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WASHfunders’ Recommended Reading section has expanded with the recent addition of some new publications. Resources added in the past several months include:

Leave No One Behind: Voices of Women, Adolescent Girls, Elderly, Persons with Disabilities and Sanitation Workforce summarizes the sanitation and hygiene hopes and aspirations of thousands of women and men of different ages and physical ability, across rural and urban areas in eight South Asian countries.

Water, Sanitation, Hygiene, and Nutrition in Bangladesh: Can Building Toilets Affect Children's Growth? provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition. 

Building Towards a Future in Which Urban Sanitation Leaves No One Behind analyzes the challenges to improving access to sanitation in towns and cities of the global South.

Sanitation and Child Health in India examines the effects of sanitation coverage and usage on child height for age in a semi-urban setting in Northern India.

New publications are added to WASHfunders’ Knowledge Center on a rolling basis, via IssueLab, a service of Foundation Center. And we accept suggestions! If you’d like us to add a case study, evaluation, white paper, or issue brief that is of interest to those in the social sector working in WASH, please contact us: washfunders@foundationcenter.org.

Editor's Note: In this post, Shauna Curry, CEO of the Centre for Affordable Water and Sanitation Technology (CAWST), presents five main challenges to achieving global access to safe water and sanitation. This post originally appeared on CAWST's blog. You can find the original post here.

The poor bear the brunt of the burden of inadequate water, sanitation and hygiene (WASH) and the link between WASH and health is undeniable. An estimated 842,000 people die each year due to diarrheal disease that could have been prevented by WASH interventions; 361,000 are children under the age of five years old. Health impacts go beyond diarrheal disease: half of global malnutrition and one quarter of stunting in children are due to waterborne diseases like chronic diarrhea and intestinal worms, and diarrhea is responsible for 17% of global disability (PMNCH, 2014).

The Sustainable Development Goals (SDGs), recently adopted by the United Nations, have sparked a renewed focus on what strategies will be necessary to achieve universal access to safe water and basic sanitation by 2030. This won’t be an easy goal to reach – how we define the challenges will influence our direction and prospects for success.

CAWST sees five main challenges to achieving sustained, universal access to safe water and sanitation:

  • The scale of the need for safe water, sanitation and hygiene.
  • The variability of water and sanitation problems and consequently the variability of solutions from place to place and from time to time.
  • How to best sustain essential WASH services over the long-term.
  • How to reach people most in need.
  • The integration of water, sanitation and hygiene for health.
Photo Credit: CAWST

Photo Credit: CAWST

Challenge 1:  

The Scale of the Need – Water, Sanitation and Hygiene to Half the World’s Population

The sheer scale of the issue is a challenge in itself. It will be no small feat for half the world’s population to gain sustained access to safe water, basic sanitation and good hygiene practices (and to do so in 15 years).

Even critical institutions like health care facilities and schools lack water and sanitation. A study in 54 low- and middle-income countries found that 38% of health care facilities lack access to an improved water source, 19% lack sanitation and 35% do not have water and soap for handwashing (World Health Organization & United Nations’ Children’s Fund, 2015).

The scale of the need will increase, particularly as populations grow, available freshwater is used and contaminated at increasing rates, and the climate changes.

To date, solutions have tended toward infrastructure, implemented by a few organizations. This approach alone has not been successful in reaching everyone, and there aren’t enough local people with the required knowledge and skills to deliver universal, safely-managed WASH by 2030. The current formal systems for training, such as university and vocational programs, are important but will not produce enough WASH practitioners to meet the demand by 2030.

No single solution will result in universal access by 2030. A range of adaptable and scalable solutions are needed to overcome geography, gender and socioeconomic barriers.

Solutions will require many organizations working cohesively to provide smaller-scale, decentralized WASH services, especially at the household level. Those many organizations need support and increased capacity in order to reach unserved populations with sustained WASH services.

Challenge 2:

The Variability of the Problem and Therefore the Solutions

Water and sanitation issues are highly variable from location to location, from season to season and community to community; and people who lack WASH are often living in the most challenging geography and climate.

One-size-fits-all solutions have not worked and cannot be the strategy to scale-up reach. For example, water quality, rainfall and hydrology are site-specific and have important implications on technology selection and siting. Incorrect choices can exacerbate an already poor condition (e.g. digging a simple pit latrine that further contaminates groundwater).

Customized water and sanitation services are needed that capitalize on existing local knowledge of conditions; and local people need to have the capability to make informed choices and be able to respond effectively to changing conditions.

Challenge 3:

Sustaining Water, Sanitation and Hygiene Services for the Long-Term

Focus over the past decades has been on water and sanitation infrastructure. This approach is costly in up-front capital, operations and ongoing maintenance. It requires a highly educated, skilled workforce and often doesn’t reach the most marginalized communities, nor address specific contextual challenges.

Sustained operation and maintenance of this infrastructure has been challenging. For example, 30% of water hand-pumps in Africa are not working (RWSN, 2009). The failure of community water and sanitation systems is often a failure of operation and maintenance, rather than a failure of the basic technology.

Addressing this failure requires learning from the successes of those infrastructure that have been used and maintained for many years. At its core, we need to (i) increase skills and knowledge of people to use and maintain the technology and/or service and (ii) select water and sanitation products and services – including household-level solutions – which are affordable to implement, operate and maintain and appropriate to the context.

Challenge 4:

Reaching People Most in Need

Overwhelmingly, it is the poorest who lack better water and sanitation. Virtually the entire poorest 25% of the world’s population does not have piped water and the inequality in coverage between rich and poor is even greater for sanitation than for water (JMP, 2014).

Addressing this challenge requires both supporting those who serve the people most in need and providing water and sanitation solutions that marginalized households can afford over the long-term.

Challenge 5:

Integrating Water, Sanitation and Hygiene (WASH) for Health

Many of the water and sanitation approaches employed to date in international development focus on providing either improved water or improved sanitation or improved hygiene. Global monitoring programs, such as the Joint Monitoring Program of UNICEF and the WHO count access to each of the three separately. Alternatively, organizations have the vision to implement all three and struggle to do so when faced with the realities on the ground.

All three – water, sanitation and hygiene – are intertwined and all three are needed for sustained impact. Water, sanitation and hygiene are fundamental for healthy homes and broader systemic change.

The question is then how to implement so people have water and sanitation and hygiene for generations? Start with interventions that will be (i) the easiest for households to adopt immediately and for the long-term, and (ii) provide an entry-point for motivating action on other WASH components. Furthermore, longer term commitments are needed that work towards households having all three components: water, sanitation and hygiene.

In Conclusion:

Overcoming Challenges to Reach Everyone by 2030

Addressing these five challenges will go a long way towards achieving universal access to safe water and sanitation by 2030. We will reach that goal through many organizations implementing many projects of varying scale, technology and approach.

There are thousands of existing local organizations and government agencies that are best-suited to reach their own populations with safe water and basic sanitation. In the weeks, months and years ahead, alongside these organizations, we need to build capacity, create and sustain demand, provide products and services, monitor for improvement and provide appropriate financing.

In this way, we can collectively achieve sustained services for generations to come.

References:

JMP [Joint Monitoring Programme] (2014). Progress on Drinking Water and Sanitation 2014 Update. WHO Press. Geneva.

PMNCH [The Partnership for Maternal, Newborn, & Child Health] (2014). PMNCH Knowledge Summary #30 Water, sanitation and hygiene – the impact on RMNCH. Available at:www.who.int/pmnch/knowledge/publications/summaries/ks30/en/

Prüss-Ustün, A., Bartram, J., Clasen, T., Colford, J. M., Cumming, O., Curtis, V., et al. (2014). Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries. Tropical Medicine & International Health, 19(8), 894–905. Available at:  http://doi.org/10.1111/tmi.12329

RWSN [Rural Water Supply Network] (2009) Handpump Data 2009. Selected Countries in Sub-Saharan Africa, RWSN, St Gallen, Switzerland

WHO [World Health Organization] and UNICEF [United Nations Children’s Fund] (2015) Water, sanitation and hygiene in health care facilities: Status in low- and middle-income countries and way forward. WHO Press. Geneva.

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As 2015 comes to a close, we’re looking back and taking stock of the variety of topics featured on the WASHfunders blog this year – from the importance of systems in creating social change to the impact of the Sustainable Development Goals and the COP21 negotiations on the WASH sector. Featured below are the top five most popular blog posts from 2015.

5. The Top 10 Groundbreaking Events to Have on the Radar for Menstrual Hygiene Day

This post was authored by Danielle Keiser of WASH United, a Berlin-based organization that acts as the Secretariat for Menstrual Hygiene Day. In her post, Danielle provided a round-up of events being organized all over the world to draw attention to this critical development issue.

4. Tackling Drought in West Africa: Training Illiterate Communities to be Water Experts

This post was authored by Sarah Dobsevage, Director of Strategic Partnerships at WaterAid America. In her post, Sarah, who heads up WaterAid’s partnerships with foundations and corporations in the US, describes her organization’s work with drought-prone communities in Burkina Faso, particularly around training local people to develop the skills needed to address WASH problems. 

3. Narrowing the WASH Capacity Gap

In her post, Shauna Curry, CEO of the Centre for Affordable Water and Sanitation Technology (CAWST), highlights the capacity gap that exists in the WASH sector due to a shortage in skills and the scarcity of local water and sanitation professionals. She describes the central focus that CAWST has placed on human resources and capacity building for WASH and suggests a number of ways in which funders in the sector can work to narrow this gap. 

2. All Talk and No Action

This post was authored by John Sauer, Senior Technical Advisor for Water, Sanitation and Hygiene at Population Services International (PSI). In his piece, John lauds the growing appreciation among WASH practitioners for market-based, holistic approaches to challenges in the sector, but also notes that this enthusiasm has been slow to translate into action. He lists several reasons for this sluggish adoption and describes what PSI is doing to apply the principles of market development to its projects on the ground.

1. Wielding Impact Investing to Accelerate Access to Safe Water

Our most-read post was authored by Alix Lebec, Director of Strategic Alliances at Water.org. Alix writes about the potential for impact investing to help address the global water crisis, which currently attracts far less funding than the WHO estimates is needed. She describes how Water.org has adopted this approach to leverage philanthropic capital and scale up their WaterCredit model in India. 

Leave a comment to let us know what WASH topics you would like to see covered in 2016. Interested in contributing a piece yourself? Contact us at washfunders@foundationcenter.org. Thanks for reading and Happy New Year!

Editor's Note: This post is authored by Giulio Boccaletti, Global Managing Director of Water at the Nature Conservancy, and Gary White, Chief Executive Officer and Co-Founder of Water.org This post was originally featured as part of a "Climate Justice" series produced by The Huffington Post, in conjunction with the U.N.'s 21st Conference of the Parties (COP21) in Paris. You can find the original post here.

Pelugu Bing Bisse, Rural Aid. Credit: Water.org

Pelugu Bing Bisse, Rural Aid. Credit: Water.org

In Paris, the world will seek -- once again -- an agreement on the future of climate. Yet for a billion of the poorest people in the world, the language of that agreement will not do nearly enough to address the impacts of climate change they are already feeling today.

Water is how we experience the planet's climate; droughts and floods will overwhelmingly define our experience of climate change. Meeting a growing need for water while the climate is changing will be even harder. Even the richest in the world are susceptible. The drought in the western United States has threatened California's way of life, while the East Coast was recently hit by devastating floods that made places like South Carolina look like Bangladesh.

But it is our world's most vulnerable -- those living on less than U.S. $5 a day -- that should come first in our concerns. The upcoming climate negotiations present us with an opportunity to not only address global emissions, but also test our ability to truly solve interconnected environmental issues like climate and water as a necessary means to avoid social instability worldwide. By scaling innovative financing options, expanding use of available technology and investing in nature-based solutions, we can make water available and affordable to the world's poor, freeing-up household income that drives economies and improving health conditions around the world.

Today, nearly 700 million people around the world lack basic access to water, and a striking 2.4 billion lack access to sanitation. It is not surprising that these numbers contribute to making the water crisis the highest threat to global prosperity. Yet, a persistent misunderstanding of this challenge is the notion that the poor are in this predicament because they cannot pay. The truth is, the poor spend an estimated U.S. $200 billion per year on water access.

The high costs are due in part to what the poor have to pay for bottled and well water due to a lack of infrastructure or the means to tap into infrastructure. Many of those without access rely on informal water vendors -- known as "tanker truck mafia" -- in slums around the world. The price of water in these informal markets is remarkably high and can reach U.S. $15 per cubic meter; compare that to the U.S. $1 per cubic meter paid by households in New York City.

Water Committee members in Demes, Ethiopia. Credit: Water.org

Water Committee members in Demes, Ethiopia. Credit: Water.org

The poor also pay in the forms of forgone income and illness. The World Health Organization estimated that the total global economic losses associated with inadequate water supply and sanitation is approximately U.S. $260 billion annually. In short, the poor incur huge coping costs because they lack access to safe, efficient piped water networks.

Charity alone will not be able to solve global access to water. Conservative estimates of the expenditures required to provide and maintain safe water access is U.S. $1 trillion with only U.S. $8 billion provided in international aid each year.

But what if we could cut those costs in half while also giving the poor much needed access to water at a rate closer to what those in developed countries pay for water and sanitation services? Such a measure would free-up more than U.S. $100 billion per year for those households and would allow dramatic improvements in water security for the vulnerable, which would have a marked stabilizing effect on social structures across the developing world.

This is possible and it does not require inventing new technology, but rather scaling proven solutions that we have seen work on the ground.

Financing urban water connections through micro loans to individuals and community groups is showing real promise in many communities. India and China are home to one-third of those without access to water and more than half of those without access to sanitation. A long trail of countries from Nigeria to Indonesia follow. For the poor that are close to an existing water grid in a city, extending financing to buy last mile connections and toilets can have huge impact in increasing access to services. The work done at Water.org has shown that, when extended a loan to pay a connection fee, people are able to tap into the water supply or build a toilet, and repay the loan in full with consistent reliability -- Water.org's repayment rates exceed 99 percent.

The growth of off-grid water treatment technologies is also showing potential for positive change. The number of rural households without access to water and sanitation is roughly five times higher than that of the urban poor. For these individuals, and some in peri-urban areas, connecting to a public utility is often not an option. Because of falling water treatment costs and the growth of social impact investment capital, there are new possibilities to set-up water kiosks and deliver treated water to dispersed populations. Off-grid solutions, such as those offered by Water Health International, allow rural communities to tap local sources of water and render them potable, at a cost that can greatly undercut their current cost.

And we cannot forget about the benefits of investing in our most basic water infrastructure: nature.The poor often live in degraded watersheds or where utilities are unable to cope with deteriorated water sources. Water funds, which create mechanisms for downstream water users to pay for upstream conservation, have shown that investments in nature-based solutions, such as reforestation and riverbank repair, can improve the quality of the water supply. This drives economic development while saving utilities money by reducing water treatment costs. A recent study conducted by The Nature Conservancy of 500 large cities shows that in at least a quarter of those cities, the savings from reduced treatment costs more than paid for the conservation activity. These interventions disproportionately benefit the rural poor and contribute to a sustainable water management system.

Social entrepreneurs, powered by smart philanthropy and social impact investing, are spurring this trend to leverage market-based solutions in service to the poor, seeing them not as a "problem to be solved" with traditional charity, but as having intrinsic power as customers. Smarter, more efficient solutions allow the poor to redirect their coping costs to affordable, sustainable and higher quality water and sanitation services.

In the year when the world is concerning itself with climate change, we must address the current impacts, including global water security. That starts with providing access to basic water and sanitation. By putting the needs of the poor front and center during the climate discussions, we stand to address many of today's greatest social and environmental challenges.

In followup to the University of North Carolina’s Water and Health Conference, which took place October 26-30, we've rounded up a number of tweets from conference presenters and participants. The conference covered a number of issues including drinking water supply, sanitation, hygiene, and water resources with a strong public health emphasis.

Were you at the conference? Share your own highlights in the comments below!

Editor’s Note: The post below is authored by John Garrett, Senior Policy Analyst at international water and sanitation NGO WaterAid, and Sarah Hénon, Analyst with Development Initiatives, an organization that works to end absolute poverty by making data and information on poverty and resource flows transparent, accessible and usable. This post is based on a recent report, Essential Element: Why international aid for water, sanitation, and hygiene is still a critical source of finance for many countries.

As the world turns its attention to the implementation of the Global Goals for Sustainable Development, making good, early progress towards Sustainable Development Goal 6 -- achieving universal access to water and sanitation -- will be essential for all developing countries. This requires ensuring the necessary resources are put in place, and the 2015 Addis Ababa Action Agenda provides an important platform for this, but a recent report released by WaterAid, based on analysis by Development Initiatives, suggests that current financing volumes and trends are not adequate to reach this goal for many countries, and that aid will continue to play a vital role in the implementation of Agenda 2030.  

Recent decline in share of aid to the sector

Aid flows to water and sanitation reached US$6.6 billion in 2013, a 10-year high in 2013, following steady growth from 2007.[1] This aid has played an important role in financing improved access to water and sanitation and allowing the world to meet the MDG water target. But the UN Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) 2014 survey of 94 developing countries found that a majority (80%) of developing countries had insufficient current finance to meet MDG targets for drinking water and sanitation.[1]

WF Chart

Despite the increase in aid in 2013, there are some troubling underlying trends. Between 2011 and 2013 aid to water and sanitation grew by only 2.5%, falling behind the pace of overall aid, which grew by 10.7%. In line with these trends, the share of aid going to water and sanitation decreased between 2012 and 2013. In 2013, the share of aid to the sector dropped to only 3.9% of overall aid, falling below 4% for the first time since 2009. To achieve universal access to water and sanitation, countries that lack financing to meet MDG targets will experience an even greater gap. External financing from aid donors has a vital role to play to support countries' progress to universal access, particularly for countries with low levels of domestic revenue.

Aid to water and sanitation is increasingly delivered as concessional loans

International aid is composed of both grants and loans. During the ten year period between 2003 and 2013, aid loans to water and sanitation increased steadily from US$1.1 billion in 2003 to US$3.3 billion in 2013. This is an increase of 205%, compared with a 123% increase for grants over the same period. Thus, the increasing total volume of aid to water and sanitation is driven by aid loans.

The share of loans in aid to the sector has increased, from less than a third in 2005 to over half of aid since 2011. In 2013, 50.2% of aid to the water and sanitation sector came as loans. Compared with other social sectors, this is a very large share. The health sector receives only 6% of aid as loans, and the education sector receives 14%.

Within the water and sanitation sector, aid loans go mainly to large system projects.[2] Between 2011 and 2013 large systems projects received on average two-thirds (64%) of all aid loans. This increase in aid loans to the sector, although helping to address financing gaps, nevertheless reduces already constrained fiscal space in low-income countries and contributes to risks around debt sustainability.

Most aid in the sector goes to water projects

Since 2010, data on aid flows to the water and sanitation sector can be broken down into aid to water-only projects and sanitation-only projects.[3] For both water and sanitation, aid to basic supply and aid to large systems can be tracked. A total of US$1.9 billion of aid to water and sanitation could be disaggregated between water and sanitation spending in 2013. Of this, aid to water received two thirds (65%). A large share went to large water systems (43%), while basic water received just over a fifth (22%).

Aid to sanitation represented just a third of aid to the sector that can be disaggregated (35%). Basic sanitation received the least at 7%, while aid to large sanitation systems was 28%. Given that the MDG sanitation target was not met, accelerating investments in sanitation are required.

Small but increasing levels of foundation grants

According to data from Foundation Center, foundation funding for water and sanitation has increased in recent years, reaching US$181 million in 2012, delivered through 340 projects. The largest donor was the Bill & Melinda Gates Foundation (US$119 million), followed by the Coca Cola Foundation, the Stone Family Foundation and the PepsiCo Foundation. While the objectives of funds are to be lauded, the volume of their financial contribution matched against the scale of the challenge of achieving universal access suggests the need for careful selectivity, with choices based on maximising impact beyond those immediately reached.  

Key recommendations from WaterAid:

  • A credible Sustainable Development Goal for universal access to water and sanitation will require increased aid to the most vulnerable and under-resourced countries, with a strong focus on equity, sustainability and strengthening systems.
  • Aid to water, sanitation and hygiene should at least double from current levels by 2020, with an emphasis on grant financing, effective targeting and addressing the neglect of sanitation and hygiene. A reassessment of progress and financing gaps should take place in 2020.
  • National governments and donors—including private foundations—should act decisively to improve aid effectiveness and strengthen country systems: through increased transparency, pooling of resources, more technical assistance, and aligning and harmonising all stakeholder inputs behind national processes.

[1] All figures on financial flows are in 2012 prices. Data refers to gross disbursements from all donors. Unlike net ODA, gross ODA disbursements do not take into account ODA loan repayments from recipient countries. Disbursements correspond to the release of funds or the purchase of goods or services for a recipient. All figures based on OECD DAC Creditor Reporting System, data accessed May 2015.

[2]  ‘Large systems’ is a sub-sector of aid the water and sanitation sector. ‘Water supply – large systems’ includes: potable water treatment plants; intake works; storage; water supply pumping stations; and large scale transmission/conveyance and distribution systems. ‘Sanitation – large systems’ includes: large scale sewerage including trunk sewers and sewage pumping stations; domestic and industrial waste water treatment plants. Other sub-sectors are: waste management and disposal; basic drinking and sanitation; systems support. For more information, see www.oecd.org/investment/stats/water-relatedaid.htm

[3] This presents some challenges, in particular that improved donor reporting under these purpose codes may skew trends analysis. The ability of donors to disaggregate reporting using these purpose codes depends on their internal management information and reporting systems.

Following up from World Water Week, we’ve rounded up a number of tweets from the annual global meeting in Stockholm. This year’s theme, “Water for Development”, allowed for the exploration of number of WASH topics -- from financing and the Sustainable Development Goals, to gender issues, climate change, and water management.

           
The author on the road in Chadiza District. Photo Credit: Sarah Fry of WASHplus, FHI 360

The author on the road in Chadiza District. Photo Credit: Sarah Fry of WASHplus, FHI 360

Editor’s Note: This guest post was authored by Sarah Fry, WASHplus activity manager for the USAID-funded project, SPLASH, which works to ensure that proper WASH facilities and hygiene education exist in schools. As the project nears its end, Sarah describes a surprise visit she took to SPLASH sites in Zambia’s Eastern Province and details a number of positive changes she witnessed, particularly in regards to engagement and ownership around WASH -- both within the schools as well as the broader communities. This post originally appeared here on the WASHplus Blog.

That’s literally, not figuratively, building bridges. Two weeks ago I would not have been able to even understand that question, but today I have a story to share with you. First of all, hello from Zambia. As the WASHplus activity manager for the USAID funded activity called SPLASH (Schools Promoting Learning Achievement through Sanitation and Hygiene), I have been here since early July working with our team to see this activity to its end on September 30th.

SPLASH began in early 2012, and since then has built over 3,000 school toilets, drilled, equipped or rehabilitated over 400 water points for schools, provided permanent handwashing and drinking water stations, and worked with teachers, the national government and local government to ensure that good hygiene practices and stronger systems for operating and maintaining school WASH facilities are put in place, and will stay in place. These activities have taken place in Zambia’s Eastern Province.

Before SPLASH started, Chief of Party Justin Lupele and I went on a “Road Show” out to the districts, where we introduced SPLASH to the government officials and local committees and started to build ownership and participation. The last three years have been a whirlwind of activity -- construction, training, community mobilizing, monitoring, publicizing, documenting. Justin and I thought that as the project nears its end, it would be good to go on another grand tour to get a solid sense of what has happened, what has changed, and maybe, what does it all mean. The only requirement we set was to not alert any schools that we were coming to visit.

Zambia is a vast, not densely populated country. Visiting schools requires spending a lot of time in vehicles riding on rough and dusty country roads. These distances impressed upon me how much staff and building contractor time and effort it took to reach the schools to carry out SPLASH activities. Bumping along, I had a chance to think and look forward to what we would find. I certainly expected to see positive changes and improvements at SPLASH schools. However, nothing prepared me for the sea of change that unfolded before us as we made our way to about 20 schools, mostly rural, but a few urban ones as well.

A school in Chipata. Photo Credit: Sarah Fry of WASHplus, FHI 360

A school in Chipata. Photo Credit: Sarah Fry of WASHplus, FHI 360

In 2012, we heard many complaints from schools about how communities were misusing their boreholes and denying any responsibility when they broke down. Now, every school has active WASH committee and pupil WASH Club and all are engaged in some form of joint school-community fundraising for maintenance and repair of the borehole. Handwashing after toilet use and before eating was a nearly universal practice by pupils, a habit acquired even if group handwashing hadn’t been inaugurated yet.

A major achievement was the presence of soap at almost all handwashing stations -- stealing soap is a thing of the past, we were told, because pupils want and like to wash their hands. Through the WASH Clubs peer education, they feel that the stations and the soap belong to them. Going beyond peer education, some WASH Clubs are visiting local health centers and performing hygiene skits and poems for women gathered for pre-natal and under-five clinics. In addition, Teachers were delighted with drinking water stations close to the classrooms because time away from lessons was reduced.

Possibly the biggest change was the universal acceptance of Menstrual Hygiene Management (MHM) as a necessary and welcome part of the school program. Zambia, like many African countries, has taboos, myths and restrictions around menstruation, which is almost never discussed openly. Facilities and support for menstruating girls in schools is nearly absent, causing girls to stay home and miss weeks of lessons during the school year. Girls at SPLASH schools were thrilled with their beautiful washrooms -- shower/toilet structures built to accommodate MHM.

However, no one had anticipated the envy of the boys, who are now demanding their own washrooms to clean up after sports. MHM has entered into the vocabulary and into the culture, to the point where one WASH Committee was holding pad making parties for the girls, but then headed out into the community to distribute them to women in need. The taboos around menstruation seem to have melted away.

While the news from schools is very good -- and we will soon be able to quantify what kind of effect SPLASH had on the schools -- we encountered even more good news during this visit, outcomes that I can only call “unexpected consequences” of WASH in schools, and that frankly, I was unprepared for. The big apparent message is that WASH in schools can lift an entire community up and can bring about changes that were previously not possible.

Classroom before SPLASH in Mambwe District. Photo Credit: Sarah Fry of WASHplus, FHI 360

Classroom before SPLASH in Mambwe District. Photo Credit: Sarah Fry of WASHplus, FHI 360

Launching SPLASH with School Led Total Sanitation “triggering” shifted social norms in surrounding communities around open defecation practices to such a degree that we heard of headmen ordering all households to build latrines or pay a fine! Over a thousand household latrines have been built as a result.

In one school receiving a water point, a new classroom block was built where previously there was only a thatched shelter. Teachers’ houses have gone up, and a new water source at another school enabled a clinic to be built nearby.

Every single school stocked soap and toilet paper -- a miracle right there -- and consequently local shops were seeing a rise in sales of hygiene products. Some schools have a “one child one bottle” policy, leading local businesses to stock up on drinks to satisfy the demand for bottles.

New classroom block built after SPLASH provided access to a new water source. Photo Credit: Sarah Fry of WASHplus, FHI 360

New classroom block built after SPLASH provided access to a new water source. Photo Credit: Sarah Fry of WASHplus, FHI 360

One of the best “unexpected outcome” is the engagement of artisans in building the latrines and washrooms, and who, in the process, have gained marketable skills.

They have found work on road crews (may the work be speeded up!) and other local construction projects and in one case were solicited by a health center next to a school that has decided to build an exact replica of a SPLASH toilet.

Leading the parade of successful new entrepreneurs is the ex-SPLASH artisan who proved so competent that once the latrine construction was done, he was hired to oversee the building of a new bridge. And that’s what WASH in schools and building bridges have in common!

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