With a legacy of sociopolitical and economic exclusion, ethnic conflicts, and an extremely arid climate, the Turkana people struggle to meet the two most basic necessities of life – food and water. One perennial river flowing from Uganda replenishes the groundwater on which the survival and growth of Lodwar depends. Lodwar’s water utility ranks poorly across national regulation metrics delivering an average of 24 litres per person per day to half of the town’s residents. Violent flash floods are known to wash away homes, people and animals almost every year. Relocating to safer grounds in peri-urban areas means losing income opportunities, education and healthcare services, and most importantly, water. A vibrant informal market has emerged, with tanker trucks and motorbikes selling water from the utility’s boreholes at high costs. For those who cannot afford vended water, scooping out dry riverbeds is the only option. With the discovery of crude oil and untapped groundwater reserves, coupled with construction of regional transport links, there is optimism for economic development in this marginalised county. Yet unless there is action to address the fundamental lack of capacity or coordination among multiple stakeholders, Lodwar’s water woes are likely to limit human and economic development.