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Fig 1.

(A) Uganda map showing Mayuge District. (B) Mayuge District map showing the three study site villages: Bugoto, Bwondha and Musubi. Created using QGIS 3.14 Software (QGIS Association. QGIS Geographic Information System. 3.14 ed2020) using a base layer from Natural Earth (http://www.Naturalearthdata.com) for the reference maps, with district boundaries created using Uganda Bureau of Statistics (Uganda Bureau of Statistics (UBOS). Uganda Administrative Boundaries GIS Database. Kampala, Uganda: Government of Uganda, UBOS; 2006) [51].

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Table 1.

Social demographic characteristics of study participants for the in-depth interviews.

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Fig 2.

Common activities at the lake.

Additional to the lake, in all three communities we observed taps with clean filtered lake water and boreholes drilled to provide naturally occurring water from the ground. However, these sources were not reliable as they were often locked, out of water, and/or faulty, especially in Bugoto and Musubi. Tap water was pumped from the lake by a solar pump which could not function during cloudy days and rainy periods. Even the functioning boreholes were often not used because people said the water was salty. In Bwondha there were several shallow wells with big queues. In Musubi, we saw people getting water from swamps and wells which were also used by animals to drink water.

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Fig 3.

Examples of pit latrines in the studied communities.

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Fig 4.

A 13-year-old boy with an extended stomach. Some community members, including some with enlarged stomachs, interpreted swollen stomachs as a symptom of ekidada (a local disease that was considered to be a result of witchcraft).

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Fig 5.

Open defecation on rocks and bushes at the lake shoreline.

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Fig 6.

Social activities performed at the lake.

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