Abstract:
Due to the semi-arid nature of Makueni County in South-Eastern Kenya, there is a high
dependence on groundwater resources for domestic use. Reliance on this source of potable water may
have health implications for the population, given the presence of several naturally occurring and
potentially harmful elements reported from aquifer source rocks, soil, and water in the area. A survey
involving questionnaires and focus group discussions (FGDs) was conducted with 115 individuals
to determine the local population’s knowledge, attitude, and perceptions of their drinking water
quality and its health impacts. The results show that most respondents (67%) preferred piped water
because it was pre-treated and not saline. Only 29% of the respondents were very satisfied with the
taste of their drinking water, while the rest complained about varying salinity levels, ranging from
slightly salty to very salty. This low satisfaction might have influenced the low daily drinking water
consumption (1–2 L) by most respondents. Health issues reported by many (43%) respondents in the
area include diarrhoea and gastrointestinal upsets, which may be associated with the saline nature of
the drinking water. Elevated fluoride (F−) in the local groundwater was reported, and the health
effects remain a concern. Although 91% knew someone with dental fluorosis, 53% did not know the
deleterious effects of high F− in drinking water. Most respondents (59%) associated the salty nature
of the water with dental fluorosis, and as a result, 48% avoided drinking the salty water to prevent
the condition. Despite the high prevalence and known psycho-social effects, most people did not
perceive dental fluorosis as a severe health threat. The increased health risks associated with high
salinity and high F− in drinking water in Makueni County are poorly understood by most residents,
regardless of their education, gender, or age. This warrants an immediate public health education
programme and detailed epidemiological studies to determine all the health effects associated with
naturally occurring, potentially harmful elements in groundwater in the area.
