Millennium Promise - Extreme Poverty Ends Here

Children under five are at greatest risk of dying from diarrheal diseases contracted from contaminated water. To help them and their families, community health workers will bring supplies to each family and train them how to keep water safe.

Instead of traditional open vessels, families will store water in a plastic secure container that has a tap for pouring. And they’ll learn how to use a year’s worth of purifying tablets to make sure water is disease-free.

The project goal of $4000 enables health workers to deliver secure containers and supplies of purifying tablets to 100 households, and training to keep water safe at home.

This practical, yet direct, response is one of many successful applied approaches that enable Millennium Villages to provide clean water in the short term, while laying the foundation for longer term solutions.

Before Millennium Villages interventions, safe water coverage in Ruhiira was only 20%. At one clear spring about a mile away, people started lining up at 5 am to draw water, causing absenteeism and tardiness in schools—especially for girls, who are usually tasked with such chores.

Since 2007, safe water coverage has increased to 45%. More than 60 water sources—springs, ponds and wells—have been protected and constructed and 90 rainwater harvesting tanks have been installed in schools, health centers and public places. An electrified piped system pumps water from sources at the bottom of hills to hilltops where people live. Safer water translates into a healthier population with more resources to climb out of extreme poverty.

Water safety improvements in Ruhiira are allowing the community to make significant progress on Millennium Development Goal # 7: Ensure Environmental Sustainability, and simultaneously impact both Goal #6: Combat HIV/AIDS, Malaria and other diseases, and Goal #4: Reduce Child Mortality.

In this photo, community leaders run a training session to teach village residents effective water purification methods.

Many safe water initiatives, such as building wells and piped water systems, must be coordinated on a village level. But two important practices are critical to safe drinking water—purifying water at home and effective use of latrines—and only by educating thousands of individuals will these initiatives succeed.

Asiimwe Museveni John is a Senior Community Health Worker in Ntungu Parish and responsible for 155 households. At first he wasn't convinced the community needed to invest in Pur tablets to purify water in homes. He couldn't understand, why not just have everyone boil water? But his visits to his clients in their homes shed critical light: "During my regular household visits, I discovered that many households would not boil drinking water, mostly because there was no firewood for cooking and some said the water would smell smoke from the dry leaves they used for boiling the water." Armed with that understanding, he has become much more successful in encouraging people to use the Pur system effectively.

Julius Musinguzi is a Senior Community Health Worker in Bugongi parish. Like his colleague, he has been working on the education aspect of latrine use. "In my parish, I cover 208 households. Since I started the sensitization campaigns on latrine usage, the latrine coverage in the area has greatly improved. All the households I am responsible for have pit latrines."

This photo shows Olivias Kyarimpa outside her home in Omururama, a village that is taking part in the Millennium Village project in the Ruhiira, Uganda area. In her hands she is holding the Pur water purifier tablets that her family uses every day to keep their drinking water safe. She learned how and why to use the tablets from a health worker who visited her home. Our project empowers community health workers (local people who receive training in public health and medicine) to visit families and small villages to deliver water purification supplies and to explain: 1) how to purify their water at home using safe containers and Pur tablets; and, 2) why it is critical for them to exercise vigilance over their water supply.

David Siriri, the Science Coordinator for the Ruhiira Millennium Villages project explains: “There was an initial cultural resistance to using water treatment chemicals. But the number of households using these supplies effectively is steadily increasing. As a result, we have found that the diarrhea disease burden at our health units has significantly decreased.”

Water-born diseases such as cholera and diarrhea are extremely prevalent all over Africa, where half of all people may be stricken at any time. In Ruhiira, much of the water supply has been contaminated because of run-off from poor sewerage and farm animals. Children under five are at greatest risk of dying from diarrheal diseases contracted from contaminated water.

This practical, yet direct, response is one of many successful applied approaches that enable Millennium Villages to provide clean water in the short term, while laying the foundation for longer term solutions. Check back to see how the project is doing, and remember to encourage your friends to consider making a donation.

This photo shows how people in Ruhiira cook in a typical Ugandan kitchen. The stoves or firepits can be very inefficient, burning large quantities of fuel, and sending unhealthy fumes into the air. Replacing those stoves with fuel efficient, low-emission models will improve the deforestation of the environment, air quality and lung function for people. Stove replacement is just one of the many holistic initiatives that the Uganda team's science coordinator discusses in the interview below, when he explains why the project is so successful.

What is your role in the project?
My name is David Siriri, the Science Coordinator of the Ruhiira Millennium Villages Project. I am responsible for ensuring sound technical design and implementation of project activities in a way that responds to the project model and community priorities. I also conduct measurements, monitoring and activity evaluation to generate data that informs project design and track achievement of project targets.
What progress has been made since 11/30/2009?
The community health workers continued to be the first responders in providing basic treatment and referring patients to health units. As a result, prevalence and severity of malaria continued to decline while monthly child births in all health units now stands at over 400. The project registered zero maternal death in the cluster during December 2009. The emergence medical response system has been strengthened with nurses trained in emergence handling and ambulance dispatch. The operating theatre at Kabuyanda health unit is now functional after a few months breakdown. Clinical staff have been trained in use of medical equipment donated by General Electric and can now perform scans for better pregnancy management. The number of households using water treatment chemicals has increased after an initial cultural resistance. As a result, the diarrhea disease burden at health units has decreased. Villagers started using improved cook stoves introduced by MVP. This has reduced indoor air pollution which causes respiratory tract diseases and has saved up to 45% of cooking fuel wood in families using the stoves. New roads were opened and old ones rehabilitated, increasing accessibility to markets and health units.
How important is this project to you?
My biggest motivation is seeing people’s lives transformed. I have for the last 12 years worked with different research and development agencies but never before has my work made real community transformations like at the Millennium Villages Project. What is different here is having an integrated holistic approach to development in which all issues affecting human livelihoods are tackled at the concurently, empowering communities to take lead in planning their future and investing their own resources in implementing their chosen interventions, and having significant development assistance that reaches the intended target. These key ingredients have combined to bring hope and dignity to the many lives that were bound by shackles of extreme poverty.

One great thing about getting involved with a Millennium Village in Uganda, is that there’s a lot that people in the developed world can learn about the amazing social organization and mutual support that can be found in rural Sub-Saharan Africa. The most local level of organization is the village that consists of 50 to 70 households and 250 to 1,000 people, depending on family size. Everyone participates in a local council, which is governed by a chairman and a 9-person executive committee.

Before any village joins the Millennium Village project, the local council must vote to participate, select key initiatives to work on, and contribute 15 percent of project costs. Here’s how one LCI (local committee level 1) chairman views the Millennium Village project, from the perspective of the area’s very first village, Ruhiira—this is where the initial research was conducted and where residents first voted to join the Millennium Villages.
An interview with Tindyebwa Johnson, Farmer and LCI Chairman Ruhiira cell:
“Before the MVP project came, we were badly off. We lacked good health services, the roads were poor and inaccessible, the schooling conditions were very poor and generally life was miserable. The MVP has within a short time done what would have taken government over 100 years to do. Now we have enough food to eat and we are making good money from selling bananas because the roads are now very good and farmers have been involved in several trainings and are now in registered groups. The health facilities are now fully functional and well equipped, classrooms have been built and children can now eat at school.

Me as a person, I am now seeing great change in the community, business is now moving fast. I now find it easy to lead my people because the services are good. Many of our community members have now got jobs because of MVP, some of the facilitators, enumerators, health staff, radio staffs have got jobs”.

"A day in the life of a villager in Ruhiira is guaranteed to beat any session at the gym," says Naomi, an intern from Millennium Promise Japan, who's looking at the region with a pair of fresh eyes. "And water is the main reason why life is so difficult." For the majority of families in Ruhiira, or at least for the women and children, the first task of the day is fetching water. Naomi found it especially interesting when meeting with various families to discuss water, that the conversation couldn’t begin without the woman of the house. "Ordinarily the men will do most of the talking, but as fetching water is decidedly women’s work, what women had to say was, for once, most important!"

Without a doubt, distance and incline are the biggest challenges people face when fetching water. In the dry season, water can be as far as 3km (just under 2 miles) away…and the walk back with 20 liters (about 10 gallons) inside your jerrican (a large flat-sided container that carries liquids, like the one carried by the boy in this photo) can seem even father. This distance would be problematic enough were it not for the terrain: most water sources and run-off ponds are situated at the bottom of precarious hillsides and valleys.

During rainy season, families can find water closer—usually only 1.5km away, but often from a pond gathering run-off water. The run-off carries with it all things imaginable down the hills, the murky brown color of the end result is enhanced by cows who come for a bath every now and then! Unfortunately, if poor quality water is available closer, people will use it instead of the safe water source provided by the Millennium Villages project. As yet, boiling water is often viewed with suspicion. So potential health risks are huge.

That is why, until more reliable water sources can be secured closer to residences, that families must continue to use water purification techniques accurately. With 1 in 2 Africans suffering from waterborne diseases at any time, scrupulous attention to this relatively simple process can make a big difference in family health.