"The people here knew how I used to live, but now I have to start again:" Lived experiences and expectations of the displaced and non-displaced women affected by the Thwake Multipurpose Dam construction in Makueni County, Kenya.

BACKGROUND: Dam construction and associated disruptive activities such as population displacement can have significant societal consequences, especially for those socially and economically disadvantaged. Though community-level health and social consequences of displacements have been documented, there is little understanding of the individual-level consequences and intra-household gendered dynamics. OBJECTIVE/METHODS: We sought to explore the experiences and expectations of displaced (n = 30) and non-displaced (n = 20) women in Makueni County, Kenya, where Kenya's second largest dam, Thwake Multipurpose Dam, is being constructed. We used qualitative techniques, including photo-elicitation interviews, go-along interviews, key informant interviews, and participant observation, to understand the lived experiences of women affected by the dam construction processes and their associated disruptions. RESULTS: We found that both displaced and non-displaced women experienced the impacts of dam construction in four areas, i.e., economic (income loss), health (hearing damage), social (disrupted social networks), and environmental (flooding) domains. Though both groups described adverse effects, the displaced women perceived worse economic and social outcomes than non-displaced ones. Further, older and married women in both groups had the worst lived experiences and negative perceptions about the consequences for social well-being, e.g., loss of cultural identity, land ownership, and access to important religious sites. Changes in livelihood also transformed gender roles as women assumed economic responsibilities to cushion their families from hunger. CONCLUSION: Development projects such as dams negatively impact the host community-displaced and the non-displaced experience adverse health, social, and environmental effects. However, poor women who are smallholder farmers bear the greatest burden. Assessment of individual-level experiences and intrahousehold dynamics might enhance our understanding of the biosocial outcomes of these consequences. Therefore, integrative biosocial approaches should be considered when examining the impacts of dam construction.

The accuracy and usability of point-of-use fluoride biosensors in rural Kenya.

Geogenic fluoride contaminates the water of tens of millions of people. However, many are unaware of the fluoride content due in part to shortcomings of detection methods. Biosensor tests are a relatively new approach to water quality testing that address many of these shortcomings but have never been tested by non-experts in a "real-world" setting. We therefore sought to assess the accuracy and usability of a point-of-use fluoride biosensor using surveys and field tests in Nakuru County, Kenya. Biosensor tests accurately classified elevated fluoride (≥1.5 ppm) in 89.5% of the 57 samples tested. Usability was also high; all participants were able to use the test and correctly interpreted all but one sample. These data suggest that biosensor tests can provide accurate, meaningful water quality data that help non-experts make decisions about the water they consume. Further scaling of these technologies could provide new approaches to track global progress towards Sustainable Development Goal 6.