Ganda community is a rural community in ward12 in Bindura district. Bindura district has a population of 100,000. During the 2008/09 cholera outbreak which affected close to 100,000 people nationwide and killed nearly 5,000 people, Ganda community was one of the communities that was affected by the cholera epidemic. The epidemic was characterized by high morbidity and community mortality. Ganda community is served by Muonwe clinic which has a staff complement of three nurses and an Environmental Health Technician. Even after the cholera outbreak, the community continued to have high diarrhoea morbidity and remained highly vulnerable to outbreaks of cholera and other diarrhoeal diseases. Through a household water, sanitation and hygiene survey conducted in 2010, it was discovered that the community had very low sanitation coverage. The community has approximately 100 households but only 9 of the households has the recommended Blair Ventilated Improved Pit latrine (BVIP). The majority of the households were still using the bush system which increased the community vulnerability to diarrhoeal disease outbreaks.
We identified and trained a community volunteer for the community, the training mainly focused on Participatory Health and Hygiene Promotion (PHHP), after the training we provided the Village Health Worker with a bicycle to ease mobility during the door to door health and hygiene campaigns. In order to increase community involvement and participation, we decided to form a health and hygiene club (CHC). Our aim was to ensure the community is informed about the causes of the diarrhoea which was common in the community and how it can be prevented and managed. Through the health and hygiene club we aimed to foster community involvement in finding achievable, practical and sustainable solutions to the health and hygiene problems. Our primary function was to give strategic direction but gave the community the prerogative to decide what they deemed feasible solutions after they had perceived they were part of the problem and the solution.
We emphasized the importance of linking up with the local health facility and the importance of reporting any unusual trends in disease incidences as soon as they occur for timeous intervention.
After several health and hygiene sessions, the club was formed but it had only twelve members most of whom formed the executive. A few months after the club was formed, club members started constructing temporary latrines, digging rubbish pit (to control fly population) at their homesteads and building pot racks to reduce contamination by domestic animals. By the end of the grant in August 2011, the membership of the club had increased to twenty one (21) and when the OFDA team visited the community in 2012, the membership had increased to seventy six (76%). All the club members had temporary latrines, pot racks and rubbish pits. One important achievement was the installation of makeshift hand washing facilities at household level using empty bottles. All the structures were constructed using locally available materials such as wood, grass, empty bottles. There was a significant improvement in the general hygiene in the community, a remarkable reduction in disease outbreaks and open defecation was reduced to insignificant levels.
If communities have a clear perception of the problem and if they are motivated and engaged, it is possible to find home grown and sustainable solutions to some of the key health and hygiene problems. Temporary but home grown solutions to sanitation have in Ganda proved more popular than other sanitation technologies that have been implemented in other parts of the district, other districts and the province without proper engagement of the communities and getting them involved. Households in Ganda still hope to reach the recommended sanitation standard but are happy to used what they proudly devised and successfully implemented. “ what we did has greatly improved our sanitation standard and we do not see feces when we walk in the bushes but we hope you will one day provide us with cement so that we build more durable structures”. This was the message from Johanne Nyakato, the chairperson of the CHC to the visiting OFDA delegation in August 2011.