The authors implemented a modified photovoice project, Ngudo Nga Zwinepe (NNZ) (Learning through Photos), in a village in Limpopo Province, South Africa where water resources are scarce and often contaminated. This project is a first step in a collaboration between the University of Virginia and the University of Venda to develop a model for sustainable water, health and environmental development. NNZ engaged community representatives in an effort to assess and improve the community's water system. These participants presented the study results to their community, promoting local buy-in. The research team used content analysis methodologies to develop codes and themes regarding water beliefs. Contrary to the researchers' expectation, the participants did not prioritize the health risks of contaminated water over infrastructure and financing issues. To maintain community engagement throughout the larger project, the researchers must address the community's primary concerns in the shorter-term while developing educational strategies regarding the health risks of contaminated water.