Senior Healthcare and Safe Water Access During the Pandemic
Kahama Village is a small town in southern Uganda, situated in the Kashambya sub-county outside the city of Kabale. Kashambya is a cold and mountainous region, full of steep green hills, impenetrable forests, and frequent rainstorms. Kahama itself is about 800 meters above sea level; standing outside the village, you can see green mountains and valleys for miles.
This remote mountain town is home to about 5,000 people, many of whom rely on farming to support their families. Kashambya is mostly a rural region, and agriculture is a large part of most people’s lives. The soil here is some of the most fertile in all the country, and the chilly, rainy climate makes it good for farming.
However, while the terrain in the village is beneficial for plants, for the people who live here it isn’t always easy. Clean water is scarce in Kahama; the nearest water source for the entire village is four to five kilometres downhill. It’s a difficult trip, especially for the very young or the very old, but it’s necessary for many residents of Kahama in order to provide water for their families. The only other option is to buy water, which is impossible for many people in Kahama. Most households here have an income of less than $10 a month; meanwhile, a family of four might spend more than four times that much just to have water in the house.
In either case, the water is rarely safe enough for use. If people choose to make the downhill trip and carry their water four or five miles uphill, the nearest water source is unprotected and open to contamination. If they decide to buy water, the containers used to deliver water are often old and unclean, which means that water also carries pathogens. To make matters worse, people often try to conserve water by reusing it; water that has washed utensils and clothes is often strained so that it may be used for cooking. As a result, waterborne diseases have gravely damaged the health and life expectancy in the village.
When something as basically necessary as water is unattainable, life becomes hard in dozens of different ways. For one thing, the daily effort of collecting water takes up a significant part of most people’s lives, especially for women and girls, who usually shoulder the burden of water-collecting in their families. The long trip is difficult, and leaves women and girls vulnerable to harassment and sexual assault. In addition, for younger girls, it often cuts into the time they should be spending at school.
Meanwhile, the risk of waterborne diseases has taken its toll on the village. Many people die of easily preventable diseases like cholera, typhoid, and diarrhea. Children who fall sick can miss weeks of school at a time, which makes education in the village a difficult process. The lack of proper hygiene in the village, which stems in part from the lack of safe water to spare, has made the problem even worse.
However, while the whole community shares the stress of water deprivation, Kahama’s elders feel the blow harder than most. The town has more than 200 elders who are the main providers for their families or their orphaned grandchildren. Part of providing for a family often means finding water to drink and to clean with, but the nearest water source is more than four kilometres downhill. If climbing a steep hill while doing your best not to spill a heavy jug of water sounds difficult, imagine if your grandmother had to do it. Since the other option is purchasing water, which the average person in Kahama cannot afford to do, many elders have simply had to make do with water being scarce; some have been known to go weeks without bathing.
For many older people in Kahama, life is a daily struggle to conserve enough water to get through the week. If they have grandchildren to support, their whole family might share in that struggle. And, as with everything this past year, the COVID-19 pandemic has made the water situation in Kahama significantly worse.
COVID-19 in Kahama
The COVID situation in Uganda has been dire. It was at its worst last December, with almost two thousand cases in one day at the beginning of the month. As of this week, according to WHO data, things seemed to be looking up: new cases were in the teens and twenties, after weeks of slow but more-or-less steady decline. Along with thousands of cases, there have been upward of three hundred deaths in the country so far.
Many of those deaths have been people over sixty. While many young people survive COVID with little more than a brief fever or even no symptoms at all, the elderly and immuno-compromised are far more likely to die. A CDC study last August found that people over sixty were more than ninety times more likely to die of COVID than the comparison group of 18–29 year old.
For many families in Kahama Village, a death from COVID-19 would mean more than one person’s death. It might mean that a family has lost a grandparent’s support. For many children in Kahama who have lost parents to the AIDS epidemic or other diseases, it might mean they have lost their family and home for a second time.
The water deprivation that affects many of Kahama’s elders only adds to the risk of COVID-19; protective hygiene is impossible when water and soap aren’t available, and the need to travel to get water makes it impossible for many elders to safely social distance. In order to protect the most vulnerable members of the community from COVID-19, the village would need to find a way to provide a steady source of clean, abundant water in the homes of those people.
The World Health Organization has stated that simply washing your hands as much as possible can work wonders to prevent COVID-19; soap and water can kill 99.9% of germs on our hands, effectively neutralizing one of the biggest avenues for the spread of germs.
It isn’t just COVID, either; CDC data shows that educating communities about hand hygiene can drastically reduce the rates of contagious illness. Handwashing education reduces diarrhea rates by up to 40% and respiratory illnesses such as influenza or COVID-19 up to 20%. In addition, absentee rates among schoolchildren due to illness can go down by more than 50% after community handwashing education.
However, hygiene tips don’t help much when water and soap aren’t available. On top of that, the need for frequent trips to the nearest water source has made social distancing difficult for many villagers, aiding the spread of COVID-19 in the village. For vulnerable seniors and their families in Kahama Village, the need for safe water access has become direr than ever.
Solution: ROTOM
To make positive change in the community, H2O4ALL found help from local people and local organizations. Our model of sustainable water access means that it isn’t enough for us to just make change and then leave; creating sustainable development in any community is impossible without the support and guidance of the community itself. Locals in Kahama have been instrumental in helping us create change in the village, and every choice we’ve made has been to ensure that the impact of our project continues after we leave.
In addition to the locals, we’ve also partnered with several organizations around the world for various projects. When there is another organization helping in that area, we help one another; local organizations provide expertise on the area, support, and infrastructure, making it easier for us to ensure that people have safe and sustainable water access. Reach One Touch One Ministries is one of those organizations.
Reach One Touch One Ministries (ROTOM) is an international organization based in Uganda, East Africa. Founded in 2003, the organization was formed with the goal of helping elders live “dignified and fulfilled lives” in the absence of a social safety net for older adults. Without any such thing as pensions, social security, or insurance, many older people in Uganda and Ethiopia are reliant on younger generations for support. However, some elders find that their families are unwilling to support them. Many others outlive their own children and may find themselves with orphaned grandchildren to support. As a result, older adults make up one of the poorest groups in Uganda, with more than half living on less than one US dollar a day.
ROTOM helps elders and their orphaned grandchildren through sponsorships, providing financial and medical support. In addition, their special impact funds have built houses, educated seniors on health and hygiene, provided them with livestock and farming materials so they can feed themselves, and supported their grandchildren’s education.
After COVID entered Uganda in March of last year, ROTOM rose to the challenge and began new efforts to protect Ugandan elders from the virus. ROTOM volunteers created safe isolation spaces for COVID-19 patients to quarantine and receive help, procured oxygen equipment for local facilities, and delivered medicines to chronically ill seniors in quarantine. They also provided education about hygiene to help people protect themselves from the virus.
Kahama Village is one of ROTOM’s regular bases; 21% of the people supported by the ministry live in Kahama. For years, ROTOM has provided the elders and their orphaned grandchildren in the village with healthcare and financial assistance. Mindful of the need for safe water to keep their households healthy and safe from easily preventable diseases, ROTOM partnered with Water Mission Uganda in 2010 to install a water pump in the village. This would have negated the need to travel for water collection and drastically improved the quality of life for everyone in the village.
However, in 2015 the water system in Kahama broke down; pipes have been damaged beyond repair and the water source has been contaminated. Since then, levels of waterborne diseases have gone up, endangering dozens of lives in the village. ROTOM’s seniors and their young grandchildren have been particularly vulnerable to these diseases. To make matters worse, the community cannot currently afford to replace the system or have it fixed.
With a global pandemic still raging on, there couldn’t be a worse time to lose the main source of water in a remote town. That’s where H2O4ALL comes in. This year, H2O4ALL will be partnering with ROTOM in order to bring safe, sustainable water back to the village, protecting elders and their families from COVID, and ensuring that Kahama has a safe and sustainable water source long after the project is over. To bring safe water back to Kahama, they plan to draw on another source of water that has always been abundant in the Kigezi region: the rain.
Bringing Water Filtration to Kahama
Starting this year, H2O4ALL and ROTOM will be working together to install a large-scale rainwater collection and purification system in Kahama. Along with rainwater collection systems on the roofs of the church and the school, they will also be bringing safe water directly to the homes of individual seniors in Kahama Village. Their rainwater collection system consists of roof gutters to catch rainwater, piping, and sealed cisterns for storage.
Collecting rainwater isn’t feasible or useful everywhere, but in an area as remote as Kahama which gets regular rainfall, rainwater can provide a steady source of clean water. In addition, rainwater is considered by UNICEF guidelines to be an improved source, since it doesn’t come into contact with people or animals before it is collected. Even before filtration, rainwater in Kahama would be much safer to drink or clean with than water from an unprotected spring.
With a steady supply of clean, safe water in their own homes, Kahama’s elders can protect themselves from COVID-19 with good hygiene. Not only that, but they’ll be able to avoid making trips to the nearest water source, therefore reducing their contact with other people and preventing the spread of the virus.
In addition to keeping Kahama’s elders safe, the installation project will also benefit the town’s children. Many of the elders who will receive access to the safe water system have dependent grandchildren who will also benefit from having a safe source of water close to their home. Furthermore, the filtration system at the school will benefit children by allowing them to practice protective hygiene.
Almost a year after the country’s first COVID-19 case, Ugandan schools are still closed. While the question of opening schools safely has been a controversial topic in the USA and Canada, it is almost completely out of the question in communities where access to sanitation isn’t guaranteed in schools. According to UNICEF data, almost one-third of schools in the world are lacking in basic sanitation, putting any hope of reopening schools soon out of the question. However, with sanitation resources at the Kahama school, children might be able to get an education again while staying safe.
Finally, in the long term, access to safe drinking water in Kahama will greatly decrease the rate of waterborne diseases such as cholera, diarrhea, and typhoid. This will massively benefit the health of the community, preventing many early deaths and debilitating illnesses. It will also improve education in the village, as children will not miss school due to illness as often.
In a community with no access to safe water, something as simple as rainwater can change a person’s life. During the pandemic, bringing safe water to Kahama could be a godsend to the village’s inhabitants, especially for the oldest people in the community. Even after the pandemic is over, however, the presence of a safe source of drinking water will greatly improve life and health outcomes for everyone in Kahama.
Thank you to Deo Kalule, our ROTOM liaison in Uganda, for providing information about Kahama Village and their water situation. Thank you to Peter Churchill H2O4ALL commissioned photographer for photos.
