H2O Health Plus Demonstrates the Unique Power of Sustainable, Safe Drinking Water

Helping 30,550 Ugandans realize measurable improvements in health, health clinic capacity, economic vitality and education.

Of Uganda's 30 million population, approximately 35% are without access to clean water and 52% of people are without sanitation.

The water crisis is a fundamental challenge to human survival. Unsafe drinking water is the world’s leading cause of disease and death. 780,000,000 people don't have access to clean drinking water and 2.5 billion people, including almost one billion children, live without basic sanitation. “Every 20 seconds, a child dies from diseases associated with a lack of clean water and sanitation. That adds up to an unconscionable 1.5 million young lives cut short each year,” stated Ban Ki-moon, UN Secretary-General.

Of Uganda’s 30 million population, approximately 35% are without access to clean water and 52% of people are without sanitation. The Government of Uganda has recognized that improvements are needed. These conditions undermine public health, anti-poverty and education efforts. Water-borne disease is the leading cause of childhood mortality in Uganda, where infant mortality stands at 54 deaths per 1,000 live-births and nearly 13% of the population dies before reaching the age of 5. An estimated 1/3rd of the health clinics in the target project region are extremely restricted due to lack of clean water points. In the District of Apac, 39% of the population lacks clean drinking water. Women and girls must walk long distances to existing unclean water sources, causing high numbers of child/infant death, low rates of girls’ enrollment in school, and minimal chances for women to live productive lives.

How is H2O+ addressing the problem and how many people do you plan to help?

H2O Health Plus (H2O+) seeks to ameliorate the dire health and socio-economic situation confronting impoverished villagers in Uganda, especially women and girls. H2O+ is demonstrating the unique power of sustainable safe drinking water, hygiene and sanitation to provide measurable improvements in health (particularly childbirth safety, maternal health and early childhood health), health clinic capacity, economic vitality and education.

In the 18-month period of phase II, H2O+ will: 1) provide sustainable access to clean water to 30,550 Ugandans and reduce water-borne diseases in 75 communities in the District of Apac, Northern Uganda; 2) provide clean water to an additional 23,200 Ugandans per year when visiting health clinics; 3) build 4,890 latrines for 24,400 household users and 6,960 healthcare clinic users; 4) establish 75 permanent Community Health Clubs (CHCs); 5) train 6,000 households, including 500 women micro-entrepreneurs and 225 women farmers, on sustainable income generating opportunities, such as fuel-efficient stove users;  6) assist 30% of non-enrolled girls to attend school; 7) reduce overall emissions by 9,000 tons and save 30,000 trees; and, 8) earn $50,000 in carbon credits for stoves and $37,500 carbon credits for boreholes.

Tell us more about H2O+’s pilot launched in 2012 and what results the project has demonstrated to date.

ILF drilled a borehole well in the Ogiroi village for the H2O+ program. 1,373 children and villagers will have safe drinking water from this water source.

H2O+ was piloted in 2012 successfully in Pallisa, a district in Eastern Uganda. The project brought clean water to rural populations and improved capacity to underserved health clinics as well as communities. Five borehole wells were constructed near health clinics providing 6,392 villagers living in t hese five communities with direct access to clean water. Additionally, those traveling from afar to these clinics have access to this clean water, which calculates to 4,000 visitors per year per health clinic. Because of the strategic placement of the wells, the program will benefit 25,600 people annually in these five communities. For more on H2O+’s pilot results and the creators behind the model, see this article.

Who are the movers and shakers of H2O+?

Blue Planet Network is leading the initiative by bringing together lead innovators in the health and water sectors. Blue Planet Network’s peer-to-peer collaboration and online technology services are increasing the impact of water programs around the world, including H2O+. Blue Planet Network leaders will train H2O+ participants to use SMS reporting technology to send progress reports and ongoing project data to Blue Planet Network’s technology platform, which will serve as H2O+’s planning, monitoring and evaluation system.

International Lifeline Fund, a member on Blue Planet Network's platform, will drill H2O+'s borehole wells and partner with Africa Ahead to launch Community Health Clubs. International Lifeline Fund reduces human suffering through water and sanitation initiatives, fuel-efficient stove programs, and micro-enterprise. They have constructed more than 212 borehole wells in the Districts of Apac, Palissa and Lira, serving over 150,000 people.

Africa AHEAD, a South African-based organization led by Juliet Waterkeyn, will launch H2O+’s Community Health Clubs (CHCs). The CHCs concept has been employed to date in several African countries including Zimbabwe, Rwanda, Sierra Leone, and South Africa, and has been supported by organizations such as CARE, the U.K. Department for International Development and Danish International Development Agency. The CHCs model is a participatory and proven approach in mobilizing community members to take responsibility for their collective health and quality of life, as recommended by the Water Supply & Sanitation Collaborative Council in Switzerland. (Page 6)

ReachScale: ReachScale brings social innovators (corporations, NGOs and governments) together to design public-private partnerships using the social enterprise models to drive innovation and impact.

What about environmental sustainability?

Young girl filling jerricans in the Ogurotapa village of the Pallisa district, Southeast Uganda.

A focus of H2O+ is to train households on environmentally-friendly technologies that save lives, and the forest, such as fuel-efficient stoves. The hazards associated with the use of wood and charcoal for cooking are severe. Nearly 95% of rural households cook on open fires, resulting in 1/3 of Uganda’s forest lost in the last 25 years and why acute respiratory disease is the second leading cause of morbidity and accounts for over 8% of infant deaths. The victims are those responsible for cooking: women and girls. Women/girls spend 4-6 hours daily collecting water/wood, leaving little time for income generation or school.

Each rural wood-burning stove reduces CO2 emissions by 1.5 tons per year and saves about 5 medium-sized trees per year. This will reduce overall emissions by 9,000 tons/year and save 30,000 trees at 75% village coverage in phase II of H2O+.

Since 2006, International Lifeline Fund has distributed 60,000 fuel-efficient stoves to households in Uganda. H2O+ will seek carbon financing for firewood stoves by adding that program to International Lifeline Fund’s recently approved application for carbon financing for its commercial charcoal stove program under the UN Clean Development Mechanism. H2O+ will also seek to become eligible for carbon credits (via International Lifeline Fund’s water program) through the Gold Standard – the world's only independent standard for creating high-quality emission reductions projects. H2O+ sustainable model expects to obtain carbon revenues: each stove and borehole yield about $10 and $500 in credits, respectively. These funds equate to $50,000 in credits for stoves and $37,500 for boreholes, which will be matched to community contributions for a water usage fund, providing beneficiaries a compelling incentive and the resources to maintain water points.

Having sustainable water points will minimize community need to burn wood (and the associated CO2 emissions) to boil water to kill bacteria. The elimination of open defecation in H2O+ communities also will greatly reduce environmental damage.

How do you plan to scale the program? Is the project feasible on a broader scale or can it be replicated in other social, cultural or geographical settings?

H2O+’s multi-sector collaborative, formed with key players at the local, regional and international levels, are equipped to replicate the project across Uganda as one collaborative effort vs. separated efforts. H2O+ leading organizations are combining assets and working together to leverage program outcomes cost-efficiently vs. a standalone water project. All outcomes are achieved for the price of only the water points, which we calculate at approximately $17.90 per person.

Boys playing near the Obutet borehole well where 2,610 people now have access to safe drinking water.

H2O+ is a community-led initiative that maximizes local leadership and in-country personnel. Through the creation of CHCs, community leaders will transfer skills to local populations who will sustain the project long-term. This community-led model, that can be replicated in other social, cultural or geographical settings, is a scalable way of mobilizing communities to virtually eliminate open defecation, maintain water sources and improve overall healthcare practices and community health. International Lifeline Fund’s fuel-efficient stoves can accrue carbon credits that enable CHCs to fund short or long-term maintenance needs at no additional cost. The combination of extensive experience and low overhead, combined with CHCs (which build on local health worker capacity and local women's capacity when freed from burdens of water and fuel gathering), enables all the outcomes above for approximately the same cost.

Extensive experience in Uganda has proven that deep borehole wells have a much higher rate of long-term success than hand-drilled and shallow dug wells. International Lifeline Fund's low-cost drilling enables sustainable results and lower maintenance, a model International Lifeline Fund has proven replicable at a low cost across Uganda. International Lifeline Fund is able to achieve this by using its own equipment and in-house drilling staff, rather than out-sourcing the work to expensive private contractors. The average cost to drill one deep borewell ranges between $10,000 to $12,000 in Uganda.  International Lifeline Fund is able to provide services for as low as $6,000 per deep borewell, saving $450,000 in drilling costs for Phase II of H2O+.

How is H2O+ improving lives?  

H2O+ expects to reduce morbidity and mortality rates by 5%-10% in the Apac district of Uganda.

Expected direct impact will include: