The installation of more boreholes means many Katine residents once forced to drink from local swamps now have access to clean water. But a year-long strike by health volunteers has delayed progress on sanitation, says Sarah Boseley.
It’s been raining in Katine. The genteel English expression doesn’t do it justice. One moment the sun is out, the next instant the sky darkens and whole bathfuls of water tip from the skies. People flatten themselves against the mud walls of houses if they can. Those who can’t, walking slowly with heavy loads on their heads or cycling with wife and children on the pannier, are drenched in an instant. And it keeps raining. The swamps overflow.
Three years ago, I watched women with yellow jerrycans on their heads wade through the swamp, their skirts gathered up in one hand as best they could. They were on their way to a place where the swamp bubbles. There is a spring beneath. Their pitiful hope was that the water there would be cleaner. In the dry season, they would frequent an old shallow well beside the swamp. In the rains, it disappears, overrun by the high water and full of mud.
Edith Apiango, 23, and her grandmother, Erima Anayo, who says she is around 70, recall how it was. “When it rained, we crossed the swamp. The water came up to here,” says Apiango, drawing a line with her hand just below her hips. “The water there was flowing a bit. We walked 4km. I had a 20-litre jerrycan. I had to rest on the way back. I was very tired because I had to make two journeys.”
She has three small children – Irene Assege, eight (children take relatives’ names, not those of their parents), Timothy Emuru, four, and Sarah Apeco, two. They all used to get ill. Diarrhoea, the biggest killer of small children here along with malaria, was a constant problem and so were worms.
“My boy almost died,” said Apiango. “I took him to Ojom [the small local health centre] but there was no improvement, so I went to town [Soroti, which is 28km away]. They treated him but they said he will continue to get sick if you use that water.”
Today, during the rainy season, they are nowhere near the swamp. They are pumping water at a new borehole, installed by Amref, near Ominit village where they live. The grandmother, who has brought a 10-litre can, is beside herself with enthusiasm, waving her hands in the air and beating them on her thighs to emphasise her words.
“We are very, very happy and very grateful to receive this borehole,” she says. “We don’t have diarrhoea these days – only malaria.”
Ominit is one of 11 boreholes the project has installed, along with five shallow wells so far. One more borehole and two shallow wells are under construction – and one borehole needs redrilling because it takes half an hour of pumping to raise a trickle of water. “Water has been very successful,” says Anthony Akello, Amref’s assistant water and sanitation officer for the Katine project. When the project started, less than half of Katine families – 42% – had access to safe drinking water. Now it is up to 69.6%, he says, and will rise to 73.2% by the end of 2010.
Just as important as digging wells has been helping communities maintain them. It’s where water projects fail. Inevitably, pumps break down. If the spare parts are not easy to obtain and there is no money to buy them, it’s back to the swamp.
Apiango pays 500 Ugandan shillings (about 15p) every month to a water committee that Amref has helped set up and train. Each well has one, and each family contributes – around 300 households in most cases. Some tried to levy 1,000 Ugandan shillings, but it was too much for these families. There is a caretaker at each well, chosen from those who live close by, who collects the money and keeps an eye on things. Each well has been surrounded with robust hedge plants to keep animals out. Women collecting water sweep away leaves every day.
The levy forms a fund to pay the handpump mechanic. Amref has trained three of them in Katine. Every six months, with the help of those on the water committee, the mechanic will clean the pipes, which can rust and develop holes because of the amount of iron in the water. Rust, in fact, has been an issue at one or two boreholes, where, understandably, people have refused to drink the brown and foul-tasting water. The district water department has installed an iron filtration plant which appears to be working.
But the most ambitious innovation to keep the wells working is a parts store, which will be run by a water and sanitation association representing all the individual well committees.
“Very few people locally will stock parts,” says Akello. There’s not a fast turnaround, so profits are limited. “The water and sanitation association opened an account at Barclays to stock pump parts in Katine.”
The monthly levies will initially go towards stocking the parts store at the sub-county local government office in Katine. Once it is operational, villagers will save their funds so they can buy a needed part from the store – and the money they pay will be used to restock.
Then there are toilets. Or rather, their absence. It’s the unsexy issue in development, but fundamental to saving lives. Faecal-borne diseases are a problem in Katine. Three years ago, only 7% of households had a latrine. Most people went in the bush – and handwashing afterwards was not even considered.
Amref trained village health teams (VHTs), comprising members of the community, to talk to families about the risks they ran without proper sanitation and hygiene. The same message was promoted in schools. Amref put together 240 dig-your-own latrine kits, consisting of wheelbarrows and tools such as spades and pickaxes, which were sent around the villages, remaining for a week or two at each. People got together to dig in groups. By last autumn, the proportion of households with a latrine had risen to 39%. Amref’s target for the next year is to increase this to 75%.
It appeared to be going so well. But now, nobody knows whether the progress has been sustained. The best guess is that it has stalled.
The 272 VHT members stopped working last September in anger and dismay at a decision by Amref in Kampala not to continue paying them an allowance of 5,000 shillings (about £1.50) every time they came to a training session, for the time they spent out of the fields and to help cover travel costs. Last month, Amref reinstated allowances.
If the health plan has suffered, the impact on hygiene and sanitation is not far behind. These were the educators, the motivators and the data collectors. Every month they filled in and submitted lists, which included the numbers of households with latrines. Even the act of touring homes asking whether people had dug a latrine helped push them to do it.
“It is critical,” says Akello. “For about one year we have had no information about progress on latrine coverage.” There is also talk of some of the latrine-digging tools having broken. Katine is too big and the homes too widespread, down rutted bush tracks, for project officers to get a clear idea of what is going on.
Recently, Akello and colleagues hit on an idea at least to get the hygiene and sanitation messages back into the community. They recruited young people into drama groups of the sort that sometimes put on performances to promulgate moral messages for the church. Two have got underway so far.
A central part of the project’s sanitation component was equipping the schools with more toilets. The situation three years ago was dire. “In Ojago primary school, they didn’t have any latrines at all,” says Akello. “Elsewhere we found one traditional pit latrine shared between boys, girls and teachers.” The worst consequence was that menstruating girls without separate facilities would stay at home out of embarrassment. That’s changed. Some 116 toilets have been built in 13 schools and there are separate blocks for boys and girls.
There have been significant problems, however, with the design and choice of materials for the toilet blocks. Some of the 24 Ecosan toilets have failed because what should have been a sealed unit underneath for faeces and urine let in rainwater. Akello believes the roofs were not wide enough, allowing pools of water to collect at the base. Amref is now looking to renovate or replace them.
But the traditional-style toilets were not sufficiently robust, either. Some of the blocks were made of plastic and did not stand up to stormy weather. At Ojama school last year, two blocks of four were blown away. They were replaced, but parents asked for a brick structure instead when one was damaged a second time. The blue plastic structures could have been moved when the pit they covered was full, but Katine residents believe they are unsuited to local conditions. Seven of the nine plastic blocks are now being replaced.