Towards EDPRS ideals: Water access, hygiene and sanitation in Rwanda give new hopes and opportunities

By Thomas Kagera Rwanda has committed itself to reaching very ambitious targets in water supply and sanitation, with the vision to attain 100 per cent service coverage by 2020. The importance of adequate water supply and sanitation services as drivers for social and economic development, poverty reduction and public health is fully acknowledged in Rwanda’s flagship policy documents and political goals. But by the look of things and according to the Permanent Secretary Ministry of Infrastructure, Marie Claire Mukasine, the sanitation coverage as a sub-component is likely to be 100 per cent by 2012. “Even though our country is among the four sub-Saharan African countries that will meet the MDG on sanitation, we have our own targets and goals. We are planning 100 percent improved sanitation coverage countrywide by 2012,” the Permanent Secretary is quoted as having noted in one of the preparatory meeting for the AfricanSan3 that was recently concluded. The other countries are Angola, Botswana, and South Africa. Access to improved sources of drinking water has reached about 74 per cent (rural: 71 percent, urban: 88 percent), according to the national inventory. Sanitation levels have evolved to write numbers from 38 per cent to 56 per cent. Coverage is currently rising at a rate which is close to the value needed to stay on track towards the flagship targets (EDPRS, MDGs, Vision 2020). However, to meet the targets it will have to continue to rise for another 4 percentage points every year. Given that population growth partly compromises the efforts to raise coverage this is equivalent to supplying on average 460,000 additional people every year (until 2012). Total latrine (or toilet) coverage in Rwanda is 96 percent. Today, 32 per cent of Rwandans use piped water, but only 3.4 per cent have access to it within their house or plot (urban: 17 per cent, rural: 0.9 per cent). On average, households – women and children spend 29 minutes per day on fetching water in rural areas (9 minutes in urban areas). By 2012, it is planned to increase the proportion of the rural population living within 500m of an improved water source from 64 per cent to 85 per cent, and to raise the proportion of the urban population residing within 200m of an improved water source from 69 per cent to 100 per cent. Special efforts have been made to provide water services in grouped settlements in rural areas; Imidugudu and small towns or trading centres. The Electricity, Water and Sanitation Authority (EWSA), as a major partner in the cleaning and distribution of water, has engaged the services of cooperative movements in the supply of water. Of the 800 water supplying systems in the country, 30 per cent of these are operated and managed by Small and Medium Enterprises that have formed cooperatives. Open defecation has practically been eradicated and most of Rwandan households have already financed and built their on-site private sanitation premises, and are now being encouraged to match them with the international standard definitions of an improved sanitation facility.The excreta are disposed with waterless latrines, which is a rational solution considering the scarcity of the average water supply. Major hotels, hospitals and some industries have installed their own (pre-) treatment systems. A conventional sewerage and treatment system for Kigali’s centre is in the planning process. Rwanda’s schools benefit from the HAMS (Hygiène et Assainissement en Milieu Scolaire (School Sanitation) program since 2000, which focuses on behaviour change in hygiene practice including considerations for menstrual hygiene. The Community Based Environment Health Promotion Programme (CBEHPP) is particularly focusing on the communities to impart the values of and create the demand for behavioural changes. In managing solid waste, the major towns are undertaking considerable efforts to maintain the urban environment clean. Plastic bags are forbidden within the bounds of the country. Sector harmonization is making significant progress and has prepared the ground for a Sector-Wide Approach (SWAp). There is a very strong government commitment for sanitation exemplified by a sanitation community service day, at the last Saturday of every month. Well elaborated environmental health policy is also in policy and the Ministry of Health takes the lead in household sanitation and hygiene promotion, of course with a strong collaboration with the Ministry of Local Government. Strategies Private investments in Water and sanitation infrastructure have been encouraged and supported. The Ministry of Infrastructure is considering options to leverage private capital investments by providing low-interest loans, through output-based aid (OBA) or co-financing. Community management has continued to be the most common approach to ensure the organization and management of point water sources, such as protected springs and boreholes equipped with hand pumps. Communities and User Committees are supported and supervised by the Districts, with technical assistance from the Ministry of Infrastructure. The concerned sector institutions – the Agency, RURA and the Ministry of Health – will cooperate to develop and implement a system for rural water quality control. This involves the clarification of responsibilities, the definition of standards, the development of viable operational procedures and the creation of decentralized laboratory capacities. The costs of urban water services are fully covered by user fees, in order to redirect public funds to extending service coverage (or, if need be, to rural areas where financial viability is more difficult to achieve). Investments are funded by a mix of public grants, loans and internal cash generation as per a financial model. While external aid accounts for a large share in the short and medium term the EWSA will endeavor to access loans and increase the share of investment financed by internal cash generation. A firm, permanent framework of cooperation has been established to coordinate the interventions of the different government institutions involved in sanitation and health promotion – essentially the Ministry of Health, the EWSA and the Districts. The Ministry of Health will continue to be the lead in the promotion of individual sanitation at the community level, essentially through its national Community Based Environmental Health Promotion Programme (CBEHPP). The EWSA on the other hand, will be responsible for the development, evaluation and support of adequate technical sanitation solutions. Sanitation and hygiene components shall also be incorporated in each water supply project. The Water and Sanitation Fund (WSF) will be one of the sources of funding of the joint programme. Ownership and behaviour change are critical steps for sustainably increasing sanitation coverage and improving hygiene practices. Government institutions therefore focus on promotion and facilitation, while households remain the main investor. Well designed sanitation programs have shown leverage ratios of up to 1:10 between public and private investments. The demand for improved sanitation shall be promoted through a combination of; awareness campaigns related to visible and non-visible health impacts of poor sanitation and aiming at behaviour change, marketing the sanitation offer, targeting on people’s expectations and preferences such as comfort, status, health benefits, value or safety and education and training in schools and universities; Other measures include the provision of limited material incentives or subsidies to accelerate the improvement, construction or replacement of sanitary facilities and using the provision of water supply services as an incentive and opportunity to improve sanitation facilities. Rwanda homegrown initiatives that augment sanitation and hygiene The government of the Republic of Rwanda has crafted a number of initiatives to extricate Rwandans from the depredations that emanate from poor hygiene and sanitation. Most of the interventions hinge on changing people’s mindset, but there are others in which considerable sums of money have been sunk. The government’s resolve to eliminate grass-thatched houses (Nyakatsi) in the country is one such initiative of improving the living domestic environments. The plan has succeeded in getting people out of scattered grass thatched houses to decent houses in planned villages (Umudugudu). The government has taken advantage of local initiatives like community work, Army and Police week, Youth and Women week to engage in activities aimed at helping the vulnerable get decent housing. The establishment of grouped settlements (Imidugudu) makes it easy and less costly to connect such areas to the national electricity and water grids, as the cost per individual connection substantially goes down. The use of clean renewable energy, is not only hygienically rewarding, but is as well environmentally friendly and sustainable.Through community work (Umuganda) that takes place every month, the general cleaning, tree planting and other activities all ensure a clean, green, inhabitable and hygienic environment. The Step and Wash (Kandagira Ukarabe—being implemented by the Community Based Environment Health Promotion Programme under the Ministry of Health), is a campaign that has widely been commissioned across the country and embraced by Rwandans. The use of local materials such as silt and cow-dung for the final coating and finishing of rural homesteads for those that cannot afford cement, has also improved the state of sanitation and hygiene among the populace.Currently, the government is working with AFRITANK, to provide mobile toilets, as well as toilet slabs, all in effort to provide clean hygiene and sanitation facilities and services. The government also mobilizes through radio and TV drama programmes such as Urunana, booklets and posters. Besides, after the community work that takes place at the last Saturday of every month, people are advised on the best hygiene and sanitation practices. The Ministry of Health has trained Community Health Workers that number to over 45,000—three per village—who participate in peer education and collection and dissemination of health-related data. A lot of useful information on sanitation and hygiene is also compiled by the Community Health Workers and Environmental Health officers who remit it the Ministry of Health, which is then routed to respective ministries concerned for action.The government of Rwanda through the Community Based Environment Health Promotion Programme, under the Ministry of Health, has encouraged the establishment of Community Hygiene Clubs (CHCs). A Community Hygiene Club (CHC) is a discussion group of peers from the same locality, who meet, identify their sanitation, hygienic and health problems or needs, and, through dialogue and using stimulant tools, get engaged in identifying solutions—together. The CHC approach appeals to an inane need for health knowledge which is then reinforced by peer pressure to conform to communally accepted standards of hygiene, thereby creating a ‘culture of health.’ Members can, for example, decide that after two months, all members shall have built a drying rack, or a standard latrine or a bathing shelter. The ideas and concepts originate from the members and implemented by them. The government however, always comes out to give technical support and guidance. Discipline and mindset change are some of the tenets that the government has fervently emphasized to ensure clean hygiene and sanitation. The government emphasizes upholding the dignity of every Rwandan, and sanitation and hygiene are some of the components that the leadership of President Paul Kagame has relentlessly put to the fore and, actually, helped implement. Ends

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Towards EDPRS ideals: Water access, hygiene and sanitation in Rwanda give new hopes and opportunities