Innovative Solution

Health-wholeness, WASH, interactive-communication, MICAH

educational

Broadening conceptual frontiers of WASH entails looking beyond hydrological and biomedical dimensions and up-scaling the stakeholder base.  Health and Wholeness is a mandatory foundation course at Uganda Christian University for all first year students, to introduce basic concepts of health. Three of the 13 units are centered on WASH.  It was a dynamic response to the high incidences of health complications that could be avoided through improved knowledge, practices and attitudes. Uganda is still far from reaching the Millennium Development Goal 7 target 10; which focuses on increased access to safe drinking water and sanitation.

Despite the fact that over 75% of Uganda’s disease burden is considered to be preventable (GOU-UNICEF 2006-2010), a number of communities in Uganda are still vulnerable to WASH related hazards. For instance, studies indicate that although latrine coverage is around 56%, open-defecation is widespread, even in homes with latrines. Related disease transmission impacts a big section of Ugandans, particularly infants and young children. In this particular initiative, attention is focused on the multidimensionality of factors and relationship that people have with their physical, social and cultural environment.  Addressing these factors through knowledge transfer and dialogue could reduce communities’ vulnerability to health related complications.

The rationale is that as consumers of water, University students need to develop a deeper understanding of linkages between water, sanitation, hygiene, eco-system and food security. Not only are students potential parents (heads of families), but they are also tomorrows practitioners, policy/decision makers, health promoters, advocates, managers of companies, opinion leaders and company/organizational executives. Besides, in many parts of the country, university students/graduates are considered to be informed opinion leaders particularly by the youths. Their counsel and wisdom is taken seriously. Equipping them with the right information/materials and appropriate communication skills could have a multiplier effect on their home communities. The course is facilitated by a multidisciplinary team of lecturers from faculties of; Health/Environmental sciences, Mass-communication, law, business, education and others.

The University is a federal one with main campus in central Uganda (urban) and others in the south-west, North and East (upcountry with rural catchments). The temperatures range between 21 to 29°C, peaking in December and February. April to May and October to November are rainy seasons. The country has many freshwater bodies, lakes, rivers and wetlands.

The project was initiated by the University Senate and approved by the University Council. Being church founded, the administration upholds the concept of community service within and outside the university community. The intensity of diseases associated with unsafe water and poor sanitation systems (diagnosed at the university health centres) ignited the need for awareness initiatives. It was realised that no amount of medical intervention could alleviate these problems without social interventions (awareness drives to change behavior and practices).

The main actors in the implementations were tutorial assistants (recent graduates of the university) supervised and coordinated by lecturers. The short generation gaps between them and students facilitated effective communication and dialogue on issues of water, sanitation and health. A department (Foundations Courses) was established to coordinate all the core mandatory courses. The inter-disciplinary nature of the content and variety of facilitators make the course practical and lively; introducing new perspectives beyond the core courses and adding meaning to student’s world.

The curriculum and the learning experiences are fully developed; occasionally reviewed and revised regularly. There is a fully fledged department and permanent staffing portfolios. The best students in the faculties are retained to serve in the department for 2 years. 

Arising out of the project, students have initiated 2 initiatives, aimed at creating awareness on health issues among communities within and outside the university. They also provide practical remedies to issues that could be addresses through behavioral change.  One of the initiatives is known as UCU HIV/AIDS initiative (focused on sexual behavior change). The other one which is more central water and sanitation is MICAH (Mission for Civic Awareness and health).   During every university recess periods, these MICAH members conduct community outreach in specified communities; raising awareness about health issues and offering practical remedies to the communities. The campaigns are conducted using culturally appropriate approaches and dialoging in local languages. Given that facilitators come from various faculties, they address health issues using multidisciplinary approaches. 

The central project question is: how appropriately could institutions of higher learning respond to WASH challenges within communities?   

The project creates potential advocates, policy makers, legislators, lobbyists, lawyers and other professionals to address the diverse issues and challenges of WASH through knowledge transfer and dialogue. The projects promote within the target participants a better understanding of the linkages between water, sanitation, hygiene, food security and health. It is expected that after equipping the students with appropriate knowledge and communication skills, the knowledge will be transmitted to the various communities where they will work. They will also be in position to use their positions at the various places of work to champion, lobby, finance or advocate for positive legislation for improved water and sanitation to the communities.  The baseline principal promoted in the project is that communication on water and sanitation has to be interactive, addressing the local concerns and issues of the communities through mutual dialogue.

One of the key outputs is a critical mass of diverse professionals in the fields of health and environmental sciences, communication sciences, law, Business, social sciences, humanities engineering and education.    

Another output is effective university community service that rotates around students initiatives on health awareness. These initiatives include voluntary students-led campaigns within and outside the university community.   

Given that the programme has already been entrenched into the university curriculum and strategic plans, it is sustainable and can deliver tangible impacts in the long term.

One of the clearest indicator of success include the fact that on their own initiative, students have developed voluntary awareness campaigns to reach out to communities to share what they have so far attained during the course on Health and Wholeness. The number of students who are willing to enroll into the students led initiatives is also a mark of success of the project.

At the university, some activities which students used to engage in before the introduction of the course have become a taboo. These include taking non-treated/un boiled water, hand washing after toilet use, littering of materials in water drainage systems.

Another indicator of success is the articulation, during project proposal writing, about what the students plan to do to alleviate community health challenges their places of work and in their home areas. There are also informal reports from the communities in regard to the impacts of the student’s activities.

Some of the conventional (and quantitative) indicators include the score that students get from the coursework, assignments and examinations on water and sanitation issues.

Universities and other high institutions of learning in Uganda and East Africa could emulate this project . This would mean that all those graduates that are rolled out into the field of work after graduation could be champions, advocates, lobbyists, practitioners on issues of water and sanitation. Implementation could be made easy if most of the professions in various offices in companies and organisations are sympathetic to the cause of water and sanitation. Besides, a substantial number of households that are manned by the sensitized graduates would be assured of effective safe-water supply and good sanitation.

The programme could be disseminated through workshops, seminars and conferences attended by educational institutional administrators, executives of government and nongovernmental organisations, companies, international agencies, top executives of the Uganda National Council of Higher Education and coordinators inter-university council of East Africa. These two organisations have great influence on the direction of curriculum development and on the accreditation of programmes in higher education in Uganda and East Africa respectively.

The project could be promoted if companies, organisations, government and other big stakeholder came out to support it through giving awards to the best implementing institutions, the best performing students, the best projects and other excelling initiatives.

The media houses and other stakeholders should also be engaged in person-to- person interactions and through using interactive media such as Talk shows on radio FM and televisions. The media companies could support the initiative by allowing subsidized rates whenever there are related programmes on air. Other companies could also consider sponsors media programmes under the framework of corporate social responsibility. All these could be instrumental in getting the initiatives disseminated effectively.

Government and non-governmental organisations and companies could also extend offers to students who wish to do internship in their premises, if the students wished to implement WASH related projects. Other companies and organisations should sponsor research projects that are related to WASH

 Factors of success: for the programme to attain its desired objectives, the facilitators need to adopt innovative approaches of interacting with students such that the students enjoy the sessions and get ready to apply the ideas in their daily life experiences. There is a strong likelihood that students may treat the course like any other which they have to pass to get their degrees. In such cases, they commit everything to memory and wait to reproduce the materials when writing examinations or tests.  

University lecturers are used to the typical lecture methods of course delivery and many of them are not professionally prepared to teach. This therefore calls for preparatory courses on pedagogy. Facilitators need to engage the participants in dialogue to derive feedback from the participants. Discussions of water and sanitations should be lively and two way; because the issues in debate are the common features of everyday life. The participants are well positioned to contribute to the discussions by citing practical examples. With time, the discussions are recorded and they become part of the learning experiences for the subsequent classes.

Minimum investments :

Funds to organise workshops and training sessions for the facilitators in the following activities: Content development, production of instructional resources such as visual aids, orientation of the facilitators,  evaluation and assessment of programme effectiveness,  reviews, revision and modification of the curriculum and instructional resources materials,

 production of the instructional resources, field trips to monitor progress of students-initiated and students-led projects, payment and upkeep of the instructors, developing demonstration units for water treatment and sewage management, transport costs for the trips that enable students to visit treatment plants and other water plants.

Infrastructure: ideally, there should be some form of water treatment plants within or near the university. Alternatively, there is need for transport to existing plants and places considered to have best practices and worst scenarios with regard to WASH development.   In absence of either the internal infrastructure or regular transport facilities to other places, illustrations could be captured on audio-visual facilities so that they are screened whenever need arises. Nonetheless, once in a while trip visits are imperative because visual aids may not capture some of the vital aspects like smell, taste, feeling, etc.

Time investments; in many universities, time has already been allocated to activities that are considered vital and inevitable in the academic operation of universities. Squeezing space and time to slot in a new course becomes a very big challenge particularly when the top administrations are not sympathetic to the cause of water and sanitation. The lecturers may also look at the programme as an extra burdensome load beyond their normal schedules. The students on their part may look at new additions with dismay; preferring to have an easy load that they feel comfortable with. The preliminary activity therefore should be an advocacy campaign to bring all stakeholders on board.

Space: conducting foundation courses which accommodate many students require very big halls and effective audio-visual systems. It also requires many break-away rooms for tutorials and small interactive sessions. Each of these rooms need to have adequate instructional facilities and where possible, audio-visual systems.

None at this stage.

 Frederick Kakembo (PhD) Associate Dean School of Research and Graduate Studies; Uganda Christian University; Uganda East Africa, www.ucu.ac.ug; P.O Box 4 Mukono 

Tel 256-41-4290828; 256-31-2350800; Fax 256-41-4290800; cell-phone 256-752-770808

Email fkakembo@ucu.ac.ug; fredkakembo@gmail.com; fredkakembo@yahoo.co.uk