[Individual articles from the Winter 2019 issue of Intersections will be posted on this blog each week. The full issue can be found on MCC’s website.]
Flooding is not only dangerous, but also dirty, particularly when the area flooded is underdeveloped and densely populated. High waters flush sewage, refuse, corpses and general debris back up into inhabited areas. Regaining access to clean water and sanitary living conditions after a flood takes significant time and resources. It can be easy to forget that dirty water is simply a fact of life for many rural communities, with or without the complication of flooding, and progress toward better water access is usually fragmented and slow. When the need is as broad as in rural Uganda, finding a place to begin is one of the biggest challenges, and one emergent pattern of development, more pragmatic than philosophical, is that long-term visions often get their footing as relief aid. In Western Uganda’s Kasese district, in the foothills of the Rwenzori Mountains that divide Uganda and the Democratic Republic of Congo, the catalyst to begin addressing widespread water, sanitation and hygiene (WASH) concerns in rural schools was disastrous flooding, which in May 2013 wiped out the health stability of several primary schools and their communities.
MCC works through partnership with local organizations which have the experience and connections to effectively navigate the local economic, political and cultural considerations that any relief or development project must address. MCC’s partner in Kasese is the development department of the Church of Uganda’s South Rwenzori Diocese (SRD). After reaching out to MCC in 2013, SRD conducted surveys of the area, looking for schools most impacted by flooding. SRD staff found high incidence of disease among students, mostly typhoid, cholera and dysentery from untreated drinking water further contaminated by flooding. The flooding had also destroyed many existing drainage systems, resulting in more stagnant breeding pools for malarial mosquitoes. The immediate concerns caused by the floods also highlighted endemic health issues at the schools, such as inadequate and under-maintained washing and toilet facilities and no established practices or systems to purify drinking water. MCC and SRD agreed on a short-term relief project, running from January through August 2014, that focused on returning identified flood-affected schools to a baseline of operation through the provision of food, school supplies and counseling to help students continue studying despite having lost homes and possessions. This partnership for limited relief activities opened the door for an ongoing partnership with SRD to address the WASH needs in these rural schools.
To counter the spread of waterborne illnesses, MCC and SRD focused at first on improving the WASH infrastructure at the schools, supporting the construction of latrines, washrooms, hand-washing facilities and water tanks to collect rain runoff from the school roofs, ensuring that this project met the standard humanitarian guidelines for the infrastructure required to meet the water, sanitation and hygiene needs of students at the schools. Building infrastructure, however, is insufficient: such construction efforts must be coupled with programs that seek to bring about behavioral change. To promote specific sanitation and hygiene practices, SRD and MCC supported the schools in setting up school WASH clubs. These clubs are active in spreading messages about WASH within the school and the surrounding community through songs and drama. These messages encourage students to practice good hygiene and use sanitation facilities appropriately.
Another club activity is to make ‘talking compounds,’ which are signs that are displayed in the schoolyard that share short health concepts such as “menstruation is normal.” Students and teachers are also provided with training on how to purify drinking water and maintain personal hygiene. Students learn to making ‘tippy taps,’ simple and inexpensive hand-washing stations consisting of a small jug of water suspended from a wooden frame: WASH clubs construct such stations throughout the school compound. Children are in turn encouraged to bring these techniques to their homes: follow-up visits by project staff have found that students have in fact begun erecting tippy taps in their homes and communities.
Perhaps the most progressive and promising aspect of the school WASH project is the provision of materials and training to young women to make re-usable menstrual pads (RUMPs). In many places, girls have a disproportionately low rate of school completion due to absenteeism because they have no simple and effective way to manage menstruation. The project staff provided training and materials to assist girl students in production and use of RUMPs. The entire school, including staff, receives education on menstrual hygiene to help break the pervasive stigma that menstruation is dirty and shameful. The project has resulted in reduced absenteeism, increased completion rates and improved performance for girls in the schools where SRD and MCC have introduced RUMPs.
The choice of where to direct resources is never easy, and sometimes commitment to a new development project needs the motivation and tangible impact of a relief effort to gain traction. In one region of Uganda, MCC and a church partner were able to build on a disaster relief response to address longer-term health needs in the community. Initial results from the construction of WASH infrastructure and the mobilization of WASH clubs show promise in preventing the spread of waterborne illness and reducing absenteeism and increasing school participation, including by adolescent girls.
Joshua Kuepfer was a SALT participant with MCC Uganda for the 2017-2018 year.