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Editor’s Note: This post was authored by Robert Hedlund, founder and CEO of Joint Development Associates (JDA) International. With a degree in Mining Engineering from Colorado School of Mines, Robert Hedlund spent 17 years in both underground and open pit mining operations before moving with his family to Uzbekistan in 1992, and founding JDA International, a humanitarian and development organization. Since 2001 JDA has been involved in rebuilding communities in northern Afghanistan. The organization’s current activities focus on appropriate farming methods and mechanization, WASH education, and birth life-saving skills (BLiSS) training in the region.

Girls enjoying a reliable source of clean well water at their school.

Girls enjoying a reliable source of clean well water at their school.

Widespread poverty and decades of war have made Afghanistan one of the worst places in the world for sanitation and hygiene. Despite ten years of international investment and relief work, it remains one of the most underdeveloped and poorest countries in the world. Eighty-five percent of the population lives a minimal subsistence life in desolate rural areas — no gas, electricity, or running water. Infant mortality is the highest in the world. Annually more than 85,000 children under the age of five die from diarrhea alone. The cause is almost always a lack of clean water. Seventy percent of rural areas don’t have a sustainable supply of safe water.

Challenges mirror those in other parts of the developing world. Thousands of previously donor-supported wells and hand pumps or community water systems are often useless or abandoned within a few months of installation because construction projects were implemented without community education or pump repair training. Additionally, WASH efforts geared toward Afghan women are particularly challenging due to overwhelming illiteracy — over 90% of the women are illiterate.

Joint Development Associates (JDA) International’s WASH initiative is multifaceted with strong emphasis on education, community initiative, and hands-on training. Based out of Mazar-e-Sharif in Afghanistan, JDA has been working with success in 10 villages in the Balkh province of northern Afghanistan. Effecting behavioral changes, lasting adoption, and transformation take time and commitment to long-term development. We consider ourselves a catalyst for transformation, and building community trust and relationships are central to how that change takes place.

Although our program is barely four years old, the dedication of our Afghan team is shaping new understanding and reducing diarrheal sickness and deaths in infants. The needs across the country are vast and our program comparatively small. Many cultural and traditional obstacles have to be overcome, such as the widespread practice of not providing liquids to infants when they have diarrhea or the misconception that canal water is safe to drink as long as it is moving.

Our WASH education program, which we introduced to rural villages and taught to illiterate women, is having tremendous impact on families’ lives. Initial contact with new villages is always preceded by meetings with elders and village leaders. Demand-driven and community supported projects include agreements to maintain new water points and send women for training. It is critical to first target women as they are the main influencers of households and in turn share the newly acquired practices with their children and husbands. In order to build community trust, WASH teams are led by Afghan female educators and training sessions are home-based. Participants learn about hand-washing, proper disposal of household waste and feces, other ways in which health is impacted by sanitation and hygiene practices, and the use of locally produced biosand filters. Using pictures and other visuals, lessons are tailored to the illiterate population.

Seeing behavioral changes and community transformation is exciting, and keeps me motivated to continue our work in Afghanistan and support this initiative. One participant, Halima, said: “When the instructor was teaching the diarrhea lesson, I thought of the woman in the story and how she could have been me. I would have done all that I knew to do, but my child would have died from diarrhea anyway. Then I would always have wondered what could I have done for my other children to control the diarrhea? Now I know what I can do.” Another woman, several months after installing and using a biosand filter in her home, happily reported: “Not a single one of my ten children has suffered diarrhea.”

JDA also teaches WASH education in elementary schools. Through puppet shows and fun, interactive play, thousands of children have learned that hand-washing can be an effective deterrent against disease from flies and bugs, and that ditch water can make them sick. Both men and women are engaged through well drilling and hand pump repair training, a critical component of keeping new wells functional long after installation. Often the men, who learn how to maintain and repair their village wells, end up training others. Behavioral change and transformation are possible even in the worst conditions. We have learned that people desire change when the change directly benefits their families. At JDA, we seek to highlight that connection and to engage in WASH solutions from a community-centered standpoint.

Editor’s Note: This guest post was authored by Shalini Nataraj, director of advocacy and partnerships at Global Fund for Women. Shalini discusses why it is important to address human rights, specifically women’s rights, on the local level to determine context-specific and appropriate WASH solutions. She also highlights the work of three Global Fund grantees based in Vietnam and Kenya who serve as examples of organizations successfully tackling these issues. 

Participant at Global Fund convening in Kenya learning about indigenous plants and organic farming methods. Credit: Global Fund for Women / Margaret Youngs

Participant at Global Fund convening in Kenya learning about indigenous plants and organic farming methods. Credit: Global Fund for Women / Margaret Youngs

A well is a well, right? As a funder, you fund the digging of a well for a community that lacks access to clean water, and the hoped-for outcome is that the problem is now solved. Unfortunately, in many parts of the world, it is not so simple. The well’s location might make women more vulnerable to sexual assault, for example. 

As a funder, Global Fund for Women supports organizations that seek to address access to water as a fundamental human rights issue. These organizations address the inequities, and ensure that the rights of the local women are respected.

In July 2010, the General Assembly of the United Nations and the Human Rights Council formally adopted a resolution calling on States and international organizations to provide financial resources, build capacity, and transfer technology, particularly to developing countries, and to provide safe, clean, accessible, and affordable drinking water and sanitation for all. While this recognition of the human right to water is based on many legal principles, what does ensuring the right to water look like at the local level?

Unless those of us who fund WASH understand that access to water is fundamentally about power relations and systemic societal inequities, with national priorities often working in favor of the powerful and wealthy, funding access to clean water and sanitation is going to be piecemeal and unsustainable.

The first question that needs to be answered is, “Who benefits?” The answer is not simple. In answering that question, the conceptual framework of the human right to water can challenge the underlying structural inequalities plaguing the poor and powerless communities around the world who lack access to water. It offers these communities the tools and arguments to hold the State accountable for implementing its human rights obligations, and to demand that the basic needs of the communities are met over the wishes of the few who have the power and money. It is about funding a range of strategies and interventions that create the enabling context for sustainable WASH programs.

Global Fund prioritizes funding women-led organizations that not only seek to address the immediate needs of communities, but also advocate for the rights of communities. We enable women to access the training and tools to advocate on their own behalf.

Global Fund grantee, Center for Water Resources Conservation and Development (WARECOD), in Vietnam, operates projects to improve water access in several poor riverine communities. Using a holistic approach, it educates the public and the government on the social and environmental impacts of dams and the benefits of alternative methods of energy development.

Women and girls in remote and rural areas of Vietnam are excluded from the decision-making processes in local development projects, especially with regard to natural resource management. WARECOD is particularly focused on fishing villages along the Red River in northern Vietnam that provides water and nutrition to millions of people. WARECOD says that, “social customs and traditional responsibilities relegate fishing women to lower social levels than males, lower even than social levels of other women in rural areas.” In a world where the Food and Agriculture Organization states that women are most often the collectors, users, and managers of water in the household, as well as farmers of crops, WARECOD recognizes the need to ensure women are supported in their vital role in managing environmental resources. WARECOD’s water management projects are designed to increase the capacity and decision-making power of women in the community, and by transferring critical skills and knowledge in their water management program, WARECOD hopes to create a channel for women to exercise their participation and rights.

WARECOD operates several projects to supply local communities with access to clean water, help rebuild elementary schools, and aid farmers in obtaining advanced farming technology to increase their income. Staff are also gathering data on the livelihoods of fishing women and their access to clean water. WARECOD plans to use the research findings to support future advocacy work, so that it can use concrete data in pressuring local governments to improve the living conditions for women and girls in the area. The findings will also be documented and distributed to local authorities and agencies, and presented at conferences.

A long-time Global Fund grantee, Groups of Women in Water & Agricultural Kochieng (GWAKO), works in Kochieng, western Kenya, to improve women’s health, protect girls’ right to education, and boost women’s economic status. The overwhelming majority of Kenyans don’t have access to clean water. Girls’ participation in education is severely restricted because they must spend hours fetching water for their families. Water-related diseases continue to be among the four top causes of death among women on the African continent.

GWAKO activities have resulted in wells in rural communities where women previously traveled for three to six hours to fetch water. The organization also conducts community education about hygiene and sanitation, improves farming methods for women, and installs washing facilities and latrines in schools. It has grown into a consortium of forty-one women’s groups in more than fourteen villages. GWAKO has also improved women’s access to food by training the women in modern farming methods that produce higher yields. Such changes are critical in a region where severe poverty increasingly forces girls into transactional sex to obtain food.

Also based in Kenya, Grassroots Organizations Operating Together in Sisterhood (GROOTS), builds demonstration plots to train women in improved agricultural practices. GROOTS works with women farming groups to provide training on sustainable agricultural practices, such as greenhouse use. More importantly, GROOTS created watchdog committees to safeguard women’s property and advocate for land tenure, housing, property, and inheritance rights of women and children. GROOTS facilitates direct participation of grassroots women in various national, regional, and global conferences, creating a platform for women most impacted by development policies to be heard by decision-makers. Its efforts have resulted in increased women’s representation as village elders, provincial administrators, members of local development funds, and in the management of educational institutions.

These examples seek to illustrate Global Fund’s approach to funding WASH — one that acknowledges the realities in which communities operate — and to creating systemic change in order to ensure long-lasting solutions to WASH issues. Using women’s rights, especially the right to water, as a lens to fund WASH programs is a sustainable way to build just, equitable, and peaceful societies. 

Urvashi Prasad, program officer of the Michael & Susan Dell Foundation

Editor’s Note: This post was authored by Urvashi Prasad, program officer of microfinance and health at the Michael & Susan Dell Foundation. Prasad highlights the intersections between microfinance and WASH, and discusses the baseline issues that must first be addressed for this kind of cross-sector work to succeed. A version of this story originally appeared on the Michael & Susan Dell Foundation blog.

A recent CGAP blog post highlights an often unrecognized role microfinance can play in the lives of the poor: enabling access to critical infrastructure services like water and sanitation. As the post explains, the idea is simple. By providing people with low cost loans, microfinance institutions (MFIs) “grow water and sanitation assets and infrastructure at the city, community and household levels.” The approach works, notes the post, by “tackling one problem (access to safe water and sanitation)” through “a related yet critical bottleneck elsewhere (access to finance).”

At the Michael & Susan Dell Foundation, we view this work as vital, and we’ve supported efforts to link microfinance with water and sanitation infrastructure in urban areas across India. But our own experience in the field has taught us an enormous amount — not just about the potential of such projects to change lives, but also about the non-financial and non-technical complexities of successful implementation — and about the challenges of successfully encouraging people to integrate new habits into their daily routines.

What we’ve found is that to advance this work, organizations must be prepared to navigate and resolve at least three major baseline issues:

1. Lack of demand among community residents 
From the outside, it’s easy to assume that communities that lack access to water and sanitation must be clamoring for it. Ready access to clean water would mean healthier kids and families, better attendance at school, less time wasted waiting for water. But that assumption is frequently incorrect. Even in urban areas where people are generally more aware of the importance of water and sanitation, our experience suggests that awareness does not necessarily (or easily) translate into willingness to pay for access to facilities. Why? Because although people who are not sick are able to work more (or if they’re children, attend school more often) and earn more as a result, there is no obvious, short-term income benefit connected to having clean water or a toilet. And among the poor, who face a struggle to meet an endless number of immediate needs, clean water and sanitation are often added to a long list of nice-to-haves.

Even when access is in place, behavior change often remains elusive. In fact “persuading the villagers to drink, and pay for, clean water,” might be the biggest obstacle to change, as noted in one recent article in the New York Times. The key to success of water and sanitation efforts is thus working with communities to create real demand for the services. Moreover, organizations must also monitor functionality and usage after infrastructure is installed. Clearly, health and other outcomes like productivity will only improve if people actually use the facilities on a regular basis.

The good news is that, if the work of building community demand is done upfront, slum families are willing and able to make the upfront capital investment — especially if it is payable in easy installments through loans from microfinance institutions. Better yet, engaging individual households in contributing to the costs of the infrastructure helps build a sense of ownership, which, in turn, mitigates maintenance issues.

2. Significant barriers to entry
Unlike traditional microloans, loans for water and sanitation must be offered in conjunction with a much broader set of services. These include not only demand creation, but also:

  • Assisting communities with technical aspects of construction
  • Liaising with the government for approval of household connections
  • Ensuring appropriate end-use of the loan
  • Monitoring functionality and usage of the infrastructure

Putting together a complete package to handle each of these elements can be quite daunting even for the most socially-oriented MFI. MFIs seeking to offer water sanitation loans should actively seek out a model that works within the constraints of their own operating environments. They might opt to build the capabilities in-house, actively collaborate with community-based organizations or otherwise offload some of these activities to a trusted partner. Grameen Financial Services Pvt. Ltd, for instance, has established partner NGO entities to handle crucial, non-financial activities.

3. Government support and subsidy
If the goal is to provide 100 percent of households in a particular slum with basic services, government programs that subsidize the costs of household level infrastructure are critical. The Slum Networking Project in Ahmedabad, which provided entire slums with a suite of basic services, is a case in point. The project required households to contribute a subsidized amount towards the infrastructure. The model depended on both household contribution (a key factor in instilling a feeling of ownership and responsibility for newly built toilets, taps and infrastructure) and subsidies, which eased the financial burden and enabled the participation of a large number of families.

Fifty percent reduction in water-related diseases
Given the complexities involved, is the effort to link microloans to water and sanitation work worth pursuing? The answer is an unequivocal yes. The cost of doing nothing is too high. Dirty water causes a host of diseases, and kills thousands of children annually. And with deliberate planning and a clear eye on managing through the intricacies at every stage, success is possible. In Ahmedabad, customer satisfaction surveys conducted by some of our partner organizations suggest that usage of infrastructure continues to be high (more than 80 percent) a few years after the facilities were constructed. An impact study (which included a different sample set than the survey) showed that incidence of water-related diseases, including typhoid, jaundice, diarrhea, cholera and malaria, as well as other stomach problems, had decreased by more than 50 percent in slums where households received both water and sewage connections.

Read the CGAP blog post that sparked this post “Microfinance for water and sanitation: An example of client-focused innovation.” Learn more about our work in water and sanitation.

Editor’s Note: This guest post was authored by Nicole Rosenleaf Ritter who is the communication specialist for the Project WET Foundation, a nonprofit based in Bozeman, Montana, and active in more than 65 countries. Nicole discusses Project WET’s evaluation work, including its innovative use of mobile technology and collaboration with Engineers Without Borders. All of the WASH education materials referenced are available for free download on the Project WET web site, including formal reports regarding the northern Uganda evaluation process.

Teachers in rural northern Uganda used mobile phones to complete follow-up surveys about the impact of WASH education. Credit: © Project WET Foundation

Teachers in rural northern Uganda used mobile phones to complete follow-up surveys about the impact of WASH education. Credit: © Project WET Foundation

The Lake Victoria Primary School (LVS) in Uganda offers an object lesson for anyone curious about the importance of WASH education. As part of a water provision project, gutters and downspouts were constructed and a water tank was provided to LVS to allow the school to harvest rainwater. What wasn’t provided as part of the project was education — either about the benefits of rainwater harvesting or the way such a system would be set up. As a result, the water tank ended up unused and in storage with small, potentially contaminated containers capturing only a tiny fraction of the usable water. Meanwhile the school was shelling out US$600 per month for municipal water that was available from only one tap.

Enter Aggrey Oluka, LVS’s head science teacher. Fed up with high rates of waterborne illness and unsustainable water bills, Oluka went looking for solutions. He found the Project WET Foundation, which was launching a new program in Africa with USAID to create culturally appropriate WASH-related educator guides, children’s books, and classroom posters, and to train teachers to use them. He participated in writing workshops for the materials and enthusiastically adopted them for use at LVS. Applying the knowledge he and his students had gained, Aggrey was able to finally get the rainwater harvesting system implemented — to the benefit of the students’ health and the school’s budget. The municipal water bill dropped to just US$30 per month, and students had increased access to clean water for healthy habits such as hand-washing.

Thanks to experiences like this one, the value of WASH education is finally being recognized. The WASH Sustainability Charter gives WASH education top billing, with the preamble singling out “the lasting provision of safe water, sanitation, and hygiene education” as a “leading development priority of our time.” (For more information on the Charter, read this WASHfunders guest post.)

Given the growing influence of WASH education, finding ways to measure and evaluate educational programs and projects is also increasingly important and challenging. While it stands to reason that a populace educated in the basics of water, sanitation, and hygiene will be better able and more likely to actively participate in sustaining water provision projects, the evidence surrounding WASH education’s impact on behavior remains in early stages.

As a longtime proponent and provider of WASH education, the Project WET Foundation is exploring new and innovative ways to evaluate the results of its WASH education materials implementation. Targeting youth through school and community educators, Project WET materials, including educator guides and lesson plans, colorful children’s activity booklets, and durable classroom posters, teach children, parents, teachers, administrators, and government officials  about WASH using games, songs, role-plays, whole-body learning, subject integration, and other interactive pedagogical methods.  Educators learn to use the materials through a train-the-trainer process, and students share the lessons they learn at home and in the community. Materials have been translated and localized on three continents, reaching millions of children.

So what happens after the intervention? Getting to that answer is critical for all WASH education actors, but it is not easy. Partnerships and novel approaches can help.

Following implementation in rural northern Uganda in 2009, Project WET used traditional site visit and survey techniques to evaluate results in 2010. However, recognizing the limitations of those techniques — particularly the lack of reliable internet connectivity for e-mail follow-up, the prevalence of teacher transfer, and the time constraints for staff — Project WET teamed up with Adam Lerer, a PhD candidate from the Massachusetts Institute of Technology. Lerer’s thesis work focused on using the Open Data Kit voice system, a web-based interactive voice response technology that allows the user to design and record survey calls to be received on any kind of mobile phone. 

The innovative combination of mobile phone technology plus traditional techniques, allowed successful follow-up with 92 of the 500 schools where educational materials were implemented at a cost of US$5.90 per teacher and US$.06 per student. The mobile phone surveys allowed teachers and schools to respond quickly and easily, boosting return rates. The data collected showed that of the schools who responded to the follow-up, 90 percent were still using WASH education materials with their students a year after implementation, and 92 percent reported positive changes in student behavior related to water, sanitation, and hygiene. Increased hand-washing behavior and facilities were most often reported, as well as healthy behaviors relating to water storage, cleaning of the latrine, and water sources. At least 25 percent of users reported that the materials had also been shared with the wider community, supporting the notion of schools as gardens where ideas can grow and be shared.

While mobile phone surveys provide a promising, low-cost evaluation technique, extended on-the-ground monitoring is likely to remain the gold standard for independent assessment. However, many nonprofit organizations cannot afford to carry out such programs on their own. By partnering with the Montana State University chapter of Engineers Without Borders (EWB), Project WET has been able to both wrap education around water provision projects EWB has underway in Kenya and tap EWB student leaders to carry out year-by-year site evaluations in areas where Project WET materials have been implemented. The results of this three-year study — due out in 2015 — should shed light on the effects of WASH education on water provision projects and communities. 

By partnering inside and outside the WASH sector, experimenting with innovative techniques, and — most importantly — sharing lessons learned, WASH education practitioners can improve the work being done and secure education’s place at the center of WASH sustainability.

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