Safe Drinking Water and Sanitation for School Children Zimbabwe Final Report to the Isle of Man Overseas Aid Committee July 2011-April 2012

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1 Safe Drinking Water and Sanitation for School Children Zimbabwe Final Report to the Isle of Man Overseas Aid Committee July 2011-April 2012 Executive Summary The project was a community-based intervention to improve the Water, Sanitation and Hygiene (WASH) situation in schools and surrounding communities in Bikita, a Cholera prone district of Zimbabwe. CARE worked closely with government departments, local authorities and communities in tackling both short term and medium to long term solutions to prevent cholera and other WASH related diseases. The project reached out to 3,865 households comprising 19,325 individuals, of which 7,730 were school children in 15 schools and surrounding communities. CARE used a comprehensive package that improved water supply, sanitation, and health and hygiene based on successes and lessons learnt from previous engagements with schools in other areas in Bikita district. Specifically, the project focused on borehole rehabilitation, latrine and hand-washing rehabilitation and construction and public health promotion sessions. A total of 771 households drawn from the schools catchments benefitted from the new water points, and the newly-founded community health clubs have 834 members, all contributing to increased awareness and coverage of health and hygiene activities within their communities. The project was designed in close collaboration with Bikita district officials and with the community needs in mind, and thanks to the vital support of the Isle of Man Overseas Aid Committee we were able to meet the immediate water and sanitation needs in fifteen schools in Bikita. 1. Aims and Objectives The project was a community-based intervention to improve the Water, Sanitation and Hygiene (WASH) situation in schools and surrounding communities in Bikita district, with the aim of reducing exposure to and the spread of cholera and other water-borne diseases. The objectives of the project were: To rehabilitate 10 boreholes across 10 schools To construct government approved Ventilation Improved Pit (VIP) latrines and adequate hand washing facilities in our target schools To improve education and conduct health and hygiene outreach activities in the target communities. 2. Project Activities Activity 1: Rehabilitating boreholes to ensure school children have access to safe drinking water Original target: Rehabilitate 10 boreholes across 10 schools. We fulfilled our aim of rehabilitating 10 boreholes at 10 schools. At the ten schools 6,820 students are now accessing clean water from the rehabilitated water points (3,393 Boys, 3,427 Girls). Four schools had good water sources and did not require support. One school required rehabilitation of a piped water supply; at the time of reporting the works were still in progress, as the materials were procured late after confirming availability of resources. The ten completed water points also provide safe water for 771 households from the community

2 surrounding the school catchments. At each water point the project facilitated the establishment of and training for a water point committee on water management and participatory catchment planning for continued sustainable management of the water points. Activity 2: Constructing Ventilation Improved Pit (VIP) latrines to ensure pupils and teachers have adequate sanitation facilities Original target: To construct 140 blocks of Ventilation Improved Pit (VIP) latrines across 15 schools. This target has been hit. A total of 3,515 boys and 3,786 girls benefited from improved access to sanitary facilities through the completed toilets. Schools received different support depending on the ratio of students to latrines. The desired ratio was 20 students per squat hole. Two schools of the targeted 15 did not require additional latrines but there were three schools that required more than 25 squat holes each. CARE leveraged additional support for the additional squat holes from a complimentary food and livelihood project funded by the European Commission. Activity 3: Constructing hand-washing facilities to ensure good hygiene practices among children Original target: Construct 15 hand-washing facilities (one per school including the provision of soap). All 15 schools now have hand-washing facilities are using soap for hand-washing. While the construction was taking place, the school health clubs erected tippy-taps, erected by the school health clubs. This simple, cost effective mechanism was something the children could then encourage their families and communities to do. Activity 4: Health and hygiene community outreach Original target: Form and train 15 community water committees and 15 school health & hygiene clubs, to ensure school water and sanitation facilities are supervised and maintained long-term and that health promotion messages are integrated into school and community life. CARE provided a five day training of trainers session on Participatory Health and Hygiene Education (PHHE) to teachers and school health masters, who then facilitated the formation of school health clubs at each school. The training was supported by the Ministry of Health and Child Welfare Technicians who had received training from other CARE projects. PHHE training was then provided to students who enrolled in the school health clubs as members. In turn, these students conducted health and hygiene promotion activities that reached out to the rest of the school children and their immediate families. Fifteen school health clubs and community health clubs were established and conducted a series of health and hygiene promotion activities, which has reached out to the wider community comprising of 14,700 individuals. The health clubs in schools held PHHE information sessions on the following topics: Social Challenges: community membership, family problems, community management Water: drinking water, water storage, germ theory, general hygiene and water pump maintenance Health: nutrition, malaria, skin diseases, helminthe infections and HIV/AIDS. Activity 5: Facilitate participatory school and community health promotion activities to improve health and hygiene practices to reduce the spread of disease Each school participated in a variety of health and hygiene promotion activities that included clean-up campaigns in the school surroundings, cleaning toilets and staging dramas and poems during school

3 assemblies. Health club competitions were held and prizes were awarded in support of the ongoing hygiene awareness campaigns in schools. Households within the immediate surroundings of the schools, especially those that shared water points with the school children, were also engaged in health and hygiene promotion. Fifteen village health workers were trained in PHHE and mobilised the communities into the community health clubs. Fifteen community health clubs were established and households participated in different health promotion activities. The project further promoted WASH outreach through support for the National Sanitation Week that was held in September School health club members were provided with t-shirts that had health and hygiene messages, lobbying for zero open defecation and proper use of toilets. 3. Timeframe The activities were conducted over a period of nine months, between July 2011 and April In the original proposal it was expected that the project would be completed in seven months but a number of challenges arose, such as a delay in the renewal of the memorandum of understanding (MOU) between NGOs and the government. The delay resulted in the temporary suspension of CARE s operations in Bikita district in the month of February This was rectified in March, and activities resumed. CARE had to conduct community reengagement outreach to rebuild relations and rapport that had been disrupted by the suspension. 4. Replication Through this project and other similar projects CARE has learned that targeting schools for raising awareness on good health and hygiene practice is a successful way of reaching out to students but also the wider communities where the children pass on what they have learned to their families. CARE has also learned that the training component on facility maintenance allowed communities to take ownership of the boreholes ensuring they are maintained beyond the life of the project. These methods will be used in other areas of Zimbabwe where water and sanitation facilities and practice is limited. 5. Development Education Although this project did not explicitly aim to raise awareness of development issues within the Isle of Man, CARE International UK is committed to raising public awareness around the importance of development cooperation through its ongoing campaigns and advocacy work worldwide. 6. Beneficiaries As originally planned, 15 primary and secondary schools and the surrounding communities were direct beneficiaries of the project. The project managed to exceed its target reach number; in the initial proposal, the project aimed to reach out to 1,890 households consisting of 9,450 people, as well as 5,250 primary and secondary school students (at a total of 14,700 direct beneficiaries). In fact, the project reached 3,865 households, comprising of 19,325 individuals (of which 7,730 are school children).

4 The reason for this is that the project was allocated schools with particularly high enrolment numbers in the district. At design level the project targeted for an average 350 students per school, but three of the fifteen schools targeted had over 600 pupils. 7. Community Involvement The 15 communities we worked with were heavily involved throughout the implementation of the project, linking them to the relevant local and national bodies to ensure the projects longevity. CARE worked closely with local authorities and communities to set up and revive sustainable community and school-based committees to manage basic operations and maintenance of WASH infrastructure. At each water point the project revived the water point committee and linked them to the District Water and Sanitation Sub-Committee (DWSSC) that has the overall responsibility of all WASH management across the district. School health clubs and community health clubs were established to promote good health and hygiene practice in schools. For health and hygiene promotion the project leveraged the support of Environmental Health Technicians (EHTs) from the Ministry of Health, who provided Participatory Health and Hygiene Education (PHHE) training to school health masters and village health workers. EHTs were also responsible for technical support in the construction of Blair Ventilation Improved Pit (BVIP) latrines. They facilitated the training of latrine builders and supervised the construction works, to ensure that the latrines were built in accordance with government standards. 8. Liaison with relevant authorities The following authorities were involved in the successful implementation of this project to varying degrees: school authorities, Ministry of Health, District Water and Sanitation Sub- Committees and District Development Fund. 9. Sustainability A school health club PHHE review workshop was held with the 15 School Health Masters where teachers from the different schools exchanged notes and ideas on school health clubs and the general WASH situation in their schools. Some examples of best practices were highlighted; these included effective engagement of school development committees to ensure continued support from parents. Other sustainability issues such as linkages with Ministry of Health EHTs were discussed and adopted by the health teachers to ensure continuity post-project. Overall the sustainability of the project lies in the District Water and Sanitation Sub- Committees (DWSSC), the health clubs and the water point committees that were strengthened during project implementation. The water point committees are responsible for the overall management of the water points, and shall work closely with the village pump minders that were trained on the project. The DWSSC will also monitor the ward level structures periodically. The water point committees will regularly engage the trained local pump minders who, with technical support from the District Development Fund (DDF), will ensure continued maintenance of the water points. 10. Monitoring and Evaluation CARE conducted regular monitoring visits to the targeted schools and communities. CARE conducted a thorough, participatory evaluation process to check achievement and gather information to demonstrate the impact on the targeted communities. Interviews with beneficiaries and targeted

5 communities were conducted along with indicators such as the number of cholera cases reported during implementation period provided concrete evidence of impact. Throughout implementation CARE fostered close linkages between the school authorities and the relevant government line ministries. Joint monitoring visits and updating of field reports was done on a regular basis. These linkages have built the foundation for future collaboration. 11. Millennium Development Goals Goal 7: Ensure environmental sustainability Target 7c: Reduce by half the proportion of people without sustainable access to safe drinking water and basic sanitation. In the communities in which the project was undertaken, we have contributed to the achievement of MDF 7c by improving the proportion of people with sustainable access to safe drinking water and basic sanitation, and provided the necessary education to ensure longer-term improvement in these areas. 12. Media Press Release With the support of the Isle of Man Overseas Aid Committee, CARE International UK has helped to improve access to safe water, sanitation facilities and improved health and hygiene practices in a Cholera prone district in Zimbabwe. According to the UN, Zimbabwe is the least developed country in the world, with the deterioration of living conditions, rising extreme poverty and persistently poor health disproportionately affecting rural communities. Between August 2008 and May 2009 Zimbabwe suffered the most severe cholera epidemic ever recorded in Africa, resulting in 98,440 cases and 4,130 deaths. In response to the cholera crisis Zimbabwe has experienced in recent years, CARE International UK has implemented a successful project in Bikita district, one of the areas worst affected by Cholera. With funding from the Isle of Man Overseas Aid Committee, technical assistance from CARE and the active involvement of government departments and local authorities, a project has been implemented to improve the Water, Sanitation and Hygiene (WASH) situation in schools and surrounding rural communities in Bikita. Alongside improving education around WASH issues, the project also saw the construction of latrines, hand washing facilities and water points for a community in dire need. In total, the project benefitted 3,865 households, comprising of 19,325 individuals (of which 7,730 are school children). One of the school children, a 13-year-old boy called Tanaka said: The project has made our lives so much easier. We use the water (from the rehabilitated borehole) for cleaning the toilets, hand washing and classroom cleaning at school, and people living nearby use the water in their homes. Fetching water is a lot easier because we are now using a wheelbarrow; previously we only had buckets that were very difficult to carry on our heads. The project responded to immediate needs for improved water, sanitation and hygiene facilities in the area, but its impact reaches far into the future. Members of the targeted communities both young and old have been educated around these issues, improving the health of their families and subsequent generations. Community members form committees to ensure the continued upkeep and maintenance of the new facilities, with individuals informed and empowered to approach the relevant local government bodies. Following the success of this and other WASH projects, CARE International plans to continue its work around water, sanitation and hygiene in Zimbabwe.

6 CARE International seeks a world of hope, tolerance and social justice, where poverty has been overcome and people live in dignity and security. CARE works in over 70 countries, providing rapid emergency relief during times of natural disaster or conflict and implementing long-term development programmes that tackle the root causes of poverty. 13. Budget CARE has spent all funds relating to this grant. Thank you to the Isle of Man Overseas Aid Committee for helping improve the Water, Sanitation and Hygiene (WASH) situation in schools and surrounding communities in Bikita district, Zimbabwe. Annex 1: Case studies

7 Case study 1: Mamutse students are a fountain of knowledge Tanaka Fusirai (13) and Norman Dhori (12) are two students at one of the schools that benefitted from the project, Mamutse Primary School. They are also two of the 40 members of the health club we helped to establish at the school, and they spoke to us about the type of activities they have been engaged in with their peers. We were eager to join the club to be hygienic and spread the message among our friends - our club motto is Use toilets always and properly said Norman. We learned a lot from the club and we have covered topics on bilharzia, skin diseases, cholera, general hygiene and water storage. The lesson that we understood most was on cholera, because it is easy to prevent we now know that zero open defecation, washing hands and using water from safe sources can prevent cholera. Tanaka and Norman have shared the knowledge they acquired with their families too. They reported improvements such as newly dug refuse pits, new hand washing tip taps, constructed pot racks, and their families no longer sharing the same cup for drinking water. Both Tanaka and Norman agreed that they now discuss health and sanitation issues openly with their families. When Tanaka was asked how the project had impacted their lives, he said: The project has made our lives so much easier. Fetching water is not as difficult as it used to be because we are now using a wheelbarrow; previously we only had buckets that were very difficult to carry on our heads. We use the water (from the rehabilitated borehole) for cleaning the toilets, hand washing and classroom cleaning at school, and people living nearby use the water in their homes. The boys say their future plans are to recruit more students into their club by continuing their hygiene promotion activities. Figure 1: Norman (12) and Tanaka (13), grade seven students at Mamutse Primary School

8 Annex 1: Photos A student returning from the newly constructed latrines One of the rehabilitated boreholes One of the clubs showcasing open defecation as one of the spread of cholera during a health club competition

9 Mamutse primary school borehole Pupils using hand washing facilities rehabilitated by CARE