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F. Tom, M.A., M.D., M.P.H.

Deputy Director, University of Central Florida College of Medicine

Stakeholders consulted during the development of this report came up with several recommendations for strengthening national capacity to address the challenges of climate change for rural and urban livelihoods. Policy measures require Zimbabwe to build resilience to climate related shocks and stresses for both rural and urban areas. The effects are particularly significant in specific rural areas in the country where crops fail and yields decline because of the frequency of droughts and long dry spells. As noted in Chapter 4 extreme weather events such as floods disrupt supply and market chains, resulting in spikes in food prices, and loss of productive assets and livelihood opportunities, which affect human wellbeing and developmental progress negatively. Since drought and dry spells were identified as leading hazards at national consultations held in the process of developing this report, efforts need to be made to rehabilitate and improve water related infrastructure. Zimbabwe has the highest number of inland surface dams in Southern Africa, after South Africa, However, the utilisation of these dams for irrigation has been limited for a variety of reasons, such as lack of investment in irrigation infrastructure and perceived insecure land tenure arrangements. Irrigation is vital to countering the negative effects of drought, especially in the drier regions of the country where most of the rural population resides and is reliant on rain-fed agro-systems and climate sensitive livelihoods. Business models that can sustain the operation and maintenance of irrigation schemes should be promoted. Investments should be centred on drip irrigation infrastructure, as opposed to overhead sprinklers or pivot irrigation where much water is lost to evapotranspiration. Dam rehabilitation and training communities, especially young people, on catchment management are central to reducing siltation of dams and improving irrigation facilities. It is necessary to review water resource infrastructure and to design dams, bridges and levees that accommodate droughts, flooding, and extreme events. Stakeholders recognised the importance of capturing or harvesting flood waters and the potential this action has for recharging groundwater supplies. Rainwater harvesting can also supplement water sources when their volume decreases. Past development interventions have not been sustained, primarily because of a focus on the functionality of hardware while neglecting the business model and institutional arrangements which underpin viability and sustainability of such schemes (Spooner, 2014). It is estimated that agriculture use currently accounts for about 80 percent of the surface water resources used in economic activities. The amount of water stored as groundwater in Zimbabwe is still unknown so it is important to improve on knowledge on groundwater storage to ascertain whether there is enough groundwater to cushion the country to the impacts of climate change, ensure agricultural productivity and improve food security. Improvement in water Boreholes Stakeholders pointed to the need to exploit underground water resources further. In this 144 Zimbabwe Human Development Report 2017 respect, the need to drill more boreholes was emphasised, as boreholes normally provide safe drinking water. This would help to increase community access to clean and safe drinking water and reduce the health risks associated with using condemned water sources, while reducing the distances that people, in most cases women, travel to fetch water. Stakeholders felt that this needs to be done for both rural areas and the high density urban residential areas that face piped water shortages and the associated health threats. Related to these programmes, is recommended that Government equip the District Development Fund with appropriate and adequate machinery and equipment for undertaking borehole drilling and dam scooping exercises. Efforts should be made to address the bottlenecks faced by communities in adopting climate smart agriculture. These authors argue that land suitable for sorghum and maize will decrease particularly in the south-western parts of the country, while cotton production is more likely to thrive.

Following is a key to the entries: airport Capitalize as part of a proper name: La Guardia Airport, Newark International Airport. The Boston airport (lowercase airport) would be acceptable if for some reason the proper name, Logan International Airport, were not used. Guidance on how to use a particular abbreviation or acronym is provided in entries alphabetized according to the sequence of letters in the word or phrase. An acronym is a word formed from the first letter or letters of a series of words: laser (light amplification by stimulated emission of radiation). For guidelines on how to use titles, see courtesy titles; legislative titles; military titles; religious titles; and the entries for the most commonly used titles. Abbreviate company, corporation, incorporated and limited when used after the name of a 4 corporate entity. If the entry for such an organization notes that an abbreviation is acceptable in all references or on second reference, that does not mean that its use should be automatic. If an abbreviation or acronym would not be clear on second reference without this arrangement, do not use it. Names not commonly before the public should not be reduced to acronyms solely to save a few words. Generally, omit periods in acronyms unless the result would spell an unrelated word. Avoid abortionist, which connotes a person who performs clandestine abortions; use a term such as abortion doctor or abortion practitioner. When used after a name, an academic abbreviation is set off by commas: Daniel Moynihan, Ph. Do not precede a name with a courtesy title for an academic degree and follow it with the abbreviation for the degree in the same reference: Wrong: Dr. Use these abbreviations only after a full name academic titles Capitalize and spell out formal titles such as chancellor, chairman, etc. Academy Awards Presented annually by the Academy of Motion Picture Arts and Sciences. To avoid any suggestion that an individual is being judged before a trial, do not use a phrase such as accused slayer John Jones; use John Jones, accused of the slaying. Because the full phrase would read in the year of the Lord 96, the abbreviation A. Spell them out and capitalize when part of a formal street name without a number: Pennsylvania Avenue. Lowercase and spell out when used alone or with more than one street name: Massachusetts and Pennsylvania avenues. Capitalize them when part of a formal name without a number; lowercase when used alone or with two or more names. Spell out and capitalize First through Ninth when used as street names; use figures with two letters for 10th and above: 7 Fifth Ave. Abbreviate compass points used to indicate directional ends of a street or quadrants of a city in a numbered address: 222 E. Do not abbreviate if the 7 number is omitted: East 42nd Street, West 43rd Street, K Street Northwest. The hyphen entry provides guidance on handling compound modifiers used before a noun. See the government, junta, regime entry for distinctions that apply in using these terms and administration. To avoid the long title, seek a construction that sets the title off by commas: the administrative law judge, John Williams, disagreed. A person who announces that he is a homosexual, for example, may be acknowledging it to the world, not admitting it. See the hyphen entry in the Punctuation chapter for guidelines on when an adverb should be followed by a hyphen in constructing a compound modifier. It occasionally is used in psychology to describe an emotion, but there is no need for it in everyday language.

A 65-year-old man has had increasingly severe headaches and diffuse muscle aches during the past 3 months. He also has a 1-month history of jaw pain when chewing food and decreasing visual acuity in his left eye. Visual acuity in his left eye is 20/100, and the left optic disc is slightly atrophic. A 19-year-old woman comes to the physician because of a 3-month history of intermittent drooping of her left eyelid each evening and occasional difficulty chewing and swallowing. She also has had two episodes of double vision that occurred in the evening and resolved by the following morning. A 72-year-old man is brought to the physician by his daughter because of a 2-day history of confusion, disorientation, and lethargy. He had a cerebral infarction 1 year ago and has been treated with daily aspirin since then. A 21-year-old college student comes to student health services requesting medication to help her sleep. Four days ago, she returned from a 1-year trip to India where she studied comparative religions. She constantly feels tired, has difficulty concentrating, and does not feel ready to begin classes. Her appetite has not decreased, but she has an aversion to eating meat since following a vegetarian diet in India. When asked to subtract serial sevens from 100, she begins accurately but then repeatedly loses track of the sequence. Today, she says she has had a persistent sensation of tingling and numbness of her left thigh that she did not report in the hospital because she thought it would go away; the sensation has improved somewhat during the past week. She has a history of mild hypertension treated with hydrochlorothiazide and hypothyroidism treated with thyroid replacement therapy. Neurologic examination shows decreased ankle jerk reflexes bilaterally and decreased vibratory sense and proprioception in the lower extremities. Laboratory studies show: Hemoglobin Leukocyte count Mean corpuscular volume Serum K+ Urea nitrogen Creatinine Glucose Which of the following is the most likely diagnosis An 82-year-old man is admitted to the hospital because nursing staff in his skilled nursing care facility report that he has appeared sad and depressed during the past 2 months. It is reported that he has a history of psychiatric illness, but details are not provided. A 25-year-old butcher has had severe episodic pain in his right thumb and right second and third digits for 2 months. He has decreased sensation over the palmar surface of the thumb and index and long fingers of the right hand and atrophy of the thenar muscle mass. A 27-year-old woman comes to the physician because of a 3-week history of fatigue and blurred vision. For the past year, she has had 3- to 4-day episodes of numbness and tingling of her arms and legs. Sensation to light touch is decreased over the hands and feet; sensation to pinprick is increased over the fingers and toes bilaterally. A 57-year-old woman comes to the physician because of a 2-year history of difficulty sleeping. After she gets into bed at night, her legs feel cold and crampy, and she cannot settle into a comfortable position. A 77-year-old man comes to the emergency department 1 hour after a 15-minute episode of right arm weakness and an inability to speak in sentences; the symptoms have now resolved. Examination, including cardiopulmonary and neurologic examinations, shows no other abnormalities. Which of the following is the most appropriate next step to prevent cerebral infarction in this patient A 62-year-old man with alcoholism is admitted to the hospital because of somnolence and hepatic failure.

Syndromes

• Destructive sores of skin and bones (gummas)
• The name of the product (ingredients and strengths, if known)
• Wegener granulomatosis
• Belly pain
• Back pain that starts slowly, which gets worse with walking but is not felt when resting
• You touch your nose, eyes, or mouth after you have touched something contaminated by the virus, such as a toy or doorknob
• Brain and nervous system (neurological) factors
• Tooth infection
• The name of the product (ingredients and strengths, if known)
• Come in close contact with other people (such as in sports like wrestling)

Underpinned by theories of social work, social sciences, humanities and indigenous knowledge, social work engages people and structures to address life challenges and enhance wellbeing. For social work in Africa and other countries of the Global South, this step implies an appreciation and encouragement of increased focus on their own cultural values, support systems, and coping strategies (Spitzer, 2018). A number of difficulties and challenges with indigenising social work have been highlighted in literature. Kreitzer (2012) contends that the task for Africans is to change the perception of their cultures as negative and Western-dependent, to being a positive contributor to the world as a precursor for social work to be developed from within. Maathai (2009, 168) had referred to these negative perceptions as the demonisation of African culture and traditions that goes back to the colonial period, and which subsequently led to a split life and an identity crisis by and among African peoples. From an education perspective, indigenisation is also faced with the pressure to train graduates that fit into the global market and context (Osei-Hwedie and Rankopo, 2008). In this regard, indigenisation is mistakenly construed as limiting the global competitiveness of social work graduates. Counter to this argument, Twikirize (2014) contends that indigenisation does not have to imply a total overhaul and rejection of everything considered Western and non-African, but rather to ensure that the ideology, the theories, practice models, and ethical principles are relevant and align well to the context within which social work is practised. Indigenous and Innovative Models of Practice Official definitions of the concept of indigeneity often link it to First Nations or the Indigenous Peoples of North America, Australia, and other mostly industrialised societies that have pockets of original inhabitants of the land in often secluded 8 Social Work Practice in Africa: Indigenous and Innovative Approaches communities, such as the Aboriginals in Canada and Australia, the Maori of New Zealand, and the Ainu people of Japan. In Africa, the Khoisan of South Africa, the Masaai of Kenya and Tanzania, and the Twa of Rwanda, Burundi and Southwestern Uganda could fit this classification. According to the United Nations Declaration (2007), Indigenous Peoples are culturally distinct and often possess a history of colonisation or external invasion that threatens their existence. According to Ibrahima and Mattaini (2017), indigenous knowledge emerges from a range of sources embedded in institutions, relationships and rituals, and is a dynamic mix of past tradition and present innovation and is, thus, ever evolving and usually tacit. Through this way, social work can become genuinely culturally appropriate, relevant, and authentic (Gray, Coates and Yellow Bird, 2008). In other words, we do not use it to strictly refer to practices with or for the officially acknowledged Indigenous Peoples. Since most African societies are still mostly organised around ethnic groups, occupying particular regions of a country and characterised by a number of unique cultures and languages, we choose to use the concept of indigeneity to describe the adopted models of problem solving, healing, and helping as well as the local knowledge systems that are associated with such groups, communities, or even countries. As argued by Ibrahima and Mattaini (2017), developing indigenous approaches to development is linked to indigenous knowledge development, as knowledge is the base for designing interventions and helps to avoid replicating futile programmes. In our case, the underlying endeavour throughout the book is to link such knowledge systems and practices to the social work profession. As stated before, in countries such as Rwanda, indigenous models of helping, healing, and problem solving have been integrated and mainstreamed into national development plans and constitute the main models of community and social development. Indigenous models do take cognisance of the cultures and practices of producers and consumers of social work interventions as well as of the contexts within which social workers practice. They gave examples of how they sometimes found difficulties in appreciating and integrating local knowledges and practices into their formal work, which sometimes led to a lack of efficacy of services and to subtle conflicts with the target communities. Yet, for practitioners to develop cultural competencies or, as argued by Weaver (1999), to progress from cultural sensitivity to cultural competence and the ability to integrate cultural knowledge and sensitivity with skills for a more effective and culturally appropriate helping processes, requires an understanding of indigenous approaches by social work practitioners. Sillitoe and Marzano (2009, cited in Ibrahima and Mattaini, 2017) acknowledge that incorporating local knowledge and values into the development process (typically dominated by foreign ideas and hierarchies) requires substantial time, efforts and resources, and that this is compounded by the fact that local knowledge is heterogeneous and complex which, according to the authors, is inconvenient for development. Some of the bases of social innovation include changes in the external environment, social problems that cannot be solved through conventional methods, and changes in the demands of a society; and specifically, unresolved social problems which demand new means and regulations in the social sphere (Makarov et al. Unravelling Indigenous and Innovative Models through Practice Research Spitzer (2017) underlines the importance of intensified research, coupled with theory building that aligns social work and social development with cultural concepts and epistemologies in order to identify innovative approaches that work in a given context. In the East African region, a lack of adequate research has been consistently identified as one of the gaps in the bid to indigenise social work. Practice research is particularly critical, since it emphasises bottom-up approaches to knowledge generation. The study that informed most chapters in this book adopted an approach that tended towards practice research to guide the collection and analysis of data about indigenous and innovative models of social work. In the Salisbury Statement (Salisbury Forum Group, 2011, 5), the following characterisation is provided: Practice research involves curiosity about practice. It is about identifying good and promising ways in which to help people; and it is about challenging troubling practice through the critical examination of practice and the development of new ideas in the light of experience. It recognizes that this is best done by practitioners in partnership with researchers, where the latter have as much, if not more, to learn from practitioners as practitioners have to learn from researchers.