Meet Isabel Carvalho, a WASH volunteer serving with CMMB’s local affiliate Access to Health Zambia. With 17 years of experience as an engineer working for global corporations, it was her commitment to giving back that led her to Zambia. In the story below, Isabel invites you to learn about her first weeks in Zambia and the community-led project that will improve water access, sanitation, and hygiene throughout the communities CMMB serves.

A Community-First Approach 

It has been three weeks since I arrived in Mwandi, a rural district of the Western Province in Zambia. I joined CMMB and Access to Health Zambia as a WASH Program Volunteer, supporting their efforts to improve water access, sanitation, and hygiene (WASH) conditions in vulnerable communities. 

My current project aims to identify the main water and sanitation gaps across the rural villages of Mwandi. Our findings will inform a strategy to determine high-priority areas and recommendations to tackle the gaps. We plan to follow the Community Led Total Sanitation methodology (CLTS), which prioritizes capacity building among neighborhood health committee members. They will go on to train others in their own communities. Based on my colleagues’ experience from previous local projects and my experience supporting WASH projects around the world, we agree the CLTS approach will lead to the greatest success, starting with behavior changes and community ownership.  

Starting at Baseline

The first phase of the project brings us to rural villages throughout Mwandi to capture baseline data on current water and sanitation conditions. We visit households and care facilities and speak with community leaders and champions. What I have seen and learned so far triggers a spectrum of feelings: shock, inquietude, sense of powerless, and also curiosity—despite such tough conditions, people are frequently smiling and laughing.  

We recently visited Mushukula, an area with around 45 villages and over 3,000 inhabitants. Before heading to the villages to visit households, we met with key community leaders and advocates at the local healthcare facility. During our conversations we introduced the project, learned about the leaders and their engagement with the community, as well their level of knowledge in sanitation. We also sought to leave the conversation with an understanding of their main challenges.  

Learnings from Ms. Brenda, a Community Advocate

Following our meeting, I had the chance to interview one of the community leaders, Ms. Brenda Milinga. As the neighborhood health committee (NHC) leader, she represents her community called Lwanza—which is comprised of 22 villages and approximately 380 people.   

Ms. Brenda walked through sandy terrain, which is typical here in the Western Province, for six hours to meet us in the morning at the health facility. Walking long distances is a common practice here due to the area’s remoteness. People not only must dedicate the time for long walks, but also need to be healthy and strong to endure such distances. This is on top of the safety risks they face when crossing through fields, commonly inhabited by elephants and other wild animals. On the positive side, since the implementation of the Community Healthcare Worker (CHW) Program, revamped by CMMB in partnership with the Ministry of Health in 2019, outpatient services can now be provided at the primary healthcare level without traveling long distances to reach a facility. CHWs, trained and supported by CMMB and other partners, deliver this basic outpatient health support directly to the communities. 

I asked Ms. Brenda about the main health problems she sees in her community. She said, “I constantly see diarrhea and vomiting, which I believe is caused by the water that we drink from the shallow wells.” 

The closest borehole is silted (a common issue here due to the sandy terrain that makes water unsafe to drink). The next functioning safe water point is four hours away by oxcarts. As a result, people collect water from closer water sources that are contaminated. They later fall sick. When I asked Ms. Brenda if it is common for families to seek medical care for these waterborne illnesses, she explained: “For those cases, most of the time we don’t even bother to go all the way to a health post. It is too far away.”  

For the past six years, CMMB has partnered with Procter & Gramble to distribute water purifying sachets across rural areas of Mwandi, which has been a true game changer in providing safe water access to these communities. However, people cannot always rely on the availability of those sachets, so I asked if other water treatment options, like boiling for example, are common practices in Ms. Brenda’s community.  

“Boiling the water is not convenient,” Ms. Brenda told me. “Sometimes it even changes the taste of the water. People don’t really see the need. They always drank this water.” Another significant constraint to boiling water is that women have to cut wood in an already semi-arid area for the needed cooking fire. 

With a long journey back home ahead of Ms. Brenda, we had to wrap up the interview.  My last question was if the community would consider moving closer to the healthcare facility and clean water sources. Her response was simple, as if the suggestion was not an option.  

“Why would we move? Our livelihood is there, our heritage is there. We cannot move away,” she said.  

Based on what I have witnessed so far, Ms. Brenda’s interview is a good representation of the reality in rural areas of Mwandi. The specific challenges and threats vary across the villages. Some lack access to water all together and others have water with improper levels of salinization, making it undrinkable. Other challenges include long distances to travel, lack of advocates, or limited education—the list goes on. However, one challenge is common across all the villages: behavior change. Strategically, the work we are doing through our CLTS project focuses on this exact challenge. I feel fortunate to be part of this movement working with such an inspiring project team. 

Interested in volunteering with us? Learn more here.