Journal of Social Development in Africa (1990), 5,1,59-71 
Case Study 
Hygiene in Three Communities. 
A Case Study of Behaviour Related to Hygiene* 
MFC BOURDILLON+ 
ABSTRACT 
The purpose of the sociological study was to look at behaviour related to hygiene in some 
detail. Because of the difficulties of obtaining information about something as private as 
hygienic practices, the study could focus only on a few families, looking for descriptive 
qualitative, rather than quantitative, data - even in the few cases studied, there were severe 
limitations to what could be observed. This article describes what was observed, and relates 
it to some of the data collected in the microbiological study. 
Introduction 
This study took place in conjunction with a microbiological study on the practice and 
effectiveness of different forms of hand-washing. In particular, the researchers wished to see 
the effect of distributing mukombes, a water container which delivers 200 ml of water for 
hand-washing when tipped. The study was conducted in three areas: a traditional village in 
Chihota Communal Land, a peri-urban area (Epworth, near Harare), and three selected 
commercial farms. Those involved in the microbiological study also administered a survey 
questionnaire, in which informants were asked to respond to a number of questions relating 
to hygiene and general background, to which the researchers added their own observations. 
The research assistants spent three weeks continuously in the field in December 1987. In 
each case five or six families were selected for detailed observation. The families were chosen 
because they were thought to be of interest by the microbiological researchers, and to 
represent a wide range of styles of living. After a preliminary visit and interviews, the research 
assistant spent three full days with the family concerned, to observe and learn about practices 
related to hygiene. The evenings and early mornings remained outside the scope of direct 
* This study took place in conjunction with a microbiological study on the practice and effectiveness of different 
formi of hand-washing, carried out by Eva Kaltenthaler and Felix Chawira, of the Blair Research Institute in 
Harare. The actual field work was undertaken by three students from the Department of Sociology at 
the University of Zimbabwe, Winnie Mukotekwa (Epworth), Florence Chidamahiya (Chihota), and Faith 
Manwa (farms). 
+ Associate Professor, Department of Sociology, University of Zimbabwe, P O Box MP 167, Mount Pleasant, 
Harare, Zimbabwe.
60 M F C Bourdillon 
observation. In Epworth, the period of observation was shorter. The research assistant 
returned to Epworth in March for a week. At the end of May, after the mukombes had been 
installed for some time, all three returned to their respective areas for a week of further 
observation. 
The traditional village 
In an earlier study of a number of areas in Zimbabwe, it was observed that 80% of the members 
of 52 households bathed daily. In only three of these families did any members fail to wash 
their hands before observed meals. No one washed after defecation (Government of 
Zimbabwe, 1985). The observations in the present study suggest that bathing is less regular 
in all three communities; that hand washing before meals is only very rarely missed; and that 
hand washing after toilet use has in the past been very rare. Comparing the three areas in the 
present study, hygiene practices were more regular in Ihe traditional village than in the other 
two areas. The microbiological study showed coliform counts from hands to be significantly 
lower in the traditional village than in the other two areas. 
Nyamungaya Village is situated approximately 60 kms by road from Harare. Field 
observations were for the most part confined to one section of it, comprising 34 homesteads. 
Each homestead comprises of a number of single-room houses used as bedrooms or kitchens, 
and sometimes also a two-roomed dwelling occupied by the household head. The buildings 
are for the most part built of plastered brick, with cement floors and corrugated iron or thatch 
roofing. The homesteads are usually fenced, and include an acre or two of gardens for fresh 
vegetables and a little grain, and are spaced roughly 150m from each other 
Buses to and from Harare pass along a nearby road, and also give access to the nearest 
chnic,whichisa20minuterideaway.Theeconomyisbasedonacombinationofwagelabour 
and subsistence agriculture. It was difficult to contact household heads other than at 
weekends, when many came home from their work in Harare to visit their families. 
Differences in wealth are apparent from house styles, and ownership of livestock and 
agricultural equipment 
InDecember.thirteenoftheAirty-fourh^ 
according to the improved 'Blair' design. A further seven families were planning to build 
toilets, and had at least got so far as to dig a hole. Others simply used the surrounding bush. 
With two exceptions, the toilets that had been built were clean and in good condition in 
December and the two exceptions were clean in May. In one case, the holes were kept 
covered, which in the Blur design increases the possibility of contamination by flies. 
Generally, the wealthierpeoplein the village havetoilets. Although government supplied 
cement, many could not afford the bricks nor the cost of hiring a builder No cementwas 
supphedbetweenD^emberandMay^^^ 
toileuwerecompleted,^^ 
SutttCG. 
Near^one part of the village isashallow pan which holds surface water during the rainy 
season. hnhedry season the water tableinuiepanissufficienUyhi^sSoflllow 
wells to be dug in the sandy sod to collect water. These ^ SSTrf h
Case Study: Hygiene Behaviour 61 
pan as the watertable falls. Between December and May aborehole was drilled to serve those 
far away from the traditional wells. 
There are a number of ways in which Nyamungaya village is not typical of the remoter 
villages of rural Zimbabwe. As a result of its relative proximity to Harare, a large number of 
household heads can work in the city, coming home at weekends with a regular wage to 
supplement the subsistence agriculture of the rural area, at the same time minimising their 
expenses in the city. This is readily seen in the number of good quality brick houses in the 
village, and the number of toilets that have been built. 
Related to economic factors are the higher educational levels in the village. At least 
fourteen out of 23 husbands had received secondary education. The education of men in the 
peri-urban and farm areas were similar to each other and significantly lower than in me 
tradlticmalvmageiieoutSOmaleh^seholdheadskEpwOTmandonthefannswerereported 
to have received secondary education, with 15 cases unknown*. There.was little difference 
between the threeareas in terms of theeducation of women: marginally fewer farm.wiveshad 
received secondary education than intheothertwo areas. There is no evidence that education 
is related to good hygiene on an individual basis: there was no correlation between cohform 
cou^JucatioTBut 
in more receptivity to new ideas in the community as a whole. 
Athirdd£tinctivecharacteristicofNyamungayavnlageisitsvdlagehealth^worker*. This 
lady isTthusiastic about her job, and the relatively high standard of education among the 
SemXstemwiumgtoaTceptto^ 
cTst^rer^ 
kTxtreindy limited, and the person who acquires the post often does so large y to advance 
h e T s « d f o t o c i a l a d « e . Consequently, she is likely to arouse only envy m the 
expressions of envy, though occasionally heard are mimmaL The: tow levels of faecal 
ter. 
w S v e r omitted during the observational research^ It appears to 
f ^ 
did not bothertomention before meals asatunewhen hands 
question about hand washing! Also faces and hands were
62 M F C Bourdillon 
regularly washed first thing in the morning in all households. In the exceptionally clean 
household, hand washing was regularly practised after toilet use, and sometimes in the case 
of a family with a high coliform count In two cases, this was never the practice; nor in these 
two cases was it the practice to wash hands before breast-feeding, or after dealing with infants' 
toiletry or nappies. In three of the cases, hand-washing was regular before and during food 
preparation - and the one exception had a low coliform count. With the exception of this 
family, practice corresponded closely with the responses to the unprompted question on handwashing 
in the questionnaire. 
Bathing was irregular in the same family, and daily for everybody only in one family. 
Small children are bathed more frequently than adults, perhaps every other day. And girls, 
who go to water sources to fetch water and do laundry, bathe more often than boys. Soap is 
widely used for bathing, rarely for hand-washing. Responses to the questionnaire on 
frequency of bathing were totally unreliable. 
In May, the research assistant went around all the houses in the section of the village under 
study, and where mukombes had been installed asked children questions about them. In all 
but one case the mukombe appeared to be used regularly, and children were invariably 
knowledgeable on their purpose and use - possibly further evidence of the efficiency of the 
village health worker. 
In the case of the family with a particularly high coliform count, generally their hygiene 
practices were superior to one of the families in the original study and inferior to another. In 
the family in question, hands were not washed after toilet use, nor after changing the baby's 
nappies. The baby and a three-year old child were reported to have virtually chronic diarrhoea, 
and the four year old had frequent diarrhoea. With such health problems, the high coliform 
count is not surprising, and with such counts the diarrhoea is not surprising. 
The farms 
The labourers on commercial farms comprise a very mixed collection of people, ranging from 
local people temporarily employed on farms near their homes to immigrants of long standing 
whose only experience of Zimbabwe comes from farm life. Educationally, the survey 
revealed no differences between the farms and the peri-urban areas in the schooling of 
husbands, although marginally fewer farm wives had received more than six years of primary 
education. 
The housing and facilities provided by farms is equally varied. The study took samples 
from three farms in the Marondera District, situated around 60 kms from Harare, and 15-25 
kms by road from the smaller town of Marondera. The housing provided on each farm was 
of relatively good quality: built in brick, plastered on the inside, and with asbestos roofs. 
Sanitary facilities, however, varied greatly, as did the general setting and lay-out of the 
compounds. I shall comment on each of the three farms in turn. 
Notwithstanding the differences, water sources on all farms are considerably more 
accessible than are the water sources in Nyamungaya Village. Nevertheless the coliform 
counts on the farms are significantly higher than in Nyamungaya village.
Case Study: Hygiene Behaviour 63 
Farm 'A' 
This is a mixed agricultural farm, producing maize, dairy products, sheep and angora goats 
for wool and mohair, and chicken products. Apart from agriculture, the farm operates a hand 
weaving factory, employing women from the compound on an hourly basis to spin and weave 
wool and mohair. 
In December, the compound had 33 families resident in it, and 32 in May. It is well 
situated, rambling under many shady trees, with some space for small gardens. Most of the 
houses have some flowers growing around them, and some have elaborate arrangements of 
flower beds and pots and hanging plants for decoration. This suggests a degree of permanence 
among the workers who regard their compound residences as in some sense home. Indeed 
some adults were born on farms owned by their present employers, and their children 
comprise the third generation in the environment. 
The houses are mostly two roomed dwellings, well built in brick, with metal doors, 
asbestos or corrugated iron roofs and walls plastered and white-washed on the inside. The 
rooms are, however, small: one is approximately 4m squared and the other about 3m squared. 
Rather than use one of these rooms for cooking in, most families build a round pole-and-dagga 
kitchen with a thatched roof. Just before the research began, sixteen Blair toilets had been 
built, though as so often happens, minor modifications were made to the design which results 
in less efficiency in eliminating smells and flies. In this case the vents were placed on the 
opposite side to the door instead of the same side. Each toilet has a shower inside, which helps 
to keep it clean, and a tap and washing facilities on the outside. There had long been running 
water and washing facilities all over the compound. In practice, the fact that the toilets are 
nearly always damp from frequent use of the shower and washing facilities, together with the 
relative absence of light, makes them an ideal breeding ground for micro-organisms and may 
partly explain the particularly high faecal coliform counts which were observed on this farm. 
The farm owner employs one of the women in the compound as a health worker, and she 
administers common drugs. It is generally thought in the compound, however, that she gets 
extra money for doing virtually nothing. There was a move by the farm workers to stop her 
receiving the standard increase when government legislated for general increases in May. 
There is a government sponsored clinic on the borders of the communal land, only a couple 
of kilometres from the farm compound. 
There is a store about 3 kms away, but most shopping is done in Marondera, about 25 kms 
away, where things are much cheaper. Beer is brewed and sold on the farm compound. 
There is a cheerful and happy air about the compound, among men, women and children. 
The researchers were welcomed. Although women liked the attention given to them by 
researchers, they were not keen to lose too much profitable weaving time. 
In May, 25 of the 32 male employees were of Malawian origin. Ten of these were 
interlinked in a network of kinship and marriage which illustrates a degree of stability of the 
core labour force under this employer. In the sample of 11 families from this farm selected for 
the microbiological study, there were eight Malawian household heads, with the origins of the 
remaining three unknown to the researchers. Of the families chosen, the majority had infants 
in the household (which partly accounts for the high coliform counts). This must be partly a
64 M F C BowdiUon 
chance factor, but could also partly be explained in terms of the fact that many farm workers 
have no other home where infants could be sent to for help in rearing and upbringing. In Farm 
'C\ by contrast, where the majority of workers are from the neighbouring communal areas, 
a mother is likely to go to her family or her in-laws for help in coping with infants. 
Farm'B' 
This farm has two main products: dairy products and tobacco. It has just under a hundred milk 
cows and a few beef cattle. 
The main compound at this farm is a collection of brick houses stretching for just under 
a kilometre along the main road. On the other side of the fence are cattle kraals, a constant 
source of flies for the compound in the hot rainy season. There are some small mango and 
papaw trees growing in the compound, and some granadilla vines. But there are few shade 
trees scattered around the compound, and few decorative flower gardens. 
The houses are of brick, roughly plastered on the inside and unpainted, with asbestos or 
iron roofing. Most of the houses have two rooms of approximately 4m squared, one with a 
smoky fire place in it. Some of the labourers have built pole-and-dagga kitchens facing the 
rooms. Running water for washing and drinking is available from three communal taps, which 
were installed in 1985. Cement slabs beneath them were installed about the time the current 
research project started. 
Two toilets had recently been built, in Blair style but with too much light and wrongly 
situated vents, with the result that neither smells nor flies were effectively eliminated. A third 
was in the process of being built at the beginning of the research. Most people defecate in the 
veld nearby. They say that the farm owner prescribed a restricted area for this purpose, which 
is now badly polluted and smelly, and many large green flies are said to return to the houses 
from there. The absence of adequate toilet facilities is a frequent complaint of the compound 
residents. 
The manager lives in superior quarters, nearer to the farm owner's residence, but also 
nearer to the cattle kraals. He has running water in the house. Adjacent to his house, and near 
the tobacco barns, are three further sets of quarters in the style of the main compound. These 
have a communal toilet. 
Near the compound is a football field for men and boys. Another form of recreation is 
fishing on the farm dam, although this was stopped by the owner when the water level was 
low. In December, beer was brewed by one of the workers' wife and sold to all at weekends. 
By May, her husband had been dismissed, and workers went to Makuti Store, a couple of 
kilometres away, to drink at weekends. This is also the nearest facility for buying consumer 
goods, but since prices are very high here, workers prefer the 20c bus ride to Marondera to buy 
their groceries. 
Fourteen of the 37 workers in May were of Malawian origin, 17 were of Zimbabwean 
ancestry, the remainder originating from Mozambique and Zambia. Nineteen of the workers 
had kin or in-laws also working on the farm, but none of the kinship/affinal networks stretched 
to beyond three persons. Some members have sought and found employment through kin or 
affines.
Case Study: Hygiene Behaviour 65 
Eight mukombes were installed on the farm. When asked, workers and their wives 
commented on how useful they were, providing easy access to water for hand-washing, but 
not everyone put them to full use. By the end of May, two of the men who had been given 
mukombes had left and taken their mukombes with them. Of the remainder, three appeared to 
beinuse.onehadstagnantwaterinitandonewasempty. One was placed outside a communal 
toilet, but was no one's responsibility, and was clearly not normally in use. The research 
assistant arrived at a weekend and checked them immediately: towards the end of the week, 
two were empty but the one with old stagnant waterhad been replenished; in one case the water 
in the mukombes appeared to be used only by children for play. But this was a time when 
women as well as men worked long hours during the week processing tobacco, and the 
favourable comments about the mukombes could have been genuine. 
The women do not have regular employment as in the first farm, and in December there 
were complaints from some wives of having nothing to do. Nevertheless, there is frequently 
seasonal work which women undertake on an hourly basis to supplement their husbands' 
meagre incomes. At such times, they are expected to do a full day's work over and above their 
normal household chores, which may explain the neglect of the mukombes in May. When 
unemployed, or when unable to work on account of small children, some wives earn a little 
extra income by buying groceries at Marondera and selling them at a profit in the compound. 
One further complaint of the workers is that their salaries were often paid late. One family 
was having difficulties buying food on December 1 lth, and claimed that this was because the 
husband had not been paid his November salary - though the wife also commented that the 
husband spent too much on beer. The point is that nutrition and general living standards may 
be a more important health factor than hygiene in such communities. 
Farm 'C 
This farm borders on Seke communal land. The owner has given up growing crops, in spite 
of the suitability of the land, on account of his inability to control thefts by Seke residents. The 
farm is now entirely made over to cattle, and at the time of the research there was a small police 
contingent resident on one corner of the farm. At that corner there is also a store and beer 
garden owned by the farm, and attracting custom from residents of the compound, as well as 
of neighbouring farms and the communal land. 
The main compound on this farm is situated not far from the store, and the main road. 
There are trees in the vicinity giving some privacy to the residents. The compound comprises 
seven houses each with three rooms and an open cooking area, roofed but with no chimney 
and consequently very smoky. The rooms are about 3,5m squared, plastered and whitewashed 
on the inside. They have iron roofs and doors. Single men and small families are 
allocated only one room each, and have to share cooking areas. Thirteen workers reside in 
this compound. 
The compound is served by one common tap, which provides water for drinking, cooking 
and washing. The water comes from a borehole and is stored in a farm reservoir. Although 
the owner uses the same supply for his home, residents of the compound say that it is 
sometimes polluted and smelly from dead animals in the tanks. There are also covered wells 
near the compound.
66 M F C Bourdillon 
There is one Blair toilet, with flaws in the design. Five of the workers and their wives use 
it: the remainder, and all the children, use the surrounding bush. No-one is responsible for 
keeping the toilet clean, and it is dirty, with faeces on the floor. 
A second compound comprises about seven pole-and-dagga huts with thatched roofs, 
clustered together near the store bar. The residents ofthis compound have to collect water from 
the tap at the beer garden, approximately 300m away. They are also expected to use the toilet 
at the garden which is not kept clean. 
There are a few houses set apart, near vlei land, where the water table is so high that it is 
impossible to dig toilets. These are scheduled for demolition, and inhabited by temporary 
employees, with homes in the nearby communal lands. They are built of cement and brick, 
and look very old. Their water supply is from open wells in the vlei. 
In May, there were 25 employees resident in the compounds, 19 permanent staff and six 
casual labourers. Eleven of these had non-Zimbabwean origins. There are only one pair of 
kin and one pair of affines among the permanent staff. A number of workers are single males, 
often with families maintained in .nearby communal areas. 
Of the four mukombes installed in the compound, only one appeared to be maintained in 
use. The one by the bar toilet had apparently been thrown away by the girl who was supposed 
to attend to it, and was picked up by another farm worker who said he intends to use it - but 
when the research assistant visited the farm, it was still empty. 
Hygiene on the farms 
Generally the families of farm workers are poor. They have little in the way of house 
furnishings, and manage to save little. Few have managed to purchase any livestock even 
among those who maintain farming rights in communal land. One family with a very young 
child, preventing the wifefrom working, claimed that they could not even buy sufficientmaize 
meal for meals. Six families were selected for detailed observation in December, one from 
Farm 'A', two from Farm 'B' and three from Farm 'C*. Three of these families had left the 
farms by May, underlining the instability of communities in the farm compounds. 
Clearly there is a problem with hygiene on the farms. Although generally water sources 
are more accessible on the farms than in the other areas under study, the average faecal 
coliform count was highest on the farms. Surprisingly, this was mainly due to very high counts 
in Farm 'A', where the facilities for hygiene are most abundant The other two farms were 
comparable with Epworth, the peri-urban area, as far as coliform counts are concerned4. 
According to a common stereotype encountered in Zimbabwe, the high coliform counts 
on farms would be explicable in terms of the high proportion of farm workers who are of 
Malawian origin. They are held to be backward, uneducated and dirty. In fact 55% of farm 
workers were recorded as being of Malawian descent, with a further 7% coming out of 
Mozambique or Zambia, although few of these admitted to being born outside Zimbabwe, an 
admission which would jeopardise their right to remain in the country. Indeed, in farm 'A' 
we found a case of the third generation of a family originating from Malawi now working for 
the employer on whose farm his father had been born. But there is a wide range of coliform 
counts among both Malawians and Zimbabweans; and in the observational exercise, some of 
the worst cases of poor hygiene practices were Zimbabwean families.
Case Study: Hygiene Behaviour 67 
Although from replies to the questionnaire, people are generally aware of expected ideals: 
people responded to the questionnaire with standard times for hand-washing and body 
washing generally, with the exception that few mentioned washing hands after toilet use (see 
the table below). The practice was well below the ideal. In most families, people did not wash 
their hands before the untraditional meal of bread and tea in the morning, or porridge eaten 
with spoons (in contrast with observations in the traditional village). Occasionally, children 
failed to wash their hands before other meals. Frequently, children failed to wash their faces 
and hands in the mornings, although only four out of 27 respondents failed to mention this as 
a time when hands should be washed (as compared with 21 out of 53 in the other areas). In 
only one family was body washing a daily occurrence. It was noticed, however, that in one 
case, when the children went to eat with their grandmother, also on the farm, she insisted on 
their washing faces and hands. In some cases, hand washing was omitted before food 
preparation. Perhaps traditional practices, and general educational discipline, die away in the 
farm communities which are cut off from their traditional networks, and where mothers often 
have to work long hours to supplement the low incomes of their husbands. 
No-one was observed to wash their hands after toilet use in December, and this 
corresponded with the frequent failure to mention such occasions in the unprompted question 
on hand-washing (see the table below). Even when hands were washed before food 
preparation, no further washing was deemed necessary, notwithstanding the fact that hands 
frequently came in contact with floors smeared with cow-dung, and even when babies' 
nappies were changed in the middle of food preparation. In some cases, children were 
observed to eat scraps of food which had dropped to the floor. There is clearly need for some 
education in this area. 
This is not to deny the health problems arising from poor toilet facilities and problems with 
flies in two of the three farm compounds, which must in part account for the high coliform 
counts. 
Epworth 
The Epworth environment is peri-urban, and the links between residents there are considerably 
weaker than they are in the other two communities. Residents vary greatly in socioeconomic 
status and in life styles. 
The area originally comprised three adjacent farms owned by the Methodist Church. 
People long established in, and working for, the church were given plots of land to settle on. 
Then in the late 1960s and 1970s settlement became less discriminate, and escalated without 
any proper planning during the war years. Now the official population of the area is around 
36 000, and the actual population considerably in excess of this. Plot sizes are larger than in 
other high density areas around Harare, the smallest being 600 square metres, and 2000 square 
metres is a common size. There is no piped water supply and no articulated sewerage system. 
In the early 1980s, people collected water from shallow wells, very often unprotected, and 
used primitive pit latrines on the same properties. To avoid the potentially catastrophic health 
risk, the Ministry of Health, through the Blair Research Institute, established covered wells 
with hand pumps at approximately 500 metre intervals, and started to subsidise the building
68 MFCBowdilton 
of improved Blair toilets. Although sometimes the wells are relatively close to the toilets on 
the same plot, tests show that the soil adequately filters the water for consumption purposes. 
By July, a number of the pumps had been in vandalised. In one case, the pump was 
apparently broken by women fighting over who got there first The more usual cause of 
vandalism were people coming at night to collect the piping in order to make illegal stills. 
The sample for the microbiological study was taken from two areas. One is a relatively 
poor area, furthest from Harare, and relatively recently settled. There is a secondary school 
situated in the area, but other services are meagre. The main shopping centre is a couple of 
kilometres away. The second area is nearer to the main shopping area, comprising largely 
wealthier households, long established in this peri-urban environment. 
Six families were observed and interviewed, four householders and two families of 
lodgers in these households (which were omitted from the survey conducted by the 
microbiological team). In all families, there were clear economic problems in giving children 
an adequate diet, with certain types of food or occasional meals being missed. In the poorer 
area, none of the families had three regular meals a day, and in each there was some evidence 
of kwashiorkor in at least one of the children. 
Hygiene 
All the famines chosen had a number of small children, and all reported trouble with diarrhoea 
in the younger children in the recentpasL In the poorer area, open pit latrines were used. Even 
where improved Blair toilets had been built in one case children used open pits to deposit their 
excreta. In three of the houses, flies appeared to be a problem. At one, the external drying 
rack for kitchen and eating utensils was right next to the rubbish pit. 
In no case, was anyone observed to wash hands after using the toilet, although three of the 
four mothers in interview said that they did so, and one insisted that she makes the children 
do so when she is about. In two cases of mothers with small children, it was evident that the 
mothers saw no danger of contamination from the faeces and urine of small children. The 
mother did not wash her hands even in one case after changing a dirty nappy in the middle of 
food preparation. 
In all observed cases, all washed their hands before and after formal meals; although in one 
case children often ate leftovers without washing their hands, and in another the hand-washing 
consisted of no more than a perfunctory dip in the water. In some other cases, the quality of 
the washing water was questionable. 
Bathing in the afternoon seemed to be fairly regular in all households. In only one did the 
children appear grubby and unwashed for some time on the first visit, and they were all bathed 
on a subsequent visit In most cases, toilets were used for bathing all but the smallest children. 
Drinking water was always kept in a container in the living quarters, and appeared clean, 
although in three cases children had access to it and occasionally dipped their unwashed hands 
into it In one case, the container was not even protected from poultry that occasionally entered 
the room. 
In June-July, the research assistant visited eight of the houses that were issued with 
mukombes, and only four of these had water in them and appeared to be in use. In other cases, 
the mother ofthe family claimed that it was usually used, and that it happened to be empty by
Case Study: Hygiene Behaviour 69 
oversight In one such case people were observed to use the toilet without a thought of hand 
washing, and in another the mukombe was still empty on a subsequent visit In half the cases, 
however, the mukombes were used. One woman commented on how useful they were, and 
that there had been no problems with diarrhoea in her family since the mukombe had been 
installed. 
Some general comments on the knowledge and practice of hygiene 
Although a number of interesting points have been raised, the small numbers involved in the 
study are insufficient for conclusive generalisations. Secondly, data on the incidence of 
disease was not adequate for any statistical analysis. It has been pointed out that the traditional 
custom of washing water containers and utensils out with sand immediately before use might 
effectively reduce the contamination of food and drink by coliforms which at other times are 
abundant on people's hands. The fact that people do not normally wash after defecation does 
not necessarily mean that food or drink thereby become contaminated (Government of 
Zimbabwe, 1985). Traditional knowledge and practices to do with health and hygiene are 
often effective, even when the knowledge behind them does not conform to scientific norms. 
Without information on the incidence of disease in relation to hygiene practices, there is a 
danger of ethnocentric prejudice. 
The relationship between knowledgeandhygienic practices remains interesting. Although 
observations covered only a small number of people and should be treated with caution, the 
responses to the unprompted question on hand-washing across the three areas, in relation to 
observations, bears some consideration (see Table 1). 
It appears that those for whom washing before meals is automatic often fail to mention it. 
In areas where the practice is occasionally omitted, it comes closer to the fore in people's 
consciousness. In the case of washing first thing in the morning, the people most lil&ly to 
mention this are those in the area where the traditional practice is notstrictly observed. In these 
cases, the answers to the questions appear to reflect consciousness of change rather than 
practice. 
When a new practice is being introduced, consciousness is probably related to practice. 
The introduced ideal of washing after using the toilet is not generally known on the farms. The 
infrequent mention of breasi-feeding, nappy changing and helping a child with the toilet is 
partly explicable in terms of the irregular presence of children of the appropriate ages, but 
nevertheless seems to indicate the need for further education in these areas; also for education 
on the dangers from, and sources of, micro-organisms. 
It has already been observed that people traditionally take pollution from the faeces of 
small children as less dangerous than those of adults. Small children are often allowed to 
defecate in the immediate vicinity of living quarters, and their faeces may be simply disposed 
of with other rubbish in a pit in the yard (Government of Zimbabwe,1985). Observations in 
Epwdrth and the farms supported this finding. It is a common factor in human cognition that 
things encountered frequently are perceived to be less threatening than things which occur 
infrequently. In the sociology of medicine, the frequency of a disease is known to affect how 
seriously it is taken in any particular society. Inattention to the excreta of small children is
70 M F C Bourditlon 
another example of the same phenomenon. When small children are around, contact with their 
faeces is a common occurrence. Accordingly, people get blase about the danger of pollution 
from these; and this attitude is justified in terms of an ideology which denies the dangers of 
pollution from such a source. 
On the importance of hand-washing, in the more traditional communities in Zimbabwe 
this is associated with a fad of the Whites. One of the signs that a woman is afflicted or 
possessed by the spirit of a white person is that she goes about washing her hands and 
demanding soap! Responses to the questionnaires confirm this. Grossly exaggerated 
accounts were given on the frequency of body washing by all communities, and positive 
responses were given to all the prompts on hand-washing. Also 76 out of the 80 said they 
always use soap for dish-washing. Although the constraint is often financial, few families in 
fact conform to this response. I would suggest that those with more education are likely to 
be more attuned to new values, and more likely to place an importance on hand-washing, 
without necessarily knowing the reason why. 
Table 2 is interesting in this respect, although it would be difficult to find any statistical 
significance in the variations. It suggests a ritualistic attitude to cleanliness on the part of some 
people in the rural village, and surprisingly a better knowledge of reasons for cleanliness on 
the farms. 
A suggestion has been made that the ritual status of many traditional water sources are 
associated with a number of traditional hygiene practices; such as the consequences which 
await those who might abuse communal water sources, taboos against the use of cooking 
vessels for water collection, and the practice of rinsing buckets with water and a handful of 
sandbeforecollection(GovernmentofZimbabwe,1985). If the more frequent washing in the 
traditional village is contrasted with better reasons for washing given on the farms and in the 
peri-urban area, there is a suggestion that a ritualistic approach is more effective than a 
knowledge of relevant causal factors. Habit and custom are more effective determinants of 
behaviour than rational argument; and habits are formed only through frequent and regular 
sanctions - such as the words of a vigilant community worker. 
Custom encourages people, from childhood onwards, to conserve water. The mere 
provision of readily available water does not of itself create better hygiene, as the situation on 
the farms, and particularly on farm 'A', indicate (Saugestad,1989). New values have to be 
created, and new habits formed, if hygiene is to be improved. 
FOOTNOTES: 
1. The difference in these figures for the rural area on the one hand, and the farms and peri-urban area on the other, 
gives a chi-squared value with a probability of less than 0,05 and greater than 0,02. The report by Kaltenthaler, 
Chawira and Waterman indicated that education was not significantly correlated with area, but in their 
calculations and tables they never combined Epworth and the farms in contrast to Nyamungaya. 
2. Since the research was carried out, the role of the village health worker has been absorbed in the role of 'village 
community worker', a paid part time civil servant, responsible to her employers rather than the community. 
3. A survey of 3 340 households sampled from all eight rural provinces of Zimbabwe showed the mean distance 
to water sources to be 718m in the wet season and 992 in the dry (Government of Zimb»bwe,1985). 
4. The report by Kaltenthaler et al simply refers tc the statistically significant correlation between 'area' and 
coliform count (see section 6.1.2). The authors do not comment on the fact that the data for farmi was highly 
skewed by the data from Farm 'A', which was difficult to explain.
Case Study: Hygiene Behaviour 71 
References 
Government of Zimbabwe (1985) National Master Plan for Rural Water Supply and 
Sanitation, Vol4,2, Social Studies, Ministry of Water Resources and Development, 
NORAD. 
Kaltenthaler E, ChawiraF and Waterman R (1988) Traditional Handwashing in 
Zimbabwe and the Use of the Mukombe: Microbiological and Behavioural Aspects, 
Blair Research Laboratory, Harare. 
SaugestadS (1989) Patterns in Water Use: Observations from the Manicaland 
Integrated Rural Water Supply and Sanitation Programme, University of Tromso, 
Norway. 
Table 1 
Responses to Question on Handwashing 
22 
No of Positive Responses 
Periurban Farm 1Rural 
16 
16 
2 15
2 
16 
15 
15
1
1 
12
1 
1
4
8
2
3 
21 
23
7 
20
3
3
8
2
2 
Before meals* 
First thing in the morning * 
After using the toilet + 
Before preparing food* 
Before breast feeding 
After changing nappy 
When they are dirty 
After assisting child with toilet 
Other times 5 
N 27 27 26 
* ,l>P>,0; +,05>P>,03; #,2:>P>,1. 
Table 2 
Importance of Hand-wash ing 
No of Positive Responses 
Periurban Farm Rural 
1 - 2 Not important 
Important 
-for disease prevention 1
3
6 1
9
7
0 11 
3
9 
- to clean hands * 
- to keep food clean 
- don't know why 
(Missing responses) 
6
-- 
- 
(1) 
1 
(1) 
N 26 27 27 
* ,l>P>,05