Theatre 1

There is considerable evidence 1 that improved WASH (Water, Sanitation & Hygene) services correlate to improved health. Clean water is one component, the others are sanitation systems and hygiene practice. Whilst donors are attracted to providing assistance because of the direct linkages between outputs and desirable outcomes (+ve change in the broader system), a significant issue is sustainability. For unfortunately, providing nice new latrines and clean water is no guarantee that they are used or maintained. As is increasingly becoming understood, sustainability is a function of ‘ownership’ in decisions made. On a recent visit to a village about 2.5hrs from the nearest sealed road I witnessed the ‘triggering’ component of the Community Lead Total Sanitation (CLTS) program.

The one I witnessed was not a normal village event, but second of two organised specifically for the Group Village Head men of about 30 target villages. This was to  generate support for the process to be carried out in their communities. I had read about the CLTS process a few years back, and was excited to have the opportunity to experience it in real life. What really struck me was both the highly professional manner in which the team (Tigwirizane, Fiona and Michael) conducted the session, and also just how theatrical an event it was. I particularly noticed how the team had changed the order of the sessions (hygiene first, followed by latrine building) to respond to the timing of the event, and also how Tigwirizane first warned up the crowd by asking how they had become Village Headmen and what they thought their duties were with regard to village development. After the warm up, Michael from the Ministry of Health took over.

Michael started with a short, interactive talk (all in Chichewa, so I’m not sure of the content, maybe hygiene or nutrition), and then produced the egg:

Michael produces a hard boiled egg. I'm not exactly sure what he says about it, but possibly something about it's nutritional value.

Michael produces a hard boiled egg. I’m not exactly sure what he says about it, but possibly something about it’s nutritional value.

He asks the Group Village Headman at the end of the semi circle to peel the egg. The lady watching is the Traditional Authority (TA).

He asks the Group Village Headman at the end of the semi circle to peel the egg. The lady watching is the Traditional Authority (TA).

 

The egg is passed around the group.

Experiencing the peeled egg as it is passed around the group.

The invitation. 'Now who would like to eat this highly nutritious boiled egg? What, none of you, why not? What's your problem?'

The invitation. ‘Now who would like to eat this highly nutritious boiled egg? What, none of you, why not? What’s your problem?’

Perhaps not in the same league, but as a theatrical/experiential event I was reminded of our bush fire simulation back in Australia where the aim was to engage the community to think about complex issues with a view to promoting individual action. http://www.youtube.com/watch?v=IB2DF10pxwM

1) Esrey 1985,1991; Fewtrell 2005; Clasen et al. 2009,2010, Waddington 2009; Norman et al. 2010

Impromptu Unofficial Impact study

I have recently been taken on a trip to Dowa & Kasunga Districts with the CU Water Sanitation & Hygene (WASH) team. One stop was at a village where CU have just finished rehabilitating a bore hole that had been out of action for 8yrs. On our arrival we were met by what soon became quite a crowd. I was expected to say or do something.

A reflection on how far away they lived from the borehole. On the left - not far, those on the right - a long way

A reflection on how far away they lived from the borehole. On the left – not far, those on the right – a long way

I asked them to illustrate how far they had to walk to this borehole (Short way, Medium and Long Way). On enquiry a short way was about 3-5 mins, medium about 10mins and a long way 20 -30mins. I then asked them if thinking back to eight years ago whether they had noticed any difference in their health without the borehole. I was somewhat surprised when there was quite a proportion who indicated not a lot of difference. On further explanation though, it was because that group had been going to the next village to get water, whilst the group that had experienced an increase in diarrhoea & cholera were far from there and had been drawing water from a closer unprotected water source.

Measuring difference in health. Those on the left had not noticed much difference, those on the right, considerable difference.

Measuring difference in health. Those on the left had not noticed much difference, those on the right, considerable difference.

I then asked them if they thought the rehabilitated bore hole would make much difference to their lives in terms of time or health. Again, there was a spread. We then numbered them off, and asked the small groups to consider what impact the bore hole would have and what they might do with the improved time and health.

Small groups considering what they might do with the improved health and time in their lives.

Small groups considering what they might do with the improved health and time in their lives.

The answers across the groups were generally similar, comprising:

  • Cleaner clothes & latrines
  • Improved marital relationships (this was with much laughter, but also agreement)
  • Able to make more things to sell (mud bricks, donuts etc)
  • More time for cultural events
  • HIV +ve people better able to survive

We then asked the groups to determine what they might be able to do to ensure that the borehole continues working. Answers were:

  • Make a door to keep kids and goats out.
  • Lock the pump with specified opening times
  • Work with the village leadership to have a bye law to keep kids out
  • Make sure the bore hole management committee has funds for spare parts

The Management Committee comprises of 5M and 5F representatives from the seven villages that would use the bore hole and that they had decided that there should be a common maize field that all should work on, with the proceeds being sold to fund maintenance costs. Given the variety of answers from the small groups, I’m left wondering how much support this decision actually has.