GCC-PHCA PROJECT IN BWAISE SLUM,Kampala City
On the September 15, 2024.we embarked on the new project Strengthening Capacity of Village Health Teams (VHTs) to Promote Prevention of Waterborne Diseases in Bwaise 1 Slum, Kampala City. The 18-month project implemented with funding from the Grand Challenges Canada (GCC) aims to enhance resilience and adaptation of slums communities in Kampala to the health effects of climate change.
The project involves a number of activities that include site visits, baseline survey local and national stakeholder meetings. The documents highlights key project stages
Project overview
In the slums of Kampala, where over 60 % of the city’s population live, poor household and community waste management practices create a problem of random waste generated from homes, business places, among others, which clog drainage systems. This clogging coupled with the increased frequency and intensity of heavy rains attributed to climate change is worsening the problem of flooding in these communities. Floodwaters carrying disease-causing germs spread into open spaces, infiltrate business places, homes, and occupy children’s play areas. The floods also contaminate open local water sources, which households rely on for drinking, cooking and bathing. These events significantly increase the risks and incidences of waterborne diseases such as cholera, dysentery, and typhoid fever. To address these issues, Purpose Health Care Africa (PHCA) proposes a community-based intervention based on the Household Cluster Health Education Model.
The Household Cluster Health Education Model leverages existing community structures and networks, fostering community ownership and sustainability. In the targeted slum of Bwaise, an area prone to flooding, the project will train and deploy 80 Health Education Volunteers (HEVs) and establish 800 clusters (10 households per cluster); each HEV will be responsible for 10 clusters. The recruitment of the HEVs will be purposively done based on recommendations from the local zone leaders and the Village Health Teams (VHTs).[1] VHTs contribution to this process will be essential as they have in-depth knowledge of the communities and can identify individuals who are well-suited for the role and are trusted by the community. The VHTs will also provide necessary technical support and guidance during routine household and cluster health education by the HEVs. This approach leverages the VHTs’ local expertise and ensures that the selected HEVs are effective and credible in their health education efforts.
HEVs will be trained and deployed to educate clustered households on proper waste management, hygiene practices, and waterborne diseases resulting from the climate-driven heavy rains and flooding. The project team, supported by technical subject matter experts from the Ministry of Health, Ministry of Water and Environment and other government agencies, NGOs, academia, and private waste recycling companies will develop health education materials including a field user guide (training curriculum) containing Frequently Asked Questions, to be used by HEVs while conducting their educational sessions with the clusters. The health education material will cover the dangers of poor waste disposal and management, definition and examples of water borne diseases, signs and symptoms, and information on how climate change is worsening the challenge of waterborne diseases. The material will also include best practices to prevent waterborne diseases. The team aims to enhance community members’ knowledge of these topics to ultimately foster behavior change to improve health outcomes. This education will be delivered through a combination of individual household visits and small group sessions within each cluster to ensure personalized attention and effective communication and community engagement.
To further support behavior change through this intervention, 65 waste collection bins (organic and non-organic waste collection containers) will be installed throughout the target community. The project team will coordinate with local leadership to identify appropriate sites to install the bins. The PHCA will leverage existing relationships with private companies and government partners to advocate for consistent and timely (bi-weekly) government-funded waste collection within the target slum community, where this service tends to be neglected.
Community-based waste disposal demonstration exercises will be conducted by HEVs with support from the VHTs and the project team to depict best practices in waste management. Guidelines on how to properly use these waste bins will be included in the health education component.
In the short-term, the project aims to enhance community awareness and adoption of proper hygiene and waste management practices, leading to a measurable reduction in the incidence of waterborne diseases. In the longer term, the goal is for the Household Cluster Health Education Model to become sustainable and replicated in other slums, resulting in long-term health improvements and resilience against climate change.
Administrative approvals
We engaged the Ministry of health, Uganda and the Kampala Capital authority (KCCA) to obtain administrative approvals for project commencement. This is part of the efforts of ensuring project endorsement, ownership and sustainability.
Left. Meeting Dr Oundo, the director medical health services, Kampala Capital City Authority.
Right : Meeting with Dr.Nabaasa Herbert, the Commissioner Environmental Health, and Ministry of Health Right..
Project site visit
The project team along with the respective Village Health teams held a tour of the entire project area-Bwaise 1 parish as part of area mapping exercise .The 9 villages were surveyed to obtain a clear area map and get an eyes on picture of the situation on ground .The site visits formed a foundation for the baseline survey.
Up :The project team undertaking the area inspection .Down: A glimpse of poor waste disposal on ground.
Stakeholder engagements
Two separate stakeholder meetings were held-local and national. The primary purpose of the meetings were to ensure that local and national stakeholders were part of the project for maximum involvement .The meetings also served to document stakeholder and their alignment with the project goals and mode of implementation. The stakeholders were engaged to promote involvement at earlier stages to ensure the project’s success.
The local stakeholders were categorized into two- the division stakeholders who comprised of the Community-based organizations (CBOs),the mayor, the division health team ,the councilors ,representatives of the minority groups ,the religious .and cultural leaders.
The images below represent division stakeholder meeting at Kawempe Division headquarters, Kampala City.
From top : The participants attending to the presentations ,the Mayor,Mr Sserunjoji .S giving opening remarks .The Project lead, Mr. Daraus Bahikire giving an overview of the project and the purpose of the meeting .The Project coordinator,Ms,Bernadette Bainomugisha providing project details
Parish stakeholder meeting
The parish stakeholder brought together the zone leaders /LC1 Chairpersons, the VHT coordinator, and the parish councilors, including the parish chairpersons.
Above: Group photo of the participants in the parish stakeholders’ health at Bwaise Community Centre, Kawempe Division
The National stakeholder meeting brought together representatives from Government Ministries Departments and Agencies like Kampala Capital City Authority, Ministry of Health, Water and Environment, Non-governmental organizations (NGOs), among others. This meeting largely focused on the need for multi-stakeholder consolidation of resources and efforts to attend to the pressing climate change challenges faced by the marginalized slum communities, this would reduce duplication of interventions and thus optimizing resources.
Top: Group photo for National stakeholders’ engagement meeting in Kampala.
Bottom: The project lead Mr. Daraus Bahikire giving a project overview at the National stakeholders’ engagement meeting
The Baseline survey
As part of the pre-project implementation requisites, we conducted a baseline survey to establish the status of waste management, flooding, waterborne diseases and the climate change impacts in Bwaise slum.
The survey involved 209 households, 20 community leaders, and 20 health facility representatives sampled systematically. Key findings revealed that 47.9% of the community experienced inadequate waste collection services, and 9.6% openly dispose of waste, while 69.38% lacked access to waste collection points, others rely on burning waste.
Additionally, 10.73% of respondents lacked knowledge regarding climate change, increasing their vulnerability. Typhoid and dysentery were the most reported diseases in the past six months. Key challenges included low awareness (33.3%), poor regulations (20.83%), and cultural barriers.
Participation in the Weyonje Campaign
The flagship campaign is an annual WASH series of activities across all the five divisions of Kampala .The campaign aims to nurture competitive behavior & practices in waste management, food handling community cleanliness etc.
We contribute to the community mobilization and awareness efforts to bring the community to the attention of the worrying challenges of waste and climate change induced flooding.
