SPRINGFIELD – This narrative takes place in a village in northern Togo, near Dapaong (25 kilometers away), the largest city in the region, with a population of about 75,000. This is in the Sahel, the arid to semi-arid region just below the Sahara Desert.
Incomes are about $1 U.S. per day, or $350 per year.
The village of Nano is a cluster of buildings surrounding a marketplace, where the open-air market is conducted twice a week.
In the village, there are a couple of restaurants and bars, a tailor shop, four churches, a mosque, schools (primary through high school), some local manufacturing shops (metal and wood), a grain processor, cotton mill, and others. All of these are one-person, family-run operations, or village co-ops. Everybody generally grows their own food, and some extra for income.
There is one “monsoon rainy season” of about 2.5 months – not the two monsoons seen in areas farther south. If the one monsoon doesn’t come, it means extremely hard times.
The village is really a large area; the heart of the village may have 300 to 500 people living there, but the village is really 4,000 to 6,000 people depending on time of year, drought conditions, and other factors. Since the area of Nano is basically agrarian, surrounding the village in all directions are mud huts with thatch roofs on individual farms extending out for several kilometers. Each farm is enough land for the family to grow crops using just hand tools, perhaps with an ox-pulled plow shared among families.
Philosophy
The following are our principles used to give the best chances for a Rotary grant project to be of long-term help (self-sustained):
1. It must be the villagers’ idea, plan, operation, responsibility, effort – and ownership. Rotarians can help in thinking it through, but in the end it has to be “theirs.” This is particularly hard when we contribute money, as they assume we own it, since we paid for it. This can be partially dispelled by pointing out if we own it we will run as a business and get money back from the project. “Now, do you want us to own it or do you want to own it?” Which brings us to the next principle.
2. Form committees, groups, leaders, or some other community-based entity that will be responsible for more than just the project at hand. In our case, the first project were clean wells. The village council wanted to form a Well Control Committee for each new well we were going to install. We said that is a great idea, but we want the committees to be more than well committees; we want them to be public health committees. Responsible for all health-related projects (wells, latrines, public health teaching, etc.).
3. The hierarchy of health benefits from lowest health benefit to highest is wells, then latrines, and finally public health education. If people understand public health principles, they will figure out how to help keep themselves healthy, infrastructure notwithstanding. This was amply demonstrated when the Nano Health Committee went out to a tiny satellite village that was experiencing cholera with 12 deaths (in a village of about 150). They taught the principles of where cholera comes from and how it spreads, and without any infrastructure of wells or latrines, the village was able to stop the epidemic.
4. Give a man a fish, feed him for a day; teach him to fish, feed him for a lifetime; teach him to teach others to fish, and change the world. Thus, Rotary trains villagers (Health Committee members) to teach others and school children public health (if you teach a 4th-grader anything, the whole family will hear about it).
5. Focus your efforts. We have focused on one village to get them, with appropriate technology, to demonstrate the power of an integrated system of public health benefits (appropriate latrines, properly constructed wells, and general public-health education). It sets an example of what can be done and shows the benefit with lives saved. When neighboring villages see fewer deaths among infants and small children, they want the same for their village.
6. GO. You have to go … repeatedly. It matters. After each step, you must go to check that it was done right and according to plan. It also shows your care and concern for the people of the village, and it’s not just a feel-good project for you. It’s expensive, but necessary. The village Chief and Council, with the Health Committee, agreed to learn and teach public health to the village because we came back, just like we said we would. We were not a one-and-done proposition. They knew we would come back and see how they were doing and help with what they needed to be successful.
Water wells get attention
Ask any village what they need most, and they will tell you, clean water. The more they get water from lakes, ponds, and puddles in seasonal streams, the more they will tell you they need clean water.
So, even though statistically, public health education would give the most immediate health benefits, installing the wells they would eventually need anyway definitely gets their attention. It’s important to have their attention. We used a Global Grant to install what was planned to be four drilled wells, with Africa Pumps (with the stainless steel hand pumps a little girl can raise water from 80 feet down).
We first went to the village, before the first grant, to gauge their interest on the installation of wells. While there, we found out there were already more than 20 wells in the village. But as the villagers told us, the water would be good for a while, then the aquifer would go bad, and you couldn’t drink the water. They would start using the ponds and puddles again. We surveyed every well for location, depth, water level, and the state of the water. Almost all wells were open-top wells like one would see in old movies, where water was recovered using a “bucket” on a rope. The problem was not that the aquifer had bad water; the problem was the well design and method for water extraction.
However, the host Rotary club decided that instead of four drilled wells with pumps, that they could get five hand-dug wells for the same money, and more is better, right? Well, not always right, but certainly a teachable moment.
Fix the wells: Fix ’em again
So, we used a Rotary grant to fund putting caps on the hand-dug wells with a solid reinforced concrete cap, disinfect the wells, and put Africa-type pumps on them. The problem with hand-dug, open-top wells is the bucket. While getting water from the well, the bucket is set on the ground beside the well. People have come to the well walking through everything imaginable, where animals roam free, often right up to the well, where they do what animals do. So the bucket gets set down in this “dust” next to the well and then, back into the well. Thus, the wells, after a short time, become contaminated.
A concrete cap is installed over the well, which keeps surface contamination out of the well. Then a hand pump is installed in the middle of the cap to extract water from the well. Because we kept in touch with the village and the Health Committee, we could use this incident as a teaching opportunity, as to why we construct wells the way we do, how wells get contaminated, and what can be done to make them good again.
Over time, perhaps the village will rehabilitate some of their existing wells in the village.
As we kept in contact with the Health Committee over the next 1.5 years we found out the wells started failing, unable to pump water. In consultation with the Health Committee, they pulled the pump equipment and found that the riser pipe had holes in it at the air/water surface. Electrolysis at the air-water interface had eroded the black iron pipe. With a Rotary grant we (the villagers and Rotarians) replaced all the well riser pipes with stainless steel pipe, including one non-Rotary well that had the same problem. This provided six good wells scattered throughout the village.
Latrines improves their health
Once the wells had gotten the village’s attention, it afforded the opportunity to teach public-health principles about breaking the pathway from the disease source to the next victim. Then latrines become the next step. Even though latrines as a public-health infrastructure would statistically be more beneficial than the wells, the village will almost certainly want the wells first.
The latrine design that we used did not use a pit, with a privacy structure above ground, as is commonly seen. The design we used is a completely above-ground facility, including where the waste accumulates. Built on a concrete pad, the structure rises up as a two-chamber waste-collection facility. Two special heavy plastic squat devices are set into the concrete floor above the two waste chambers. This device separates urine from feces and can be closed off with a flat rock to prevent flies from getting to the waste. Urine is shunted out to a 5-gallon container. Steps are built for access to the floor where people do their “’business.” Above the floor is a structure with a door for privacy, and vector control.
In operation, one chamber is used for six months, then one switches to the other side. As the second side gets close to its six months, the first side is ready to harvest as a fertilizer.
As this process continues, every six months fertilizer is ready for the garden and a freshly cleaned-out chamber is ready for latrine duty. Meanwhile, every month or so the urine container is switched with a second container which must sit for about two weeks to “mellow,” and then the urine is used as fertilizer as well. Thus, the issue of final waste disposal is taken care of by the latrine design and operation. The waste doubles as a valuable fertilizer source.
We went to Nano to witness the first opening of a latrine chamber to remove the waste for use as a fertilizer. The entire 25-member Health Committee was in attendance, along with village officials, and our team of seven Rotary travelers. The latrines have an access cover for each chamber, and as the cover attachments were loosened for the chamber to be cleaned out all the people assembled were 20 to 30 yards upwind of the latrine. The cover came off, and there was about 1.5 cubic yards of rich dark soil-like material with no odor of human waste. Within one hour, every one of the 23 latrines that had been built in Nano had been stripped of its waste and had the waste applied to crops.
However, these latrines cost about $750 U.S. dollars each. Too much for the people of this area to do themselves. Some other solution would be necessary.
Let’s book it
Now that we have had opportunities to teach public health through the installation and repairs for wells and latrines, what could we do to further public-health awareness? Remember, we believe that teaching a 4th-grader is like sending a message to every family of those students. So we developed a book targeted at about the 4th-grade level.
What kind of book? In the village, the elementary schools have almost no books. Even teachers have no books. We also thought, how do people learn best? Through stories. Especially, oral cultures like in African countries teach and learn their history and the things they need to know to survive through stories.
So we developed a story that teaches public-health principles. The story is of a young boy who is ill, and asks his family how he got sick.
We illustrated the book with pictures, and then had it translated from English, to French, Spanish, and Portuguese. These are the languages of commerce for most all the equatorial countries, where most of the poorest countries that Rotary helps exist. The book can then be used to teach reading, learn a new language, and public health. Every page has all four languages, and an illustration. It is available as a PDF for free, too. Recently a Swahili translation has been completed.
After introducing the book to the village of Nano, we asked the Health Committee members to teach others. When we next came back to the village we gave them a test to see what they had learned. The average score was 80%.
You can build your own
Since the latrines we originally built in the village were too expensive for the people to build on their own, we needed an alternative. So with a Rotary District Grant we devised a contest. We would give a prize to anyone who could build their own latrine, with their own resources, that met our criteria for a good latrine. The criteria we required:
• Privacy, for protection, particularly for females.
• Must be able to isolate the waste from vectors (flies, bugs, rodents, farm animals, etc.)
• Must be able to easily remove the waste, once it has aged, for use in the garden
• Must be safe to occupy
There were many good examples built by these resourceful people, a number based upon the latrines we had built. However, it was the village chief that made the contest culturally appropriate. Our western cultural idea about the contest did not fit their culture’s idea of fairness. We were so relieved to have the chief make the “contest” into the positive we wanted it to be. Mistakes can be teachable moments for us as well.
Finally, one of our team was able to show that simply taking a cloth hung on sticks that could be shoved into the ground for privacy, and a small shovel to dig a shallow hole in the garden for use in defecating actually met all the criteria, with almost no cost. When that was shown to the health committee, a light bulb went off for those involved. Another great teaching moment.
