Tough life in Kampala's slums

We began Friday by meeting with officials from the Kampala Capital City Authority and the National Water and Sewerage Corporation. They gave some interesting presentations which were useful in setting the scene for our visit to Kampala's slums. It was strange sitting round a board table with people smartly dressed in suits thinking about the awful conditions of the slums we were shortly to experience.

Kampala City covers 200km2 with a population of 1.5 million. This population can double in the day whilst commuters have travelled into the city to work. 60% of people live in informal settlements in an area which is not big but is very dense at 400 people per hectare. 70% of people are tenants in rented accommodation.

Kampala Capital City Authority are responsible for providing safe water and sanitation to city communities. They are working on increasing the sanitation and safe water coverage and providing more free public toilets. 84% of households have access to a toilet, however many of these are vastly inadequate, unhygienic, and padlocked by local caretakers a large proportion of the time. Only 6% of the city has a proper piped sewerage system. The remaining raw sewage runs down open drains, or worse still in some areas, just down the street. The frequent floods make an already bad situation a lot worse.



The new expensive out of town malls have free toilets, yet in the downtown malls which local people are more likely to use, people have to pay to use the toilet ( if they can afford it). The city Authority have plans to increase the number of free public toilets from 15 to 23 - a pitifully small number compared to the population of 1.5 million.



WaterAid have formed a partnership with Kampala Capital City Authority and the National Water and Sewerage Corporation, and together they have formed the Kampala Water and Sanitation Forum. The Forum are working with communities, institutions and schools to improve water, sanitation and hygiene services in the city. For example by working with schools to build new latrines and set up children's health clubs to educate them about hygiene.

The Forum is a great example of WaterAid's important role in advocacy and partnership building. The Exec Director of the City Authority explained that the city's water and sanitation situation has progressed well with WaterAid's support, however there are still huge challenges and there's long way to go. Sludge management is an issue, and many schools have huge queues for the toilets in the morning as many children do not have toilets in their homes. With Kampala's population growing at 80% a year (many people moving from western Uganda) it's hard to imagine how the huge water and sanitation issues in the city can ever be solved. Improvements will just have to be made gradually over a long period of time.

The representative from the National Water and Sewerage Corporation explained that they try to provide a socially responsible and equitable service, carrying out social mapping to establish where the urban poor stay. Their main way of providing safe water to communities is through pre-paid water meters. The meters take tokens which people pay to charge with credit from vendors in the community. The Corporation have installed 130 meters in partnership with WaterAid and plan to install 3000 more meters over the next couple of years. They cost $1000US each to install so this is a huge expense, but is great for the communities as they don't pay for the connection.

The tariff for water from the pre-paid meters in the urban slums is 25 Ugandan Shillings to fill a 20 litre jerry can, which is about 5 pence. This is supposed to be an affordable price for everyone, but with large families who need to drink, wash and cook, the money is still difficult for some to find. Families have to be very careful with their water - they certainly don't use 120 litres a day which is the average per capita we use in the UK. I can understand why the Corporation have to charge for water, and appreciate that it's a very small charge. However it's sad that the very poor still have no choice but to use untreated unsafe water from the free taps in the slums, leading to the spread of illness and disease. Some families have private water pumps installed if they can afford it, which their neighbours then pay to use. This disparity is understandable but still seems very unfair.

The slum area was even more of a terrible sight due to the deep floods which had quickly developed from the terrential rainfall the previous night. These floods happen often and I was shocked and saddened to learn that a young mother lost her life in the flood water that morning near to where we were. Fortunately, the baby she was carrying survived after being rescued. I couldn't help but wonder who was going to care for this small helpless baby with no mother, and how the whole thing could have been prevented with proper infrastructure.



I was surprised when we entered the back streets of the slums that everyone was so welcoming. I smiled at people trudging through the muddy polluted alleyways and learning in doorways of shacks, and was so pleased when they smiled back. Then more than ever, I appreciated the international language of the smile and how it crosses nationalities, languages, cultures, and religions.

We walked through the slums trying to take it all in - the narrow streets between dilapidated concrete and corrugated iron shacks; the polluted muddy water running through household rubbish; and the children and ducklings playing in the dirty water and sludge.



Our guides from Kampala Capital City Authority, the National Water and Sewerage Corporation and a local priest took us through the slums to show us the various water supply options for communities. One area had just one spring to supply hundreds of families with unsafe water contaminated by faecal matter (poo). It looked clear, masking the dangers lurking in the water waiting to attack its many consumers. These included children in a nearby nursery school. Unsuspecting kids happily played in the waste water as it trickled down from the dirty pipe. Us supporters all felt very sad to know they would probably become ill from this.



Other areas had the pre-paid water meters we'd heard about earlier in the day. I met 65 year old Willy, who is a caretaker for one of the water meters. The meter is located in an open area outside his house and he keeps an eye on it, helps people use it and calls the maintenance team if there are any issues. Willy has 5 children aged 20-35 and 8 grandchildren some of whom live with him. I felt really uplifted to hear how proud he was of the water meter and of his role as caretaker. He explained that previously he had to walk 3 km to the dirty water spring we'd seen earlier, and now he can access clean water right outside his house for a small fee. He is really happy to save loads of time and for his family's health to be so much better. WaterAid and their partners rely on positive community leaders like Willy to make their projects a success. I left the slums with a mixture of sadness but also hope that improvements are being made and the problems will be solved - it will just take a long time.



Our day was not over yet, as in the evening we were treated to a brilliant traditional dancing show at a local cultural centre. I felt so lucky to be able to see and hear the fabulous dancers and their music and join in dancing at the end, but also guilty that I was enjoying myself after others we'd met earlier in the day have so much hardship.

Soroti to Kampala via the source of the Nile

After the excitement of World Toilet Day on Wednesday, we had a much more relaxed day on Thursday, making the 6 hour journey from Soroti back to Kampala. We were very fortunate to be able to squeeze in a very enjoyable 1 1/2 hour boat ride along the River Nile to its source.



The Nile is the longest river in the world, travelling 6696km from the source at the White Nile in Uganda to the Nile Delta in Egypt. The Nile's powerful waters pass through 4 countries - Uganda, South Sudan, Sudan and Egypt. The Ugandan guide assured us that the genuine source of the Nile is where we were near Jinga, where Lake Victoria meets the River Nile, despite claims from some that the source is instead in Kenya. I was interested to discover that Mahatma Ghandi's ashes were scattered in the Nile just where we were, as he'd often enjoyed visiting there.



It was a fun boat trip with lots of wonderful bird life to observe, as well as velvet monkeys on the shore. I was surprised to see one of the most inaccessible toilets I've ever seen, located on the end of a small island in the middle of the Nile with the door opening into the river! There was also a very bizarre souvenir shop with the Nile waters lapping inside it.



Whilst travelling along in our jeep, I pondered about water being life, not only for us humans but for all animal and plant life on Earth. Onto the hustle and bustle of Kampala, I tried not to feel apprehensive about our next day visiting the urban slums.

World Toilet Day celebrations

19 November is World Toilet Day and we were extremely fortunate to be able to join in with the Ugandan national celebrations in Amuria District. As this was after seeing he shocking conditions at Amuria health centre, it proved to be another eye opening and pretty overwhelming day, both emotionally and physically draining.



First thing, we visited the District Local Government Office to meet the CEO and hear from the District Water Officer how Amuria District has become the most improved district in Uganda in terms of sanitation. Pit latrine coverage was 38% in 2011 and in just 3 years this has increased to around 75-80%. Amuria District has benefited from some money from the Global Sanitation Fund as well as support from WaterAid.

This impressive improvement in sanitation has mainly been achieved through the District Water Officer and WaterAid staff educating and encouraging villagers to build their own pit latrines. In some cases this has also been done through coercion by making those who don't build them them help others who are old or disabled. Apparently this forces them into building their own latrines when they return home.

Whilst positive, these generalised statistics of district averages mask the disparities between communities. Some harder to reach communities have only have 20% coverage of latrines whilst others have much more. Also, the quality of the latrines varies along with hygiene levels. WaterAid plan to produce a map of Uganda to highlight the pockets of poor latrine levels so they can see where to concentrate their efforts.

Our visit to Amuria primary school began with a lovely welcome song by the children and a speech by the headmaster. We were then taken on a tour of the latrines which would had been fine had there been more of them, and had they had hand washing facilities near by. With 850 children at the school and only a few blocks of latrines there are 53 children per toilet which can cause queues, and maintenance and cleaning issues.

I was surprised when we entered one of the classrooms that 114 children looked up at us, crammed along benches so tight I wondered how they'd got in there and how they'd ever get out, especially if there was a fire. I was very impressed that the one enthusiastic teacher was teaching English to 114 very attentive children, all of whose names she seemed to remember.



I really enjoyed chatting with the very bright 13 year old Martha, Mary and Keren and 12 year old Joan in the kids health club. Their role is to teach the younger kids about the importance of hygiene. I asked if they teach their parents at home too and they laughed and replied yes, they did. It was so refreshing to be able to discuss menstruation with girls of that age - I can't imagine being able to chat with girls that easily at home about issues like that.



Onto the Ugandan national World Toilet Day celebrations with over 1000 people, including 3 government ministers, also held at Amuria Primary School. A fun afternoon of really lovely poems, plays, singing and dancing, all about toilets and hygiene, by the children. I was so impressed with their confidence, intelligence and talent. We were also treated to an energetic performance of traditional dancing.

It was great to hear all the thank yous and 'you are most welcome's from various dignatories and local leaders. Although fascinating, the speeches went on 2 hours longer than planned (something we've come to expect in Uganda) which was rather tiring in the intense heat. The Minister for Health gave a very long but interesting speech, highlighting the links between sanitation and health. A big part of the Ugandan health budget is being spent on preventable sanitation related diseases. Water, sanitation and hygiene are essential in combating dysentery, typhoid, scabies, cholera, and dealing with HIV. Also solving education and inequality problems.

It was in this heat that I suddenly found myself dressed in a full plastic toilet costume in front of over 1000 people! Caroline from WaterAid UK and Barry, one of the other volunteers, gave some amazing speeches and I posed smiling dressed as a toilet to illustrate their points and provide some fun. Caroline had to explain what I was as I was dressed as a western style toilet and many of the people in the audience would only have seen a squat latrine style toilet. I was rather overwhelmed by the popularity of the toilet costume as I was surrounded by photographers from Ugandan TV, newspapers, other organisations and individuals. I guess that was my 15 minutes of fame!



The villages and schools in the Amuria district seem so peaceful and the people positive and relaxed, I have to keep reminding myself that the whole area was a battlefield in 2003 with many local people beaten and killed. They are very resilient people in so many ways and I really admire them for that.

Big challenges at Amuria Health Centre

Yesterday proved to be another eye opening and pretty overwhelming day, both emotionally and physically draining. It was a bizarre day of contrasts and mixed emotions as we got an insight into the shocking conditions at a local Ugandan health centre in the morning, and then celebrated World Toilet Day at a huge national event in the afternoon.

The most shocking and eye opening part of my trip so far was visiting Amuria Health Centre. I've visited several developing countries before and have seen real poverty but nothing could have prepared me for the sights at the health centre.

Although positive in that people do have somewhere to go for treatment when they are sick, ill or pregnant, the conditions at the hospital were truly awful. The health centre manager, doctor and midwife, Claudia, are very strong, positive people to be admired for the incredible work which they do with very little resources. It is great that the health centre helped fund medical training for their one doctor, however he, one midwife and a few nurses and support staff have to deal with the 24,000 patients who visit the health centre each year! These wonderful hard working people are very proud of their health centre, despite its problems.

We walked (accompanied by a stray chicken) through the crowded maternity ward where sick and recovering mothers lay. There were only 14 beds so many mothers lay on thin mattresses or simple mats on the floor. They all shared their beds with their tiny new babies as there were no cots. I felt overcome with sadness for these poor ladies who were feeling exhausted and ill after recovering from a Caesarian or suffering from malaria. All us supporters were fighting tears back.

The midwife explained that they have on average 160 births at the hospital a month, despite the maximum capacity being 130 a month. This means that they are often sent home early before they are fully recovered. There is one old ambulance but most heavily pregnant women have to walk or cycle to the hospital to give birth from their remote rural locations up to 30 kilometres away. Then back home again after. The only available painkillers whilst they give birth are paracetamol.



There is no incinerator at the health centre, no laundry and no kitchen. We were shown the placenta pit - this was a rancid concrete deep pit which the placentas are thrown into. It's assumed that they just degrade and seep into the soil in there.

Patients wash and dry their clothes outside. I assume with no laundry the same happens with the sheets. I can only imagine what bugs are lurking on the bed clothes ready to spread disease and cause infections. I will look with new eyes at UK hospitals with their comfy beds, nice clean sheets, plentiful toilets, sinks and hand sanitiser stations when I return.

I went to see the latrines and was horrified to see that many of them are filling up. As they are old style latrines which cannot be emptied the health centre will have to try to find the money to build new ones. Us volunteers all helped to scrub the exterior floors of the centre with disinfectant but it felt futile when there are so many other problems there.

WaterAid are planning on working with Amuria health centre and partners to improve the water, sanitation and hygiene there. They hope to then use the health centre as a good practice model to improve other health facilities. This is really encouraging news and accentuates the importance of the work of WaterAid in improving water, sanitation not only for homes and schools, but also health facilities.

I left the health centre feeling very sad and incredibly humbled by these wonderful people who work so hard with huge effort and a kind heart to help those in such need. I also felt so impressed by the positive uncomplaining attitude of the patients who are so grateful for what they've got. It's going to make me much less tolerant of British people complaining about the NHS. We should appreciate what we've got, and realise we're extremely lucky.

What a difference taps and toilets can make!

Wow, what an inspiring day! Despite another very early start, my excitement in anticipating meeting more lovely people and hearing their stories gave me huge amounts of energy. After a dusty drive of an hour we arrived in the friendly village of Bogol of 83 households. This is a community which had a new water pump installed with help from WaterAid and partners 2 1/2 years ago. And what a difference it's made to the lives of the people living there!

Like yesterday we spent most of the day with a local family, helping them with their typical daily activities. Our family of 14 members were a father, Osuban Glasio aged 63, and a mother, Lucy Alayo 56, with 10 children aged 10 to 26, plus a grandmother and her sister. Two of their daughters, Robin 24, and Mary19, acted as our interpreters. They could not have made us feel more welcome and very much treated us as part of their family. We helped weed their cassavas with hoes, collect sweet potatoes, prepare bean leaves and ground nuts for lunch, wash dishes and spent time chatting with them about their lives. I really admired their hard work, enthusiasm, strong sense of family values and community spirit.



Their appreciation and thankfulness to WaterAid and partners for installing their new pump and for our role with WaterAid was so uplifting. Before the water pump their had to walk a round trip of 2 hours to an unclean spring carrying heavy jerry cans 3 times a day. They were sick often with diarrhoea, other illnesses and some member of their community even died.



Since the pump was installed they save over 5 hours a day which they can spend caring for their family, crops, animals, travelling to market and going to school. They are also a lot healthier and therefore happier too. You could actually feel the positivity radiating around the people gathering by the water pump to collect their water and meet us.

The family's latrine was so clean, with a smart 'tipi-tap' constructed outside for hand washing, I quite enjoyed using it, and didn't miss my western style toilet at all!



We shared a delicious breakfast of sweet potatoes and fresh warm milk just milked from their cow, and later a lunch with cassava, bean leaves in a ground nut sauce, (and a freshly slaughtered chicken for the non-vegetarians).



We enjoyed ourselves so much, I felt really sad to leave. Before we did we were presented with a kind and generous gift of a bag of ground nuts each, and took some lovely photos with the family.



In the afternoon we were greeted with an enormous amount of enthusiasm from the wonderful children at Wera Primary School. There are over 800 pupils and 14 teachers at the school and it felt like they all ran out of the buildings to greet us at once when we arrived! The children sang us a lovely welcome song and we sat to listen to a prayer, plus speeches by the headteacher and chair of the Parent Teacher Association. I felt overwhelmed by emotion when 2 children performed poems about clean water, and HIV sanitation with real feeling. Another song, and then suddenly to my surprise we were all up dancing!



I was really impressed by the latrines installed in partnership with WaterAid, including one with disabled access. Colourful murals by the children with hygiene education messages were really eye catching. We watched the children do drawings with hygiene messages, and the girls make sanitary towels out of reused pieces of materials. The awareness level about sanitation and hygiene was outstanding. It's great that both girls and boys seem comfortable talking about menstruation - somewhat of a taboo subject in most of the world.



Today has been such an amazing positive, first hand experience of how WaterAid, their partners and supporter's make a huge difference to many communities, schools, families and individuals' lives. It's a privilege to have been able to experience this and it has made me feel even surer of the importance of my ambassador role for WaterAid.

Family life in Ojolai

After a very early start from Soroti we drove 2 hours through a beautiful sunrise along dusty red roads, bumpy dirt tracks, then thick tall vegetation, to arrive in the small rural village of Ojolai. It really seemed like this pretty village of 588 people living in very simple dwellings was in the middle of no where. This very rural location and poor access, coupled with a very low water table, are some of the reasons why Ojolai does not yet have a clean drinking water supply.

After a quick authentic African toilet stop in one of the community's very simple but clean pit latrines (along with fierce gang of resident wasps) we were introduced to our fantastic interpreters and guides for the day. Paul and Evelyn were bright and charming and took our group of 3 WaterAid supporters to meet our host family for the day. Although just packed down soil, the family's compound area was so clean and well swept.

Our wonderful host family of 6 were very welcoming and seemed genuinely pleased to meet us. A smile and a quick 'yoga' (meaning 'hi') was the perfect greeting. Paul, the father, had just returned from weeding his cassava crop with a hoe, and Aguti Agnes, the mother was breast feeding her 18 month old twins, a girl called Acen Robin and a boy called Opio Brian. Their 4 year old son, Opongo Calvin, was hiding from us as he was scared, and their 8 year old daughter Apedo Machret was at school.

The first task we helped the family with was to collect cow dung, add water, mix it, and smear it round the base of the family's pit latrine. Women do this every 3 months to strengthen the building. I felt silly using gloves when Aguti Agnes didn't and the family and several onlookers thought it was hilarious to see us visitors obviously using bad technique to do an easy job!

I must admit that seeing the water source that this and 113 other households depend on was a shock. The interpreters used the word 'well' so in my head I'd pictured a neat round brick well. Instead, it was a dirty murky looking pool of water surrounded by sticks to stop livestock drinking from it. Most definitely not a clean water source and the reason why many of the local children often suffer from diarrhoea. Aguti Agnes walks, often carrying her twins, half a kilometre 6 times a day with heavy Jerry cans to collect this unclean water for drinking, cooking, washing and cleaning.

The family's next activity was not easy to watch - the slaughter, plucking and preparation of a chicken for lunch. Hard for us to see but real life for these families. I wonder how many people in the UK would still eat meat if they had to slaughter and prepare it themselves? Cooking of the chicken, beans, cassava and a green leafy veg, took place in one of the simple mud brick, thatched huts in metal pans over a very hot fire, with smoke stinging our eyes.


Off to another further unclean water source, I had a go at carrying a big water container on my head. My neck ached after less than 5 minutes and I resorted to carrying the heavy container by hand, whilst walking behind the family's 17 year old niece who had no problems balancing a larger container on her head for about a kilometre. We were shocked to hear that in the dry season these two water sources dry up and the community have to walk almost 3 kilometres to a borehole to get water.

We showed the family our postcards and photos we'd bought from the UK. Our postcards of the Queen were particularly popular. We sat and shared our packed lunches with the family, and others who joined us, and they shared their lunch with us. The family's old aunt was particularly taken by us, asking us to sit closer and telling us via the interpreter that 'we're all human'. After some thank yous and good byes we were sad to leave our lovely hosts, touched by how friendly, welcoming and generous the family and community had been to us, and how content they are with their lives.

Next, we visited Ojolai Primary School, and were warmly greeted by a beautiful welcome song by the children. Amazingly this school of 301 pupils and 7 teachers was set up 18 months ago with no permanent classrooms, changing rooms or staff room and only 2 simple pit latrines. The biggest issue is that there is no water source so he children have to bring water from home (collected from the dirty water sources) which often runs out by lunchtime, leaving them thirsty.

The headmaster, chair of the Parent Teacher's Association and sub-county chief all welcomed us. They had never had such a big group of white people visit before and the children were fascinated by us, some of them having never seen someone with white skin before. We helped sweep the school yard and planted some trees, which the children will care for. It was lovely of them to name a mango tree 'Sophie' when they planted it! The kids also loved playing football and doing the Hokey Cokey with some of the other supporters!

All in all, a wonderful, inspiring and touching day. It was hard to leave but fantastic to know that these hard working, positive people are trying to change their community for the better for future generations, and that WaterAid Uganda are planning to help them to do this by enabling a safe healthy water supply to be installed.

From Kampala to Soroti

After a smooth 8 hour flight from Heathrow to Entebbe airport on Saturday, with Ebola checks on arrival, and a 1 hour bus journey on a bus called 'Faith in God Enterprises Limited' with dodgy headlights, we were greeted at our hotel in Kampala in the early hours. A much needed and appreciated sleep, hot shower and great breakfast later, we had the delight of meeting he wonderful WaterAid Uganda staff who will be accompanying us during the next week.

We spent most of today (Sunday) on a fascinating drive through the urban sprawl of Kampala, red dusty streets of Jinga and Mbale at the foot of Mount Elgon, and the rural potholed roads through lush green vegetation and agricultural land. Jinga has a huge hydro-electric power station which powers most of Uganda. We may have more toilets in the UK but the Ugandans have the edge on us in terms of energy self-sufficiency! The people are welcoming and friendly here with kids waving at us whilst drove past. We had quite a crowd watching when our drivers had to change a flat tyre on one of our jeeps!

The journey gave an interesting moving picture of life by the roadside. What I found really amazing was the vast number of marketing signs and murals for huge western companies like Coca-cola, Pepsi and soaps made by Unilever. Coca cola's catch phrase painted on walls here is 'open happiness'! I feel that people's happiness and health would be so much more improved by clean drinking water and a safe place to the toilet rather than a bottle of Coca-cola!

I have decided to take photos of all the toilets I go to in Uganda so I can do a sort of 'bog blog'! So far, these have been clean western style flushing toilets with toilet roll, taps and soap. I feel very lucky but spoilt so far as this is a lot better than most local people here experience. I know that not all the toilets will be like this.

We had a fascinating briefing this evening from the WaterAid Uganda staff on our amazing week ahead. Tomorrow sounds brilliant as we are spending the day in small groups with families in Ojolai village, in the Keriau sub-county in Amuria district. This is a community which do not yet have access to clean water and sanitation but where WaterAid and their local partners are planning on working in future. We will help the families with whatever they usually do, which could be collecting water, gardening, cooking, ploughing the land, milking cows, etc.

So, time for some sleep before my 4.45am alarm and a big day tomorrow...

Big day tomorrow!

So, the big day is tomorrow! A 6am start from home near Brighton to travel to Heathrow airport to meet my lovely fellow WaterAid ambassadors. A straight through 8 hour flight to Kampala and our adventures in Uganda begin!

I'm feeling excited and am really looking forward to the trip but with a little bit of apprehension too. I'm sure it's going to be a brilliant experience but also tough at times. I'm expecting to feel inspired, uplifted and amazed but also sad, humbled and guilty too. Energised at some times and exhausted at others.

I've been reading about water and sanitation issues in Uganda. I'm amazed that almost two thirds of the population in Uganda (24 million people) lacks a safe place to go to the toilet. A quarter of people don't have access to safe water (9.2 million people). Over 12,000 children die every year from diarrhoea caused by unsafe water and poor sanitation in Uganda. It's hard to comprehend such huge figures.

WaterAid has been working in Uganda for 30 years focussing on the 9 districts where people are most in need. Last year WaterAid reached 65,000 people with safe water and 102,000 people with improved sanitation. To date WaterAid have helped 920,000 people access safe water, and improved sanitation and hygiene education in Uganda. This is so encouraging and I am really looking forward to meeting some of the people whose lives have been transformed by WaterAid's work. There is so much more great work for WaterAid and their supporters to do.

Time to go and finish my packing and get some sleep before the amazing but challenging week ahead!...