Climate, Water and Community Health: COHESU’s Work on Schistosomiasis

Along the shores of Lake Victoria, COHESU is exploring how climate variability, everyday water use and community-led digital tools can inform the response to schistosomiasis.

For many communities in Kisumu, western Kenya, Lake Victoria is central to daily life. It supports livelihoods and provides water for household activities and livestock. These connections to the lake also shape people’s exposure to schistosomiasis, commonly known as bilharzia.

COHESU’s ongoing work examines how changing environmental conditions interact with people’s livelihoods, access to clean water and ability to seek treatment. Alongside this research, we are testing a WhatsApp-based platform to help communities access health information and connect with care.

Understanding a changing environment

Schistosomiasis transmission involves freshwater snails that act as intermediate hosts for the parasite. Rainfall and temperature can affect the conditions in which these snails survive and reproduce.

These relationships are complex. Rainfall can create suitable snail habitats, while heavy flooding can disrupt or displace them. Temperature changes can also affect snail populations, with different effects depending on local conditions.

Climate variability changes how people use water, too. In the communities where we work, flooding can temporarily displace households and disrupt sanitation systems. During dry periods, people may move closer to the lakeshore or rely more heavily on lake water for domestic use and livelihoods.

Understanding these patterns means looking beyond the environment alone. It requires listening to communities about where, when and why they come into contact with freshwater.

Fieldwork at a waterlogged site.

Connecting communities through WhatsApp

COHESU is testing a community health information and surveillance platform built around WhatsApp, a familiar communication tool.

The platform is designed to bring together accessible health information, community-based reporting and connections to treatment services. It aims to provide locally relevant messages about schistosomiasis, including information on transmission, prevention, symptoms and how to access care.

An important part of this approach is connecting community members with community health workers for treatment support and referrals. The project is also exploring how health messaging can respond to changing conditions, including periods of heavy rainfall and flooding.

By using a widely used platform, we aim to reduce barriers to information while generating community-level insights that could help guide public health responses. The project is testing how these elements can work together in practice.

Recognising different experiences of risk and care

Communities do not experience schistosomiasis in the same way. Our work points to differences in exposure and treatment-seeking shaped by gender, livelihoods and household decision-making.

Living close to the lake, collecting water, caring for livestock and carrying out other daily activities can create different patterns of water contact. Access to clean water and sanitation also matters.

The ability to seek care is another part of the picture. Knowing about a disease does not always mean someone can act on that information. Household responsibilities and decision-making power can influence when and where people obtain treatment.

These findings reinforce the importance of designing interventions around people’s circumstances. Advice about reducing water contact must account for the fact that water-based activities may be essential to a household’s income or daily needs.

Participants sharing knowledge during a workshop.

Building the response with communities

Community members, citizen scientists, health workers and policymakers each bring knowledge that can strengthen this work. Involving them from the beginning helps ensure that new tools respond to local priorities and are practical to use.

Our approach brings these perspectives together with environmental research and community health information. It also highlights the importance of clean water and sanitation as part of disease prevention and climate resilience.

Through this ongoing project, COHESU is exploring how community knowledge and accessible digital tools can support a more responsive approach to schistosomiasis—one grounded in the realities of life around Lake Victoria.