Kenya – Kisumu set to run prepaid water trial
Kisumu set to run prepaid water trial, Nov. 10, 2009.
Consumers in Kisumu town and its environs may soon be able to pay for the commodity in advance as the first prepaid billing system in the sector comes under pilot in a year’s time.
Under the system meant to curb payment default and ease administration costs, residents will purchase water to the value of cards that will be loaded onto their prepaid meters.
Water is sold in the town at Sh50 for 1000 litres of water and consumers will be able to buy prepaid cards based on their estimated consumption.
The managing director of the Lake Victoria Water Services Board Michael Ochieng’ said that the service would be rolled out in some estates in the town on a pilot basis.
Other areas that are targeted during this initial rollout include the middle class sections of the town and water kiosks in informal settlements.
“We will use this to gauge the response before scaling up the service to the rest of the town,” Mr Ochieng’ said.
Illegal connections
The prepaid service, which will be managed by the town’s water service provider, Kisumu Water and Sewerage Company (KIWASCO), is expected to be rolled out after the town’s water supply is stabilised.
He said he expected the company to “double profits within a year of introducing the system.”
It will be introduced under the second phase of the Sh3 billion Kisumu Water Supply and Sanitation Project funded by the French Development Agency that kicks off at the beginning of next year. The component that will introduce the prepaid water payment system will cost Sh50 million.
The project, as well a series of other interventions, is intended to increase water supply to 92 million litres by 2012.
KIWASCO managing director David Onyango said that at present, water supply in Kisumu is 23 million litres against a demand of 50 million litres.
In addition, an estimated 60 per cent of the water that is released from the water treatment plant cannot be accounted for due to leaks and illegal connections.
The company is in talks with mobile money transfer service providers to facilitate payments through mobile phones.
The company is also planning to introduce e-billing to inject efficiency into the system and boost revenue collection.
Voice of America – Harnessing waste for cooking in Kibera
The scourge of so-called “flying toilets” – where human waste is put into a plastic bag and tossed into the air, landing on roads or in gutters – has plagued the slums of Kenya’s capital Nairobi for decades. But an innovative project in the slum of Kibera has dramatically cut down on the problem by converting human waste into gas that can be used to fuel cookers and other devices.
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| Roseline Amondi cooks githeri at the community kitchen powered by gas from the community toilet in Kibera, Kenya |
Roseline Amondi is cooking up a storm. Today’s menu for the tiny restaurant she runs is githeri, a traditional dish consisting of beans and maize.
Amondi cooks every day in this community kitchen. She will then take the food back to her kiosk to sell to her customers. She says the community stove saves her a lot of money that she would otherwise spend on charcoal or wood.
“Before the gas started working, I was using almost 100 or 200 [shillings] per day for cooking any meal in the house, but right now, it is only 10 bob [shillings] per meal,” she said. “It is very cheap. If I cook two different types of food, I may use only 30 shillings for the whole day. That is wonderful.”
The gas that Amondi uses comes from an unlikely source, the community toilet. This is a rare sight in Kibera, where up to 200 people can share a single latrine in neighborhoods that have no electricity or running water.
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| The TOSHA community toilets in Kibera slum |
The toilet and kitchen are run by a coalition of five community groups calling themselves TOSHA (Total Sanitation and Hygiene Access). “Tosha” also means “enough” in the national language Ki’Swahili.
Some 600 people a day use the toilets for a small fee.
The human waste is transported via pipes into an underground tank, where it is converted into bio-gas.
The gas is then piped up to the community kitchen, where members can use the stove for pennies per pot.
Groups often rent out the facility’s top floor for meetings and functions. TOSHA earns some $400 each month renting out the facility, the community kitchen and use of the toilets.
Aidah Binale is a coordinator with Umande Trust, a development group that partnered with TOSHA to formulate the project.
She says it was difficult at first for community members to accept the gas.
“People will have the idea of, ‘Ah, no, I can’t cook from there, it is from [human] waste.’ Right now we are still trying to capacity build, we are trying to tell them [there is] nothing wrong,” she explained. “We get to have more visitors from different countries coming to visit us. We make sure that when they come to the office, we tell them, ‘Let’s go down there and have tea.’ So when the community comes and sees us drinking tea, they are thinking, ‘Ah, this is a foreigner taking tea. These people are taking tea, we can also cook.’”
Running water and sanitation facilities are virtually non-existent in slums like Kibera, where most people earn less than $1 a day. Human waste in plastic bags is often dumped on roads, alleys and gutters.
But locals say there has been a dramatic reduction in these so-called “flying toilets” since the bio-gas center was constructed two years ago.
Roseline Amondi is also secretary of TOSHA.
“At the time we were using flying toilets, there were so many diseases around us like cholera,” she noted. “Once an outbreak of cholera occurs, we are the sufferer. Many of us died, some got into the hospitals. But right now, for the last three months, there was an outbreak [of cholera] within Nairobi, but we were safe because of the bio-center.”
Project supporters say the TOSHA Bio-Gas Centre is a model for communities everywhere, especially those dealing with power shortages.
Paul Muchire, communication manager with Umande Trust.
“We have the problem of [supplying enough] energy. Poverty levels are going up. Sanitation is a problem in the developing world. We have the issue of pollution from the oil and diesel. There is need to go into other sources of energy, adapt other sources of energy that would be environmentally friendly,” he said.
Muchire says there are about 10 bio-gas centers in Kibera under construction and that an engineer is looking at how the gas can be piped into peoples’ homes.
Source – http://www.voanews.com/english/2009-11-07-voa17.cfm
ISUH – Nairobi Statement on Urbanization & Health
International Society for Urban Health
8th International Conference for Urban Health
Urban Health Champions Forum
October 19, 2009
THE NAIROBI STATEMENT ON URBANIZATION AND HEALTH
WE, THE SIGNATORIES OF THE NAIROBI STATEMENT ON URBANIZATION AND HEALTH AND WELL BEING DECLARE THE FOLLOWING:
We Urge Recognition of the Facts of Urbanization:
- Over half the world’s population live in cities
- Urbanization is a reality facing all countries
- Between now and 2050, 3 billion people will settle primarily in cities, a fact that demands planning and action now to assure urban health and well being
- The majority of urban residents in developing countries live in informal settlements where they lack proper housing, water, sanitation, garbage disposal, security, schooling, and health services.
We Recognize the Benefits of Urbanization
- People move to urban areas largely to improve their lives and economic opportunities and urban residents often provide important support to their rural home economies as a result.
- Formal and informal economic contributions of the urban poor are often critical to overall economic development of cities and nations
- Urban settings can improve access to health services, education, and social and cultural opportunities and, when growth is effectively managed , cities can be part of the solution and not just part of the problem in national growth.
- If well managed, cities can be engines of development for national economies and centers of positive sociopolitical transformation
- The high population density in cities can facilitate delivery of development interventions to large numbers of people
We Acknowledge the Risks of Urbanization
- Countries that fail to plan for increasing urbanization place themselves and their citizens at serious health, economic, and security risk.
- The health of slum dwellers is typically well below that in other urban and rural areas, even when stratified by poverty level. These inequities are also observed in other critical development indicators like schooling and affect the health of the entire city.
- Settlements without legal status and services can become focal points for social tensions, conflict and illicit economic activity.
As Urban Health Champions, We commit to Promoting the Following Ideals to Improve Health Outcomes and Overall the Effectiveness of Cities and Major Urban Settlements in Our Countries:
- Effective, transparent, accountable, and proactive governance that is broadly inclusive is a critical factor in the growth of healthy cities.
- Solutions to urbanization should be developed within a framework that is inter-sectoral where governments work effectively in partnership with the public, organizations of civil society and the business community.
- Donor agencies and governments must include urban concerns in their strategies as adapted to country circumstances
- Interventions and programs to improve the functioning of urban areas and cities should be designed with equity consciousness to ensure that the most vulnerable urban dwellers have input to and benefit from the programs
- An urgent priority is the development of effective strategies that create incentives to health to address the challenges of slum settlements to ensure they are places where the informal sector to thrive, human needs are met, and people can live decent lives.
- Cities must integrate health and urban planning and begin planning for the growth of their cities now.
- Links between urban health, sustainable development, and MDG’s must be demonstrated to policy makers
- Cities should respond appropriately to climate change in the interest of protecting and promoting human health
Improved surveillance, evidence, and research from robust evaluations of interventions must be shared and used to identify best approaches for investing in healthy cities. - Increased capacity is needed to assure the availability of the expertise to provide health impact evaluation and monitoring.
Overall Commitment to the Nairobi Statement
- We commit to advancing the achievement of these Urban Health Champion Solutions through continued consultation, mutual learning and actions that promote development and evaluation of policies and programs that promote the health and well-being of all urban residents as a path to effective national economic and social development.
Pakistan – Children in city’s 2nd largest slum battling with diarrhoea
KARACHI: Viral diarrhoea has gripped the city’s second largest slum settlement, Machhar Colony and children are falling victim to this deadly disease.
The reasons for this outbreak include a lack of proper sanitation system, a huge open drain running in the centre of the colony and absence of clean potable water.
The health experts working in the colony have declared this an emergency situation and said if the government does not take any immediate safety measures, the condition could worsen. They also warned that the disease might spread in other parts of the city.
“Since last week, diarrhoea has become epidemic in the colony and children are dying,” said Dr Aisha Siddique, a young lady doctor at Mother and Child Heath Centre, which is run by a non profit and non government organisation Concern for Children Trust (CFC). She said that she receives 60 patients everyday, but since the spread of diarrhoea, the majority of the patients visiting the centre are children.
“A child in almost every home is suffering from diarrhoea in this colony, which has a population of about 0.7 million,” said Dr Siddique. She said that there are about 72 clinics working in different areas of the colony and almost every clinic is receiving large numbers of children with viral diarrhoea.
Located in the backwaters of Karachi Port, just off the edges of the Arabian Sea, Machhar Colony is the second largest slum settlement after Orangi Pilot Project and is home to approximately 0.7 million people of different ethnic backgrounds and nationalities including Biharis, Burmese, Bangladeshis, and Afghans. As the colony is illegal on government records, therefore it is suffering from a lack of basic facilities such as clean drinking water and proper sanitation.
“There is no water supply system in the colony, therefore the people get water from other localities through a network of plastic pipes, and you can see these pipes are spread amongst the garbage on the surface of the main sewerage drain passing from the middle of the colony, Dr Siddique explained. “Sometimes when the garbage catches fire, these pipes are burnt resulting in sewerage water getting mixed with drinking water causing the spread of diseases” She said that the practice is common in the colony, but the reasons for the diarrhoeal disease as well as its spread need to be ascertained through a study.
Official data from different international organisations reveals that in Pakistan, 38.5 million people lack accesses to safe drinking water, and 50.7 million lack access to improved sanitation, due to which 25 percent of the total hospital beds in Pakistan are occupied by the people suffering from waterborne diseases.
The study further reveals that diarrhoea is the leading cause of mortality and second leading cause of morbidity among children under five years of age.
“Due to poverty, there is almost one patient of tuberculosis in every house in the colony, besides this typhoid fever, viral fever and other diseases are also common, but this recent diarrhoeal epidemic could be very fatal if certain measures are not taken,” said Dr Siddique.
Water, Sanitation, and Hygiene Improvement Training Package
The USAID Hygiene Improvement Project has prepared a “Water, Sanitation, and Hygiene Improvement Training Package for the Prevention of Diarrheal Disease” which provides information for organizations worldwide that seek to add WASH activities to their current programs or to start a diarrhea reduction program. It is intended to support the training of local outreach workers and their work in communities to promote improved WASH practices to reduce diarrhea.
The Training Package consists of three separate parts:
(1) a step-by-step “Guide for Training Outreach Workers,”
(2) an “Outreach Worker’s Handbook” for community outreach workers to use during and after training, and
(3) a “Collection of Resource Materials” to use as a source for visual aids.
This WASH training package is available on CD and online at http://www.hip.watsan.net/page/3396.
To request free copies of the CD send an e-mail to hip@aed.org.
India – Health insurance for the urban poor
Experts meet to fine-tune insurance for the deprived
New Delhi – The Capital’s urban poor will soon be able to afford healthcare up to Rs 1.5 lakh without paying a paisa. Set up as a registered society, the Delhi Sanjeevni Trust met for the first time on Wednesday to work out the finer details of the programme.
The ambitious insurance scheme aims to enroll the entire city’s population — starting with BPL families — within the next six months.
To put together the best health insurance scheme for people from the Economically Weaker Sections, public health experts from all spheres have been brought together as trustees of the Board. They include specialists like Dr Srinath Reddy, President of Public Health Foundation of India, Dr Ajit Nagpal, Chairman of Batra Hospital, Som Mittal, President of The National Association of Software and Service Companies and Dr Shyama Nagarajan, health specialist with the World Bank.
“This is a welcome initiative from the Delhi government, which is trying to ensure that economic barriers do not distance people from the essential healthcare,” said Reddy.
“The objective is to facilitate universal healthcare though third party financing mechanism,” said Dr Nagpal. “We are aiming to provide insurance for the city’s population but will be starting with the BPL families first.”
The health department is currently working on a Cabinet note, which will be tabled at the forthcoming Cabinet meeting.
The trust — headed by a chief executive officer — is modelled on the Rajiv Arogyashri Health Insurance Scheme run by the Andhra Pradesh government. Under it, the BPL beneficiaries can be treated at hospitals without making any payment there for procedures covered under the scheme. The same is the case for diagnostics, if eventually the patient does not need surgery or therapy. Plus, the hospitals have to conduct at least one free medical camp a month, taking advanced evaluation to the doorstep of patient.
The Delhi government’s ambitious project to provide low-cost healthcare was put on hold in 2005 and 2007.
Seasonal pattern of pneumonia mortality among children in Nairobi’s informal settlements
Am J Trop Med Hyg. 2009 Nov;81(5):770-5.
Seasonal pattern of pneumonia mortality among under-five children in Nairobi’s informal settlements.
Ye Y, Zulu E, Mutisya M, Orindi B, Emina J, Kyobutungi C. African Population and Health Research CenterAPHRC, Nairobi, Kenya. yyazoume@aphrc.org
Using longitudinal data from the Nairobi Urban and Demographic Surveillance System (NUHDSS), we examined the seasonal pattern of pneumonia mortality among under-five children living in Nairobi’s slums. We included 17,787 under-five children resident in the NUHDSS from January 1, 2003 to December 31, 2005 in the analysis. Four hundred thirty-six deaths were observed and cause of death was ascertained by verbal autopsy for 377 of these deaths. Using Poisson regression, we modeled the quarterly mortality risk for pneumonia. The overall person-years (PYs) were 21,804 giving a mortality rate of 20.1 per 1,000 PYs in the study population.
Pneumonia was the leading cause of death contributing 25.7% of the total deaths. Pneumonia mortality was highest in the second quarter (risk ratio [RR] = 2.3, confidence interval [CI]: 1.2-4.2 compared with the fourth quarter). The study provides evidence that pneumonia-related mortality among under-fives in Nairobi’s slums is higher from April to June corresponding to the rainy season and the beginning of the cold season.
Is mortality among under-five children in Nairobi slums seasonal?
Trop Med Int Health. 2009 Nov 2.
Is mortality among under-five children in Nairobi slums seasonal?
Mutisya M, Orindi B, Emina J, Zulu E, Ye Y. African Population and Health Research Center, Nairobi, Kenya.
Objective: To investigate the seasonal pattern of overall mortality among children aged below 5 years living in two informal settlements in Nairobi City.
Methods: We used data collected from January 2003 to December 2005 in the Nairobi Urban Health and Demographic Surveillance System on demographic events (birth, death, and migration). Analyses of seasonal effects on under-five mortality are based on Poisson regression controlling for sex, age, study site and calendar year.
Results: During the study period, there were 17 878 children below 5 years in the study sites. Overall 436 under-five deaths were recorded. The overall death rate for the under-five children was 19.95 per 1 000 person years. There is a significant seasonal variation of under-five mortality. The mortality risk was significantly higher in the second and third quarters of year than in the fourth quarter (RR = 1.6, CI: 1.3-2.2 and RR = 1.5, CI: 1.1-2.0).
Conclusion: This paper demonstrates that overall mortality among under-five children in the urban poor is seasonal. Overall during the second quarter of the year, the death rate increases by nearly twofold. This evidence generated here may help to support well targeted interventions in reducing under-five mortality in the slums.
Kenya urban poor to get monthly pay
Needy Kenyans will soon get a monthly income to meet their basic needs in a programme similar to those carried out in welfare states.
However, before the programme dubbed Saidia Jamii (help the family) is rolled out, the government will first disburse Sh600 million to a group of vulnerable people living in the slums as a test project.
“The outcome of the pilot programme will inform the roll-out of Saidia Jamii programme in July 2010, Prime Minister Raila Odinga told journalists Wednesday at his Treasury office after receiving an interim report of a task force formed to come up with a food subsidy scheme to cushion the poor from increasing food prices and effects of famine.
The pilot programme, he said, will be implemented in three phases by the government and its development partners.
In the first phase, a group of 100,000 people drawn from 20,000 households in Mathare, Korogocho, Mukuru and Kibera slums in Nairobi will benefit.
“Each household will be receiving Sh1,500 per month delivered through mobile phone transfer and electronic card system,” the PM said.
The phase is expected to end in June next year.
The second phase of the programme, which will also end in June, Mr Odinga said, will be extended to Kisumu and Mombasa. This will be in the month of March next year.
In the two towns another 100 people, he added, will benefit before it extended to other parts of the country.
Beneficiaries of the project will be identified through community participation, said the PM.
The taskforce was formed in response to escalating food prices, which some of the poor cannot afford.
The entire Saidia Jamii programme, which the taskforce has developed, is aimed at protecting the vulnerable and poor households in urban and rural areas from the negative impacts of food insecurity.
Mr Odinga said the report will first be adopted by the Cabinet before it is taken to Parliament for debate.
If approved by Parliament, it will become law.
The Premier said that through the report, the government has emphasised its commitment to solving poverty across the country.
“A lot of emphasis has been put in the past to the rural poor, but we know that many Kenyans out there have difficulties in making ends meet. The urban poor, for instance, get seriously affected by fluctuations of food prices and need assistance,” Mr Odinga said.
He gave assurances that the programme would succeed.
The task force members, in their report, say that the government and its partners will first set up internal administrative mechanisms to deliver cash to the beneficiaries.
They will also test the design and implementation of a cash-transfer programme.
The programme will be evaluated, the report continues to say during a mid-term review planned for March next year.
Mr Odinga, however, pointed out that out of the Sh600 million 30 per cent of it will be used on administration.
Apart from the task force members, others present during the press briefing were ministers Dr Naomi Shaban (Special Programmes) and her Planning counterpart Wycliffe Oparanya.
Finance assistant minister Dr Oburu Oginga was also present as well as permanent secretaries Prof Karega Mutahi (Education) and Dr James Nyikal (Gender).
Siddharth Agarwal – Incrementalism in Addressing Challenges of Slums
Incrementalism in Addressing Challenges of Slums: Lessons from Urban Health Practice in India: Key Note Address, International Conference on Urban Health, October, 23, 2009.
Siddharth Agarwal, Urban Health Resource Centre (UHRC), India.
Link to presentaton – http://uhrc.in/name-CmodsDownload-index-req-getit-lid-124.html
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