Component A - Housing, Crowding and Hygiene
Forty-one of the 47 houses (89.3%) had one or more items described as needing major or urgent repair or an item considered essential was missing. Among these houses, the primary reasons for household items having major problems (n = 49) were the provision of inappropriate technology (28.6%, n = 14), normal wear and tear (26.5%, n = 13) and inappropriate use (20.4%, n = 10). The primary reasons for household items needing urgent repairs (n = 90) were normal wear and tear (27.7%, n = 25), inappropriate technology (20%, n = 18), general damage (18.8%, n = 17), inappropriate use (14.4%, n = 13) and malicious damage (12.2%, n = 11). Combining the results from these two categories (major problems and urgent repairs) found that normal wear and tear (27.3%, n = 38) was the most common cause of items needing major or urgent repairs. The provision of inappropriate technology ranked second (23%, n = 32). General damage, considered to be caused by residents trying to do repairs themselves, accounted for 13.7% (n = 19) of the urgent or major repairs required. The three government officers who completed the 2002 Pilot Study housing survey believed there were several likely reasons to explain these findings.
Firstly, they considered that at the time of the survey the community did not have the resources available to undertake the timely repair and maintenance of essential items. This meant that the service was unable to be proactive in its activities. After speaking to housing administrators and households, it was clear that there was a vicious cycle. Administrators blamed the households for the large amount of repairs required, and households blamed the administrators for allowing infrastructure to deteriorate. Many households had stopped reporting their repair needs because the waiting time for repair services was so long, or believing that action would not be taken. It appeared that some householders failed to recognise that items of infrastructure required ongoing maintenance to stay in good order, while not reporting problems early (when minor repairs would suffice) was also an issue.
Wear and tear, thought by the focus group participants to be the result of increased usage due to crowding, was found to be responsible for 27.3% (n = 38) of items of infrastructure that needed repairs. The reasons for three toilet cisterns needing repairs included normal wear and tear (2) and general damage (1). The reason for 30 of the 45 taps needing repair was normal wear and tear. Participants considered that a timely repairs and maintenance service would have prevented the need for some repairs and the extent of the problem with others. Faulty or non-functioning infrastructure items considered inappropriate because of design issues or the materials used included hot-water systems (17), kitchen bench tops (10), stove tops (1), ovens (4).
The two categories, 1) the provision of inappropriate essential housing infrastructure items and 2) inappropriate use by householders, somewhat overlap. The first category focuses on the quality of items (workmanship, materials used and design), while the second takes account of householder behaviour. Some might see the former as the primary cause of the problems, while others see householders as primarily responsible.
Inappropriate use of infrastructure items accounted for 16.5% (n = 23) of the repairs needed. The items affected by inappropriate use included stovetops (9), ovens (9), bathroom basins (2), shower drains (2) and toilet pan (1). Examples of the inappropriate use of stovetops by householders included placing heavy cooking pots on the coil elements causing them to break and using elements in place of matches to light cigarettes.
The focus group participants believed that the non-functioning infrastructure items categorised as general damage (13.7%, n = 19) also reflected the absence of a timely and effective repairs and maintenance program in the community. The category 'general damage' was included in response to the concern that some items of infrastructure might be incorrectly identified, based on appearance only, as intentional damage. Participants considered that this type of damage occurred when items became faulty or non-functional and householders' failed attempts to undertake repairs made the problems worse.
Thirteen items were considered to need repair, or were missing, due to malicious or other intentional damage. Householders frequently reported that individuals under the influence of drugs or alcohol, or 'petrol sniffers' caused this type of damage.
Of the items missing from houses (n = 41) but urgently needed, seven houses (17%) did not have a functioning refrigerator, and 17 (41%) did not have a functioning washing machine.
In only two cases (1.4%) was the primary reason for an item needing to be repaired coded as 'indeterminate'. This highlights the confidence the participants had in stating what the primary reason was for items needing repair, as well as the degree of consensus as to the reasons why infrastructure items progressed to have serious problems. The alternative reasons provided generally resulted in the reversal of the options normal wear and tear and use of inappropriate technology, and inappropriate use by residents and general damage.
The results of this study indicate that in the study community household residents, and particularly the young children, live constantly with a medium to high-level risk of acquiring infections from environmental contamination. In 19 (42.2%) of the houses, faeces or other decaying matter such as meat and other food remnants was observed in the immediate living environment. In five (11%) of the houses contaminated matter was observed on surfaces both inside and outside the house.
A significant level of crowding was present in many of the houses with young children. The mean number of persons per bedroom in the houses where children under seven years lived was 3.4. In 38 of the 47 houses, the housing occupancy standard [
34] of a maximum of two persons per each available bedroom was breached. However, there was no statistically significant association between the level of crowding and the number of items that needed repairs or missing items.