Watsan Survey Report Gulu

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Watsan Survey Report Gulu Powered By Docstoc
					Water & Sanitation
Survey in IDP Camps

   Gulu District
    Conducted by CRS
      January 2004




           1
Index of tables………………………………………………………………3

Main Findings and Recommendations……………………………………4

1 Introduction………………………………………………………………5
1.1 Geography……………………………………………………………………………..5
1.2 Context and rationale…………………………………………………………………5

2. Methodology……………………………………………………………..6
2.1 Limitations…………………………………………………………………………….7
2.2 Assessment Sites………………………………………………………………………7

Assessment Findings………………………………………………………..8

3. Water……………………………………………………………………..8
3.1 Water Services………………………………………………………………………...8
3.2 Water Coverage/Access………………….…………………………………………..10
3.2.1 Coverage………………………...…………………………………………………10
3.2.2 Access……………………………………………………………………………...12
3.3 Security………………………………………………………………………………14
3.4 Water Collection and Storage………………………………………………………..14
3.5 Gender Dimensions………………………………………………………………….15
3.6 Quality of water…………………………………………………………………...…16
3.7 Seasonality……...……………………………………………………………………17

4. Camp Institutions………………………………………………………18
4.1 Facilities……………………………………………………………………………...18
4.2 Health training provided……………………...……………………………………...20

5. Environmental Sanitation……………………...………………………21
5.1 Incidence of Disease in selected Camps……………….…………………………….21
5.2 Hygiene behaviour…………………………………...………………………………22
5.3 Traditional/Cultural beliefs on excreta disposal……………………………………..23
5.4 Household excreta disposal…………………………………………………………..24
5.5 Public Latrines and Construction Needs…………..…………………………………25
5.6 Perceived Obstacles to Improvement of Latrine Coverage………………………….26
5.7 Waste disposal…………………………………………………………………….....26

6. Some Recommendations…………………………………………..…...29
6.1 Coordination…………………………………………………………………………29
6.2 Women’s Strategic needs……………………………………………………...….….29
6.3 Local capacity………………………………………………………………………..29
6.4 Children’s needs………………………………………..………………………….…30
6.5 Water user fees……………………………………………………………………….30



                                   2
Index of tables
Table 1: Estimated population………………………………………………………………………………..7
Table 2: Provision of Services………………………………………………………………………………..9
Table 3: HHld respondents on water source ownership and maintenance………………………………….10
Table 4: Estimated status of water sources, based on feedback from women only focus group……………10
Table 5: Estimated water coverage in selected camps………………………………………………………11
Table 6: Access and Distance to water sources and water use…………...…………………………………12
Table 7: Measured against Sphere……………….………………………………………………………….12
Table8: The different sources not easily accessed to insecurity, based on Hhld perceptions………………14
Table 9: Household Water collection and Storage facilities in selected Camps……………………………14
Table 10: % respondents who use the Containers for fetching and storing water……………………….….15
Table 11: Breakdown of borehole use in selected camps in one day……………………………………….15
Table 12: % of respondents who described whether water is safe and treated or not………….…………...16
Table 13: No. of respondents who describe the various water sources in the different as safe or not……...17
Table 14: Number of respondents experiencing different problem during different seasons………………17
Table 15: Health Clinics…………………………………………………………………………………….18
Table 16: % level of hhld satisfaction with health services…………………………………………………19
Table17: Level of Watsan Services for Camp Schools (Source: Camp Leaders)…………………………..19
Table 18: Proportion of the respondents who remember training received…………………………………20
Table 19: The topics that the respondents remember and who provided the training………………………21
Table 20: % of Malaria and Diarrhea cases reported at time of the study…………………………………..21
Table 21: % of respondents that reported the occurrence of the different diseases in the various camps…..22
Table 22: Household disposal of excreta and waste in selected camps…………………………….……….24
Table 23: % Household disposal of excreta and waste in selected camps…………………….……………24
Table 24: Hhld Access to Public latrines and Latrine Construction needs………………………………….25
Table 25: Latrine Construction- Needs (Source: Camp leaders)……………………………………………25
Table 26: Categories of waste disposal methods by households in 11 camps…………………………..…..26


Figure 1:Percentage respondents’ water use from various sources……………………..…………8
Figure 2: Compliance with Sphere Standards…………………………………………………….11
Figure 3: Water Consumption versus travel time……………………………………………..….13
Figure 4: % breakdown of borehole use by gender and age…………………………………...…15
Figure 5: Hygiene behaviour that encourage water related diseases and transmission…………..22
Figure 6: Traditional beliefs about excreta disposal……………………………………………...23
Figure 7: Chart showing overall breakdown of excreta disposal…………………………….…...24
Figure 8: Obstacles for Hhld latrine construction, based on interviews with hhlds……………...26
Figure 9: % total hhld waste disposal methods in selected camps in Gulu District……...………27
Figure 10: Camp Leaders Perceptions of Refuse Disposal methods as a Percentage……………28




                                                    3
SUMMARY OF RECOMMENDATIONS AND FINDINGS

MAIN FINDINGS:
   All agencies currently working on water and sanitation interventions in Gulu District
    are providing services that are having a positive impact on improving quality of life in
    the camps despite the numerous challenges faced in terms of security, accessibility
    and coordination. But more needs to be done.
   Water coverage is poor in the camps, with an average number of 2698 persons per
    water source.
   69% of households collecting less than eighty litres of water per day. In other words,
    rather than the Sphere recommendation of twenty litres per person per day, each
    person has eleven litres per day. In addition, 37% of people live further than 500m
    from the nearest water source.
   All respondents have access to adequate and separate water collection and storage
    containers.
   Over 70% of women are responsible for the collection of daily water needs.
   88% of respondents are satisfied with the quality of water available.
   The level of water and sanitation services provided in the camp schools is far from
    sufficient. Amuru, among others for example, with 438 school children has only four
    latrine stances, providing coverage of over 109 persons per latrine. However, Paicho
    with 1070 children with 40 latrines has a coverage that almost meets the standards set
    out with coverage of 26 persons per latrine, as does Purongo at 20 persons.
   60% of respondents are not happy with care provided by existing health facilities.
   67% of total respondents continue to remember the training they received in the
    promotion of good hygiene practices, this is probably an indication of the
    effectiveness of the training provided and the organizations that provided that
    training. However, there are variances between camps.
   Heaslth institutions blame fouling of water sources for over 59% of water-related
    diseases. Poor household hygiene is also at fault, with institutions attributing 32% of
    diseases to this.
   73% of respondents report no cultural beliefs on excreta disposal.
   85% of respondents do not have access to public latrines.
   34% of respondents report shortage of space as an obstacle to latrine construction.
   50% of households practice controlled dumping with 37% of IDPs practicing open
    dumping. 45% of respondents feel that controlled dumping to be easiest and most
    accessible, although only 10% consider it to hygienic.

RECOMMENDATIONS
 Coordination must be improved.
 Pivotal role of women as providers and users of water and guardians of the
  environment must be reflected and recognised in the design and implementation of
  any interventions.
 Local capacities must be used and built upon. To have a more sustainable impact,
  supply/transfer of skills should also be an essential element.
 Agencies should look at ways of making water user fees work for the communities.


                                             4
1. INTRODUCTION

The eighteen-year war in Northern Uganda has caused untold suffering to the civilian
population of Acholi-land, and devastated the local economy and infrastructure, resulting
in economic stagnation and massive unemployment. The Lords Resistance Army (LRA)
rebels have used brutal methods to terrorise the population and indoctrinate their fighters,
most of who are abducted children. Following the failure of the latest effort by the
Government to defeat the rebel movement, the LRA have re-entered Northern Uganda
from Sudan, waging intensive and more vicious attacks on villages and camps. These
attacks included looting, burning, killing, raping and abducting children to boost their
fighting force. Events show that the situation remains complex, fluid and dangerous.

Rebel attacks have forced thousands to flee and seek refuge in towns or “protected
villages”. Congested camps have created a huge burden on existing health services such
as the provision of water and sanitation. Furthermore, increased insecurity has meant that
access to many camps poses serious challenges leading to poor delivery of basic services
by government and relief agencies preventing many organizations from responding
appropriately.

1.1 GEOGRAPHY

Gulu District is geographically located in northern Uganda, bordered by Sudan in the
North, Kitgum and Pader Districts in the East, Masindi District in the South, and
Adjumani and Arua Districts in the West. The Gulu, Pader/Kitgum Districts are usually
referred to as Acholiland, in reference to the predominant Acholi tribe.

1.2 CONTEXT AND RATIONALE FOR SURVEY

There is growing recognition among local and international actors of the urgent need to
take action to combat the impact of poor water and sanitation facilities in the IDP camps.
In addition, experience has shown that an approach focusing on people’s participation in
the identification of needs is far more effective in ensuring greater coverage and more
positive impacts than one that is supply-driven by outside agencies. Improvements in
quality as well as access to clean and safe water, and good sanitation can have positive
impacts on lives of IDPs.

The health care for IDPs has continued to deteriorate due to the worsening security
situation and consequent increase in numbers that has overwhelmed the infrastructure and
capacity of most camps. Despite improvements in providing access to safe drinking
water and environmental sanitation since 2000, recent influxes of IDPs to the camps has
reduced the water and sanitation coverage in the camps and services that were already
marginal have become over-stressed. Unfortunately, measures to respond to the
worsening health crisis in the camps has been inadequate due to limited government
capacity, persistent turmoil, an operating environment where current needs outstrip
capacity and resources, as well as relatively poor access and monitoring by INGOs and



                                             5
others of the camps due to insecurity. Uganda’s government is severely deprived of the
financial, material and human resources needed to provide for all the needs of the IDPs.

In response to this perceived gap in assistance, Catholic Relief Services- Uganda
Programme (CRS/Uganda), with other stakeholders involved in water and sanitation in
Gulu District formed a team to conduct a qualitative and quantitative assessment of the
current water and sanitation situation. The assessment took place over four days. Twelve
camps in four sub-counties were targeted. To summarise, the objectives were:

   Identify priority watsan needs of IDPs and current gaps in responses

   To help map out the different interventions being carried out by the different
    stakeholders in the water and sanitation sector.

   Finally, to provide a basis for planning and implementing any intervention.


2. Methodology
A series of meetings were held prior to the field visits to discuss current gaps and
challenges. A Water and Sanitation Survey Planning Meeting, with participants1 from
different actors handling watsan interventions, was held from 8-9 December 2003 to help
design a range of tools to facilitate a more thorough and representative watsan analysis.
These meetings provided useful background information on any actors that would be
involved in a watsan response in Gulu District and the assistance, if any, that they could
typically provide to identify camps or to counterparts.

These meetings also had the added value of bringing together the disparate organizations
working on watsan in the District.2 With follow up meetings and better dialogue,
improved coordination and linkages should be established and maintained.3 These shared
collaborations and common understandings of Gulu’s problems meant that the
assessment carried out is more reliable and appropriate, providing essential information
for any planned interventions.

Through these meetings, an assessment team consisting of members of Health and Water
officials, and representatives from CRS and AMREF was identified and trained. The
main assessment methods included fieldwork involving semi-structured interviews and
meetings with key informants, walkabouts and direct observation.



1
  Representatives from CRS, COME-Uganda, AMREF, CARE, ACF, and GDLG attended.
2
  Prior to the discussions around this assessment, there had been only one other 2003 Watsan Committee
meeting, held in May, although the District Water Office does coordinate activities for the different camps
in order to avoid overlap and duplication by various agencies.
3
  Those present at the Watsan Survey Planning Meeting (8-9 December 2003) have resolved to meet
monthly.


                                                     6
To facilitate a greater understanding of existing services and gaps, the Assessment Team
met with a diverse range of stakeholders, using a variety of tools. This allowed for a
greater level of participation from the target beneficiaries of any watsan response, and
also meant that information collected was triangulated for better reliability. Key
informants included

   Other actors working on water and sanitation interventions.

   Camp leaders of host and displaced populations and healthcare workers.

   Displaced and affected individuals.

2.1 Limitations:
The assessment team faced significant security constraints in carrying out the survey.
Despite this it was possible for the teams to visit twelve camps and obtain a considerable
of information for this report. The mapping exercise focused on three sub-counties. In
each sub-county, four camps were assessed. It should be noted that each camp was
assessed on a single day and that the camp populations are often fluid and so data on
numbers and needs should not be considered entirely accurate. Also, some communities
may have inflated population numbers or claimed a far worse situation in the hope of
receiving more assistance.

2.2 ASSESMENT SITES

Twelve camps in four sub-counties were targeted in the survey.

       Camp          Date Established        Population
Paicho                       1996              41,086
Unyama                       1996               15235
Pagak                        1996              11,043
Purongo                      1998               9,151
Parabongo                    1996               9,453
Amuru                        1996              33,797
Teya Padhola                 1997               8,963
Lalogi                       1997              20,602
Opit                         1997              23,990
Anaka                        1996              26,909
Acet                         1996              21,723
Wii- Anaka                     -                 2051
Table1: Estimated population demographics in selected camps, December 2003




                                                7
        ASSESSMENT FINDINGS

        In order to properly ascertain needs and gaps in responses, this assessment sought to
        provide precise information of the target area, based on a survey conducted in twelve
        camps. The assessment looks at access to water, sanitation coverage, existing
        infrastructures, and distribution of current NGO and government responses.


        3.   WATER

        According to the Global IDP Project, access to safe drinking water and to a clean healthy
        environment are of the most commonly unfulfilled human rights, with the situation made
        increasingly worse by ever more congested camps. A range of different water supply
        systems has evolved to meet the needs of the beneficiaries- mainly due to increasing
        numbers. The main water sources are boreholes, shallow wells and protected springs
        providing for the water needs of most respondents, as demonstrated by Figure 1. The
        assessment also illustrates significant gaps in the delivery of adequate clean and
        accessible water, with the situation disproportionately affecting women and children.

        Figure 1:Percentage respondents’ water use from various sources


                                                                               6%
                                                                         6%
 100%                                           Surface Water
  90%
  80%                                           Protected Well     13%
  70%                                                                                           44%
  60%                                           Protected Spring
  50%
  40%                                           Shallow Well
  30%
  20%
  10%                                           Borehole
   0%
                                                                         31%
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                                                                                    I.I Provision
                                                                                    of Water and


        3.1 Water Services
        Most camps surveyed demonstrated a high level of community involvement in the
        management of water sources, with respondents reporting community committees
        owning and responsible for 92% and 89% respectively of the water sources in their
        camps (see Table 2 and Figure 3). Seven of the twelve camps surveyed also stated that
        they had trained water maintenance teams.



                                                    8
       In addition, 95% of respondents pay a user fee for the use of their water sources. It must
       be noted that in some cases this user fee was more of a nominal one-off payment. While
       this assessment did not go into advantages or otherwise of community ownership and fee
       charges, experience has shown that community involvement and ownership through user-
       committees, if set up and managed properly, and the payment of user fees encourages
       long-term durability/sustainability of water points and reduces dependency.

       Table 2: Provision of Services, (source: interviews with camp leaders, December 2003)
              Existing Water Services Available
Camp          Water User    Membership     Trained Water Facilities   District Water   Availability of Repair   Water Quality
              Committee     Contribution   Repair Team                Team             Equipment                Treatment Tablets
Acet                                                                                     
Anaka              
Amuru                                           
Lalogi                                                                                    
Opit               
Pagak                                                                                    
Paicho                                         
Parabongo          
Purongo                                       
Teya                                                                                     
Padhola
Unyama                                          


       Water sources operated by user committees are more likely to be sustainable than those
       operated by people from outside the camps/communities. Where a fee is charged and
       where households contribute towards recovery costs, this should create a sense of
       ownership. Nevertheless, there are caveats and considering the poverty of many IDPs, it
       cannot be expected that many will be in a position to contribute towards operating costs. 4
       This assessment did not examine whether any fees charged are sufficient to pay for a
       caretaker to manage the source or to provide for proper maintenance.

       Obviously, another form of sustainability is to work through local partners and camp
       institutions, and the transfer of skills to and training of water repair teams. Seven of the
       eleven camps surveyed reported that they had teams trained to repair water supply
       systems. Such training offers sustained benefits to the communities in the camps, beyond
       the duration of any external interventions by government or NGOs.




       4
         Some agencies have experienced problems with promoting user fee charges for this and other services
       provided such as sanplats.



                                                             9
             Table 3: HHld respondents on water source ownership and maintenance, Dec 2003
              Ownership of Water Source                   Borehole Maintenance                                     User Fee
Camps             Total      Community   Gov    NGO/     Camp        Community     Gov      NGO/     Camp          Yes   No
                Respondent   Committee          Others   leaders     Committee              Others   Leaders
Acet            14           13          0      1/0      0           13            0        1/0      0             14    0
Anaka           24           23          0      0/1      0           23            0        0/1      0             24    0
Amuru           28           17          6      O/4      1           19            4        0/4      1             24    4
Lalogi          24           24          0      0/0      0           24            0        0/0      0             23    1
Opit            24           22          0      2/0      0           22            0        2/0      0             24    0
Pagak           24           24          0      0/0      0           24            0        0/0      0             24    0
Paicho          23           21          0      2/0      0           21            0        2/0      0             21    2
Parabongo       16           15          0      1/0      0           15            0        1/0      0             16    0
Purongo         22           22          0      0/0      0           22            0        0/0      0             22    0
T. Padhola      14           14          0      0/0      0           14            0        0/0      0             14    0
Unyama          20           19          0      0        1           10            0        4/0      1             14    6
Wii-Anaka       14           14          0      0/0      0           14            0        0/0      0             14    0

TOTAL           247          228         6      6/5      2           221           4        10/5     2             234   13
   %            100%         92.2%       2.5%   2.5/2    .8%         89.5%         1.6%     4/2%     .8%           95%   5%




             3.2 Water Coverage/Access

             3.2.1 Coverage

             Table 4: Estimated status of water sources, based on feedback from women only focus group, Dec 2003
                                                       Water Sources
         Camps               # of   Current     # of     Current       # of    Current        # of       Current
                             B/H    Status      P/S      Status        S/W     Status         PRW        Status
         Acet                5      60%         1        100%          2       100%           0          -
         Anaka               9      100%        3        100%          0       -              0          -
         Amuru               9      55%         3        66%           0       -              0          -
         Lalogi              3      100%        1        100%          1       100%           0          -
         Opit                8      62%         1        100%          1       100%           0          -
         Pagak               3      66%         4        100%          3       100%           0          -
         Paicho              1      100%        1        100%          1       100%           0          -
         Parabongo           4      100%        4        100%          1       100%           0          -
         Purongo             1      100%        1        100%          0       -              0          -
         Teya Padhola        4      100%        0        -             1       100%           1          100%
         Unyama              3      100%        0        -             1       100%           0          -
         Wii- Anaka          2      100%        0        -             0       -              0          -




                                                               10
Tables 4 and 5 show quite clearly that the water coverage for the Gulu IDP camps is not
good enough, according to the women interviewed. Although current water sources are
mostly functioning, it is very likely that, looking at figures from table 5, most of these
sources will become over-stressed due to over-use and very likely break down. On
average, 2698 persons are using one water source for their needs. While the figure is
lower in some camps like Wii-Anaka with 1025 persons per water source, other camps
like Paicho have 4695 persons per source. Obviously, when compared to the Sphere
Minimum Standards of 250 persons per source, as shown in Figure 2, these results
demonstrate a clear need for a greater number of water sources in the camps, or
alternatively, a reduction in the number of IDPs in some of the camps.

Table 5: Estimated water coverage in selected camps

                        Total # of          Average # of        # of persons if   % Coverage based on
                    Functioning Sources   persons per water    Complying with      Sphere Standards
Camps                                          Source          Sphere Standard
Acet                        6                   3620                 1500                6%
Anaka                       12                  2242                 3000                10%
Amuru                       7                   4828                 1750                 5%
Lalogi                      5                   4120                  750                 4%
Opit                        7                   3427                 1750                 7%
Pagak                       9                   1227                 2250                19%
Paicho                      3                   4695                  750                 5%
Parabongo                   9                   1050                 2250                22%
Purongo                     2                   4575                  500                 5%
Teya Padhola                6                   1493                 1500                16%
Unyama                      4                   3808                 1000                 6%
Wii- Anaka                  2                   1025                  500                23%
TOTAL                       73                  2698                 18250               9.3%

Figure 2: Compliance with Sphere Standards



         Unyama


         Purongo

                                                        Actual Number per water
           Paicho                                       source
                                                        Sphere Standard (250
                                                        people per source)
             Opit


          Amuru


             Acet


                    0      2000     4000     6000




                                                  11
          3.2.2 Access

                Average                                              Distance to nearest    Average # of 20 L jerry
                HHLD        HHLD Access to Water Source %               water source       cans collected daily (% of
Camps             size                                                % Respondents          HHLD respondents)
                            B/H       PW       SW        PS         < 500m       > 500m       <4     5-8          9-12
Acet               8         100%       0         0          0        66%         33%        71%       29%          0
Anaka              6          50%      35%        0        19%        94%          6%        77%       23%          0
Amuru              7          85%       0       11%        14%        76%         24%        71%       25%         4%
Lalogi             6          87%       0       17%         4%        76%         24%        66%       34%          0
Opit               8          83%       0         0        26%        69%         31%        79%       21%          0
Pagak              7         100%       0         0        16%        47%         53%        79%       21%          0
Paicho             6          91%       0        8%         8%        38%         62%        68%       32%          0
Parabongo          6          53%      20%      26%        33%        60%         40%        43%       25%        32%
Purongo            6          73%       0         0        45%        64%         36%        82%       18%          0
T. Padhola         7         100%       0         0         7%        18%         82%       100%        0           0
Unyama             7          25%      30%       5%        35%        60%         40%        30%       50%        20%
Wii-Anaka          7         100%       0        3%        38%        90%         10%        64%       29%         7%

TOTAL             6.8        79%       7%       5.8%      20.4%       63%        37%       69.2%     25.6%        5.2%
          Table 6: Access and Distance to water sources and water use. (Source: Based on interviews with random
          IDPS during CRS survey of selected camps, December 2003)

          As table 6 shows, 79% of total respondents feel that that they have access to at least one
          water source- a borehole, though the figures vary across camps. Unyama, for example
          has poor coverage with 25% having access to a borehole and 35% with access to a
          protected spring. In Acet, Pagak and Teya Padhloda, on the hand, respondents report
          100% access to a water source. This access is also reflected in the amount of water these
          households report collecting daily (with the exception of Teya Padhloda, which will be
          dealt with later).

          While the Sphere Standards state that no household should be further than 500m from the
          nearest water source and UNCHR state a distance of 100m, table 6 shows that some
          camps fall outside these recommended standards. On average, over the 12 camps
          assessed, 37% of respondents claim to be further than 500m from their nearest water
          source. While some camps such as Wii-Anaka (90%), Anaka (94%), Lalogi (76%) and
          Amuru (76%) show excellent or good compliance with the minimum standards set out by
          Sphere, in others such as Teya Padhloda (82%), Paicho (62%) and Pagak (53%), a
          significant number of households walk further than the recommended distance.

          Table 6 also quite clearly demonstrates that most households do not meet the minimum
          standards set out for water used/needed per day per person. With household sizes
          averaging seven persons, 69% of respondents do not collect more than eighty litres of
          water per day, falling far below the Sphere minimum of 15 litres needed per person per
          day. Households of seven persons should collect, at the least, 105 litres per day.
          Obviously, these figures may be imprecise as there were no observations done in this
          survey (due to time constraints brought about by security concerns) on whether


                                                           12
households used local springs or rivers to wash themselves. This would, of course,
increase average household consumption.

Some agencies believe that there is a link between the amount of water collected and the
distance traveled (see Figure 2 for a graph illustrating this based on studies in other
countries over a period of time).5 While this is not proved by the feedback from all the
camps, it is clearly supported by the figures from Teya Padhloda, where there seems to be
a link between distance traveled and water consumption figure; 82% of respondents live
further than 500m from the nearest available water source and 100% collect less than the
minimum recommended. This is important, also, for limiting the transmission of water-
washed diseases. Some agencies6 have shown that the quantity of water collected is often
as important as the quality of water collected, especially in the reduction of diarrheal
diseases.




Figure 3: Water Consumption versus travel time
Source: DfID (taken from Cairncross and Feachem, 1993, in a water-use study of East, West and
Southern Africa)



Performance Against Sphere Standards
Table 7: Measured against Sphere
Sphere indicator                                          Sphere Standard          Gulu Actual Result
Less than 500m to water source                            100%                     63%
Litres of water per person per day                        15                       11
Persons per water point                                   250                      2698




5
  For example, FANTA believes that distance to water may be an indirect indicator of water use. Per capita
use may average less than 10 litres a day when the source is greater than 1 Km away. WaterAid has as one
of its criteria for appraisal of water schemes the reduction of travel time from distant sources.
6
  DfID, UNCHR


                                                   13
             3.3 Security

             Table8: The different sources that are not easily accessed to insecurity, based on Hhld perceptions
                                                        Water sources that are not Safe
             Camp
                                   Boreholes       Shallow wells     Protected springs         Unprotected well
             Acet                      X
             Amuru                                        X                     X
             Anaka                                        X                     X
             Lalogi                    X                                                              X
             Opit                                                               X
             Pagak
             Paicho                                       X
             Parabongo                                    X                     X
             Purongo                                                            X
             Teya Padhola
             Unyama                                                             X
             Wii-Anaka                                    X                     X

             Table 8 shows the perceptions that respondents have in relation to security in accessing
             the different water sources. In ten camps, access to boreholes is considered safe while
             getting water from protected springs is considered a risk in seven of the camps. As table
             seven shows, when women or children carry the burden of traveling distances to obtain
             water and other services they may get exposed to unnecessary risks. Obviously, the
             perceived risks of getting water from protect springs is a real concern and should be
             addressed.

             3.4 Water Collection and Storage

     Table 9: Household Water collection and Storage facilities in selected Camps, December 2003
     (Source: Camp leaders)
Camps             Acet Anaka Amuru Lalogi Pagak Paicho Parabongo                       Purongo Teya                    Uyama
                                                                                                 Padhola
             Jerry cans                                                                                         
Collection




             Water Pots
 Water




             Sauce Pans                                                                                         
             Gourd
             Bucket                                                                                    

             Jerry cans                                                                                     
             Water Pots                                                                                          
Storage
 Water




             Saucepans
             Buckets                                                                                     
             Basin                                                             
             Gourd                                                                                                     


                                                                  14
Table 10: % respondents who use the Containers for fetching and storing water in Gulu District
                                % of Hhlds that use
Type of container
                          Fetching water       Storing water
Jericans                        98.1                  3.8
Water Pots                      1.9                   79.6
Jericans/water pots             0.0                   14.3
Others                          0.0                   2.3
Total                           100                   100

All respondents have access to adequate collection and storage containers, with 100% of
camps reporting use of jerry cans for collection of water. Based on UNHCR’s
recommendation that water storage containers should be different from those used to
collect and transport water from the distribution points, it is clear that a large majority of
respondents are in compliance. Over 98% of households use jerry cans to collect water
while only 3.8% of those use those jerry cans to store water. Water pots are typically
used to store water with over 76% using them. These figures are supported by feedback
from the camp leaders as shown on Table 5.

3.5 Gender Dimensions

Table 11: Breakdown of borehole use in selected camps in one day


   200
   180
   160                                                                     Acet
   140                                                                     Anaka
   120
                                                                           Lalogi
   100
    80                                                                     Parabongo
    60                                                                     Pagak
    40                                                                     Paicho
    20
     0
              Women          Men           Children



Figure 4: % breakdown of borehole use by gender and age



     Children
      27%
                                                   Women
                                                   Men
                                                   Children
        Men
        3%                                     15
                                           Women
                                            70%
Table 11 and Figure 4 show that women and children, usually young girls,
disproportionately carry the burden for the collection and carrying of water. Over 70% of
women are responsible for the collection of daily water needs, with 3% of men
contributing towards this effort. This opportunity cost of collecting water should be
recognized and perhaps addressed in future interventions, such as bringing water sources
closer. Improved sanitation and water facilities would provide tangible benefits for
them. Where women spend less time collecting water and when the water is of good
quality, women have better health7 and spend less time caring for the sick, as well as
working on schemes to earn income.

3.6 Quality of Water

Table 12: % of respondents who described whether water is safe and treated or not
                                        Status of the water source
    Camp
                    Safe/treated   Safe/not treated    Not safe/not treated     Not Sure
    Acet               100.0             0.0                   0.0                0.0
    Amuru               60.6             12.1                  27.3                 0.0
    Anaka               68.8              9.4                   6.3                 15.6
    Lalogi              80.8             19.2                   0.0                 0.0
    Opit                79.2             20.8                   0.0                 0.0
    Pagak               100.0             0.0                   0.0                 0.0
    Paicho              92.3              0.0                   7.7                 0.0
    Parabongo           75.0             18.8                   0.0                 6.3
    Purongo             95.8              0.0                   0.0                 4.2
    Teya Padhola        70.0              0.0                  30.0                 0.0
    Unyama              77.8             16.7                   5.6                 0.0
    Wii-Anaka           62.5              0.0                   0.0                 37.5
    Total               79.5              8.4                   7.3                 4.8




7
  Some may tend to reduce the amount of water needed, leading to an increase in the transmission of
washed diseases. Further, they usually carry 20 litre jerry cans which weigh about 20 kg. This can have
serious health implications for women and girls



                                                  16
Table 13: Number of respondents who describe the various water sources in the different as safe or not
                     Boreholes       Shallow wells      Protected springs Unprotected wells Total
Camp
                    Yes       No       Yes       No      Yes        No          Yes        No
Acet                 14        0        0         0        1         0           0          0        15
Amuru                22        3        1         5        5         1           0          0        37
Anaka                15        0        0         2        14        0           0          0        31
Lalogi               21        0        0         0        1         0           3          0        25
Opit                 20        0        0         0        6         0           0          0        26
Pagak                24        0        0         2        4         0           0          0        30
Paicho               24        0        2         0        2         0           1          0        29
Parabongo            8         0        4         0        8         0           1          0        21
Purongo              18        0        0         0        10        0           0          0        28
Teya Padhola         14        0        0         0        1         0           0          0        15
Unyama               5         0        1         0        9         6           0          0        21
Wii-Anaka            13        1        1         0        5         0           0          0        20
Total               198       4         9        9         66        7           5          0    298

Quality and protection of water is important. As well as treating water, sources should
also be physically protected, as well as regularly maintained. Adequate closure should be
provided to prevent any contamination from humans or animals (Is this true- check risk
analysis). 79.5% of respondents believe that their water is treated and safe to drink, with
only four households expressing dissatisfaction with the quality of water from their
borehole.


3.7 Seasonality
Table 14: Number of respondents experiencing different problem during different seasons
Problems                                       For all seasons     Dry season         Rainy season
Too many fetching water from the
boreholes, shallow wells, protected and               27                 171               1
un-protected springs
The water sources dry up during the
                                                                         37
dry season
The paths to the protected springs and
shallow wells become flooded and                                                           5
muddy during the rainy season
There are many people fetching water
from boreholes, protected springs and                 13
shallow wells during morning hours
Total                                                 40                 208               6

It is quite clear from the above table that households experience significant difficulties
with their water supply systems during the dry season, with 171 respondents reporting


                                                 17
             difficulties due to overcrowding at the water source. This is probably caused by low
             yields at certain sources,8 creating queues at certain points. Also, 37 households reported
             their water source as drying up completely during the dry season. On a positive note,
             households report little crowding at the water sources at other times, which perhaps
             demonstrates good water coverage at the camps.


             4. Camp Institutions

             4.1 Facilities
             The survey found that each camp assessed has a health clinic, although the services
             provided vary. For example, Anaka and Lalogi have clinics that provide different
             category health care services than those found in the other camps assessed, as shown in
             Table 15. Obviously, the increased insecurity may explain the weaknesses of these
             clinics to provide adequate care for the IDPs. Size and access may explain why clinics in
             camps like in Acet, Pagak, Unyama, Paicho, Parabongo, Teya Padhloda and Purongo do
             not provide the basic health services found in Lalogi and Anaka.
             Table 15: Health Clinics, December 2003
                   Acet   Anaka Amuru Lalogi                 Opit      Pagak    Paicho    Parabongo    Purongo      Teya        Unyama
Camps                                                                                                              Padhola
Functional                                                                                                                
Health Center
Type                 II        IV          III        IV       III       II        II          II         II          II           II
Staff                4         47           2         13        4        5         3           4           4           4            3
Services           DP,      Cons,       Cons,       Cons,    Cons      Cons,    Cons,     Cons, DP,    Cons,       Cons,        Cons,
Provided           GM,      DP, GM,     DP, GM,     DP,      , DP,     DP,      DP,       GM, PC,      DP, GM,     DP, GM,      DP, GM,
                   PC,      PC,         PC, EPI,    GM,      GM,       GM,      GM,       EPI, STD,    PC, EPI,    PC, EPI,     PC, EPI,
                   STD,     STD, HE     STD, HE     PC,      PC,       PC,      PC,       HE           STD, HE     STD, HE      STD, HE
                   HE                               EPI,     EPI,      EPI,     EPI, HE
                                                    STD,     STD,      STD,
                                                    HE       HE        HE
Free                                                                                                                      
Free Drugs                                               No                                                                
             Key: II: Basic                III:                           IV:
                    DP: Drug prescription, GM: Growth Monitoring, PC: Prenatal Care, Cons: Consultations
                    STD: STD Counseling, EPI: Extended Programme on Immunization




             8
              Using local information show limit the risk of providing dry sources- if the spring is identified during the
             dry season and is flowing well, there is a strong possibility that, with the advent of the rains, its yield will
             improve.


                                                                    18
          Table 16: % level of hhld satisfaction with health services
                                      Respondents (%)
          Camp
                            Satisfactory Not satisfactory
          Acet                          8                 92
          Amuru                        56                 44
          Anaka                        30                 70
          Lalogi                       17                 83
          Opit                         33                 67
          Pagak                        83                 17
          Paicho                       22                 78
          Parabongo                    31                 69
          Purongo                      31                 69
          Teya Padhola                 61                 39
          Unyama                       83                 17
          Wii-Anaka                    37                 63
          Total                        40                 60

          Table 16 highlights a certain level of dissatisfaction with the services provided, with only
          a majority of respondents in Unyama (83%), Pagak (83%) and Teya Padhloda (61%)
          expressing any satisfaction. Acet, with 92%, and Lalogi (83%) is clearly in need of better
          support in terms of providing effective health services. It is worth noting that although
          Lalogi, Anaka and Opit have Level III or better clinics, these do not seem to be providing
          adequately for the needs of IDPs as reported by respondents.

          Table17: Level of Watsan Services for Camp Schools (Source: Camp Leaders)
                         Schools                      Water Services                             Sanitation Facilities
Camps             Student    No. of                Services          Functioning      No. of latrine   Stances Per   Functioning
                  Numbers    Schools                                                     blocks           Block
Acet                  -          -                    -                   -                 -              -               -
Anaka                -             -                  -                   -                 -              -               -
Amuru               438            1                 B/H                                   1              4              Full
Lalogi               -             -                  -                   -                 -              -               -
Opit               1037            1             B/H & Tank                                2             12                
Pagak                -             1                 B/H                  X                 4              -                
Paicho             1070            2                 B/H                                   4             10                
Parabongo           913            1                 B/H                                   3              5             Some
Purongo             800            2                 B/H                                   8              5                
Teya Padhola         -             -                  -                   -                 -              -               -
Unyama              946            1        B/H & Protected Spring                         1              5                

          As Table 17 shows, the level of water and sanitation services provided in the camp
          schools is far from sufficient and a cause of concern9, especially with growing numbers


          9
           Proper water and sanitation in schools is important as children are the main sufferers from excreta-related
          diseases and are also the main excretors of many of the pathogens that cause diarrhoeal diseases. Poor
          sanitation facilities have a stronger negative impact on girls. Further, a UNICEF study in 1994 in


                                                                19
from displaced schools. While not camp leaders provided information for their camps, it
is clear that much more needs to be done. Amuru, for example, with 438 school children
has only four latrine stances, providing coverage of over 109 persons per latrine (The
Sphere Standards recommend 20 persons per latrine). Further, these latrines are no longer
functioning as they are reported full. Almost every school in the camps that provided
information demonstrates a similar problem, for example, Opit has coverage of 43
persons; Parabongo has 60 persons per latrine, some of which are not working. Pagak is
also in need of assistance with water, as its present water source is not functioning.
However, Paicho with 1070 school children with 40 latrines has a coverage that almost
meets the standards set out with coverage of 26 persons per latrine, as does Purongo with
a coverage that meets Sphere Standards perfectly at 20 school children per latrine.

4.2 Health Training Provided
Hygiene education is important if we are to see an impact in health improvements. 67%
of total respondents continue to remember the training they received in the promotion of
good hygiene practices, this is probably an indication of the effectiveness of the training
provided (see Table 18). However, as always there are variances between camps with
respondents from Lalogi (33% remembering), Anaka (54%), Unyama (55%) and Purongo
(56%) reporting relatively poor awareness of training received.

The survey found that all camps have received training on water and sanitation from a
variety of organisations- World Vision, AVSI, District health and Water Offices,
ACCORD, AMREF, ACF and local leaders- as shown in Table 18. Hygiene is also
covered by organisations in most of the camps with the exception of Purongo.

Table 18: Proportion of the respondents who remember training received
                                              Respondents trained
Camp
                      Remember (%)        Do not remember (%)       Neither of the two (%)
Acet                         66.7                     16.7                         16.7
Amuru                        62.5                     28.1                         9.4
Anaka                        54.5                     39.4                         6.1
Lalogi                       33.3                     66.7                         0.0
Opit                         79.2                     20.8                         0.0
Pagak                        75.0                     20.8                         4.2
Paicho                       62.5                     25.0                         12.5
Parabongo                    62.5                     37.5                         0.0
Purongo                      56.3                     37.5                         6.3
Teya Padhola                 70.6                     29.4                         0.0
Unyama                       55.0                     15.0                         30.0
Wii-Anaka                    73.9                     26.1                         0.0
Total                        62.5                     30.3                         7.2

Bangladesh showed that providing effective sanitation facilities in schools increased girls’ attendance by
15%.


                                                     20
         Table 19: The topics that the respondents remember and who provided the training
                                                 Malaria                                            Immunization
Camp            HIV/AIDS         Hygiene                        Nutrition      Water and Sanitation
                                                 control
                                                                      World Vision        UNICEF
Acet             World vision   Health Department Health Department
                                                                      Health Department   Health Department
Amuru                           Health Department Health Department                       Health Department          Health Department
                                ACF                                                       ACCORD, ACF
Anaka                           Health Department
                                                  Health Department
                                                                                          Health Department
                                                                                          Health Department
Lalogi                          Health Department
                                                                                          Community Leaders
                                Health Department                                         Health Department
Opit                            Community leaders                                         Local leaders
                                                                                          World Vision
Pagak                           Health Department
                                                                                          Health Department
                                                                                          Health Department, AVSI
                                Health Department
Paicho                          Local leaders
                                                                                          Local leaders
                                                                                          World Vision
                                CPAR
                                                                                          AMREF, ACF, World Vision
Parabongo                       Health Department
                                                                                          Health Department
                                World Vision
                                                                                          Health Department
                                                                                          Local leaders
Purongo                                                                                   ACF
                                                                                          Emmanuel International
                 Health                                                                   Health Department
Teya Padhola Department         Health Department Health Department
                                                                                          World Vision
                 Dyere Tek                                                                World Vision, Local Leaders
Unyama           World Vision                                                             Health Department
                                                                                                                      Dyere Tek
                                Health Department                                         Health Department           Health Department
Wii-Anaka                       Community leaders                                         Community leaders




         5. Environmental Sanitation

         5.1 Incidence of Disease in selected Camps
         Table 20: % of Malaria and Diarrhea cases reported at time of the study
               Camp         Both Malaria & Diarrhea (%)                  Diarrhea (%)              Malaria (%)
        Acet                                 50.0                               5.0                      45.0
        Amuru                                41.0                              12.8                      46.2
        Anaka                                32.5                              17.5                      50.0
        Lalogi                               48.8                              17.1                      34.1
        Opit                                 16.7                              26.7                      56.6
        Pagak                                37.5                              12.5                      50.0
        Paicho                               41.4                              13.8                      44.8
        Parabongo                            59.3                               7.4                      33.3
        Purongo                              42.9                               9.5                      47.6
        Teya Padhola                         38.1                              19.0                      42.9
        Unyama                               40.9                              18.2                      40.9
        Wii-Anaka                            57.2                              17.1                      25.7
               Total                        42.4                               14.6                     43.0



                                                                  21
 Table 21: % of respondents that reported the occurrence of the different diseases in the various camps.
                                Percentage of Respondents that Reported
    Camp
                 Diarrhea Malaria Skin Infection Intestinal Worms Cough and cold
Acet                 46.1         21.1                   17.1                   15.8            0.0
Amuru                37.6         18.3                   15.6                   14.7           13.8
Anaka                33.3         29.6                   11.1                   19.8            6.2
Lalogi               35.2         19.3                   21.6                   21.6            2.3
Opit                 36.6         20.7                   18.3                   19.5            4.9
Pagak                47.0         24.2                   12.1                   16.7            0.0
Paicho               37.5         22.5                   15.0                   17.5            7.5
Parabongo            40.0         20.0                   10.0                   23.3            6.7
Purongo              44.6         16.9                   15.4                   20.0            3.1
Teya Padhola         49.0         19.6                    9.8                   21.6            0.0
Unyama               29.3         31.0                   10.3                   13.8           15.5
Wii-Anaka            32.1         27.2                   18.5                   16.0            6.2
Total                38.6         22.4                   15.1                   18.2            5.8



 While the camps reported low levels of morbidity, the survey found frequent cases of
 diarrhea and malaria. 38% of households reported cases of diarrhea; with malaria (22.4%)
 and intestinal worms (18.2%) the next most commonly reported illnesses.
 Disease: Access to safe water sources and adequate sanitation is limited??? Is this true
 for those camps worse affected? What do the results indicate about awareness??? How
 many households reported that hands should be washed after using the toilet and before
 eating?

 5.2 Hygiene Behaviour

 Figure 5: Hygiene behaviour that encourage water related diseases and their transmission
 Source: health clinics in selected camps, December 2003


                                           Using Dirty
                                           Containers
                                               5%
                                                            Drinking Unboiled
                                                                  Water
                                                                   5%

                             Poor H/H Hygiene
                                   32%




                                                  Fouling Water Source
                                                          58%




                                                           22
Behaviors related to safe water and good hygiene is important for the prevention of
diseases. The above chart demonstrates that, whike the camps are appear covered with
traioning from different agencies on water and sanitation and hygiene, the health clinics
report households continuing with bad behaviours, which contribute to the transmission
of diseases. It appears that the protection of water sources is problematic with the heaslth
institutions blaming fouling of water sources for over 59% of water-related diseases.
Poor household hygiene is also at fault, with institutions attributing 32% of diseases to
this.


3.3 Traditional/Cultural beliefs on excreta disposal

For many of IDPs, being displaced is a new and difficult situation with some unsure as to
how to adapt and change their previous cultural practices regarding defecation and
sanitation. This survey’s results demonstrate that the IDPS in the Gulu camps have little
cultural or traditional beliefs on the excreta disposal. 73% of respondents report no
cultural beliefs on excreta disposal. However, some respondents did report certain
practices/beliefs in the use of sanitation facilities, with 5% saying that children and
pregnant women (3)% should not use latrines. Interestingly, we had no household saying
that women and men should not share facilities, so we can assume that there is no need,
when designing a sanitation programme, to build separate latrines for men and women
and perhaps children. Nevertheless, to ensure that the concerns of those parents who
express concern over children’s use of latrines are addressed, agencies could design and
construct special latrines that are not dark, smaller squat holes with a support bar to hold
on to.

Figure 6: Traditional beliefs about excreta disposal (Source: Households -278 respondents)
Note: Other contains 20 respondents who demonstrated poor understanding of the question, while an
additional 28 responded that excreta is associated with disease.



                       Pregnant women should
                           not use latrines    Children and disabled
                                 3%            should not use latrines
                                                        5%




                                                       Other
                                                       18%




     No traditional beliefs
            74%




                                               23
                    5.4 Household Excreta Disposal

                    Table 22: Household disposal of excreta and waste in selected camps, December 2003
                        Acet   Anaka   Amuru   Lalogi   Opit   Pagak   Paicho    Parabong     Purongo    Teya     Uyama   Wii-    Total
           Camp                                                                                         Padhola           Anaka
           Pit          21     25      29      18       21     20      20        15           17        15        20       10      231
Category




           Latrines
           VIP          0      1       0       1        2      5       0         0            2         1         0         1      13
           Disposable   2      2       0       0        0      1       0         0            0         0         0         0       5
           Bush         3      3       3       5        1      1       2         1            5         2         0         3      29
   Total                26     31      32      24       24     27      22        16           24        18        20       14      278
Respondents


                    Table 23: % Household disposal of excreta and waste in selected camps in %, December 2003
                        Acet   Anaka   Amuru   Lalogi   Opit   Pagak   Paicho    Parabong     Purongo    Teya     Uyama   Wii-    Total
           Camp                                                                                         Padhola           Anaka
           Pit          81     81      91      75       88     74      91        94           71        83        100      72     83.1%
Category




           Latrines
           VIP          0      3       0       4        8      18      0         0            8         6         0         7     4.6%
           Disposable   8      6       0       0        0      4       0         0            0         0         0         0     1.8%
           Bush         11     10      9       21       4      4       9         6            21        11        0        21     10.5%
   Total                100    100     100     100      100    100     100       100          100       100       100      100     100%
Respondents

                    231 respondents use pit latrines representing 83% of total respondents interviewed. Very
                    few households used disposable means, i.e. bags etc to store and later dump excreta.
                    10.5% of households continue to use the bush with 21% of respondents in Lalogi using
                    this method.


                    Figure 7: Chart showing overall breakdown of excreta disposal

                                       10%
                        2%



                    5%


                                                                                       Pit
                                                                                       VIP
                                                                                       Disposal
                                                                                       Bush


                                                                           83%




                                                                       24
                5.5 Public Latrines and Construction Needs

                Obviously, individual latrines for each household would be beneficial (the UNHCR says
                that to guarantee use and cleanliness, latrines should be allocated on a individual or
                family basis) but as Figure 7 demonstrates Gulu’s camps face constraints in terms of
                space and resources. Consequently, the camps may be better served by a communal
                latrine system, which as table 22 shows 69% of households are agreeable to. At the time
                of this survey only 37 households, or 14% of total respondents, have access to public
                latrines. Pagak with 16 households (69% of households respondents in Pagak) reporting
                access is the best served camp with public latrines.
                Table 24: Hhld Access to Public latrines and Latrine Construction needs
                     Public Latrine Facilities               Latrine construction
                 Access to          Willingness        If no
                 Public             to use Public      latrine,          HH contributions                                           Support needed
  Camps          latrines           Latrines           preferred
                                                       type
                 Yes        No      Yes        No      Pit    VIP        B          G        Slabs     Lab       Tim      Slabs     Pipe     Lab       Mat       Tools
  Acet           0          24      11         9       9      5          12         9        4         6         7        14        0        3         9         9
  Anaka          1          26      10         3       8      4          18         20       6         8         14       23        6        3         12        10
  Amuru          0          30      7          7       7      5          19         7        0         14        11       20        15       5         12        0
  Lalogi         1          20      12         7       6      3          15         18       2         6         10       21        1        4         7         1
  Opit           1          21      6          3       3      3          12         10       0         11        12       19        5        1         12        5
  Pagak          16         7       16         2       6      3          16         13       9         4         17       14        2        4         9         9
  Paicho         1          20      8          5       4      1          14         13       1         4         11       18        0        3         10        4
  Parabongo      8          8       11         2       2      0          12         10       4         4         7        14        2        0         7         5
  Purongo        7          17      15         5       4      1          15         15       0         5         10       17        3        5         9         9
  T. Padhola     0          18      12         2       4      2          5          6        6         5         2        12        0        3         5         11
  Unyama         1          15      1          3       5      2          11         10       0         6         5        14        0        6         12        7
  Wii-Anaka      1          12      3          1       3      0          8          7        0         7         3        12        7        0         7         2

  TOTAL           37    218 112          49  61    29       157 138 32          80      109 198        41        37                                    111       72
                Based on feedback from 12 camps and 278 respondents
                Key: Tim: Timber, B; Bricks, G; grass/roofing, Lab: Labour, Mat: Materials such as cement, timber,
                iron sheet, nails and bricks


                Table 25: Latrine Construction- Needs (Source: Camp leaders, December 2003)
Camps                Acet        Anaka Amur                  Lalogi          Opit        Pagak        Paicho    Parabongo         Purongo     Teya           Unyama
                                                                                                                                             Padhola
                                       u
Preferred      VIP               VIP           Disposabl    VIP          Drainable       VIP          VIP       VIP           VIP            Drainable       Drainable
latrine type                                   e
Why            Avoid smell       Avoid         -            Avoid                        -            Avoid     Avoid smell   Easily         Lack of         -
                                 smell                      smell                                     smell                   transferable   land
Willing to     Sand, stones,     Sand,         Roofing,     Labour,      Labour,         Digging      Labour,   Labour,       Roof,          Bricks,         Digging
contribute     gravel and        labor for     labour,      bricks       bricks,         pit, roof,   bricks    bricks,       bricks,        sand,           pit,
               water             digging       bricks                    roofing         sand                   roofing       labour         roofing         roofing,
                                                                                                                                                             labour
Support        Slabs,            Skilled       Cement,      Cement,      Skilled         Skilled      Slabs,    Vent pipes    Skilled        Provision       Slabs
needed         cement, iron      labour,       Slabs,       Slabs,       labour,         labour,      iron                    labour,        of tools,
               sheets, vent      slabs,        vent pipes   vent pipes   slabs           slabs        sheets,                 slabs, nails   sand
               pipes, skilled    nails, iron                                                          vent
               labour            sheets                                                               pipes




                                                                                   25
                       5.6 Perceived Obstacles to Improvement of Latrine Coverage

                       Figure 8: Obstacles for Hhld latrine construction, based on interviews with hhlds in selected camps.




                           80


                           70


                           60


                           50

           Number of
                       40
           respondents

                           30


                           20


                           10


                            0
                                 Land shortage   Lack of knowledge   Lack of resources Willingness to share Attitudinal(Culture      Old Age
                                                                                                            and motivational)




                       Respondents reported a number of constraints that they felt were creating obstacles to
                       more effective latrine coverage. These include lack of space/land shortage with 75 (or
                       34%) households citing this as a reason, 14 households claimed lack of knowledge was a
                       factor, while 48 households gave a limited availability of materials as a reason. 61
                       households or 28% of total respondents claim that attitudinal factors were important
                       obstacles, while seems to contradict the earlier assumption (Figure 5) that 75%
                       households hold no traditional beliefs with regard to excreta disposal.

                       5.7 Waste Disposal

                      Table 26: Categories of waste disposal methods by households in 11 camps
                   Camps      Acet Anaka     Amuru    Lalogi  Opit  Pagak   Paicho   Par’go  Purongo                        Teya       Unyama   TOTAL
                                                                                                                           Padhola
Household Refuse




                   Open         9       24       14        4         5       12         2         5          14           3           11         103
                   Dumping
    Disposal




                   Controlled   10      15       18        19        16      4          19        11         11           9           9          141
                   Composting   6       4        0         0         0       5          0         0          0            6           0           21
                   Burning      0       2        1         2         3       0          0         0          0            0           0            8
                   Other        0       3        0         0         0       5          0         0          0            0           0            8
                   TOTAL        25      48       33        25        24      26         21        16         25           18          20         281



                                                                                 26
Figure 9: % total hhld waste disposal methods in selected camps in Gulu District



            3%         3%
                                          37%

  7%                                             Open Dumping
                                                 Controlled
                                                 Composting
                                                 Burning
                                                 Other
   50%




A significant percentage of IDPs practice open dumping, with 37% of respondents using
this method. As Figure 9 shows, 45% of respondents this method to be easiest and most
accessible, although only 10% consider it to hygienic. 63% of households consider
controlled dumping to hygienic but find that this method is difficult as the sites are felt to
be inaccessible. Very few households practice composting (7%) or burning (3%). Lalogi
(82%), Parabongo (69%), Opit (76%) and Paicho (91%) are camps with most households
practicing controlled dumping.




                                                  27
Figure 10: Camp Leaders Perceptions of Refuse Disposal methods as a Percentage




                                                28
6. Some Recommendations:
This survey has demonstrated that in order to be effective, water (quality, quantity) and
sanitation facilities- what DfID calls the “hardware” components- must be combined with
good basic health education and training- the “software” components.




6.1 Coordination:
Most agencies on their own do not have the absorptive capacities to respond to provide
100% coverage in the camps. Agencies with an interest in providing water and sanitation
interventions must coordinate and liaise with the relevant Districts who are, usually the
best-placed bodies to identify gaps and guide interventions that meet a need. Certainly,
the proposed monthly meetings must take place.

6.2 Women’s Strategic needs:
The Dublin Principles 1992 from The International Conference on Water and the
Environment said that: “ Women play a central role in the provision, management and
safeguarding of water”. The pivotal role of women as providers and users of water and
guardians of the environment must be reflected in institutional arrangements for the
development and management of water resources. Improved sanitation and water
facilities would provide tangible benefits for them. Interventions should consider ways
to improve their circumstances.

6.3 Local capacities:
With so many camps physically isolated because of security concerns, agencies should
continue to show a strong reliance on initiatives and resources provided by the camps.
This assessment has shown that the camps are able to provide for much of the materials
needs to facilitate greater water and sanitation coverage, as well as participate actively in
water and sanitation committee. However, it is true that most of these committees
invariably fail due to poor support and follow-up by the agencies. Programmes should
build on what already exists as a means of ensuring sustainability and fostering a move
from relief to development. There should be more sustainable elements (difficult but



                                             29
worth trying) in our projects. Often, water supply is improved, but a lasting impact on
supply/transfer of skills should also be an essential element.

6.4 Children’s needs:
Where possible, agencies should ensure that the special needs of children are met and that
parents’ concerns addressed- Children do not like dark latrines. Special features could be
designed into the latrines to help this. The squat hole should not be so large that children
fall in or intimidated by it. Perhaps, even not sheltering the squat for children, and also
providing a support to hold onto would help.

6.5 Water user fees:
As table 3 shows, 95% of respondents pay user fees for the use of the water. This pays
for maintenance and some contruction costs. While the user fee charged is not sufficient
for all costs and in some cases the money collected is usurped by individuals, it does have
the value of creating a sense of ownership by the community and provides some funds
towards the running costs of the water supply systems. Importantly, government
encourages this, although clearly, this can be difficult with most IDPS having no money.
Agencies should look at ways of making this work for the communities.




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