Kuite’s Sanitation Improvement Program

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Table of Contents !1.0 EXECUTIVE SUMMARY …………………………………………………………………P. 3 2.0 INTRODUCTION ………………………………………………………………………...P. 4

2.1 OBJECTIVE ……………………………………………………………………...P. 4 2.2 PURPOSE ………………………………………………………………………..P. 4

2.3 COMMUNITY DESCRIPTION ……………………………………………………..P. 4 TABLE 1 ………………………………………………………………………...P. 5

GRAPH 1 ………………………………………………………………………..P. 6 2.4 SITE DESCRIPTION AND FEATURES ……………………………………………...P. 6

2.5 PEACE CORPS RELATIONS ………………………………………………………P. 6 3.0 PROJECT DESCRIPTION ……………………………………………………………….P. 7

3.1 WASH INDEX ……………………………………………………………………P. 7 3.2 COMMUNITY MEETING ………………………………………………………….P. 7

3.3 COMPOSTING LATRINE DESIGN AND BUILDING PROCESS ….....………………...P. 8 3.4 PILOT COMPOSTING LATRINE PROGRAM ………………………………………...P. 9

3.4.1 CAPACITY BUILDING …………………………………………………...P. 9 3.4.2 RESULTS ………………………………………………………………..P. 9

3.5 COMPOSTING LATRINE PROGRAM ……………………………………………….P. 9 3.5.1 HEALTH COMMITTEE …………………………………………………...P. 9

3.5.2 PHASE 1 …..…………………………………………………………...P. 10 3.5.3 PHASE 2 …..…………………………………………………………...P. 10

3.5.4 MONITORING AND EVALUATION ………………………………………P. 10 3.6 SUSTAINABILITY ……………………………………………………………....P. 10

4.0 BUDGET ………………………………………………………………………………P. 12 4.1 BUDGET NARRATIVE ………………………………………………………….P. 12

4.2 BUDGET PROPOSAL ……………………………………………………...PGS. 12-13 5.0 CONCLUSIONS …………..……………………………………………………………P. 14

6.0 REFERENCES …………………………………………………………………………P. 15 7.0 APPENDICES

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1.0 EXECUTIVE SUMMARY

Globally, 2.4 billion people lack basic sanitation systems such as latrines (WHO 1). According to the United Nations Children’s Fund (UNICEF), 88% of diarrheal related diseases manifest from “poor hygiene and lack of access to sanitation systems.” In effect, roughly 1.6 million people die annually from diarrheal related diseases (WHO 1). Furthermore, diarrheal diseases are cause to approximately 760,000 child deaths under the age of five, per year (WHO 2).

The Peace Corps has initiated a global effort, parallel to that of the United Nation Millennium Development Goal (MDG) 7, target 10: “halving by 2015 the proportion of people without sustainable access to safe drinking water and basic sanitation” (UN 2). Both the United Nations (UN) and the Peace Corps believe that with improved sanitation systems and hygiene education, diarrheal diseases in low-income countries will decrease while promoting proper hygiene practices.

Nonexistent sanitation systems and poor hygiene practices are present in the Panamanian community, Kuite. 194 people currently reside in Kuite and each person utilizes the Mananti River for all sanitary activities, including open defecation. Although the community has access to potable drinking water, many villages down river use the Mananti as their main water supply. The prevalence of diarrheal diseases and deaths is an issue for those in Kuite as well as communities downstream, given the uses of the Mananti River. Yet, the most alarming issue in these river communities is the high infant mortality rate. Sub-standard hygiene practices, behaviors, and access to sanitation facilities are threatening the health of Kuite’s youth population. Kuite’s lack of sanitation systems and proper hygiene education is in effect creating a public health hazard; however, this dilemma is preventable and can be improved.

In order to improve the sanitation efforts in Kuite and contribute to the MGD 7, the Peace Corps plans on facilitating the construction of eighteen (18) composting latrines. Composting latrine systems, also referred to as ecological sanitation, are aboveground cinder block structures that convert human excrement into a soil amendment (Mihelcic, Fry, Myre, and et al). With proper implementation of these composting latrines, in conjunction with hygiene education, Kuite’s state of public health can improve significantly.

The Peace Corps has recently developed and implemented a pilot latrine program that introduced the composting latrine and its concepts to participating families. With the success of the pilot latrine program, and the positive response towards the new sanitation system, the Peace Corps and the people of Kuite are prepared to initiate the composting latrine project.

In order to begin construction in Kuite, the community is seeking the funding of $4,817.38 towards of the first eight (8) composting latrines. With this funding, the community members of Kuite will be able to purchase the necessary materials and equipment to construct these composting latrines, effectively improving the overall public health in Kuite.

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2.0 INTRODUCTION

2.1 OBJECTIVE

The core objective of the Kuite’s sanitation improvement program is the construction and proper implementation of composting latrines for each household. This objective will be reached through capacity building and reinforcing education concerning community, household, and personal hygiene. The sanitation improvement program will be divided into two construction projects. This grant is associated with the first eight (8) composting latrines that are scheduled to be built during July of 2014.

2.2 PURPOSE

The purpose of this project was created to meet Kuite’s request in creating a cleaner environment and a strengthening public health. This project will also contribute to the goals set by the UN’s MDG 7 target 10, but more specifically the Peace Corps’ second goal assigned to environmental health Peace Corps Volunteers: Rural community members will adapt behaviors and practices to improve access and use of sanitation systems.

In addition, pursuant to Peace Corps Panama and the Panamanian Ministry of Health (MINSA) sanitation improvement goal, “By September 2017, 7,500 community members will benefit from rehabilitated or constructed sanitation systems.” By implementing the construction of this project, Kuite will contribute 2.59% towards this goal.

Improved sanitation will also foster strength in areas of social, community, and economic development. For example, education is highly correlated with levels of sanitation in a community. In low-income countries, girls are more likely to attend schools that have water and sanitation systems. Girls who menstruate are less likely to attend a school that does not have a proper bathroom, and parents are also less supportive in sending them (UNICEF). In addition, the World Health Organization (WHO) estimates that with the implementation of the MDGs regarding improved sanitation, approximately 194 million school days will be added in result of lowering diarrheal diseases. The WHO estimates, across countries, a 10% increase in female education is associated with a 0.3% increase in economic output. Educated females are also “more likely to raise healthy, well-nourished, educated children, to protect themselves from exploitation and HIV/AIDS in addition to developing skills to contribute to their societies” (UNICEF). By creating sanitation systems and hygiene education, we are in effect laying a foundation for improvements in education, fiscal security, social progress, and public health.

2.3 COMMUNITY DESCRIPTION

Kuite is a small indigenous community located within the Comarca Ngöbe-Buglé (CNB): a region of land acknowledged by the Panamanian government for the indigenous groups, the Ngöbe and the Buglé. Kuite is located within the province, ÑoKribo (Translated as, “Of Big Water”). The community’s name, Kuite, is derived from the word Kui, or Chicken, in the native spoken language: Ngöbere. According to the local citizens of Kuite, nearby communities, and former Peace Corps Volunteers (PCV), the community was established roughly 30-40 years ago.

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Currently, the community of Kuite includes 194 individuals and 22 households. This is an average 8.82 persons per household. According to the data collected by the previous PCV during the years of 2011-2013, Kuite included 178 individuals and 22 households. This was an average of 8.09 persons per household. Based on a recent census complied by the current PCV, Kuite is in the midst of population expansion. According to Table 1, 77.3% of Kuite’s population is between the ages of 0-29 years of age. 40.7% of the population is between the ages of 10-29: the age group most likely to reproduce based on social norms. This table is graphically represented in Graph 1

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The main source of income for the majority of Kuite’s citizens is by government welfare. There are currently few sources of income besides government well fare. Most welfare money is re-circulated throughout the community by means of small stores, buying and selling of livestock, and home-improvements. Although most citizens of Kuite play the role of subsistence farmers, some do sell their agricultural products outside the CNB. Other forms of economic opportunities include cutting lumber, making or hemming of clothing, designing local artisan crafts, and boat driving which is the most lucrative occupation.

2.4 SITE DESCRIPTION AND FEATURES

Kuite is located adjacent to the Mananti River: a tributary that flows north towards the Chiriquí Lagoon. Because of the Kuite’s proximity to the river, many areas are marshy and saturated. On average, the depth to water is approximately 0.5’. The local geology of Kuite is generally comprised of clay and silts, with traces of sand and gravel near the riverbanks.

2.5 PEACE CORPS RELATIONS

The Peace Corps has had a presence in Kuite for eight (8) years. Between the years of 2008 and 2013, PCVs and the community members of Kuite constructed a chlorinated aqueduct system that now services every household. The water system now supplies potable, chlorinated water to each household for drinking and bathing purposes. The system is now fully functioning and is no longer maintained by the Peace Corps.

Kuite and the Peace Corps have developed a strong relationship over the years. The collaboration between the two parties has contributed towards successes in creating access to potable water in addition to strengthening Kuite’s public health. Recognizing the approach the

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Peace Corps views regarding development, community members are taking more initiatives on projects, and management roles are being transferred to community members.

3.0 PROJECT DESCRIPTION

The construction of a sanitation system in Kuite will help engage the community in strengthening its public heath while reducing diarrheal related illness. The ultimate goal of this project is to give the citizens of Kuite an improved understanding of sanitation and hygiene, in addition to creating a sustainable sanitation system for present and future needs.

The core objectives of this project are as follows:

1. Identify and understand the current sanitation systems and potential sanitation issues in the community

2. Work with the community in identifying the best possible solution in creating a stronger sanitation system

3. Facilitate a pilot program to analyze the progress and commitment to a rehabilitated system

4. Initiate the construction phase of the project 5. Determine the effectiveness of the project through monitoring and evaluation

3.1 WASH INDEX

The WASH Index is a Peace Corps tool adapted from a UN program that is used to analyze hygiene and sanitation on community and household levels. In order to better grasp the hygiene and sanitation levels in the community of Kuite, the former and current PCVs observed every household’s sanitation practices, in addition to the community’s general sanitation practices. Observations were made and recorded based on the Peace Corps’ WASH Index outline (Appendix A).

After reviewing the data from the former and current PCVs’ observations, it became apparent that the lowest scores in the WASH Index concerned latrines and sanitation systems (Appendix B). Currently, each household in Kuite uses the local Mananti River for defecation and no functioning latrines are in existence.

3.2 COMMUNITY MEETING

Once the Peace Corps was able to understand the degree of sanitation practices in Kuite, several meetings were organized with community members to address the current behaviors, issues, and possible solutions. Community members in Kuite understood the risks surrounding their sanitation practices.

According to the community members, nothing was done to change the current sanitation practices for the following reasons:

1. A lack of education surrounding sanitation practices and sanitation systems 2. A lack of funding to support a project to install modern flush toilets

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3. The existence of a high water table limited the use and functionality of commonly used pit latrines

In order to better understand the wants and needs of Kuite, community members were asked why they would want an improved sanitation system. The following points were exclaimed:

1. To reduce the pollution and bacteria released in the Mananti River 2. To reduce the amount of diarrheal related illness and deaths 3. To create a safer area for sanitary practices. It can be a very dangerous for the young and

elderly when the river is flooded 4. To create a more private space

After understanding and addressing the issue, the community concluded that a composting latrine project would best meet their needs in sanitation improvements. Although composting latrines have a higher initial cost compared to pit latrines, they can be constructed where water tables are high. If used properly, composting latrines have a longer lifetime in comparison to pit latrines: approximately ten (10) years Composting latrines are also more resourceful than flush toilets, as they are not reliant on water.

The program would include the construction of a composting latrine for each participating family, and also educational support surrounding proper hygiene and sanitation practices. Before the project could begin, the Peace Corps created a pilot composting latrine program to first test the preparedness and education of the community.

3.3 COMPOSTING LATRINE DESIGN AND BUILDING PROCESS

The Peace Corps works with each community in deciding which sanitation systems are most appropriate based on local geology, available funds, practicality, and social acceptance. Based on Kuite’s high water table, the materials accessible, and the agricultural workforce present, composting latrines are considered the best option for the Kuite’s new sanitation system.

Although composting latrine designs are tailored to meet the need of each community, the Peace Corps in Panama uses a standard design that is already successfully implemented in the CNB. The design includes a two (2) chambered, aboveground cinderblock structure. Each chamber is used alternatively. While one compartment is being used, the inactive compartment houses human excrement that is being composted as pathogens are eliminated. Pathogens are killed by proper use, decomposing temperature, and the dry additives applied. A seat is stationed above each chamber, and each seat is designed to divert urine by a polyvinyl chloride (PVC) pipe to a separate receiving container. The illustration in Appendix C shows a visual description of a composting latrine and how they function.

Due to the aboveground design, composting latrines can be built in areas with high water tables, flood plains, and near water-bodies. Since composting latrines separate wet and dry excrement, bad odors are not produced which in turn does not provide a breeding ground for insects. Composting latrines also reduce the need for resources such as water, but create a resource such as compost for the purposes such as soil amending.

Each participating family will be trained by the current PCV on how to construct a composting latrine. Training sessions and materials will include the following:

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1. The use of visual diagrams taught in a classroom-like setting 2. Written and visual guides on building composting latrines will be given to each

participating family 3. The building of small composting latrine models will be implemented in order to

practice building techniques 4. A hands-on group project, including each participating family, of the construction of

the first composting latrine in Kuite

After members of each participating family receive a background in composting latrine construction, the health committee will assemble work groups. Each work group will include four (4) people that will consist of various families. Work groups will implement the construction of the composting latrines, and a PCV will be on site for guidance if needed.

3.4 PILOT COMPOSTING LATRINE PROGRAM

The pilot composting latrine program is an assessment implemented by the Peace Corps in order to evaluate the understanding, functionality, practicality, and acceptance of composting latrines on a community and household level. The former PCV that served Kuite completed a pilot composting latrine program to assess the community’s preparedness.

3.4.1 Capacity Building: After several meetings and educational seminars regarding the use and maintenance of a composting latrine, each participating family used the pilot composting latrine for one (1) week. After each week, the former PCV observed and recorded the effectiveness based on a standard outline. Once the data was collected from each participating family, each group was given a grade based on the latrine use during their given week.

3.4.2 Results: Based on the information gathered from the pilot latrine program,

eight (8) families were deemed ready for the next level of the composting latrine project. This readiness will include the support and construction facilitation of eight (8) composting latrines: one per family. The remaining participating families will receive further educational support, in addition to a second pilot latrine analysis. Once the remaining families are considered educationally prepared, they will then be considered for the second round of composting latrine construction.

3.5 COMPOSTING LATRINE PROGRAM

The composting latrine project is currently seeking funding to transition to the construction phase of the project. To make the process more streamlined, steps and goals have been taken to organize the community and the project.

3.5.1 Health Committee: In hopes of better empowering the people of Kuite and strengthening the composting latrine project, a health committee was established. The health committee, along with other duties and responsibilities, will help coordinate and assist in the management of the

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composting latrine project. The committee is made up of elected community members from Kuite. The officers and their duties were determined by the community during a community meeting facilitated by the current PCV.

3.5.2 Phase I: The first phase of the project will include the preparation and fundraising of eight (8) composting latrines. The health committee with the oversight of the current PCV will determine the work groups and coordination of the project. During the fundraising period, workdays will be scheduled to move sand and stones from the river to each construction location. The current PCV will work with the school in producing an advertisement geared towards raising support and funds for Kuite’s composting latrine program.

3.5.3 Phase II: The second phase of the program will include the construction portion of the project. Through preparations with Kuite’s Health Committee, work teams will be assembled on scheduled workdays to construct the composting latrines. Each work team will be assigned to construct a single composting latrine at an individual time. One person from each work team will be trained as the “group technician”, or leader of the specific composting latrine construction. A PCV will supervise each work team, and guide the construction if any problems or questions arise during the process.

3.5.4 Monitoring and Evaluation: In order to evaluate the functionality of each composting latrine, the health committee and the current PCV will inspect each composting latrine on a bi-weekly basis. Based on standards regarding proper use, cleanliness, odor, and overall appearance, each composting latrine will be given a grade made visible to the citizens of Kuite. Through proper monitoring, the health committee and the PCV can locate functional flaws in the composting latrines, or provide additional education support as needed.

3.6 SUSTAINABILITY

Creating a sustainable project and a sustainable system is a priority concerning Peace Corps supported projects and programs. The lifetime of the composting latrines, the implementation, the application of compost, social acceptance, and behavioral change are all aspects in whether or not the sanitation improvement program will be successful and sustainable in the community. From the choosing of the proper sanitation system in Kuite, to the formation of the health committee, the community and the PCV has made efforts in bringing longevity to the program.

One reason composting latrines are more beneficial than pit latrines, is because they can be used for a longer amount of time. Based on past projects, the Peace Corps’ projected lifetime of a composting latrine is approximately 20 years when maintained appropriately. The current training and capacity building concerning composting latrines will prepare the participating families to build an additional composting latrine in the future if need be. The current PCV is working with the health committee in creating a more affordable composting latrine that utilizes local resources.

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Through the composting latrine project it is expected that diarrheal illnesses will decrease, sanitation behaviors will improve, and transmission of fecal-oral diseases will lessen. There is however the risk of unintentional consequences. Because behavioral change is often a coercive process, there is the risk that the new sanitation practice will not be implemented. There is also the risk of misuse and a lack of proper maintenance that can lead to various sanitation household issues. Although these potential consequences are possible, steps are being taken to ensure the resiliency of the program.

The directives that will most support a sustainable system have already been completed through capacity building, composting latrine education, and the pilot composting latrine program. Preparing the community was the largest step towards laying a foundation for a successful, sustainable program; however, there are many directives that will be created to ensure a maintained system including:

1. Health committee support: One of the main purposes behind the creation of a health committee will be to monitor the progression or potential issues with the composting latrine program. Bestowing education, knowledge, and power to the community will bring support from within Kuite.

2. Inspections: A continuation of bi-weekly inspections and grading to rate the functionality of each individual composting latrine

3. Additional PCV support: An additional PCV will be requested to assist Kuite is the area of Sustainable Agricultural Systems (SAS). A SAS PCV will be able to assist and guide community members in using compost in a healthy and proper manner.

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4.0 BUDGET

This budget was prepared with the assistance of community members of Kuite and the guidance from the current PCV. This budget reflects the funds necessary to continue with Kuite’s sanitation improvement project. The funds necessary to complete this project total $ 4,817.38.

4.1 BUDGET NARRATIVE

To achieve the funding required to continue with Kuite’s sanitation improvement program, the current PCV is applying for a Peace Corps Partnership Program (PCPP) grant. The PCPP program gives projects, such as Kuite’s composting latrine project, the opportunity to seek funding through private sector donations (individual or organization). This is an imperative step in terms of funding. Families in Kuite do not currently have the financial capabilities to venture a project of this sum; however, pursuant to the Peace Corps’ standard regarding funding PCPPs, each participating community must contribute at least 25% of the total cost of the project. This 25% does not necessarily need to reflect monetary support, but can be offered through labor and local resources.

Although the participating families will not be able to contribute monetarily, each family will support the project through labor support, in addition to the local funding though the local resources of wood, sand, and gravel. Through labor and material support, the community members will be contributing approximately 57.57% towards the composting latrine project.

4.2 BUDGET PROPOSAL

Community Contribution Grant

Contribution Cash In-Kind Total ($US)

Labor ~ ~ 5,712.00 5,712.00

Materials/Supplies 2,236.10 ~ 825.60 3,061.7

Equipment 1,141.28 ~ ~ 1,141.28

Material Transport 1,200.00 ~ ~ 1,200.00

Travel/Food 240.00 ~ ~ 240.00

Total $4,817.38 6,537.60 $11,354.98

% Contribution Cost ($US)

PCPP’s Contribution 42.43 4,817.38

Kuite’s Contribution 57.57 6,537.60

Total Cost of Project 100% $14,721.68

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Grant Amount Community Contribution

Item Description

Budget Category

Unit Cost Local

Currency Quantity

Total Cost Local

Currency Local

Currency $ US Percentage In-Kind

Local Currency

In-Kind $ US

Bag of Cement Materials 11.25 70 787.50 787.50 $787.50 0 0 $0 3/8" Rebar Materials 6.5 32 208 208 $208 0 0 $0 1" PVC Branch Materials 5.95 8 47.6 47.6 $47.6 0 0 $0 45* 1" PVC Elbow Materials 1.25 32 40 40 $40 0 0 $0 90* 1" PCV Elbow Materials 1.25 16 20 20 $20 0 0 $0 PVC Cement Materials 3.95 8 31.6 31.6 $31.6 0 0 $0 Metal Molding Wire Materials 1 1 1 1 $1 0 0 $0 3.5" Nails Materials 1.25 24 30 30 $30 0 0 $0 Zinc Sheet Nails Materials 1.35 8 10.8 10.8 $10.8 0 0 $0 8' Zinc Sheet Materials 15.5 24 372 372 $372 0 0 $0 Mesh Screen Materials 0.95 8 7.6 7.6 $7.6 0 0 $0 Wood Materials 0.6 976 585.6 0 $0 0 585.6 $585.6 Cement 4¨ Block Materials 0.85 800 680 680 $680 0 0 $0 Sand and Gravel Materials 0.5 480 240 0 $0 0 240 $240 Wheel Barrow Equipment 80 4 320 320 $320 0 0 $0 5 Gallon Bucket Equipment 5 8 40 40 $40 0 0 $0 Carpenter's Square Equipment 9.52 4 38.08 38.08 $38.08 0 0 $0 Heavy Duty Construction Bags Equipment 1.9 56 106.4 106.4 $106.4 0 0 $0 Metal Float Equipment 7.25 8 58 58 $58 0 0 $0 Wooden Float Equipment 8.75 8 70 70 $70 0 0 $0 Wood Saw Equipment 9.5 4 38 38 $38 0 0 $0 Shovel Equipment 7.95 4 31.8 31.8 $31.8 0 0 $0 Spade Equipment 9.95 4 39.8 39.8 $39.8 0 0 $0 Tape Measure Equipment 9.25 4 37 37 $37 0 0 $0 Cement Trowel Equipment 11.85 8 94.8 94.8 $94.8 0 0 $0 Level Equipment 9.95 4 39.8 39.8 $39.8 0 0 $0 Cord Level Equipment 1.5 4 6 6 $6 0 0 $0 Pliers Equipment 7.5 4 30 30 $30 0 0 $0 Stone Chisel Equipment 1.4 4 5.6 5.6 $5.6 0 0 $0 Hacksaw Equipment 7.5 4 30 30 $30 0 0 $0 Plastic Tarp Equipment 35 4 140 140 $140 0 0 $0 String Equipment 2 8 16 16 $16 0 0 $0

Boat Transport Materials Transport 200 6 1200 1200 $1200 0 0 $0

Work Labor Labor 2.55 2240 5712 0 $0 0 5712 $5712 Peace Corps Volunteer Travel

Travel/Per Diem/Food 20 2 40 40 $40 0 0 $0

Food Travel/Per Diem/Food 1 200 200 200 $200 0 0 $0

Total: 11354.98 4817.38 $4817.38 57.57 6537.6 $6537.6

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5.0 CONCLUSION

The Peace Corps has implemented sanitation projects throughout Panama in reaction to preventable illness and deaths associated with fecal-borne related diseases. The Peace Corps has worked alongside several communities in creating and rehabilitating sanitation systems, in hopes of reducing preventable diseases. Kuite has worked effortlessly alongside the Peace Corps in creating a health initiative such as the proposed sanitation improvement. Through the implementation of the composting latrine project, community members hope to make a difference in their hygienic lifestyle and health practices. Furthermore, citizens realize the impact this can make in protecting the health of Kuite’s youth. In reaction to Kuite’s expanding population and large youth cohort, in is imperative that sanitation improvements are implemented now in hopes of curbing future sanitation issues.

Kuite’s sanitation improvement program is the next necessary component in promoting and protecting Kuite’s public health. Parallel with improving access to potable water, creating a functioning sanitation system can contribute towards a decrease in diarrheal related illnesses and deaths, a stronger public health, and can also lead to fewer sick days associated with work and school. Yet, this project has even broader implications for the entirety of Kuite.

Through the composting latrine project, a wider understanding of related topics will help empower the community as well as prepare them for future projects. Through leadership and management roles, community members will practice communication and organizational skills. By establishing a health committee, this group can begin a professional dialogue with organizations, such as the Ministry of Health, in gaining support for additional health initiatives. Members of Kuite will also have an increased knowledge of construction for future projects; however, the most essential goal of this program is protecting the health of Kuite.

There is a stigma in Kuite and the surrounding communities regarding the naming of infants younger than the age of one. Some locals attribute this to cultural, socials, or religious norms. Others claim this is in direct relation to a high infant mortality rate (IMR). Many infants in Kuite and surrounding communities have succumbed to diarrheal related deaths due to a lack of potable water and proper sanitation systems. This composting latrine project can extinguish such a stigma and will ensure the protection of Kuite’s children, Kuite’s public health, and Kuite’s potential to succeed in future projects concerning health and education.

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6.0 REFERENCES

Mihelcic, James, Lauren Fry, Elizabeth Myre, et al. "Composting Latrines." Field Guide to Environmental Engineering for Development Workers. Reston:

United Nations (UN1)"Tackling water, sanitation, energy nexus key to sustainable future â!“ UN officials." UN News Center. UN, 18 Feb. 2014. Web. 20 Mar. 2014. <http://www.un.org/apps/news/story.asp?NewsID=47165&Cr=development+agenda&Cr1=#.UyKUWVFdVWb>.

United Nations (UN2). "The Millennium Development Goals Report." United Nation. UN, n.d.

Web. 4 Mar. 2014. <http://www.undp.org/content/dam/undp/library/MDG/english/mdg-report-2013-english.pdf>.

United Nations Children Fund (UNICEF). "Why Improved Sanitation is Important for Children." UNICEF. UNICEF, n.d. Web. 17 Mar. 2014. <http://www.unwater.org/wwd08/docs/kids-sanitation.pdf>.

World Health Organization (WHO 1). "Health through safe drinking water and basic sanitation." WHO. World Health Organization, n.d. Web. 19 Mar. 2014. http://www.who.int/water_sanitation_health/mdg1/en/.

World Health Oganization (WHO 2). "Diarrhoeal disease." WHO. World Health Organization,

n.d. Web. 18 Mar. 2014. <http://www.who.int/mediacentre/factsheets/fs330/en/<

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APPENDIX A

Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3 First Observation

Second Observation

Third Observation

Household water treatment No treatment Occasional treatment by chlorine, boiling or SODIS

Consistent treatment by chlorination, boiling or SODIS

Household water storageWater is stored in unsanitary

containers on the floor or within reach of children or animals

Water is kept off of the ground but containers to not appear to be

cleaned regularly

Water is kept off the ground in regularly clean containers.

Household water useWater is used for washing, drinking and cooking out of any container.

Anyone can access the water.

Drinking water is separated from wash and cook water but anyone can

access it. Wash water isn't offered before eating.

Drinking and cooking water is separated from wash water and is

managed by an adult with clean hands. Water is offered to wash hands before

eating.

Household faucet areaFaucet area is dirty/muddy, there is no

tap stand. Faucet leaks and tube is not buried.

Tap stand present and relatively clean. Tap may leak or tubes

exposed.

Tap stand area is clean and cared for. Faucet is clean and does not leak.

Tubes are buried.Total Points Section 1 0 0 0


Second Observation

Third Observation

Waste disposalLeave trash out and do not dispose of trash appropriately (burn plastics while

cooking food).

Burn all trash or occasionally deliver trash to nearby dump site, if available.

Members bury and burn their waste appropriately or take it to a dump site, if

available.

Drainage/Standing water Frequent standing water and mud. Mosquito larvae are present.

Some drainage, but some standing water

No standing water and there is good drainage around the house

Mosquito control Mosquito nets are not used. Fire and smoke is used to deter mosquitoes.

Mosquito nets are used for infants or coils are used regularly.

Mosquito nets are used by several family members, and coils are used.

House StructureHouse is in need of much repair, mud is visible in the house, uneven floors, leaking, and other issues are visible.

House is in need of some repair but in decent condition

Well built house that keeps out weather and pests, relatively new roof, hard packed dirt, wood, or cement floor

Placement of fire hearth/kitchenKitchen area is close to sleeping/living

area and has very poor ventilation with a lot of smoke.

Kitchen is in the same building but far from living/sleeping area, with decent

ventilation.

There is a separate building for kitchen with good ventilation. May have a fire

hearth that is above floor and/or contained, improved stove, or use a

gas stove.Total Points Section 2 0 0 0

PEACE CORPS/PANAMA ENVIRONMENTAL HEALTH PROJECT

Section 2: Home Sanitation

Section 1: Household Water

HOUSEHOLD LEVEL WASH INDEX (Water - Sanitation - Health - Hygiene)


Second Observation

Third Observation

Distance from House Latrine is far too close to a house (within 10 feet) Latrine is 15-30 feet from a house. Latrine is 30 to 50 feet from any house.

Distance from Water Source Latrine is far too close to the water source (within 30 feet).

Latrine is 30- 50 feet from the water source.

Latrine is 50 to 70 feet downhill from the water source.

Covered Hole Latrine has no top and is left uncovered most or all of the time

Latrine has a top but is frequently uncovered Hole has a top and is always covered.

Privacy/enclosed area

Latrine does not have a door, walls or roof that are well built or is not

enclosed, allowing frequent entry from animals and others creating unsafe

and unhealthy access

Latrine has a door, walls and roof, but they are somewhat decayed and

sometimes allow entry of animals.

Latrine has a door, walls and roof that are well enclosed, provide privacy and are safe from the entry of animals or

children.

Pit Latrine: Appropriate depth/maintenance

Latrine is below the water table, fills up when it rains, overflows, or is near

to full (within three feet of surface)

Latrine is above the water table and does not fill up when it rains. It may be near being full and needing to be

topped off (within five feet).

Latrine has appropriate and proper depth; it does not fill up with water

when it rains and is at least five feet below the top (fill)

Pit Latrine: Ventilation

Latrine does not have proper ventilation; there is either an enclosed

space with no ventilation, or ventilation due to a lack of enclosure.

Latrine has piping and moderate ventilation within some kind of

enclosure.

Latrine has appropriate and proper ventilation through PCV pipes within

well enclosed areas

Composting Latrine: Appropriate use/maintenance

Foul odor is present, no dry material is available, both chambers are being

used, liquid is present in the chambers, the seat is dirty/urine tube

clogged.

Dry material is present but the chamber shows inconsistent dry

material use, some odor is present, not everyone in the family is using the latrine, compost is not harvested on a

regular basis.

Latrine is used properly by the whole family, the seat is clean and covered when not in use, there is no odor, dry

material is available and present in the chamber, compost is harvested and

used properly. Total Points Section 3 0 0 0


Second Observation

Third Observation

Pens and Enclosed Spaces There is no penning of any animals. Animal feces are present in the yard.

Pigs are penned most of the time. Chickens may have pens, but are free

range much of the day. Some pens may be near water sources.

Chickens and pigs and other livestock are kept in enclosed areas or pens

most of the time, including chickens. Homes may have perimeter fences. Pens are not near a water source.

Animals in the HouseAnimals roam freely in and out of the house. Animal feces are present in

the house.

There is no barrier to keep pigs and chickens out of the house, but most of the time they shoo animals out, other

than the roosting fowl.

There is a barrier to keep pigs and chickens out of the house at all times.

When animals get in, families shoo them out. Some families may keep

dogs and cats out.

Animal disease Dogs and cats, and other animals appear diseased and sick.

Dogs and cats are relatively disease free.

All animals, especially dogs and cats, are visibly disease free.Total Points Section 4 0 0 0

Section 3: Human Waste Disposal

Section 4: Animals Around the Home


Second Observation

Third Observation

Keeping food Leftover food is kept out and uncovered, flies are present

Leftovers are kept in kitchen area and covered.

Leftovers are covered and disposed of before they go bad.

Food preparation

Hands are rarely or never washed. Food may not be cooked thoroughly. Vegetables are not cleaned before

cooking.

Hands are sometimes washed. Food is thoroughly cooked. Most

vegetables are rinsed with water before cooking.

Hands are washed prior to cooking, food is thoroughly cooked, vegetables

are washed before cooking, ideally with bleach, meat is clean, separate utensils

and surfaces between meat and vegetables, or cleaning between use.

Cleaning of dishes and utensils prior to cooking

Rinsing dishes in non-potable water without soap, or reusing water to rinse

dirty dishes. Leaving utensils and dishes uncovered most or all of the

time.

Wash without soap or bleach. Dishes and utensils are usually covered.

Utensils and dishes are kept in covered containers most of the time and

overnight. Wash using soap or bleach.

General cleanliness of kitchen areaFloors and surfaces are not kept

clean. Insects (flies or cockroaches) are visible.

Floors and surfaces are sometimes clean. Just water is used to clean.

Floors and surfaces are kept clean. Bleach, soap or lime is used frequently.

Clean drinking water Drinking water is unclean or not available.

Clean drinking water is usually available, but may not be kept

covered.

Clean drinking water is available in covered containers, or potable water is

available and safe to drink.Total Points Section 5 0 0 0

Section 5: Kitchen Habits


Second Observation

Third Observation

Tooth brushing No visible toothbrush. Teeth are visibly unhealthy.

At least one toothbrush is visible. Teeth may sometimes look healthy.

Multiple toothbrushes visible, Toothbrushes. Are kept clean and/or

covered. Teeth look healthy.

Hand washingNo water, or soap is visible. Family rarely or never offers water for hand

washing.

Water is available and visible. Family offers water to wash hands.

Soap is available. Water is available, clean and covered. Family offers clean

water to wash hands.

Latrine useThere is no latrine, or if there is one, it

is clearly not being used for its intended purpose.

There is a latrine. It seems to be used.

Latrine is available for use and is clearly used by family members on a

regular basis. Family member will frequently wash hands after using the

latrine.

Footwear Most family members don't wear shoes. Shoes may not be available.

Some members of the family wear shoes. Shoes are available for wear.

Most members of the family have and wear footwear (including flip flops)

Bathing and Personal Appearance

Most family members appear unkept (don't wear clean clothes), and do not smell fresh most of the time. Members

of the family are not seen bathing daily.

Many family members bathe daily, but without soap. Children may not be

washed thoroughly. Many members of the family wear clean clothes most

of the time. Children may be dirty.

Most or all family members bathe daily with soap. Children are washed. Most

members wear clean clothes, have clean hair, and smell fresh most of the

time.

Illness

Family members appear to be sick: coughing, sneezing, mucus and

general malaise. No one goes to the clinic when ill. No medicine or

treatments are present.

Some of the family appear to be sick. Will visit clinic when symptoms persist or illness becomes grave. Knowledge

on disease and illness is low.

Family members appear healthy with not complaint of malaise. When they are sick they will go to the clinic and

receive treatment. General knowledge on disease and illness is shared.

Total Points Section 6 0 0 0


Second Observation

Third Observation

QuantityFamily members are hungry and

appear malnourished. Children are thin and look too small for their age.

Family members usually eat two meals a day or the meals are not

quite enough, do not appear malnourished.

All members of the family eat three full meals a day and appear nourished

Sweets & SnacksFamily members feed sweets and

snacks as a meal or let children eat them very frequently.

Family members give kids sweets and snacks but not every day or as a

meal.

Family members don't regularly give children sweets and snacks and

discourage eating them frequently.

Quality/Balanced Diet Families rarely or never eat fruits and vegetables.

Families occasionally eat fruits and vegetables.

Families regularly serve a balanced diet, including proteins, fruits and

vegetables. Total Points Section 7 0 0 0

Total Points 0 0 0

Section 6: Personal Health and Hygiene Habits

Section 7: Nutrition

!!!!!!!!!!!!

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APPENDIX C

Kuite’s Sanitation Improvement Program

Documents

Transcript of Kuite’s Sanitation Improvement Program