WRITING THEIR CHAPTER

WRITING THEIR CHAPTERWRITING THEIR CHAPTER

Kirisia Water, Sanitation

and Hygiene Project for Trachoma

Control

www.amref.org

WRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control i

Published in 2013 by AMREF Kenya

AMREF Kenya Country Office Wilson Airport, Off Lang’ata RoadP.O. Box 30125-00100, Nairobi, KenyaTel: +254 0(20) 699 4000Fax: +254 0(20) 600 6340/ 600 2531Email: [email protected] Website: www.amref.org Writing: Stephen WakhuPhotography, Layout and Design: Anthony Muninzwa

©AMREF 2013

ii

WRITING THEIR CHAPTER

KIRISIA WATER SANITATION AND HYGIENE PROJECT FOR TRACHOMA CONTROL, SAMBURU CENTRAL DISTRICT

Lessons Learnt and Best Practices for Water Sanitation and Hygiene for Trachoma Control

Project Funded by: Junta Castilla y Leon through AMREF Spain

Project Implementation Period: 15th August 2011 to 14th November 2013

Republic of Kenya

WRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control

WRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control 1

TABLE OF CONTENTS

ACKNOWLEDGEMENT ...........................................................................................2

BACKGROUND ..........................................................................................................3

PROJECT GOAL ........................................................................................................8

PROJECT OBJECTIVE ................................................................................................8

BENEFICIARIES ..........................................................................................................8

PARTNERS .................................................................................................................. 9

CHALLENGES FACED DURING IMPLEMENTATION.....................................12

PROJECT SUCCESSES ............................................................................................13

BEST PRACTICES .....................................................................................................18

LESSONS LEARNT.................................................................................................. 24

2WRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control

ACKNOWLEDGEMENT

AMREF would like to acknowledge the generous support and funding of Junta Castilla y Leon through AMREF Spain towards the Water Sanitation and Hygiene (WASH) project for trachoma control in Kirisia division.

We would like to thank the communities of Kirisia division for their support and participation in implementation. Their commitment to the project and the practice of proper hygiene and sanitation has immensely contributed to the success of the project.

We acknowledge our partners: the Ministry of Water and Irrigation, Ministry of Health, Ministry of Education and the Provincial Administration for their support and commitment in the implementation of the project.

We also thank the members of the Project Implementation Team (PIT) especially Joseph Rotich from the Ministry of Health, Robert Muhindi from the Ministry of Water and Irrigation and area chief Peter Lerosion, for tirelessly working with the community in the implementation of the project.

The success of the project is likewise attributed to the commendable work done by the Trachoma programme staff led by the Project Officer, Solomon Mwaniki and Project Assistants, David Owino and Mary Opondo.

We acknowledge the leadership and support of the AMREF Kenya Country Director, Dr Lennie Bazira S. Kyomuhangi, Deputy Country Director, Dr Meshack Ndirangu, Programme Manager, George Kimathi and Project Manager Francis Dikir.

Finally, we recognise and acknowledge the efforts of the AMREF Kenya Communication team in documenting, editing and layout of this publication.

3WRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control

BACKGROUND

The Water Sanitation and Hygiene (WASH) project for trachoma control was implemented in Kirisia Division, Samburu Central District. Samburu Central District covers an area of 21,127 km2 and has a project population of 105,052; or a population of eight people per square kilometre.

A map of Samburu Central District

Samburu Central District generally has an undulating topography and lies in the arid and semi-arid ecological zone characterized by dry, hot and dusty conditions. The district suffers drought around the year. Rainfall is erratic, inadequate and unreliable ranging from 300mm to 900mm annually. The district is inhabited mainly by the nomadic Samburu and Pokot communities who keep large herds of cattle and seasonally migrate to other regions in search of pasture and water.


WRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control4 WRITING THEIR OWN CHAPTER

Kirisia Water Sanitation and Hygiene Project for Trachoma ControlWRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control

The main economic activity in the area is livestock rearing with 87% of the people involved in it. To add to the harsh climate characteristic of arid and semi arid zones, cattle rustling and prevalence of livestock diseases have accelerated the poor performance of livestock as a source of livelihood.

With a Human Development Index (HMI) of 0.293 and a Human Poverty Index (HPI) of 59.6%,1 Samburu is one of the poorest counties in Kenya. A sizeable population lives on less than a dollar per day. The district’s poverty is aggravated by lack of access to safe adequate water, proper sanitation facilities and poor hygiene and sanitation practices exposing the population to water and sanitation related diseases such as trachoma, diarrhoea, dysentery and cholera.

Social cultural practices are a hindrance to the adoption of desired health behaviour. 84% of the population has no access to proper health care 2. People in the area seek the services of traditional healers and care at health facilities is sought much later. This is partly due to poverty levels, inaccessibility of health facilities, ignorance and belief in superstition.

Kirisia division has two health centres and three dispensaries. Due to cattle rustling and insecurity, these health facilities are within urban and settled areas. The road network is very poor (not even a kilometre of tarmac road) and impassable during rainy seasons. There are no public service vehicles to most parts of the division and people therefore mainly walk to the health facilities located at a distance of over 10 kilometres apart.

Poor access to water and sanitation facilities slows down socio-economic development in the region. Women and girls are particularly affected because of their daily task as water collectors for domestic use. They have to walk long distances which limit opportunities for other productive issues, adding further restrictions on household income levels as well as on gender disparities.

1UNDP 2009, Human Development Report2GOK - Ministry of Health: National demographic health survey Report 2008





With a latrine coverage of 20% and 72% 3 of the community relieving themselves in the bush the district has low access to excreta disposal. This is due to the nomadic lifestyle of the pastoralists, poverty levels, illiteracy levels and ignorance on the relationship between excreta disposal and health.

The two year WASH project for trachoma control by AMREF was funded by Junta Castilla y Leon through AMREF Spain to the tune of €170,000. AMREF and local authorities supplemented this budget with an extra €45, 900 bringing the total cost of the project to €215,900. The project aimed to sustainably increase access to and utilisation of improved water and sanitation services thus contributing to poverty reduction, improving equity of genders and quality of life in Kirisia division.

The project rehabilitated two boreholes and two shallow wells, protected two new shallow wells, distributed 20 5,000 litre tanks, 100 leaky tins and constructed 20 Ventilated Improved Pit (VIP) latrines in schools, constructed 80 community pit latrines in the community, constructed 100 dish racks, dug 100 refuse pits for the community and constructed a 50,000 masonry litre tank. These were aimed at creating better access to water from improved water sources and also improve the access to sanitation facilities.

These project activities associated with water aimed at increasing access to safe water. The evaluation findings indicate a significant increase in number of respondents using water from ‘protected’ sources. At ETE, 58.1 percent and 52.3 percent of the respondents got water from protected sources respectively during wet and dry seasons as compared to 56.1 percent and 49.1% respectively during wet and dry seasons at Baseline. Further, the evaluation shows that 25.3% of the respondents accessed water within their home compounds compared to only 4.4 percent reported at baseline. Overall, the distance travelled to access water by the households has reduced with majority (94.6 percent) accessing water within a radius of 2 Kilometers, compared to 82.9 percent at baseline. The WHO recommends 20 litres of water per capita per person. The project evaluation results indicate that the

3AMREF, (2009), Comprehensive Baseline Survey, Samburu Central District




majority of the respondents (40.8%) used between 60 - 80 liters per day (3-4 jerricans). Considering that there is an average of 6 people per household in the area, per capita water volume is about 13.3 litres per person per day as compared with 10 litres which is less than the WHOs recommendation of 20litres per person per day.

On sanitation, analysis show that latrine coverage has increased to 30.5 percent, this is equally an improvement from the baseline coverage which was only 28 percent. Evaluation recorded improvements in the personal and household hygiene actions such as: bathing daily, throwing garbage in compost pit, cleaning the compound covering of the latrines and treating water before usage compared to the situation at baseline.

With access to improved water and sanitation facilities, and improved hygiene and sanitation practices in the region, the project hoped to help in the attainment of some of the Millennium Development Goals (MDGs). Sustainable access to clean water and sanitation facilities will contribute to the reduction of the risk of child and maternal mortality (MDG 4&5); combat diseases (MDG 6) and reduce the poverty burden (MDG1).





A rehabilitated shallow well

Children going to fetch water




PROJECT GOAL

The overall project goal was to sustain the reduction of trachoma prevalence and other water related diseases such as cholera, diarrhoea and dysentery among children aged 1-9 years. The project focused on face and hand washing, construction of toilets and construction and rehabilitation of water sources.

PROJECT OBJECTIvE

The project objectives were; contribute towards poverty alleviation and improve the quality of life of the target community through capacity building, increased and sustainable access to safe water and sanitation facilities, improved hygiene practices and control of trachoma and other endemic water related diseases.

This was done through safe behavioural change through training, awareness raising and health education for improved hygiene and sanitation.

BENEFICIARIES

The target population was 68,372 people residing in Kirisia division, Samburu Central district. The primary beneficiaries group were children between 1-9 years and women of child bearing age who were the most vulnerable to active trachoma and other water related diseases. They constituted 50% of the population.

Children aged 1-9 years are the main reservoirs of trachoma and repeated infection without treatment may lead to blinding trachoma. Women are 2-3 times more affected than men due to their caring for the children and easily get infected through hands, clothing and flies which have come into contact with discharge from the eyes and nose of an infected child.





The secondary beneficiaries were older children above 10 years and the entire community at large.

PARTNERS

Ministry of Water and Irrigation•

Ministry of Health •

Ministry of Education•

Provincial Administration•




Rehabilitated Shallow well a Blessing

Damaris Lengidi is a 25 year old housewife and a mother of three in Lakira location. In 2012, her last born child suffered from cholera and diarrhoea that almost took his life.

“When I went to the hospital, the doctor informed me that my son had ingested contaminated food or dirty water,” says Damaris.

Damaris recalls that she went back home and vowed that she will always treat her drinking water and will ensure that she cooked her food with clean water.

Her resolution was given a boost by the AMREF WASH project that was initiated in her community. She is grateful for the sensitization done on latrine construction and usage, dish rack installation and usage where the project provided the nails and mesh wire and Damaris constructed the dish rack outside her manyatta using locally available materials and the rehabilitated shallow well just 300 metres from her home. Damaris actively contributed the unskilled labour during the shallow well development and trained as one of the water management committee member. The participation has lead to intervention ownership and sustainability.

“I always fetch clean water from the well. This helps me cook my food with clean water and I do not have to travel for long distances in search of water”





Damaris says that because of the dish rack, her utensils are never contaminated by the dogs that roam the compound and the goats that graze around the homestead.

She recalls that after the proper health and sanitation practices talk by the project, her husband took it upon himself and constructed an animal shed. This significantly reduced the number of houseflies in the house which she learnt is a major transmitter of trachoma.

“My husband has been active in the attainment for a cleaner environment in our manyatta. He cuts down the long grass in the compound and clears the bushes around the manyatta.

The WASH project, through material support, helped them dig a refuse pit that has been instrumental in the disposal of rubbish around the homestead.

Damaris is grateful that the WASH project was introduced in schools. She says that the children in the community are always cheerful while going to school and are always reminding each other to wash their hands after visiting the toilet and before handling food.

“This has been important especially in the fight against water related diseases like trachoma and diarrhoea in Lakira”




CHALLENGES FACED DURING IMPLEMENTATION

vandalism

Vandalism of water sources especially rehabilitated boreholes and shallow wells were a major occurrence in the division. The division has a high demand for weapons especially spears and swords due to the cattle rustling among local communities. The blacksmiths of the community end up removing the metals pipes and visibility sign posts in so as to satisfy the demand for weapons in the community.

To curb the vandalism, the project involved the local administration especially the chiefs of the division to help prevent the vandalism. The chiefs and local authorities were instrumental in tracing the perpetrators of vandalism and punishing them accordingly. The PIT also held sensitisation meetings on the importance of these water facilities.

Cultural Barriers

Cultural beliefs have been one the challenge faced during the implementation of the project. Some men in the division argued that their culture does not allow them to use the same toilet as their mothers and daughters while others argued that they cannot defecate in a house like structure. Due to the migratory culture of the local communities, they did not see the need of constructing a pit latrine just to use it for a few months and leave.

The project made use of the Chief Barazas and public congregation to address the issues of proper hygiene and sanitation practices. The project created awareness on the importance of the use of a pit latrine and the disadvantages and consequences of open defecation. With the knowledge gained through the school health clubs, school children helped in passing hygiene information to their parents.

Harsh Weather and Poor Terrain

Due to erratic and unreliable weather, the division experienced heavy





rainfall that destroyed most of the roads in the community. Access to most of the targeted area became a challenge hence delaying implementation of scheduled activities. To address this, the project team reviewed the work plans and ensured that the delayed activities were implemented in those areas.

PROJECT SUCCESSES

The rehabilitation of two boreholes and two shallow wells and •the construction of two new shallow wells has improved the access of clean water in the division. 58.1% access clean water during wet seasons compared to 56.1% at baseline reporting while 52.3% during dry season compared to 49.1% at baseline reportingWith the rehabilitation and construction of boreholes and •shallow wells, the distance travelled to access clean water in the division has reduced, with 94.6% accessing water within a radius of 2km compared to 82.9% at baseline The construction of 80 community pit latrines and 20 VIP latrines •has improved the latrine coverage from 28% to 30.5% in both the schools and community and reduced open defecation in the divisionDue to the sensitisation and capacity building carried out by •the Water Management Committees (WMCs), the percentage of people paying for clean water increased by 8.4% i.e. from 42.7% to 51.1%Due to the empowering of the community to access and correctly •utilise safe water by treating their drinking water, there was an increase of 2.8% in the usage of various water treatment method i.e. from 31.2% to 34%The distribution of 20 (5,000 litre) tanks and 100 (20 litre) leaky •tins in the 10 schools improved hand washing practices in the schools. 98% of the pupils across the schools now practice hand washingAbout 60% of the homesteads in the division now have a •leaky tin strategically placed and in use by the members of the homestead




A Health Champion

“Inadequate clean water and long distance covered to access water are major hindrance to health in this community” says Nelly Lekaikum, a 21 year old small scale business woman in Sirata.

The mother of two and a member of the Sirata Women Group, is one of the community members who benefited from a dish rack that was constructed by the WASH project in the district.

Before the construction of the dish rack, Nelly used to dry her utensils outside on the ground. At this time, her family suffered from frequent bouts of diarrhoea. From health talks carried out by the AMREF WASH personnel, she understood why her family suffered from diarrhoea.

“I am grateful for the dish rack in my manyatta. Ever since it was constructed the cases of diarrhoea in my manyatta has reduced.”

She also appreciates the community toilets constructed by the project and she has even gone the extra mile to construct a leaky tin in her homestead that she encourages her husband and children to use after visiting the toilet.

Nelly understands that for the community to prosper health wise, they need to be empowered and educated on proper hygiene and sanitation practice. She lobbied her fellow women group members to educate and inform community members on the importance of proper health, hygiene and sanitation practices.





“I am happy that most of the women in the community testify to either boiling or treating their drinking water and have also started constructing dish racks and digging refuse pits in their Manyattas.”

Nelly is grateful for the water kiosk constructed in Sirata. The water kiosk sells water at an affordable price of Ksh2 per 20 litre jericans. She acknowledges that the kiosk has reduced the distance they had to travel to fetch clean water and the community has adequate water for bathing at least once a day.

She thanks the AMREF WASH project and hopes that the knowledge of proper hygiene and sanitation practices they imparted will be of use and that the cases of water related diseases such as trachoma, diarrhoea and cholera will be history in Sirata community.




Striving For a Clean Manyatta

Sein Shiro is a class six pupil in Sirata Oirobi Primary School. She is the first born of Carolyne Lenimiria, a beneficiary of a dish rack and the digging of a refuse pit. Before the WASH project for trachoma control was introduced in Shiro’s community, her family was not keen on proper hygiene and sanitation practices.

“I think our manyatta was the dirtiest in the whole village” says Shiro.

“The AMREF WASH project has changed my life in a major way. I know the benefits of a healthy and clean environment”

Shiro is a School Health Club member in her school and says that the information of proper hygiene and sanitation practices that she has been learning from the club has been important in improving the cleanliness in her homestead. Shiro educate her younger siblings

about proper sanitation and hygiene practice and the importance of a clean environment.

Since the introduction of the school health club in her school, Shiro has been imparting knowledge on the importance of keeping a clean environment and how it helps prevent diseases such as trachoma and cholera and in the long run improve the hygiene and sanitation in the homestead.





Shiro even reminds her father to cut down the grass in the homestead and cut down the bushes around it.

She has taken up the responsibility of cleaning the compound and ensuring that the rubbish in the refuse pit is burnt every week. She has even constructed a leaky tin that she encourages the family members to use.

Shiro recalls that through the training and demonstration carried out by AMREF project staff, her mother ensures that she boils her drinking water and stores it in a clean container which is exclusively used for storing drinking water.

She is grateful for the community toilet constructed by AMREF. She acknowledges that not everybody uses it but it has greatly reduced the number of people who defecate in the bush hence the environment smells fresh and clean.

With the knowledge she has gained from the school health club, Shiro is determined to keep up the practice of proper hygiene and sanitation and strives to make their homestead the cleanest in the whole community.




BEST PRACTICES

During the project implementation, the project rolled out a number of best practices:

Establishment and use of Water Management Committee•

Construction of water kiosk•

Supply installation and use of leaky Tins •

Training of Teachers, CHWs, and local leaders in PHASE•

Introduction of school health clubs•

Establishment and Use of Water Management Committee

The project team established a Water Management Committee (WMC) that was mandated with the management of the constructed and rehabilitated water sources. To ensure a true representation of the division, the project let the community members elect WMC members. The WMC is responsible for the maintenance of the boreholes and shallow wells in the community. They ensure that the water pumps are running effectively and efficiently.

The committee also passed information to the community on the importance of the water sources and the use of clean water. With the help of the local leadership, the committee encouraged the blacksmith in the division to stop vandalising the water sources. Since the water sources are run by members of the community, it enhances the sustainability and ownership of the project.

Construction of Water Kiosk

The project constructed four water kiosks at strategic points across the locality to enhance the accessibility of water and sustainability of the





project. These water kiosks are run by the WMC. The kiosks were set up to help with revenue collection to support the function of the WMC of maintaining and rehabilitating the boreholes and shallow wells.

The committee sells water at an affordable price of Ksh 2 per 20 litre jerican. The money collected from the water kiosks helps the committee to, repair breakages and buy fuel to pump water to the kiosks, tanks located in neighbouring schools and a 50,000 litre tank in the community. The community members are grateful for these water kiosks as they have reduced the distance covered in search of clean water.

A water Kiosk

Supply, Installation and Use of Leaky Tins

The leaky tin, an improvised water tap used for hand and face washing, has become a common sight in schools and homesteads in Kirisia division. The project supplied 100 leaky tins to schools and homesteads and these were placed strategically near the toilets to ensure that people washed their faces and hands.




With high poverty levels, erratic, unreliable and inadequate rainfall in the division, leaky tins offer a cheap, easy to produce, easy to use, hygienic and economical solution for hand washing.

Leaky tins have proved to be an invaluable appendage in the fight against trachoma and diarrhoea and a resounding success for the practice of proper hygiene and sanitation among school going children and community at large. Homesteads that did not benefit from leaky tins, improvised from a jerican and a stick.

A leaky tin

Training of Teachers, CHWs, and Local Leaders in PHASE

The project trained 20 teachers from 10 primary schools, 20 CHWs and 20 local leaders on Personal Hygiene and Sanitation Education (PHASE). The trained teachers, CHWs and local leaders are the health champions in the community. They were mandated to empower and create awareness on the importance of proper hygiene and sanitation practices.





The training was carried out by the project team. The 20 teachers trained further trained their fellow teachers and pupils in their respective schools. They were also given the responsibility of forming a school health club where they were to be the clubs patron. The trained teachers and pupils shared information on proper hygiene and sanitation practices with the members of the community and other out of school children.

The trained CHWs and local leadership ensured that all the community members adopted proper personal hygiene and sanitation practices. The CHWs and local leaders were mandated with demonstrating the practices of proper hygiene and sanitation in the community. This enhanced the ownership of the project by the community members. The community felt that the project was being driven by one of their own therefore embracing proper hygiene and sanitation practices.

A signboard




Christopher Lemaletian Hope and Dream

38 year old Christopher Lemaletian is a Community Health Worker (CHW) in Kirisia division and a cultural ambassador of the Samburu community. Christopher understands that the issue of poor hygiene and sanitation is a major problem in his community. He says that Kirisia being an area inhabited by pastoralist communities, many are not keen on practicing proper hygiene and sanitation hence hindering development of the community.

“My dream and hope is to see a healthy Samburu free of water, hygiene and sanitation related diseases,” says Christopher.

He appreciates the trainings carried out in the community terming them as an eye opener. Through his capacity as a CHW and cultural ambassador, Christopher empowers, educate and inform the members of his community on the importance of proper hygiene and sanitation practices.

Christopher is one of the community members who benefited from the construction of a community pit latrine. He has made it his purpose to persuade community members to use the toilet and stop open defecation. He informs them on the disadvantages and the consequences of open defecation.

He admits it is not a walk in the park but says he will not give up on his dream and hope.

“The Samburus are very practical people. For proper hygiene and sanitation to be practiced they need regular demonstrations”

Every two weeks, Christopher calls his community members to his homestead and demonstrates to them proper hygiene and sanitation practices; from how to wash their faces and hands to how to treat drinking water.

Christopher is happy that his fortnightly class is growing in numbers with every meeting. He believes that the WASH information he is advocating for is making a difference. He has taken his hygiene and sanitation classes to the chief’s baraza. Every time the chief holds a baraza in his village, Christopher always speaks to the people in attendance on proper hygiene and sanitation practices.

Christopher, who is also a farmer, saved up and piped water to his compound. To enable fellow community members access clean piped water, he sells the water to them at an affordable rate of Ksh2 per 20 litre jerican.

Christopher acknowledges that sharing of health information and capacity building is key for the promotion of hygiene and sanitation practices. He believes that capacity building will bridge the illiteracy gap that hinders the promotion of health in his community.




Introduction of School Health Clubs

The school health clubs were introduced in schools for the purpose of sustainability and continuity of proper hygiene and sanitation practices beyond the life of the project. The clubs, under the leadership and guidance of their respective club patrons, were given the responsibility of:

Creating awareness on health issues1.

Cleaning the school and its environs2.

Developing a school health library with adequate material on 3. health

Starting a tree nursery for conservation of the environment4.

Starting a school garden to supplement the school diet.5.

The school health clubs initiated Income Generating Activities (IGAs) such as poultry keeping and tree planting. The schools sell the seedlings from the tree nursery and eggs to the neighbouring community members. The school health clubs have developed a school garden for planting sukuma wiki to supplement their school diets.

The school health clubs have helped pupils build their knowledge, skills and means to transform their personal hygiene and sanitation in both the school and community levels.





A pupil washing hands from a Leaky tin in the School compound

A 5,000 litre water tank distributed in schools by AMREF




School Health Club Bears Fruit

The bell rings. The shouts and cheers are deafening as the pupils rush to the leaky tins to wash their hands. Standing next to the leaky tins are the school prefects ensuring that fellow pupils wash their hands properly before lunch.

This is what happens every lunch hour at Lokuto Primary school in Ng’ari sub location. Head master, Titus Lenolngenje, is happy with the improvement of hygiene and sanitation practices in his school.

“This is the product and result of the school health club introduced by the AMREF WASH project,” says the headmaster as he watches the pupils wash their hands.

Lokuto Primary School has a population of 343 pupils and has six classes; class 1 to 6. It is one of the schools that benefited with two water tanks of 5,000 litres each, construction of four VIP toilets and four leaky tins from the WASH project.

The WASH project introduced school health clubs in schools for sustainability of proper hygiene and sanitation practices. The club at Lokuto Primary School was initiated in 2011 and is responsible for carrying out health education, cleaning the school and its environs and starting of a school garden for planting vegetables to supplement the school diet.

The head master says that the club has been a major success in the school.

“The rate of absenteeism has drastically reduced and water and hygiene related diseases has greatly reduced among the pupils”

The enrolment of pupils in the schools has greatly improved since the inception of the project. The children in the community dream about a life beyond herding goats and cows. The enrolment has improved from 260 in 2012 to 343 in 2013 pupils. The headmaster attributes this growth to the WASH activities initiated in the school.





Titus says that the WASH project in the school has trickled down to the community level. During teacher/parent meetings, the parents are always eager to discuss hygiene and sanitation issues affecting the pupils and the community as a whole.

Most of the parents, if not all, have a leaky tin in their homestead and have stopped open defecation. They are making use of the community pit latrines constructed by the project.

During dry season, the school allows community members to fetch clean drinking water stored in the tank. Titus says he encourages the parents to treat the water before drinking. The community members are grateful for the two water tanks in the school and say that they have improved the health status in the region.

“With the significant role the health information and water and sanitation facilities play in the school, I am determined to take this school greater heights not only health wise but also in their performance.”




LESSONS LEARNT

Coordination, Involvement and Stakeholders Partnership

Partnership is a key element of AMREF’s approach to project implementation. A key lesson learnt during implementation was the significance of coordinating, involving and partnering with all stakeholders throughout the life of the project. The involvement of relevant line ministries (Ministry of Water and Irrigation, Ministry of Health, Ministry of Education and the provincial administration), community members, pupils and teachers was paramount to the success of the project.

This partnership brought a sense of project ownership as every stakeholder was involved and their roles were clearly defined. The mutual partnership provided a deeper and broader appreciation of the project hence proper planning and smooth project implementation.

Regular meetings of the PIT members presented a good platform to discuss issues related to the project and way forward.

Capacity Building

Capacity building of the people involved in the project was necessary for the project success. This was important especially in tackling cultural barriers. The project made use of the Chief Barazas and public congregation to build the capacity on issues of proper hygiene and sanitation especially in the control of trachoma.

The project also made use of the trained teachers, CHWs and local leaders to build the capacity of community members. This ensured that messages on proper hygiene and sanitation practice reached as many beneficiaries as possible.

Children: Agents of change

Through the establishment of school health clubs, the project surmised





the role of children as change agents. Children are receptive to the communication approaches and information offered to them. They have played a key role in the achievement of sustainable hygiene and sanitation practices.

A 50,000 litre water tank constructed by AMREF in the community




Charity Begins at Home

54 year old George Lenguru is a Community Health Worker (CHW) in Ng’ari sub location. In 2010, George recalls, the health, hygiene and sanitation status in Ng’ari was in a dire state. George is grateful for the training he received as a CHW.

“The WASH training was invaluable. It greatly improved the hygiene and sanitation status in my Manyatta.”

According to George charity begins at home. After the training, George went back home and convened a meeting with his family and informed them of the importance of a clean environment and proper practices of hygiene and environmental cleanliness especially in the fight against trachoma.

He delegated duties to his family members and ensured that they were carried out. His four boys were responsible for the general cleanliness of the compound while his three girls were responsible for the provision of clean water to the homestead.

During the training, George learnt that the major transmitter of trachoma in the community was houseflies. This was due to the animal waste and open defecation practiced by people in the locality. He encouraged his community members to use the community pit latrines constructed in Ng’ari and construct a leaky tin for face and hand washing. He informed his community members of the importance of hand washing after visiting the toilet.

George encouraged community members to regularly clean their animal

shelters and encouraged those who did not have one to construct one. George reckons that this will go a long way in reducing the number of houseflies in his community hence the reduction of trachoma infections.

George says that some of the community members were not receptive to the health message he was passing to them. This did not discourage him.

“I never gave up on informing these community members of the importance of proper hygiene and sanitation practices. I made it my point to visit them on a daily basis talking to them about health issues,” says George.

For George, the empowerment of fellow community members on health issues does not stop at the community level. During parent/teacher meetings in schools, George always makes it a point to talk to parents and pupils of the importance of a clean environment and encourages them to practice proper hygiene and sanitation practices.

George says the WASH project has played a major role in the reduction of cases of water related diseases such as trachoma and diarrhoea. He is grateful for the strides the project has made in his community and is resolute that the hygiene and sanitation practices will continue to be practiced.

32 WRITING THEIR OWN CHAPTERKirisia Water Sanitation and Hygiene Project for Trachoma Control

Project Ownership

Sustainability of water sources and sanitation facilities depends on the ability of the local community to carry out maintenance and curb vandalism of shared water resources. It was important to build the capacity of the community on the importance of the water and sanitation facilities.

The Water Management Committee that was mandated with the management and maintenance of the constructed and rehabilitated water sources. This enhanced the ownership of the water source thus ownership of the project. The project also worked side by side with the people of Kirisia, building knowledge, skill and means to transform their hygiene and sanitation thus laying a foundation that will be felt for generations to come.

For more information contact

AMREF KenyaP.O. Box 30125-00100,

Nairobi, KenyaTel: +254 0(20) 699 4000Fax: +254 0(20) 600 [email protected]

www.amref.org

WRITING THEIR CHAPTER

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