Okot, P., Kwame, V., & Waterkeyn, J. (2005). Rapid Sanitation Uptake in the Internally Displaced People Camps of Northern Uganda through Community Health Clubs. Kampala. 31st WEDC Conference.
Abstract: When thousands of people are forced to live in poor living conditions in a closely confined area the immediate health risk is the lack of sanitation and the likelihood of cholera outbreaks as well as diarrhea resulting in high levels of mortality and morbidity especially amongst the children. In Uganda an insurgency by the Lords Resistance Army, has for the past 18 years been responsible for the displacement of over 1.6 million people in the North. In Gulu District, where this intervention is based, 89% of the population have moved from their rural homes into 33 Internally Displaced People’s (IDP) Camps, each with an average of over 15,000 per camp. IDPs live in temporary housing in squalid conditions, with open defecation, no solid waste disposal, and low levels of home hygiene. The few boreholes provided at these vast camps cannot meet the demand and serve between 1,000 to 2,000 people each. In the largest settlement of Pabbo Camp with 68,000 people there was an outbreak of cholera and investigation pointed to contamination of boreholes as a primary cause. There is also 31% acute malnutrition in the camps, and malaria is endemic.
A local NGO, Health Integrated Development Organization (HIDO), has recently been formed, supported by CARE International, to tackle this issue. Their field officers, mainly clinicians, live full time in 15 IDPs camps and have started 116 Community Health Clubs with 15,522 regular members who meet weekly for hygiene sessions. Although this programme has only been going since January 2005, it has been readily received by the IDPs themselves and despite the failure of many previous efforts to involve the community this strategy has met with little resistance. Within three months health club members have constructed 3,504 latrines, as well as 3,372 drying racks and 1,472 bath shelters. A base line survey was done before the project start up showing less than 5% sanitation and extremely poor hygiene practices. Judging from the acceptance of recommended practices within the health clubs to-date, it will be possible by September 2005, to see some significant improvements. In addition new technologies such as the Poly sanplat, (which has been designed specifically for this programme), and the Tipppy Tap for handwashing, (a method recommended by Ministry of Health for some time), are proving appropriate for the massive task of improving hygiene and sanitation in IDP camps. The strategy has been based on the AHEAD methodology using participatory PHAST training tools, and this adaptation to suit local conditions may provide a future model for other agencies working in these areas. The target is to involve 120,000 people in health promotion and provide 10,000 latrines by the end of the programme. If this is achieved, preventable diseases should decrease and given that people from the same village tend to cluster together in the same IDP camps, their Health Club should continue to manage community health when they are eventually able to return to their home areas, so helping to rebuild their lives on hygienic principles.
For full article in pdf, click here: Rapid Sanitation Uptake in the Internally Displaced People Camps of Northern Uganda through Community Health ClubsFor a copy of the presentation from the WEDC Conference in pdf, click here: Rapid Sanitation Uptake in Internally Displaced People Camps in Northern Uganda through Community Health Clubs: Presentation at 31st WEDC Conference, Kampala