This project is part of Bridge Water Project's program in Western Kenya. What follows is direct from them:
BACKGROUND INFORMATION
Chombel Health Centre started in the year 1994 through efforts of Chombel Women Group in response to the problem of accessing health services in the community. In the year 1995 the government of Kenya took over the operations of the Health facility and managed to construct permanent buildings at the facility. This enabled the facility to start offering maternity health services and out and in patient services for other endemic diseases in the community. The facility provides a range of preventive, promotive and curative services including immunization campaigns and carrying out community outreaches. The facility has a maternity wing with a capacity of 14 beds.
The facility has 1 drilled borehole. The borehole was drilled by Kenya Finland Company to a depth of 54 m and installed A NIRA PUMP. The borehole stalled in 2014, interrupting reliable and affordable water supply at the facility. The facility’s management committee unsuccessfully attempted repairing the borehole on several occasions. Women delivering at the facility have to pay at least Ksh. 20 per 20 litre jerrican of water that is collected from nearby unprotected spring.
The Chombel Health Centre committee made an appeal to Bridge Water Project requesting help to rehabilitate their borehole so as to enable access to affordable, quality and reliable water supply at the facility.
CURRENT WATER SOURCE
At the time of assessment, the facility was connected to Samitsi piped water supply. Poor management of the piped water supply and the high demand had occasioned frequent rationing, hence interfering with service delivery at the facility, particularly maternal health care. Due to the challenges posed by the piped water supply, the hospital incurs high expenses in purchasing water from vendors. Most vendors source for water from unprotected spring located 2km away from the facility.
POPULATION
Approximately 1000 – 1500 patients visit the facility at any given month. The facility has the following staff: 1 Clinical officer, 1 nurse, 6 lab technicians, 1 Community Health Extension officer, 1 peer educator, 3 Community Health Workers (CHW), and 9 volunteers. According to the facility records, at least 1,500 people were served by the proposed borehole.
(Editor's Note: While this many people may have access on any given day, realistically a single water source can only support a population of 350-500 people. This community would be a good candidate for a second project in the future so adequate water is available. To learn more, click here.)
HYGIENE & SANITATION
The facility has 7 ventilated improved pit latrines distributed among staff and patients visiting the facility: 5 serve patients while 2 serve the staff. The facilities are washed only once in a day due to limited access to reliable water supply. Hand washing sinks had been installed at most 10 paces away from the latrines though there was no water in them or any detergent nearby at the time of assessment. The facility also had bathrooms installed with showers. The facility managed their solid wastes in a well secured pit while hazardous wastes were managed through an incinerator installed at the facility. The facility has a kitchen where food for both in patient and staff are cooked. The kitchen was in a good sanitary condition and well ventilated. The facility engages in health promotion through training of patients on proper hygiene but a rapid assessment of the neighboring homesteads revealed poor hygiene and sanitation practices. Most households had no hand washing stations at all with only a few owning a dish rack. The hospital reported a high prevalence of diarrhea and typhoid diseases among patients attending the facility.
ASSESSING THE NEED
Limited access to reliable, quality and affordable water supply has negatively impacted the hygiene and sanitation condition of the facility. The facility accommodates a high number of people at any given time who need access to clean water supply. The quality of maternal health services has been constrained. The prevalence of diarrhea and typhoid diseases in the community places a heavy burden on community members and overwhelms the capacity of the facility. Rehabilitating the proposed borehole will provide the community with an opportunity to access clean and reliable water as well as expose them to hygiene and sanitation training through PHAST (Participatory Hygiene And Sanitation Transformation).
PROJECT BENEFICIARIES
If Chombel Health Centre well is rehabilitated the staff and patients will be the beneficiaries, and community members around the Health facility.
WATER COMMITTEE
The Chombel Health Centre Management Committee is organized and ready to take full responsibility of operating, maintenance and management of the water supply if rehabilitated for the facility.
NARRATIVE REPORT
PHASE 1
6TH 10 April HYGIENE AND SANITATION TRAINING
Chombeli dispensary is a health facility that is located right at the centre of the Chombeli, serving a large population including neighboring communities. To reach the targeted population to undergo the training, a Monday was the best day to carry out the activities since it is a day when women come for clinics.
More than 35 women and 10 men were present ready for the training. By the advantage of having the health officers on the ground, the facilitation was done by both the Bwp’s staff and the health workers.
The presence of the health centre in the community has led to a great impact especially on the issues of hygiene and sanitation. The health workers have extended outreach services, which are meant to train the communities on the good practices of hygiene and sanitation.
During the training, the community members were trained on the following aspects;
- Always consume safe water: This practice required the community members to observe essential behaviors like;
- Treat all water used for drinking and cooking by chlorination, filtration or boiling to reduce pathogens.
- Always cover water-storage containers or use narrow neck containers.
- Extract water from a tap or with a clean utensil such as dipper.
- Place containers where young children cannot get into it.
- Always use different (clean) vessel to transfer water for drinking.
- Prevent anyone from putting his/her hands into the drinking water vessel, especially children.
- Clean the water storage container twice a week with soap.
- Always safely dispose feces and other wastes: to ensure this is done, the community members were trained to;
- Have young children always use a potty, washable diapers or disposable diapers.
- Always dispose of the feces in a sanitary latrine or toilet.
- Always wash the potty or washable diapers with soap and ensure that the wastewater from washing ends up in a sanitary facility.
- Consistently put disposable diapers in covered garbage containers that are part of a solid waste disposal system that keeps the diapers out of the household and community environment.
- Wash hands with soap or ash at critical times: washing hands is an important aspect of good hygiene and therefore the community members were trained to observe it through the following behaviors;
- Always use correct hand washing techniques .i.e. Rub at least three times, especially fingers; use a cleansing agent; use dripping or running water if possible; air dry.
- Always wash at critical moments, i.e. after going to the bathroom, contacting feces, and before eating, feeding, or cooking.
- Prepare and store food safely: to ensure this is done, the community members were trained to;
- Always peel or wash fresh food before eating.
- Always heat or reheat cooked foods at a high temperature shortly before eating.
- Wash food preparation surface with soap and water.
- Never consume animal products that have been improperly prepared for consumption.
- Keep flies off food.
PHASE 2:
13TH – 17TH April PAD CONSTRUCTION
The bridge water project construction team mobilized to the site as part of the community members were also to help where necessary.
Despite the fact that it was raining heavily, the workers had to ensure that the work was well done and completed. The community members stretched their helping hand where needed and provided food for the workers.
The work was well done and the pad was left to cure for four days there after the pump will be installed and finally handed over to the health centre and the community.
PHASE 3:
20TH – 24TH April PUMP INSTALLATION AND HANDING OVER
Once the pad was cured, the service team mobilized for pump installation. The process was well done without any complications. During this process, a good number of community members were present eagerly waiting to receive their water system and enjoy its services.
The well was then handed over to the beneficiaries.
During handing over ceremony, the medical officer in charge of the facility said that the presence of the rehabilitated well will have a great impact on the health centre and the community at large. He further said that there will be no more problems of deliveries since there is enough water for such services.
PHASE 1
6TH 10 April HYGIENE AND SANITATION TRAINING
Chombeli dispensary is a health facility that is located right at the centre of the Chombeli, serving a large population including neighboring communities. To reach the targeted population to undergo the training, a Monday was the best day to carry out the activities since it is a day when women come for clinics.
More than 35 women and 10 men were present ready for the training. By the advantage of having the health officers on the ground, the facilitation was done by both the Bwp’s staff and the health workers.
The presence of the health centre in the community has led to a great impact especially on the issues of hygiene and sanitation. The health workers have extended outreach services, which are meant to train the communities on the good practices of hygiene and sanitation.
During the training, the community members were trained on the following aspects;
- Always consume safe water: This practice required the community members to observe essential behaviors like;
- Treat all water used for drinking and cooking by chlorination, filtration or boiling to reduce pathogens.
- Always cover water-storage containers or use narrow neck containers.
- Extract water from a tap or with a clean utensil such as dipper.
- Place containers where young children cannot get into it.
- Always use different (clean) vessel to transfer water for drinking.
- Prevent anyone from putting his/her hands into the drinking water vessel, especially children.
- Clean the water storage container twice a week with soap.
- Always safely dispose feces and other wastes: to ensure this is done, the community members were trained to;
- Have young children always use a potty, washable diapers or disposable diapers.
- Always dispose of the feces in a sanitary latrine or toilet.
- Always wash the potty or washable diapers with soap and ensure that the wastewater from washing ends up in a sanitary facility.
- Consistently put disposable diapers in covered garbage containers that are part of a solid waste disposal system that keeps the diapers out of the household and community environment.
- Wash hands with soap or ash at critical times: washing hands is an important aspect of good hygiene and therefore the community members were trained to observe it through the following behaviors;
- Always use correct hand washing techniques .i.e. Rub at least three times, especially fingers; use a cleansing agent; use dripping or running water if possible; air dry.
- Always wash at critical moments, i.e. after going to the bathroom, contacting feces, and before eating, feeding, or cooking.
- Prepare and store food safely: to ensure this is done, the community members were trained to;
- Always peel or wash fresh food before eating.
- Always heat or reheat cooked foods at a high temperature shortly before eating.
- Wash food preparation surface with soap and water.
- Never consume animal products that have been improperly prepared for consumption.
- Keep flies off food.
PHASE 2:
13TH – 17TH April PAD CONSTRUCTION
The bridge water project construction team mobilized to the site as part of the community members were also to help where necessary.
Despite the fact that it was raining heavily, the workers had to ensure that the work was well done and completed. The community members stretched their helping hand where needed and provided food for the workers.
The work was well done and the pad was left to cure for four days there after the pump will be installed and finally handed over to the health centre and the community.
PHASE 3:
20TH – 24TH April PUMP INSTALLATION AND HANDING OVER.
Once the pad was cured, the service team mobilized for pump installation. The process was well done without any complications. During this process, a good number of community members were present eagerly waiting to receive their water system and enjoy its services.
The well was then handed over to the beneficiaries.
During handing over ceremony, the medical officer in charge of the facility said that the presence of the rehabilitated well, will have a great impact on the health centre and the community at large. He further said that there will be no more problems of deliveries since there is enough water for such services.
