Studies have shown that 50% of child morbidity in Uganda is due to poor hygiene and sanitation. In 1997, over 1,200 school children died because of poor sanitation conditions at school during the 1997 cholera outbreak. As a result, 560 primary schools around the country were closed because they lacked acceptable WASH facilities. The World Bank Water and Sanitation Program (WSP 2012) estimated that Uganda loses Shs. 389 billion (about USD$130.5m) which is equivalent to 1.1% of GDP every year due to poor sanitation. Though the country developed a school WASH strategic plan in 2006, its implementation remains weak due to limited funding. There is no national budget allocation for WASH in schools, save for isolated funding for sanitation, especially the school facility grant that goes towards construction of latrines. Moreover, the inadequate sanitation situation in schools has been exacerbated by the implementation of Universal Primary and Education policies which entitles all school age children to free education, causing the number of students per latrine stance ratio to skyrocket, reaching 400:1 in some schools.
Studies have shown that investments in WASH have a direct impact on the health and wellbeing of the population by reducing water and sanitation-related illnesses like diarrhea, dysentery, typhoid, cholera and hepatitis that kill hundreds, especially children, who are most vulnerable. Improved WASH in schools also translates into increased enrollment and attendance rates.
Kalangala district (also called Ssese Islands) is located in Lake Victoria with a total of 84 islands. It has an area coverage of 9,066.8 sq. km out of which only 432.1 sq. km (4.8%) is land. Bugala is the biggest island in the district with 296 sq. km of land, representing 68.5 percent of the district land mass. Sixty-four out of 84 islands in the district are inhabited with an estimated population of 66,300 (2012 Estimate).
A needs assessment study conducted in May 2018 in 8 schools on Buggala island in Kalangala district identified big gaps in the water and sanitation situation. There was inadequate availability and access to safe water; access to, use and maintenance of hygienic latrines was poor; availability and use of washrooms for use by girls during menstruation as well as hand washing facilities were lacking; pits for solid waste disposal were missing; and the knowledge, attitudes and practice of pupils were wanting. Inadequate water sources were also noted to be a cause of conflict between the local community and some schools.
The study showed that:-
• The principal source of safe water in 50% of the schools was through rainwater harvesting. In 30% of these institutions, the facilities were either broken down or needed some form of repair.
• All the schools lacked a fence. Hence, 4 schools reported some form of conflict with local communities over water use. Local communities allegedly draw water from these institutions forcefully, leading to frequent water shortages; and damage to the water facilities.
• Latrines were present in all the schools; but only 50% of the latrines had doors. So half of the latrines in the schools had no privacy.
• The majority of the pupils said that they used the latrines but only one school met the recommended pupil to latrine cubicle ratio of 40:1. In the remaining schools, ratios were between 50:1 and 90:1.
• Only 50% of schools had latrines assigned to girls only or boys only. In 2 out of the 8 schools, teachers and students shared toilets.
• Only 2 schools had washrooms for use during menstruation but even these were makeshift structures that lacked doors for privacy.
• Only 3 schools had improvised hand washing facilities next to the latrines. But even these lacked water at the time of the visit.
• 75% of the school had urinals. Of these, 40% were smelly with flies and were poorly drained.
• Solid waste disposal other than faeces was said not to be a major problem; though only 2 schools had refuse pits.
• Sanitation and hygiene knowledge among the pupils was relatively low. 30% reported knowledge of diarrhea-related diseases and only a few knew that cholera was due to poor sanitation.
• Regarding sources of information on sanitation, 90% of students mentioned teachers as the main source, although 50% of the teachers reported that they had not received any training on sanitation.
• Educational materials present in the schools were posters (50%) and books (50%). Where posters were available, they were not pinned in strategic places.
The project therefore seeks to improve safe water access and coverage by creating more water supply sources and facilities as well as repairing broken ones; to enhance sanitation and hygiene by constructing and rehabilitating pit latrines, girls' washrooms and hand washing facilities; and to improve garbage and waste disposal by providing garbage pits. To minimize conflict with the local communities, the project will protect/repair 15 community water points/wells. This will be in addition to planting live fences around the premises of the schools. The project will also raise hygiene awareness and promote behavioral change. Peaceful co-existence between the schools and the local communities will also be promoted. The project will also address the district and local structures capacity gaps in planning and implementing WASH programs in schools and the local communities.