CENTRE FOR SANITATION AND HEALTH PROMOTION (CENSAHEP) UGANDA

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Kampala, Central, Uganda
Mobile:+256(0) 772 662 062 Email:lukaaya@yahoo.com OR censahepuganda@gmail.com

Thursday, December 29, 2011



WaterAid (London)

Africa: Going Backwards on Continent's Biggest Child Killer

18 November 2011

press release
On the current trajectory, it will take over two centuries for Sub-Saharan Africa to meet its sanitation MDG target.  What is more, only 20 countries in the region are on track to meet the water MDG target by 2015.  All of this has massive consequences for child mortality in Africa.A new report Off-track, off-target, released today by the international charity WaterAid, shows that there are more people in the world today lacking adequate sanitation services than in 1990.  Unless urgent action is taken, nearly all governments in Sub-Saharan African will fail to meet the Millennium Development Goal (MDG) pledge they made to halve the proportion of people without sanitation by 2015.Released a day before World Toilet Day, the report states that to get the sanitation and water MDGs back on track, countries in sub-Saharan Africa need to spend at least 3.5% of gross domestic product (GDP) on these services.  The report also calls on donor countries to double global aid flows to water, sanitation and hygiene by prioritising an additional US$10 billion per year.
The report also identifies that it is Africa's poorest people who are being left behind; poor people in Africa are five times less likely to have access to adequate sanitation and over 15 times more likely to practise open defecation than Africa's rich.  According to WaterAid, governments should tackle this inequity through better targeting of water and sanitation resources and services to the poor.
The WaterAid report highlights that the shortfall in water and sanitation services costs Sub-Saharan African countries around 5% of GDP each year ($47.7 billion in 2009), more than is provided in development aid to the entire continent ($47.6 billion in 2009).
In a coordinated move, an international group of 34 female economists have also written an open letter to the leaders of eleven donor and developing country governments, to draw attention to the international water and sanitation crisis.  In it they state:
On the day you read this letter, 4,000 more children under five will die due to diseases brought about through unsafe water and poor sanitation.  This equates to more child deaths than AIDS, malaria and measles combined, making it the biggest child killer in Sub-Saharan Africa.
Every $1 invested in water and sanitation generates on average an $8 return; making it the deal that will deliver for billions of the poorest people across the globe.
Barbara Frost, WaterAid's Chief Executive, said:
"Governments in both donor and developing countries have it in their power to save hundreds of thousands of children's lives every year by increasing what they spend on water and sanitation.  Investments in these basic services are engines of economic growth and prosperity in developing countries, but unless we grasp this opportunity we will be failing the millions of poor people whose health, livelihoods and opportunities suffer because they lack these essential services."

Sanitation Efforts Off Track, Report Says

The Off-track, off-target report is being published on the day WaterAid launches the Water Works campaign to urge governments across the world to do more to tackle the water and sanitation crisis. The campaign aims to show world leaders that taps and toilets are simple, effective and affordable, and that investing in these basic human needs is an urgent priority.
On World Toilet Day WaterAid will also join other members of the End Water Poverty campaign in 50 coordinated 'Crisis Talk' events in over 20 countries where local groups will be meeting with politicians to discuss the water and sanitation crisis.
In Tanzania, Crisis Talk events are being organised to coincide with the local government budgeting cycle; in the UK, WaterAid's local supporter groups are meeting with their Members of Parliament; in Bangladesh regional events will be held where the public affected by poor water and sanitation provision will hold members of parliament to account.

THE FATE OF OUR HEALTH


A child plays in the slum of Kifumbira, a maze of rubbish, unplanned housing, mud and human waste which flows through makeshift drains, Kawempe District, Kampala, Uganda.

Kenya: Breaking Toilet Taboos


allAfrica.com
Wacui Makori
18 November 2011

Coastal Province — Among members of the Mijikenda community of Kenya's Coastal Province, it is taboo for a father-in-law's faeces to mix with those of his daughter-in-law.
Gender-separated open defecation spots are designated to ensure that this taboo is not broken. With such strong cultural edicts, the idea of a pit latrine - or a toilet of any kind for that matter - simply is not acceptable.
In Kilifi District, where many Mijikenda dwell, open defecation is the norm. Dr. Benjamin Tsofa, the district's public health and sanitation officer, said there is a daily battle against the high rate of sanitation-related diseases locally, leaving the youngest children extraordinarily vulnerable.
It is a problem played out across Africa. One of the United Nations Millennium Development Goals (MDGs) involves improving access to affordable clean water on the continent by 50 percent by the year 2015.
But a new report entitled "Off-Track, Off-Target" released this week by the international charity WaterAid, shows that there are more people in the world today lacking adequate sanitation services than in 1990, and there are still 2.6 billion people with nowhere safe, private or hygienic to go to the toilet.
'Chief's Toilet'
Unless urgent action is taken, nearly all governments in sub-Saharan Africa will fail to meet the MDG pledge they made to halve the proportion of people without sanitation by 2015, WaterAid said. Only 20 countries in the region are on target to meet that goal. Even more alarming, researchers estimate it will take more than two centuries for sub-Saharan Africa to attain the MDG goal.
Dr. Benjamin Tsofa, the Kilifi district public health and sanitation officer, stands in an area where people used to go to defecate.
Diarrhoea kills a child every 20 seconds worldwide. In fact, it kills more children every year than Aids, malaria and measles combined, according to WaterAid. Lack of access to clean water, and poor hygiene practices such as open defecation and lack of hand-washing afterwards, are leading causes of diarrhoea.
In Kilifi district, as across the continent, powerful cultural practices and taboos around personal issues such as defecation pose daunting challenges to public health officials. To address the problem, in 2007 the Ministry of Public Health and Sanitation issued a directive requiring all villagers to cease open defecation and build pit latrines in every homestead.
Tsofa says villagers complied and built the pit latrines. However, "They were never used, as the villagers sarcastically referred to them as the 'chief's toilet.' And then they were eventually converted into stores."
"We stakeholders realised that the use of force would not get us to address the sanitation challenges our district was dealing with," Tsofa said. "Instead, if we hoped to succeed, we needed to have a process that the villagers could identify with and that they could own as theirs; we had to go back to the drawing board."
The solution came from Plan-Kenya, which is affiliated with Plan International. Plan Kenya staffers had just returned from a Community Led Total Sanitation (CLTS) training held in Ethiopia and Tanzania. CLTS was started in 1999 by Kamal Kar in a small village in Bangladesh, and has enjoyed tremendous success in many other Asian and African countries. It emphasizes having the community lead the project.
Breaking Taboos
Tsofa and other stakeholders introduced CLTS in July 2007 in the village of Jaribuni (Swahili for 'let us try'). Led by the Ministry of Public Health and Sanitation and Plan Kenya, this program tapped into the already existing network of community health workers to inspire conversations about open defection and community-led pit latrine construction and usage.
When the project started, only three of the 45 homesteads had a pit latrine. Within three months and with no external funding, pit latrines had been constructed in all homesteads and were used by everyone. By May 2008 in response to the success of this initial CLTS project, all Kilifi public health staff was trained in the CLTS approach.
Community health worker Francis Katana said the CLTS project works where other attempts have failed because it demystifies a deeply held taboo.
"We walk around the village viewing the open defecation sites," he said.
"As we do this, villagers observe that though the sites are segregated, when it rains the faeces do in fact mix, and because of this they are able to deduce that it is not the construction nor the use of a pit latrine that will lead to the breaking of this important cultural taboo - it is already happening."
This was an eye-opening experience for villagers in Katana's Chuda village.
"Once we began to use the latrines, there was a marked decrease in the number of deaths, especially those related to diarrhoea and vomiting," Katana said. "The villagers began to notice this difference and today they not only observe this hygiene, they have begun to teach the use of pit latrines to their children so that the concept is passed on to the next generation."
Defecation Certification
However, Tsofa said this public education and enlightenment must be vigilantly maintained. CLTS workers capture the attention of villagers during public meetings, and they begin with a rather provocative statement: "Nyinyi mnakula kinyesi chenu." This is Swahili for: "You are eating your own faeces." Tsofa said this always gets the villagers talking.
Next, defecation areas are identified, walks are organized and real faecal specimens are collected. Residents go back to the village, and the CLTS facilitators put food, such as a slice of bread, next to the collected faecal sample and the villagers are asked to observe. Soon, flies swarm, and sometimes a chicken or dog will wander by, step on the faeces then step on or nibble at the bread before moving on.

Sanitation Efforts Off Track, Report Says

A sense of disgust is triggered among the villagers as they observe this direct contamination of food and the facilitator will then ask them: "Who wants to stop eating [faeces] in this village?"
By the end of the session, the villagers readily admit they have been unknowingly making themselves sick. They are prepared to commit not only to building pit latrines, but they also vow to use them. Once their homesteads are certified as "open defecation free", celebrations are held in honour of the village and officials from the Ministry of Public Health and Sanitation offer the villagers a certificate.
"This certification works wonders," Tsofa said, "and out of the villages that have so far been certified [as open defecation free], none has lost its status. The push now is to have Kilifi as the first [certified] district - not only on the coast but in the whole of Kenya."

Uganda: Water Shortage Hits Bukomero



New Vision (Kampala)
Denis Dibele
27 December 2011

Residents of Bukomero sub county in Kiboga district lack clean and sufficient water.
With only 13 functioning boreholes and nine shallow wells, the residents are seeking help from any well-wishers to construct more boreholes.
The Local Council 111 chairperson for Bukomero sub county Charles Katangole, who officiated at a commissioning of two boreholes at St. Henry primary school and Bukomero Junior School said that 40,000 residents currently depend on only two boreholes.
The construction of the boreholes was funded by FUKUOKA (Uganda Friendship Association) in partnership with residents of Bukomero under their umbrella Ugandans living in Japan founded by Livingstone Kyeyune.
Katongole also called on the government to rescue them and construct more boreholes to help the residents have access to clean water.
The two boreholes commissioned serve approximately 1000 pupils from both schools and 200 households in the area.

Uganda: Without Planning, Urban Areas Wallow in Filth and Disease


Urban living can be bad for your health — at least in Uganda. To mark World Health Day tomorrow, whose theme this year is urbanisation and health, the Daily Monitor will run a two-part series, beginning with this story, on the many dire health consequences of the country’s failure to plan its cities, by Evelyn Lirri
On the porch of a tiny mud-and-wattle hut in a slum section of Ggaba, a Kampala suburb, Ms Sarah Namutebi, 29, sits clasping her nine-month-old baby. She looks deeply worried.
Ms Namutebi’s baby, looking frail and dehydrated, has been down with diarrhea for the past three weeks. The baby’s eyes are sunken and the mother is desperately struggling to save its life.
It is easy to see why the child is sick. In front of the one-roomed house runs a drainage ditch carrying a mass of sewage, rotting garbage and plastic materials. The unsightly hodgepodge emits a horrid stench that suffocates the neighbourhood.
This is the reality of life for an estimated 3.3 million of the 5.5 million Ugandans who live in urban areas today.
Effective urban planning and enforcement would improve living conditions and sharply reduce disease. But the population is growing far faster than authorities can plan, hobbled by lack of funding, incompetence and corruption, can keep up.
The result: rapidly-growing mass slums where poor sanitation, dust, lack of proper ventilation, overcrowding and uncollected garbage all pollute and choke the living environment, making urban centres a death trap for dwellers (read a special report on rot of our towns in tomorrow’s Daily Monitor).
The problem promises to get worse before it improves. “Uganda is fast urbanising and if you don’t address urbanisation problems like health, water and infrastructure you will have a catastrophe,” warns Mr Urban Tibamanya, the state minister for Urban Development.
The consequences are already here to see. In Kampala alone, some 40 per cent of the city’s 1.8 million residents live in informal settlements like Katanga, Wabigalo-Namuwongo, Makerere-Kivulu, Ggaba, Kifumbira and Kisenyi.
Records show most communicable and hygiene-related infections break out in these areas, which often are unplanned and lack adequate housing and access to clean water and sanitation.
Intestinal worms, diarrhea and asthma topped the list of the most prevalent diseases in Kampala city between 2006 and 2009. Kampala City Council’s health division says these diseases jointly contribute to more than 80 per cent of the disease burden in the city.
In 2009, 43,434 intestinal infections were registered in Kampala district from common parasitic worms like ascaris, tapeworms and pinworms found in unfiltered water. Acute diarrhea cases totaled 27,694 cases, while persistent diarrhea cases reached 9,717.
In Ggaba mission slum, diarrhea is so common that few there consider it a disease anymore. Rather, it is seen as a normal part of life.
Cholera, another deadly disease usually associated with poor hygiene, had been dropping, from 1,104 cases in the 2006/7 financial year, to just 40 the year after, but the number of cases increased to 74 in 2009. Dr. John Lule, the KCC chief health inspector, said increased public education and awareness on hygiene and sanitation have contributed to this decline over the years.
Respiratory illnesses also are on the rise. According to the State of the World Cities report 2010/2011 published by the United Nations Human Settlements Programme (UN-Habitat), acute respiratory infection cases in Uganda are high in slum and rural areas- with slums and rural areas. Twenty-three per cent of their residents suffer acute respiratory infections, compared to only 14 per cent of residents in urban non-slum areas.
Many of the hygiene-related illnesses arise from poor sanitation. Although latrine coverage in Kampala district stands at 85 per cent, health experts say the access is not even geographically because many slum dwellers cannot afford the Shs100 they are charged to use them. As a result, many end up using polythene bags — commonly referred to in slum parlance as “flying toilets” – to dispose of their waste.
The indiscriminate disposal of human waste, officials say, is the reason underlying perennial cholera outbreak in the city.
Organised developments
Most of these diseases can be prevented by making the environment healthier through proper planning, health experts say.
Source: Evelyn Lirri,  Monitor / allAfrica.com, 6 April 2010

Growing Calls for Water to be Prioritised

By Joshua Kyalimpa

DURBAN, South Africa, Dec 5, 2011 (IPS) - Efforts to establish water as an agenda item in its own right in climate change negotiations are gaining momentum in Durban, South Africa. Water experts say doing this will lead to a greater focus on developing policy, and attract more resources into the water sector through adaptation programmes.

"For every one of us, the first thing you use when you wake up in the morning is water, and when we are going to bed, it is water. Yet, it’s taken for granted," says Chris Moseki, research manager at the Water Research Commission (WRC) in South Africa. WRC is a member of the Global Water Partnership (GWP) - a global alliance of organisations working on water issues.

Access to water is an urgent issue here in the Southern Africa region, where nearly 100 million people lack adequate access to water. Modelling by the Council for Scientific and Industrial Research (CSIR) in South Africa shows the region will become hotter and drier over the next 50 to 100 years, putting farms, industry, domestic water supply and natural ecosystems at risk.

International water experts and policy makers are concerned that planning for changes to water availability is not getting the prominence it deserves. Bai-Mass Taal, the Executive Secretary of the African Ministers' Council on Water (AMCOW), says they are working to raise the profile of water within the framework of the United Nations Framework Convention on Climate Change(UNFCCC).

"We are saying to the parties, look: we appreciate what you are doing in other sectors, but without addressing water directly, all of that will be in vain," says Taal.

At this point, water issues are being discussed by treaty negotiators as part of wider planning, prioritising and implementing of adaptation to a changing climate.

Dr. Ania Grobicki, GWP Executive Secretary, says that with growing numbers of countries expected to experience water scarcity, the current position of water in climate talks is inadequate.

"The GDP of many countries in the least developed countries is dependent on water. More than 50 percent of food for the world will come from Africa in the future, and this is dependent on availability of water," she says. "That is why this discussion should go beyond where it’s now."

More than 70 percent of the Southern African Development Community's population depends directly on farming, overwhelmingly on rain-fed agriculture. The CSIR's projections are among many drawing attention to how predicted changes to rainfall, limited resources for adaptation and a lack of institutions and capacity to regulate river and stream flow will leave people in Southern Africa and across the continent extremely vulnerable.

Similar challenges are predicted not only for Africa, but across the world as weather patterns change, but Africa's lack of irrigation and other infrastructure is a factor that magnifies the need for urgent intervention.

Africa's response

As rainfall patterns change, Africa is facing major crises. Millions faced famine in Niger and Mali in 2010 after drought hit farmers and herders. This year, the Horn of Africa has been facing its worst drought in 50 years and millions are suffering from hunger. According to the U.N. World Food Programme, some 12.3 million people in the Horn are in need of emergency assistance.

Rhoda Peace, the African Union Commissioner for Rural Economy and Agriculture, points out that when African leaders talk about climate change; they invariably talk about droughts and floods’, showing that water is already a high priority.

In 2008, African heads of state agreed to make water and sanitation a priority.

"Leaders agreed to allocate at least 0.5 percent of their national budget to water," says Peace. "Now whether that is actually the case is another story, but some countries are doing very well and may reach their targets."

Providing adequate access to water across Africa will cost billions of dollars. And for the many African governments which are failing to honour earlier commitments will not be able to raise the required amounts without support.

Simon Thuo, the Eastern Africa coordinator for GWP, says he is surprised that despite the clear need, even the African negotiating group's proposals mention water only in passing. Along with other experts, he believes that if climate negotiations address management of this essential commodity specifically, it will not receive the necessary attention and funding.

(END

Ghana: donors urged to help prevent corruption in the water sector

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The Ghana Integrity Initiative (GII) has appealed to donor agencies to introduce anti-corruption policies and tools in all their water sector activities. This was one of the recommendations of Ghana’s National Water Supply Integrity Study [1] undertaken by GII as part of the Transparency and Integrity in Service Delivery in Africa (TISDA) programme funded by the Bill and Melinda Gates Foundation.
The GII study mentions not only petty corrupt practices like illegal connections and illegal payments to meter readers, but also instances where a single contractor bought and priced all bidding documents.

Tuesday, December 13, 2011

Over 4,000 hand washing SMS pledges from two districts in Uganda


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Over 4,000 pledges were generated from local people in Sembabule and  Mityana districts In Uganda  within a period of a week after 15 October  who texted the word ‘PLEDGE’’ to 8181. With that they showed their commitment to wash their hands with soap. In reply, a message was sent back to them educating them about the importance of washing hands as one of the most effective and inexpensive ways to prevent diarrheal diseases and pneumonia, which together are responsible for the majority of child deaths
Text to Change provided a platform for this, partnering with USAID through STRIDES for Family Health and Unilever Uganda to promote healthy communities through a Global Hand Washing Day celebration on 15 October 2011. Amsterdam-based TTC is a nonprofit organization that uses sophisticated mobile phone technology to send out and receive information on health and other vital issues in developing countries.
During the Uganda event, the community was taught the importance of hand washing through demonstrations by the health workers. Dr Paul Kagwa, a Commissioner at the Ministry of Health was the chief guest who also demonstrated the full process of effectively washing hands with soap.
SourceText to Change, 19 Oct 2011

Over 4,000 hand washing SMS pledges from two districts in Uganda


Posted on  by  | Leave a comment

Over 4,000 pledges were generated from local people in Sembabule and  Mityana districts In Uganda  within a period of a week after 15 October  who texted the word ‘PLEDGE’’ to 8181. With that they showed their commitment to wash their hands with soap. In reply, a message was sent back to them educating them about the importance of washing hands as one of the most effective and inexpensive ways to prevent diarrheal diseases and pneumonia, which together are responsible for the majority of child deaths
Text to Change provided a platform for this, partnering with USAID through STRIDES for Family Health and Unilever Uganda to promote healthy communities through a Global Hand Washing Day celebration on 15 October 2011. Amsterdam-based TTC is a nonprofit organization that uses sophisticated mobile phone technology to send out and receive information on health and other vital issues in developing countries.
During the Uganda event, the community was taught the importance of hand washing through demonstrations by the health workers. Dr Paul Kagwa, a Commissioner at the Ministry of Health was the chief guest who also demonstrated the full process of effectively washing hands with soap.
SourceText to Change, 19 Oct 2011