Towards understanding the water and sanitation hygiene beliefs and practices of the Twa of south-west Uganda
The Twa of south-west Uganda have reported high morbidity and mortality rates since eviction from their traditional forest lands in 1991. This study seeks to identify their current beliefs with regard to health and hygiene practices. The study is based on semi-structured interviews with 20 individuals in three communities in Kanungu district, Uganda. The Twa attributed most illnesses to changes in their lives, such as food and smells, which fitted a narrative of leaving an idealized forest life. Views with regard to illness prevention ranged from a belief that nothing could be done, to using practices without understanding the reasons for their efficacy (or otherwise), to a use of practices informed by an understanding of Western germ theory. Hygiene behaviours have been adopted where external teachings or practices of neighbours make sense in the Twa world view. It is therefore recommended that future hygiene promotion takes a participatory form, rigorously identifying and working with existing beliefs.