By Elisha Singira
Around one in four people lack access to basic safe drinking water especially in rural areas, putting them at risk of contracting a number of waterborne diseases, such as cholera, worm diseases, typhoid and dysentery, according to the Centre for Disease Control (CDC).
Moreover, it is projected that billions of people around the world will be unable to access safely managed household drinking water, sanitation and hygiene services in 2030 unless the rate of progress quadruples, according to a new report from World Health Organization (WHO) and United Nations Children’s Fund (UNICEF).
According to both organizations, unsafe water is responsible for more than 1.2 million deaths each year and claims the lives of over 1,000 children every day. It’s the most common cause of diarrhea, which is in turn the world’s second-leading cause of child mortality. It is also a leading cause of malnutrition, and a multitude of other diseases such as typhoid, cholera, and hepatitis A.
However, UNICEF says, more Kenyans have access to safe drinking water now when compared to previous years. Access to safe water has significantly increased by 12 percent which has tremendously led to a reduction in waterborne diseases in the country.
They posit that access to safe drinking water is essential for the survival of 29,700 children under five- years globally. Nationally, 59% have access to clean and safe water. UNICEF is calling for other organizations to come in and help provide people with clean and safe water for drinking to eliminate waterborne diseases completely.
One of the organizations responding to this call is Evidence Action through its project Dispenser for Safe Water (DSW). The organization has put chlorine dispensers at water points in rural regions, assisting the locals to have access to clean water.
According to research by Nobel Laureate Michael Kremer and coauthors, shows that water treatment may be one of the most economical ways to help save the lives of children under five years from all causes, by around, 25%.
As part of their analysis, they looked at implementation data from Dispensers for Safe Water; they estimate the program is over 45 times more cost-effective than the World Health Organization (WHO)’s “highly cost-effective” threshold. This compares the effects of water treatment on children’s health to those of nutritional therapies, insecticide-treated bed nets to combat malaria, and routine childhood vaccines.
Emmanuel Dennis, Policy and Partnerships Manager at Evidence Action said, “Evidence Action scales initiatives that are cost-effective and based on evidence to help hundreds of millions of people escape poverty. The organization’s strategy bridges the gap between what has been proven to succeed in research and solutions for those in need. We have operations in Kenya, Uganda, Malawi, Nigeria, Liberia, India, and Pakistan. Every year, we have a measurable positive impact on the lives of hundreds of millions of people.”
According to Dennis, placing chlorine dispensers right near untreated water sources as the project does, enables locals to add a precise amount of diluted chlorine to their barrels after filling them with water. A service that is provided to community members free of charge.
In Kenya, the program maintains 18,610 dispensers in nine counties. These include Homabay, Siaya, Busia, Bungoma, Kakamega, Vihiga, Trans Nzoia, and Uasin Gishu.
Dennis says that planning and implementation of the dispensers are done in consultation and partnership with county government officials and Health Management Teams, then Evidence Action signs memorandums of understanding with the County Departments of Health and Water with key deliverables focusing on program sustainability.
Additionally, he said: “The initiative is supported by a last-mile service delivery network made up of 109 local workers and 37,000 community-elected volunteers who advise Evidence Action when repairs or chlorine refills are required and provide dispenser usage guidance.”
The duration between one chlorine refilling to the next is relative depending on the population that is dependent on one chlorine dispenser in a community. In some communities, it will take weeks, while in others it takes a month or two, especially in less populated areas.
The chlorine dispensers for the scheme are produced locally thanks to a Nairobi warehouse and a deal with a Kenyan plastic injection molding business. In order to expand its ability to supply sodium hypochlorite for the dispensers, the organization has partnered with a local manufacturer of chlorine.
Each dispenser is calibrated for directions on what amounts to add. For a 20l barrel with water, 25 milligrams of chlorine is enough.
Jacqueline Atieno, a resident of Siaya County, Yala Sub-County, expressed her satisfaction with how the project has helped eliminate waterborne diseases arising from unsafe drinking water. “The installation of these blue cans with the chlorine in them has helped me personally a great deal. I am a mother of three children, my firstborn daughter experienced a lot of sickness during her childhood which most hospitals I visited attributed to drinking unclean water,” she said.
“Severally, I was advised by doctors to always boil drinking water for her because being an infant, she was very susceptible to contracting diseases like typhoid. She suffered a lot because of the sickness whose cost was really high for me and my husband. Boiling the water daily proved to be quite difficult given the situation of rainfall here in Yala which made getting firewood difficult.”
Compared with her other two children, Atieno says, “they have not suffered the same fate that my daughter went through since the two of them were born during the installation of the chlorine dispensers.
“I have not had any problems of having to boil water to make it safe for drinking. The dispensers have lessened for us the work of having to boil the water to make it safe. We really appreciate the people who came with this initiative which is bound to save us the cost of boiling water and going to the hospital for treatment due to waterborne related diseases like typhoid and dysentery.”
Leonida Oronje, a resident of Bungoma County, said she used to drink water directly from the stream which brought her severe stomach problems because due to her old age she could not boil water for drinking. Now she can drink water without boiling it because it is chlorinated and cleaned before it gets to her “siongo” (pot), where she stores her water.
Ranje observed that the project will be better if the organizers can supply the dispensers to homesteads for those who have sunk boreholes and wells.
Khavere Joseph from Emabungo ward in Vihiga county says, “At first we did not want to have these things here in Vihiga because of the misconceptions about the white man wanting to make us impotent in order to regulate our population. We thought they were using the project to hoodwink us into drinking the drugs they wanted us to use but we later realized the relevance after the first few people to use it expressed satisfaction and including its ability to prevent typhoid which is prevalent in this area.”
He continued, “I am very much elated to see the dispensers in every water stream I go to because I am sure they will enhance the safety of the residents here against waterborne diseases.”
Despite benefits, challenges remain. According to Nelson Wafula, a resident of Khaoya, Bungoma county, some community members lack knowledge on the correct quantity of chlorine to apply for example, for a 20-liter barrel. This, he says, has led to wastage of chlorine in some cases as people use more than required.
Also, the over-application of chlorine in the barrels has led to nausea and vomiting, especially among first-time users. “The taste of water is always tampered with hence most people avoid taking water that has been chlorinated,” he says.
“The taste of chlorine has made me hate water but I have to drink it to quench my thirst. When mixed with water, it really tampers with the original taste making us, who are used to the natural taste of water lose the urge to drink water from our homes since our wives must always mix it with chlorine before they carry it home,” Steve Biko, a resident of Kodongo, Siaya County affirms.
He, however, disclosed that the dispensers have helped reduce waterborne diseases around his area since he hardly hears of anyone being taken to the hospital suffering from typhoid or other diseases like dysentery.
He continued, “Women in this area have embraced the use of chlorine since they are very cautious of the diseases that have been ailing this community of Kodongo. They care about the health of all family members and hence they will not miss mixing the water they draw from the stream with the chlorine before carrying it home. Even though we old men hate it, we have no option but to drink the water brought to us by our wives because they know better.”
Being that government contribution is important for the cost-effectiveness and long-term sustainability of the program, the organization is advancing negotiations with county governments to help fund chlorine procurement to prove their commitment to providing clean and safe water for the people in their counties.
In Vihiga County, the Department of Health provides storage space for chlorine refills at designated County Health facilities while Busia County supported the purchase of chlorine in the year 2019. Evidence Action is also a member of the Water Sanitation and Hygiene (WASH) Stakeholder Committees in all nine counties.
The organization estimates that by mid-2023, the project will be providing over 9 million people with access to safe water across Kenya, Malawi, and Uganda – an increase of nearly 5 million people from the current footprint. By mid-2023, there will be three times as many chlorine dispensers across Kenya, Uganda, and Malawi, Dennis says.
