Challenges associated with access to safe water in Rhino Camp refugee settlement in Arua District, Uganda

ABSTRACT The study evaluated water access and disease prevalence in the Rhino Camp refugee settlement by mapping water sources, interviewing residents, and reviewing health centre records. Primary water sources were tanks providing 10.2 litres per person per day (L/p/d). Microbial contamination including total coliforms reaching 2.8 × 104 cfu/mL (household container – Tika), thermotolerant coliforms, and faecal enterococci were observed throughout the water supply chain, suggesting faecal contamination and posing a health risk. We attributed this to poor handling and storage related to poor sanitation in the settlement, highlighting the importance of promoting hygiene practices among refugees, particularly in the Ofua Zone, which had the highest contamination risks and the highest sanitary risk scores. Malaria and Typhoid were the most prevalent diseases, with Ofua having the highest disease incidence. Water collection was mostly done by adult females and female children (34.7 and 30.3%, respectively) although water collection was generally low (<4 times a day). Boiling water was associated (p < 0.05) with the incidence of hepatitis A in Ofua. Adequate water (>20 L/p/d), water treatment, and education on hygiene practices especially for adult females are essential in lowering contamination and the incidence of diseases.