Banteay Meanchey Province Health Center Water Project – Cambodia
This project is made possible through the partnership of WATER CHARITY and the NATIONAL PEACE CORPS ASSOCIATION.
This project has been completed. To read about the conclusion, CLICK HERE.
Banteay Meanchey Province, Cambodia
Banteay Meanchey is a province of Cambodia located in the far northwest. It borders the provinces of Oddar Meanchey and Siem Reap to the east, Battambang to the south, and shares an international border with Thailand to the west. Banteay Meanchey is the 13th largest province in Cambodia. With a population of 678,033, agriculture, particularly rice paddy, plays a very important role in the province’s economy.
The rainy season lasts from May-October. However, from late October-April there is little or no rain.
The health center has identified two problems to be solved: First, the current water system of the health center is poorly designed, and the building has no running water as a result. Secondly, there is a high incidence of hygiene-related health issues within the commune.
In 2016, 37.30% of the 7,294 patients that came into the health center were suffering from illnesses whose transmissions can largely be prevented by improving hand-washing techniques (colds & diarrhea). The goal is to reduce the overall number of patients coming into the health center with diseases related to poor hygiene practices by turning the health center itself into a model of hygiene and teaching hand-washing techniques around the commune.
When the health center was constructed, its architects constructed a 6,000L concrete water basin outside the health center to collect rainwater and feed it into the building. However, because the basin is at ground level, there is inadequate pressure. Consequently, there is no water flow into the building.
The health center has four sinks already, one in the OPD room, one in the pediatric room, one in the ANC room, and one in the delivery ward. However, because the cistern is too low to the ground, none of these sinks receives water (midwives even need to carry buckets of water from the latrines to the delivery room), even though all of these sinks have existing piping. Because water is not readily available, even the health center staff do not wash their hands. The closest water source is in the latrines.
This project is to install a well and water tank on the health center premises.
Sinks (equipped with soap and hand-washing infographics) will be installed in the patient waiting area, outside the latrines, and the cooking area outside the delivery ward.
Lastly, VHSGs will be trained to conduct health outreach and teach villagers about the importance of handwashing in preventing disease transmission as well as proper handwashing techniques.
The new well will be drilled to about 50 meters and located near the main building.
The health center will purchase a 2,000L water tank to be used as the new water storage unit feeding into the existing piping.
The health center will install sinks with soap in three locations of high patient density where handwashing is important: (1) patient waiting area, where patients spend the longest amount of time at the health center, (2) outside the latrines, which can be a breeding ground for germs, and (3) the cooking area outside the delivery ward, where families can spend an entire day waiting for their loved one to birth a child.
11,000 people served by the health center will benefit from the project
Peace Corps Volunteer Directing Project
Monitoring and Maintenance
The operation district provides the Health Center with a monthly budget which allows for maintenance on the well and water tank and allows for the replacement of supplies such as soap.
The VHSGs, once educated in handwashing knowledge and trained in facilitating this knowledge to others, will continue to educate families in their villages.
Funds raised in excess of the project amount will be allocated to other projects in the country.
Donations Collected to Date
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This project has been completed under the direction of Peace Corps Volunteer Rajath Kenath. To read about the start of the project, CLICK HERE.
The project was designed to install a well and water tank on the health center premises.
The central goal of this project was to make the health center a model of hygiene in the commune. Specifically, we aimed to highlight the benefits of handwashing in disease prevention by constructing a new water system at the health center. The previous water system – due to poor design flaws – prevented there from being any running water at the health center.
At Peace Corps’ Project Design Management Workshop, my health center chief, and counterpart: Proeung Lo immediately proposed this water & hygiene project as something he wanted to work on. He thought that a health center without running water was a failure on a basic level of health provision. Not only did patients not have easy access to handwashing, but health center staff were also hindered in their work by a lack of access to water. For example, midwives would need to fill up buckets of water in the latrines and carry them to the delivery ward whenever a woman went into labor.
As such, after receiving grant funds, we dug a new well to have a permanent source of water year round (as opposed to just relying on rainwater and rice field water). This well water feeds into a 2,000L water tank that has piping enter the health center, latrines, and delivery ward.
Simultaneously, we added three new sinks to the health center. These sinks were placed in areas that had the highest number of patients: 1) Patient waiting area 2) Post-delivery ward 3) Latrines. By doing this, my health center chief and I wanted to provide patients easier access to handwashing.
The second goal of this project was to educate locals on why handwashing is so important. While the new water system at the health center provides the physical means to wash one’s hands, and education component was also designed and implemented such that the health center can truly become a center for hygiene in the commune.
In this education component, VHSGs were trained to properly identify diarrhea, proper handwashing techniques, and crucial times to wash hands. They were also trained in how to conduct home visits themselves. As a result, VHSGs would gain the skills and confidence to be pillars of hygiene in their respective villages.
Goals Achieved, Changes in Initial Objectives, and Community Feeling:
Once the grant funds were received, my counterpart and I immediately began the purchasing of materials. However, there were delays in construction. While all construction was initially agreed to be completed by 3/12/18, contractors were not able to meet the agreed upon schedules. Well construction was not completed until 3/29/18. Additionally, the contractors who agreed to install the water tank and sinks informed us last minute that they would not be able to take on the project. My health center chief and I were scrambling to find new contractors.
Luckily, the contractors who dug the well agreed to install the water tank and connect it to the well itself. Furthermore, because Khmer New Year was approaching, some workers from Thailand returned to the village for the holidays. Among these workers were a few laborers who said they could complete sink installation before returning to Thailand. In addition, which is more; there were fewer workers than those in the initial team of contractors so less grant funding was spent on sink installation.
Unfortunately, the sink installation was delayed by a month beyond the date previously planned. As a result, we cannot accurately determine if the presence of sinks and educational handwashing material next to the sinks has a positive effect on cold & diarrhea prevention in the area. However, from purely observational methods alone, it is clear that patients are actively using the sinks to clean their hands. Once they see health center staff washing their hands with soap, many patients choose to do so as well. The presence of soap and educational posters outlining handwashing steps provides a visual aid on how to properly wash hands as well.
The feeling among health center staff regarding the new water system is incredibly positive. The nurses and midwives at the health center are using the sinks regularly to wash their hands, utensils, and medical instruments as needed. Three of the health center staff even offered up their time to teach the VHSGs proper handwashing practices. In talking to my commune chief about community sentiments regarding he project, he had to say that everyone in the area is proud that their local health center has been updated in its facilities. Something as simple as having sinks at the health center allows people to believe that the commune cares about their health.
Capacity and Skills Built:
In partnership with three health center staff, we were successfully able to transfer knowledge regarding proper handwashing practices to the VHSGs. In fact, 10/12 VHSGs passed the post-education evaluation and were able to identify crucial times to wash one’s hands, techniques to wash one’s hands when soap is not available, as well as to clearly define what “diarrhea” is. As these health center staff assumed the main role of “educator” in the transfer of knowledge to the VHSGs, this not only strengthened their relationship with the VHSGs but also allowed the HC staff to feel more competent in their ability as leaders of health in the community.
Additionally, a key part of this project was to get the VHSGs themselves to conduct home visits in their respective villages and further transfer the knowledge gained about handwashing. So, following the education portion of the VHSG training, the Peace Corps Volunteer educated the VHSGs on how to lead an education portion themselves and how to transfer their knowledge learned onto locals in the community.
Finally, Proeung Lo, the health center chief, is the main counterpart in this project. He was taken to the Project Design Management Workshop held by Peace Corps and learned about sustainable development. During the course of the project, Proeung learned how to efficiently budget a project before hand and how to ensure that it does not fall apart in the long term.
The commune provided a monetary contribution of $500 to the completion of this project. That being said, they are fully invested in monitoring well/water tank/piping/and sink maintenance.
Previously, the health center would have to rely on rainwater or rice field water as their main source of water. However, by digging a well 40 meters deep, the health center now has a sustainable and constant water source. Water was struck after 20 meters, and while it would have been cheaper to stop digging the well at that depth, the water source would have been consumed within one year. As a result, the contractors were told to keep digging until the water table was hit.
Finally, the skills and knowledge transferred to the VHSGs will allow them to continue to teach handwashing practices in the community. For those who completed the home visits, they have certificates to reward their efforts, and feel validated and empowered
to continue being the first point of contact in their villages for health.
We extend our thanks to Rajath for completing this important project.