Programming Water, Sanitation and Health

From CARE Cambodia

CARE has been active in Cambodia since 1973-75, and from 1979 onwards providing humanitarian assistance to Cambodian people in border refugee camps. Since 1993 CARE has undertaken development activities in a range of provinces and sectors, including health, rural development, disaster mitigation and education. Many of these activities have included WASH elements. CARE’s draft programming strategy for Cambodia identifies three key impact groups: the Rural Poor, Women at Risk and Marginalised Ethnic Minorities. WASH will continue to be a significant component of CARE’s activities across all three impact groups.

CARE sees WASH activities as part of a long term approach that will change the lives of people who are members of the impact groups. In particular, WASH activities have the capacity to make significant improvements for the situation of women and girls in rural areas. Women in rural Cambodia are still mainly responsible for household tasks such as collecting water, which can take several hours per day. CARE has found that improving household access to water not only saves these women time, but the availability of water also significantly improves home garden and livestock production. This provides women with both additional income and a greater range of nutritional options. CARE has also learned that WASH activities have a higher impact and are more sustainable when part of an integrated approach that includes other activities such as health, education and creating income generation opportunities.

The aim of project implementation is to make interventions sustainable. In Cambodia, CARE works with government agencies and communities to establish linkages and allow for both scaling up and replication of WASH initiatives. CARE assists in the formation of village based Water User Groups, with members trained in planning, maintenance and repair and financial management. At local and provincial government level, CARE’s WASH activities are integrated into Commune Investment Plans and technical advice and support for interventions is provided by Department of Water Resources and Meteorology staff.

Recent and Current Activities with WASH Elements:

·  Successful implementation of the Rural Water, Sanitation and Health Education in the Northwest of Cambodia Project (funded by EU) in 2005-07, reaching 3,253 rural households in four districts of Pailin and Bantay Meanchay Provinces. Results included:

o  Improved access to potable water supplies in 49 villages, through the construction of 149 water points and distribution of 1,300 water related equipment items (such as containers and ceramic filters)

o  Improved household hygiene and sanitation practices, through education and awareness programs in 49 villages and the distribution of household sanitation equipment to 1,300 (700 Banteay Ampil and 600 Pailin) vulnerable families

o  Communities empowered in the ownership and management of common property, including water sources through the formation of 130 water user groups.

·  Successful implementation of the Cambodia Farmer Food Security Project (funded by EU) in Prey Veng and Svay Rieng Provinces in 2002-06, reaching 3,920 rural households, with specific water and sanitation activities including:

o  Distribution of water containers for safe drinking water

o  Creation of water points for safe drinking water

o  Household, personal and school based hygiene education and awareness programs

o  Distribution of hygiene kits.

·  Successful implementation of the Rural Water, Sanitation and Health Education in Pailin Municipality Project (EU funded), Pailin Province from 2006-07, reaching 1,983 urban households. Results included:

o  Construction/repair of 44 boreholes to provide safe drinking water

o  Construction of 6 communal water ponds

o  Safe drinking water equipment (4,824 water containers, 925 jars and 2,609 ceramic filters) provided

o  Hygiene awareness program delivered.

·  Successful pilot of the SODIS system (2007-2009), USD 30,000 funded by Irish Aid and implemented in 69 villages in Prey Veng and Svay Rieng provinces. The project focused on health and hygiene education to 1,000 people in households with children under 5 years old through an innovative solar water disinfection system.

·  Currently implementing the Australia Cambodia Integrated Mine Action Project in Pailin Province from 2006-11 (USD 500,000 funded by AusAID). The 12,000 beneficiaries include the most vulnerable households in the province. Primarily concerned with de-mining and food security, the project also includes activities that improve access to water for poor households.

·  Currently implementing Integrated Rural Development and Disaster Mitigation Project in Prey Veng and Svay Rieng Provinces from 2006-11 (USD 2.1 million funded by AusAID). Primarily concerned with food security and disaster risk reduction measures for around 48,000 people, activities have included:

o  Safe drinking water equipment - 8,707 ceramic filters distributed to poor and vulnerable households

o  Health and hygiene education in 188 targeted villages

o  Cooking Contests organized in all villages to promote nutrition

·  Ongoing implementation of the Cambodian Highlands Food Security Project (USD 445,000 funded by EU from 2008-10), which works with 8,500 people from poor households in 25 villages in Ratanakiri Province. Activities have included household water improvement through renovation ad construction of wells for poor families.

Current Activities with a Girls’ Education Focus – Ratanakiri Province

Child Friendly Secondary Schools (CFSS) – AusAID/CARE Australia (USD 196,000)

·  The CFSS project provides support to 11 lower secondary schools in the form of school improvement grants. These schools develop their own school improvement plans and receive a grant to implement them. So far, this money has been used to buy water filters and build/repair latrines and wells.

·  CFSS also support a large scholarship program, which includes 128 boarding house students (37 girls). At the Borkeo boarding house, CARE has built latrines and repaired existing wells. A third boarding house will be built in 2011 at Andong Meas which will also have a well and latrines.

·  Both the Borkeo and Ban Lung lower secondary schools and boarding houses are in serious need of improved water and sanitation facilities. The Borkeo lower secondary school has been so successful that it is attracting many students; not only poor indigenous students, but Khmer students too. This is creating some challenges for existing facilities. CFSS plans to make some funding available to build an extra kitchen and a block of toilets in 2011. CARE has also been requested to provide support to repair the well and kitchen at the Ban Lung boarding house.

Bending Bamboo (BB) – CARE USA/Private Benefactors (approx USD 600,000)

·  BB supports 7 primary schools in the form of school improvement grants. This money has been used to buy water filters, pumps, a water tower and rain water catchers.

·  BB also supports 7 early childhood development (ECD) centers. These centers currently lack latrines or wells, although BB has this in the workplan (beginning June 2011). The ECD curriculum includes hygiene in the lesson plan and ECD faciltators receive training from CARE on how to teach this.

Highland Children’s Education Program (HCEP) – CARE USA/Private Benefactors (approx USD 600,000)

·  HCEP provides support to 7 primary schools in 6 indigenous ethnic minority villages. CARE has constructed latrines at 6 of the schools (2 latrines each) and all 7 have wells/water pumps. As these wells are often the only ones in the village, the pumps are used heavily and need to be continually repaired. There are still difficulties in getting the students to use the existing latrine facilities which they are unaccustomed to using. All 7 primary schools will get drinking water filters this year.

·  HCEP has developed a teachers’ guide and student book on personal hygiene. These educational materials are being used all HCEP and BB schools, and is also being used in state schools (in total 30 schools this year in Ratanakiri, Mondokiri, and Steung Treung). The teachers’ guide and student book has been developed in Khmer and two indigenous languages: Kreung and Tampoun. As part of the teacher training component of HCEP, 123 community teachers have received training on how to use the educational materials and teach students about hygiene.

Planned Activities with WASH Elements

·  Response to Acute Watery Diarrhea/Cholera, due to commence November 2010 with 6 months emergency funding of USD 500,000 from EU/ECHO. Located in Koh Konh, Pailin and Prey Veng Provinces, this project will work with village health workers and staff of local health centres to improve surveillance, referral and treatment of AWD and cholera. The target population is located in 1,351 villages and consists of 294,000 women and children. Activities include:

o  Community hygiene education and awareness

o  Provision of household hygiene kits, including safe water containers

·  Interim Food Security Project, Ratanakiri Province (Jan – Dec 2011), USD 240,000 funded by CARE Australia. Activities will include:

o  A sanitation needs and behaviours assessment for remote ethnic minority villages

o  A pilot program of household latrine construction, using community partnerships

·  CARE is currently monitoring a pilot sanitation program being implemented through the Ministry of Rural Development with funding from a private benefactor from Singapore. This pilot program seeks to create demand for improved household sanitation through social marketing, with low cost materials then being made available via an improved supply chain involving local businesses.

.