Vulnerability

For the purpose of this study, vulnerability will be defined both as “...the degree to which a system, subsystem, or system component is likely to experience harm due to exposure to a hazard, either a perturbation or stress/stressor” (Turner et al., 2003, p. 8074), and “... the characteristics of a person or group and their situation that influence their capacity to anticipate, cope with, resist and recover from the impact of a natural hazard...”

(Wisner et al., 2004, p. 11).¹

It is common to think of a disaster as a sudden perturbation or spike in pressure in a system such as an acute outbreak of cholera or a devastating flood, however pervasive stress and continuously present and slowly increasing pressure on a system can have equally disastrous impacts (Blaikie, Cannon, Davis & Wisner, 1994; Turner et al., 2003; Wisner et al., 2004). Thus, in a community with frequent exposure to the hazards of untreated

wastewater and associated bacteria and parasites, any diarrhoeal disease in that community constitutes a disaster. The presence of the hazard itself is not the disaster, as natural events cannot be considered disasters until negative consequences are experienced. One is further not vulnerable to a flood, earthquake, or other natural disaster; they are vulnerable to the loss of life, livelihood, assets, or income, that may be caused by these hazards (Vatsa, 2004).

One conceptual tool available for the analysis of vulnerability is the Pressure and Release (PAR) Model (Blaikie et al., 1994; Wisner et al., 2004). In this model, root causes of vulnerability are present, and are translated by dynamic pressures in the system into unsafe conditions. The presence of these unsafe conditions means that when a hazard event occurs, individuals and communities are susceptible to damage and disruption (Wisner, et al., 2004).

Increases at any of the stages along the progression of vulnerability lead to a build-up of 1 The concept of vulnerability was originally put forth by Blaikie et al. (1994) in the first edition of the book At Risk: Natural hazards, people’s vulnerability and disasters., and then further developed and elaborated upon in the second edition in 2004, where Ben Wisner is listed as the first author for his significant contributions to the process.

'pressure' which is released when the vulnerable parties are exposed to a hazard and the 'release' occurs in the form of a disaster. The value of the PAR framework is that it “directs attention to the conditions that make exposure unsafe, leading to vulnerability and to the causes creating these conditions” (Turner et al., 2003, p. 8074). PAR can be used in conjunction with the Access Model (Wisner et al., 2004), which takes into account capabilities, assets and livelihoods available for reducing vulnerability.

For the purposes of this study, the presence of coliform bacteria and phosphorous (as indicators of sewage contamination) in drinking water wells will be considered as a hazard.

When this hazard intersects with unsafe conditions, it leads to negative health impacts.

Thus, according to the PAR model, the outbreak of any water-borne infectious disease is a disaster to affected communities.

Birkmann and Wisner (2006) define four thematic areas within root causes of vulnerability as: social, economic, environmental and institutional. Social contributors to vulnerability include aspects of their identity such as gender, age, race, ethnicity and religion, alongside “Social relations and the historically rooted patterns of discrimination, inequity in access to resources, and power...” (Birkmann & Wisner, 2006, p.16). The economic area includes source of livelihood, educational status, and income level.

Environmental vulnerability encompasses the likelihood of a hazard occurring in the immediate environment of an individual. Lastly, institutions like governments, businesses, markets and health systems play an influential role in the ability of individuals and

communities to respond to extreme events when they do occur (Birkmann & Wisner, 2006).

The dynamic pressures that mediate the creation of unsafe conditions, and therefore the influence of these hazards, are multidimensional. Rapid urbanization and population growth, for example, represent changing conditions that create new and exacerbate old stresses on communities' abilities to provide clean water and handle waste appropriately.

Salinisation of aquifers and lack of widespread access to piped water and adequate sanitation can both lead to transient water insecurity. The inability to access safe and

sufficient water for drinking and household use creates an unsafe condition which increases risk of exposure to disease causing pathogens, as those who are water insecure may be driven to depend on sub-par water resources. Further unsafe conditions may stem from lack

of community awareness of best practices for preventing water contamination and protecting public health. It is possible to represent this progression of vulnerability by adapting a well known figure from Wisner et al.'s (2004) book At risk: Natural hazards, people’s

vulnerability and disasters (Figure 2). Another way of understanding this is that the risk, or likelihood of negative impacts in a coupled human-environment system, is a function of the sensitivity and exposure of that system and its component parts, combined with its capacity to adapt (Adger, 2006). Risk is defined by Wisner et al. (2004) as an objective hazard mediated by social processes, determined by a micro-environment including educational and nutritional status, access to water and sanitation, and livelihood. Thus, to decrease pressure -thereby reducing risk- one must first understand the root causes of vulnerability, and how it can be possible to address them through reducing sensitivity and exposure, improving the micro-environment, or increasing adaptive capacity.