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.