The Joys and Challenges: Clean Water for Kenya
Water is one of the biggest challenges facing the women, children, and communities in Kitui South, Kenya. Kitui South is a semi-arid part of the country, prone to drought. Women and girls spend hours each day walking to safe pumps or shallow wells to collect water, often only to find them empty. When the water runs dry, people often rely on water sources that can be contaminated.
When we reached out to P&G explaining the serious need for clean, safe water resources in Kenya, they responded quickly and positively. P&G is a committed partner of CMMB and have played an important role responding to water related emergencies in South Sudan, Peru, and Zambia. They are committed to improving water, sanitation, and hygiene globally. P&G’s support includes short-term solutions to water emergencies – in the form of water purifying powder – as well as mid-and-long-term solutions, through behavioral change at the community level.
Kevin Mulama, our monitoring and evaluation specialist in Mutomo, recently collected a series of stories told by CMMB staff and health workers about the joys and challenges of implementing change at the community level.
The Ways of Our Forefathers
By Patricia Kulita, community health volunteer, serving 41 households in Maliango and Kisayani villages, Kanziko Ward, Kenya
CHV training and demonstration on water purification
When Benedict, the community health extension worker, invited me to a training on water purification, I was excited. I have referred many people, including children, to Kituvwi Dispensary to be treated for diarrhea. In my villages, dry river beds where we scoop out sand and draw water from water holes are the only water sources. The water is usually brown and often contaminated by feces, because cows and sheep, too, come here to drink.
Facilitated by CMMB and the Ministry of Health, the training session was very good. Afterwards, I was given P&G water purifiers, the report form, and posters that illustrate the importance of drinking safe water.
The next day, as I walked from house to house in Kisayani conducting health talks about what I had learned, I met the assistant chief. When he told me about a baraza (meeting) the following day, I asked to be given the opportunity to sensitize the community on water safety, and when the day of the baraza dawned, left home armed with buckets, water purifiers, a mwiko (cooking stick), and a piece of white cloth for my demonstration.
After I ended, a village administrator declared from under a shade tree, “We will not use the water purifiers.”
“Why?” I questioned.
“Purified water reduces males’ libido and is a form of family planning,” he insisted.
“Those are myths and misconceptions!” I asserted. “Look at the ingredients. Ferric sulfate is a coagulant; calcium hypochlorite kills germs. These ingredients have no relationship with sterility and family planning.”
“But our forefathers drank the water as it is. And we ourselves have grown old drinking water as we find it.”
As a community health volunteer, I routinely see cases of diarrhea. We do have a diarrhea problem. But he was not persuaded. Although the village elder’s wife and others had requested P&G water purification sachets to use at home, other village participants questioned my message.
Weeks passed. Then one day, alighting from the bodaboda after a long session at Kituvwi Dispensary, I encountered the elder at my doorstep, suffering from acute, excessive diarrhea and looking miserable. “Do you have some medicine for diarrhea?” he asked.
I referred him to Kituvwi Dispensary and returned to the household the next day. When I arrived, he was relaxing under a tree with a bottle of what looked like clean water at his side.
“Is that water purified?” I asked, pointing at the bottle next to him.
“Yes, it is,” he said. “The nurse told me to drink plenty of safe water, and from this incident I have learned the hard way. I will always drink clean, safe water. Is there room for a clean water ambassador?” Amid laughter, he said, “I will share this at the next meeting as an ambassador for water purifiers.”
I thanked him for his offer, and he bade me farewell, saying, “The ways of our forefathers are best, but oh, Lord, make us wise that we may accept change.”
The Maluma Conspiracy
By Kevin Mulama
Community health volunteers with CMMB and local leaders, educated residents of Mulama Village on water safety
During a community health volunteer meeting in July 2017, five Maluma sub location community health volunteers alerted CMMB that families had rejected the donated Procter & Gamble water purifiers, despite health education on water safety. As a matter of urgency, the Athi Ward public health officer—Benedict, the community health extension worker—visited the village to explore the refusal. But as he tried to explain why the purifiers were important, residents argued, citing numerous myths and misconceptions. They would not even listen to him.
Calls to the Ministry of Health and the CMMB office in Mutomo for help mobilized all relevant stakeholders—the Ministries of Education and Water in addition to the Ministry of Health, plus local administration and ward administrations—for a huge August community meeting to address community concerns.
At the meeting, held under a huge tree in the chief’s office, the discussion continued. When David, CMMB’s officer in charge of water, sanitation, and hygiene, called for questions, a moment of silence ensued. Then, turning to one another, people began whispering. It felt like a conspiracy to reject the water purifiers.
CMMB sensitizing Kevin Maluma community on water purification
“What is the problem?” David inquired.
A mzee (old man) stood up. “Sirs,” he announced, “We cannot drink treated water. It killed a chicken and reduces the life span of the person drinking it.” At this, other attendees rushed to offer other reasons to justify resistance: The purifiers are laced with contraceptives; the water causes heartburn, is poisonous or cumbersome to prepare, and tastes and smells different, they contended heatedly.
David’s response was calm. He explained purifiers’ ingredients and their functions. One woman seated in the shade countered, “But contraceptives contain ferrous, like the water purifiers.”
“Aha,” said David. “The ferricsulfate in the purifiers coagulate dirt in the water. The ferrousfumarate in contraceptives is an iron supplement that treats or prevents low blood iron levels. Ferric sulfate and ferrous fumarate are different.” Community members nodded. But the war continued.
“Whose chicken died after drinking treated water?” asked David.
“My neighbor said that, but I did not see the dead chicken,” said the mzee.
“Well,” explained David, “Treated water is safe, but for consumption by humans—not for livestock or chickens. The purifiers remove contaminants. Drinking treated water will help reduce incidence of diarrhea in our community.” As David answered further questions, public health officers and community health volunteers demonstrated how to treat water using the sachets. David explained that the water’s taste is caused by free chlorine and it is the chlorine that rids the water of contamination.
As the community dialogue ended, David highlighted purifiers’ benefits: They make the water clear; are easy to transport; have a long shelf life; and are proven to reduce bacteria, virus, and protozoa levels and communities’ burden of diarrheal disease. The disadvantage is simply the multiple steps required in the water purification process and the need for equipment (i.e., two buckets, a cloth, and a stirrer). Hearing this, community members relaxed. Some even began asking where they could obtain the purifiers.
All issues were resolved. “Thank you for clearing things up,” said one woman. “We understand and will now treat all our drinking water.
Mary and the Bedbugs
By Florence Kamwila, community health volunteer serving 52 households in Mbyuni, Katiliku and Kathumula villages, Kanziko Ward
One day as I was visiting households in Mbiuni village to help families understand the importance of safe water, I went to the home of Mary (not her real name), a lactating mother of three. Her family is poor: Although I discourage child labor, she insists that it is needed if food is to be put on her table; one of her children is a casual laborer, although he is still in Class 8. Mary herself has had nutrition problems, mostly due to poverty, and another of her children was referred just the other day for malnutrition and is now receiving Plumpy’Nut nutrition supplement. Mary gets her water from a dry riverbed, so I usually give her seven P&G water purification sachets a week, as we were taught during training.
Community health worker and project sensitizing community during household visits
On the day I visited most recently, I asked for a cup of water just to see whether Mary was treating it. The taste and smell of chlorine confirmed it. She passed the test. “I see that you still treat the water—good work! Keep it up!” I cheered.
“You taught us well and I do not want my family to get stomach problems,” replied Mary.
As we talked, she noted that she had been sleeping poorly and suspected bedbugs. Upon investigating her bedding, I confirmed her suspicions. I also saw a white powder on the mattress—which, embarrassed, she acknowledged being water purifier.
“Wait . . . What? Did you use water purifier on the bedbugs?”
“Yes.” Mary looked down, sheepishly. “You taught us that the water purifier kills germs, viruses, and protozoa in water, so I assumed it could kill mites, bedbugs, and cockroaches. I used half a sachet this morning to see.”
I could not believe what I was hearing. “This is not a proper use of water purifiers. I will have to take the remaining sachets,” I said sternly.
“I used just half a sachet,” Mary conceded. “We are due for top up today, and since we were not at home last Monday, one sachet was not used. That is why I experimented.”
I emphasized that water purifiers were not meant to kill insects but to disinfect and clarify water. “Bed bugs are killed by what we call fumigation. I will call the public health officer to come and address your bedbug problem.”
After admonishing her, I gave her seven sachets and asked her to report the next day whether the water purifier had killed the bed bugs. To her dismay, it had not. Her experiment had failed.
Mary’s household completed, I moved to the next household for its weekly visit.
Community Champions
By Kevin Mulama
Kasua, a community health volunteer in Kisiio village of Athi Ward, is tasked with ensuring that village residents develop and maintain healthy behaviors and practices. He is always available to respond to health questions and provide advice and himself models good health behavior. Kasua’s wife takes a keen interest in his activities and attends the meetings he facilitates on community dialogue days. She supports his message.
CHAMPS champion demonstrating water purification
After Kasua returned home following CMMB and Ministry of Health water purification training, he briefed his wife, gave a demonstration, and explained how the treatment works, what the water purifiers contain, and how to record the number distributed per household based on household size.
One day, Kasua’s aging father was taken ill and admitted in the Machakos Level 5 hospital. As Kasua traveled from Kisiio village to take care of his parent, his wife stayed at home to care for their children. Unaware of his situation, residents of many households that he supervises wondered at his absence. When they ran out of purifiers, many resorted to purchasing them or simply boiled their water.
CHAMPS-P&G nurse champion sensitizing the community
In addition, one by one, they visited Kasua’s home. After his wife explained his absence, they understood, but wondered about the next week’s stock of water purifiers.
In Kasua’s absence, his wife stepped in. She gave health talks to visitors and taught them about the importance of antenatal care visits, skilled delivery, immunization, and clean water and how to make it safe for drinking by boiling, filtration, and chemical treatment. To neighbors enrolled in Kasua’s care already, she issued water purifiers and recorded the details, as her husband always did.
When Kasua returned, he found that his wife had distributed the P&G water purifiers and had correctly recorded the number distributed. She had also accurately calculated the drinking water requirements for each household, bearing in mind average water consumption—two liters per day per capita.
Kasua’s wife exemplifies the many community health volunteer spouses in Athi and Kanziko who have become CMMB champions in mobilizing and advocating for better maternal, newborn, and child health outcomes in their villages.
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Kevin Mulama is our monitoring and evaluation specialist in Kenya. Here he shares a little bit about himself.
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