January 6, 2008 – 1:55 pm
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PHASE 2. APPLICATION
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Applied Health Education
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Safe Water
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Safe Sanitation
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Productive Water Points
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| Applied Health Education: The second stage is to apply the health lessons learnt. Whilst some improvements can be achieved without much financial input there are basic requisites such as safe water and sanitation, which require considerable investment of capital, and are usually communal projects. It is recommended that if Agencies wish to use the Community Health Club Strategy there should be adequate provision in the budget for improvements in water and sanitation in the area. The community is so motivated by the end of the health sessions that implementation is rapid and can be managed very effectively by the club. It would be unethical to start health clubs without this budget, unless there is already a safe water supply in the area and sanitation coverage is high.
Demonstrating Appropriate Hand Washing Practices
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| Safe Water: By this stage health club members will be able to make effective action plans for improving water sources in the area, and this can be done by ‘Mapping’ and other participatory activities such as ‘2-way Ranking’ to establish priorities. Some typical water projects may involve the following: • Changing hand-pumps to more user friendly designs which can be easily dismantled and maintained at village level • Upgrading existing open shallow wells by adding a cover and windlass/bucket and providing upgraded wells for each family • Protecting existing natural springs • Repairing or rehabilitating existing boreholes • Gravity fed pipelines and storage tanks • Rainwater harvesting for members roofs.
Improved/Protected Well
A small water point committee is nominated from within the club membership and the club members elect those who are known to be reliable and thus will ensure sustainable safe water. Typically this committee consists of 6 people of whom more than half, (including the Chairperson) are women. They are then trained in the roles and responsibilities of managing the water point. Fund raising is done to secure a maintenance budget and a schedule is drawn up. |
| Safe Sanitation: This does not necessarily mean the construction of latrines. Sanitation in the rural context ranges in complexity from the simple covering of faeces (Cat Sanitation) to covered pit latrines, and eventually a Ventilated and Improved Latrine (VIP) or Pour Flush Latrine. The main objective of ‘total sanitation’ is to break the transmission of germs through the faecal-oral route and this is dependent on a faecal-free environment as a primary barrier. Using the above concept of safe sanitation, a latrine which is left uncovered or is soiled with faeces is in fact of more threat to public health than when there are no latrines at all, but the thorough use of ‘Cat sanitation’. The preliminary health education component of this programme is a vital foundation to ensure that all members practice safe sanitation not only with adequate facilities but also correct behavior. Past experience has shown that Community Health Clubs not only create a strong demand for sanitation but also that facilities are correctly maintained. (Waterkeyn & Waterkeyn, 2000) Community members are organized by the health club committee to dig and line pits before receiving any assistance from the programme. The issue of providing subsidies for the construction of private latrines is hotly debated, but in countries (such as Zimbabwe ) where this is the norm, it has been found that those receiving either cement or slabs should first have completed the health sessions. This not only provides a fair distribution system but ensures that those benefiting will use the inputs correctly.
Latrine with Pedestal
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| Productive Water Points: Community Health Clubs are by the 2nd year usually well organized and wanting to have a communal income generating programme. In areas where the local community is traditionally agricultural, this is the opportunity to use the water point for the production of fruit and vegetables. The expense of fencing for protection from livestock is often a constraint which has prevented the individual growing of vegetables. This has resulted in vitamin deficiency in the diet and the subsequent lowering of the immune system. In most health clubs a communal plot of around a hectare is fenced by the programme and within it each member is given land to grow vegetables. If there is no budget for fencing, traditional local hedging can be grown (euphorbia) to provide a sustainable and eco-friendly protection against livestock. Culturally, in many African societies, there existed a communal ‘Chief’s Plot’ where each member of the clan volunteered some time to grow food for the disadvantaged within the community. This practice has been adapted to provide for those families suffering from the effects of the HIV/AIDS pandemic. |
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çPHASE 1: KNOWLEDGE
PHASE 3: ECONOMIC SUPPORTè
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