Providing sustainable latrines in OBIRA, Uganda.

An evaluation

Summary

• The project aimed to improve sanitation and hygiene to reduce the incidents of water-borne disease by increasing the availability and use of latrines and improved latrines in Obira. (Improved latrines are more sustainable and have a sanplat or concrete sanitation platform).
• The project involved the building of sanplats for 131 latrines. These were given to individual households to enable them to build their own improved latrine.
• Hand Washing (HW) Ambassadors were also trained. They trained the residents of Obira on the hygiene aspects and how to construct a tippy-tap.
• Between 2011 and 2019 the number of households with their own latrine has increased from 10% to 98% and 88% of households have improved latrines.
• 91% of residents reported that they wash their hands after going to the toilet using tippy-taps they have built close to their latrines and 20% use soap.
• People have noticed fewer flies in the home and that improved latrines are easier to clean, safer for their children to use and more private.
• The improved sanitation has resulted in the reporting of fewer incidents of sickness and diarrhoea and an improvement in school attendance.

The village

Obira in 2017 was a village with a population of 1,360 people (170 households) located within Nawanyingi sub-county of Iganga District in Eastern Uganda. The project was carried out between 2011 and 2017. (The population has now grown to 1600 with 200 households SEE BELOW)

Prior to Water for Kids (WfK) Intervention

In 2011, it was estimated that just 10% of the 170 households had simple latrines installed. These latrines were poorly constructed (posing a danger of collapse), difficult to clean and provided limited privacy for users. The majority of Obira practiced open defecation. This may have been considered safer, hygienic or culturally deemed more appropriate than defecating ‘inside’. Open defecation is commonly attributed to increased rates of sickness and diarrhoeal conditions, especially where food crops, potable water and the immediate environment is contaminated with faecal bacteria.

Aims and Objectives of Project

The aim of the project was to reduce the incidents of water-borne disease in Obira. The objectives were to deliver improved latrines to individual households and to provide safe water and hand washing training, thus improving sanitation and hygiene.

How was the Project Delivered?

Latrines

A total of 131 latrines were built in Obira using WfK sanplats (two sanplats per latrine). During 2013 and 2014 a total of 44 latrines were built with ready-made sanplats purchased elsewhere. Then between 2015 and 2017, 87 more were built using sanplats constructed in Obira following the training of some residents. This reduced the costs and allowed custom designs to be created which improved overall quality and fit for purpose.

Training

Six people in the Iganga district were trained as Hand-washing (HW) Ambassadors (by the Uganda National Hand-washing Campaign) including the local WfK team and one resident of Obira. HW training was then carried out in Obira village. Training was led by a Hand Washing Ambassador; allowing information to be delivered in local dialect and by a familiar community member. Residents were encouraged to install a tippy tap near to their latrines enabling hand washing facilities.

Water

The village has a spring-water source and a borehole. In 2011 WfK protected the spring by building a dam at the spring water source to provide clean water which is easier to collect from a pipe. It has also repaired and helped to maintain the borehole since 2014. The effect of improving the water supply has not been evaluated in this report.

Obira in 2019

In April 2019, WfK returned to Obira. It is estimated that the population has grown to 1,600 people (200 households).

A survey of 50 households (representing 394 people) looked at sanitary arrangements in more detail. 49 (98%) households had latrines, with 1 household sharing their neighbours’. 44 (88%) latrines had Sanplats of which 25 were purchased and 19 were made locally.

Households indicated some latrines were not complete. 18 households had latrines with walls only, 13 latrines had a roof. Several latrines therefore were missing screen walls and doors. Interviewers noted households were not always informed as to what stage a latrine is fully completed. Other reasons given by households for not completing their latrines were lack of funds and they found it comfortable as it was.

41 of 44 Sanplat latrines were confirmed to be in use. Those not in use were not fully installed. Of the 44 households with Sanplat latrines, 31 previously had simple latrines which were not lined but covered with logs and earth and collapsing from time to time. 13 households previously practised open defecation. 49 out of 50 households said they have reduced open defecation.

40 (91%) out of 44 households now wash their hands after using the latrine, with 10 (23%) households using soap. 46 out of 50 households said they received a sanitation visit from the Authorities in the last 6 months.

Impact of Project on the Community

Interviews with residents of Obira reported fewer incidents of sickness and diarrhoea and an improved rate of school attendance. Residents also reported fewer flies in the home after the installation of a latrine, and that new or improved latrines were easier to clean, safer for their children to use and more private.

At least 94% of those interviewed are now using latrines, so the Obira community has almost eliminated open defecation.

Handwashing culture was also reported to be implemented amongst the majority of households with the use of tippy taps positioned near to latrines. This is a credit to the Hand Washing Ambassadors promoting hygiene within the community.

92% of households interviewed recalled a sanitation visit from the Authorities in last 6 months. The positives are two-fold; residents are familiar with the Authorities and vice versa, and an Authority presence may encourage residents to maintain good hygiene practices.

These outcomes are immensely beneficial. Sickness and diarrhoeal conditions can be highly infectious; accelerated by poor handwashing and sanitary arrangements. Less incidence of sickness at a household level reduces the overall burden on health for the community. It is highly probable that the use of latrines and tippy taps has contributed to the reduced incidence of sickness reported by residents.

Having latrines that are sustainable, safe and private to use has encouraged the further installation of and use improved latrines by the whole community. Since the project ended in 2017, sixty households in the village have constructed their own improved latrines without the help of WfK.

The project has made huge progress towards delivering improved latrines to individual households and Obira continues building latrines independent of WfK intervention. A new preference for latrines prevents almost all households from practising open defecation and demonstrates residents are using latrines without fear. This project was therefore immensely effective in providing sustainable improvements to hygiene and sanitation in Obira.

The views of Obira residents

The local people of the area were interviewed to find out what impact the project had on their lives, this is what they had to say:

• “Many thanks to Water for Kids for thinking about the poor, we now don’t fear to host visitors in our homes because we have good latrines and safe drinking water” said Nambi Beatrice
• Nabirye Mirabu added that the latrine they had before could not be used by the kids because the holes were too big for them to squat on, they therefore resorted to defecating behind the houses (open defecation) where she could remove with the hose and take to the pit latrines late, but with san plat latrines, even kids can use them very well. And now due to reduced open defecation they are able to pick vegetables for eating from anywhere.
• John Kibalya said “ I used to repair my latrine made in mud and wattle after every three months but after getting the san plat, I decided to build a brick one which I have been using for over 3 years without any repair.”
• Ruth Naikoba said “life has changed too much now I do not fear to use the latrine at any time as it has a door and screen wall for privacy and it can easily be cleaned unlike the traditional latrines we used to have.”
• “We now wash our hands and feel healthy” said Kagoya Hadija.
• “Water for Kids is more of parents to us, they first gave us free san plats, free protected spring and now trained us to make our own san plats at a cheap rate, who else on earth could do this?”said Aggrey Kasango.

Recommendations for future projects

The following recommendations are made for future WfK projects.

1. Research local traditions. Communities may have varying customs around the use of a latrine. One household interviewed in Obira referred to their belief – that latrines should not be shared with their In-Laws. In this case, it may be preferred to have separate latrines for different genders or family members. Prior research could overcome a foreseeable barrier to accessing latrines.
2. How can WfK encourage Authorities to continue a strong presence in Obira? Checks on sanitation, maintenance of latrines and hand washing facilities is a key factor in promoting hygiene practices long term.
3. Could WfK promote recording public health data within the target community? This may be through local Environmental Health Technicians. Data would help quantify any project outcomes and establish the most significant burdens on health. This information may assist in applying charitable resources to address multiple public health issues. For example,
   1. Interview data identified rubbish pits were not available to almost half of households; with the majority of pits in a fair or poor condition.
   2. Interview data identified 10 out of 50 households wash their hands with soap after using the latrine.

Could these issues have been identified earlier in the project with the help of public health data? Could Hand Washing Ambassadors and those residents trained to construct Sanplats pooled their skills to address these issues during the project?

Many thanks to Mary Mcloughlin and Rose Dindol(volunteers) for compiling this report and thanks to our Iganga WfK Team  carrying out the Survey.