WRITING THEIR CHAPTER

WRITING THEIR
CHAPTER
WRITING THEIR
CHAPTER
Kirisia
Water, Sanitation
and Hygiene Project
for Trachoma
Control
www.amref.org

WRITING THEIR OWN CHAPTER
Kirisia Water Sanitation and Hygiene Project for Trachoma Control i
Published in 2013 by AMREF Kenya
AMREF Kenya Country Office
Wilson Airport, Off Lang’ata Road
P.O. Box 30125-00100, Nairobi, Kenya
Tel: +254 0(20) 699 4000
Fax: +254 0(20) 600 6340/ 600 2531
Email: info.kenya@amref.org
Website: www.amref.org
Writing: Stephen Wakhu
Photography, Layout and Design: Anthony Muninzwa
©AMREF 2013

ii
WRITING THEIR CHAPTER
KIRISIA WATER SANITATION AND HYGIENE PROJECT FOR
TRACHOMA CONTROL, SAMBURU CENTRAL DISTRICT
Lessons Learnt and Best Practices for Water Sanitation and Hygiene
for Trachoma Control
Project Funded by: Junta Castilla y Leon through AMREF Spain
Project Implementation Period: 15th August 2011 to 14th November 2013
Republic of Kenya
Kirisia Water Sanitation and Hygiene Project for Trachoma Control

Kirisia Water Sanitation and Hygiene Project for Trachoma Control 1
TABLE OF CONTENTS
ACKNOWLEDGEMENT ...........................................................................................2
BACKGROUND ..........................................................................................................3
PROJECT GOAL ........................................................................................................8
PROJECT OBJECTIVE ................................................................................................8
BENEFICIARIES ..........................................................................................................8
PARTNERS .................................................................................................................. 9
CHALLENGES FACED DURING IMPLEMENTATION.....................................12
PROJECT SUCCESSES ............................................................................................13
BEST PRACTICES .....................................................................................................18
LESSONS LEARNT.................................................................................................. 24

2WRITING THEIR OWN CHAPTER
ACKNOWLEDGEMENT
AMREF would like to acknowledge the generous support and funding
of Junta Castilla y Leon through AMREF Spain towards the Water
Sanitation and Hygiene (WASH) project for trachoma control in Kirisia
division.
We would like to thank the communities of Kirisia division for their
support and participation in implementation. Their commitment to
the project and the practice of proper hygiene and sanitation has
immensely contributed to the success of the project.
We acknowledge our partners: the Ministry of Water and Irrigation,
MinistryofHealth,MinistryofEducationandtheProvincialAdministration
for their support and commitment in the implementation of the
project.
We also thank the members of the Project Implementation Team (PIT)
especially Joseph Rotich from the Ministry of Health, Robert Muhindi
from the Ministry of Water and Irrigation and area chief Peter Lerosion,
for tirelessly working with the community in the implementation of
the project.
The success of the project is likewise attributed to the commendable
work done by the Trachoma programme staff led by the Project
Officer, Solomon Mwaniki and Project Assistants, David Owino and
Mary Opondo.
We acknowledge the leadership and support of the AMREF Kenya
Country Director, Dr Lennie Bazira S. Kyomuhangi, Deputy Country
Director, Dr Meshack Ndirangu, Programme Manager, George Kimathi
and Project Manager Francis Dikir.
Finally, we recognise and acknowledge the efforts of the AMREF Kenya
Communication team in documenting, editing and layout of this
publication.

3WRITING THEIR OWN CHAPTER
BACKGROUND
The Water Sanitation and Hygiene (WASH) project for trachoma
control was implemented in Kirisia Division, Samburu Central District.
Samburu Central District covers an area of 21,127 km2 and has a
project population of 105,052; or a population of eight people per
square kilometre.
A map of Samburu Central District
Samburu Central District generally has an undulating topography and
lies in the arid and semi-arid ecological zone characterized by dry, hot
and dusty conditions. The district suffers drought around the year.
Rainfall is erratic, inadequate and unreliable ranging from 300mm
to 900mm annually. The district is inhabited mainly by the nomadic
Samburu and Pokot communities who keep large herds of cattle and
seasonally migrate to other regions in search of pasture and water.

Kirisia Water Sanitation and Hygiene Project for Trachoma Control4 WRITING THEIR OWN CHAPTER
The main economic activity in the area is livestock rearing with 87%
of the people involved in it. To add to the harsh climate characteristic
of arid and semi arid zones, cattle rustling and prevalence of livestock
diseases have accelerated the poor performance of livestock as a
source of livelihood.
With a Human Development Index (HMI) of 0.293 and a Human Poverty
Index (HPI) of 59.6%,1
Samburu is one of the poorest counties in Kenya.
A sizeable population lives on less than a dollar per day. The district’s
poverty is aggravated by lack of access to safe adequate water,
proper sanitation facilities and poor hygiene and sanitation practices
exposing the population to water and sanitation related diseases such
as trachoma, diarrhoea, dysentery and cholera.
Social cultural practices are a hindrance to the adoption of desired
health behaviour. 84% of the population has no access to proper
health care 2
. People in the area seek the services of traditional healers
and care at health facilities is sought much later. This is partly due to
poverty levels, inaccessibility of health facilities, ignorance and belief
in superstition.
Kirisia division has two health centres and three dispensaries. Due
to cattle rustling and insecurity, these health facilities are within
urban and settled areas. The road network is very poor (not even a
kilometre of tarmac road) and impassable during rainy seasons. There
are no public service vehicles to most parts of the division and people
therefore mainly walk to the health facilities located at a distance of
over 10 kilometres apart.
Poor access to water and sanitation facilities slows down socio-
economic development in the region. Women and girls are particularly
affected because of their daily task as water collectors for domestic use.
They have to walk long distances which limit opportunities for other
productive issues, adding further restrictions on household income
levels as well as on gender disparities.
1
UNDP 2009, Human Development Report
2
GOK - Ministry of Health: National demographic health survey Report 2008

With a latrine coverage of 20% and 72% 3
of the community relieving
themselves in the bush the district has low access to excreta disposal.
This is due to the nomadic lifestyle of the pastoralists, poverty levels,
illiteracy levels and ignorance on the relationship between excreta
disposal and health.
ThetwoyearWASHprojectfortrachomacontrolbyAMREFwasfunded
by Junta Castilla y Leon through AMREF Spain to the tune of €170,000.
AMREF and local authorities supplemented this budget with an extra
€45, 900 bringing the total cost of the project to €215,900. The project
aimed to sustainably increase access to and utilisation of improved
water and sanitation services thus contributing to poverty reduction,
improving equity of genders and quality of life in Kirisia division.
The project rehabilitated two boreholes and two shallow wells,
protected two new shallow wells, distributed 20 5,000 litre tanks, 100
leaky tins and constructed 20 Ventilated Improved Pit (VIP) latrines
in schools, constructed 80 community pit latrines in the community,
constructed 100 dish racks, dug 100 refuse pits for the community and
constructed a 50,000 masonry litre tank. These were aimed at creating
better access to water from improved water sources and also improve
the access to sanitation facilities.
These project activities associated with water aimed at increasing
access to safe water. The evaluation findings indicate a significant
increase in number of respondents using water from ‘protected’
sources. At ETE, 58.1 percent and 52.3 percent of the respondents got
water from protected sources respectively during wet and dry seasons
as compared to 56.1 percent and 49.1% respectively during wet and
dry seasons at Baseline. Further, the evaluation shows that 25.3% of the
respondents accessed water within their home compounds compared
to only 4.4 percent reported at baseline. Overall, the distance travelled
to access water by the households has reduced with majority (94.6
percent) accessing water within a radius of 2 Kilometers, compared
to 82.9 percent at baseline. The WHO recommends 20 litres of water
per capita per person. The project evaluation results indicate that the
3
AMREF, (2009), Comprehensive Baseline Survey, Samburu Central District

majority of the respondents (40.8%) used between 60 - 80 liters per
day (3-4 jerricans). Considering that there is an average of 6 people per
household in the area, per capita water volume is about 13.3 litres per
person per day as compared with 10 litres which is less than the WHOs
recommendation of 20litres per person per day.
On sanitation, analysis show that latrine coverage has increased to 30.5
percent, this is equally an improvement from the baseline coverage
which was only 28 percent. Evaluation recorded improvements in
the personal and household hygiene actions such as: bathing daily,
throwing garbage in compost pit, cleaning the compound covering of
the latrines and treating water before usage compared to the situation
at baseline.
With access to improved water and sanitation facilities, and improved
hygiene and sanitation practices in the region, the project hoped to
help in the attainment of some of the Millennium Development Goals
(MDGs). Sustainable access to clean water and sanitation facilities will
contribute to the reduction of the risk of child and maternal mortality
(MDG 4&5); combat diseases (MDG 6) and reduce the poverty burden
(MDG1).

A rehabilitated shallow well
Children going to fetch water

Project GOAL
The overall project goal was to sustain the reduction of trachoma
prevalence and other water related diseases such as cholera, diarrhoea
and dysentery among children aged 1-9 years. The project focused on
face and hand washing, construction of toilets and construction and
rehabilitation of water sources.
Project Objective
Theprojectobjectiveswere;contributetowardspovertyalleviationand
improve the quality of life of the target community through capacity
building, increased and sustainable access to safe water and sanitation
facilities, improved hygiene practices and control of trachoma and
other endemic water related diseases.
This was done through safe behavioural change through training,
awareness raising and health education for improved hygiene and
sanitation.
Beneficiaries
The target population was 68,372 people residing in Kirisia division,
SamburuCentraldistrict.Theprimarybeneficiariesgroupwerechildren
between 1-9 years and women of child bearing age who were the most
vulnerable to active trachoma and other water related diseases. They
constituted 50% of the population.
Children aged 1-9 years are the main reservoirs of trachoma and
repeated infection without treatment may lead to blinding trachoma.
Women are 2-3 times more affected than men due to their caring for
the children and easily get infected through hands, clothing and flies
which have come into contact with discharge from the eyes and nose
of an infected child.

The secondary beneficiaries were older children above 10 years and
the entire community at large.
Partners
Ministry of Water and Irrigation•
Ministry of Health•
Ministry of Education•
Provincial Administration•

Rehabilitated Shallow well a Blessing
Damaris Lengidi is a 25 year old housewife and a mother of three in Lakira
location. In 2012, her last born child suffered from cholera and diarrhoea
that almost took his life.
“When I went to the hospital, the doctor informed me that my son had
ingested contaminated food or dirty water,” says Damaris.
Damaris recalls that she went back home and vowed that she will always
treat her drinking water and will ensure that she cooked her food with
clean water.
Her resolution was
given a boost by the
AMREF WASH project
that was initiated in
her community. She
is grateful for the
sensitization done on
latrine construction
and usage, dish rack
installation and usage
where the project
provided the nails and
mesh wire and Damaris
constructed the dish rack outside her manyatta using locally available
materials and the rehabilitated shallow well just 300 metres from her
home. Damaris actively contributed the unskilled labour during the
shallow well development and trained as one of the water management
committee member. The participation has lead to intervention
ownership and sustainability.
“I always fetch clean water from the well. This helps me cook my food
with clean water and I do not have to travel for long distances in search
of water”

Damaris says that because of the dish rack, her utensils are never
contaminated by the dogs that roam the compound and the goats that
graze around the homestead.
She recallsthat afterthe proper healthand sanitationpracticestalk by the
project,herhusbandtookituponhimselfandconstructedananimalshed.
This significantly reduced the number of houseflies in the house which she
learnt is a major transmitter of trachoma.
“My husband has been active in the attainment for a cleaner environment
in our manyatta. He cuts down the long grass in the compound and clears
the bushes around the manyatta.
The WASH project, through material support, helped them dig a refuse
pit that has been instrumental in the disposal of rubbish around the
homestead.
Damaris is grateful that the WASH project was introduced in schools. She
says that the children in the community are always cheerful while going
to school and are always reminding each other to wash their hands after
visiting the toilet and before handling food.
“This has been important especially in the fight against water related
diseases like trachoma and diarrhoea in Lakira”

CHALLENGES FACED DURING IMPLEMENTATION
Vandalism
Vandalism of water sources especially rehabilitated boreholes and
shallow wells were a major occurrence in the division. The division
has a high demand for weapons especially spears and swords due to
the cattle rustling among local communities. The blacksmiths of the
community end up removing the metals pipes and visibility sign posts
in so as to satisfy the demand for weapons in the community.
To curb the vandalism, the project involved the local administration
especially the chiefs of the division to help prevent the vandalism.
The chiefs and local authorities were instrumental in tracing the
perpetrators of vandalism and punishing them accordingly. The PIT
also held sensitisation meetings on the importance of these water
facilities.
Cultural Barriers
Cultural beliefs have been one the challenge faced during the
implementation of the project. Some men in the division argued
that their culture does not allow them to use the same toilet as their
mothers and daughters while others argued that they cannot defecate
in a house like structure. Due to the migratory culture of the local
communities, they did not see the need of constructing a pit latrine
just to use it for a few months and leave.
The project made use of the Chief Barazas and public congregation
to address the issues of proper hygiene and sanitation practices. The
project created awareness on the importance of the use of a pit latrine
andthedisadvantagesandconsequencesofopendefecation.Withthe
knowledge gained through the school health clubs, school children
helped in passing hygiene information to their parents.
Harsh Weather and Poor Terrain
Due to erratic and unreliable weather, the division experienced heavy

rainfall that destroyed most of the roads in the community. Access
to most of the targeted area became a challenge hence delaying
implementation of scheduled activities. To address this, the project
team reviewed the work plans and ensured that the delayed activities
were implemented in those areas.
PROJECT SUCCESSES
The rehabilitation of two boreholes and two shallow wells and•
the construction of two new shallow wells has improved the
access of clean water in the division. 58.1% access clean water
during wet seasons compared to 56.1% at baseline reporting
while 52.3% during dry season compared to 49.1% at baseline
reporting
With the rehabilitation and construction of boreholes and•
shallow wells, the distance travelled to access clean water in the
division has reduced, with 94.6% accessing water within a radius
of 2km compared to 82.9% at baseline
The construction of 80 community pit latrines and 20 VIP latrines•
has improved the latrine coverage from 28% to 30.5% in both
the schools and community and reduced open defecation in the
division
Due to the sensitisation and capacity building carried out by•
the Water Management Committees (WMCs), the percentage of
people paying for clean water increased by 8.4% i.e. from 42.7%
to 51.1%
Duetotheempoweringofthecommunitytoaccessandcorrectly•
utilise safe water by treating their drinking water, there was an
increase of 2.8% in the usage of various water treatment method
i.e. from 31.2% to 34%
The distribution of 20 (5,000 litre) tanks and 100 (20 litre) leaky•
tins in the 10 schools improved hand washing practices in the
schools. 98% of the pupils across the schools now practice hand
washing
About 60% of the homesteads in the division now have a•
leaky tin strategically placed and in use by the members of the
homestead

A Health Champion
“Inadequate clean water and long distance covered to access water are
major hindrance to health in this community” says Nelly Lekaikum, a 21
year old small scale business woman in Sirata.
ThemotheroftwoandamemberoftheSirataWomenGroup,isoneofthe
communitymemberswhobenefitedfromadishrackthatwasconstructed
by the WASH project in the district.
Before the construction of the
dish rack, Nelly used to dry
her utensils outside on the
ground. At this time, her family
suffered from frequent bouts
of diarrhoea. From health talks
carried out by the AMREF WASH
personnel, she understood
why her family suffered from
diarrhoea.
“I am grateful for the dish rack
in my manyatta. Ever since it
was constructed the cases of
diarrhoea in my manyatta has
reduced.”
She also appreciates the community toilets constructed by the project and
she has even gone the extra mile to construct a leaky tin in her homestead
that she encourages her husband and children to use after visiting the
toilet.
Nelly understands that for the community to prosper health wise, they
need to be empowered and educated on proper hygiene and sanitation
practice. She lobbied her fellow women group members to educate and
inform community members on the importance of proper health, hygiene
and sanitation practices.

“I am happy that most of the women in the community testify to either
boiling or treating their drinking water and have also started constructing
dish racks and digging refuse pits in their Manyattas.”
Nelly is grateful for the water kiosk constructed in Sirata. The water
kiosk sells water at an affordable price of Ksh2 per 20 litre jericans. She
acknowledges that the kiosk has reduced the distance they had to travel
to fetch clean water and the community has adequate water for bathing
at least once a day.
She thanks the AMREF WASH project and hopes that the knowledge of
proper hygiene and sanitation practices they imparted will be of use and
that the cases of water related diseases such as trachoma, diarrhoea and
cholera will be history in Sirata community.

Striving For a Clean Manyatta
Sein Shiro is a class six pupil in Sirata Oirobi Primary School. She is the first
born of Carolyne Lenimiria, a beneficiary of a dish rack and the digging of
a refuse pit. Before the WASH project for trachoma control was introduced
in Shiro’s community, her family was not keen on proper hygiene and
sanitation practices.
“I think our manyatta was the dirtiest in the whole village” says Shiro.
“The AMREF WASH project has changed my life in a major way. I know the
benefits of a healthy and clean environment”
Shiro is a School
Health Club
member in her
school and
says that the
information of
proper hygiene
and sanitation
practices that she
has been learning
from the club has
been important
in improving the
cleanliness in
her homestead.
Shiro educate her
younger siblings
about proper sanitation and hygiene practice and the importance of a
clean environment.
Sincetheintroductionoftheschoolhealthclubinherschool,Shirohasbeen
imparting knowledge on the importance of keeping a clean environment
and how it helps prevent diseases such as trachoma and cholera and in
the long run improve the hygiene and sanitation in the homestead.

Shiro even reminds her father to cut down the grass in the homestead and
cut down the bushes around it.
She has taken up the responsibility of cleaning the compound and
ensuringthattherubbishintherefusepitisburnteveryweek.Shehaseven
constructed a leaky tin that she encourages the family members to use.
Shiro recalls that through the training and demonstration carried out by
AMREF project staff, her mother ensures that she boils her drinking water
and stores it in a clean container which is exclusively used for storing
drinking water.
She is grateful for the community toilet constructed by AMREF. She
acknowledges that not everybody uses it but it has greatly reduced the
number of people who defecate in the bush hence the environment smells
fresh and clean.
With the knowledge she has gained from the school health club, Shiro is
determined to keep up the practice of proper hygiene and sanitation and
strives to make their homestead the cleanest in the whole community.

BEST PRACTICES
During the project implementation, the project rolled out a number of
best practices:
Establishment and use of Water Management Committee•
Construction of water kiosk•
Supply installation and use of leaky Tins•
Training of Teachers, CHWs, and local leaders in PHASE•
Introduction of school health clubs•
Establishment and Use of Water Management Committee
The project team established a Water Management Committee (WMC)
that was mandated with the management of the constructed and
rehabilitated water sources. To ensure a true representation of the
division, the project let the community members elect WMC members.
The WMC is responsible for the maintenance of the boreholes and
shallow wells in the community. They ensure that the water pumps
are running effectively and efficiently.
The committee also passed information to the community on the
importance of the water sources and the use of clean water. With the
help of the local leadership, the committee encouraged the blacksmith
in the division to stop vandalising the water sources. Since the water
sources are run by members of the community, it enhances the
sustainability and ownership of the project.
Construction of Water Kiosk
The project constructed four water kiosks at strategic points across the
locality to enhance the accessibility of water and sustainability of the

project. These water kiosks are run by the WMC. The kiosks were set up
to help with revenue collection to support the function of the WMC of
maintaining and rehabilitating the boreholes and shallow wells.
The committee sells water at an affordable price of Ksh 2 per 20
litre jerican. The money collected from the water kiosks helps the
committee to, repair breakages and buy fuel to pump water to the
kiosks, tanks located in neighbouring schools and a 50,000 litre tank in
the community. The community members are grateful for these water
kiosks as they have reduced the distance covered in search of clean
water.
A water Kiosk
Supply, Installation and Use of Leaky Tins
The leaky tin, an improvised water tap used for hand and face washing,
has become a common sight in schools and homesteads in Kirisia
division.Theprojectsupplied100leakytinstoschoolsandhomesteads
and these were placed strategically near the toilets to ensure that
people washed their faces and hands.

With high poverty levels, erratic, unreliable and inadequate rainfall
in the division, leaky tins offer a cheap, easy to produce, easy to use,
hygienic and economical solution for hand washing.
Leaky tins have proved to be an invaluable appendage in the fight
against trachoma and diarrhoea and a resounding success for the
practiceofproperhygieneandsanitationamongschoolgoingchildren
and community at large. Homesteads that did not benefit from leaky
tins, improvised from a jerican and a stick.
A leaky tin
Training of Teachers, CHWs, and Local Leaders in PHASE
The project trained 20 teachers from 10 primary schools, 20 CHWs
and 20 local leaders on Personal Hygiene and Sanitation Education
(PHASE). The trained teachers, CHWs and local leaders are the health
champions in the community. They were mandated to empower and
create awareness on the importance of proper hygiene and sanitation
practices.

The training was carried out by the project team. The 20 teachers
trained further trained their fellow teachers and pupils in their
respective schools. They were also given the responsibility of forming
a school health club where they were to be the clubs patron. The
trained teachers and pupils shared information on proper hygiene and
sanitation practices with the members of the community and other
out of school children.
The trained CHWs and local leadership ensured that all the community
members adopted proper personal hygiene and sanitation practices.
The CHWs and local leaders were mandated with demonstrating the
practices of proper hygiene and sanitation in the community. This
enhanced the ownership of the project by the community members.
The community felt that the project was being driven by one of their
own therefore embracing proper hygiene and sanitation practices.
A signboard

Christopher Lemaletian Hope and Dream
38 year old Christopher Lemaletian is a Community Health Worker (CHW)
in Kirisia division and a cultural ambassador of the Samburu community.
Christopher understands that the issue of poor hygiene and sanitation
is a major problem in his community. He says that Kirisia being an area
inhabited by pastoralist communities, many are not keen on practicing
proper hygiene and sanitation hence hindering development of the
community.
“My dream and hope is to see a healthy Samburu free of water, hygiene
and sanitation related diseases,” says Christopher.
He appreciates the
trainings carried out in the
community terming them
as an eye opener. Through
his capacity as a CHW
and cultural ambassador,
Christopher empowers,
educate and inform the
members of his community
on the importance of proper
hygiene and sanitation
practices.
Christopher is one of the community members who benefited from the
construction of a community pit latrine. He has made it his purpose to
persuade community members to use the toilet and stop open defecation.
He informs them on the disadvantages and the consequences of open
defecation.
He admits it is not a walk in the park but says he will not give up on his
dream and hope.
“TheSamburusareverypracticalpeople.Forproperhygieneandsanitation
to be practiced they need regular demonstrations”

Every two weeks, Christopher calls his community members to his
homestead and demonstrates to them proper hygiene and sanitation
practices;fromhowtowashtheirfacesandhandstohowtotreatdrinking
water.
Christopher is happy that his fortnightly class is growing in numbers with
every meeting. He believes that the WASH information he is advocating
for is making a difference. He has taken his hygiene and sanitation classes
to the chief’s baraza. Every time the chief holds a baraza in his village,
Christopher always speaks to the people in attendance on proper hygiene
and sanitation practices.
Christopher, who is also a farmer, saved up and piped water to his
compound. To enable fellow community members access clean piped
water, he sells the water to them at an affordable rate of Ksh2 per 20 litre
jerican.
Christopheracknowledgesthatsharingofhealthinformationandcapacity
building is key for the promotion of hygiene and sanitation practices. He
believes that capacity building will bridge the illiteracy gap that hinders
the promotion of health in his community.

Introduction of School Health Clubs
The school health clubs were introduced in schools for the purpose of
sustainabilityandcontinuityofproperhygieneandsanitationpractices
beyond the life of the project. The clubs, under the leadership and
guidance of their respective club patrons, were given the responsibility
of:
Creating awareness on health issues1.
Cleaning the school and its environs2.
Developing a school health library with adequate material on3.
health
Starting a tree nursery for conservation of the environment4.
Starting a school garden to supplement the school diet.5.
The school health clubs initiated Income Generating Activities (IGAs)
suchaspoultrykeepingandtreeplanting.Theschoolsselltheseedlings
from the tree nursery and eggs to the neighbouring community
members. The school health clubs have developed a school garden
for planting sukuma wiki to supplement their school diets.
The school health clubs have helped pupils build their knowledge,
skills and means to transform their personal hygiene and sanitation in
both the school and community levels.

A pupil washing hands from a Leaky tin in the School compound
A 5,000 litre water tank distributed in schools by AMREF

School Health Club Bears Fruit
The bell rings. The shouts and cheers are deafening as the pupils rush
to the leaky tins to wash their hands. Standing next to the leaky tins are
the school prefects ensuring that fellow pupils wash their hands properly
before lunch.
This is what happens every lunch hour at Lokuto Primary school in
Ng’ari sub location. Head master, Titus Lenolngenje, is happy with the
improvement of hygiene and sanitation practices in his school.
“This is the product and result of the school health club introduced by
the AMREF WASH project,” says the headmaster as he watches the pupils
wash their hands.
Lokuto Primary School has a population of 343 pupils and has six classes;
class 1 to 6. It is one of the schools that benefited with two water tanks of
5,000 litres each, construction of four VIP toilets and four leaky tins from
the WASH project.
The WASH project introduced school health clubs in schools for
sustainability of proper hygiene and sanitation practices. The club at
LokutoPrimarySchoolwasinitiatedin2011andisresponsibleforcarrying
out health education, cleaning the school and its environs and starting of
a school garden for planting vegetables to supplement the school diet.
The head master says that the club has been a major success in the
school.
“The rate of absenteeism has drastically reduced and water and hygiene
related diseases has greatly reduced among the pupils”
The enrolment of pupils in the schools has greatly improved since the
inception of the project. The children in the community dream about a life
beyond herding goats and cows. The enrolment has improved from 260 in
2012 to 343 in 2013 pupils. The headmaster attributes this growth to the
WASH activities initiated in the school.

Titus says that the WASH project in the school has trickled down to the
community level. During teacher/parent meetings, the parents are always
eager to discuss hygiene and sanitation issues affecting the pupils and the
community as a whole.
Most of the parents, if not all, have a leaky tin in their homestead and
have stopped open defecation. They are making use of the community pit
latrines constructed by the project.
During dry season, the school allows community members to fetch clean
drinking water stored in the tank. Titus says he encourages the parents to
treat the water before drinking. The community members are grateful for
the two water tanks in the school and say that they have improved the
health status in the region.
“Withthesignificantrolethehealthinformationandwaterandsanitation
facilities play in the school, I am determined to take this school greater
heights not only health wise but also in their performance.”

LESSONS LEARNT
Coordination, Involvement and Stakeholders Partnership
Partnership is a key element of AMREF’s approach to project
implementation. A key lesson learnt during implementation was
the significance of coordinating, involving and partnering with all
stakeholders throughout the life of the project. The involvement
of relevant line ministries (Ministry of Water and Irrigation, Ministry
of Health, Ministry of Education and the provincial administration),
community members, pupils and teachers was paramount to the
success of the project.
This partnership brought a sense of project ownership as every
stakeholder was involved and their roles were clearly defined. The
mutual partnership provided a deeper and broader appreciation of the
project hence proper planning and smooth project implementation.
Regular meetings of the PIT members presented a good platform to
discuss issues related to the project and way forward.
Capacity Building
Capacity building of the people involved in the project was necessary
for the project success. This was important especially in tackling
cultural barriers. The project made use of the Chief Barazas and public
congregation to build the capacity on issues of proper hygiene and
sanitation especially in the control of trachoma.
The project also made use of the trained teachers, CHWs and local
leaders to build the capacity of community members. This ensured
that messages on proper hygiene and sanitation practice reached as
many beneficiaries as possible.
Children: Agents of change
Throughtheestablishmentofschoolhealthclubs,theprojectsurmised

the role of children as change agents. Children are receptive to the
communication approaches and information offered to them. They
have played a key role in the achievement of sustainable hygiene and
sanitation practices.
A 50,000 litre water tank constructed by AMREF in the community

Charity Begins at Home
54yearoldGeorgeLenguruisaCommunityHealthWorker(CHW)inNg’ari
sub location. In 2010, George recalls, the health, hygiene and sanitation
status in Ng’ari was in a dire state. George is grateful for the training he
received as a CHW.
“The WASH training was invaluable. It greatly improved the hygiene and
sanitation status in my Manyatta.”
According to George charity
begins at home. After the
training, George went
back home and convened
a meeting with his family
and informed them of
the importance of a clean
environment and proper
practices of hygiene and
environmental cleanliness
especially in the fight against
trachoma.
He delegated duties to his family members and ensured that they were
carried out. His four boys were responsible for the general cleanliness of
the compound while his three girls were responsible for the provision of
clean water to the homestead.
During the training, George learnt that the major transmitter of trachoma
in the community was houseflies. This was due to the animal waste and
open defecation practiced by people in the locality. He encouraged his
community members to use the community pit latrines constructed in
Ng’ari and construct a leaky tin for face and hand washing. He informed
his community members of the importance of hand washing after visiting
the toilet.
George encouraged community members to regularly clean their animal

shelters and encouraged those who did not have one to construct one.
George reckons that this will go a long way in reducing the number of
houseflies in his community hence the reduction of trachoma infections.
George says that some of the community members were not receptive to
the health message he was passing to them. This did not discourage him.
“Inevergaveuponinformingthesecommunitymembersoftheimportance
ofproperhygieneandsanitationpractices.Imadeitmypointtovisitthem
on a daily basis talking to them about health issues,” says George.
For George, the empowerment of fellow community members on health
issues does not stop at the community level. During parent/teacher
meetings in schools, George always makes it a point to talk to parents and
pupils of the importance of a clean environment and encourages them to
practice proper hygiene and sanitation practices.
George says the WASH project has played a major role in the reduction
of cases of water related diseases such as trachoma and diarrhoea. He
is grateful for the strides the project has made in his community and is
resolute that the hygiene and sanitation practices will continue to be
practiced.

32 WRITING THEIR OWN CHAPTER
Project Ownership
Sustainability of water sources and sanitation facilities depends
on the ability of the local community to carry out maintenance and
curb vandalism of shared water resources. It was important to build
the capacity of the community on the importance of the water and
sanitation facilities.
The Water Management Committee that was mandated with the
management and maintenance of the constructed and rehabilitated
water sources. This enhanced the ownership of the water source thus
ownership of the project. The project also worked side by side with
the people of Kirisia, building knowledge, skill and means to transform
their hygiene and sanitation thus laying a foundation that will be felt
for generations to come.

For more information contact
AMREF Kenya
P.O. Box 30125-00100,
Nairobi, Kenya
Tel: +254 0(20) 699 4000
Fax: +254 0(20) 600 6340
info.kenya@amref.org
www.amref.org

WRITING THEIR CHAPTER

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