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Greg Allgood, MSPH, PhD, Vice President at World Vision

Editor’s Note: This guest post is authored by Greg Allgood, MSPH, PhD, Vice President at World Vision, where he helps lead their water, sanitation, and hygiene efforts. He is also the retired Founder of the P&G Children’s Safe Drinking Water Program. In his post, Dr. Allgood affirms that, despite recent focus on innovative business solutions in WASH, philanthropic institutions play a crucial role in solving the global water crisis. He also encourages implementing organizations to participate in a survey sponsored by World Vision that will generate aggregated estimates of the number of people reached with WASH. The survey can be accessed here.

I applaud the work to create sustained business models providing clean drinking water; however, we need to remember that philanthropy has a critical role in reaching the poorest of the poor.  

As a person who spent 27 years with the private sector, I know the power of brands and the resources that can be mobilized based on using a for-profit model. And I believe that everyone should have clean water as well as adequate sanitation and hygiene that is sustained. But, I also know that the base of the pyramid -- the billions of people living in poverty -- represent a diverse population. Unfortunately, there are hundreds of millions of people who do not have clean water and cannot currently afford to pay for access to water.

In my visits to villages in the developing world, I frequently meet with people who do not have the resources to invest in clean water. Women have told me that they’d gladly pay for water if they had the money, but they can’t even afford the few pennies it takes to buy salt. People like these are probably best served by a philanthropic model that builds up the capacity of the community instead of investment in a for-profit model that may quickly fail and discourage future private sector investment.

In the development community, it seems recently that the voice for innovative business solutions to solve the global water crisis is drowning out the legitimate role of philanthropy. Both are needed. My organization, World Vision, -- like many other non-profit groups -- reaches into the hardest to reach places to provide clean water. We are playing a role to help enable governments to serve their people with clean water and to lift communities out of poverty so that the private sector can function.  

Through its WASH programming, World Vision reaches one new person with clean water every 30 seconds. Credit: World Vision

Through its WASH programming, World Vision reaches one new person with clean water every 30 seconds. Credit: World Vision

Furthermore, I frequently hear that charity isn’t going to solve the problem of the global water crisis. This is a misleading statement. Philanthropy or charity is playing a big and critical role in solving the global water crisis. But, I agree that philanthropy alone will not solve the crisis. We need philanthropic and private sector investment as well as governments all playing their role.  

The good news is that there’s growing confidence that we can solve the global water crisis by 2030. The scale of current efforts is estimated to reach 50,000 people a day in Sub-Saharan Africa with clean water. For perspective, World Vision, one of the largest providers of clean water, is reaching one new person with clean water every 30 seconds. And, we have plans to do even more. 

While it’s true that there is still a gap that we need to fill to make sure that everyone has clean water, dignified sanitation, and proper hygiene, isn’t it best that we give adequate voice to the role of charity in solving the global water crisis? 

In order to better quantify the role of philanthropy in doing their share to help solve the global water crisis, World Vision has commissioned a survey by KPMG. We are asking WASH implementing organizations to participate in a brief survey. It should take less than 20 minutes to complete. The survey results from all responding organizations will be used by KPMG to generate an aggregated estimate of the people who will be reached this year and next year with WASH. The overall purpose is to show the progress being made and the gaps needed to fill in order to solve the global water crisis. We anticipate that the combined tally of people being reached will be significant and help give a stronger voice to the legitimate and critical role of philanthropy.

Here is a link to the survey: KPMG World Vision survey

 

 

Leith Greenslade, Vice-Chair at the MDG Health Alliance

Editor’s Note: This guest post was authored by Leith Greenslade, Vice-Chair at the MDG Health Alliance, a special initiative of the Office of the United Nations Special Envoy for Financing the Health Millennium Development Goals. To coincide with the Global Day of Action for Child Survival, Leith writes about the relationship between toilets and childhood stunting, describing the scope of the problem and discussing the potential for improved sanitation through public-private partnerships. The original version of this post appeared here.

October 16th is Global Day of Action for Child Survival and I’m thinking about my mother…

“Don’t ever, ever eat in the toilet!” When I grew up I imagined every mother in the world admonished her children with this warning. If you’ve grown up hearing this message, as so many children in middle and high income countries have, you simply cannot think of food and toilets in the same sentence without some discomfort. And yet it turns out the relationship between food and toilets is much more positive than our mothers ever led us to believe. 

Quite simply, children who grow up in communities who use toilets are less likely to be malnourished and children who grow up in communities that defecate openly are much more likely to become what is called “stunted”, a horrible word that means much more than just being too short for your age and describes a condition that slows mental as well as physical development preventing children from reaching their full potentials.

How does the relationship between toilets and stunting work? The evidence is rolling in. Children who grow up surrounded by feces -- animal and human -- ingest it constantly which can trigger a disorder of the small intestine called “environmental enteropathy”. The intestinal walls of children who have this condition constantly "leak" bacteria into the blood stream causing chronic low-grade infections that consume vast amounts of energy to fight, leaving less nutrients available for growth. 

Small problem?…Not exactly. An estimated 1 billion people practice open defecation globally and 165 million children are stunted, with the greatest concentrations of both in countries like India, Indonesia, Pakistan, Ethiopia, Nigeria, Sudan, Nepal, China, Niger, Burkina Faso, Mozambique and Cambodia. In these countries, open defecation and childhood stunting have enormous health and economic costs. Globally, they are major contributors to the 6.3 million child deaths that occur each year, most from infectious diseases such as pneumonia and diarrhea, cost hundreds of billions of dollars in medical treatment for those who get sick, and significantly depress economic growth and development.

India is the eye of the storm with the world’s highest concentrations of open defecation (600 million), stunted children (62 million) and child deaths (1.3 million). To accelerate investments in reducing open defecation and improving child nutrition in India, the United Nations Foundation, the MDG Health Alliance and WASH Advocates co-hosted a discussion in September with leading experts to explore how public-private partnerships could tackle the sanitation/nutrition challenge in a more integrated way.

Participants included the Public Health Foundation of India’s Ramanan Laxminarayan, UNICEF’s Sanjay Wijesekera, Jean Humphrey from Johns Hopkins School of Public Health, Analia Mendez of Unilever, Lucy Sullivan from the 1000 Days Initiative, and Gardiner Harris from the New York Times, whose scathing article on the lack of access to toilets in India inspired the conversation. The discussion was in support of the UN Secretary-General’s Every Woman Every Child movement.

The panel acknowledged that food interventions alone can close only about a third of the average growth deficit of Asian and African children and that the global development community has substantially underestimated the contribution of sanitation and hygiene to childhood growth. Although there was agreement that increasing access to locally designed, manufactured and marketed toilets in participation with the private sector is a critical part of the solution (with Jim McHale from American Standard sharing details of their success in Bangladesh with the SaTo toilet and Analia Mendez outlining Unilever’s new Uniloo project), the panel argued for a big push to increase demand for toilets.

Gardiner Harris cited the recent SQUAT survey that revealed a strong preference for open defecation among older males in India and the work of the Rice Institute’s Dean Spears which shows that Hindus are 40% more likely than Muslims to practice open defecation, a factor that accounts for the large (18%) child mortality gap between Hindus and Muslims. Experts agreed education efforts and incentives to encourage toilet use should target the sub-populations most resistant to change.

Despite barriers on both the demand and supply sides, panelists acknowledged that political commitment for ending open defecation has never been stronger. At the global level the United Nations Deputy Secretary-General, Jan Eliasson, is leading the End Open Defecation campaign and the Indian Prime Minister, Narendra Modi, announced the Swachh Bharat Mission with the goal of ending open defecation in India by 2019, to coincide with Mahatma Gandhi’s 150th birthday. There is now an opportunity for  other stakeholders, especially the private sector, to fully engage with these public partners to drive down open defecation rates and simultaneously invest in child nutrition interventions. By delivering sanitation and nutrition investments together to the largest populations of children living in the open defecation communities, the deaths of many more children could be prevented and the lifelong impacts of stunting dramatically reduced.

Almost fifteen years ago the Millennium Development Goals (MDGs) set out to halve child hunger, reduce child deaths by two thirds and double access to toilets. With just 450 days left until the MDG deadline, the world has managed to reduce childhood stunting by 35%, child mortality by 50%, and those without basic sanitation by 30% -- impressive, but not enough to achieve the targets. In the time remaining, we need to pull out all stops to build new public-private partnerships to invest aggressively in integrated sanitation and nutrition solutions prioritizing the largest populations of children who grow up constantly exposed to feces.  

If you have ideas for a new sanitation/nutrition public-private partnership in any of the countries listed above please contact me at lgreenslade@mdghealthenvoy.org or send an email to everywomaneverychild@unfoundation.org.

Editor’s Note: This guest post is co-authored by Jonna Davis, Senior Program Manager for Dispensers for Safe Water in Kenya, and Nabil Mansouri, Program Manager in Malawi, both of Evidence Action. Jonna and Nabil describe how the program maintains user adoption rates in Kenya, Uganda, and Malawi. To learn more about Dispensers for Safe Water, read Evidence Action’s post for WASHfunders on the evidence-based origins of the program. Another post describes strategic efforts to diversify the initiative’s financing models.

On the face of it, Dispensers for Safe Water is easy to understand. Dispensers for Safe Water is a fast-growing initiative of Evidence Action that provides access to clean and safe water for close to three million people in Kenya, Uganda, and Malawi. It is slated to grow to 25 million users in the next five years. We do this by installing and maintaining chlorine dispensers directly at the water source where people in rural areas fetch their water. 

Customers simply add half a teaspoon of diluted chlorine to the jerry can in which water is typically collected, dosed correctly to safely disinfect the drinking and cooking water. Chlorine, of course, is a very effective additive to water used around the world in sanitation systems that kills 99.9% of harmful bacteria that, in turn, cause diarrhoea and other water-borne diseases such as cholera. 

Using the dispenser simply means turning a knob to release a dosed amount of diluted chlorine into the jerry can used for water collection. Credit: Evidence Action

Using the dispenser simply means turning a knob to release a dosed amount of diluted chlorine into the jerry can used for water collection. Credit: Evidence Action

Conveniently, chlorine dispensers are installed directly at the water source -- such as a borehole or simply an unprotected spring -- and are very easy to use. We see sustained adoption rates between 42% and 80% (such in Malawi where we have just begun an aggressive expansion).

We keep tabs on these adoption rates by regularly sampling cooking and drinking water in people’s homes to determine whether there is actually chlorine present in their water.

But getting people to use the dispensers to make water safe to drink is not achieved by the installation of dispensers alone. As we have seen time and again, a new gadget in and of itself is not enough for behaviour change to occur. We see high and sustained rates of adoption because Dispensers for Safe Water is more than just the dispenser. It’s the underlying foundation of community engagement, delivery, and ongoing maintenance that makes the program effective. 

Here is how it works:

Expanding into a new areas involves significant preparation weeks ahead of the actual installation. Dispenser for Safe Water team members meet with community leaders to get their approval for a dispenser as well as to familiarize these key stakeholders with how and why dispensers work. After approval is granted, we work with those leaders to engage users in the ‘barn raising’ of the actual installation of the dispenser. 

Dispenser for Safe Water community education meeting in Malawi. Credit: Evidence Action

Dispenser for Safe Water community education meeting in Malawi. Credit: Evidence Action

There are additional community meetings to elect a community ‘promoter’ -- typically a respected person in the community -- who is charged with maintaining and refilling the dispenser, and who reports any problems. The promoter also educates community members on how chlorine and the dispenser work, and why it’s important to disinfect the water. 

The promoter is a very important part of the success of the dispenser in a given community. Adoption rates have been as much as 17 percentage points higher when the promoter's water tests positive for chlorine than when s/he does not.

Once the promoter is in place and installation and community education meetings have been completed, there is the ongoing maintenance of the dispensers. Dispensers that are empty or in disrepair are not going to be used by our customers over time. We know that the biggest driver of decreased adoption is empty or poorly maintained dispensers, which is why we have developed such a strong “last mile” delivery and maintenance network.

A promoter is trained on how to refill and maintain the dispenser she is responsible for in Malawi. Credit: Evidence Action

A promoter is trained on how to refill and maintain the dispenser she is responsible for in Malawi. Credit: Evidence Action

Evidence Action maintains the dispensers through a network of circuit riders on motorbikes who visit a target number of dispensers daily in their catchment area, deliver a three-month supply of chlorine to the promoter in charge of the dispenser in a given village, and repair anything that needs to be fixed.

Promoters and circuit riders use mobile phone technology for tracking this work--for issuing and resolving maintenance tickets, checking off steps in the supply chain and other tasks.  

Tracking dispenser maintenance issues with mobile phones at the water points in Western Kenya. Credit: Evidence Action

Tracking dispenser maintenance issues with mobile phones at the water points in Western Kenya. Credit: Evidence Action

Economies of scale, combined with efforts to optimize the supply chain in the maintenance phase, ensure that the cost for Dispensers for Safe Water at scale is very low: just 50 cents per person per year. This makes Dispenser for Safe Water one of the most cost-effective WASH interventions with sustained high adoption rates on the market. With community engagement, promotion, and ongoing maintenance, users have a reliable product that is consistently used over time.

H2infO

Editor’s Note: This guest post is authored by our colleagues at the U.S. Water Partnership, who announced the launch of H2infO, a new web platform that provides global access to U.S.-generated data and knowledge on WASH. The official launch, hosted by Catherine Novelli, Under Secretary of State for Economic Growth, Energy and the Environment, took place yesterday afternoon at the U.S. State Department.  

Taking the first step in combating a problem is often the most challenging. For infants, that exhilarating first step unleashes a new freedom that takes them to new places (and sometimes trouble). Unfortunately, thousands of children may never take that first step or will experience increased difficulty due to stunting, as a result of unsafe water, inadequate sanitation and poor hygiene.

While water challenges vary across the globe, these issues are solvable. However, decision makers worldwide need to be equipped with the right tools to harness innovative technologies, expertise and resources to build sustainable solutions. Accessing useful information is the first step for designing these lasting solutions, but finding the right type of information can be a daunting task for users in developing countries.

In response, the U.S. Water Partnership (USWP) announced the launch of H2infO – a new platform that offers the global community easy on-line access to a growing library of U.S.-generated water data and knowledge. The United States has information and solutions to share.  However, our knowledge has been too fragmented for accessible use – until now. 

Launched on October 6, H2infO harnesses U.S.-based information and connects people to the data, knowledge and resources they need to address water challenges.  The portal currently hosts over 3,000 resources from leading institutions and more resources will be centrally accessible as this interactive tool continues to expand.. 

Step 1 – Visit H2infO

H2infO was developed by the U.S. Water Partnership, a public-private alliance formed to unite and mobilize U.S. expertise, resources and ingenuity to address water challenges where needs are the greatest. The U.S. Department of State provided additional support in the development of H2infO. The 3,000 resources currently hosted on H2infO are exclusively from U.S. Water Partnership members, a growing coalition of over 90 partners, including 19 federal agencies, academia, private companies, foundations and NGOs. Additional resources will be added to the portal regularly.

Step 2 – Explore the resources

H2infO was designed to help create catalytic solutions to diverse water challenges throughout the developing world. The portal serves as a water resource librarian – directing users to resources and linking them to relevant websites. Policymakers, service providers and service developers worldwide are able to access resources to engage in the following USWP themes: WASH, integrated water resource management, efficiency and productivity, and governance. Available H2infO resources range from training manuals and water scarcity maps to case studies and project reports.

For example, a policy maker in Angola can learn from experiences in Arizona on how to best manage water resources in times of drought; NGOs in the field can easily find training manuals to help design programs that build on decades of experiences; and lessons on trans-boundary water management in the Colorado River Basin can help build good neighbors in international river basins.

Step 3 – Build your toolset

H2infO recognizes the value of connecting multiple stakeholders to contribute resources from federal agencies, private sector, civil society and universities.  Water challenges cut across multiple sectors such as health, energy, and food.  A robust set of tools prepares decision makers to navigate these diverse sectors to build lasting solutions.

Climate change and population dynamics are among the factors to add stress on global demand and water supply. Decision makers around the world will increasingly search for available data and information on these topics. H2infO is the first installment of the U.S. Water Partnership’s commitment to the President’s Climate Data Initiative, which is a key deliverable of the President’s Climate Action Plan to cut carbon pollution in America, prepare communities for the impacts of climate change and lead international efforts to address this global challenge. A recent White House Council on Environmental Quality fact sheet recognized H2infO as a platform to help create a “virtual community of practice to share data, experiences, lessons and practices,” consistent with the goals of the Initiative.

The U.S. Water Partnership is excited to work with partners in the water sector to build on this platform and expand the diverse library of resources.  H2infO is now live at www.H2infO.us

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

Realising the human rights to water and sanitation, a handbook developed by the UN Special Rapporteur Catarina de Albuquerque to provide guidance on the implications for human rights in WASH services provision

Sanitation as a Business: Unclogging the Blockages, a report from the July 2014 conference, which includes concrete action plans around the challenges related to the scale up of sustainable sanitation

2014 WASH Sustainability Forum

The conference report from the 2014 WASH Sustainability Forum, which provides a summary of recommendation, next steps, and participant feedback that emerged from the meeting on WASH sector sustainability

New publications are added to WASHfunders’ Knowledge Center on a rolling basis, via IssueLab, a service of the 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.

As political leaders and civil society advocates converge in New York this week for the U.N. General Assembly -- as well as concurrent events such as the Clinton Global Initiative Annual Meeting and the U.N. Climate Summit -- advocates in the WASH sector are receiving some high profile attention. Here are some WASH highlights so far from this year’s UNGA week:

Climate Summit 2014

WaterAid’s Barbara Frost at UN Climate Summit

Chief Executive of WaterAid, Barbara Frost, spoke yesterday at the U.N.’s Climate Summit 2014 about the implications of extreme weather events and climate change for water, sanitation and hygiene. A blog post discussing the content of her speech is featured here on The Huffington Post.

Clinton Global Initiative

Water.org co-founders at the Clinton Global Initiative Annual Meeting

Water.org co-founders Gary White and Matt Damon participated in the Clinton Global Initiative meeting as part of yesterday’s plenary, Cities as Labs of Innovation (video starts at 53:15). The pair highlighted their collaboration with corporate philanthropy, including the Ikea Foundation, the MasterCard Foundation, PepsiCo Foundation, and the Caterpillar Foundation, to support their WaterCredit model, which assists poor households in secure loans to pay for water and sanitation facilities in their homes.

A post authored by Gary White and the CEO of the Ikea Foundation and published this week on the Guardian’s website also touches on the importance of innovative financing models and the participation of the public and private sectors in scaling safe water access.

Global Citizen Action Summit

WASH at the Global Citizen Action Summit 2014

Global Citizen Festival 2014 will be held this Saturday in Central Park, and while tickets for that event have already been distributed, at the time of publishing, registration is still open for this Friday’s Action Summit. The Summit’s session on sanitation starts at 11:30 am at New York University’s Skirball Center for the Performing Arts and the lineup of featured participants working in the WASH space includes:

Feel free to add other events going on in the world of WASH during UNGA week in the comments!

Alexandra Chitty, Research Uptake Officer at SHARE Research Consortium

Editor’s Note:This guest post is authored by Alexandra Chitty, Research Uptake Officer at SHARE Research Consortium. The Consortium comprises five organisations that have come together to generate research to inform policy and practice in the areas of sanitation and hygiene. In June, SHARE launched a toolkit on Violence, Gender and WASH, which brings together best practices as well as tools and policy responses to help make WASH safer. In her post, Alexandra shares the origins and goals of this project and describes the contents and reception of the toolkit.

The connection between poor WASH and gender-based violence has long been posited but, until recently, the realities of this relationship had received very little recognition or exploration. So, the SHARE Research Consortium, funded by DFID, decided to undertake research and learning on this issue and develop a Practitioner’s Toolkit on Violence, Gender and WASH in order to:

  • Shed light on the intricacies of this link
  • Raise awareness on types of violence which can occur with linkages to WASH
  • Offer practical guidance to practitioners on how to improve their programming and services to minimise the risks of gender-based and other types of violence, as well as how to respond to incidents of violence should they occur

You can view the toolkit here.

WASH and violence: the links

Although the root cause of violence is the differences in power between people, for instance between men and women or between people of different social groupings, poor access to WASH services can increase vulnerabilities to violence. A lack of access to a toilet in or near the home or poor access to water supply can lead to women and children defecating in the open after dark or having to walk long distances to collect water. This in turn can increase their vulnerability to harassment and violence, including sexual violence. A lack of easy access to water can also lead to tensions in the household or fights between neighbours or other users, particularly where water is scarce.       

The starting point for the research and the subsequent formulation of the toolkit was a need to better understand the scope and scale of the problem and to provide guidance for practitioners on how they can improve their programming to reduce these risks.

This bridge joins two areas of the community together. The banks are oftern used as a dumping ground for waste, and if people have constructed their own make-shift toilets, quite often they are situated along the banks, where children often play, Kamla Nehru Nagar, India. Credit: WaterAid/Jon Spaull

This bridge joins two areas of the community together. The banks are oftern used as a dumping ground for waste, and if people have constructed their own make-shift toilets, quite often they are situated along the banks, where children often play, Kamla Nehru Nagar, India. Credit: WaterAid/Jon Spaull

What’s in the toolkit?

The toolkit, co-published by 27 organisations, examines the available evidence around how a lack of access to appropriate WASH increases vulnerabilities to violence. Although much of the available evidence is anecdotal or from small scale studies, the research found case studies from more than 30 countries and a number of more in-depth qualitative and quantitative studies. A study in India, for example, found that women felt intense fear of sexual violence when accessing water and sanitation services. These findings were echoed in a similar study in Uganda where women reported that that journeying to use toilets, particularly at night, was dangerous for their security.

The toolkit provides practical guidance for policymakers, programme funding personnel, advocacy staff, implementers, trainers, monitoring and evaluation staff, and human resource staff on how the sector can help make WASH safer and more effective. For example, one of the ten key principles it advances is institutionalizing the requirement to analyse and respond to vulnerabilities to violence in WASH-related policies, strategies, plans, budgets and systems. To achieve this, organisations could, it suggests, undertake advocacy for increased attention on, and allocation of finances and resources to, reducing vulnerabilities to violence linked to WASH.

Key messages

Three main takeaways emerge from the toolkit:

  • Poor access to WASH services can increase vulnerabilities to violence, but the root cause of violence is the differences in power between people
  • Provision of WASH facilities alone cannot prevent any form of violence from occurring as they do not address the root cause of violence; for this wider societal change is required
  • WASH and associated practitioners can, however, make a very positive contribution to trying to reduce the exposure of those most vulnerable to violence

Progress so far

The toolkit was presented to DFID during World Toilet Day (2013) and was officially launched at the London School of Hygiene and Tropical Medicine on 9th June 2014. There, participants discussed how to better to engage women and adolescent girls in programming, how to engage men and boys on issues of safety, and how best to encourage busy WASH practitioners to consider these issues and integrate considerations of violence into their work.

The toolkit was commended for being highly relevant to DFID’s commitment to reducing violence against women and girls and to WaterAid’s focus on equity and inclusion as a framework for WASH service delivery. UNICEF also indicated that the toolkit was being used to adapt WASH programming and facilities in South Sudan and would be beneficial to the on-going work updating the Inter-Agency Standing Committee’s Guidelines for Gender-Based Violence Interventions in Humanitarian Settings.

Professionals working in over 40 different countries and working for 132 different organisations/institutions have received copies of the toolkit. It has also been distributed through the headquarters of international organisations and can be downloaded here.

Drawing on the toolkit, WaterAid will lead a one day capacity development workshop on the nexus between violence, gender, and WASH at the 37th Water, Engineering and Development Centre Conference being held in Vietnam this September. You can register for this event here.

The authors hope this toolkit will be a valuable resource to WASH and associated practitioners working across the globe to reduce WASH-related vulnerabilities to violence.  For more information on the toolkit, please contact us by email: gbv@wateraid.org

In recognition of last week’s World Water Week in Stockholm, we’ve gathered a number of standout tweets from this year’s event. Check out our selection below – and add your own impressions of World Water Week 2014 in the comments.

        

Editor’s Note: This guest blog post was co-authored by Erin Boettcher, Director of Program Excellence & Strategic Partnerships at Arc Solutions, and Adrienne Lane, Director of Development at Water for Good. In their post, Erin and Adrienne describe both organizations’ efforts in providing long-term WASH solutions in conflict areas. Stressing sustainability in WASH strategy, they highlight the importance of maintaining existing infrastructure, building local capacity, and identifying areas in which need is greatest.

The 2015 Millennium Development Goal for water access has been met, but the world’s most disadvantaged and vulnerable populations still lack improved access. Among the remaining 768 million people, populations living in conflict zones face distinct obstacles to safe drinking water including displacement, damage to infrastructure, and security threats. Common WASH responses in conflict settings involve temporary relief efforts that save lives. However, there is also a need for long-term WASH solutions, especially where low levels of water access existed before the crisis.

Students in Mogadishu enjoy clean drinking water at their school as a result of an Arc Solutions project. Credit: Arc Solutions

Students in Mogadishu enjoy clean drinking water at their school as a result of an Arc Solutions project. Credit: Arc Solutions

Water for Good has worked in the Central African Republic (CAR) for 10 years and has continued operations over the past year and a half as CAR has descended into civil war. Arc Solutions is committed to providing WASH services exclusively in conflict zones, working in Somalia for the past two years. Recently, our organizations have partnered on hand pump maintenance and community health trainings in CAR. We would like to share lessons we have learned working in WASH, where our goal has been to be attentive to the local context and to address underlying, long-term development needs.

Approaches to WASH development in conflict zones

1. Prevent the deterioration of existing infrastructure

In war-torn countries, water providers struggle to maintain WASH infrastructure. In rural areas, rehabilitating hand pumps is a common relief response and we participate in this work in CAR. Water for Good and Arc Solutions are also working to provide handpump maintenance for a network of 1,000 water pumps in CAR. Local maintenance teams travel to pumps on a regular basis, providing performance checks and minor repairs to manage the lifecycle costs of the pumps, preventing downtime and the premature need for rehabilitations.

2. Support resiliency of local institutions

July 24th, 2014, Water for Good team drilled a 278 ft deep borehole at St. John of Galabadja parish in Bangui, CAR, where thousands of displaced people are seeking protection. Credit: Water for Good

July 24th, 2014, Water for Good team drilled a 278 ft deep borehole at St. John of Galabadja parish in Bangui, CAR, where thousands of displaced people are seeking protection. Credit: Water for Good

Amid conflict, strategic investments in the expansion of sustainable WASH access can shore up and support local institutions that assist displaced families. In the last two months in CAR, local Catholic missions have co-funded 18 well-drilling projects for their compounds, where tens of thousands of displaced people reside. In Somalia, we have partnered with schools where the leadership takes ownership of the water project, including upkeep and maintenance. These types of projects serve the immediate needs of conflict-affected people and increase the ability of local institutions to support the population after conflict subsides.

3. Respond to protracted conflict

In Somalia, 70% of the population does not have proper access to water and temporary relief cannot be expected to sufficiently meet these widespread, long-term needs. Arc Solutions supports sustainable WASH projects currently reaching almost 10,000 people.

Lessons learned

1. Build local partnerships

Leyla Hassan, Arc Solutions Program Excellence Officer, collects information at a project site in Mogadishu. Credit: Arc Solutions

Leyla Hassan, Arc Solutions Program Excellence Officer, collects information at a project site in Mogadishu. Credit: Arc Solutions

Both of our organizations have found it to be critically important to operate through local staff and partner organizations. This is desirable in most contexts, but is essential in the midst of conflict. Foreign staff will likely be evacuated or hyper-restricted in their travel. The greater the capacity for local project management and implementation, the greater prospects are for the success of the project.

In CAR, Water for Good spent nine years recruiting and training over 100 local staff, establishing administrative offices in two cities (Bangui and Berberati), two full-service garages, two drilling teams, and four handpump maintenance teams.  The other firms left the country or lost capacity to drill once the war started, in part because they could not ensure the safety of their international staff and assets.

2. Anticipate and manage risks

Appropriate risk mitigation measures vary across contexts. However, we take the stance that international philanthropic organizations ought to take risks and provide capital and technical assistance to places where market-based and government-led resources are lacking.

In Somalia, Arc Solutions relies upon a local security partner to help determine project locations. Although risk cannot be completely eliminated, security vetting by a trusted partner can help us to choose locations with a higher likelihood of achieving sustainability. In addition, we seek to implement cost-effective projects, which make good use of resources and reduce financial risk if a project is damaged or destroyed.

3. Gauge prospects for sustainability

In the midst of conflict it is hard to know what local financial, administrative, and technical resources will remain available to maintain WASH infrastructure. Both of our organizations have had to ask questions about the status, dependability, and associated costs of local markets and supply chains that provide essential components for implementing and maintaining WASH projects. In response, we have connected local staff/partners to international supply chains and we provide ongoing logistical and financial support.

Water for Good hand pump functionality map, based on maintenance team’s on-site reporting. Interactive map available here.

Water for Good hand pump functionality map, based on maintenance team’s on-site reporting. Interactive map available here.

In CAR, there is low availability of basic parts required in the country and rural well committees have low capacity to maintain their wells. We have connected local staff with the India and Vergnet hand pump suppliers, creating a system for materials management and setting up a professional pump repair and maintenance program.

In countries with low state capacity and active conflict, sustainable WASH plays a critical role in bolstering civil society, maintaining infrastructure, and supporting displaced populations. While we recognize the value of emergency relief efforts, we wanted to share our experiences working to meet the long-term WASH needs of vulnerable communities in conflict zones. If you have questions about our work, please contact Adrienne Lane of Water for Good at alane@waterforgood.org or Erin Boettcher of Arc Solutions at erinboettcher@ilovearc.org. 

Advocacy in Action: Tackling an Overlooked WASH Challenge

Editor’s Note: This guest post is authored by Danielle Keiser, social media strategist at WASH United. The Berlin-based NGO harnesses the power of fun-to-play educational games, sport stars and positive communications to bring about attitude and behavior change around sanitation and hygiene. In her post, Danielle describes the genesis of the first ever Menstrual Hygiene Day, celebrated this past May. To find out more about the day, view the infographic here.

Until recently, considerations of menstrual hygiene management (MHM) have been largely overlooked in the general WASH agenda. Why? Is it because menstruation is strictly a “girls and women’s issue”? Or that boys and men are to a large extent unaware or uninvolved in discussions about menstrual hygiene? Or is it that menstruation is such a clandestine topic that makes people too uncomfortable to even talk about?

The average woman menstruates for 3,000 days in her life and during these days, she needs certain WASH conditions to maintain her dignity -- access to a safe and private toilet, access to clean, hygienic and absorbent materials, clean water and soap for washing, and adequate collection and safe disposal of the soiled materials. While these may be the physical conditions needed to ensure good menstrual hygiene, MHM as such is predicated on the idea that factual information about menstruation and menstrual hygiene practices must be widely understood, free from myths and unfounded taboos. 

What happens when these conditions are lacking, or don’t exist at all? Girls can drop out school. Their health can suffer. They can miss workdays. In essence, they can fall gravely behind.

An increasing number of organizations across the world are working to improve the lives of girls and women around this issue. Some focus on breaking taboos and banning traditional practices, such as the Nepal Fertility Care Center, while others such as Sustainable Health Enterprises in Rwanda, create locally-produced, sustainable sanitary pads.

And on May 28th, 2014, for the first time ever, 155 of these organizations joined forces and partnered to celebrate the first ever Menstrual Hygiene Day (MH Day).

How it all started 

In order to tackle the ‘private’ nature of menstruation in captivating way, WASH United wanted to create a Menstruation Extravaganza – a time and space to address menstrual taboos by providing factual guidance and positive information around menstruation. Thus, May MENSTRAVAGANZA was born, a social media campaign in 2013 that turned out to be wildly popular.

From all this positive feedback, it became clear to us that there was a need for an open advocacy platform around MHM that would bring together organizations from the diverse sectors working in the area. Wouldn’t it be great to create a global awareness day dedicated exclusively to putting the spotlight on menstrual hygiene and get the conversation around menstruation started?

Let’s do it!

The more partners we could get on board, the bigger the movement could become.  And by autumn, we were on track. We had over 25 partners, giving us a sign that we were moving in the right direction. However, it was really in the five months leading up to May 28, 2014 that the word of MH Day spread like wildfire. The intense interest people had in MH Day reinforced the fact that we were filling a very important void in MHM advocacy.

Why an open advocacy platform?

A diversity of actors – men and women alike - helps forge a strong, holistic movement that captures the different perspectives inherent in the complexities of MHM.

In our communications and outreach materials, we strive to mirror the open and collaborative nature of MH Day itself. “28 Conversations”, a guide to help start the conversation about menstruation in smaller, rural communities was collaboratively developed with Indian partner EcoFemme. And when the producers of the new short film “Monthlies” contacted us about coordinating the world premiere with Menstrual Hygiene Day on May 28, we were thrilled to give our partners another tool for raising awareness.

On the day itself

We were ecstatic to see a wide range of activities happening all over the world; the celebrations of MH Day were just as diverse as the MHM coalition itself. MH Day partners took genuine ownership over their individual activities and organized 31 events in 18 countries. A selection included:  

  • In Tharaka Nithi in Kenya, the county government along with a 30-partner coalition put on an event for 10,000 attendees that included entertainment, speeches by dignitaries, and the free distribution of pads, panties, and soap.
  • In Delhi, India, a multi-stakeholder discussion on MHM, expert consultations, and an exhibition were part of a national-level event led by PATH, Azadi, Water Aid, and WASH United.
  • In Nepal, the Nepal Fertility Care Center (NFCC) established a national menstrual hour, both in school and on radio stations, giving students and the public the chance to have their questions about menstruation and menstrual taboos answered.

Other activities that took place across the globe can be found in the 2014 MH Day Event Report.

What’s next?

The first MH Day exceeded our expectations, but was not without its challenges.

A major challenge we faced was the need to justify the use of the word ‘hygiene’ in Menstrual Hygiene Day. A few individuals coming from menstrual activism backgrounds felt that the word ‘hygiene’ carried negative connotations and reinforced the myth that women and girls are ‘dirty’ during their periods. In many developing countries, we explained, it is a matter of having access to certain WASH conditions to maintain hygiene, and thus dignity. We thoughtfully addressed this misconception and, in some cases, even garnered their support.

Another challenge had to do with capacity and scale. Because of the ever-increasing number and involvement of partners, we found it difficult to keep track of how and where events were developing. In the future, it might be a good idea to have regional coordinators to help organize this process. 

Finally, despite the good intentions of MH Day, we came to realize that talking about menstruation makes many people uncomfortable only because their views are colored by long-standing societal stigmas. All the more reason to keep talking and break the silence!

If you want to support the movement or learn more, get in touch with Danielle Keiser at danielle.keiser@wash-united.org or sign up for the MH Day newsletter.

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