Sustainable Water and Health Solutions for Moshi

Authored by: Abby Chang

Art by: Kenneth Li

As the sun rises over Moshi, Tanzania, Mount Kilimanjaro appears from the morning fog like a guardian in silence. Its glaciers, long seen as symbols of East Africa's abundance, feed springs and rivers that sustain generations of farmers, families, and communities. The mountain is more than symbolic; it is a lifeline. That lifeline, however, is under strain. Rising temperatures accelerate glacial retreat, and rainfall patterns are increasingly erratic. As a result, the security of Moshi’s water systems, and its capacity to withstand climate impacts, grows more uncertain each year [1, 2].

In the heart of town stands the Kilimanjaro Christian Medical Center (KCMC), the largest referral hospital in northern Tanzania. Caring for over 11 million people across East Africa, it depends on a steady source of clean water for surgery, sanitation, and laboratory diagnostics. When supply falters through fractured pipes, drought, or inconsistent treatment, consequences ripple through wards and neighborhoods. At times, water is diverted from community points to hospital operations [3]. Although Moshi is not yet in a full crisis, its present status signals a regional turning point. The factors that once guaranteed water reliability such as glacial runoff, stable rainfall, and moderate population density are shifting. Acting before scarcity becomes systemic is not only strategic; it is a public health and moral imperative.

Kilimanjaro has long been among the water-richest regions in Tanzania, with forest catchments, spring-fed rainwater, and groundwater aquifers [1]. These natural resources support agriculture, urban life, and institutions like KCMC. Yet glacial evaporation and retreat, which exceeds 80 percent since the early 20th century, and increasingly variable rainfall have disrupted this equilibrium [2, 6]. At the same time, Moshi’s population grows, increasing stress on water infrastructure built more than five decades ago. Although MUWSA works continuously, it is often overwhelmed by aging metal pipes and strained reservoirs. Leaks are common, contamination remains a threat, and service interruptions are increasingly frequent [4]. These issues are not unique to Moshi. Urban systems across sub-Saharan Africa lose up to 35 percent of water to inefficiency and leakage, which affects households and healthcare systems alike [5].

Moshi’s story reflects the broader reality of many mid-sized towns in the Global South. These communities are large enough to face complex water needs but often too small to receive consistent investment. They are becoming the frontlines of climate-linked water insecurity. Limited infrastructure, population growth, and environmental instability all contribute to this pressure [7].

One Health and Shared Survival

The One Health framework offers a useful way to understand this challenge. It emphasizes that human, environmental, and social system health are connected [8]. In Moshi, this is visible. Poor water supplies and infrastructure failures undermine infection control, nutrition, and hospital safety. Improved water management strengthens both ecosystems and healthcare delivery. Moshi’s tropical rainforests also rely on Kilimanjaro’s water tower for adequate supply. All of these systems are tied to the same source and are similarly vulnerable to water shortages. Fortunately, awareness within KCMC is encouraging proactive responses.

Health professionals are collaborating with engineers, researchers, and local NGOs to implement small-scale environmental projects, including permaculture education and reforestation, to stabilize the water table [3]. For Moshi, climate change is not only a distant threat. It is increasingly visible in daily life. The community is shifting from treating environmental change as background context toward treating it as a central target of health action.

The Future Begins Now

Urgency lies in timing. Moshi still has the opportunity to act before water scarcity becomes severe. Many regions have already crossed that threshold, and many more will soon. Building water resilience will require foresight, coordination, and balance between technology and community engagement [2]. Practical interventions, developed with input from the Moshi community, can help support a secure water future [9]:

1. Rainwater harvesting: Implement roof and gravity-fed systems using the Kilimanjaro Concept to supplement supply during dry periods and relieve pressure on springs and boreholes.

2. Infrastructure renewal: Replace old metal pipes with corrosion-resistant HDPE to limit leakage and allow regular chlorination.

3. Cross-sector collaboration: Improve coordination among KCMC, MUWSA, and NGOs for data sharing, investment planning, and emergency response.

4. Public education: Provide school and hospital programs with emphasis on water conservation, hygiene, and climate resilience awareness.

5. Water monitoring and transparency: Establish a shared surveillance committee to track water quality, usage, and early signs of system failure.

   
   

These measures are not only technical solutions. They are acts of care and governance. Investment in resilient water systems protects infrastructure, lives, livelihoods, and community trust.

Resilience as Collective Responsibility

The story of Moshi has implications far beyond Kilimanjaro’s slopes. It reflects a global reality. The wellbeing of people, the planet, and the environment are tightly connected. Water security supports public health, food production, economic growth, and social cohesion. When water declines, all of these pillars weaken [6]. Moshi has not yet reached a crisis stage. Preventive action is still possible. Lessons from this region can guide similar responses across East Africa and the Global South, where climate change and rapid urban growth create shared challenges. Tanzania’s water and climate policies highlight that adaptation is not a single initiative. It is a continuous and collective process built on planning, learning, and community participation [4].

As the sun declines, Kilimanjaro’s glaciers still reflect the day’s final light, faintly glimmering along the horizon. Their slow retreat is a warning and a call to action. Protecting the water systems they support is not only a technical task. It is a matter of public health and shared responsibility. The choices made today in Moshi will determine whether mountain waters continue to sustain life for generations. Water is more than a commodity. It is a shared inheritance. To safeguard it is an act of science, stewardship, and solidarity.

References

1. Agrawala, S., Moehner, A., Hemp, A., Aalst, M. V., Hitz, S., Smith, J., & Mwaipopo, O. U. (2003). Development and climate change in Tanzania: Focus on Mount Kilimanjaro. OECD.

2. Codalli, A., Mboya, J., & Mcharo, L. (2024). Water scarcity, infrastructure, and adaptation in the Kilimanjaro region: A systems-based approach. University of Dar es Salaam Environmental Research Series, 12(4), 57–69.

3. Seijger, C. (2023). Integrated water management and resilience planning in Tanzania’s northern highlands. Water Policy, 25(3), 455–471.

4. GIZ — Deutsche Gesellschaft für Internationale Zusammenarbeit. (2021). Water Sector Development Programme Phase II (WSDP II): Evaluation Report. Dar es Salaam.

5. World Bank. (2023). Water Supply and Sanitation in Sub-Saharan Africa: Challenges and Opportunities for a Resilient Future. World Bank Group.

6. Tarrass, F., & Benjelloun, M. (2012). The effects of water shortages on health and human development. Perspectives in Public Health, 132(5), 240–244.

7. Qi, W., Reidsma, P., Su, B., Xia, T., & Deng, H. (2019). Exploring water sustainability and resilience in African mid-sized cities. Environmental Research Letters, 14(9), 094011.

8. Pitt, S. J., & Gunn, A. (2024). The One Health concept. British Journal of Biomedical Science, 81, 12366.

9. Chang, A., Sinda, D., Fabian, E., Craig, L., Masubi, N., Anga, S., & Jongo, Y. (2025, June). Facilitating climate change readiness through education and sustainable partnerships in the context of water stress in the Kilimanjaro region, Tanzania: A policy case study. Cornell University & Kilimanjaro Christian Medical University (KCMU).

10. Deus, D. (2016). Water resources management in Tanzania: Challenges and future prospects. African Journal of Environmental Science and Technology, 10(12), 467–479.