Assessing biosocial vectors in water contamination, the incidence of water-borne illnesses, and insecurity in Kathmandu, Nepal

ABSTRACT In this study, we use water quality tests, epidemiological data, and ethnographic interviews gathered in Kathmandu in 2017, to provide an interdisciplinary analysis of water insecurity, illness, and targeted responses. Our findings fit the pattern of the past 20 years: the concentration of coliform bacteria across water sources remains unsafe. Our epidemiological data documents high rates of water-borne infectious diseases consistent with fecal contamination of water sources. Our ethnographic interviews suggest that social marginalization, poverty, and dislocation are major drivers in the incidence of illness. Evaluating some of the collective responses to water insecurity and contamination, we argue that effectively addressing water pollution, scarcity, and health outcomes in Kathmandu requires redirecting the focus of programs and the primary methods of implementation. Instead of large-scale top-down infrastructural interventions such as the Melamchi Water Supply Project, programs should target women's leadership and subsidize funding for small-scale, community-managed interventions.