By Monique Uwimpuhwe, WASH Behavior Change Officer, Water For People Rwanda
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When I started working in Masaka Sector in Kigali as an intern during a cholera outbreak in 2006, I had a dream. I wished to see community members changing their daily life of waking up, walking long distances to fetch unclean water, and using their neighbors’ toilets or practicing open defecation to a life with clean surroundings with access to clean water and improved latrines. My dream was to see the people smiling again.
In 2006, students in Environmental Health Sciences at College of Medicine and Health Sciences (former Kigali Health Institute) were called to support the efforts to control a cholera outbreak in Masaka Sector of Kigali City. There, children, men, and women were suffering, even dying. Our intervention entailed visiting community members house by house, creating awareness about the causes of the disease and prevention measures. The community fetched dirty water from the river and used it without treatment. Many households did not have toilets, and as a result, people did not bathe or wash their clothes. It was a big challenge. Since that experience, I have been motivated to pursue a career in helping people change their behaviors toward water, sanitation, and hygiene (WASH) and avoid preventable diseases.
When I joined Water For People in 2015 as a WASH Behavior Change Officer, I saw it as a good opportunity to be in direct contact with community members. Prior to Water For People, I had completed my studies and taught disease prevention, including WASH related diseases through behavior change, at the university. Being part of the Water For People team gave me a great opportunity to do what I had wished for a long time.
The Rwanda National Program of Community Based Environmental Health Promotion, which aims to reduce the national disease burden through community-based hygiene behavior change and improved sanitation and contribute to poverty reduction is an effective platform for community WASH behavior change. This program was launched in Rwanda in 2009 and uses the approach of community health clubs (CHCs), empowering communities to address hygiene, sanitation, and environmental issues. The program establishes "clubs" that include entire communities and promote a culture of health through altering norms, increasing social capital, and alignment with cultural values. In 2013, Rulindo District adopted the program and now each village has a CHC with six members. Water For People supported the district in the training of CHC committee members in all villages across the district. In return, CHC committee members recruited households of the village to be part of the clubs and conducted different sessions on WASH best practice, including water usage and storage, using and maintaining improved latrines, and handwashing with soap, among others. We ensured the CHCs were operational, met at least once every two weeks, discussed WASH related issues in their villages, and took measures to improve hygiene and sanitation in their community.
Icyerezo is one of the best performing CHCs in Rulindo District. When their village got clean water and started the club, most households did not have improved toilets, and children were sick most of the time. After analyzing the situation, club members worked together to construct improved toilets for each member and helped the most vulnerable community members have their own toilets. They also taught about personal hygiene, handwashing practices, and having a kitchen garden for a balanced diet, among other activities. They even went further and started a cash round group where every member saves a certain amount of money. This has helped them start an income generating project where they make soaps to sell to their neighbors.
Today, seeing these people singing with joy, I think of the time before they had access to water and were not aware of proper WASH practices. They would be as sick as the people I had seen in Masaka during the cholera outbreak. Icyerezo club members’ commitment to positively change WASH behaviors has changed their community. They have reduced diseases related to poor hygiene, their children are attending schools instead of being sick all the time, and they are improving their lifestyles through making and selling soaps.
Water For People recognizes that without promotion of proper WASH behaviors, facilities can be misused and will not be sustainable. Even with new facilities, it is easy to return to personal, traditional, and habitual behaviors that can negate the intended health and wellbeing benefits. This is why behavior change interventions should always be incorporated WASH programs. These interventions are implemented in all Everyone Forever districts and is a key contributor to successful and sustainable delivery of water and sanitation services.
