Water, Sanitation, and Hygiene (WASH)
Under the Healthy Villages initiative, hygiene and sanitation interventions supplement innovative and comprehensive water chain interventions to ensure safe water from the source and into the home.
Poor sanitation and hygiene is a cross-cutting health concern in all rural Ugandan villages. Poor sanitation leads to diarrheal diseases, which are responsible for 17% of all deaths of children under five (World Health Organization). Poor personal and household hygiene can lead to trachoma, increased rate of infections, and a number of other diseases. A home with standing water can become a breeding ground for mosquitoes and increase malaria rates not just for that family, but for the neighbors as well.
We educate our village communities about the importance of household hygiene, personal hygiene, and sanitation through outreaches. We also have partnerships with local schools, encouraging children to adopt personal habits of hygiene, and to help their schools and their families adopt small sanitation measures like having ‘tippy-taps’ outside of latrines. Tippy taps are locally-constructed hand washing stations that make it easy for people to follow good hygiene practices.
To teach about the importance of safe water, we hold village outreaches about the importance of gathering water from clean water sources (even if it means a longer walk to the source), and importance of treating — or at least boiling — water intended for consumption. We also educate villagers about the nature and danger of water-borne diseases contracted by drinking contaminated water. At times we bring in local community based organizations (CBOs) to do educational performances or outreaches about safe water, similar to the CBO performances given on HIV/AIDs or malaria.
Throughout the years that we work in a village, UVP continues to facilitate safe water outreaches. Village Health Teams also sensitize the community about the dangers of contaminated water, and how to best to treat water for consumption.
Our 70 Healthy Villages were chosen partially on the basis of having very poor latrine coverage, a condition that increases the prevalence of cholera, dysentery, worms, and many other diarrheal diseases. We conduct ‘Sanitation Pushes’, innovative and inclusive campaigns to increase latrine coverage and sanitation measures in our villages. These campaigns involve four steps:
- Uganda Village Project conducts pre-campaign and post-campaign household surveys to determine the increase in coverage for each sanitation improvement, and follows up with households to help finish the longer projects such as latrine construction.
- We work with our community Village Health Teams to create ‘model households’. The Village Health Teams demonstrate all the sanitation improvements at their own homes, including tippy taps (what is a tippy tap?), latrines, plate stands, drainage systems for cooking areas, and rubbish pits.
- We gather teams of high school and university students, local government officials, Uganda Village Project staff, and the community Village Health Teams for the Sanitation Campaign. Each team works in one neighborhood of the village, going house-to-house during the sanitation campaign and making improvements to the homes it visits.
- Over the week-long Sanitation Push, the community becomes excited and motivated to make sanitation improvements to their homes, and learns how to build the sanitation improvements from the teams made up of their neighbors and friends. The cumulative effect is the spread of sanitation improvements throughout the community and a major increase in sanitation coverage over the course of just a few days of hard work. Our teams often build over 100 tippy taps in one village campaign!
A household thanks Uganda Village Project after a sanitation campaign
Where needed, we construct shallow wells in our Healthy Villages, using our already-established Community Constructed Shallow Well Program (CCSW). Through our CCSW, we work in partnership with the District Water Office, which donates well parts, and the villagers themselves, who donate the land, do the digging, and provide food and shelter for the mason who lives in the village during the whole process.
This method of partnership forges a sense of village ownership over the well, so that the community will continue to maintain and repair the well over the years, instead of looking to the government or UVP to provide this upkeep. (This is a common problem with NGO-built wells in Uganda.) We help the village to establish, if they do not have one already, a Water User Committee, who collects money from the villagers for just this purpose.
All well locations are chosen so as to reach at least 60 households, and for many families this is the first time they have ever had access to a clean water source. Over the course of our three years in each village, we hope to construct enough wells that every family is proximate to at least one clean water source. The number of wells required, therefore, depends on the size and lay-out of the village.
WaterGuard Provision and Supply Chain
Along with hygiene and sanitation and clean water sources, we focus on the prevention of home contamination of water and the promotion of a product called WaterGuard. At all village outreaches we sell WaterGuard to villagers, a water treatment product obtained through PSI Uganda/PACE. Volunteer teams living in the village also sell WaterGuard from their house. While many villagers are initially skeptical about putting ‘a chemical’ into their water (“Will it taste bad?”, “Is it bad for you?”), education and the provision of sample treated water wins many villagers over. Volunteer teams living in the village and staff in the office use WaterGuard to treat their own drinking water, and so each visit to the crowded borehole to gather and then treat water may serve as a mini-outreach on the benefits and safety of WaterGuard.
Besides selling WaterGuard directly, we set up a ‘WaterGuard distributor’ (usually a local shopkeeper, but sometimes a member of the Village Health Team), in each Healthy Village. This individual will sell WaterGuard perhaps indefinitely, sourcing straight from PSI Uganda. Each strip of 10 WaterGuard pills is sold for 50 shillings over its cost, enough of a profit to keep a shopkeeper or individual selling the product as long as demand is there. We help create that demand through our village outreaches, and Village Health Teams and other village leaders monitor the WaterGuard distributor, to ensure that he does not raise the price.
Our goal is to increase the household practice of water treatment -– and therefore decrease instances of water-borne diseases -– dramatically by the time we leave each Healthy Village. Uganda Village Project staff conduct follow-up with all villagers who buy WaterGuard, to ensure that they are using the product properly and to survey the household on the frequency that water-borne diseases are experienced.