ACF-France
WASH sector
Field visit report
Zimbabwe
February 2009
Date: 06 March 2009
From: Pierre-Yves ROCHAT, ACF, WASH Advisor / Paris
To:
Mission / Zimbabwe
Pool desk Zimbabwe / Paris
WASH sector / Paris
TABLE OF CONTENT
ACRONYMS / ABBREVIATIONS ............................................................................................................... 2
1
OBJECTIVES..................................................................................................................................... 2
1.1 General objective:.......................................................................................................................... 2
1.2 Specific objectives: ........................................................................................................................ 2
2
SCHEDULE & ACTIVITIES ............................................................................................................... 3
3
A3B .................................................................................................................................................... 4
3.1 Questions & Answers .................................................................................................................... 4
3.2 Recommandations ......................................................................................................................... 7
3.3 Action Points ................................................................................................................................ 12
4
EMERGENCY RESPONSE ............................................................................................................. 13
4.1 ACF strategy ................................................................................................................................ 13
4.2 WASH support to CTC ................................................................................................................ 14
4.3 PHHP ........................................................................................................................................... 16
4.4 Water points repairing ................................................................................................................. 17
4.5 Hygiene kits ................................................................................................................................. 18
4.6 SWOT analysis ............................................................................................................................ 19
4.7 Organization of the response and teams .................................................................................... 19
ANNEX
Annex 1
Annex 2
Annex 3
Annex 4
Annex 5
TOR
Minutes of meeting with MSF-B
SWOT Analysis of the ACF cholera interventions
Rope & washer pump (or Elephant pump) by Pump Aid / Zimbabwe
Various photos for the field visit
WASH Field visit report
1/20
Zimbabwe / Feb 09
ACRONYMS / ABBREVIATIONS
APR
Co
CTC
CTU
E
E-WASH Co
EHT
GI
HH
HOM
HP
HQ
INGO
IV
MoH
MoU
MvT
ORS
P Co
PDM
PHHP
PM
RRT
SWOT
TOR
VHW
VIDCO
WASH
WASH Co
WP
WPC
WS
WT
Zim
ZINWA
1
Activity Progress Report
Coordinator
Cholera Treatment Centre
Cholera Treatment Unit
Emergency
Emergency WASH Coordinator
Environmental Health Technician
Galvanized iron
Household
Head of Mission
Hygiene Promotion
Headquarter
International Non Governmental Organisation
Intravenous
Ministry of Health
Memorandum of Understanding
Mvuramanzi Trust
Oral Re hydration Salts
Program Coordinator
Post Distribution Monitoring
Participatory Health and Hygiene Promotion
Project Manager
Rapid Response Team
Strength, Weakness, Opportunity, Treat
Terms of reference
Village Health Worker
Village Development Committee
Water, Sanitation, Hygiene
WASH Coordinator
Water Point/s
Water point committee
Water & Sanitation (WatSan)
Water trucking
Zimbabwe
Zimbabwean National Water Authority
OBJECTIVES
1.1
General objective:
Understand the current WASH issues/challenges of the mission and advice on future
development
1.2
Specific objectives:


A3B



Where we stand?
Visit of projects/activities
Problems and recommendations
Emergency programs
 Where we stand?
 Visit of projects/activities
 SWOT analysis
 Problems and recommendations
WASH Field visit report
2/20
Zimbabwe / Feb 09

HR


2
Meeting/training with WASH staff (A3B + emergency) in Masvingo
Individual meeting with each key WASH staff (PM + co)

Meeting with some WASH partners:
 WASH Cluster coordinator
 ICRC
 MSF Luxemburg + Spain
 ZIMWA

Collection of data and documents to be used for the revised PAD in Paris (maps, pictures, files,
etc.)

Discussion about the 2010 strategy
SCHEDULE & ACTIVITIES
1
2
3
Day
Sun
Mon
Tue
Date
08/02/09
09/02/09
10/02/09
Location
Paris
Harare
Harare
Activities
Departure: 2315
Arrival: 1755
Briefing
Meeting with MSF-B
4
Wed
11/02/09
5
Thu
12/02/09
Harare Masvingo
Masvingo
Transfer
Meeting with A3B PM
Meeting with A3B team
Meeting with E-team
Meeting
with
A1H
evaluators
Field visit A3B (WASH
co)
Meeting with A3B PM
Field visit E-program
(CTC)
Field visit E-program
(CTC)
Transfer
Meeting with E-team
Meeting with MDM
6
7
Fri
Sat
13/02/09
14/02/09
Masvingo
Masvingo
8
Sun
15/02/09
Masvingo
9
Mon
16/02/09
Masvingo
Chipinge
-
10
Tue
17/02/09
Chipinge
11
Wed
18/02/09
Chipinge Harare
Field visit E-program
(CTC + PHHP)
Transfer
Meeting with ICRC
Harare
A1H evaluation
12
Thu
19/02/09
Meeting
Cluster
WASH Field visit report
3/20
with
WASH
Non-ACF interlocutors
MTV
Emergency
Co
/
Brussels
Francesca COLONI, WS Co /
Brussels
Eugene Epidemiologist / Zim
team
MSF-B
Souleymane SOW: Former
WASH Cluster Co
Joe DI GABRIELE & Alima
Anna, Medical Co, MDM
Sophie, Program Co, MDM
Sandra EIGENHEER FUST,
WatHab Engineer, ICRC
Joe
DI
GABRIELE,
Consultant
Ben HENSON, WASH cluster
Co, UNICEF
Zimbabwe / Feb 09
Debriefing
13
Fri
20/02/09
Harare
14
Sat
21/02/09
Paris
3
Meetings with ECHO
Debriefing
Departure: 1430
Arrival: 0600
Paul AJAY, Head of Project,
GAA
François GOEMANS, Head of
Office / Technical Expert,
ECHO
A3B
After re reading carefully the A3B proposal, the following questions have raised by the WASH Advisor.
Intensive discussions with A3B key staff and in particular the PM have allowed answers and
recommendations to be proposed.
3.1
Questions & Answers
1) Project documents
 Has the “field study on mainstreaming HIV/AIDS within ACF programs” been done
(from Jul to Nov 2006?)? If yes, what results and recommendations?
It seems that the study has been cancelled. The only reference document is “Water and
HIV: Working for positive solutions” which is available at the mission level. The mission
must reconsider whether such a study has to be carried out or whether existing
information can be collected among partners in Zimbabwe.
 Do we have “Zimbabwean standards for water quality”?
A3B PM has a copy.
 Do we have the national guidelines for water points?
A3B PM has a copy of the national guidelines for water points + manual for Bush
pumps + latrines + “Well Sinking guide” + Peter Morgan’s book (in Harare).
2) Purchases
 “Purchases of the whole necessary items must be done ASAP”. What has been
done/planned?
Order for training materiel (stationeries, food, etc.), order of 60% of the spare part (the
remaining 40% are part of the co funding) + order for tools kits have been placed.
No order for head works/upper ground masonry because it is budgeted on a co funding
budget which is not yet approved (see Recommendations: Admin issues).
3) Selection of beneficiaries
 What has been done?
Selection for water points in only one ward (where 8 C-Bush pumps have been
installed).
 How are the most vulnerable HH selected? (construction of 230 pit latrines)
MvT will do it (MvT has a tool for selecting vulnerable HH). MoU signed (to be
confirmed). MvT supposed to start in Feb (but has to be revised).
 How have HIV/AIDS people been identified?
Check and validate the MvT “tool”.
 Have schools and rural health centres been identified? (construction of 470 pit latrines +
access to safe drinking water)
In process (see below).
 How many schools + rural health centres are going to be targeted?
Get monthly data (of patients) over a year time. Produce graph and determine min, max
and average monthly patients. Select “your limit” and justify. Calculate daily visit (by
dividing by 30) and calculate the number of pit latrines to be built. Prioritize health
centres over schools in relation to the cholera crisis.
Chivi + Mberengwa: Mid-March (Chivi + Mberengwa data and report)
Gutu: End of April (Gutu data and report + finalize selection)
Start work in May.
4) Coverage
WASH Field visit report
4/20
Zimbabwe / Feb 09




How is the coverage calculated?
Population per village (given by Authority and confirmed at community level) + number
of WP (F&NF). In 12 out of 25 wards, existing and maximum potential coverage can be
calculated (without considering new WP). A base coverage can decided (60%?) and
define priority work and start implementation. Analysis & proposition for first rehab work
done by A3B PM by end of Feb. Validation Harare + Paris before communication and
implementation (see Recommendation: Rehabilitation of water points).
Can the expected coverage achievement (100%) be turned into how many water points
and latrines must be installed per ward?
See above.
Do we have the total number of water points per wards? Have they all been assessed?
12 out of 25 wards completed.
Do we have a mapping of the water points? Schools? Rural heath centres? Coverage?
No but a mapping officer must be recruited ASAP at Harare level. He/she will map A3B,
previous WASH projects (A1F + A1G + other ECHO projects if data are still available at
Harare level) + Emergency data.
5) KAP surveys
 Has KAP 1 been completed?
Ongoing: data collection will finish on 20/02/09. Final report expected by mid-Mach for
Chivi + Mberengwa. Gutu report by end of March + Final report covering all the 3
districts by the end of the first week of April. Validation Harare + Paris by mid-April.
 Are we still planning to conduct KAP 2 and 3?
KAP 2 & 3 have been cancelled.
 Have water analysis been done at HH level? If yes how much and what are the results?
Yes in the 12 completed wards. Represent results for E.Coli, type of storage containers
and lid or not + short interpretation. Work to be done by the M&E team. Validation A3B
PM + WASH Co and send results to Paris no later than final KAP survey report. In
addition, take pictures of water containers + devices for taking water out from the
storage containers and add them to the reports.
6) Alternative technologies + spare parts + water storage
 Has a mobile family latrine been developed by Mvuramanzi Trust?
No, we don’t know what it is. Ask MvT! But this activity is not important and can be
cancelled.
 Have rope pumps been installed/tested/monitored by ACF?
No. Selection of sites will start in May during the dry season and implementation will
follow until end of August. MoU has to be signed ASAP (see Recommendations:
Rehabilitation of water points).
 Is it realistic to plan manufacturing rope pumps at ward level (25 wards)? Won’t it be
better to have a more centralized production (198 rope pumps)?
Rope pumps are going to be produced and installed by Pump Aid. Pump Aid will advise
on manufacturing spares for the pumps (where? who? how?)
 Is it realistic to plan repairing/manufacturing B-Bush pumps spare parts at ward level?
Won’t it be better to have a more centralized approach?
A study will be launched. A TOR is going to be prepared and validated by end of Feb by
Harare and Paris. Methodology will be chosen according to expected outputs (done by
the mission? External consultant? Additional HR provided by HQ? Zimbabwean
student? Etc.). See Recommendations: Pumps spare parts components.
 The specific objective states that “water is properly stored”. What is done/going to be
done in relation with water storage?
Promotion of safe storage and practices during HP.
See what can be done to include distribution of water storage containers? (additional
budget related to cholera crisis ?). A possibility would be to prioritize the selection of the
A3B cholera affected wards for the distribution of the hygiene kits budgeted by ECHO
(A1I). Issue to be discussed between E-WASH Co, WASH Co and A3B PM.
7) Water points management
 What are the recommendations coming from the review of previous ECHO programs?
Report almost finalized.
WASH Field visit report
5/20
Zimbabwe / Feb 09




Does the “creation of an operation and maintenance fund” still be promoted?
Yes. Since 1st of Feb, some foreign currencies (Rand, USD, Pula and British Pound) are
authorized to be used as trading currency in Zimbabwe. The WPC fund can thus be
created with a “stable” currency which would allow savings over a long period of time.
What has been done regarding the creation of IGA related to water points
sustainability? What ideas and recommendations?
Baseline survey done and feasibility study will start in Feb in project areas according to
the agreed methodology: random selection of one WPC per VIDCO represented by 2
members (one male + one female), focal group discussions a ward level with VIDCO
members (separate discussions with females and males followed by a common
meeting). Since they are between 5 and 6 VIDCO per ward and 25 targeted wards, the
sampled WPC will represent at least 16% of the overall targeted WPC (800). The
sample size can thus be considered as representative. The purpose of such a feasibility
study is to get an idea of the possible IGA which could be proposed. Then the yearly
running cost (budget) of a WPC has to be established including all usual operation and
maintenance and savings for unusual expenses. In addition to that, the earning of the
committees members must be estimated (they must earn some money in order to
remain committed and dedicated). After estimating the targeted benefit (business plan)
which a given IGA must produce (in order to remain profitable and sustainable), each
IGA must be designed and sized accordingly. Each IGA will then need to be budgeted
(how much would it cost to the project to set up the identified activities?). To assess
feasibility, the cost estimates will then be compared to the available budget (260,000 €
= average of 2,600 € for each IGA but all IGA must not necessarily worth the same
amount). After the identification, cost estimation and distribution of the 100 IGA and
selection of the WPC (according to criteria combining motivation and geographic
distribution), implementation could start. The entire process prior to the establishment of
the first IGA is going to be quite long and the activity schedule must be revised
accordingly. It is expected with all the described steps and the description of the
proposed methodologies/approaches by end of March (for action: IGA supervisor)
See Recommendations: IGA component.
Is the proposed model for repairing water points still valid? (access to spare parts +
communication lines)
Can be revised after proposed study (see above)
What is the role of the local craftsperson (private sector)? Have they been identified and
trained?
Not clear yet. The role/existence of the craftsperson must be clarified after the study on
spare parts management and recycling.
8) Community based approach
 Is the list of local/community based stakeholders still valid?
Yes it is still valid, except for the “craftsperson” whom we are still designing TOR for.
 Is the proposed model for communication and capacity building of stakeholders still
valid?
Yes, but however there is need to reinforce the issue of reporting of WASH Activities by
the Ward Councillors to the District. The question is: Is it practical? How often are they
supposed to report & through which meetings (Full Council meetings or Committee
Meetings)? Is it the councillor who should write these reports or it’s the VHW/WPC?
 What is done/going to be done for improving/strengthening relationship between District
and local stakeholders?
By putting in place the communication link between the District Authorities & the Local
Stakeholders. How? Encouraging the Ward Councillors to get reports from the VHW
(Health & Hygiene Issues) & WPC (Water Supply Issues) & submitting them to the
district through Full Council Meetings. NB. This needs to be discussed with each district
& see how feasible it will be.
9) M&E

What has been/will be done by the M&E team?
They looked at the Log Frame & Programme Planning and from the Expected Results
checked for the existing Tools to measure these & established ones that were
outstanding. (See copy of Document representing this) Apart from this they also went
WASH Field visit report
6/20
Zimbabwe / Feb 09



through the existing tools & gave their comments. (In general they said that the existing
Technical tools are ok) The Team then carried the IGA Base Line Survey & Produced a
report which is almost being finalised. Following the M & E Standardisation workshop
held in Dec 2008 the team designed the M & E Plan & it has been submitted to the M &
E Advisor for comments & validation.
How does the M&E team interact with the other project teams?
M & E conduct regular Monitoring exercises in all the three field offices and produce
Monitoring/Analytical Reports for implementation/improvement of the Programme.
When ever there is any Survey/investigation to be done, M & E assist in the design of
the tools for the survey. E.g. they have assisted the IGA team in coming up with the
Feasibility Study Tools. In consultation with the technical members of the programme
the M & E team is expected to come up with the WASH A3B Data Base. The interaction
is a continuous process which is intended to improve the quality of the programme.
Please note that the incorporation of an M & E department in WASH Programme is the
1st of its kind in ACF Zimbabwe & we are learning as we go.
What is the indicator/s for measuring that “sanitation facilities are properly used”?
A3B PM proposes:
1. Utilisation – presence of fresh stool
2. Frequency of visits to the latrine
3. Existence of an opened up pathway (traffic of feet) leading to the latrine clearly
indicates that the toilet is being frequently used – this is measured by mere
observation.
And indicates that: the task of measuring this indicator can be assigned to the trained
Village Health workers.
Since the mentioned indicators are very difficult to assess and verify, it is rather
proposed to contact a survey based on the physical conditions of the latrines
(cleanness, presence of water for hand-washing, access, etc.) inspired form a sanitary
survey form.
How “domestic water quantity used by the people per day is significantly increased” is
going to be measured?
We are currently recording through the KAP 1 survey amounts of water used by the
sampled household per day (which can be calculated down to amount used by each
person per day by dividing the total qty by the average number people per HH). We will
then measure the degree increase in the qty of water used per person per day when we
have the results of KAP 2 survey.
10) Current cholera epidemic (from August 08 to ? 09)
 To what extend does the cholera crisis affect the project, its objectives and
methodologies?
The District Authorities involvement in the A3B programme is affected because some of
the members especially the EHTs will be concentrating on cholera response activities.
The CBOs sometimes take part in responding to the outbreak by recording information
on number of cases occurring in our area of operation & finding ways of transmitting the
information as soon as possible to the Office in Masvingo.
 What components of the project have to be revised regarding the cholera crisis?
In Chivi, 3 wards out of 5 are completed. The A3B Chivi team will be temporally re
affected to the repair of WP in cholera affected wards. After some time (to be defined
according to the epidemic evolution), the team will return to its assessment activities (in
the 2 remaining wards) and complete them.
 How HP can take cholera prevention into consideration?
A3B field staff (working in the 3 wards) has to be briefed and trained on key cholera
messages in order for them to be able to transmit the messages in their respective
working areas. Training has to be organized on the field together between A3B and
Emergency teams.
3.2
Recommandations
1) APR
WASH Field visit report
7/20
Zimbabwe / Feb 09
The existing APR tool isn’t useful neither for monitoring, nor for programming. It has to be redrafted
in order to be used as management tool at the mission level (field & capital) and a monitoring tool
which can reflect progresses or delays. It is recommended to:
- Have a similar APR for each of the 3 districts covered by the project which must be filled up
individually. By so doing, a forth APR representing the whole project (the addition of the 3
districts) must automatically be incremented.
- Redesign the APRs by considering the activities achieved up to date as a starting point. By so
doing, the APR will be reset and restart by considering the current state of implementation.
- Distribute the foreseen activities over the project schedule (as planned). In so doing, the APR
can be used as a planning tool which will record delays.
- Make sure that a total column appears in the front page which must only show the 2009
activities (without cliquing)
- Graphs and activities schedule can be neglected as they going to be removed in the revised
ARP format which is currently being worked on at Paris level.
- Propose first draft version to HoM and HQ in May (APR of April).
For Action: WASH Co + A3B PM
Deadline: Early May 2009
2) IGA component
With the implementation of 100 IGA over a 2 years period of time and a total budget of 260,000
Euros (excluding staff), the IGA component must be seen as a real sub-project of the project itself.
It requires specific skills in the fields of WASH, food security and finance/economics. In order to
achieve the ambitious objectives of the IGA component which aims at providing sustainable
solutions for WP maintenance (and which is now achievable thanks to the recent legalization of
some foreign currencies in Zimbabwe), it is recommended to:
- Conduct the feasibility study as discussed (see above) and draft the report (which must
includes the a methodology section)
For Action: IGA Officer
Deadline: Mid-March (submission of the report to WASH Co)
- Redraft the activities schedule until the end of the project (according to propositions made)
and shortly describe the methodology proposed to achieve each activity. Identify what
collaboration is required from the mission (FS, WASH, Log, etc.) and whether additional HR
support is needed. This paper must then be used as a guideline helping the sub-project
implementation. It must thus be presented to and validated by the Co Team. According to the
quality of the report and the recommendation provided, decisions are going to be made in terms
of the HR set-up related to the IGA component.
For Action: IGA Officer (after clear briefing from WASH Co)
Deadline: End of March (submission of the revised schedule and report to WASH Co)
3) Rehabilitation of water points
With the rehabilitation of 590 existing water points (+ the construction of 10 new boreholes), the
project is clearly ambitious. In order to achieve the expected results within the project timeframe, it
is recommended to:
- While finishing the technical assessments (in 13/25 wards), rehabilitation work must be
launched as soon as possible. A first selection of water points to be rehabilitated can thus be
made in the already assessed wards (12/25 wards). The selection will not identify the water
points based of 100% coverage but according to a lower limit (such as 60% or 70%). In so
doing, water points which will anyhow be part of the final selection can be identified and their
rehabilitation anticipated. The final selection will still be completed in June after finalizing the
technical assessments but it must not prevent the launching of the implementation phase.
- Make first selection of water points to be rehabilitated in the already assessed wards (in
particular in Mberengwa District where 7 out of 9 wards have been finalized).
For Action: A3B PM
Deadline: End of Feb (submission of the selected WP to WASH Co)
- Launch WP rehabilitation (in particular in Mberengwa District) and get organized accordingly
(procurement, contract, social mobilization, etc.)
For Action: A3B PM
Deadline: Early April (launching of the rehab phase)
- Finalize the selection of the WP (including the wells)
For Action: A3B PM
WASH Field visit report
8/20
Zimbabwe / Feb 09
Deadline: End of May 2009 (submission of the final list to WASH Co)
- The project aims as well at promoting innovative and low cost technologies through the
installation of 198 rope and washer pumps. This component of the project is important as well
since it represents 1/3 of the targeted WP and since it is for the mission (and ACF as a whole)
an opportunity to pilot such technologies at a broad scale. The identified partner Pump Aid
based in Mutare has been met and their workshop visited (see annex x). Since Pump Aid needs
3 months to be able to produce all the required pumps and since pumps must be installed
during the dry season (starting in July), a MoU between ACF and Pump Aid must be signed as
soon as possible. The MoU must clearly states the roles and responsibilities of each party and
includes a detailed activity schedule. It must be validated by the Co Team and HQ.
For Action: WASH Co (together with Admin Co)
Deadline 1: End of March (draft MoU sent to HQ)
Deadline 2: Mid-April (MoU signed)
4) Pumps spare parts component
The following recommendations have been made by the WASH advisor following his first visit to
Zimbabwe in Jan-Feb 2007: “Since the repair of hand pumps is no longer conducted by local
authorities but by private pump minders (who were though previously employed by the government)
and since the provision of spare parts has become a private business, the mission should see how
spares could be made available without profits. The main factory and local suppliers should be
approached in order to know prices and profits. A comprehensive approach should be adopted by
the main WS organizations regarding distribution of spare parts and tools. Contacts have to taken
with partners and propositions made”. In 2 years time, the mission has neither conducted a review
with its partners, nor defined any clear positioning regarding both the issues of spare parts
availability and the recycling of used spares. Since those points are crucial in term of sustainability
of the water points, it is recommended to:
- Consider both the availability of (new) spare parts at local level (village, VIDCO, ward, district)
and the recycling of used spares
- Draft a TOR which must define the scope of the review to be conducted and its methodology
(objectives, expected outputs, stakeholders to be met, etc.). In addition, propose a schedule
and list options for conducting the study (the mission itself, a student, a consultant, etc.)
For Action: WASH Co + A3B PM
Deadline: End of Feb (TOR sent to HQ)
5) Water point headworks and fence
The designs of the upper ground masonry and fence are inspired from technical guidelines issued
by UNICEF in the 90s. All water points rehabilitated by ACF are fenced either by diamond mesh,
barbed wires or wires and sticks. In order to propose the most suitable designs (in terms of price,
impact on the environment, sustainability, participation of the beneficiaries, etc.), it is recommended
to:
- Make a review among WASH national and international NGO of the technical options used
and recommended (nationwide and not only restricted to the ACF areas of implementation).
- Address both the issues of the size and the nature of the fence (what is minimum size
required? What are the different options for fencing?).
- Make a table of comparison between the different options and list the pros and cons (including
precise cost estimations)
- Consider in particular, the life fencing option which seems to be very promising. Indeed, it’s
clearly a transversal issue with the FS department (FS Co is willing to get involved), it seems
that the practice is used in villages (at least around fields or compounds), it seems sustainable
(in the contrary of any other fence options, life fences are prone to improve with time rather than
deteriorate), etc.
- Meet some key partners (including Plan International, Tree Africa and Environment Africa: the
2 last ones haves been recommended by Pump Aid) and draft first recommendations (if the
mission does not have the time or the means to contact a full review, TOR must thus be drafted
accordingly).
For Action: WASH Co + A3B PM
Deadline: End of March (First review report sent to HQ))
6) Response to the cholera crisis
WASH Field visit report
9/20
Zimbabwe / Feb 09
3 wards out of the 25 wards targeted by the project are currently affected by cholera. Since the
epidemic is nationwide and is a major “external event” occupying during the project implementation
period (like the 3 months suspension due to political unrests), it necessary for the project team to
reconsider its positioning. Since cholera is clearly a WASH related disease and since ACF mandate
is (first) to respond to emergencies, possible implication of the project regarding the crisis must be
identified. In addition, explanations from ACF are going to be legitimately requested by the donor:
What ACF has been doing in cholera affected wards? How this major sanitary crisis has affected
the project? It is thus recommended:
- The A3B project has 3 field teams based in each of the 3 targeted districts (Chivi, Mberengwa
and Gutu). The teams are currently finishing the technical assessments. Since Chivi is (among
the 3 districts) the most affected district, the teams must temporally stop its assessments (3/5
wards have already been completed) in order to start repairing WP. The assessments will then
be completed when cholera is not affecting the district any more (decision to be taken together
between WASH Co and E-WASH Co).
- The Chivi A3B team will first repair water points located in the project targeted wards (2, 4, 12,
18 & 20) but can be involved in other wards in regards to cholera cases. Quick and easy to
repair WP are going to be selected in priority in order to improve access to protected WP with
the greatest efficiency. In addition, it has been agreed that pumps spares and materiel (like
cement) are going to be provided to the A3B team by the E-program.
- The repaired WP which belongs to the A3B selection will be registered as such. The quick
repairs will only be considered as the first phase of the rehabilitation process. The remaining
work such as completing the head works or training the water committees will be done in a later
stage. In so doing, the expected results of the A3B are not changed but only the methodology
proposed to achieve them.
- The repaired WP which are not part of the A3B selection (either not selected or located in a
other ward) will only be registered by the E-program (A1I).
- All the field A3B teams must be briefed and trained on cholera issues by the E-team. It is first
important to make sure that a common understanding of the epidemic is shared by all the
teams. Secondly, any ACF teams and in particular WASH teams must be sensitized to the key
hygiene messages which must be promoted and to specific information which can be collected
in the field with population and authorities.
- It’s advised that A3B PM remains the only focal point for all A3B staff members even when
involved in cholera related activities. A3B PM will then liaise with the E-WASH Co and vice
versa.
For Action: E-WASH Co + WASH Co + A3B PM
Deadline: Late Feb (to launch WP repairing activities in Chivi District)
7) Admin issues
The 3 years project which started on 01/10/07 is almost halfway through. In terms of budget, the
A3B project is certainly one of the biggest ACF project with an overall budget of 3 569 890 €. 75%
of the total budget is already granted by the UE. Among the required co funding (25%), only 6.8%
(= 242 472€) is still missing (see here below table). ACF is currently looking for funding
opportunities and the mission will soon be advised by the Program Responsible, Anne Catherine
REA, who will conduct a field visit to Zimbabwe in April 09. In the meantime, the missing co funding
must not prevent the project to continue and be implemented (e.g. ordering only 60% of the pumps
and spare parts needed, not ordering materiel for head works, not hiring a staff, etc.). It is therefore
recommended to:
- If any doubts/questions, A3B PM must seek advice from WASH Co and Admin Co. In case of
remaining questions, the HQ and in particular the Financial Controller must be informed and
solutions provided.
- A3B PM and WASH Co must identify the key program related budget lines which can not be
used without formal approval of A3B PM. The list has to be provided to the Masvingo base
Administrator and Admin Co in order to avoid charging budget lines with spending not related to
the line headings (e.g. in Nov 08, 9 463 € have been charged on the line FA06 = IGA pilot
project without conducting any activity…).
For Action: A3B PM + WASH Co
Deadline: End of Feb
WASH Field visit report
10/20
Zimbabwe / Feb 09
2007
2008
2009
2010
O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S
Project
3 569 890 €
Donor Code
Funding
2 677 418 €
UE
A3B
€ granted
Feb 09
2 677 418
€
expected
0
75
300 000
150 000
150 000
0
892 472
350 000
300 000
242 472
25
9,8
8,4
6,8
%
Co funding
892 472 €
150 000 €
150 000 €
200 000 €
150 000 €
242 472 €
Multi
AEAG
AESN
ACF
I7A
Table: Funding and co funding of the A3B project
8) Log issues
In relation to the admin issues discussed above, it is recommended to:
- Plan orders based on the project needs/expected results rather than on the existing/approved
budget. Submit the needs to Admin Co and Log Co who will request HQ advices if needed. In
particular, since rehabilitation work must start early April, material for head works must be
ordered without delay.
For Action: A3B PM + WASH Co
Deadline: Mid- March (for head works materiel)
- Revise if necessary the order for pumps and spare parts. Since the procurement process is
already heavy and difficult, it’s much easier to order the total quantity of items rather than only
60%. If the A3B PM and WASH Co feel that it is comfortable to keep a flexibility, ACF can order
now 80% to 90% of the items and wait later for the rest. But if so, it has to be verified with Log
Department that procedures for the remaining 10% to 20% will be simplified.
For Action: A3B PM + WASH Co
Deadline: End of Feb (for pumps and spare parts)
- The storage facilities in Masvingo and/or in the 3 Districts of implementation have to be
assessed in order to make sure that all the procured materiel and equipment can be properly
stored. Since the Masvingo warehouse is now full with the emergency stocks, new storage
capacities may be required.
For Action: A3B PM + WASH Co + Log Co
Deadline: Mid-March
9) Management
The A3B project must be considered by all management staff both at field and HQ level as a project
at risk. Despite the huge work already completed, such an observation can be explained by: a very
ambitious project, a “long” project (which tends to lower attention and visibility), a 3 months
suspension period (due to political unrest), a ongoing major cholera outbreak, co funding not yet
granted, a gap of WASH co, etc. All the mentioned factors result in significant delays
(implementation phase not launched, procurement not done, MoU with major partners not signed,
etc.) which endanger the project itself.
In order to avoid additional delays and risks, a special attention and support must be brought on the
project and its implementing team. It thus recommended:
- As a first priority, the WASH Co must appropriate the project in order to be able bring the expected
support to the PM. In order to do so in an efficient manner, the WASH Co must share her time
between Harare and Masvingo and devote at least half of her time specifically to the project.
- The Co team must as well demonstrate more concern and involvement in the project. To stimulate
interests and discussions, it is proposed that a monthly A3B meeting is organized in Harare with the
Co team. The meeting must be led by A3B PM and seeks to generate exchanges, resolve problems
and emphasize transversal issues. It must be well prepared and last at least an hour (10 minutes is
not enough!).
- The WASH Advisor will also be more implicated and ask for regular updates (at least twice a
month) from WASH Co.
- At HQ level, all the pool desk team will also be sensitized about the project (its risks, challenges
and opportunities) in order to provide better attention, advices and support to the mission. In that
regard, FS Advisor and Program Officer will visit the mission in April and will also advice on the
project.
WASH Field visit report
11/20
Zimbabwe / Feb 09
3.3
Action Points
Key action points for the 3 coming months are listed in the here above table.
x
x
x
x
x
x
x
x
x
x
x
x
x
12/20
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Revise IGA activity schedule & methodology
Draft first review related to WP head workds
x
and fences
List key program budget lines
x
Plan orders related to WP rehabilitation (in
x
particular head works)
Revise (if needed) order related to pumps and
x
spare parts
Assess storage capacities in Masvingo
x
Launch WP repairs in cholera affected wards
x
in Chivi District
x
WAS
H
x
FS C
o
x
Log
Co
x
x
Adm
in
x
HOM
x
x
Prog
ram
Offic
er
Advi
sor
IGA
Offic
er
x
E M L E M L E M L
x
Finalize KAP 1 survey report for all 3 Districts
Compile HH water analysis data
x
Draft MoU with Pump Aid
x
Sign MoU with Pump Aid
x
Draft TOR for review related to pump spare
x
parts
Propose new APR
Finalize IGA feasibility study and report
x
WASH Field visit report
Co
May
A3B
PM
Action Points
Select of rural health centres (+ schools) in
Chivi + Mberengwa
Select of rural health centres (+ schools) in
Gutu
Revise MvT MoU (?) and activity schedule
Validate MvT methodology for selecting the
vulnerable HH
Hire GIS officer
Select first WP to be rehabilitated in 12/25
wards
Finalize selection of all WP
Launch first WP rehabilitations
Finalize KAP 1 survey report for Chivi +
Mberengwa
Apr
WAS
H
Mar
Co
ACF involvement
Deadline
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Zimbabwe / Feb 09
4
4.1
EMERGENCY RESPONSE
ACF strategy
Since Late December, a clear strategy in response to the cholera outbreak has been drafted by the
Madrid E-pool WASH Advisor. It stats that in order to contribute to the reduction of mortality/morbidity
due to cholera, ACF interventions must aim at:
- improving access to sufficient quantity of safe water in CTC/CTU
- avoiding contamination at HH level
- improving access to safe water for the population.
From the expected results, the 4 main fields of activities have been defined and integrated in the
proposals submitted to UNICEF and ECHO:
- WASH support to CTC
- PHHP sessions
- Distribution of hygiene kits
- Repairing of water points
Lessons lernt / recommendations:
 Define a strategy and stick to it (unless it becomes not valid any more)
The ACF strategy has been defined late (it should have been drafted during the
preparedness phase of the A1H project or at the early stage of the epidemic) but has
proved to be valid for rural settings.
However, it has been difficult for ACF to stick to its strategy and defend/promote it. The
following factors can explain the ACF lack of confidence and “shyness”:
- A major crisis: the size of the crisis has exceeded all predictions and models.
None of the stakeholders have anticipated such an epidemic. The entire
humanitarian community (and the national Authorities) has been running
behind the epidemic since the beginning.
- A complex crisis: by starting in the urban context (Harare and Beitbridge) and
then spreading deep into the rural areas, the epidemic has been hard to follow
and understand. Contradictory messages have been issued by the different
actors and the WASH cluster has failed at defining priorities and providing clear
advices to field agencies.
- A Health and WASH crisis: cholera lies in between the Health and the WASH
sectors. Since the curative approach has been prioritized by focusing on
opening CTC and since ACF has never got (neither requested) a medical
expertise or support, the mission has not being participating to the main
debates for quite a time (until January). It’s only when the WASH issues have
been brought back on the table (after realizing that the epidemic was out of
control), that ACF has been able to demonstrate its self capacities and skills
(and not only be perceived as an implementing partner of MSF or UNICEF…).
- Lack preparedness, anticipation and reactivity: Despite the launching of
activities at an early stage of the epidemic (starting in November), ACF has
been running behind the crisis as all the others stakeholders. After realizing
that the provided responses were not adapted to the scope of the crisis, ACF
has taken a long time in getting back on track.
In conclusion, ACF must have been positioning itself with more strength, self-confidence
and independence. ACF must remember that one cholera case is already an epidemic and
that quick and large interventions must be launched in order to fight cholera.
 Distinguish rural and urban contexts
After meeting and discussing with some of the main WASH stakeholders (MSF-B, MDM,
GAA, the WASH cluster, ICRC or ECHO) it appears that the type of responses to cholera
may vary significantly if provided in a rural or an urban context.
Strategy
Activity
Improve
access to safe
water in CTC
Water
trucking
WASH Field visit report
Urban context
Rural context
Relevant when no other option
Pre-identify supply sources. While launching the WT activity, always define an
exit strategy and implement it as a priority.
13/20
Zimbabwe / Feb 09
and for the
population
Repairing
of/support to
water supply
network
Setting up of
water
network
Very relevant
But specific HR skills required (electro
mechanic, hydraulic, etc.)
Can be very relevant when an
existing borehole can be identified (in
peri urban context).
But prioritize existing networks.
Can be relevant in peri urban context.
Repairing of
boreholes
Drilling of
boreholes
Transporting
water with
donkey carts
HP sessions
Avoid
contamination
at HH level
Bucket
chlorination
Disinfection
at HH level
Not relevant
Not recommended to drill boreholes in the early stage of the emergency.
Boreholes can be drilled later but reliable companies must be pre-identified
during the preparedness phase.
Not relevant.
Very relevant because using local
means.
Very relevant but the methodology
has to be adapted to the urban
context. PHHP sessions are not
relevant. Rather prioritize house to
house visits and mass communication
(posters, radio, newspapers)
Can be very relevant in densely
populated area when the population
is getting water from boreholes or
public tabs. It seems however that the
activity has not been developed by
any WASH actors (?)
Can be very relevant when conducted
right after a patient has been admitted
in CTC (the same or next day). Has
been conducted by ICRC in Harare
(ask for lessons learnt!)
Can be relevant if
Distribution
of hygiene
kits
Improve
access to ORS
4.2
ORS corner
Can be very relevant when small
networks supply CTC/rural communities.
But has not been done by ACF and
other WASH actors (?) during the
current crisis.
Can be very relevant when an existing
borehole can be identified (install a sub
pump + generator + bladder + tabs)
But has not been done by ACF and
other WASH actors (?) during the
current crisis.
Very relevant activity
Conduct quick and easy repairs (when
possible) in order to reduce risk (using
the sanitary survey tool).
Can be very relevant in cholera
affected areas. But has to be put in
place in coordination with medical
actors (MoH and INGO).
Very relevant
Conduct PHHP sessions at ward/village
level.
Apply a coverage based approach (see
below).
Not very relevant when the population
density is low. Rather prioritize HH water
treatment with water purification tablets.
Not relevant because the disinfection
can not be done “on time” (always too
late).
Can be relevant but restrictive in terms
of feasibility (see bellow)
At an early stage, rather prioritize
distribution (and promotion) of water
purification tablets (Aquatabs)
Not relevant when the population is
scattered.
But still make ORS available at village
level by identifying an ORS holder (VHW
or EHT) and at rural clinics. Make sure
that the availability of ORS do not delay
or prevent people to go to the clinic
when sick.
WASH support to CTC
Once CTC have been opened by Medical NGO and/or MoH, ACF has been implicated in the provision
of safe water (by trucks or alternative options) and the donation of NFI such as latrines slabs or handwashing facilities. In regards to CTC, ACF has been providing WASH support to medical stakeholders
(mainly responding upon request) and has not, in theory, been implicated in the WASH management of
the medical facilities.
Lessons lernt / recommendations:
 Implicate WASH expertise in the selection/identification of CTC
WASH Field visit report
14/20
Zimbabwe / Feb 09
ACF has not been much implicated “upstream” in the selection of sites or facilities meant to
host cholera patients. The coordination between Med and WASH stakeholders and overall
efficiency of the interventions would have been improved if a WASH expertise would have
included in the initial assessments. Since, medical actors (mainly MSB-B) lack of WASH
expertise and since ACF has not been involved in the identification/selection phase (has
ACF ever proposed its implication?), ACF has been running behind from the beginning… In
addition, ACF been perceived as being an implementing partner from MSF and not an
independent actor as such.
 Start with water trucking (if no other options) but identify as well immediately
alternative options for water supply
In December and January, when many new CTC opened up, ACF has been responding to
the water needs by installing water tanks or bladders and supplying treated water by trucks
(ACF has 2 trucks which were purchased by the A1H project). Alternative options have not
been looked for as priority by lack of time and/or human resources. It appears that an exit
strategy from water trucking should have been prioritized and done in parallel with the
launching of the WT activities. Alternatives options, which have been identified, are the
following:
i. A hand pump when a protected borehole is located close to the CTC (< 100 m).
ACF repairs/disinfects/protects the pump/borehole if necessary. Water
provision to the CTC is dealt by the CTC staff.
ii. A hand pump associated with a water delivery service provided by a donkey
cart when the borehole is located further away (>100 m). ACF
repairs/disinfects/protects the pump/borehole if necessary. Water provision to
the CTC is done by the donkey cart. ACF pays a daily wage the person in
charge of collection and transporting water (5 USD/day).
iii. A borehole with a submersible pump. Transport by donkey cart or truck. The
option has not been used by ACF but the available equipment allows it.
iv. Local ZINWA network. It seems that quite a few networks exist in rural areas.
They are managed by ZINWA, are not running regularly and are poorly
maintained. When used to supply water to a CTC, a complete assessment
must be done up to the water source (river, borehole, dam, etc.). If needed, ad
hoc support to ZINWA can be brought in order to guarantee that safe drinking
water in provided on a regular basis to the CTC and the surrounding
communities (spare parts, fuel, HTH, etc.). For future projects, it seems that it
would be interesting to target rural water networks which both supply water to
rural clinics and the population. Data must be collected in that regard while
providing WASH support to CTC.
 Define roles and responsibilities of each stakeholders related the WASH
management within the CTC
In theory, ACF is not implicated in WASH issues occurring within the CTC perimeter such
as preparing different chlorine solutions, treating drinking water or water used for ORS
solutions or establishing or maintaining latrines for both CTC patients and medical staff. It is
the responsibility of medical actors (MoH and NGO) to look after those issues. However,
since ACF is visiting CTC on a regular basis (while providing water), the teams encounter
frequent mismanagement issues related to the WASH sector such as: no treated water in
the hand washing containers, drinking/ORS water not treated with HTH or Aquatabs, poor
storage of HTH, latrines for cholera patients not enclosed by a fence, staff confused when
preparing chlorinated solutions, etc. When facing such problems, ACF reacts/acts case by
case by providing advices or ad hoc trainings. Since the WASH knowledge and
management of medical actors is usually quite poor, it is recommended that ACF role
regarding WASH issues within a CTC is increased. With the approval of medical actors (by
signing a MoU), ACF can deliver training to CTC staff and monitor key WASH indicators. In
particular, the systematic treatment of drinking/ORS water must be enforced. If it is not
done, no effecting cure can be delivered!
 Pre position and distribute cholera kits to clinics in case of epidemic
In December, in the Chipinge District, MDM has been distributing 44 cholera kits to clinics.
Each kit is designed for 10 patients and holds buckets, water containers, ORS, IV fluids,
HTH, beds? Etc. The distribution of those kits has allowed the MoH (with the support of
MDM) to set-up CTC in an efficient and standard manner. In the Districts covered by MSFB, any systematic approach has been done neither in providing standard kits, nor in
WASH Field visit report
15/20
Zimbabwe / Feb 09
supporting MoH staff. While visiting CTC in the field, the ad hoc approach reveals clearly its
weaknesses with huge discrepancies between clinics, some being very nice and rather well
managed (like Musiso in Zaka District), some being below any acceptable standards (like
Takavarasha in Chivi District). For future preparedness, ACF must consider assembling
cholera kits to be provided to heath premises and must approach MDM in that regard.
4.3
PHHP
It’s very clear that cholera has been spreading among the country due to inappropriate and unsafe
hygiene practices. Even if inadequate hygiene practices are not the only transmission vector, the need
to promote safe behaviours at household and villages level is obvious and has to be considered as a
first priority activity together with the WASH support to CTC.
Lessons lernt/recommendations:
 Coordinate with MoH and implicate MoH staff during the sessions
ACF has been working hand in hand with MoH regarding planning and conduction of PHHP
sessions. This approach is definitely appropriate since it takes advantage of the MoH
structure and competences and is thus much appreciated by Authorities and villagers. A
PHHP team is made up by one ACF promoter (a female staff has to be prioritized) and one
MoH member designated by the District Authority. In order to implicate more the MoH
person and to make the sessions livelier, it is recommended to better share the session
topics between the 2 animators. Each of them must be in charge of some key topics (like
hand washing, defecation, drinking water, food and/or causes, prevention, treatment) but
the 2 animators must seek for better interaction.
It must be noticed that MSF-B has not developed the same approach than ACF. MSF-B has
been indeed training MoH staffs who are then conducting PHHP sessions by themselves. It
seems that the direct involvement of ACF during the sessions is much appreciated (by
Authorities and villagers). In addition, the impact of such an involvement is certainly greater
but still need to be monitored.
 Make the session participative but improve its structure
Even if the participative method is appropriate and the involvement of the population is
important, there is a need to better structure the session in order not to make it too long (a
session must last less than 2 hours) and make sure that all key topics have been well
addressed. While a session is held, since new comers are joining in, there is also a need to
constantly repeat key messages. At the end of the session, it is recommended as well to
summarize the key recommendations and findings.
It is recommended to organize a meeting with all promoters and MoH staff involved in
PHHP sessions (at each base level or if possible with the teams from both Chipinge and
Masvingo) in order to define a clear and common frame for each session. In addition,
questions/problems raised by the population must be listed and common answers must be
agreed upon (cholera comes from the evil spirit! Pigs are spreading cholera, issue of
funerals, etc.).
 Have a coverage approach at ward level
It has been agreed internally and with partners that PHHP sessions must be contacted at
ward level and aim at covering the entire ward. Such a systematic approach is definitely
recommended and should be implemented by all stakeholders involved in PHHP (it must be
recommended by the WASH cluster). Considering the size of the epidemic, cholera affected
wards must be targeted in priority with PHHP sessions. In a later stage, non affected wards
(or not yet affected) can be targeted in a strictly preventive manner.
 Introduce demonstrations within the sessions
Generally speaking, the PHHP sessions are too theoretical and not enough practical.
Explanations are not sufficient and demonstrations must be held involving participants.
Topics such as hand washing, hand shaking or “cat defecation” can easily be
demonstrated. Active participation from the participants will make the sessions livelier and
will contribute to a better promotion of the key messages. However it requires preparing a
“demonstration kit” which is made of soap, ash, different type of water containers, cups, a
table, etc. In addition, since no training material is used during the sessions, it must be
considered whether using the 5F diagram can bring an added value. If so, it can be drawn
be an artist on a big peace of cloth (at least 3 x 2 m) and held by polls. Leaflets to be
WASH Field visit report
16/20
Zimbabwe / Feb 09
distributed at the end of the session can also be designed. This option must be discussed
with the teams and the local partners. At the same, the mission must look for promotion
materiel which is already available in the country and request the WASH cluster in that
regard. Since, the design and the printing of a leaflet take time; the mission must at least
consider the option as a preparedness measure anticipating the next cholera outbreak…
 Promote and distribute water purification tablets
In term of access to safe drinking water, since most water resources are of doubtful quality,
the only safe alternative is treating drinking water at HH level. In that regard, considering
the size of the epidemic, the promotion of water purification tablets (Aquatabs) seems the
best option.
ACF is willing to systematically distribute water purification tablets (2 months ration = 6
strips of Aquatabs) after conducting practical demonstrations involving participants and
using water containers which are popular among the communities (buckets, jerrycans, jars,
etc.). However, since an enormous quantity of Aquataps would be required, ACF can not
include their purchase as part of the ongoing projects. Alternatives are either donations in
kind to ACF by UNICEF or others (PSI?), or an additional budget requested just for the
purchasing Aquatabs (OCHA?). All options must be listed and investigated by the Co Team
(ask the WASH cluster again!) while a supply from the HQ must also be considered.
 Monitor the impact of the sessions
For the time being, the only indicators related to the PHHP sessions are the number of
participants and the wards covered. No indicator allows the evaluation of the impact of the
session. Since no exhaustive survey can be contacted (in emergency), it is though
recommended implementing a qualitative monitoring before and after each session. A
simple questionnaire addressing key issues related to cholera and hygiene practices (which
are addressed during the session) must be drafted. Before the session a sample of 6 to 10
people (3-5 men + 3-5 women) is selected and each person answers the questions (5
minutes per person). At the end of the session, 6 to 10 other people answer the same
questions. In so doing, the understanding of the messages can be estimated and if needed,
the sessions can be modified in order to emphasize on the topics which are not well
understood. The results can then be compiled and presented in the final donors reports.
4.4
Water points repairing
ACF has been rehabilitating more than 700 water points over the past years. The rehabilitation itself
belongs to a rather long and complex selection process which includes technical assessments, water
analysis, and contacts with water committees and Authorities.
In rural area, at least half of the water points are non-functioning. When facing a major cholera crisis, it
is obvious that improving asses to safe water becomes a top priority. However, the methodology which
has been used in previous projects (A1F and A1G) or is used in ongoing projects (A3B, A3C, A1F) is
not adapted to emergencies and must thus be modified/adapted.
Lessons lernt/recommendations:
 Use sanitary surveys (as an assessment and monitoring tool)
The selection of the water points to be repaired (rather than rehabilitated) first must be
based on a risk assessment. The activity must aim at reducing the (environmental) risks in
the most efficient way. In that regard, the systematic use of sanitary surveys must be
adopted. Sanitary survey must be conducted during the assessment phase (allowing to
target the most at risk water points) and after the conduction of the first repairs (allowing
measuring the risk reduction).
A sanitary survey form as been agreed upon with the team which is slightly modified from
the one proposed in the ACF WASH book (p 682). It takes into consideration the
Zimbabwean context by differentiating wells and boreholes when it is necessary. Training
on the use of the form must be done to all team members who could possibly conduct
assessments. It must include staff from A3B (including the M&E team), A1F and Eprograms. A practical exercise must be organized as well in order to verify the coherence of
the results among trainings participants.
For action: WASH Co + E-WASH Co. Deadline: Mid-March.
 Use existing database
WASH Field visit report
17/20
Zimbabwe / Feb 09
During the past years, ACF has been working in many areas which have been hit by the
cholera epidemic. Database of all water points located within some cholera affected wards
are available (A1F, A1G, A3B) and must be considered prior to the conduction of any field
assessment.
Since no single WASH database exits, there is a great need to establish such a tool. A GIS
Officer must be recruited and while providing support to the E-program must start
establishing the WASH database.
 Implement quick repairing/rehabilitation of water points
As proposed in the ECHO proposal: “The rehabilitation of water points will focus on
emergency rehabilitation. This will consist in a quick intervention allowing repair of the hand
pump and basic protection of the water point”.
With the previous projects, the mission is not used to such an approach and methodology.
However considering the size of the epidemic, all the teams must adapt their way of
working. Cholera has now become part of the working environment in Zimbabwe and any
ongoing or future project must forget that. In addition, donors will legitimately request about
the effects of the crisis on activities launched prior to the epidemic. Regarding water points,
the adaptation is rather obvious: instead of going through a long and complex selection
process, water points which can be repaired must be repaired!
4.5
Hygiene kits
ACF will not implement a district-wide blanket distribution of hygiene kits. In contradiction with the
WASH Cluster but in agreement with MSF-B, ACF considers that a mass (blanket) distribution of
hygiene kits will not have a significant impact on the epidemic (people have already water containers at
home!) with respect to the tremendous investment (financial, logistic and HR) that such an activity
would require. Moreover, it does not appear feasible that the number of kits needed to blanket cover 16
districts as UNICEF intends to do is possible to source within a reasonable time period.
The 20,000 kits that are foreseen to be distributed with the ECHO and UNICEF proposals will be given
to some communities after a careful assessment. The ACF team considers that this activity is not a top
priority and that efforts must first be concentrated on CTC, PHHP sessions and water points repairs.
However, criteria for targeting communities with the kit distribution must be defined. They could include
communities which are particularly vulnerable such as resettled population or people living in camps.
Selection criteria could also be related to water access by targeting people living in areas with no or
very few wells/boreholes (low coverage) or areas where underground water is the most at risk of
contamination (shallow wells, rivers sides or densely populated areas).
Unfortunately, the kits provided by UNICEF are not respecting what was initially agreed upon at the
WASH cluster level. It was indeed decided that kits be composed of:
1. A bucket with a lid for water transportation
2. A water container with a lip and a tap for water storage
3. 1,250 kg of soap
4. 2 strips of water purification tablets
ACF agreed on standardizing the hygiene kits and on the selection items which allow proper water
management at HH level. By replacing the water container with lip and tab by a simple bucket with a lid,
UNICEF has modified the whole concept of promoting safe water management at HH level. With 2
similar buckets used both for transport and storage, the opportunity for promoting simple and clear
water management is lost. In addition, UNICEF has now introduced ORS as part of the hygiene kits.
ACF fears that confusion between water purification tablets and ORS is going to be introduced among
the population. For that reason, ACF will not add ORS as part of the hygiene kit but will rather, either
distribute ORS at health centres, or hand them over to medical NGO and/or MoH (or trained Village
Health Workers). ORS must be seen as a curative item which must be delivered on an as needed basis
and not on a blanket basis while water purification tablets are preventive items which must be used at
HH level by the entire population. In that regard, at the end of each PHHP sessions, ACF is willing to
systematically distribute water purification tablets (2 months ration = 6 strips of Aquatabs) after
conducting practical demonstrations involving participants and using water containers which are popular
among the communities (buckets, jerrycans, jars, etc.). However, since a enormous quantity of
Aquataps would be required, ACF can not include their purchase as part of the ongoing projects.
Alternatives are, either donations in kind to ACF by UNICEF or others, or an additional budget
requested just for the purchasing Aquatabs (OCHA ?).
Since the ECHO project intends to distribute “9,300 hygiene kits to most affected communities/villages”,
the identification of suitable water containers with lids and taps must start. An alternative to “closed”
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water containers which are not easily transportable (since them don’t fit into each other) would be a
simple bucket with a hole into which a tap can be screwed. Logistics has to start sourcing such items
(first in Zimbabwe and South Africa) and/or workshops which could make a hole in every bucket (after
conducting tests to guarantee waterproof quality).
In the ECHO proposal, it also specified that stickers must be prepared and put on every water
containers (5,400 Euros available). Those have to explain how to handle the container (where to put it
?, how to use it properly ? how to maintain it ?) by using simple and clear illustrations, drawings and
messages in local languages. It is important that the illustrations represent the exact same container as
the one which is going to be delivered. Therefore the sticker can only be finalized after the final product
selection but its preparation can be anticipated (identification of a local artist, draft drawings and
messages, identification of printing companies, cost estimations).
4.6
SWOT analysis
The cholera outbreak which is currently sticking Zimbabwe will certainly remain a reference for the
humanitarian community. Since the outbreak has not been contained by the implicated stakeholders
(Authorities, UN, NGO, donors, etc.), there is a great need to look back at what happened and identify
lessons learnt. In that regard, a SWOT analysis of the ACF interventions has been drafted (see annex
3).
The analysis needs to be discussed and validated (at mission and HQ level) in order to be shared within
ACF or ACFIN. Solutions must be proposed in order to reduce weaknesses and treats.
Considering the scale and the complexity of the cholera crisis in Zimbabwe, it is recommended to
address the issue during the yearly HOM meeting.
4.7
Organization of the response and teams
The following organisation chart has been agreed upon:
WASH
Advisor
HOM
P Co
E-WASH
Co
WASH Co
A3B
A3C
F1A
A1I
D3A
Blue line = Technical support
Red line = Hierarchy
Lessons lernt/recommendations:
 E-WASH Co position
Considering the size of the crisis, a single WASH Co can not give support, supervise and
monitor the E-programs and the regular projects. For future large WASH emergency (flood,
earthquake, cholera epidemic, etc.), which do not prevent regular projects to go on, the EWASH Co position must be prioritized.
 Program Co position
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The Program Co position based at field level has proved to be very relevant. The needs for
managing to E-team, representing ACF, insuring the coordination with others projects
teams and keeping a direct link with the HOM (and thus the HQ) are clear. By taking such
responsibilities in terms of management, the P Co allows as well the technical teams to
focus on their field of expertise and the response itself to the emergency.
For future large emergency, the P Co position must be systematically requested at the early
stage of the crisis.
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