The AHEAD Model:2
When health club members realise how germs can be transported in water they usually make efforts to protect their own water supply and take many steps to help themselves. Some even manage to supply themselves with safe underground water through digging and protecting wells for their own family. This ‘self supply’ of water, often without any outside organisation from agencies subsidy or donors, is an indication of community commitment to managing their own resources. The protected family well programme in Zimbabwe is an example of how this technology has spread all over the countries after it was introduced into a few districts by Zimbabwe AHEAD in 1995-1997. In recent years it is clear that families have been upgrading their own wells and installing their own windlasses, handpumps or diesel pumps.
- Maintaining a protected source: Roster of handpump attendants or mechanics who volunteer or paid by community
- A Water Point Committee to manage and repair village handpumps, family well or piped gravity scheme
- Women will voluntarily walk further to collect their drinking water because they know the value of a protected / safe water source
- Carry water home in a container that is clean and sealed so dust does not spoilt water en route
- Ensure their water container at home is clean and sealed so no access by dogs, fowls or toddles can contaminate drinking water
- Use a safe method of taking water from a bucket, either with a ladle jug or two cup system
- Never share cups between each other when drinking water
- Construction of family well, and ensure it is well covered with a lid and a windlass is used to prevent contamination by rope and bucket
4. Safe Sanitation
The spread of germs through human faeces is one of the main causes of diarrhoea, which kills so many infants from poor families. Faeces can be ingested by five main transmission routes: through dirty fingers when we eat, through flies that move from faeces that are left uncovered in nearby fields, through food that is not washed or cooked which may have been in contact with people with dirty hands, and through dirty food that is uncooked or been fly walked. The first barrier to stopping diarrhoea is to make sure everyone in the villages either buries their faeces if they do not have a latrine or has a safe covered latrine that does not give any access to flies. There has been a huge resistance to building latrines in the past as villagers have other priorities and do not appreciate the importance to their health of clean latrines. The power of the Community Health Club is that, as a group, people decide that everyone must have latrines. This group decision results in a huge demand for sanitation which often is too great for the project to meet. Everywhere that health clubs have been started the pattern has been the same. To summarise:
- In Zimbabwe in two years 3,600 VIP latrines were built in 2 years (with minimal subsidy) this was 1/5 of all latrines build through the country at the time.
- In Sierra Leone in six months, the sanitation coverage rose from zero to 57%
- In Uganda in 8 months sanitation coverage in IDP Camps rose from 11% to 47%
3. 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.
4. Safe Rubbish Disposal
In urban areas, and particularly in informal settlements one of the main challenges is to dispose of rubbish safely. This is usually a issue where municipal collections are non existence or erratic. It is therefore a major role that a CHC can play because it has the necessary organisation to be able to effectively arrange safe disposal and institute a system that is locally accepted. This may involve private sector collection and recycling of non bio-degradable items. It may also be a spring board to organic gardening projects with the bio-degrable waste used for trenching and growing of vegetables. The control of vectors such as rats are also something that can be tackled effectively as a group.