thematic framework. The needs of the grandparent fostercarers varied: the rural participants were essentially concerned with meeting children's basic needs (housing, food and education), while those in urban areas more often felt pressure to provide emotional and psychological support for orphans. In both groups, women were at the forefront of foster care. Important problems identified by the grandparents were child discipline and a feeling of disharmony in the intergenerational relationship. Government foster care grants were identified as a regular source of income for especially the rural foster-carers. The findings may help programme managers better understand the differences in the needs of urban and rural foster parents. The experiences of grandparents as carers of orphans affected by HIV or AIDS are unique considering their age, frailty and poverty status. More research is needed on the role played by men in fostering children orphaned by AIDS.