Sagbadai Clinic Borehole Project – Togo

Sagbadai Clinic Borehole Project – Togo

This project is made possible through the partnership of WATER CHARITY and the NATIONAL PEACE CORPS ASSOCIATION.NPCA and WC logos

This project has been completed.  To read about the conclusion, scroll down the page.

Sagbadai Clinic Borehole Project - TogoLocation
Sagbadai, Centrale Region, Togo

Community Description
Sagbadai, located 12 km from Sokode, the regional capital in the Centrale region of Togo, was established as a village by the German government in the early 1900s as a forced labor community to build the road from Sokode to the town of Bassar to the north-west of Sagbadai. Men, women, and children were brought from several areas in northern Togo. Hence, the community today is comprised of several different ethnic groups, with Kotokoli and Kabyé the dominant groups.

The population of 2,000 people is spread out over 5 km on either side of the main road. The community is predominantly Christian and Muslim with a livelihood based on subsistence agriculture of staple crops i.e. maize, sorghum, soy, and beans.

The use of herbicides and pesticides is common in fields surrounding shallow wells. Hence, contamination as such may be a problem, though no water quality data exists. Household animal husbandry is common (chickens, goats, sheep, and pigs) though as in most villages, animals are allowed to roam the village particularly during the dry season resulting in a higher mortality rate than enclosed animals, in addition to adding to the unsanitary conditions around some of the wells.

In recent years, foreign-owned cashew tree plantations have deforested large swaths of land and conflict has arisen between the inhabitants and the local authorities over land rights. A large cashew-nut processing plant was built in the village with borehole wells supplying water needs. No information exists on the impact of the local aquifer. The workforce is brought in from outside the village thus there is a little direct benefit to the villagers themselves in what otherwise could be a local source of income.

Sagbadai Clinic Borehole Project - TogoRegarding the water situation in Sagbadai, most people rely on unprotected wells. There are a number of seasonal shallow, open wells scattered about the village, and two closed wells with hand pumps within a km of the clinic. One of the latter was installed in 2000 and is currently not functioning. The second well with a hand pump lacks a formal water committee and is apparently made available to the public at the whim of one individual. A borehole well and water tower are present at the local primary school. However, this well has been inoperable since its establishment, as either a generator was never purchased or most likely, was never connected to the pump (i.e. disappeared), and thus remains inoperable.

Open defecation is the norm as in most of Togo, and often close to the wells though not exclusively. A few seasonal creeks run through the village and are used mainly for laundry, though consumption is also prevalent, and by herders for watering their herds.

There is currently an environment and agriculture sector Peace Corps Volunteer serving at the site.

Description of Clinic
The health clinic in Sagbadai was constructed in 2000 by Plan International and consists of the standard 6-room cement block building, including a birthing room. The population served is around 3,800 as the neighboring villages utilize the clinic.

In the absence of municipal power in Sagbadai, the clinic sparingly uses light powered from a gas generator, though the head nurse reported night-time births are often by flashlight. Births currently average seven a month. The clinic treats primarily malaria, gastro-intestinal diseases, child malnutrition, and surface wounds.

The clinic was plumbed for running water as most of the rooms have functioning faucets and drains. Water is pumped from a shallow closed well to a metal water tower and gravity-fed to the clinic through a hose.

Sagbadai Clinic Borehole Project - TogoProblem Addressed
Sagbadai experiences an overall water scarcity particular during the dry season from early February to the onset of rains in June. The shallow wells located throughout the village typically run dry near the first of the year.

The shallow well at the Sagbadai clinic also runs a dry mid-dry season. This well, like all other open wells in the village, is around 10 meters deep and thus only reaches the weathered, clayey, lateritic subsurface, recharged with seasonal infiltration, and not the more sustainable aquifer found at depths greater than 40 meters.

A lack of potable water for staff and patients necessitates the use of clinic funds for purchasing water and inadequate overall water supply for general cleaning results in less than ideal sanitation practices. Once the clinic well is dry, water is purchased and transported from a borehole well 4 km from the clinic.

Relatives of patients are required to provide water for both consumption and in the case of birth; for cleaning the maternity room, surgical utensils and cloth used during birth. Water is drawn from what few wells are still producing and carried to the clinic. Water is treated with bleach, though how consistently the practice is unclear.

A gas-powered generator supplies power to the submersible pump. However, due to leakage in the water tank, fuel costs are considerably higher than normal, thus adding a financial strain to an already limited supply of clinic funds.

Project Description
This project is to build a borehole well for the clinic. Under the guidance of the Department of Hydraulics and Sanitation’s regional office in Sokode and with support from the Ministry of Health regional director, who identified clinics with the most critical need, and a local drilling company, this project proposes to drill a 60- to 100-meter borehole well at the clinic, equipped with the following:

• An electric submersible pump,
• a 4-meter high cement block water tower,
• a 2 meter**3 polyethylene tank, and
• indoor plumbing (water basin and faucet) to the one room with a subsurface drain (mentioned above).

The submersible pump will be run using a gas-powered generator as there is currently no electric power in the community. The local drilling company selected, Plomberie Génerale de Réalisation de Forage, in operation since 1998 and based in Tchamba, has extensive experience drilling deep borehole wells throughout Togo and regionally in Burkina Faso, Benin, and Nigeria.

Sagbadai Clinic Borehole Project - TogoProject Impact
3,800 people will benefit from the project.

Project Administration
This project will be managed by Anne Jeton, hydrologist and Returned Peace Corps Volunteer (RPCV), Burkina Faso (’82-’85) and Returned Peace Corps Response Volunteer (RPCRV), Togo (’16 -’17).

Anne was sent to Togo on behalf of Water Charity to develop and administer new projects, and to coordinate with the Peace Corps.

Monitoring and Maintenance
Along with staff from the Department of Hydraulics and Sanitation who will monitor the well “indefinitely” (the well data becomes part of the official borehole well database, and as such is included in periodic field monitoring by technicians based in each Prefecture ), the contract for well drilling states a one-year guarantee provided by the drilling company. Problems with pump and borehole functioning are typically resolved in the first month of use.

Proper screening of the borehole and submersible pump placement relative to the static water table often mitigates the most common problems. However, any mechanical problems surfacing in the first year will be the responsibility of the drilling company. The clinic staff will be responsible for maintaining a well repair account which will be funded from the sale of medicines. The clinic will decide a nominal fee for water use should the water account be insufficient, or the community will be asked to contribute directly to the costs.

The PCV near the site will monitor construction and do periodic evaluations.

Project Funding
This project has been funded by an anonymous donor.

Sagbadai Clinic Borehole Project - Togo   Sagbadai Clinic Borehole Project - Togo

Conclusion of Sagbadai Clinic Borehole Project – TogoWater from the new well.
The percentage of the total population in the Tchaoudjo District (which includes Sagbadai clinic) with access to potable water is estimated to be 35 percent. In the Centrale region as a whole, only 41% of the population is estimated to have potable water hence the need is immense. The current Togo water assistance program in Togo chooses to focus on village-level health care clinics with the intention of addressing both a health care need and to provide potable water to the surrounding neighborhoods during months of water scarcity.

The maternity delivery room was equipped with a sink, faucet and running, potable water, and through additional outside funding; a floor drain and a discharge chamber, both plumbed to a dedicated subsurface cement-lined and ventilated septic tank. Delivery room waste (blood and tissue) can now be dispensed with directly in the maternity room in a safe and hygienic manner, rather than hand-carried by the midwives to an outdoor pit or in many cases poured into the latrines.

The Togolese Ministry of Health’s regional office compiled a list of community health clinics in critical need of water for each of the four districts within the Central Region. These community health clinics are run by the Ministry of Health and are the first rung of health care services designed for rural communities, known locally as a Unité Soins Périphérique or “USP” (hereafter refers to as “ health clinic”) typically staffed with a salaried licensed nurse and midwife. Other personnel at the clinic often include a midwife assistant, a “pharmacist” i.e. someone who dispenses medicines with the supervision of the head nurse, and a community member trained in basic accounting skills to manage the clinic account. The clinic typically cares for a range of illnesses, most prominently malaria, gastro-intestinal and respiratory ailments, and surficial infections; childhood malnutrition and maternal care. However, providing women with maternity care, pre and post-birth, was the primary reason for their establishment several decades ago and has since been the main emphasis of these rural clinics.

Drilling the well.The scope of the current Water Charity assistance program managed by the in-country coordinator is to meet this water scarcity by installing deep borehole wells and a water distribution system to provide yearlong, potable water to both the clinic and the surrounding community. By maintaining appropriate hygiene in the clinic facilitated by indoor plumbing and uncontaminated water, the presence of pathogens should be reduced. Indoor plumbing will also alleviate the burden on both the clinic staff in general and in particular the mid-wives who typically operate under severe and very unhygienic conditions. Additionally, the added burden imposed on the female relatives of the expectant mother to fetch water from the open, unpotable clinic well (during the rainy season) or further to distant sources during the dry season will be eliminated. The health clinic borehole well program uses the term “borehole” to refer to the mechanical insertion of a vertical pipe (or casing) with a modern, mechanized drilling rig, to depths typically between 60 and 100 meters to reach water-filled fractures, and not a hand-drilled borehole used in some countries with shallower depth to the water table.

Initial site assessment of a designated health clinic (including Sagbadai) was carried out by the Department of Hydraulics hydrologist and the Water Charity coordinator where the following information was collected to determine the feasibility of a borehole well distribution system, in consultation with both clinic staff and community leaders:

–        Date of construction of the clinic and by whom.
–        Assessment of the water system currently at the site, date of installation and by whom, maintenance history if any, and subsequent modifications to the original system.
–        The current power source (solar, electricity, generator).
–        Staff positions and numbers funded by the community.
–        Assessment of clinic infrastructure (building, indoor/outdoor plumbing, septic, presence and or condition of latrines)
–        Frequency of patients and type of illnesses treated, number of births per month, community training (for example family planning, STD, HIV, maternal-child nutrition)
–        Community oversight by leaders – community development organization, village heads and religious leaders (Imams).
–        Financial soundness of the clinic insofar as the ability to provide maintenance and upkeep and to pay for fuel to run the generator for those clinics without power, or for the later, to make a regular payment to prevent disruptions of service.

Community meeting.All of the health clinics visited were in critical need of water however given the limitations in funding, final determination of a project site were based on several factors including the motivation of the clinic staff to responsibly managed the borehole well water system to ensure future repairs, the community leaders to contribute building material and labor during well implementation, the presence of an established water committee to manage community access to the well during months of water scarcity, viability of the clinic itself i.e. frequency of clinic visits, and financial means (and willingness) to create a separate well repair account.

Sagbadai met the project criteria discussed above, particularly given the water shortages in the neighborhoods surrounding the health clinic.  The purpose of the borehole well project at the Sagbadai health clinic was to address both a shortage of year-round water and unpotable water at the clinic, to provide running water to the clinic, and to make available to the community on an as specified basis, water during times of scarcity.

The scope of the borehole project entailed drilling a 64-meter borehole well, properly “developed” using modern technology and equipment; equipping the borehole with an electric submersible pump, constructing a 4.5-meter high cement block water tower topped with a 2,000-liter polyethylene water tank, installing a gas-powered generator as no electric power is available in village, outdoor water access points (faucets next to the clinic), a water access point on the water tower for community members, and the servicing of the well to the indoor plumbing.

Work in progress.WORK ACCOMPLISHED (progression of work through each stage)
1) Site assessment of the existing water system. Community meetings with village leaders, community development members, and the health clinic staff to discuss the feasibility of project relative to the community contribution (labor, housing for drill crew and building material for the cement water tower. In addition, the financial strength of the clinic budget was assessed and the motivation of the clinic staff to maintain the well system in constant working order. Discussed the ability of the clinic staff to repair/replace indoor plumbing necessary as the project limits its scope to the borehole well, water tower, power source and plumbing for both outside and indoor access. The clinic was notified of its responsibility to repair or replace indoor plumbing and hardware as needed prior to the completion of the project.

2) A geophysical field study lead by a Togolese firm (overseen by the drilling contractor) was implemented to determine borehole drill placement using the electric resistivity method to locate deep-seated water-filled fractures (or fissures). Based on prior hydrogeological investigations characterizing the Centrale region groundwater as contained within fracture-filled, borehole placement was identified based on geophysical indicators of a known fracture-filled water aquifer (defined as a “saturated permeable geologic unit that can transmit significant quantities of water under ordinary hydraulic gradients” [Freeze and Cherry, 1979. Groundwater p.47].

3) A local Togolese drilling company based in Tchamba with extensive experience was hired to oversee the borehole well water system for the Sagbadai health clinic. The Department of Hydraulics Director prepared a contract stipulating the conditions, responsibilities, and timelines for the project. A borehole drilling machine was brought to the clinic and the borehole site prepared for drilling. The community provided a secure building for equipment storage and housing for the drill crew. A borehole well was drilled using an industry-standard rotary drilling machine attached to a flatbed truck which accomplishes two tasks; using rotation, a drill bit cuts away at the bedrock while PVC drill pipes are lowered progressively into the drilled or vertical “borehole”, in this case using compressed air. The well was drilled to a depth of 64 meters, through the lateritic overburden into the crystalline bedrock. Material brought to the surface during drilling was identified to assist the driller and hydrogeologist in classifying the geologic formations within the borehole (figure 1). The geophysical study also helped to identity shallower, less desirable groundwater intrusions which were sealed from entering the borehole. The aquifer tapped by the borehole water is a confined aquifer ( where there an impermeable layer above the aquifer thereby allowing groundwater in a borehole well to rise above the aquifer). The static water table (the water table before pumping) was at 9 meters, while the dynamic water table ( the water table during pumping at the desired yield) was at 19 meters. The well was screened (slits cut into the casing thus allowing groundwater to enter the borehole) between 56 and 59 meters.

The storage tank.4) An electric submersible pump was inserted at 34 meters and a pump test initiated to determine the well’s productivity. Essentially the pump is run for several hours at a rate similar to actual pumpage use, the declining water table is measured at regular intervals and the return flow to the initially measured water table provides information on the transmissivity of groundwater through the subsurface material i.e. how rapidly the well recovers from pumping. Once a well is free of any accumulated fines, it can be properly evaluated for the amount of water it will yield. The well at Sagbadai Clinic was drilled to a depth of 26 meters and produced an average water yield of 2,600 liters/hour which is more than adequate to supply not only the clinic and the surrounding households. The pump test also indicates a rapid refilling of the borehole after pump use. Simply put, the hydraulic conditions of the well are favorable to ensure sustainable water supply.

5) Water samples from both the borehole well and the original clinic well were taken and sent to the Regional laboratory in Sokodé, the regional capital, for a complete microbial and inorganic compound analyses. The results of this analysis indicate zero presence of any of the disease-causing bacteria tested (E Coli, Salmonella, Fecal Streptococci, Enterococci and a general category of thermotolerant Coliforms) in the new borehole well. This is in sharp contrast to the water sample from the existing open well where all classes of the above-listed bacteria were present and in concentrations in the 100’s of counts per milliliter. The international standard is 0/ ml. Of the inorganic elements tested (elements found in the bedrock, or soil in the case of the shallow well, and nitrate which is a product of fertilizer use and sewage/septic leakage ) both samples were within acceptable levels. The Sagbadai open well, a typical shallow well common throughout the region is very probably representative of many communal wells.

6) Construction of 4.5-meter high cement block water tower equipped with a 2,000 liters polyethylene water tank. The community contributed sand, gravel, and labor in manufacturing the cement bricks needed for constructing the water tower.

A village meeting.7) Piping installed from the borehole well to the water tank and from the tank to both the outdoor faucets and the intake valve to the building allows for a gravity-fed routing of water powered by a gas generator as there is no electricity at the clinic. Additional water spigots were installed at head height on the water tower to allow the community members (women) to fill their basins directly without having to lift heavy basins of water as is the case with hand pumps. The clinic staff replaced worn faucets and indoor plumbing as needed prior to the opening.

8) Numerous visits were made during the well installation by the Coordinator and the government hydrologist to ensure the clinic and community leaders understood the responsibilities associated with maintaining and ensuring sustainable water supply. A final visit by the Regional Director of hydraulics insured the borehole well and the associated delivery system met all of the driller’s contract requirements and functionality.

9) An official technical opening concluded the project with a presentation by driller on the borehole well components, brief discourses by the Department of Hydraulics Regional Director, the village head, a member of the community development committee, and some of the clinic staff. As the representative for Water Charity and its donor(s), the Coordinator reinforced previously discussed themes of maintenance and upkeep through the active participation of a community water committee and a clinic repair account, managing public access to the well in a non-disruptive manner to the clinic staff and patients, and most importantly to take ownership of this valuable resource.

Fresh, clean water.Monitoring
The Department of Hydraulics will assume monitoring of the borehole well from a maintenance perspective for an indefinite period. The Department has on its staff personnel trained to work with community water committees and clinic staff. The contract states a one-year guarantee for the submersible well. Any technical problems that arise with the initial use will be addressed by the drilling company. The clinic staff does not foresee a need for the community to access the well water until later in the year when the local wells begin to dry up ( anywhere from December onwards ). While there has been much discussion around the issue of how the clinic will manage community access to the well, it remains to be seen how this will play out. The well is primarily for the clinic however, in water-scarce communities, water sources are shared.

Given the well is powered by a gas generator that the clinic is responsible for running and maintaining in constant working order, the clinic will collect a nominal fee from the users to be deposited in a separate account. The Sagbadai clinic serves a population of approximately 3,800 people, including the neighboring villages. In terms of those households accessing the clinic well for personal use, approximately 150 people live near the clinic and will probably access the well. This number could increase to several hundred people at the peak of the dry season, and possibly many more depending on functionality of other wells. The clinic anticipates seeing a rise in births at the clinic now that there is running water and female relatives are no longer obliged to fetch water for the patient – not to mention the overall hygiene. The clinic will use access to potable water to encourage better overall hygiene given most of the disease-causing bacteria in the community water sources are due to fecal transmission by both animals and humans.

ConclusionThe finished well.
The Regional Director of the Department of Hydraulics stated in his technical report ( information provided in this report on borehole characteristics and figure 1) the following: “ The political view of the government of Togo states shallow wells on the order of 7 to 25 meters are considered unhygienic and unpotable. The subsurface zone at this depth receives only infiltrated water directly from the surface of water that flows laterally into this zone from contaminated sources (other wells, wastewater, septics, streams). Deep borehole wells reaching uncontaminated water is the only acceptable water for our population”. In this light, the Sagbadai health clinic borehole well water system has fully succeeded in meeting both the local and national objectives for potable water. The community of Sagbadai offers its sincere thanks and gratitude to the donor(s) for this valuable water resource. As they here “ l’eau est la vie”. Water is life, and the cleaner the water the longer and more satisfying than life will be! Un grand merci!