One of the most pressing primary health challenges identified in the participatory rural appraisal is lack of access to clean water and poor sanitation. The water tables in the areas where NFC works are relatively complex. NFC decided to take this very seriously and spend much of the first few years concentrating in these areas of primary health.
NFC has since branched out into the other prioritized areas such as HIV/AIDS, TB, Malaria maternal health and family planning interventions. NFC’s main plan for 2010 in health is to pilot running small private clinics on our plantations, mainly addressing malaria, HIV/AIDS, family planning and other primary services for our labour. Once this model is perfected, we can replicate it in our other countries of operation.
Shallow Wells and Protected Springs
NFC has constructed and protected four shallow wells near Namwasa Plantation and one near Luwunga Plantation. We have also constructed 3 protected springs near Kirinya Plantation. The water situation is very bad in those areas, and people are forced to buy jerry cans of water during the dry season or use water from the area where others are washing trucks, animals, clothes and other things. These projects have been largely successful in both decreasing time spent fetching water and anecdotally decreasing incidence of water born diseases. This is extremely important because of the large number of children in particular in Uganda who die of simple, preventable water born disease every year.
These projects are also community partnerships where the community contributes the land and the local materials and unskilled labor and NFC provides the technical expertise and tools and materials that are very hard to access locally.
Rain water harvesting in widely considered one of the cleanest models for safe drinking water. It is particularly beneficial in Uganda which has two rainy seasons. However, it is only viable when there is a large roof from which the rain can be harvested. Luckily on NFC’s classroom blocks, there is ample roof space, so adding on an extra water tank for rain harvesting is easy. To date NFC has contributed three water tanks at Umea Primary School, Ddalamba Primary School and the New Hope Day Care Centre and assisted to fix the drainage into existing tanks at 2 other schools. These are all used as the main source of water for the school or day care centre. The teachers have reported decreases in time spent fetching water as well as incidences of water borne diseases among pupils. NFC intends to continue doing more projects like these in the local schools.
Unfortunately, the schools in Uganda are often ill-equipped in the area of sanitation as well. Neither the day care centre nor Ddalamba nor Bweyongedde had adequate sanitation facilities, and therefore NFC invested in these alongside the construction projects. The teachers also reported that these have both decreased on absenteeism due to illness and opened up the eyes of the pupils to the importance of sanitation.
HIV/AIDS Awareness and Volunteer Counselling and Testing
While Uganda is widely considered an HIV/AIDS success story due to their implementation of a countrywide A B C (Abstinence, be Faithful, use Condoms) behavioural change campaign in the 1990s, spearheaded by His Excellency, President Museveni. The infection rates dropped from over thirty percent of the population to less than ten percent within less than a decade. However, Uganda’s HIV/AIDS rate is still hovering around 7.5% and remains a problem across the country. Therefore, NFC provide sHIV/AIDS awareness to its labourers and the surrounding communities through regular trainings and volunteer counselling and testing opportunities. The labourers and community members have both expressed strong support of this project and have pledged to bring more people to each session. In an awareness and testing session near Luwunga in 2009, over 400 people were tested. While the infection rates remain relatively low around out plantations, in a population with an income who are working together on a daily basis, the number of positive people threatens to grow if the right precautions are not taken against it. This is one of the main reasons we’ve decided to pilot the clinics on the plantations in Uganda which will provide awareness, counselling and testing and Antiretroviral Therapy. In Mozambique, the awareness is much lower as is the demand for counselling and testing, but we are currently partnering with Doctors without Borders to provide trainings for peer educators, increase awareness and then begin offering counselling and testing.
When we began community engagement around our plantation in Mozambique, the most identified need in the community was a maternity ward. The maternal mortality rates are extremely high in Mozambique and women did not want to go to the health centres to have their babies because there was not enough privacy. NFC partnered with the local communities to build a Maternity ward which was officially commissioned in August 2009 and is run by the government health workers. Since then, most women in the catchment area have stopped giving birth at home and about 300 are receiving pre- or ante-natal treatment or family planning services.
Immunisation Campaign Support
Through its field research into the challenges of the local public health systems in Uganda, NFC realized that the local public health centres were fairly well equipped with vaccines and refrigeration services. However, the public health workers were not well facilitated to travel to their immunisation outreach centres. This meant that many of the vaccinations were getting spoiled without being used, while many children were left unvaccinated. NFC partnered with the health centres and local government administrations to provide two bicycles to each health centre to assist in the immunization outreaches. The health workers and local government were very excited about this intervention, but unfortunately have failed to fully utilize the bicycles. Until the health workers and local government officials can work out a way to utilize the resources effectively, NFC will not invest in any more.