Working incrementally at a health facility

Nearly 900 million people globally access medical care at health centers which that do not have clean water, increasing the risk of infections.

That was the case with the clinic in Osedzi. The local government initially provided the clinic with a manual borehole with a hand pump.

With that installation, the clinic had clean water, but health care personnel had to fetch buckets of water from the pump and fill larger containers within the clinic to use while they treated patients. “There was a lot of going back and forth,” says Eric Defor, a member of the Rotary Club of Accra-Osu RE.

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With that in mind, the partnership made a second improvement – providing an overhead water storage tank and mechanized the borehole so that water could flow through pipes into the clinic. Energy costs were also factored into the solution.

“If you use electricity, it’s going to be expensive. So we decided to make it solar, so the operating costs could not be too much,” says Kwabena Nkrumah, a member of the Rotary host committee overseeing the partnership program in Ghana.

“Now, we don’t suffer too much. We can now access water directly inside the facility, and we don’t use our energy to pump the water,” says Victoria Biney, a midwife in charge of the community health center who previously had to leave a patient to go fetch water.
The Rotary-USAID contributions, says Defor, have “substantially increased” the clinic’s ability to treat patients.

The challenge of sustainability of such a system depends on securing budgetary support from local government, according to Rockson Dutenya, a WASH advocacy consultant working on behalf of the Rotary-USAID partnership.

“Water at health facilities is very essential, so we need to have a maintenance system to sustain the supply the water. There has to be an arrangement between the health directorate that oversees the health facility–be it a chief’s compound, a health center or a regional hospital–so that they can set aside some funds to maintain the facility when it breaks down,” Dutenya says.

There was a broader lesson learned in the 2019 WASH Sustainability Index retrospective  assessment of the pilot phase projects. It found that manual boreholes with hand pumps were most successful in remote rural areas where there were no other options for safe water. People in peri-urban communities value mechanized boreholes and reticulated systems and are willing to pay to maintain them, making them more sustainable than hand pumps.