F t E L
~24 MLDO92 HEALTH IMPACT ASSESSMENTS OF SMALL DAMS IN THE DOGON COUNTRY, MALI
Field Peport No. 357 July 1992
1 I~L*Z~
Sponsored by the U.S. Agency for International Development Operated by CDM and Associates
824—MLDO—9710 -t WASH Fleld Report No. 357
HEALTH IMPACT ASSESSMENTS OF SMALL DAMS IN THE DOGON COUNTRY, MALI
Prepared for the USAID Mission to Mali under WASH Task No. 262
by Arthur Dennls Long Issa Degoga • - -~—--,,—------.. -s--S-- LH ~~ARY,~ TEP~I.~OF~ Eve Crowley \j,\, --~ SUPPLY Hamancire Daou ‘1 - Rita Klees
1 -~ S- Mohamed Konare •_~~ ~ — r—,_ —~ —
~ - t ~ July 1992
Water and Sanitation for Hanlth Project Comract No. DPE-5973-Z-00-1011 -00 Project No. 936-5973 is .poo.orsd by the Of&c. of Hndtb, ~r.au for Res..rch and DeveIopm~~ US. Agency for International D.v.~op~ Wndiington~DC 20523
CONTENTS
ACRONYMS v ABOUI’ THE AUTHORS vii EXECUTIVE SUMMARY ix
INTRODUCTION 1
1.1 Otijectlves and Problem Statement 1 1.2 Background 2 1.2.1 Locatlon 2 1.2.2 Climate 2 1.2.3 Hydrogeology 2 1.2.4 Small Dam Constructlon 3 1.2.5 Agiicultural Practices 4 1.2.6 Dogon People and 1-Ilstory 5 1.3 Methods and Materlals 6 1.4 Clients and Audience for this Repoit 8
2. SOCIAL FACTORS AND HEALTH ISSUES RELATED TO THE SMALL DAMS 11
2.1 Sodallssues 11 2.1.1 Soclal Organlzatlon 11 2.1.2 Water 13 2.1.2.1 Water Uses 14 2.1.2.2 Significance of Water Use for Health and Hyglene 21 2.1.3 Hyglene Practices and BeIlefs 22 2.1.4 Local Perceptions of Illness and Health 24 2.1.4.1 Guinea Worm 24 2.1.4.2 Schistosomlasls and Skin Infections 27 2.1.4.3 Dlarrhea 29 2.1.4.4 Malarla 30 2.1.4.5 Eye Infections and Onchocerciasis 30 2.1.4.6 Infant Moitality, Morbidlty, and Other ilinesses 31 2.1.5 The Dogon and Development 33
1 2.2 I-Iealth Problems . 34
2.2.1 Waterborne Diseases . . 34 2.2.2 Water-washed Diseases 36 2.2.3 Water-contact Diseases. 42
2.2.4 Water-related Diseases . 44
3. ENVIRONMENTAL AND ENGINEERING ISSUES RELATED TO THE SMALL DAMS AND HEALTH CONDITFONS 45
3.1 Environmental Engineering 45 3.1.1 Small Dams for Inigatloi~ 45 3.1.1.1 Dam Construction 45 3.1.1.2 Dam Repair 49 3.1.1.3 Operatlon and Maintenance 49 3.1.2 Water Supply and Sanitatlon 50 3.1.2.1 Water Contact 50 3.1.2.2 Water SuppI’~, 52 3.1.2.3 Water Quality 54 3.1.2.4 Sanftatlon 56 3.2 Envlronmental Assessment 57 3.2.1 Key Physlcal, Blological, and Cultural Factors 58 3.2.2 Assessment of Different Interventions 60 3.2.3 Environmental Assessm~ntCriteria 62
4. CONCLUSIONS 65
5. RECOMMENDATIONS 67
6. LESSONS LEARNED 73
7. BIBLIOGRAPHY 75
PHOTOS 79
II APPENDICES
A. Scope of Work/Requesting Cables 85 B. Schedule 95 C. Persons Contacted 97 D. Assessment Questlonnalre 105 E. Catholic Mission Small Dam Inventory 111 F. DED Small Dam Inventory 113 G. Map Indlcating Villages Visited 119 H. Descrlptlon of Villages Visited 123 1. Tables on Water Sources and Water Consumptlon 129 J. Tables on Hyglene Practices and Latrine Use 137 K. Tables on Dogon Perceptions of Disease 141 L. Tables on Dogon Development Priorities, Communicatlon and Migratlon 159
TABLES
1. 1991 Price of Dried Onlons—Bandlagara YleIds 6 2. Dogon Disease Terms 25 3. Disease Statlstlcs 26 4. Estlmated Mortality of Chlldren in the Dogon Country 32 5. Reported Guinea Worm Cases in the Dogon Region, by Year 38
FIGURES
1. Bandlagara Annual Ralnfall, 1965-1990 3 2. Life Cyde of the Guinea Worm 37 3. Life Cyde of Schlstosomlasls 43 4. Cumulative Construction of Dams Since 1950 46 5. Key Environmental Factors 59
lii
ACRONYMS
A.I.D. U.S. Agency for International Development (Washington)
CFA Local currency: 280 CFA - US $1 DED Deutscher Entwickiungs Dienst, a German NGO DNHE Direction Nationale de I’Hydraullque et de l’Energle GIS Geo-base Information System GRM Government of the Republic of Mali GTZ Geseilschaft for Technische Zusammenarfelt 1-IDS Harmonie du Sahel lEE Initlal Environmental Evaluatlon MOH Ministry of Health NGO Nongovemmental organlzatlon O&M Operatlons and rnalntenance OCP Onchocerciasis Control Program (sponsored by WHO) ORT Oral rehydratlon therapy PCV Peace Corps Volunteer PVO Private Voluntary Organlzatlon R&D/H Bureau for Research and Development, Office of Health
SAC Service Agricole - SHBC Systeme d’Hyglene de Bandlagara Cercie UNDP United Nations Developnient Program USAID U.S. Agency for International Development (Overseas Mission) VBC Vector Blology and Control Project WASH Water and Sanitatlon for Health Project WHO Wond Health Organizatlon WID Women In Development (Office in A.I.D.)
v
ABOUT THE AUTHORS
The consultant team for this report conslsted of the following individuals.
Team leaders:
• Aithur Dennis Long, Sc.D., P.E., Office of Health, A.I.D., Tropical Dlsease Specialist and Environmental Engineer who had worked in the Dogon Country in 1975.
• Issa Degoga, MD., Natlonal Guinea Worm Coordlnator, GRM, Public Health Spedallst who studied Guinea worrn In the Dogon Country in 1977.
Team members:
• Eve Crowley, Ph.D., Anthropologlst, WASH consultant. Research affillatlon wlth the University of Leiden in the Nethenlands. Extensive research experlence In the Upper Guinea Coast and the Sahel.
• Hamancire Daou, Clvii Engineer, USAID/Bamako.
• Rita Klees, Ph.D., AAAS Fellow (American Assodatlon for the Advancement of Science Award), Office of Health, A.I.D. Prevlous fleld experlence In water supply and sanitation activitles in Africa and Central Ametica.
• Mohamed Konare, Water Resources Engineer, Africare, who deslgned and supervised consfructlon of the Yamé dam.
Translators:
• Antiamba Tembely, Secretary ofSodal and Cultural Affairs, Harmonie du Sahel (HDS).
• Aguibou Degoga, USAID/Land Tenure Center Translator.
vii
EXECUTIVE SUMMARY
The objectlve of this activity was to assess the health Irnpacts of small dams In the Dogon Country of Mali. During the last 40 years, approxlmately 108 small dams have been built in the reglon to support the production of onlons (the prirnary cash crop in the reglon), whlch aresold throughout Maliand areexported to nelghborlng countrles. Approxlmately 80 percent of the dams contain suffldent water to support one to two growing seasons (from September to January for one season and from January to May for the second season). However, 50 percent of the dams support only one season. Due to poor siting and/or poor construction, approxlmately 20 percent have falled; thatis, they do not hold water beyond the ralny season.
The provlslon of a year-round supply of surface water for agricultural purposes presents potential health rlsks in West Africa, notably malarla, schlstosomlasis, and Guinea worm. Of course, surface water also offers potential health benefits, such as lmproved nutritlon and lmproved hyglene, wlth a reduction in skin and eye diseases. In the absence ofbaseline health data, the consultant team’s approach was to look at villages wlth dams, without dams, and with falled dams to determine 1f there were significant health rlsksassoclated wlth the presence of dams. The team developed and Investigated health, soclo-economic, engineering, and environmental criteria for an Impact analysis. In all, the team visited 12 villages, 8 wlth and 4 without dams, during a 12-day perlod. The relatlonshlp of village water supply and sanltatlon conditlons to water-assoclated disease was also studied.
Health conditlons were found to be universally poor In all villages and induded high levels of dlarrheal dlseases; Guinea worm; skin dlseases; eye diseases, Inciudlng trachoma; schistosorniasis; and malarla. Knowledge ofbasic hyglene and ofsimple proven solutlons such as Oral Rehydratlon Therapy (ORT) were minimal. Latrlnes were virtually nonexistent. Whlle all villages wlth dams also had a source of safe drinking water, most used the Impounded dam water to drink at least occaslonally, and/or other unsafe drinking water sources because of convenlence or taste factors. Practices of collection and storage of water were unsafe in many villages. Not surprisingly, dlarrheal dlsease was reported as the most serlous health conditlon. The eradicatlon of Guinea worm was noted In all cases in whlch a safe drinking water supply was located and used exduslvely for drinking.
Only one dlsease was found to be speclflcally related to the presence of darns— schistosorniasis. The Government of the Republic of Mali (GRM), with asslstance from the Gesellschaft for Technische Zusammenarfett (GTZ), has been operating a schistosomlasis research and control program In the Bandlagara reglon for several years. This program was started In response to the GTZ’s own concerns about the health effects of small dams they had built In the reglon. The researchto date has shown that although schistosomlasis (Schlstosoma haematoblurn) Is endemic tothe reglon, both the prevalence and Intensity ofinfection increase
Ix following dam construction. Therefore, GRMs cLirrent strategy Is to provlde treatment In villages that possess danis.
The consultant team also concludes that dams maysllghtly reduce water-washed diseases. The need to Incorporate plans for a safe drinking water supply, sanitatlon facilitles, and a hyglene educatlon program into small dam projects Is manifest. Flndings Indicate that the most cost- effectlve and potentially sustainable Intervention to address health Lssues Identifled during the team’s study would be child survival activttles. linproved nutritlon, an antidpated indirect benefit of the dams, was not investigated but would be assumed to occur due to Improved economic drcurnstances.
Determinatlon ofeconomic benefits reallzedbecatue ofthe dams was beyond the scope ofthis project. Clearly, however, the Dogon people percEive economlc beneflts assoclated with small dams.
Given the relatlonsbip of dams to schlstosomlasls and the exlsting control program, the team’s recommendatlons focuseci on schlstosomlasls control and addressed 1) dam constructlon, design, and operatlon; 2) altematlves to small darns; and 3) possible approaches to reducing water contact. The team also Identifled the need for the Dogon to address marketing Issues related to lncreased onlon production.
x Chapter 1
INTRODUCTION
1.1 Objectlves and Problem Statement
The objectlves of this study are to
• Assess the health lmpacts of construction of small dams in the Dogon Country, Mali
• Make recommendatlons to mitigate potential Impacts
• Recommend future research, 1f appropiiate
• Assess other health rlsks related to water use and sanitatlon practices and recommend possible mitigatlon measures
Approxlmately 108 small dams have been bulit in the Dogon Country durlng the last 40 years. Thelr purpose Is to provide water for Irrlgating onions and other vegetables, whlch the Dogon produce as cash crops. As more dams were bulk, however, donors became aware of possible negative health effects involved. Africare, whlch recently completed two dams in the region, ralsed this lssue. As a result, this study Is being conducted at the request of Afrlcare and USAID/Bamako to deterrnlne 1f there are significant health effects from the construction of small dams (see the scope of work and requesting cables, Appendix A). The study was conducted 4-26 September 1991, during the ralny season and just prior to the harvest, and therefore a time of food scarcity. Although 1990 was a drought year, good rains occurred In 1991, from which the harvest promised to be plentlful. In all, the consultant team visited 12 village,s, 8 wlth and 4 without darns, during a 12-day perlod. (See Appendix B for the schedule.)
Mali’s populatlon Is approxlmately 8.2 million, with a life expectancy of 48 years and an illiteracy rate of 83 percent (World Bank, World Developnient Repoit 1991). By most measures, Mali Is one of the poorest countrles in the world and has performed very poonly with respect to basic human needs. Approxlmately 85 percent of Its total labor is employed in the agricultural sector, whlch accounts for nearly 50 percent of gross domestic product (GDP). Given this economic picture, onlon production Is an Important aspect of both the Dogon and natlonal economles.
Despite being adversely affected by OPEC 1 and II, Mali has experlenced real per capita Income growth since the military took over in 1968. After perlods of real dedine in 1972-74 and 1982-85, Mali enjoyed perlods of rapid growth In 1974-77 and 1985-86. Gross natlonal
1 product per capita In 1989 was $270 (World Bank, World Development Report 1991). In March 1991, a coup overthrew the one-party regime of Moussa Traore. With multiparty elections currently scheduled for January 1992, this Is a time of political change within the country.
1.2 Background
1.2.1 Locatlon
The Dogon Country covers 7,250 square kilometers and Is located on a sandstone plateau (Bandlagara Plateau) between 14 and 15 degrees northern latltude. The Bandlagara Plateau Is in central Mail and runs northeast-southwest for sorne 200 km and ranges from 75 to 100 krn In wldth. Ernerging wtth a gentie slope from i:he banks of the Niger and Bani rlvers, the plateau reaches Its greatest helght In the northeast, where It termlnates In a series of 300 to 350 m (and in some places higher) escarpments abutted by the Seno Plain. The terrain Is rugged and can be descrlbed as rocky hilly country wlth scattered tree cover, deep gorges, valleys, and large eroded sandstone outcrops. The lnfrequently flat rocky spaces on the plateau are occaslonally covered wlth very thin ~oilsthat possess very little water retention capacity. These poor soils make up the Iargest pairt of the plateau’s arable land. The seat of the Dogon Country Is Bandlagara City. The reglorli Is dlvided into elght arrondlssements wlth a total populatlon of about 300,000 living In approxlmately 400 vlllages.
1.2.2 Climate
The Dogon Country Is located within the semI-ai~Soudan-Sahelian dimate zone, whlch Is dominated by two seasons: a dry season from October to May, and a rainy season from June to September. Rainfail varles from one ecologlcal :wne to another. Flgure 1 presents annual ralnfali data for 26 years from the Bandlagara ram gauge station. The mean annual rainfali from 1965-90 was467.0 mm (standard devlatlon of 96.3), with arange of329.2 mmm 1967 to 638.2 mm in 1977. Analysis ofthe rainfali data shows that there Is a trend of Iess rainfail In recent years, wlth the 1970s’ 10-year average at 565.8 mm (standard devlatlon of 55.5) dropplng In the 1980s to a mean annual rainfail of 407.9 mm (standard devlation of 56.3).
1.2.3 Hydrogeology
The hydrogeology varlesthroughout the Dogon reglon. The Bandlagara Plateau Is rlddied wlth faults of varylng wldth and depth that serve as natural water reservolrs In the impermeable sandstone. On the plateau in the Yam~River system are small water courses, ponds, and sprlngs. These are all fed by raInwater and, wlth the exceptlon of the springs, do not flow durlng the dry season. On the adjacent Seno PlaIn, water resources are more scarce. Only depresslons that carry rainwater and then dry up wlth the end of the ralny seasori have been ldentifled there.
2 700 -
600 -
600
400 1 ‘.1
300 -
200 -
100 -
0—
1966 1966 1.970 1972 1974 1976 1676 1960 1962 1.964 1966 1966 1.990
Source Bandlagara Ram Gaug. Station
Figure 1
Bandlagara Annual Rainfail 1965-1990
1.2.4 Small Dam Construction
The prlmary water resource management activity ofthe Dogon Country hasbeen constructlon of small dams to provlde irrigatlon water during the dry season. The construction of the first concrete dam on the plateau In Sangha durIng the late 1940s was an Important landmark in the diffuslon of gardening, the primary target of the dam proJects. The gardens that grew up In Sangha demonstrated the posslbilitles of cash cropping and, in concert with the expansion ofthe road system in the 1950s, stlmulated a giowth of gardening in the Dogon Country that was augmented by increased small dam constructlon. As noted prevlously, to date, 108 small dams have been bulk. WIth the passage of time It became evident that in additlon to the economic advantages assoclated with small dams, there were health and environmental ramificatlons to consider as well. In 1977, the chief doctor of Bandlagara indicated evldence of an increased Incidence of schistosomlasis and Guinea worm among vlllagers wlth access to dam water for gardens. It was also suspected that aquatic plants In the dam reservolrs were
3 serving as support for snalis, the intermedlate hos~of schlstosomlasts. WhIle these concerns were volced by many, no deflnitlve study was coir~ductednor any remedial action taken.
Slnce the dams in the Dogon were bulk wlth on~purpose—to Increase the Income of the Dogon farmers by increaslng crop ylelds—It Is necessary to keep in mmd the agrlcultural and economlc beneflts accrued whlle weighing the heailth costs. Based on this kind of analysis, some donors have begun to questlon the value of continued dam construction. Fails In onlon prices suggest to some that onlon production has reached a level of saturatlon on the natlonal market durlng the harvest. Some of the onlon transformation technlques developed by the Service Agrlcole (SAC) may help overcome this bottleneck, as would diversiflcatlon of garden crops.
1.2.5 Agricultura] Practice,
Traditlonal Dogon gardens are situated around faults covered by sand and sediment. The quantity of water held in the fau.lts and avallable for gardenlng Is difficult to deterrnlne. To extract the water, the Dogon dig shallow weils.
The Dogon have several hundred years of expertence wlth the production of onlons and have proven themselves competent wlth the resources at thelr disposal. For example, they have developed composting methods for maintalning soil fertility; they have used the rocks in the environment for fendng and terracing and eroslon control; they have moved soil to rocks adjacent to water sources to develop gardens; and they have molded local materials into suitable vessels for Irrigatlng dry-season gardens. Thus the dams can be vlewed as an augmentatlon to traditlonal agricultural practlces and as one method of increaslng agrlculiural productivity in the area.
The most Important vegetable the Dogon grow Is the small whlte onlon Allium cepa. Onlon gardening can only take place near water sources. Onlons are hand watered with large calabashes that hold from 7 to 25 liters of water (rnost hold about 15 liters). Water Is dipped from the water source, usually by people wadlng Into the water wlth the open calabash held in both hands.
Dogon onlons have a 60 to 70 day growing season, In contrast wlth American varleties of open-pollinated short day onlons, which requlre 160 to 180 days to mature and must be propagated by seeds. In deterrrdnlng agricultural benefits ofthe onlon crops, consideratlon of length of growlng season and availability ofwater Is necessary. The lack of water Is the largest factor limiting Increased onlon acreage (Remmngton, n.d.).
The actual economic benefit to the vlllagers from Increased onlon production has been the subject of some controversy. A 1977 study examhwd the Issue of overproductlon of onlons and Identifled marketing difficulties as lmpedlments that keep vlilagers from reallzlng the full benefits ofthe Increased water supply available for Inigatlon (Remlngton, n.d.). More recently,
4 to addressthese marketingdlfflculties, the SAC has developed a project that seeksto enhance the beneflts ofincreased onlon growth. SAC has a project involving 13 villages throughout the Dogon that heips villagers wlth the technical and marketing aspects of producing drled onlons. After a pilot-scale investlgatlon, a simple machine wasdeveloped for farmersto use on-site to shred onlons. A solar screen drylng device has also beendesigned to dry the shredded onlons. Additlonally, farmers can opt to transport the onlons to Bandlagara themselves at a savtngs or have SAC plck up the onlons in the village. The onlons are then brought to a small enterprlse in Bandlagara that packages them.
The project buys the onlons dlrectly from farmers and guarantees them a prlce for their participatlon Inthe project. The onlons ultlmately are sold prlrnarily in Bamako, although there Is also a market for them In Dakar and Abidjan. Table 1 gives the most recent prices pald to the farmers for dried onions.
The project produced 15 metric tons of drled onions In 1990, Its fIrst year of operatlon, and 8.7 metric tons In 1991. The drop was due to the price ofonions falling last year. SAC’s goals for the project indude enhandng the farmers’ independence from traders and encouraging a private enterprise In Bandlagara to take over the packaging and marketing component. This project Illustrates the potential for Innovative solutlons to overproductlon of onlons.
1.2.6 Dogon People and Hlstory
The Dogon are a fairly homogeneous people II~’IngIn an extremely hostile natural envlronment. The populatlon numbers about 300,000, wlth densitles In the Dogon Country dlstrlcts varylng from 5 to 50 inhabltants per km2. With the exceptlon of Bandlagara Town, the areas of greatest density also happen to be the most Inaccessible. The geographlcal varlatlon and Isolatlon ofsettlements on the Bandlagara Plateau have contributed to a strlking plurailty and varlatlon In Dogon soclal and lingulsticgroupings. Severalof the 40 to 50 dlalects in the reglon are mutually incomprehenslble. Desplte this diversity, Dogon people are bound together by a common work ethic that has enabled themto survlve in difficult conditlons and to endure the major problem of water scarcity through enterprise and hard work.
The Dogon are organized Into pafrnmneages, groups of people tracing descent through their fathers. Members of the same lineage cannot Intermarry. At marrlage, the new conjugal household establishes residence wtth the husband’s lineage. In most respects, Dogon society Is patriarchal and women occupy few positlons of authority. Lineage afflllatlon, resldence, and age grades form the prindpal bases for the organlzatlon of labor and space. Time Is structured In a five-day week, In keeping wlth markets that occur once eveiy five days in larger villages.
Throughout the reglon, roads are poor and many vlllages can only be reached on foot. Poor roads contrlbute to the soclal and linguistic diversity of the reglon, hinder access by government and International services, and harnper the transportatlon of market vegetables,
5 Table IL
1991 Price of Dried Onlons--Bandlagara YleIds
Who!esale piice (minimum 40 kg) In CFA/kg
Cash Paymi~nt Credit (6 moe.) 40 kg sacks 615 650 500 g packets 680 715 100 g packets 865__- 900
Note: The ylelded price in Bamako = the ~iIeIdedprice in Bandlagara + 20 CFA/kg. The yielded price in Sévaré/Mopti = the ylelded price in Bandlagara + 5 CFA/kg.
thus redudng farm-gate prlces. The Improvement of basic Infrastructure, such as road networks, would have a marked positlve irnpact on health conditlons and the commerclallzatlon of market products. Difficult acc~ssand the plurality of Dogon dlalects block the flow of Information and explain the absence of many communicatlon networks In the reglon.
1.3 Methods and Materials
Theteam spent 12 days In the Bandlagara region, working out of Bandlagara (see Appendix B for a copy of the team’s schedule). So as to observe disease burden flrsthand, the team’s work took place during the ralny season, whlch ccrresponds wlth the transmission season for most of the dlseases of concern, and allowed for Inspection of dams at tlmes of peak water levels. Due to the absence of baseline health data, for comparative purposes the team chose to study villages with dams, wtthout dams, and wlth dams that were no longer working properly. For villages without a dam, the team chose to study villages wlth and without a safe drInking water supply In order to Isolate the health lmpacts of this varlable. A descrlptlon of the villages studied Is glven in Appendix H. Villages were selected based on the following criteria.
6 They were villages:
• In whlch the dient, Afrlcare, had worked;
• In whlch team members had prevlously worked, or In whlch pzior studies had been conducted;
• From different watersheds on the plateau;
• WIth no safe drinking water supply; and
• That were accessible.
The villages chosen covered three admlnlstratlve zones, four to flve dialect groups, and three watersheds (see Appendix H). The team’s methodological approach was to conduct focus group discussions uslng a standard questlonnalre (see Appendix D) and additlonal questions as approprtate within each subdlsdpllne. In additlon to Information about dams, the questlonnalre inciuded Information on other water sources and sanitation conditlons and practices. Fleld observatlons were made of all village water sources, lncludlng the dam and reservoir, and sanitatlon facilitles. When possible, water contact and use behaviors were also observed. Men, women, and chlldren were questloned separately.
Market days occur every flfth day on the plateau and involve most of the villagers. Therefore, the team also spent three market days In Bandlagara intervlewing small enterprlses and government, local, and International servlces based In Bandiagara thatare working throughout the reglon. Interviews were also held with key officials in Bamako. (Appendix C comprlses a list of persons inteMewed.)
The team was divided Into two subgroups: health and soclal; and engineering and envlronmental. Initlally the two groups worked together to develop and finailze the questionnalre. After the initlal village study the two groups worked separately in several villages, coming together In the second week for the final three vlllages. In these last three villages, the female members of the team Intervlewed focus groups of women and children, while male members focused on male village representatlves. Therefore, among all villages visited, some were visited by only one group. The health and soclal team also spent one night in the village of Koundo-Da, whlch allowed for more detailed observatlon on water use.
The team did not attempt detailed diagnostic, epldemlological, or environmental measurements (e.g., measurements of water quallty), assuch measurements were beyond the scope of this study, and would have requlred laboratory and other faclllties. For the purposes of this study, gross indlcators such as the presence of Guinea worm were thought sufficlent.
7 At the village level, all interviews were conducted In Dogon wtth the use of two male professional Interpreters.
The consultant team for this report consisted of the followIng Individuals.
Team leaders
• Arthur Dennis Long, Sc.D., P.E., Office of Health, A.I.D., Troplcal Disease Specialist and Environmental Engineer who had worked In the Dogon Country in 1975
• Issa Degoga, MD., National Guinea Worm Coordlnator, Government of the Republic ofMali (GRM), Public Health Specialist who studied Guinea worm in the Dogon Country in 1977
Team members
• Eve Crowley, Ph.D., Anthropologlst, WASH consultant
• Hamancire Daou, CMI Engineer, USAID/Bamako
• Rita Klees, Ph.D., Environmental Engineer, Office of Health, A.I.D.
• Mohamed Konare, Water Resource~iEngineer, Africare, who designed and supervlsed construction of the Yamé dam
Translators
• Antiamba Tembely, Secretary ofSoclal and Cultural Affairs, Harmonie du Sahel (1-IDS)
• Agutbou Degoga, USAID/Land Tenure Center Translator
1.4 Clients and Audience for tihis Report
This activity was conducted at the request of Africare/Mail and USAID/Bamako. The audience for this report Indudes the following:
• Government of the Republic of Mali
• Local services and nongovernmental organizations (NGOs) working In the Dogon Country, Indudlng Africare and the Peace Corps
8 • USAID
• Other bllaterals and multinationals
9
Chapter 2
SOCIAL FACTORS AND HEALTH ISSIJES RELATED TO THE SMALL DAMS
2.1 Social Issues
2.1.1 SocialOrganlzation
Dogon villages range in size from a few hundred to several thousand Individuals. Settlements are often located on rock outcrops and dliffs, offerIng securlty from attack by outsiders and animals, and allowing the commurdty to take full advantage of the cultivable areas found at the base of the rocks. Dogon houses are rectangular, built of stone, and covered wlth mud. Most are wlndowless, withlow doors and a celling hole supported by beams. Households and multlple thatchedgranarles are usually dustereddoselytogether Into stone walled compounds. Within these walls Is an endosure for bathing and urlnating. Nearby and also within the compound, farmers create a compost heap wlth organic materlal where they tie their animals and wash utensils. The compost accumulates throughout the year, and Is transported to garden sites to enrlch the meager soli.
The basic unit of soclal organlzatlon Is the patrilineage, whlch is the organizatlonal principle that guldes Inheritance and residential, production, and consumption actlvitles. A typical compound consists of several households of different brothers, each composed of a man, his wife, and his children. In the dry season, family members work together in a common fleld, but as brothers and sons reach maturtty and marry they may acqulre separate plots of land, where they may work In thelr spare time to suppiement indlvldual Income. During the rainy season, family members consume the compound’s harvest, but in the dry season, each adult male and his nuclear family are expected to fend for themselves. A series of cross-cutting age grades and communal work groups (tons) are an Important basis for organizlng villagewide labor actMtles.
Dogon villages are usually organlzed around a palaver shed (toguna), where village elders and other authority figures meet to dlscuss village affairs. Vlllages are typically subdlvlded into wards, often located at a considerable distance from each other and separated by crevlces and faults. The number ofwards varles, usually between two and five wards, depending on village slze. Ward members are Linked by klnshlp relations and, wlth the exceptlon of spouses and other affines, most inhabltants bear the same family name.
Dogon society is hlghly diversifled and stratifled, wtth vartous decislon-making centers. Senlority plays an Important role In determining poLitical power and status. Senior members of foundIng lIneages (ginna) generally hold the most Important positlons of authority, such as that of village chief. Many Dogon practlce traditlonal anlmist religlons; less than half have
11 become Islamiclzed, and even fewer have conveiled to Cbrlstlanlty. In many cases all three belief systems coexist within the same communitlEs om househoids. In anlmlst villages, the Hogon is the supreme rltual and political authoitly, and his decislons are made with the asslstance ofa couricil ofvillage elders. In additlon to free Dogon (dibön), a number of villages contain members of dlfferent occupatlonal castes (nyânyo): pralse slngers (saké), leather workers (d~onor kossociJo), cobblers (gogoné), and blacksmlths (dembé). Many villages also accommodate Fulbe populatlons, most of whom are pastoralists who take pait In seasonal transhumance through the Dogon area. For the mcst part, Fulbe are exduded from declslon- making processes.
Many villages also have cornmnlttees and commissions createdto address the needs of specific interest groups. Dam commisslons, women’s groups, and youth age grade organizations all serve as bases for mobilizing communlty support and for acqulrlng the funds (usually through dues) needed to address members’ concerns. The management capacity ofthese groups varles considerably, and only a few have literate treasurers to keep accounts and the capacity to sanction mle vlolatlons. Nevertheless, these groups have the potential of providing the basic stiucture needed for organlzlng programs Involvimig community participation.
The Dogon are essentlally patrlarchal and women occupy few positlons of authority. Notable exceptlons include traditlonal and introduced mid~rlves,the wife of the village chief, and the president ofvillage women’s committees, where these exlst. Nevertheless, the involvement of women in villagewide decislon making Is normally limfted.
Throughout the plateau, Dogon have been greatly affected by seasonal and permanent migratlon. Appendix L, Table 2 provides some Inslghts into the reasons for and destination ofDogon migrators. Permanent migratlon occurs year-round, while seasonal movements occur most frequently during the dry season. Dry-seasor mlgrants return totheir home village in the rainy season to assist with agricultural tasks. In both cases, most emlgrants are male youths between the ages of 18 and 35 who go to towns and citles, such as Bandlagara, Mopil, Sikasso, Ouagadougou, and Abidjan, because of tnsufflclent employment opportunlties and low levels of labor remuneratlon at home, and the desire for economic Independence.
For the most part, Dogon view seasonal emigiatlon as posttlve. Through remittances, emigratlon provides rural familles wlth an alternalive source of cash income, whlch helps to pay taxes and provides an Important buffer in years of drought and crop failure. Seasonal emlgrants have also been Instrumental In Introducing Innovatlons In their home villages: they are often the first to recomrnend the constructlon of latrines to lmprove health conditlons. Permanent emigratlon, on the other hand, Is consl~1eredto be negative. In some cases famnilles may continue to pay taxes and hold land for family members who have been absent for as long as 40 years. In some cases, entlre vlllages have reseftied to Sikasso om the Seno Plain in search of better land and more regular water suLpplles.
12 Low literacy levels, poor roads, and the plurality of Dogon dlalects Impede Information flow and limit the number ofavallable communicatlon networks. Dogon relayImportant Information both wlthin and between villages orally by messenger.
2.1.2 Water
“DI yal wo, kini wolo.” “Without water, there Is no life.” —Dogon Proverb
As this proverb Implies, water (dl) Is an essentlal factor in the formatlon and survlval of Dogon villages. Dogon establish settlements only where water bas been dIscovered; thus, the origins of most villages are intimately connected wlth water sources. Similarly, the disappearance of water requlres resettlement. Years of drought have caused numerous springs and streams to dry up, forcing whole villages torelocate, usually to lower lands, in search of more permanent water supplies (e.g., Songo, Arou, and one-flfth of Koundou-da). As the maIn constraint in village survival, water Is the single most valuable resource in the Bandlagara Plateau.
Because the rock plateau has a very low water table, each Dogon village Is generally forced to rely on water from a number of different sources. Every village requlres a potentially permanent water supply. Some ofthe most comrnon supplies are pools ofrainwaterthat have collected in a series of open faults or fracture mes in the rock surface of the plateau. These pools may be as targe as 20 m by 4 m, are often algae covered, and because of their substantlal surface area are exposed to evaporatlon. Natural pools such as these may be used by anyone within the village territory.
A second source of water Is subswface water that collects In hand-dug holes, sumps, om traditlonal weils. Many are essentlally natural sources of water that collect run-off during the rainyseason, and have been deepened by farmers in an aftempt to pursue the receding water level. Others are entlrely man-made and dug over several years during the dry season. Whatever a sump’s orlglns, precipitatlon determines sump water availability in any given year. Water holes dug In the beds of watercourses are generally open to anyone for use, whereas those dug by an individual om group areconsidered private property and may be exploited by nongroup members only upon request.
Small springs that trlckle out from between rock layers and flow down to lower elevatlons are a third common supply of water. Some provide yearlong suppiles, but many that were once thought to be permanent now flow only during the ralny season, due to successive droughts.
Among the temporary sources of water in the Dogon Country are seasonal streams that flow through valleys between May and October but dry up shortjy afterward. Duming this season, shallow puddles of rainwater also collect In hollows on rock surfaces.
13 For the mostpait, newly Introduced water sources, such as weils and dams, coexist wlth rather than supplant these traditlonal water sources. Appendix 1, Table 1 provides a list of some of the principal water sources and what tbey are used for in the villages studled.
2.1.2.1 Water Uses
The quanttty and distributlon of water lnfluence crop ylelds, animal growth, and living conditlons. Naturally, water quallty dlrectly affects the general state of health.
The Dogon concelve of water as a resource used in two general domains, depending on tts use. Water for agricultural pursuits Is mostly a male domain, and Indudes rainwater used In raIn-fed millet cultivatlon and river, spring, om ralnwater used for irrigating crops. Water for domestic use, such as drinking, batbing, and launclry, Is considered mostly a female domain. These different spheres have Important Implicatlors for the definitlon oftarget populatlons to whlch development projects in agriculture, potable water supply, om hyglene might be orlented.
~ Water for Agrlculture (dl gidi)
The Dogon main subsistence actlvity Is rain-fed cultlvatlon of staple grains, principally bulrush millet, and to a lesser extent, sorghum, fonlo (digitorta exilis), and rlce. ThIs activity occurs during the ralny season, between May and October, and throughout this period is given priority in labor allocation. Family members who have migrated during the dry season return to their villages to assist in millet cultlvatlon. Dogon accord prlortty to rain-fed agriculture because It provides for the subsistence needs of the compound from one ralny season to the next.
Once the harvest Is completed (October), each hoiusehold looks after ItseLf and must attend to its own consumptlon needs. Younger family rn~amberswho do not have theim own fields must purchase gram to eat until the next ralny season begins. These seasonal differences In labor and grain supply make vegetable gardening and marketing a cruclal means of suMval for all Dogon, and land-poot vlllagers In particular.
Although secondary to millet cultivatlon, dry-season market gardening Is vlrtually the only source of income in the plateau reglon; most vegetables are sold to purchase grains needed to supplement the millet harvest. For this repoit, however, gardening Is most signiflcant because It, more than any other activity, has been profoundly affected by dam construction.
The most Important vegetable that Dogon grow Is the small whlte onlon (Alilum cepa). This appears to be an ancient practlce, and sorne evldence exlsts that onlon cultivatlon in the area predates colonlal discovery (“Bulletin Agricole” in Eskelinen, 1977; Bouju, 1984). Other comrnon vegetables Indude sorrel om “dah” (Hblscus sabadarlffa), eggplants (Solanum melongena), hot peppers (Capslcum frutescens) , ~quash (Cucurbita pepo), melons, calabash, tomatoes, and tobacco.
14 Proxirnity to exlstlng water sources rather than to village settlements determines the locatlon of garden sites on the Dogon Plateau, In order to fadilitate hand-watering of vegetables. Gardens are located adjacent to water sources and are of two basic types: full soli om artificlal soli gardens. Full soli gardens are often createdIn fields afterthe rriillet has been harvested and consist of small beds ofsoli bordered by earthen dikes on relatlvely flat terrain. Protected from animals by stone wails or thatched fences, full soli gardens are generally trrlgated wlth water obtalned from water holes and natural spmings.
Arttflclal soli gardens, bulk upon bare rock, are perhaps the most strlkIng example of Dogon ingenulty and lndustrlousness. These plots, surmounded by stones, are made of soli that has been brought from some distance, mixed wlth organic compost and debris, and surrounded by small stone walls to prevent runoif. These plots requlre special care In watering, slnce excess pressure can easily wash the soli away. Arttflclal garden plots present a rare case of how tenure iights to solI and land do not necessarily coincide.
Onlon gardening begins in October (although some seeding may begin In September) and waterlng of the crops begins the same day om the day afterwards and continues on a dally basis. Some vegetables are cultivated in small garden plots duilng the rainy season. Waterlng Is the most arduous task in onlon cultivatlon because of Its duratlon. Able-bodled men, women, and chlldren leave for the gardens by about 6:00 a.m. Using a calabash (sadla- kodjon), gourds (djogou, saballe) , or a ceramic water jar (deyn), the gardenerdescends to the level ofom into his water supply, fills the container, and then cllmbs back out to water each bed by spmaylng. The amount of water requlred in onlon cultivatlon depends upon the particular stage of onlon growth but, by some estimates, averages about 9.4 liters per m2 or 94 m3 per hectare per waterlng, twice a day (Eskelinen, 1977). This figure does not take into account the splllage that occurs when water Is carrled from the water source to the plots, whlch may be located anywhere from 2.5 m to half a kilometer away. As the water level drops, farmers must descend even lower Into the sumps in orderto fl11 the container. Where permanent water sources exist, such as springs, hand-dug canals are sometimes used to transport water to the gardens and to adjolning holes, from whlch water Is drawn for spray-waterlng.
Several factors are cruclal to market-garden irtigatlon. One Is labor availability. The regularity and duration of watering whlch vegetable plots requlre present a labor constraInt because vegetable cultlvatlon begins at the same time as the millet harvest. The fact that early onlon crops recelve hlgher prlces constitutes an additlonal economlc pressure to begin onlon cultivatlon as early as possible. Larger familles generally divide up to allow the slmultaneous performance ofmillet harvest and vegetable Irrlgatlon tasks. Small families, howevem, generally do not have this luxury.
A second factor in mamket garden Irrigatlon Is proxlmfty to a water source. This is critical because gardens are hand watered. Unlversally, land located closest to the water source is of highest value and is generally controlled by senior members of the village, be they Llneage chlefs om elders. In contrast, the plots of junior lmneage members and of residents from
15 nelghboring villages who have borrowed land are LLSUaIIy located at some dlstance from the water source. Proximity also seems to determine plot size, since larger plots located dosest to the water source can be Irrigated more easlly wlth, the same labor requlred for smaller plots further away.
Thlrdly, In contrast to millet cultivatlon, market gardening Is essentially an individual and male pursult. In several areas, 79 percent of all males age 15 and above are actlve in gardening (Eskelinen, 1977). Although women may also partlclpate Inthis actlvlty, Inmost areas, women are excluded from ownlng their own plots due to inadequate water supply and to the pattiarchal system In whlch males are the focus of income-eamlng actlvltles. Women do, however, work on their husbands’ plots and sorriethnes recetve small profits by selling the pmoduce. In some areas, men have rlghts to the bulb and women to the green shoots of the onlons, providing an additlonal source of Income 10 woman.
Indeed, farmers daim that the maIn constraint to the expanslon of gardening Is Inadequate water supply. Of all the resources wtthln a village territomy, water for Irrlgatlon Is the most valuable and Is assoclated wlth clearly defined usa~erules. Each village terrttory consists of a collectlon of water, land, soli, and other resources that deterrnlne the locatlon of fields and residences. The boundarles of the territorles are clearly demarcated by traditlon. All natural resources found wlthin thelr frontiers and all lmprovements made to these resources are Intended for the use and benefit of village member;. The resources within the tenitorles are, in turn, divided up lnto many plots, whlch are ex:plolted in common by members of dlstlnct lineages. Access to Irilgatlon water determines the value of the other resources within a terrltory and, in fact, govems the organizatlon of space.
• Effect of Small Dams on Dogon Life
By providing a more regular supply of Irilgatlon water, small dams have revolutlonlzed Dogon life. Dams make cultivatton possible in lands that had once been marginal and of littie value. They allow individuals wlth prlme fields to cultivate lamger surface areas wlth less labor. Dams also permit cultivatlon during the dry season, a perlod In whlch agricultural actlvitles would otherwlse be limited. Through their contributlons to agrlculture and especially market gardening, these water control stmuctures have tr~nsformedDogon definitlons of space and time.
As in the case of traditlonal water sources, farmers usually descend to about knee level Into the dam and carry water out wtth calabashes or ceramlc jars. For dams that only retain water through part ofthe season, farmersare forced to descend further and further Into the tiverbed as the water level recedes. When water level Is extremely low, farmers dig holes In the tiverbed and drop Into these to collect extra water.
Aside from providing lnigatlon water, dams are peicelved as brlnging many other advantages, although they were unintended In the dams’ design. Dams permit fish cultlvatlon, the
16 propagatlon of lilies for consurnptlon, the creatlon of recreatlonal swlnimlng areas, a source of drinking water, and a place to water animals. In areas where dams have produced increased slitatlon, the new soli Is also consldered to be a beneflt to vlllages owning the land, as It Is tmanspomted and used for vegetable cultivatlon. All villagers ofthe terrltory In whlch the dam Is constructed are permltted to use dam water for these secondary purposes.
Dam water for Irrlgatlon, however, Is govemed by strict usage rules and, as a consequence, damconstructlon often contiibutes to dlsparitles betweenwater-rich and water-poor wards and villages. Only wards and villages with terrttortes that adjoin a dam site have the rlght to use Its water for Irrigation. Where watem supply and available arable land exceed village demand, outsiders may acqulre a ban of land near the dam site from the village chief. However, dam constmuction often benefits surrounding villages unequally. Although It Is dose by, the village of Korou, for lnstance, Is exduded from using Irrigatlon water from the Korou Dam because the stream Is bocatedjust outside Its territory and belongs excluslvely to the more distant village of Dourou, whose resldents also have access to two other dams. Korou residents may only Inlgate using water from a small stream, whlch appears to have little potentlal for the constructlon of water control structures.
In addidon to intercommunity disparitles, villagers attrlbute other problems to the existence of dams. The resldents of numerous villages studied asserted that dams produced changes In watercourses that resulted In the obstructlon of roads. As a consequence they are forced to walk much longer dlstances to reach their fields or health and government servlces. A second problem, whlch Songo woman identified, was that thè dam caused all of the largest, ancient trees (e.g., Baobab, Silk Cotton, Tamarind) to die. These frees had been an Important source offruit, condlments, firewood, and medicines for whlch the Dogon have been unable to find appmoprlate substltutes.
Despite these problems, Dogon dalm that dams have had an important positive Influence 0fl their lives. Vlllages without dams request them, villages wlth poorly or nonfunctioning dams seek assistance In repairs, and vlllages wlth dams assoclate them with prosperity and well- being. For the most part, vlllages wlth functioning dams claim that health has lmproved since they were constmucted. It Is undear, however, tf this perception Is due to the general assoclatlon of dams wlth weil-being, an actual lmprovement of nutritlon, or bettem hyglene because of gmeater availability of water. Whatever the reasons, the Idea of stopping dam construction because of potential health rlsks is anathema to the Dogon conceptlon of development and improved quallty of life.
As wlth the construction of dams, other new water sources also occaslon changes in land values and give rtse to tenure disputes. In Vaou, for Instance, the discovery of an arteslan well produced a dispute between the landowner and other vlllagers. In the end, the land was redistributed among villagers and the landowner recelved a larger parcel om some other form of compensatlon.
17 • Water for Pastoral Use
Water scarctty makes watering of animals the most arduous task of livestock herders. On the plateau, sheep, goats, cattle, and donkeys are watered at danis and natural surnps, usually at some dlstance from the village. These animals frequently descend lnto ponds and faults to drink. In some areas, dlfferent water sources may be dasslfled for animal consumptlon om for human consuniption, bot as thedry season progresses, the distinctlon betweenthese two types often becomes blurred.
Although most Dogon hemd their own animals, some entrust them to Fulbe herders, who acqulre all the milk produced In return for their setvices. Where water scarctty Is a real problem, Fulbe herders take Dogon herds on a northeasterly transhumance to the Niger Delta. In addition to Dogon-owned animals, many Fulbe herds vlslt the plateau on seasonal transhurnance; these animals are permitted to graze on millet remains because of the rlch manure they deposit on farmers’ fields. The presence of Fulbe herders in many corrimunitles introduces a potential vector for disease transmlslon.
• Water for Domestic Use
Water for domestlc use Is principally a female dornain, as women are responslble for fetchlng water for drInking, bathing, laundry, and most other household uses. As a rule, women tend to use the dosest water supply whlch in many ameas requlres walking and climbing long dlstances over extremeby steep rocky terrain. AppEndix 1, Tabbe 2 represents household water consumption and fetchlng and storage practlces in the villages studied. These figures are based on ralny season estlmates; the quanttty consumed, Is said to be somewhat less during the di~ season. Woman use a varlety ofcontainers to hokt water, inciuding rubber well bags, narrow- mouthed gourds, and rnetal buckets. Able-bodled girls and woman usually fetch water for the consumptlon of thelr own households, although in some vlllages, woman of numerous households of a common lineage fetch water togEthem, store the main supply with the senior household, and transfem smaller quantltles into separate containers for thelr own household’s consumptlon. Both processes usually lnvolve fransfenlng water to two or more consecutive containers. Woman claim tofetch water only wheri the existing supply Is depleted and to rlnse the containers before each fliling, but observatlon showed that this was not always the case.
Whereas iights to irrigation water are carefully guarded, most water to be used for domestlc needs Is considered to be common property and may be expboited by both villagers and nonvillagers, even when It comes from a dam. Some villages use all water sources indlscrlminately; others dlstlngulsh between water sources destlned for drmnldng and those for other purposes. For example, one pond may be used for drinking water (di nod t), while an adjacent pond may be used for bathing and washing utenslls and clothes.
Water sources used for all types of domestic consurnptlon vary greatly from season to season, as numerous temporary ponds and puddies formed by ralnwater become sources of drinking
18 and bathing water. As water supplies become limited during the dry season, ponds that were dedicated excluslvely for drinking water may also be used for Inlgaflon, waterlng anirnals, om bathing. It Is significant to note that this prollferatlon of water sources during the rainy season colncldes wlth a marked increase In dlarrhea, malarla, GuInea worm, and rashes assoclated wlth schistosomlasis.
Based on the volume of the water containers and self-reported data of the numbem of tlmnes the containers are replenlshed dally, the team determined that the average amount of water used by Dogon for domestlc purposes ranges from 15 to 30 liters per person per day. The average Is about 23 liters per person, wtth roughly one-third being used for drinking and two- thirds for other domestic uses. These figures do not Indude water used at nearby stmeams and puddles for bathing and baundry.
When drinking water and water for other domestic usescoma from dlfferent sources, quantttles are usually stored In different containers. Otherwlse, the househobd water supply Is usually held In narrow-lipped ceramic bowls. Most of these bowls are kept In a kltchen In the house, although in the rainy season they may be left open outside to catch extra raInwater. Despite the abundance offiles, there seem to be few mies about covering stored water; both covered and uncovered containers were observed. Covers are usually metal dishes om are made of wlcker. Soma woman complained thatthey had nothing wlth whlch to coverthelr storagejars.
The presence ofpumps and lmproved wells greatly facilitates woman’s work, though In many cases these may also be bocated at a conslderable distance from the settlement. Among the other disadvantages oflmpToved weils thatwoman dted werebad taste (due to metallic pipes), short or fragile cords, cost (750 to 1000 CFA), and scarcity of nibber well bags, fordng soma familles to walt their turn to borrow well bags from other families.
Woman consider accesslbllity and taste as the prindpal criteria for selecting drinking water sources. Sweet tastlng ponds or sprlngs that have been used for generatlons are often the preferred drinking water sources, even when these are a known source of Guinea worm. In Dourou-tanga, a ward renowned for the prevalence ofGuinea worm, villagers continue totake sweet tasting drinking water from a traditlonal seasonal spring, Kametutt~iru,even though an Improved well Is located even doser to the village and a Peace Corps Guinea worm vobunteer lives In a nearby village. For the most part, farmers working In their fields and gardens also select accessible and tasty water sources, though In at least one case, farmers brought well water wlth them to the field to drink during the day.
Even though Dogon generally prefer traditlonal sources of drinking water, when a sweet tasting, easlly accessible improved well Is Installed, the results are drarnatic. In Korou-na, for example, woman claimto take drinking water only from the lmproved well and use two other
19 traditional weils for bathing, laundry, and dish washing. The two types of water are stored In separate containers. In 1989, the year after the Catholic Mission lnstalled the lmproved well, Guinea worm disappeared.
Although rareby employed today, filters (dl tegz~ru)to Improve potabbe water quallty and prepare certaln foods and beverages were tradltlcnafly used by Dogon people. This practice is demonstrated by this popular riddle:
Q: “Neme dlie mogozl. Din Injele mogorI?~ One deans dimty things wlth water. WIth what Is water deaned?
A: “Din yagire ie mogozi.” Water Is deaned by flltering.
Traditlonal filters usually conslsted of a basket 01 an old perforated metal container placed above a ceramic jar and filled wlth millet husks. Some also contalned layers of ash or sand. The purpose of these filters was less to purify wat~rthan to stmaln out the worst of the debrls. Many vlilagers dalmed that they no longer use filters because they now have clean water sources om becausethey have fewer diseases than before. Nevertheless, some filters (tommo) continue to be used to make ash potasse for a popular dlsh (called to) om for millet beer.
Anumber ofyears ago the Hyglene Service aftempi~edto introduce sand, charcoal, and gravel filters, bot vlllagers found the process too labom ln1en~Ive,particularly because the sand and charcoal requlred for the filters needed to be changed regularly and could be obtalned only at great effortand expense. More recently, the Pedce Corps has attempted to introduce nylon filters in their Guinea worm eradicatlon program. Some of these have been attached to traditlonal sleves (tamt) used for stralning millet four. The success of these efforts bas also varied, prlncipally because most women do not draw the connection between Ingesting water and Guinea worm. Some woman also clalmed that the tomt were not always easily avallable or, at a cost of 125 to 200 CFA aplece, were too expensive.
As a result of the Peace Corps and Hygiene Service Guinea worm campalgn, many women have begun to use lmprovlsed filters. Sieves covered wlth boose-mesh net doth are comrnon but lneffective. Woman’s headties are also used tc IFilter drinking water. Womendo not always dlscmlmlnate betweenthe types offabric used, althcugh both Peace Corps and Hyglene Service personnel encourage them to use the tlghter woveii rnaterlals. Women dip the cboth in water, mal&tg It easler to stickto the redpient, and then pour water tbrough. Afterward the cloth Is left in the sun to dry, to be reused later. The Hyglene Service malntalns that this Is the most approprlate form of filtering for the Dogon and cilaIm to have Instructed woman to draw a point on one side of the head cloth before It Is dipped In the water to ensure that the underside doesnot become contaminated. The P~aceCorps does not encourage the practice of dipping the doth in the water prlorto filtering. WIth some experlrnentatlon and a carefully
20 run extenslon program, lmproved water filters would probably be adopted given that Dogon use an equlvalent technology in traditlonal beverage and food preparatlon.
To motivate residents to take drinking water only from Impmoved and tested weils, some vlllages have instltuted a system of fines for water usage vlolatlons. These fines can amount to 2,000 CFA per person per vlolation. Hyglene officials assert that these regulatlons are Intemally generated by village counclls and that the proceeds are kept in a village calsse for the benefit of all resldents. Nevertheless, many villagers appear to be dearly dissatisfied wlth these regulatlons, suggestlng that they provide an opportunity for officials to extort money from villagers.
2.1.2.2 Significance of Water Use for Health and Hyglene
Water use and scarcity have a major Impact on the state of health and hyglene on the Bandlagara Plateau. Three factors in particular are crudal to cornmunity health. One Is water contact. Farmers everywhere coma Into regulardirect contact wlth dam and pond water in the performance of theirdally subsistence actlvltles. Farmers remain for hours, knee-deep In water while deepening ponds and fetchlng inigatlon water. In many areas, vlllagers have to wallc through streams and ponds to reach their fields or visit family.
This water contact seems to be unavoldable. Failing the Introduction of hundreds of small brldges and vemy cheap, labor-savlng, sustalnable, and universally avallable altematlves, farmers are forced to come into contact with water to Irtigate their gardens and to travel. As long as dean, safe, sweettasting (this Is a tmanslation of the local word, whlch lrnplies pleasant or good tasting), and easlly accessible water supplies remain scarce, chlldren will continue to be exposed to schistosomlasis as they bathe in dam reservoirs and streams, and woman will continue to fetch water from sources that spread Guinea worm. Part of the solutlon to the water contact problem, then, dearly Is the Introductlon of clean, abundant, accessible water supplles. Only then could approprlate technology and traIning be intmoduced to reduce some of the behavloral constmalnts.
A second factor relating to the water use and scarcity is poor hyglene practices, particularly among ceitain segments of the populatlon, occurring when water Is scarce. Woman and children appear to suffer most from poor hyglene. Men often bathe at homa wlth water that thelr wlves have obtalned for them. In the ralny season, able-bodled woman and children frequently bathe in shallow puddles on rock surfaces, ponds, streams, and dams. However, thistype of washing Is Impossible in the dry season. Because carrylng water Is such an arduous task, men tend to recelve pilority in using household bathing water and woman and children attempt to bathe when It Is convenlent. Not surprisingly, woman are those who most suffer from hee. Woman wash small Lnfants daily wlth soma of the household bathing water, but children between the ages of 5 and 15 do not recelve this attention and seldom wash themselves more than once or twice a week. Many of these chlldren can be seen wlth nasal and eye dlscharges that attract files and remain undeaned for hours or days. In villages that
21 have them, dams offer an opportunity for better hyglene as an Important source of bathing water, particularly for chlldren of this age group.
Dogon often wash their hands only before meals om after defecatlon; soap Is a luxury and Is rarelyused. There isa conslderable risk oforal-anal contaminatlon, particularly among cbildren above the age of five who are responslble for their own hyglene. The lack of latrines and Irifrequent handwashing contrlbutes to the spread of oral-fecal diseases.
Seasonal changes In water supply are a third factor in water use and scarcity, making water contact behavior difficult to control. In vlllages wthout dams, chlldren become exposed to schistosomlasls especlally in the ralny season, when they bathe at seasonal streams and puddies producing rashes related to cercarlae perietratlon. During this perlod, villagers also obtaln drinking water from many other sources that are difficult to protectfrom contamination, hence the prevalence of Guinea worm and dlarrl’teal lnfectlons during this perlod.
These points demonstrate that woman are key to the success of any development project almed at lmproving water, sanitatlon, om hyglene. They obtaln water for domestlc uses, are responslble for nutrition, and teach their childreri hyglene. In some villages, dlscmepancles between male and female responses to the questlonnalre suggested that, wlth the exception of irrlgation, men did not really know whlch wate~rsources were used for whlch purposes om from where household drinking water came.
2.1.3 Hyglene Practices and l3eIiefs
Dogon compounds contain thatched om walled eridosures used for urinatlon and bathing. When far from the village, Dogon urlnate wherever It Is convenlent or private (In the case of women).
Many Dogon belleve that body products (eg., fingemails) and excretions have contaglous properties and can be used in magie aimed at the person from which the product emanates. For fear that thelr feces will be used agaInst them in harmful “medicines,” many Dogon attempt to be as inconsplcuous as possible when they need to rehieve themselves. Others consider defecatlon to be a shameful activlty and something that should be hidden and as unobtmslve as possible, even among family mernbers. Resldents of a few vlllages sald that defecatlon Is a natural bodily function that need not be hidden. These beliefs have Important Impllcatlons for defecatlon practlces and the poteritlal acceptance of latrines in Dogon areas.
Most villages have no hatrlnes, so resldents defecate In the bush or In the area surrounding the village, sometlmes within 10 m of the house. Usually, however, defecatlon takes place at a distance of some 50 m or more from the village, wlth the exceptlon of children, the elderly, and the Infirm (Eskelinen, 1977). Most people tend to defecate in the early morning om evening hours; therefore, the tendency Is not to go too far from the village. Whlle working In the fields, defecation is often permitted only In uricultivated areas. Residents of a few of the
22 largem and more accessible villages dalmed to take water wlth them to dean themselves following defecatlon, but none used soap. Most others, however, use stlcks and stones, or walt to bathe when they return home. LittIe children defecate in the house and are deaned wlth the mother’s bangle. The fecal matter Is then covered wlth dirt and swept away. When children reach the age of six or seven, they begin to accompany thelr parents to the bush and leam about approprlate defecaflon sltes. Chlldren of this age and older are sald to be less careful about washing afterdefecatlon; anal scratchlng suggests thatthis Is an Important source of oral-fecal contaminatlon. Privacy and convenlence are the two main considerations in the selection of a defecatlon site. Append]x J, Table 1 provides data on these hyglene practices.
The locatlon of bush defecatlon sltes varles conslderably from village to village. The team observed sites both at higher elevations and lower ehevatlons from settlements. Some of these were located near rainwater pools and other seasonal supplles ofdrinking and bathing water. Defecatlon sites located above the village present a risk ofcontaminating settlements and water sources located downhill from rainwater fiow.
Very few wards have latrines; those that do exlst are usually assoclated wlth public servlces, such as schools om rest houses. As Appendix J, Table 2 shows, the rare cases of pilvately owned latrines belong to village chlefs, merchants, midwives, government functionarles, om familles wlth mambers who had migrated to urban areasfor soma time. Children begin to use the lafrmnes when they are about 14 om 15 years of age, since before then they are sald to disregard the hole, taklng advantage of the privacy to relleve themselves.
Dogon beliefs about the magical properties of feces suggest that they would be hesitant to adopt latmines. The team speculated that communal latrines would be easler to Introduce slnce the waste of many villagers would be mixed together, making It difficult to Identify the target for a vlctlm of magie. Family latrines, on the other hand, would provlde an easy means for enemles to attempt to eliminate an entire lineage.
Contrary to the team’s theomy, however, most Dogon vifiagers seemed interested In the Idea of establishing latrines, partlcularly 1f this could be done on a family-by-family basis. The main advantages cited were privacy, convenlence, easy access (particularly for the ill and elderly), and soclal status. Vlllagers without latrines stated that the main obstades to thelrconstruction were expense and lack of materlals, habor shortages, difficult malntenance, Insufficlent space, and inadequate know-how for construction. The main problems cited in villages that already had latrines were unsanitary conditlons as a result of Improper use, especlally from children mlsslng the hole, and hesitancy In sharing the latrlne wlth chlldren and nonfamily members. Wlth the exceptlon ofschool latrlnes, children aregenerally permittedto usehousehold latrines only when they reach about 12 to 14 years of age.
23 2.1.4 Local Perceptions of IlI~iessand Health
“Indé konou selé Ioulo la ya.” “lllness Is the enemy of humankind.” —Dogon provemb
Dogon perceptlons of disease causatlon and frealment are Intlmnately connected wlth bellefs in supematural forces. The High God (Amma), AIlah, and bad luck (dougo) are frequently reported as the cause of maladies. This assoclatlon wlth uncertain and unforeseeable forces refiects a somewhat passlve attitude toward disease and other dllemmas generally consldered to be beyond human control. Nevertheless, Dogon populations have developed a number of traditlonal remedies for some of these affilctions, and villages exposed to regular health services usually have a sllghtly more developed sense of disease causatlon. The presence of numerous traditlonal healers and the coexlstence of anlmlsm, Islam, and Chrlstianlty also offer sufferers soma psychological consolatlon and altematives to homemade remedies. Appendix K provldes tables on local perceptions of causatlon, treatment, and change for the major diseases studied.
The Dogon language contains words for a wide number of lllnesses and affilctlons that are endemic to the area. Table 2 provides Dogon equivalents for soma of the affilctlons deemed relevant to this study.
This table shows that Dogon categorles of dlsease do not correspond dlrectlyto Engllsh terms. For the most part they focus on single symptoms rather than on a collectlon of symptoms assoclated with specific causes. The first five diseases listed are significant for this study, although they do not always coincide wlth what Dogon consider to be the worst lilnesses. Depending on the village, dlarrhea, Guinea worm, chlcken pox, rheumatlsm, sickle-ceil anemla, schistosomlasis, and malarla were consiciered the most seilous health problems. In aggregate terms for nine vlllages, local perceptlons of the worst diseases in descending order were dlarrhea, schistosomlasls, malarla, eyeInfectlons, Guinea worm, meashes, skin Infections, coughs, and sickle-ceil anemla (see Appendix K, Table 1). Glven that onchocerclasls has been eradlcated, interviews with 48 woman about dlsea~esamong thelr 174 children yielded data on Guinea worm, schlstosomlasls, dlarrhea, and malarla. A summary ofthese data is provided below In Table 3 and form the basis of the statlstics provlded in the following subsectlons.
2.1.4.1 Guinea Worm
Because of Its dearsymptoms, Guinea worm is one ofthe diseases that Dogon diagnose mast easlly. Perceptions ofcauses vary greatly dependln~~on exposure to health semvices. Appendix 1<, Table 2 provides data on percelved causes, treatment, affected populatlon, and changes In Guinea worm prevalence In the study area. Mariy vlllagers, elthem In affilcted om emadicated zones, see no direct assoclation between water Engestion and Guinea worm, particularly
24 Table 2
Dogon Dlsease Terms
Ilinegs Dogon Term Guinea wonn téguele, yord, yolo diarrhea kolosâle (“runny belly”) bilharzia ndiarf tentén (“tlnted urine”) malarla/fever godunomd (“hot body”), usually accompanled by body and headaches
headache Koudjin eye Infectlons/onchocerclasls grid) (n simple eye pmoblems gircifi (n sâIa conjunctivitis apollo (believed to have been brought down by the space shuttle) Intestinal parasites soudi (“worms”) big worms in feces sust~n,kikébu small worms in feces odfl t skin infectlons/rashes godumenou lice cou semé red hair (due to Illness om kinguele bane malnutritlon)
night blindness nyanganyama (pinki, Fulbe)
25 Table 3
Disease Sta~IstIcs
Viliags Sampl. 6W % Schisto 4 Diairhsa % MaIarla % sla.
Dourou-tanga 12 4 33 11 92 1 8 — —
Korou 18 0 0 8 44 2 11 — —
Yam~ 31 0 0 31 1CO 7 23 7 23
Koundou-da 29 0 0 29 100 2 7 — —
Nandoli 12 0 0 12 1CO 4 33 12 100
Songo 14 0 0 2 14 3 21 4 29
Vaou 19 0 0 4 21 1 5 5 26
Kori.korl 39 ‘0 0 12 ai 8 21 13 33
Total 174 4 2 109 63 28 16 41 36 (sample 115)
• Denotes villages wtth Guinea worm, but wtth no cases In sample studied.
Key: GW — Guinea worm; schisto — schistosomlasis - because ofthe long gestatlon perlod. Rather, walldrLg in Infected water, wltchcraft or speils cast by jealous family mambers, om God are common explanatlons for the malady. In some Peace Corps vlilages, womenhad been told thatGuinea wormwas caused byIngesting contaminated water and had begun to use water filters on a limit~dscale, even though they stil doubted the connection. In soma places where lrnproved watersupphles have been provided (e.g., Korou), the resuits have been dramatic and the populatlori Is well aware of the causes of the dlsease. More often than not, however, even wlth improvecI water sources, villagers continue to drink from contaminated seasonal water supphles during the ralny season, and progress Is slow (e.g., Songo).
Guinea worm is sald to be common In three ofthe elght vlllages studied, but a sample of 174 children revealed only four cases, all of whlch were found In a single ward, Dourou-tanga. Four of the villages had not had a case of GuInea worm for a number of years. Woman intervlewed in one village (Kon-kou) mentioned three Guinea worm cases, but these were believed to have mesulted from water sources usedi during travel outside of the village.
Guinea worms erupt during the rainy season, the agricultural season in which labor demand for subslstence Is at Its hIghest. Farmers dalm that the debilitatIng illness has a sIgTulfiCant
26 economic cost, since It senlously meduces productMty by hinderIng most physlcal activlty. Depending on the number of worms and their location, sufferers are often unable to work om walk at all. Because ofthis drain on labor, large households wlth an avallable substltute work force appear not to suffer qulte as severely as smaller househoids.
The populatlon that Is sald to be most affected by Guinea worm varles greatly from village to village. In many villages, Guinea worm affects all soclal categonles equally, wlth the universal exceptlon of nursing Infants. In Dourou, one ward (Dourou-tanga) had an exceptlonally large number of sufferers, undoubtedly because of a contaminated water source. Similarfy, in some areas, ceitain compounds or famliles were sald to be more affected than othens. In stil other vlllages, men om children were sald to be the majon vlctims, suggestlng that cholce of drinking water sources varled by age, gender, and household. Effonts at eradication would have to take these demographic factors into account, especlally household consumptlon pattems.
Dogon usually treat Guinea worm by puncturlng the blister where the worm is to emerge, rubbing the area with shea butter, often mixed wlth medicinal leaves, and covering the area with a cloth. Over a perlod of weeks, the dead worm and pus slowly ooze out of the sore. Dogon say that Guinea worm sufferers try to avold water contact at this time because plactng the affected area in water, especlally cool water, Is extremely painful and can pmoduce infection.
1f local pemceptions can be consldered accurate, residents of all affected villages have noticed a marked declIne In the prevalence of Guinea worm (see Appendix K, Table 2). In several cases, eradicatlon occurned spontaneously, without any campalgns or behavloral changes. In others, the dedilne was assoclated wlth Improved wellconstructlon, well treatment, filters, and sanctions agalnst drawing water from contarninated sources. In additlon to these measures, a logical first stepto eradicatlon would be prohibitlng Guinea worm sufferersfrom coming Into direct contact with unlmnproved drinking water sources. Another solution whlch would help to mitigate this problem would be the introduction of approprlate nylon-mesh water filters, circulated initlally by local NGOs or Peace Corps volunteers.
2.1.4.2 Schistosomlasle and Skin Infections
Skin Infections are inciuded in this section on schistosomlasis because the most common skin problem mentioned by villagers was descrlbed as “a rash-like eruption over the entire body affecting children Immediately afterswlmnmlng In freshwater sources” (see Appendlx K, Table 3). ThIs descmlptlon, given by Dogon from many villages, suggests that the rash Is assoclated with the penetration of cercarfae followlng exposure. These rashes are sald to be particularly frequent during the ralny season. Infectlous boils assoclated with poon hyglene and eczema were other skin infections mentioned, but were ofa secondary nature. The team documented no traditfonal remedy for any of these skin problems.
27 Schlstosomlasls Is a partlculai1y lnsldious dlsease in Dogon Country because Its apparent symptoms (blood In the urine) are assodated principally wlth one particular age group (children ages 5 to 15). This fact suggests that chkLren become exposed to the disease when they are first able to swlm and play Independently in nearby water holes. The overall nate of schlstosomlasls In elght villages studled was 63 percent. In a sample of 174 chlldren, this mate ranged from 14 percent in Songo to 100 percent in Koundou-da, Nandoli, and Yarné. Although the conduslons from this random sample are tenuous and the nesuits are hlghly varlable, the highest schistosomlasis rates were generally found in villages wlth working dams and nonfunctioning dams (Yamé,Koundou-da, Nandoli, and Dourou-tanga). Thelowest rates were in vIllages without dams (Songo and Vaou). Two villages exhlblted medium rates of the disease: Korf-korf (31 percent), wlth a partially functioning dam, and Konou (44 percent) ,wlthout nights to a dam for Irnigatlon but wlth one In the vldnlty used by chlldren for swlmmlng. Only one village, Arou, had no neported cases of schistosomlasis among Its 18 lnhabltants, but this is an exceptional case for many neasons (see Appendix H). These resuits suggest that the prevalence, but not the presence, of schistosomlasis Is related to dam constmuction.
Because the dlsease is so widespread (in most area; It has existed as far back as the elders can remembeT) and because the evident symptoms eventually disappear, many Dogon do not conslder schistosomlasis tobe a disease and narely seek freatrnent for It. In these places, blood in the urlne Is thought to be sent by God om is airnost considered to be a necessary rite of passage for children. Other vlllages recognize schlstosomlasls as a disease because children expenlence so much pain when they urlnate on becaüse people who have urinated blood in thelr youth never becoma very strong. Only two of the nine villages (Dourou, Korf-kort), both wtth school and health services, cormectly assocIal~eschistosomlasls wlth water contact. Most Dogon intemviewed sald they knew of no treatrnent but that the dlsease eventually “cured itself,” although three villages mentioned hembal folk remadles and dlspensary pils sald to have varlable resuits. Appendix K, Table 3 provldes data on Dogon views of schlstosomlasts causation, treatment, and epldemniology.
Reducing water contact and pneventlng people from urinating In standing-water sources, the behaviomal solutlons to schlstosomlasls, would be ‘ieny difflcult to Implement. Such a program would requlre Intenventlon on a reglonal scale in the many, isolated villages where small dams have been bullt. I-Ieat and water scarcity makeswlrrimlng in infected areas an Important rneans for chlldren to bathe, cool off, and enjoy themselves. Children urinate whene they swlm. Unless alternative, unlnfected water supplles are provided, dam sites will continue to be used for these purposes. Boots or plems into the dam reservoir aimed at reducing water contact, even 1f affondable and made universally available, would probably be of limited effect since It Is unlikely that chlldren would have access to thErn.
28 2.1.4.3 Dlarrhea
Of all the diseases that the Dogon descrlbed, dlarrhea was most often consldened the most deadly (see Appendix K, Table 1). Vlllagers were unable to Identify the causes of “runny belly,” as dlarrhea is called, but nesidents of a number of villages postulated that It could be due to poor drlnldng water, bad food, or teething. Appendix K, Table 4 pnesents Dogon perceptions about this dlsease. Although dlarrhea affects people of all ages, It Is said to be particularly common among chlldren under five years of age and Is a typical cause of Infant death. It is Important to note here that Dogon mothers have the habit of supplementlng the breast milk for nursing lnfants wlth drinking water and even mashed foods beginning as early as three months.
In a sample of 174 chlldren, about one out of evemy six chlldren (16 percent) had dlarnhea during the two weeks preceding the study. Duning this time penlod, dlamrhea rates ranged from 5 to 8 percent In Vaou, Koundou-da, and Dourou-tanga to 33 percent in Nandoli. These figures are probably at the high mange of the scale, given that the sample focused on children and that most villagers visited sald dlarnhea occurs most fmequently duning the rainy season, the perlod of the team’s research. Vaou and Dourou-tanga are examples of watem-rich communitles, bot generailzatlon about the connectlon between water availablilty and dlarrheal disease should be made wlth cautlon (asthe water-poor community ofKoundou-da suggests). Nandoil, Korf-korf, and Dourou, all wlth falmly high rates of this dlsease (21 to 33 percent), cited diarrhea as the worst of all maladies for thelr communities.
Dogon employ a varlety of home nemedies to treat dlarrhea. The most common remedy Is drinking coolfresh water. Other treatments indude a varlety of herbal Infuslons (such as guava leaves, baobab fruit Julce, or sonnel) and foods (millet and jackfrult). When traditlonal remedies fail, villagers located near health senvlces request medicatlon or injections from nurses. Two vlllages mentioned as remedies dlarrhea medicine from dispensarles om the Catholic Mission. Only one village (Korf-korf) was aware of ORT, but there It was descrlbed accurately and was common knowledge to all women intervlewed, probably because ofthe hard work of a single, dillgent midwife.
Woman were dearly unaware of the connection between diarrhea and fecal contaminatlon. Some woman openly admitted to givlng one Irufant bneast milk wlth the same hand that had just been used for deaning another child’s defecatlon. Dlarrheal Infections could be reduced through the intmoduction of locally made covers for water storage containers where these do not exlst, consdousness-raising about the Impontance of covenIng of Impnoved weils and keepIng well bags and cords free from contaminatlon, and traIning In the lmportance of uncontaminated drinking water sources. A long-term program of woman-run and wonnen- orlented training In basic hyglene and first ald would also greatly allevlate this problem. Traditlonal and govemment-tralned midwives present In many ofthe largen villages would be a logical catalyst for this type of project.
29 2.1.4.4 MaIarI*
Many Dogon of all ages complalned of fever and headaches, the main symptoms they assodate wtth malarla, suggesting that the disease Is endemic throughout the reglon. A surpnlstngly small number ofvillages (three) nelateci the disease to mosqulto bites, as Appendix }(, Table 5 shows. Most had no Idea what caused the dlsease om attnlbuted fever to bad nutritlon, Insufflclent water, and strenuous agricijihural labor under the hot sun. One village (Konou) descrlbed the symptoms of a strange lllness they sald was equfvalent to malarla but that they called danâ. The main symptom of d~n6in tnfants, whlch Is said to be most common during the late ralny season in September and October, is the nising and falling of the connective tlssue at the soft spot on an Infani:’s cranlum. This symptom is sald to signify an advanced stage of malarla and almost ceitain death.
In a sample of 115 chlldren, 36 percent (41) had malaila-related fevems at some point during the nalny season. The highest mate was in Nandoli, which neported that 100 percent (a sample of 12) ofthe children had sevene fevers and headaches due to malarla in the lastfew months. Resldents of Yamé and Songo consldered maLiirla to be the worst disease affecting their populations. In most communitles, all ages and sexes wene equally affected by the dlsease and, as would be expected, It Is sald to be most prevalent durIng the ralny season.
Once again, a varlety of herbal infuslons and warm water baths are traditlonal remedies most commonly used for malarla. Few villagems appeared to use mosqulto nets, probably because of their cost. At present, Dogon wfth easy access to health facilltles dalm that “quinamax” Injections and chlonoqulne pils are the best remedies to malarta they have encountered so far, although preventive maasures may also be In order.
2.1.4.5 Eye Infections and Onchocerclasla
Dogon do not dlstingulsh between onchocenciasis, conjunctivitis, trachoma, and other Infections of the eyes. Onchocemclasls is now saki to be eradicated, although the black fly contlnues to exist In many areas. The team observed only a handful ofcases of eldenly people who may have becoma blind as a result of this disease.
Most of the other cases of eye Infections may be consldered water-washed dlseases, related to lack of water. Eye Infections wene of unknown cause and sald to be spontaneous, coming and going In a few days. As Appendix K, Table 6 shows, these Infections affected all soclal categonles. A numben of cases of persistent eya Infectlons leading to blindness (perhaps trachoma) were also observed.
Two vlllages (Nandoli and Songo) listed eye lnf~ctlonsamong the worst diseases affectIng residents. Songo was one of the two vlllages that had no dam or other abundant supply of water, such as an arteslan well. The Nandoli dam holds water only part ofthe year. Although more nellable data can only be acqulred during the dry season, when water-washed diseases
30 would probably be at thelr highest, these two examples suggest that water scarcity and subsequent poon hyglene are Instrumental In the proLiferation ofeye Infections. Enigmatically, It is the ralny season that is most often mentioned as the perlod In whlch eye Infections abound.
The Dogon believe most eye problems to be caused by supematural fonces. A few vlllages treated them wlth herbal eye drops that had been bolled and cooted. Others used antiblotic creams obtalned from health dispensarles. Better hyglene practices, particularly greaten care by mothers in deaning eye discharges in thefr chlldren, would help allevlate some of these Infections, such as trachoma.
2.1.4.6 Infant Mortality, Morbidity, and Other Ilinesse,
The most strlldng of all illnesses obseived were those affecting emaclated Infants wlth no single symptom or easlly ldentlflable disease. These sc~awnynursing infants no longen had dlarnhea or fevers; they were just the products ofrepeated illnessand long penlods ofpoor nutritlon and hyglene. It would seem that It is this general conditlon, nathen than any single disease, that most takes Its toil on chlldren’s lives. The following table shows that the avemage montality of children as reported by mothers was 45 percent (144/319), but this figure is probably too high, due to the relatively advanced age of many of the woman intervlewed (I.e., It could inciude deaths of grown children).
A list of other Illnesses and Dogon views about them Is provided In Appendlx K, Table 7.
Two slgns indicated problems of malnutnitlon in many ofthe villages studled. One Is the lange number of children wlth kwashionkor, apparent by unnaturally reddish hair. A lange number was obsemved In three villages (Kort-korf, Yamé, Songo), and the problem appeared to be most prevalent among young girls of 5 to 15 years of age and nursing lnfants with dlarrhea. Girls intervlewed sald they were not bom that way, but that the ned could not be washed out of their hair. Many of them also showed slgns of stunted growth. Mothers assoclated the red hair in Infants wlth illness but could provlde no explanatlon for Its prevalence among girls. In many cases, It was considered to be natural and a conditlon that would be outgrown wlth aduithood.
A second slgn ofinsufficlent vttamin intake Is night bLIndness, an affllctlon that In some villages is clearly necognlzed as being nelated to poor nutritlon. Depending on the vifiage, aduits, the eldenly, and, above all, woman are the populations most negularly affected. For the most part, night blindriess was seen as rare among children, posslbly because they gather and eat a varlety of fruits that aduits consider to be unsultable for consumptlon. No dear correlation was observed between season and frequency of the Illness; Dogon frequently describe It as a malady that comes and goes. The most common remady known to Dogon is to cook beef or mutton liver, and have the patlent mInse his or her face and eyes in the julce and eat the liver.
31 Table 4
Estlmated Montality of Chidren In the Dogon Country
Vlilag. Samplo Sla. of Total Niu~berof Number of % D..d Moth.r. Blith. Datha
Korou 4 29 11 38
Dourou-tanga 5 12 50
Yam6 13 99 45 45
Koundou-da 6 58 26 45
Nandoli 3 13 1 8
Songo 4 54 26 48
Vaou 5 10 1 10
Kon-kort 12 58 22 38
Total 4* 319 144 45
A number of other lilnesses mentioned are Indicative of poor hyglene. The most notable are Intestinal parasites and lice. Wonms were found to be particularly commnon and of two types: flat whlte worms and small thin round worms. These affected all segments of the populatlon and were very common in sevemal villages. Lice also seemed to be a problem in some areas, especlally among woman who left their hair plalted for long peniods. Two villages sald that measles was a major cause of child montality. All ~.iillagesknew of the vaccinatlon carnpalgns as the only treatment for the disease. Measles were sald to be most common In the dry season. Epldemlcs plague different villages In diflerent years, but 1988 is remembered as a particularly bad year. Skin Infections, bladder and urlnary trad lnfectlons, and coughs are difflcultto analyzesince soma ofthese may be secorLdary symptoms ofschlstosomlasls om other parasitic diseases. Soma cases of skin and bladder infections may also be attnibuted to poon hygiene. Rheumatism wasa common adult compla int, especlally affllctingolder people. Sickie- ceil anemla, hemorrholds, and constipatlon wer~asoma of the other wldespread maladles noted.
The sample of 174 chlldren analyzed here can only be considered a cursory nepresentatlon of illness in the Bandlagara Plateau. This sample esi:ablishes no dear connection between four of the five principal lilnesses (Guinea worm, diarihea, malarla, and onchocercfasis) and the presence or absence of dams. The data suggest, however, that dams may be llnked to increases In the prevalence of schistosomlasis. Clearly, more extenslve research Is needed to venlfy these flndings. A dry-season study would Illuminate seasonal changes In disease
32 frequency and provide useful Inslghts Into water-washed diseases and changes In hyglene pmactlces in tlmes of water scarcity.
2.1.5 The Dogon and Development
For almost 40 years, the Dogon have been recelvlng assistance from vartous outside actors, first the colonlal administratlon and, more recently, a host of forelgn donors and government agencies. This has led to mixed receptions on the part of vlllagems, as swarms of outsiders coming in for unknown neasons can be a bewlidening expenlence. Numerous villages, for example, critidzed state-run vaccination campalgns for not Infonming thempropenly about the reasonsfor the campafgn or explaining why certain segments of the populatlon were selected as opposed to others. Most vlllagers did not know the purpose ofthe vaccines they received. WIth expenlence, villagers have become extnemely adept at telling development agents what they want to hear. Furthenrnone, the vast majonlty of the local nepresentatlves of these organizations are men, whlch necessarily contributes littie tofemale participatlon. Forexample, In the Hyglene Service, aside from midwlves, there Is only one woman among the 33 extenslon agents, or anlmateurs. As a mle, development prog~amsthat are village based, such as the Peace Conps, or that involve long-term and nepeated visits to the same village, such as the Catholic Mission, tend to be more easily comprehended, better recelved, and more effective.
In many paris ofthe world, donor conslderatlons In formulating developmant programs donot necessarily coinclde wlth village level pnioritles. With familles, age grades, and Intenest groups as the basis for organizing labor, vlllagewlde systems capable of ensuring the participatlon of the entire community are often only nudimentary. In the Dogon Country, however, donor priorlties complement those of the villagems.
Appendix L, Table 1 shows soma of the gender-based diffemences in development piioritles from the Dogon penspectlve. The major development prionltles of Dogon men in the villages Intervlewed were Irnpnoved food security, either through more on Impnoved dams on food ald In drought years, and Increased water supply (In villages wlth nonfunctioning dams om where the only water sources were located at a great distance). Other prlonltles induded educatlon (in Fnench), fertilizer, roads, dlspensarles, and graIn credit banks. Woman mentioned more accesslble water sources, such as lmproved wells, and management asslstance in marketing local produce as thetr main development piionltles. Grain mills, pharmaceutlcal dispensarles, and child care wene other otijectlves that woman mentloned.
These local development pnlonltles show a surpnlslng conslstency between donor focus and village intenests. Labor-saving devlces for woman (such as gram muis) may give wonnen more free time to concentrate on child nutrltion and hyglene. Improved roads also promise to have an Important health and economic effect by promoting access to health facilitles and markets. Over all, from thelr present penspective, the Dogon conslder the economic beneflts of dams to outweigh slgnlflcantly any environmental and health dlsadvantages they mlght cause.
33 Too often development Intenvenfions make target villages dependent on nonlocal and nonrenewable products or leave them even more vulnemable to the clrcumstances of their sodal and physlcal envlronment than they had been befone. Suggestions of new technologles and training to neduce water contact and Improve drinking water sources should take these shortcomlngs into account.
2.2 Health Problem*
The objectlve of this study Is to determlne 1f the construction of small dams in the Dogon reglon Is hamming the population’s health. Several potential negatlve health effectshave indeed resulted (most notably schistosomlasis), as well a; possible benefits (nutritlon and Increased water for washing). The framework for this analysis is that first presented by Whlte, Bnadley, and White (1972) and expanded upon by McJurikin (1982). Their dassificatlon of water- assoclated diseases breaks the vanlous health problems Involved Into four categonles:
• Watemborne dlseases
• Water-washed diseases
• Water-contact dlseases
• Water-related diseases
This dassificatlon also necognizes the different routes of Infection (consumptlon, hygiene practices, physlcal contact wlth lnfected water, and vector-borne dlseases). The consultant team selected representatlve diseases within each category and Inqulred about thelr presence, absence, and Impontance Ineach community vlstted, using the village-type categorles descrlbed in Section 1.1:
• Villages with working dams
• Villages wlth bnoken dams
• Villages without dams
The following is a brIef descnlptlon of each disease, along with the team’s findings.
2.2.1 Waterborne DIseases
Although there are many waterbome dlseases prevalent in the Dogon Country, the team focused on two: diarrhea (undefined) and Guinea worm.
34 Dlarrhea
Descrfpffon and treatment: There are many etlologlcal causes of dlamnhea. Dlarnhea, defined as frequent watery, loose stools, Is the result of the lack of adequate, safe water; lack of pnotection from human excreta; and contaminated food, filth, and files, nesulting in acute morbidity. In lnfants and chlldren there is also the sertous risk of death. Dlarrhea Is treated with the use of ORT—a simple, inexpenslve, and standard nemedy that cân be purchased om made at home.
Flndlngs: Dlarrhea was a major complaint in all villages vlsited. Dlarrhea seems to be most severe In the ralny season and at the end of the dry season, causing loss of life in Infants and small children. One village estlmated that one out of eveny two chlldren die of dlarrhea, a figure that Is dearly ovenestimated but that lndlcates the percelved Impontance of diamrhea as a health problem. The team was particularly dlstressed to find, wtth the exceptlon of one village, a general lack of knowledge of ORT. Dlarnhea is endernlc throughout the plateau but no assodation was found wlth dams. It would appear that dams would Increase water supply and therefore reduce the Incidence of diarrhea; however, dams are not the pnlmary source for drinking. Rathen, dam water Is pnimarily, but not excluslvely, used for washing and Imrigatlon, thus the lack of an assodation.
Guinea Worm
Descrlpnon and treatment: Guinea wonm disease ij)i-acunculus medinensis) is common throughout the Dogon Country. The dlsease is obtained by drinking water contalning Infected cydops, a small crustacean. The worm then takes up to one year to develop before the mature female worm plerces the skin to discharge her eggs when the wound is placed in water. The larvae Infect cydops, whlch when consumed by man continue the cyde (see Flgure 2). flndlngs: Among the villages vlslted, the team found several wlth and wlthout GuInea wonm (See Appendix K, Table 2). Whlle the presence of a protected well may be a factor In the disease’s absence, the team visited a village (Doumou-tanga) that had a protected well but where villagems preferred another, contaminated soumce, and a village (Koundou-da) that did not have a pmotected source but whene Guinea worm was not present. Dams appeared to be a secondamy source of drinking water and therefore are not clearly assoctated wtth Guinea worrn (the Dourou Dam Is adjacent to several villages, only soma of whlch harbor Guinea worm).
Guinea worm is a senlously debilitatlng disease that occurs from late June to Octoben/November. This Is the cnttlcal planting and gardening season; therefore, the Impact of Guinea worm Is dlrectly feIt in village economles. Mali Is participating In the global Guinea worm enadicatlon program. The use of filters has already been dlscussed (Section 2.1.2.1), and allsorts ofdoths are curnently being used for the filter matenlal, although several obsemved
35 wene too ponous to wonk effectively. Proper use of filters, health educatlon in all vlilages In whlch the disease Is endemlc, and provislon of safe drinking water sources are nequlred 1f Guinea worm Is to be emadicated.
Table 5 provides Information on repontedcases sirice 1986. It Is difficultto interpret these data, as the team belleves gaps in the data and underreponting to be a problem; however, there appears to be a downward trend. Twenty-flve percent of all villages have dams, and 25 percent of vlllages wlth dams repomt Guinea worin. Anecdotal Information from interviews showed some connection between impmoved drinking water supplies and Guinea womi eradicatlon. This Information also Illustrates the beneflts whlch can accrue wlth the combined introduction of small dams and a safe drinking water supply. Cun~entpractices of Afnicare and other donors cail for pmovlslon of safe drinking water in each village provided wlth a dam.
2.2.2 Water-washed DIsease~
This group of diseasescovers those in whlch water avallabilty and quantlty nather than quallty are the criteria for poor health; the lack of sufficient water for basic hyglene can result In senious health problems. In most villages wonnen carry water for domestic use, although men weresometlmes observedcarnylng water, usually for Irtigatlon. Undem no conditlons Isthis easy work, but It Is particularly hard in the hIlly, rocky, hot terraIn in whlch the Dogon lIve.
The team looked at three watem-washed diseases: skin problems, eye diseases, and yaws. Yaws, whlch is prevented by good personal hyglene, appears to be endemic and is Indicatlve of the basic lack of sound hyglene pmactlces plaguing the Dogon people. Skin infections were found to be common in all villages, particularly airiong children. Again, good hygiene can be effective In reducing skin diseases. Additionally, in several vlilages, cases of trachoma and conjunctivltis wene a common complaint.
The study took place during the rainy season, when water Is relatlvely avallable. During the dry season, water is scarce, and somatimes people need to travel far to obtain water. Under these conditlons, water use Is restnicted. Thus, throughout the year, the Dogon use very little water—on the average approxmmately 25 liters per person pen day. In this respect, dams have a potentially positive effect. As noted In prevlous sections ofthis report, Inthe Dogon Country, the use of water for bathing and hyglene compete!~wlth other uses, such asswlmrnlng, playlng and washing clothing. Therefore, an Increased au’ailabilty of water for hyglene could result In fewerwater-washed dlseases, but the team was uriable to measure this, and, nevertheless, this potential benefit may be countered by lncreased schistosomlasis. Understandably, health educatlon could have a significant Impact on hyglene practices and assoclated diseases In the Dogon Country.
36 MicroscopiC copepods are Ingsstsd In drinking water Larvs• rSlSiUd from inslds copspod into intsstm.s
Larves migrats to loos. connictivi lasus and mature Into aduits
Mature females. up to one meter long. mlgrats to 11mb
protrudes through blist.r. ready to release larvas
(
Copepod becomes Infected with Iarvae
Larvas r.leaisd info wstv from worm protrudlig tfuough bN$tsr
Figure 2
Life Cyde of the Guinea Wormn
Source: Tropfcal Dlseases In the Developing World. The VBC Project Tropical Disease series.
37 Table 5
Reported Guinea Worrn Cases in the Dogon Reglcin, by Year
R.glon/Vll1sg 86 87 88 89 90 91’
Central
Benedlely 40 16 1 47
Boro 11 3 0
Koundougou 7
(~iguibombo 144 35 0 52 38
Anakanda 15 18
Lougourou Goumbo 15 7
Goro 11
Tabagola 0 0
Songo 0 0
Kon-kon 0 - 0
Kani Gogouna
Kani 0 3
Goundoly 5 52
Irely-Bolo 35 37 9
Sobo 66 22 4
Amalaguene 7 53 0 17
Dologou 26
Kediely 7 5 26 23
Elmo 39
Sougoudounou 2
Dono Nandoli 3 35
•~ are provlded by Peace Conpe for Dourou only.
38 R.glon 86 $7 8$ $9 90 91
Tabatongo 36 Sal Oguol 2
Ningart
Doumogou 5
Kidou 33 11 6
Komodia 3 39 32
SObOdt 1
Kouguini 10
Guinekanda 34 1 3
De 22
Banakane 2
Donou 11
Indou 7
Soughily 14
Dimbti . 29 0
Indeli 3
D~aganda 1
Banna 9
Kendle
Koundiala 191 45 36
Dleye 3
Doni 33 41
Honguye 29
Sogodougou 7 0
Madina 60 50
Goeie 48 17
Indeguln 21
39 R.glon 86 87 8$ $9 90 9P
Kendie 55 0
Kende 45
Tuol 35
Inguire 3
Kantabale 2
Dourou
Dourou 0
Dourouc tanga 87 38 41 39
Dourou na 58 0 3
Pelou 33 4
GwuininlKum 5 1
Yawa 7 34 4
Gulndodjou 8
Nomboit 88 75 2 6 6
KomboKani 24 16 8
Gognogourou 44 14 16 5
Wedie 5 31 50
Konsogou do 6 12
Kayes 1
Yamé 1
Ouo
Komo 56 9
Toumouni 54 10
Bolimba. 24 13 19
Ghaniley 10
Mendoli 3 4
Dialloht 1 4
40 R.gio~ 86 $7 8$ 89 90 91
Eguela Do 0
Arna 5 16
Niogono 0 11 22
Pah 1 4
Koubewal 16 13 0
Gamba 25 0
Koko 48 3
Guoni 18 30
Tegueri 48
Ouo 0
Soh 0
Toli 0
Goundaka
Fiko 12 30
Kanssila
TangaDouba 0
Bounou 2
Bomboni Sare 1
Niana 44
Kargve 1
Makou 11
Kounsila 0
Sangha
K. Komodiguili 11 0
K. Gondakilemo 6
Kamba Bandle 0 TOTAL 913 631 626 39$ 627 134
41 2.2.3 Water-contact DI8ease5I
The team focused on one water-contact dlsease--schlstosomlasls.
Schlstosomlasis
Descnlptlon and treatrnent: WhIle both Schlstosort,ci mansoni and Schlstosoma haematoblurn are found in Mali, within the Bandiagara Plateau, the organlsrn’s presence Is Ilmited almnost exduslvely to the latter specles. In field work, S. tiaematoblum is easler to Identify because It Is charactenized by blood In the uilne. The team fcund that schlstosomlasis occurred in all but one village, the exceptlon being the chantry of tiw Hogon of Hogons, Arou. This one family community Is not involved in Irtigated agrlcultural production and therefore has llmrilted water contact. Further, Its very small dam and reservoir are covened by rock and do not support aquatic life.
Adult schistosomes excrete eggs (S. haematoblu;rn) that are discharged through the urlne. Upon entening fresh water, the eggs hatch into rnlracldia, whlch are free swlmmlng and Infect a host snail (for S. haematoblum these are of thi! species Bulinus, whlch were found in all standing-water bodies studled). Sponocysts form in the snails and rupture out as free-swlmming cercarlae, whlch then infect humans through direct skin penetratlon when a penson enters the water. The disease can be controUed through changes In water contact behavlor (difficult), chemical or biological snail control (expensive and nqt long lasting), and chemotherapy (see Figure 3).
flndings: There was soma Indication that schlstosomlasis was worse In villages with dams, but host snails were also found in natural water bodies. Thetransmission season Is associated wlth the ralny season, when water contact Is frequent.
Schistosomlasls has been a recognized pmoblem for soma time, and dam constnictlon Is a possible source for spreading the disease. The GRM, wlth support from GTZ, has for the last several years carnied out a control program. The government neports that while schlstosomlasls was endemic before the slgnlficant Increase in dam construction, following constmuctlon, increases In both the prevalence and Intensity ofIrifections has been obsenved. Bnlnkmann et al. (1988) report that schlstosorniasis Is a man-made health problem In rural Mali that is associated wlth Irrlgation projects. Infections are assodated wlth water contact pattems for play, washing, and agricufture. Currently GRM and GTZ are provlding mass chemotherapy for all villages wlth dams, but this leaves untreated cases in nelghbonlng villages, whlch are a source for neinfection. The two groups are also looking at possible natural biological control agents (aquatic plants) and the nelationshlp between Intensity of infection and morbidity.
The work of GRM and GTZ dearly lndlcates that dams are a source of increased pnevalence and intensity of schistosomlasis and, therefore, dL~ease.There Is no indlcation that dams have
42 Eüs are deposited In watef In eces or urin. Adutti Droduce eggu that Iodg. Ii ttauues. causrig damage to Iifl9L Nver. spten. ntestbis and urI~ary~sct
Larvel worms matwe to sdutts vi deeD blood veue~ (after about 6 weeks)
penetrate skIn
MWacudpjm hatchei from egg
After asexual reproduCt~fl. thousands of cercarlie emsrgs
Flgure 3
Life Cyde of Schistosomlasis
Source: Troplcal Dlseases In the Developing World. The VBC Project Troplcal Dlsease series.
43 resulted in the Introduction ofthis disease, but this Is oflittie help to newly infected Lndivlduals. Wenen (1989) has tested focal molluscidde treaIrnent uslng nilosamide but found It too expensive. Because each dam Is an Isolated storage system, the Dogon Country may be a good test slte for blological control using predator snails.
2.2.4 Water-related Disease.
Water-relateddiseases indude those vector-bome cllseases for whlch the vector nequlres water to breed. The team asked questions about two d1~eases:malarla and onchocenciasis.
Malarla
Descrlptlon and ftndlngs: Malarla Is endemic In the reglon, wlth the vector (Anopheles mosqultoes) breeding in puddies and other standing sources of water. Whlle Impoundment and water use creates additlonal potential breedlng sltes, malarla Is endemic in villages with and without darns. The major transmission season is the rainy season, when mosqultoes are most abundant. No active control program exlsis. Soma individuals seek treatment at a government dlinic, but most do not. Malarla Is probably a slgnificant cause of Infant and early childhood death. Most of those who have been exposed to and have survived malaila develop soma resistance to the dlsease. Sickie ceil anemla, cornrnon in Mail, also provides some protection against malarla. House construction, sleepingbehavlor, and mosquito biting pattems suggest that this mlght be a sultable reglon for the~use of bed nets.
Onchocerciasis
Descriptlon and findlngs: The rnajor river In the country, Yamé River, and, potentially, dam splllways offer breeding sttes for the vector (Simultum files). Mail was Induded in the original zone covered by the WHO Onchocerciasis ConLrol Program (OCP). After 15 years this program has proven very effectlve; as a result a ger~erationhas grown up without this disease and Its assoclated blIndness. Mail Is scheduled to be Included In devolution (transfer of the International program to the varlous host governrrients). Glven the lack of other investments In the Dogon Country, It is unllkely that the GFLM will be able to maintain spraylng as conducted by OCP, and the lack of knowledge atthe village level of ORT on other basic child survival tools makes one question the potential for effectlve dlstrlbution of the drug, Ivermectin, even though It Is free. Therefore, onchDcerclasls may return, and dams may have increased the number of breeding sites. However, given the curnent effectlveness of the OCP program, onchocendasIs Is not a public health prcblem at the present.
44 Chapter 3
ENVIRONMENTAL AND ENGINEERING ISSUES RELATED TO THE SMALL DAMS AND HEALTH CONDITIONS
3.1 Environmental Engineering
The environmental focus ofthis study and ofthe following discussion Is on the Impact of small dams on the physlcal environment as It pertalns to water-related dlsease and the interrelatlonshlp between environmental conditlons, water supply and sanitation, and water- related health conditlons.
Whlle small dam projects may enhance the project envfronment and increase the economic weil-being and quality of life of the target population, dams also produce negative effects on the natural and human envlronment. Regarding the natural environment, theseadverse effects may lnclude soli eroslon, excesslve water percolatlon resulting in groundwaten contaminatlon, and disruption of native flora and fauna. (The team dId team that a valuable resource, tamarind trees, had been ellminated from one village due to reservoIr construction.) An environmental assessmentto Indude these parameters wasbeyond the scope ofthis study, but a checklist of key envlronmental factons to consider in such an assessment Is Induded in
Section 3.2. -
3.1.1 Small Dame for Irrigation
The purpose of the small dams constructed In the Dogon Country Is to lncrease the water supply in order to impnove smail-scale Irnigation, pnimarily of onion gardens. The first small dam in the Dogon Country was built in 1947. Since then, 107 additlonal concrete dams, typically of about 100 to 150 m In length and 2 to 4 m high, have been built.
3.1.1.1 Dam Construction
Figure 4 shows the cumulative growth In dam construction since 1950. As can be seen, the total number of darns has lncreased sharply since 1977, wlth the largest number (12) being buik in 1987. Flgure 4 also Indicates the number ofgrowing cydes for whlch the dam can hold water. This is an Important criterlon for judging the success of a small dam and wIll be discussed in depth later.
A number of donor organlzatlons have been active in small dam construction, most notably the Project d’I-Iydrauilque Rurale ofthe Catholic Mission, Genie Rural, and GTZ. Afnicare has recently entered into small dam construction, building two small dams (Ouolo and Yamé)
45 70
60
50 ::40
10
0 151 40 641 IS 11170 72 71 1711 10 12 1 lajse 57 59 61 63 65 67 69 71 73 75 77 79 Ii. 63 IS
Total + ZTØ Cyal.. ~> 0fl. Cyal. ~ 1~ Cyci..
Figure 4
Cumulative Constnictlon of Dams Since 1950 since 1987. Appendix E presents information frotri 1987 on donors, dams constructed, and conditlons of the dam. According to these data, approxlmately 65 percent of the 78 dams listed wene found to be in some kind of working onder. Another, more comprehensive Inventory of Dogon dams was conducted by GTZ in 1988 and includes 96 of the 108 dams (Appendix F). The inventory Includes the following Information:
• The number of dams in each of the elght arrondlssements
• The year of dam completion
• Who financed the dam
• The helght and length of the dam
46 • The voluma of masonry used
• The reason the dam does not hold water as planned
• The Deutscher Entwlcklungs Dienst (DED) dassificatlon ofthe state ofthe dam and necessary nepairs
• The avallability of water in the reservoIr. This Inciudes three components: 1) the month(s) In whlch water wIll be found Impounded in the reservoir; 2) after the reservoir is depleted, the month(s) in whlch water will be found in upstream pulso.rds (littie wells In the niverbed); and 3) the month(s) in whlch water will be found In pulsards In the rlverbed downstream of the dam.
• The number of growing cydes for whlch water is made avallable by presence of the dam
The length of time a dam holds water is used in the GTZ Inventory as a crfteiion to evaluate the success of a dam. In the Dogon Country, where the purpose of the dams Is to increase water supply for Inigatlon, dam failure or success Is measured by the amount of time water Is retalned in the reservoir followlng the end of the raIny season In September. Dams are categorized as those that will hold water for one growing season (roughly two and a half months—until December) or for two seasons (until May), after whlch time the ralny season comrnences. Totally failed dams are those that hold no water. Wlth thIs crlterlon In mmd, the Inventory, whlch gives water avallability data for only 74 dams, Indicates that 30 percent of the dams hold water until May and, therefore, are fully successful; 50 percent hold water until December and thus would be consldered partially successful, and 20 percent are useless. It can be sald that 80 percent of the small dams are functlonal to some degnee.
The reasons for dam failure are Important to Indlcate, since small dam construction Is very expenslve. Africare estimates that It has spent 19 to 20 million CFA on each of the two dams It has bulk. The followlng reasons for dam problems have been Identifled by the GTZ Inventory. The number In parentheses Indicates the numben of dams experlendng this problem. Note that a dam can have more than one structural problem.
• The dam wall Is not watertlght. (10)
• The dam foundation Is poor. (17)
• Vertical fissures under the dam allow for the leakage of water. (26)
• Horizontal passage of water occurs around the side of the dam. (13)
47 Of the 96 dams on the GTZ survey, 40 percent werefound to be in good condiflon, requlring no repair; 15 darns are considered to be poorly sited and virtually useless; and 44 dams need repalr of the following:
• A new plasterlng or new asphalt on wall. (19)
• A new watentlght wall upstream. (20)
• Injection of mortar under the soli. (14}
• Repair or replacement of metal parts. e.g., slulce gates. (12)
The consultant team’s observaflons found that the conditions of the dams vlslted were as reported in the GTZ inventory.
The reasons and frequency of dam failures were dLc~cussedIn Bamako with the director of the Service Hydraullque. 1-1e explained that It Is difficult to supervise and coordinate the dam construction activities in the Dogon not only because ofthe remote locations Involved but also because of the varlety of organlzations active in th area. No standard design criterIa or penmit requlrements exlstfor dam constnuctlon. The consultant team’s concern was thatlack of design standards mlght account for the large number of dam failures under the aforementioned conditlons. However, the director and others active it~dam construction Indicated that there are so many different reasons a dam would fail that standards would not guarantee remediatlon of this large failure rate.
The varlous donor groups building small dams in the Dogon Country each take their own approach to the task. The team met with the major dam builder donor group, the Catholic Mlssion, In Bandiagara to determine the guldellnes It used. The Project d’Hydraulique of the Cathollc Mlssion has constructed 35 dams in the last 19 years in the Dogon. The villages requesting a dam need to demonstrate thelr wiillngness to partldpate in constructing and malntaining It. In Its village meetings, the CathoiLic Mission staff met wlth the Village Dam Comrnlttee to determine village contribution. A vii]age must be wIllIng to provide board for the dam laborers, who are often provlded via food-for-work programs. The project next conducts hydrogeologlc tests to determine a proper dam site. Given that the largest number of dam failures are due to teakage under the dam through fissures, this testlng Is obvlously crucial. Yet, as the Catholic Misslon reports, given fleld conditlons and financlal limitatlons, sophisticated testing adequate for proper sitlng Is Impossible. Following construction of the dam, the village Is responsible for alerting proper organlzations of needed repairs.
The lack of cornmunlty participatlon in dam constnictlon was mentloned nepeatedly as a hindrance to sustainability. Applylng lessons learriLed in this area, Afrlcare, a relatively new player in dam construction, has incorporated the following activitles Into dam projects. A Village Dam Committee must be formed wlth a treasurer, and a bank account with 500 CFA
48 per family per year should be established. WhIle this money is intended for dam nepalrs, the Africare dams are too new to have incurred any repair costs, and, therefore, the money Is used as a kind of bank, from whlch loans are made to villagers. The Village Dam Committee also Is charged wtth maintalning the dam reservoir as much as possible. Two young people are chosen to be dam guardians, work for whlch they recelve no pay. Their task Is to go to the city to report dam problems should they occur. The hope Is that this level of participatlon wIll foster a sense of dam ownershlp among the vlllagers, something that Is consplcuously lacking at older dam sites.
3.1.1.2 Dam Repair
Dam repairs in the Dogon are conducted under a project operated and financed by the DED, a Genman NGO. The project’s goal Is to repalr 70 dams in the perlod of 1990-93 with a budget of 3 million Deutsche manks. Roughly 10 to 15 dams are repalred each year from October to March. In onder for repairs to occur, villages must request them from DED. DED pays for the materlals and mason costs but requlres the village to have a fund such as that descrlbed above; 500 CFA per fainily per year Is the recommended contilbutlon. The village pays approxlrnately one-fouith to one-third of the dam repair costs to DED, whlch sets this money aside. Cracks in the Jolnts and masonry are noted to be the most common repair necessary. The largest Impediment to dam repair Is transportation; a bag of cement weighs 50 kilograms, and necessary vehldes for hauling materlals are lacking.
DED has noted the lack of a sense of ownershlp on the village level. Other donor groups have reported that In villages where the community was active In requestlng, fundlng, providing labor for, and sitIng ofthe dam, there was a noticeable increase In attention to the dam. This expertence lllustrates the Impontance of communlty partlcipatlon In development activltles.
3.1.1.3 Operatlon and Maintenance
On the village level there are vlrtually no dam operation and maintenance activities. Villages wlth darns recently bulk may have an appointed guardlan whose task It is to repont dam problems to town. In theory, the Village Dam Commlttee Is responslble for overseeing the general functioning of the dam, Induding reservoir maintenance. Most of the dams In the Dogon Country are overfiow dams wlth no splllways or slulce gates. When the gates are operated, It Is usually at the beginning of the ralny season, when they are used to “clean out” the dam. A villager Is asslgned this task.
One maintenance area in whlch the village could be active Is in reservoir management. As prevlously descrlbed, most danis are not constructed in a mannen to allow for control of the water level In the reservoir. However, the village could be Involved in maintalning the reservoir. For example, in one fleld vlsit, the team observed several dead trees caught at the dam wall, a problem that could nequfre dam repair in the future. In additlon, reservotrs should
49 be keptfree of aquatic vegetaflon. This Is another area In whlch village participation would be needed.
3.1.2 Water Supply and Sanitatlon
A common envlronmental concern assoclated wlth small dam projects Is water-related health problems. The quallty of the water Impounded may be detrlmental to humans, whether by vlrtue of dermal contact or ingestion; wldespnead water availability may offer potential for contamination of the drinking water supply as humans gather to bathe, wash dothes, and obtaln water for domestlc purposes. Accumulatlori of aquatic plants in the resewoirs make control of vectors and intermedlate hosts more dii&ult, and lack of adequate sanitatlon may also result in contaminatlon of the Impounded water as well as other water supplles in the community. The following discusslon will descrlbe problems In the areas of watercontact and water supply and sanitatton and present suggestions for remediatlon.
3.1.2.1 Water Contact
Transrnisslon of schistosomlasis, a focal point of this study, occurs when a community comes Into contact wlth contarninated surface water. As prevlously discussed (Figure 3), schlstosome eggs In human excreta or urlne hatch upon reaching water. The resulting larvae must invade sultable snail hosts or perlsh. Followlng a multiplicatlon process withln the snail, the free- swlmmlng schlstosome larvae (cencarlae) escape from the snail to Infect humans by penetrating Immersed or wet skin. The cercarlae usually remain just below the surface of the water. Therefore, the effect of dams on the human envli-onment, as they nelate to water contact, Is an Important conslderatlon.
Snails were observed attached to aquatic vegetaticn and/or the dam wall. Aquatic vegetatlon provldes snails wlth a firm footIng, a place for fixing egg dusters, and algae feeding grounds. The team observed snails and egg dusters on the bottom of many of the lilypads. Aquatic vegetation also facllltates the breeding of some species of mosqultoes. Consequently, control or removal of this vegetatlon Is a recommended approach to schistosomiasis control. Aquatic vegetation was usually abundant in the dam resewolrs and in the downstream nlverbed.
Snails were only found in those reservoirs that ccntalned aquatic vegetation (Ouolo Ouolo, Yamé, Koii-korl, and Dourou). No snalis were observed in reservoirs without aquatic vegetatlon (Tegourou andupstream Nandoli Dam). In Nandoli, however, the villagersreported that 1f they wash In the reservoir they “get ltchy skin.” The snails found were thought to be Bulinus, whlch transmlt Schistosoma haematoblum. Only In Korf-korf did the team find both Builnus and Blompholorfa snails, and, Indeed onty In Korf-kort was there any suggestion of the posslble presence of Schlstosomlasls mansonl per vlllager health reports.
Team members were interested to know 1f the villagers percelved any benefits to the vegetatlon. Some thought It reduced evaporatlon (whlch It probably does); others mentioned
50 that It was good for flsh. Additionally, the vegetatlon is used for animalfeed, and some people eat the fruit of the lily pad. Slnce there seemed to be no high value placed on the vegetation, a program to involve the vlllagers in Its nemoval from the reservoir as a schlstosomlasls control measure seems vlable.
Assuming the reservoir waters are transmission points for schIstosomlasis, water-contact activttles are Important to understand. Table 1 of Appendlx 1 presents water-contact activitles observed or reported at the dam altes visited. As they wene designed, the dams provlde water for irilgation. The mostcommon method of using the water is to gather It In a calabash, whlch Is carnled to the garden and Its contents spninkled on the garden. This usually involves wading into the water up to the knees many tlmes a day throughout the year. The hands are also submersed as the calabash is fliled. These irrigatlon practices obvlously present health nlsks to the farmers.
Several altematlves to these water-contact Irnigation measures have been considered In the Dogon Country. In the constnictlon of the Tegourou Dam, several technical measures were used to reduce farmers’ contact wtth reservoir water (BrInkman, 1986). One Is a system of gravity-fed canals that reduce contact wtth the water. Another Is water intakes situated in the deep reglons ofthe reservoir. These measures areneported not to be used by Tegourou whlch continues to nepont a high level of schistosomlasls. Unfortunately, a gravlty-fed canal system Is unrealistlc In most of the Dogon Country.
In another aftempt to protect workers from cercarlae1nfected waters, the Catholic Misslon In 1976 tnled to introduce a pump that would deliver the water to the garden from the dam. The project was consldered a failure and abandoned In 1977, because the pump was found to be too dumsy and heavy. In additlon, the nature of the garden soil is such that water pressure would wash It away. The spniniding method wfth the calabash is well sulted for these gardens and not a method to be easily discarded.
Other measures that would reduce farmers’ contact with cercarlae-Infected waters while irnigating need to be Implemented in the Dogon Country. One posslbility would be to place stalrs at the dam slie that would allow farmers to walk to the water level and not into the reservoir. The use of sprinkler cans to replace the calabash and ellminate hand contact while drawing or spniniding the water Is another alternative. Spninkler cans are common In Bamako for gardenlng and cost about 700 CFA. Protecflve gearfor farmers, such as mbber boots, may seem unreallstic but as the Mallans pointed out, other workers, e.g., beekeepers, are used to the notlon of protective gear. In summary, methods need to be explored to reduce farmer contact wlth reservoir water for Irrigatlon.
Besides Iriigaflon, other water-contact actlvitles of concern are recreatlonal and domestic activltles. Schistosomlasis Is so common among Dogon chlldren In villages wlth and without dams that It often seems to be a natural part of chlldhood. Although most vlllages assoclated swlmmlng in the reservoir wlth some health problems (Itchy skin), only in Nandoli and Dourou
51 was the team told that chlldren are strlctly forbldclen to swlm in the dam area. Elsewhere It was recommended not to swlm on bathe In the reservoir, bui the team observed these activitles nevertheless. Washing bodies and dothes Is also more the rule than the exceptlon, as Is cattie drinking. Fishing was observed at several dams buit always from the wall so thatthe IndividuaL was not in contact wlth the water. As desciibedL prevlously, in villages wfth dams where chlldren were routinely swlmmnlng, skin and eye Infections seemed less prevalent than in vlllages with no dams, such as Songo. Finally, In one case, Tegourou, the major road crossed the riverbed just downstream of the dam. When the dam is overfiowlng, as It was during the team’s visit, people walk through the water as they pass along the road—another contact poInt for schistosomlasis transmission.
Clearly, the Increase in surface water associated wlth dams Infected wlth cercarlae has Implications for schlstosomlasls transmission via rccreational, domestlc, and agricultural use. Since the villagers do not have a dear understandlng of transmission, thelr motivation to change water-contact behavlors may be limited. As descnibed earller, It does not appear that they connect water-related diseases wlth the dams. A program directed toward health education and hyglene behavlor Is clearly needed in the Dogon Country to address this problem.
3.1.2.2 Water Supply
The Immediate consequence of the building of a dam Is the establlshment of a reservoIr of water directly available to the local populatlon. As described prevlously, In the absence of a dam, traditlonal water sources are numerous. Since water is at a pnemium, people will use water found anywhere, and water sources often change seasonally. The most common source Is a series of open faults or fracture Ilnes in the rock surface of the plateau. Secondarily, in some low-lylng valley areas, dug holes tap a subsuriFace water source or water collects In small caves or trickies out from between rock layers, whene people collect It. Durlng the ralny season, seasonal streamsflow through vaileys and are exploited for bathing, drinking, clothes washing, and agniculture. ItIs Important to note the 2vaporatlon losses in Mali are considerable and that much of the surface water Is lost to evaporatlon between ralny seasons, even In high ralnfail years.
The use of reservoir water for drinking Is of great briportance in deterrnlnlng the health effects of small dams. It is Interesting to note in documerLts from the 1970s that the dam is referred to as a drinking water supply In additlon to an Inigatlon supply. Given the scarclty of water, this Is not surpnising. However, as the relatlonshlp between drinking dam water and dlsease became evident, dam builders and health officials cautfoned the populace not to drink the dam water. It was dear from the team’s fleldwork that all villages wtth dams have been educated not to drink dam water. Compliance is another nl2ltten. In all vlllages wlth and without dans the teams gathened Information about water sourc2s for all purposes (see Tables 1 and 2 In Appendix 1). In villages wlth dams that hold water for any tength of time, all but one, Kort- kort, report that at some point in the year the inhabll’ants drink the dam water despite warnings
52 to the contrary. Convenlence Is most often cited as the reason for this, as well as taste. In Nandoli, for example, where the upstneam dam holds water untll December, the vlllagers choose to drink the water because the bonehole-cistern well Is 20 minutes away; the dam is only 5 minutes away. An unprotected well is located in town but, “the watertastes bad” there. When the dam Is dry, vlllagers dig holes in the bed that f111 wlth water; this becornes the domestic and drinking water supply. Yamé villagers also commented that the pump was too far away (25 minutes), although people passing by on the road use the well. Two vlllages at first dalmed not to drink the water (Dourou and Tegourou), but when It was explalned that the team was there to help wlth health and needed honest answers, the people again sald the dam water tasted better and was convenlent.
An Iron taste to well water from India Mark II handpumps is the common taste complaint. This has been a pnoblem throughout Mail and activifies are currently underway to seek a solution. The UNDP/World Bank Water and Sanitation Program has proposed fleld tests of PVC nlsing mains to provide suftable altematlves to stalnless steel pipes. The U.N. is also working wlth Direction Nationale de l’Hydraullque et de l’Enengle (DN1-IE) in fleld tests of simple iron- removal devices.
Some villages repont that when a dam Is full and the water Is flowlng over the top, inhabltants feel It is safe to drink the water; when It is stagnant they use another source (Ouolo-Ouolo, for Instance).
Realizing the Importance of pnovldlng a safe drinking water supply to villages wlth dans, the Catholic Mission, as part of Its Project Hydraullque Rurale (whlch has Installed 35 dans), has Installed more than 500 weils and more than 100 pumps in the Dogon Country since 1972. The mission’s goal is to have at least one pump om well In every Dogon village wlth or without a dam. In a swltch from eaxller methods, the Catholic Mlsslon now only constnicts dans in villages where a well is also put in. The dam is virtually free to the villages, but they must contribute up front for pump Installation. The cost of the pump (India Mark II, manufactured In Mali) Is 300,000 CFA. Whether villagers use the pumped water as a drinking water source, of course, Is more a matten ofeducation. In general, the villagers prefer a system of a borehole wlth a dstem well attached from whlch they draw their water because they want to avold broken pumps. Repairs are reported by villagers to be prohibitlve (Korou). No system Is in place on the village level for operatlon and maintenance of the pumps.
Traditlonal hand-dug weils have been rehabilitated by the Catholic Misslon and other donors. The protection of these weils may Indude a wall around the well, a lining in the well, an apron around the well, draInage devices, and a cover. The need for some kind of protection was evident In the consultant team’s fleld observatlons. The team obsenved several unprotected weils thatwere virtually algae covered ponds that requlred one to enterthe water to get water, were open to llvestock, and were enoding along the sides. These holes should be fllled In where thene is an altematlve source of water. The level of protectlon and Its use varles from community to community. Tegourou had the best-protected borehole-cistern well observed.
53 Bulk by the Catholic Mlsslon, It induded an apron, a surnounding wall, structures around the circumfenence ofthe apron to hold the water contaIners (cannenles) upiight, and a drainage canal whene excess water went to a basin for livestock. Ithad no coverthough. People usually bning their own vessel to the well. It Is Important to note that there Is no method of netrievIng water from the wellto avold contaminatlon. Thene Is a need to lncorporate a wlnch and pulley system into well design and a place to rest watE~rvessels safely (such as that descrlbed In Tegourou). However, as mentioned befone, pmotected sources are insufficlent to ensure usage. In Kort-kort the team saw the only well fltted wtth a cover, bui It was ralsed penmanently— the vlilagers thought It was too much trouble to lltft the metal cover each time they wanted water. In other locatfons, the well cover was perrrianently removed.
Drinking water supplles in villages wlth no dan~swere also examined for comparative purposes. The Catholic Misslon Is Involved In prcvldlng safe drlnldng water In these villages as well. As Table 1 in Appendix 1 shows, only Yawa and Koundou have no Impnoved water supply. An Ideal groundwater source Is an arteslan spning, of whtch there are few known In the Dogon Country. Of all sites vislted, Vaou probably had the best quallty and quantlty of year.round water supply. An Improved arteslan spring built in 1984 provldes Vaou resldents with all their drlnldng water needs. There is no Guinea worm in Vaou.
Another village wlth no safe drInking water source, Yawa, uses an unprotected spning In the niver. One wades in the rlver, 1f It is flowing, to capture the sprlng water as It flows from the ground. Yawa supplements this wlth pulsards in - the Yamé niverbed. Songo has an unprotected well that It uses for drinking water because Its borehole Is too far away. (As prevlously mentloned, It Is this type of hole that 5hould be fliled in, since It presents a public health risk and another, safer water supply sourc exlsts.) The bomehole Is onily used when everything else dries up. Guinea worm Is prevalent in Yawa and Songo.
Villages wlth dans that report no Guinea worm Indicate that since they began drinking well water, Guinea wonm has gone away. This Information demonstrates that the presence of the dans does not affect Guinea wonm dlsease. Guln~aworm can be eradicated by the provislon ofa protected safe drinkIng water supply. Schlstosomlasls was reported in all the villages with and without dans, with the exceptlon of Arou. Only Yawa reported “very little” schlstosomlasis, whlch could be nelated to the scarcity of surface water anywhere In the area.
3.1.2.3 Water Quality
The consequences of lrnpoundment by dans on water quallty indude: 1) drastic reductlon in the rate at whlch water fiows, resulting in an lncrease in the number of mlcroorganlsrns present; 2) likelihood of human or animal excrela depositlon near the reservoir, whlch can rapldly pollute the stagnant water; and 3) conceniratlon of matenlals carried by the water in the reservoir. Although the water quallty of the Dogon reservolms has not been measured or monitored, It can be assumed that some of the consequences of Impoundment are operative and thatthe water Is unfit for human consumption. Purtflcatlon ofunsafe drinking water under
54 rural conditlons Is expensive and requlres technical training. Therefore, It Is critlcal to protect the viable drinking water sources from pollution. Particularly in the hydrogeologic conditlons in the Dogon Country, groundwater contamination and subsequent pollutlon ofdrinking water supplles is a concern. Groundwater Is filtered as It fiows through the ground. Whene It fiows through rocks and fissures, as It does in many places in the Dogon Country, natural flltration may be minimal. Unprotected weils, whlch are the drinking water source for many of the Dogon, are subject to pollution by split water as people stand on the edge; by the vessel and rope used for drawing water; by rubblsh or dead anirnals that get In the well; by Infected persons walldng Into the edge of the well; by surface water runoif; and by polluted groundwater. Given the multiple sources of contaminatfon present In any Dogon village and the conditlon of much of the water supply, the quality of the groundwaten nesources used In the Dogon villages Is of concern.
An official wtth Systeme d’Hyglene de Bandlagara Cercle (SHBC) descrlbed the water quality testing and monitoring program used. He is the sole staff member assigned to this task in the reglon. His office is also in charge of general environmental health conditlons In the urban area, a responsibility that consumes most of the office time and resources. In theory, the foflowing Is the water quality monitonlng program. Each well should be tested bactenlologlcally on an annual basis. 1f the well Is contaminated It Is treated with chlonine, retested in three months, and then tested three times yearly 1f there have been problems in the past. No weils are ever closed. In practice, however, little testing occurs. Villages reported to the team that someone came out Infrequently (every one to three years) and put cblonlne In the wells. The SHBC official notes that lack of staff, transpontation, and materlals makes the job Impossible. Currently, there is no battery for the fleld coliform test kit. Of particular concern to this study, the SHBC official, along wlth a representative of the Catholic Misston, notes that the well test resuits frequently show fecal contaminatlon. This is thought to be due to pollution of unprotected weils by livestock and by the ropes and buckets used to extract water. Glven the potential for contaminatlon of the drinking water source, the use of filtration technlques was of Interest to the team. As prevlously described In Section 2.1.2.1, procedures for flitratlon of water for domestic use varles among villages.
The team visited the Bandlagara market wlth a local entrepreneur who makes buckets out of Inner tubes wlth whlch to draw water. These are lightwelght and small (about 4 liters). The water Is then transferred at the well to a larger container. The entrepreneur’s company also makes sleves for food straIning and adapts these, uslng a finer woven materlal, to make water filters. This shows the potential to market effectlve filters for Guinea wonm 1f the matenlal can be provided.
The Impontance of water quality to the maintenance of health and the difficulty In provlding a water quallty monitoring system in remote rural settings serve to hlghllght the need for adequate sanitatlon within the village.
55 3.1.2.4 Sanitatlon
The hyglenic disposal of human excreta Is vItal to community health. The sanitary disposal of wastes will help to control all those infectious diseases that are caused by pathogens in the urine or fecesof humans, includlng diarrheal diseases and schistosorniasis. Whlle most dlseases are rarely transmitted in urine, Schlstosoma hcrematobium, the predominant form of schistosomlasls in the Dogon reglon, Is the exceptton, whlch hlghllghts the need for sanitary disposal of urIne as well as excreta.
Prior to the team’s fleld visits, the team was told that sanitary facilitles were nonexistent In the Dogon Country. On a natlonal level, rural sanltatlon coverage is 5 percent (UNDP/World Bank Water and Sanitation Program, 1991). However, as can be seen in Table 2 of Appendix J, latrines wene indeed observed in the fleld. In addition, the team was Informed that the Latrlnizatlon Project of the Systeme d’Hyglene ha; installed 35 latrines in 20 Dogon villages (some of those observed in the team’s study). Team membens expected some cultural nesistance to the Ideas of latrmnes, since excreta dlsposal is often considered to be more complex soclally than technically. What was founct was a general acceptance of the Idea but a lack of knowledge, on the village level, of how to construct appropnlate latrines glven the reglon’s soil conditlons. On the district level, the team found the dassic lack of staff, funds, and tnansportation as lmpedlments to the latninizatiton program.
As descnlbed in Section 2.1.3, traditlonally, in rnost areas, people defecate In the bush, sometlmes wfthin 10 m of the home. Usually, defecation takes place at a distance of some 50 m from the village, wlth the exceptlon of childien, the elderly, and the Infirm (Eskeilnen, 1977). In areas wlth darns, the villagers sald they cLefecated in areas far away from the dam but agreedthat the possibllity existedfor rain to wa~hfecal rnatenlal Into the dam. Human fecal matenlal within 20 m of the dam reservoir was observed during the Held visits at two sltes. Privacy and convenlence are the two main conslderations in the selection of a defecatlon site. For urInation, the tradltlonal practice is to urinate in a spot In the home compound that Is outdoons and often in a comer area. This is also whene people wash.
When asked 1f they would use a latrine 1f the had one, villagers always responded affimiatively. The advantages they percelve indude 1) convenlence - when one has dlarrhea It is easler to go dose to the house and not to the bush; 2) when one has dlarrhea sometirries one cannot make It to the bush and $0 YOU defecal’e in the house, whlch Is embarrasslng; 3) privacy; 4) the elderly find walking down the rocki difftcult; therefore, a dose latrmne would be easler; and 5) snakes live in the bush. The villaqers who have latnines In their compound are usually Important community members: the chief, the chief’s assistant, the midwife, and the teacher (1f these people are part of the cornirnunity). Thus, there is a soft of cachet attached to havlng a latrlne.
Most latrines observed in the Held were single untrnproved pit latrines. Most wene equipped wlth a concrete squat plate. In some Instances the superstructure was simply a wall wlthout
56 a roof. The most sopbisticated latrlne was the communal latnlne In Tegourou located adjacent to the mosque. People clean the latrine as they come and go to the mosque. This latrmne, constructed by the Systeme d’Hyglene, was a modifled version of the ventilated Improved double-pit latrlne. One pit was sealed, but the other now fllls. Each pit had the nequlsite ventilatlon plpe, although the plpe was sealed within the adobe supenstnicture. The plpes had screens on top. Other types of latrmnes obsenved induded elevated pit latrines wlth a superstructure but no roof at the school In Kou-kon. Although there are three latnInes at the site, the chlldren could not keep themclean; consequently, two are now closed and the third sports a hand-drawn picture of how to use the latrlne properly. Nevertheless, the floor of the school latrine was littened with fecal matenlal, substantlatlng adults’ dalm that “children miss the hole.”
The request for latrines often occurs after vlllagers on migratlon return to the Dogon Country having seen latrmnes in more developed areas. A village puts in a request at the Systeme d’Hyglene latrinizatlon program. The latrine costs 30,000 CFA, and the population is nequlred to participate in diggingthe hole. The salary ofthe mason and the cost ofthe slab and cement are pald for by the project. When the Systeme d’Hyglene constnucts latrines in villages, It first has several animateur sessions with the villagers to acqualnt people wlth their use.
The agency has many more requests for latrines than It can meet. Clearly, there is a need for Improved sanitatlon throughout the Dogon Country and a latrine program would contrlbute to the overall health of the populatlon while serving to mltlgate agalnst some of the negative health Impacts assoclated wIth the dams. Also needed Is an approprlate, low-cost latrine. Due to the rocky soil, there are places In the Dogon Country where dlgging down Is difficult. The latrlne observed in Nandoli hit rock at a depth of 1 m. Furthenmore, the cost is considered exorbitant by some. For comparison, the latrmne costs 30,000 CFA; a metric ton of millet, whlch would feed an average family for a year, costs 50,000 CFA. Much of the latrine cost is In the concrete slab and the pipe. Therefore, modifications are needed. Finally, location of the latnines is Important to conslder. Most home compounds are not large enough to house a latrine safely; therefore, the use of communal property may need to be considered.
3.2 Environmental Assessment
Observatlons In the Held, comments from interested partlesin Mali, and the above assessment led the consultant team to condude that small dam projects should incorporate a preliminary environmental assessment as part of the design phase. For pnojects funded by A.I.D., this would be covered by an Initlal Environmental Evaluation (lEE). However, dams have been built by a host of nelief and development agencles, each of whlch has Its own project design process. Therefore, the following simple checkllst Is provlded to ensure that environmental issues are consldered during any design phase and that mitigatlon measures are taken where appropnlate. Thischeckllst should not be considered exhaustlve, but rather helpful in provlding a basic direction for envlronmental Investigations.
57 In the design and development of small dams, dievelopers are encouraged to incorporate proactlve steps in the Identificatlon and rnltigatlon of potential environmental Impacts. To do so, project planners should demonstrate the following:
1. Knowledge of the existlng ecologic condltlons of the project area
2. Identification ofthe potential effects, positive onnegative, ofproject activitlesupon the envlronment
3. Development of strategles for the mitigatlon and/on preventlon of potentlal, negative Impacts
To facilitate this process, these environmental gulclelines have been developed. Section 3.2.1 provldes a list of physlcal, blological, and cultural factors whlch will assist project planners, PVOs, NGOs, etc., to assess environmental characteristics of the project area. Sectlon 3.2.2 asslsts in the Identlfication of the potential Impacts of different Interventions. Examples of mitigative measures are pnovlded, and questlons to ask about projects are induded. Sectlon 3.2.3 indudes planning and design recommendations whlch will help PVOs and NGOs to plan environmentally sound projects.
3.2.1 Key Physical, Biological, 4nd Cultuzal Factor,
These guldellnes aredeslgned to assist in understanding the ecologlc charactenlstlcs ofthe area where the project will take place. An Lnventory of basicphyslcal, blological and cultural factors will provlde planners wlth an understanding of components that they will need to monitor in the future.
A listlng of key factors to be considered Is provlcled in Flgure 5.
58 PHYSICAL FACTORS
Climatic factors • PrecipItation—average monthly raInfall amounts • Temperature—mean annual temperature
Watershed characterfstk~ • Locatlon of the project area within the watershed induding a topographic map of the project area. A larger scale vlcinity map may be necessary to Identify adjacent/nearby strearns and nivers and project Infrastructure • Size ofthe watershed—hectares above the project area, Induding the project area • Overall slope of the watershed
Groundwater hydrology and quallty • Well Inventory and prevaillng depth of the aqutfer
Surface water hydrology and quallty • Elevation clifference between intake and the water users • Stream discharge rates—llters/second • Waterbome pathogens (E. coil bacterla, Salmonella, Schtstosome, etc.) 1f
intended as a potable water source -
Morphology of the area • Prevalling slopes in the project area • Slope concavity or convexity as an indicator of erodability • Aspect of the project area; an indicatlon of the quallty of the site • Floodplaln characterlstlcs, the frequency of floods, depth of floods, etc., delineatlon of the floodplain on the larger scale vlcinity map • Stability ofland forms—mass movement of soli In the vicinity of the project area • Water eroslon ofsolI—the degree to whlch It Is occurning pnesently, locatlon of silt depositlon as a nesult of the enoslon
SoILs • Soli dasslfmcation—from a soli scientlst or government soli dassiflcatlon maps, Induding physlcal structure and depth to bedrock • Percolation capacity • Compactlon of solI from past activltles
Figure 5
Key Environmental Factors
59 BIOLOGICAL ]FACTORS
Fauna • Threatened specles—state of the population • Endangered specles—state of the populatlon • Critical habltatsfor threatened, endangered, and commercially explolted specles
Flora • Existing vegetative cover—secondary forest, pasture, agricultural lands • Traditlonally utilized specles—food, medicinal, etc. • Threatened species—state of the populatlon • Endangered specles—state of the populatlon • Critical habitats of threatened and endangered specles
CULTIJRAL & LAND USE FACTORS
• Tradktlonal/culturally sensltive sites • Land/soli ownenshlp • Access routes to villages • Water use practices • Level of community participation In the project
OTHER Pi-IYSICAL OR BIOLOGICAL FACTORS
Please list any other environmental factors your fleld staff has Identifled that could be affected (positively or negatively) by the project, and whlch your staff will need to monitor In the future.
Figure 5 col]Itinued
Key Environmental Factors
3.2.2 Assessment of Different Interventlon
This section will asslst project planners to deterrnlne the type of Impact that can be expected for different types of pnojects. The projects are mostly designed for water storage for Irnigation and potable water supply. Other actions will likely Inciude training and educatlon, and
60 operation and maintenance. TakIng no action is an altemative whlch should be considered, 1f any of the proposed activities are judged to be undesirable In the long or short term.
In general, projects should not be located in areas where they will produce signiflcant negative environmental lmpacts on:
• Hlstonlcal and archaeologlcal resources,
• Endangered anlrnal and plant specles, or
• Groundwater quallty.
Archaeologlcal resources are the remalning traces left over by earller cultures. As the science of archaeology matures, every fragment of matenlal in an archaeologlcal site is of potential value to reconstruct the way of life of peoples of the past. Consequently, archaeologlcal resources should be pnesenved.
Endangered and threatened specles are those that are in danger of extlnction as a result of human activities on other conditlons. These specles need to be protected to maintain the bio- diversity of the ecosystem.
Gnoundwater should be protected because Itis the source of water for many communities, and once polluted, It Is very expensive to purify.
Environmental Impacta and Impact Mitigatlon
Development of water pnojects will produce short-tenm construction impacts and other long- term impacts.
Short-Term Construcffon Impacts:
Constructlon lmpacts are generally short term and may Inciude dust, nolse, siltatlon and eroslon. Approprlate construction techniques should be used to control slitation, e.g., the use of hay bales to catch the silt but allow passage of water. To prevent enoslon and dust, construction should be carnied out in the dry season, uslng dust control measures such as wetting. Constructlon noIse should be mlnlmlzed and controlled so that It does not becarne a nulsance to the dwellings in the vlclnlty of the construction project. Project planners should also be sensitive to the sodal lmpacts of the constmctlon crew on villagers who may be nequlred to pnovlde housing and food.
61 Long-Term Impacts:
Long-term Impacts are those that affect the physlcal charactenlstics of the environment in a permanent way.
Archaeologlcal resources can be inipacted by constnuction activltles of the projects. During project planning a prellminary investlgatlon to deLermine 1f an archaeologlcal site is llkely to be found In the project area should be conducted. 1f that possibilIty exlsts, an anthropologlst or archaeologlst should be engaged todetermine the Importance ofthe site, and to dlscuss the importance of the site wlth village leaders.
Endangered plant and anirnal spedes could be adversely affected by the project. The projects should therefore dlsturb surroundlng vegetation as littie as possible.
• Downstream soli eroslon needs to be rnlnlmal and may indude soli catchment basins or other mitigatlng activitles.
• Flooding due to dam failure is a risk. Sites should be selected to ensure that downstream communitles are protected.
3.2.3 Envlronmental Assessrnent Criteria
Project developers should use envlronrnentally sound planning and design practicestopropose projects whlch will:
• Maintain on enhance water quality • Use water efflclently • Protect native and animal populatlons • Protect water nights of existing users • Use existing soclal organlzations and cultural values for environmental rehabllitation and conservatlon • Maintain or lmprove soli productlvtty • Inciude plans for protection of native specles and undisturbed wild areas • Decrease existfng levels of water-assodated disease • Insure long-term sustainability of the water source • Make optirnal use of locally available materlal and human resources • Have communlty support and Involvement • Be based on communlty-Identifled and/or community reallzed needs • Increase potential for community seU~-reliancein both short and long term • Be compatible wlth avallable funding • Make use of and adapt traditlonal technologles
62 • Have a reasonable time frame for the community to take responslbllity for the subproject • Have potential for being maintalned and monitored by the community
When planning a project the deslgners should ask themselves these general questlons:
• Have other possibilitles been considened for accomplishing project objectlves?
• Have all alternatives been examined in detail?
• Have all environmental aspects been considered?
• Are the planned project actions environmentally sustainable?
• Have all the negative environmental aspects of the project proposal been Identifled? Can some or all of those negative environmental effects be mitigated?
• Are the development plans in agreement wlth Mallan laws regarding the envlronmental sector?
• Are there national, reglonal, or subreglonal water nesource plans? Is the project proposal in general agreernent wlth those plans?
• 1f the project Is not In agreement wlth national, reglonal, or subregional water resource plans, can the project proceed and succeed negardless?
• Is the project area near an establlshed protected area?
• Have crltical sites been Identlfled?
• Have cnitical habitats been Identifled (for example, threatened and endangered specles, subsistence or hunted specles, medicinal plants, etc.)?
• Finally, and perhaps most Important, have the planned beneflciarles ofthe project been consulted in project development?
63
Chapter 4
CONCLUSIONS
The objectlve of this study was to detemilne whether the construction of small dams in the Dogon Country had potential health effects. The consultant team’s concluslons are as follows:
• Dams are a source of lncreased prevalence and Intensity of schlstosomlasis, but because dams are not a prlmary source of drinking water they do not present other significant health rlsks.
• Dams may slightly reduce water-washed dlseases.
• Dams are percelved by the villagers to have a signiflcant positive economic Impact on the village, providing a cash Income that is used to buy gram during the dry season.
Given that schlstosornlasls Is the only serlous negative health effect, what should be done? GRM and GTZ are already managing a schlstosorniasis treatment and control program, but this program could use additlonal asslstance. Further, the program should be expanded to cover villages wlthout dams, and there should be Increased health education to Improve hyglene practlces and reduce water contact. However, there may be an altemative to dam constniction that would not result In the same health effects. The team feit that the reglon’s groundw.ater potential bas not been fuily Investlgated, and that groundwater may provide a permanent source of safe water for both agriculture and domestic uses.
Other pressing health Issues should also be addressed—namely child suMval (particularly tbrough dlarrheal disease control) and Guinea worm disease control. Recornrnendatlons addresslng these needs have been Induded and focus on the need for safe drinking water suppiles, sanltatlon facilitles, health educatlon, and hyglene education.
In the agriculture sector, water Is in the domain of men, but for domestlc uses, water Is involved in women’s work; therefore, the team suggests targeting health educatlon programs to women. Aside from the indirect advantages of lncreased household Income and lmproved hyglene because of Increased water availability, dams have benefltted women very littie.
65
Chapter 5
RECOMMENDATIONS
The team’s necomrnendatlons address the initlal objectlve of this study, namely the potential health effects of small dams in the Dogon Country, as well as other health, sodoeconornic, and envtronmental Issues Identifled during the study. Further, the recommendations are specifically addressed to 1) GRM, 2) the NGO communlty, particularly Afnicare, 3) USAID, the Peace Corps and other bilaterals, and 4) the World Bank and other multinationals. While there Is no speciflc project assoclated wlth this study that can lmplement these necommendatlons, the team has attempted to keep them simple and Implementable in hopes that the varlous players involved will act on them.
In response to the objective of this study, the consultant team offers the following recommendatlons.
For GRM/Minlstry of Health (MOH):
• The schlstosomlasis treatment program must continue but should be expanded to all villages In the neglon. Whlle ownershlp of a dam Is assodated wlth Individual villages, schistosomlasis Is endemic In the reglon, and vlllages without dams use the dammed areas for swlmming and washing. Leaving nelghbonlng villages untreated invttes continual reinfection.
• Greater emphasls should be put on hyglene educatlon atthe village level. Most people do not percelve schistosomlasis as a disease, but rathen conslder blood In the urine a normal event for chlldren between the ages of 5 and 15. The potential Impact of schistosomlasis on productivity and long-term negative health consequences have not been analyzed In the Bandlagara context. Health educatlon on these toplcs may be effective in changing penceptions about schistosomiasls and therefore water-contact behavlor. TheSt. Luda, Rlchfond Valley project, a major research project funded by the Rockefellen Foundatlon (Jondan et al. 1975, 1978), demonstrated the effectlveness of water supply and sanitation in nedudng Schtstosoma mansonl. Schistosoma haematoblum Is more difficult to eliminate because people are more likely to urinate In or near water. Providing altemative safe sources of water for drinking and washing will reduce contact wlth contaminated water and therefore reduce the burden of this disease.
67 For Afnlcare and other NGOs working on water ~nojectson the Bandlagara Plateau:
• All proposed dam projects shouldi Inciude a basic envtronmental assessment piloT to Implementatlon (see Section 3.2).
• To ensure that villagers do not use dams for drinking water, before providing a dam donons should adoipt the Catholic Mission policy of providing a safe source of drinking w~ten(protected well or handpump). This should be an explicit policy of all future water projects. In addilion, unsafe water sources should be elirninated by filling in holes, puddles, and so on once a safe water source Is provilded. Unprotected weils should be protected. This indudes incorporating a safe method of water retnieval, such as a winch and pulley system. Success of any water supply and sanitation program requlres active community partidpatlon. The development ofthe community participation program needs tobegin pnior to construction and will involve several meetings wtth the village committee. The purpose of these meetings Is not only to ensure active partidpation In the construction phase, but also to ensure community ownershlp of the project once construction Is complete. Many villages reported that It was the responslblisy of the donors to repair broken pumps, and so on, indicating that the perception of ownershlp was lacking. Acommunity operation and ni~1ntenance(O&M) programshould be established and be responsible for the O&M of the dam, reservoir, weils, and pumps. These responslbilltles would indude removing debris and aquatic vegetation from the dam reservoir. Provislon of safe water sources for drinking water should be accompanled by an educational program demonstrating hyglene practices and the advantages of safe water use.
• In Dogon culture, child rearing, nutritlon, domestic water use, and hyglene are consldened to fali wlthin ~hewomen’s domain. Even though women have littie authonity at the village level, these functions make them cruclal actors In the struggie against undennutnitlon, III health, and Irifant and child mortality. Future health, nutrltion, and hyglene projects should be targeted specifically to women. To have a lastlng Impact, these Interventions would have to involvelong-term education and fundamental soclal change and specific training of village women or female village committees as health agents. Such projects should Inciude baslc instruction In hyglene and first aid, inciuding ORT, advice on locally avallable nutnltlonal supplements, training In culturally appnoprlate water purification technlques, and studies art feasible behavlonal modificatlons to Ilmit water contact.
68 • Coordinatlon of alldevelopment actlvitles must take place on the plateau. The team’s work made Its members aware of the interconnections between health, water supplles, agniculture, and cultural practices. A local NGO (theteam recommends Harmonie du Sahel-.-HDS), wlth assistance from an international NGO (the team necommends Africare), should take on the functlon of providing overall coordlnatlon of all development actMtles and should become art information resource to each development partner. As part of the global Guinea womm enadicatlon program, UNICEF Is developing a simple Geo-base Information System (GIS) to characterlze reglonal Guinea warm. This system could easlly be adapted for the needs of neglonal coordinatlon. Therefore, Afnicare and HDS may want to work dosely with UNICEF and the natlonal Guinea worm eradicatlon program. The other two key players In the reglon are GTZ and the Catholic Mission.
• All developers of water resources and promoters of onlon production should conslder alternative Irrlgatlon approaches (e.g., gravity om siphon systems for downstream fields) om othermeasures toreduce water contact. The Catholic Mlssion looked at pumping as a possibility, and GTZ has developed art extenslve Irnlgation system at Tegourou, whlch the team observed. The disadvantages to these systems are cost, maintenance, accessibility, and gettlng the farmers to use these new technologles as intended. Other possibilitles mlght inciude the use of boots or small bnidges over the water to allow collection without entry. The possibility of replacing calabashes wlth spnlnkling cans (available in Barnako) should be explored. Reducing water contact Is difficult but effective in disease prevention.
• All new dams should be constructed with release mechanlsms such as slulce gates. This would allow for control over the water level In the reservoir and provide a habitat control mechanlsm for schlstosomiasis. It would also allow for dam repairs throughout the year.
For USAID:
• Technical asslstance should be provided to the schistosomlasls control program through R&D/H’s Vector Blology and Control Project II (VBC). Staff in the program have already worked wlth a subcontractor on the VBC Project. Of particular interest are further charactenlzation of the dlstiibution ofschistosomlasis, particularly wlth respect to the presence om absence of dams, measurement of morbidity nesultlng from schlstosomlasls, and the potential economlc lmpacts ofschlstosornlasls on
69 Dogon onlon pmoductlon. This offers an opportunity ofdose collabomatlon between GRM, GTZ, and USAID.
For bilatenals and multilaterals:
• The emphasls to date has been on the provlslon of surface water storage for agricultural producilon. However, the structural geology, partlculazly along the cllffs, and the presence of artiaslan sources (Vaou), plus the high dam fallure mate (loss of water through seepage), suggest that there are significant untapped groundwater resources. New techniques In groundwater exploratlon using LANDSATImagemy and honizontal drilling could nesult in Identification of slgnikant new water resources. Ventlcal wells on the top of the plateau, uriless they are arteslan, have the disadvantage of requlring pumplng. Horlzontal wells in the dlffs, while technically more clifficult to drill, could result in gmavlty-fed systems. A Genman consulting flrm (Agrar-Und Hydrotechnik GMBH) is already conducting Initlal studies on the existing arteslan sources. This should be coupled wlth state-of-the-art explor2ltion studies. Why groundwater? Because groundwater Is more sustsinable than surface water, could support three onlon production seasons, bas no negatlve health effects, and would also be a safe source of drinkIng water. In additlon, along the cllffs, there Is the potential for spmlngs and gravity-fed systems, whlch have not been explolted.
In addition to the above mecomnmendations addressing dam Impacts on the prevalence and Intensity of schistosomlasis, the following recomrriendations are made.
For GRM:
• Guinea worm Is a serlous and debilitaling disease for the Dogon. As part of implementatlon of Its eradicatlon program, the following are recommended:
o GRM should wonk dosely wtth (JNICEF in the development and Implementatlon of an InformatIon system (GIS).
o GRM should obtaln and distribute filter matenlal. Local craftsmen (Daphene) already make filters bul: wtth inappropnlate matenlal. 1ffilters can be produced and sold at the local level, perhaps wlth Peace Corps volunteers (PCVs) om other local NGOs providing health educatlon, eradicatlon of Guinea worm Is atialnable.
70 o It Is Important to charactenize the economic Imnpacts of Guinea worm on onlon production to justify expendltures to control this dlsease. Reduction In health lrnpacts, particularly Guinea worm, may be more effective in increaslng ytelds than fuitherinvestments In water schemes, insecticides, and so on. Therefore, the team strongly encourages such a research study.
o Where possible and In heavily infested villages, provislon of protected water sources Is the most effectlve way to eradicate Guinea wonm at the village level. Filters only deten Guinea womm, while safe water sources detem several health problems.
o It Is Important that the program not only focus on the Dogon but also the Fulbe, as they are also Infected and move from village to village when they seil milk. Whlle the Dogon are village based, the nomadic Fulbe are a posslble source of transporting Guinea worm from an Infected village to an uninfected village, although the Dogon themselves are an altematlve source.
• Health and hyglene educatlon should be particularly directed toward wonnen because in the Dogon Country, the collection of water, the training of children in hyglene practices, and basic health, nutritlon, and first ald are the responsibility of women. Water and water supply is a Women-In-Development (WID) activity.
• Malarla Is a major problem throughout the reglon and a cause of Infant and childhood death. Dogon house structures arevery permanent and the Dogon tend to sleep inside. Therefore, this Is a communlty In whlch bed nets should be an effective control strategy 1f the cost is not prohibitive. As a natlonal health Intervention, the GRM should considem subsldlzing the Importing of bed net matenlal, or at teast ensuring that there are no taxes on the Impontation of this matertal.
For NGOs:
• The consultants Identifled a strong lnterest in latnines; Indeed, the pnmmary stated objectlon to latnines was cost, not sodal taboos or unfamillarlty. It has been found that providing safe water alone does not result In significant health mmpmovements, but when It is coupled wlth sanitatlon, health Improvements occur. Therefore the team encourages a pilot latrine project that builds upon expenlence gained to date.
71 • The team was surprised by the lack of knowledge of ORT and the repomted high infant death mate (up to 50 percent fetal deaths reported, although the team questions this figureL Therefore, wlth the advances of the child suMval program, prornoted by A.I.D. and UNICEF, the team necommends that a child survival program be targeted to the Dogon.
• WIth dams, significant water is lost through evaporation (approxlmately 1 cm a day). One approach to reduce evaporatlve losses Is to construct a compartmentallzed reservoir. Using althen smaller dams and gravtty-fed systems or pumps in a compartmentalir~edreservoir, depth to surface area can be maintalned, thus reducing evaporative losses and extending the usefulness of the reservoIr.
For the Peace Corps:
• The Peace Corps Guinea worm program should be dosely tled to the national eradicatlon program. The nallonal program could provide the filter materlal, whlle volunteers could asslst in the production of filters for sale at local markets and provide health education in their use.
• PCVs need also to focus on child suivival interventions, e.g., ORT.
For USAID and other bilatemals and multinational;::
• Child survival Is a critical lssue In the Dogon Country and should be given emphasls.
• Many development inltlatives beginwllh education, but levels ofeducation services in the plateau are very low. Therefore, the USAID-funded education program should be expanded to the Mopti-Bandlagara reglon.
• The presence of arteslan sources suggests the potential for an economically vlable water bottllng operatlon In the Dogon Country. Currently, hard curnency Is used to Import bottied water. 1f a local source could be developed, forelgn exchange could be reduced, and depending upon the quality and quantlty of the supply, the product could be exported.
• The Dogon reglon Is an Isolated but extremely beautiful reglon ofMali and an Important tourlst attractlon. However, the natlonal volce ofthe Dogon Is limited as they are a minorlty group. Initlatlon of effective programs will requlre an outneach effort by GRM, NGOs, and bi- and multilatenals.
72 Chapter 6
LESSONS LEARNED
Based on the team’s expenlence in carrying out this activity, the following recommendatlons are made for conducting future fleld studies:
• The composition of the team, InvoMng both Mallan and outside experts, dients, and funders (Afnlcare, GRM, WASH, and A.I.D.) proved extremely helpful In understanding the pnoblem and completing the activity with the necessary loglstical support. Therefore, similar diversity Is necommended in the future.
• By conducting a two-day team planning meeting in-country following WAS1-l’s guldeilnes, allteam members were In agreement as to the scope ofwork, noles and responsibilltles, and expectations ofteam members. As a result, this team worked veny effectively together once It went to the fleld. Again, as a result, the team recommends continuing such a process in future studies.
• Rapld village assessment for water supply and sanitatlon projects is an activlty all team members have undentaken In the past, yet there is no standard protocol om checidistfor conducting such rapid assessments. The team therefore recommends thatWASH develop a rapid assessment tool.
• The use of local NGOs (in this study, 1-IDS) was particularly helpful In arranging loglstlcs and fadiltatlng entry Into the villages and the culture and is a practice that should be continued.
• Fleld methods that Inciude inteivlews wlth female focus groups are crudal for acqulring rellable Information on Issues relatlng to wonnen and development. Interviews wlth focus groups of women revealed gender- based differences In development prionitles and knowledge of health and water use practices. Women are generally hesitant to speak In male- dominated meetings and committees, perhaps becausefemale Interactiofi tends to be less asserttve and more participative. These differences made team members aware ofboth the Importance oftalking to women and the need to focus Interventions and educatlonal programs toward wonnen.
73
Chapter 7
BIBLIOGRAPHY
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Bouju, Jacky. 1984. Graine de l’homme, enfant du mii. Paris: Sodété d’Ethnographle.
Bninkmati, A. and R. Steingruber. 1986. “Possible Modlflcations in the Construction of Small Dams to Prevent the Spread of Schistosomlasis,” Tropical Medlcal Parasitology, 37: 199-201.
Brinkmann, U.K., R. Korte, B. Schmldt-Ehry. 1988. “The dlstmlbution of schistosomlasis in relation to water resources development in Mail,” Tropical Medical Parasitology, 39: 182-185.
Bulletin agricole et comrnerclal du poste de Bandlagara, 1893-1905, Soudan Françals. Unpublished reports (National Archives, Bamako).
Cathollc Misslon. 1987. Projet Hydraulique Rurale. Bandlagara: Mali.
Cluff, C. Brent. 1975. Surface Water Storage Potential in the Nam and Sangho Areas of Mail. Report submltted to Hans Guggenhelm.
Dangerfield, B. (ed.) 1983. Water Supply and Sanitatlon in Developing Countrfes. London, England: The Institutlon of Water Englneers and Sclentists.
Degoga, Issa. 1977. La Dracunculose du Mail: Enquête Epidemioioglque dans Deux Villages du Cercie de Bandlagara. Thesis for Doctorate in Medicine. Bamako: Ecole Nationale de Médecine et de Pharmacle du Mail.
Frahan, Bruno Henry de and Moussa Boré Dlarra. 1987. Resultats de l’Enquête Preliminaire en Cinquieme Reglon du Mali: La Plaine du Seno et le Plateau de Bandlagara. Bamako: Instltut d’Economle Rurale, Mlnlstère de l’Agrlculture.
Eskelinen, Rilta. 1977. “Dogon Cereals Project,” in M. Homowltz (ed.), 1979, Sodal Anthropological and Rural Economic Studies in Mali: Dukolomba Forest, The Bandiagara Plateau. Blnghamton, NY: Research Foundatlon of State University of New York. Contract No. AID/afr-C-1045.
75 Eskehnen, Rilta. 1977. “Dogon Agiicultural Systems,” in M. Homowltz (ed.), 1979, Sodal Anthropologlcal and Ruro.I Economlc Studies In Mali: Dukolomba Forest, The Bandlagara Plateau. Blnghamton, NY: IResearch Foundatlon of State Universlty of New York. Contract No. AID/afr-C-1045.
Gallals, Jean. 1965. “Le paysan dogon (Républlç~uedu Mali),” Les Cahters d’Outre-Mer, 18 (70): 123-143.
Geler, Jacquelyn. 1991. “Bandlagara Guinea Worm Conference of 1991,” Final Report. Bamako: Peace Corps.
Guggenhelm, H., and R. Fanale. 1975. Guggenheim 1975 Mali Project A Shared Technology for Development. The Wundterman Foundatlon.
Guggenhelm, Hans. 1976. Guggenhelm 1976 Mail Project: Post Harvest Food Problems, the 5th Reglon of Mali. Repomt ifi to Chrlstlan Ald, The Wundemman Foundatton.
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77 Whlte, Gilbert F., David J. Bnadley, and Anne U. Whlte. 1972. Drawers of Water/Domestlc Water Use In East Afrlca. Chicago: Unlver3lty of Chicago Press.
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78 PHOTOS
4 4~ _Ç ‘~t:f~3~r~4~0 Photo 1 Well in Nandoli, built in 1991 by the French This well is a 20-minute walk from the village When the well in town dries up during the drs, season, villagers use water from this well to drink. People working in the fields also use it
79 1,
—- .s~-~-~—~- _- -4 ‘t ~ T~.- -
Photo 2 Dourou dam built in 1984, 3 5 meters high and 131 meters long Villagers bring the soil to garden plots adjacent to the dam and build up gardens on top of the rock
t4~
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a -. ~
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Photo 3 Kon-kon dam, built in 1973, is 2 meters high and 234 meters long Besides irnigation and livestock watering, the reservoirs are used for bathing, swimming, domestic uses, fishing, and sonnetimes drinking The reservoirs typically contain large quantities of aquatic vegetation ~vhichprovide a habitat for the snails which transmit schistosomiasis Also apparentin this picture is leakage at the dam’s downstream base
80 Photo 4 Kori-kori dam Water contact with reservoir water is extensive in most villages Here one woman is bathing henself and another is prepaning to wash her clothes
81 Photo 6. In Yawa, a village v~iLh no dam or protected water supply, villagers have been taught to filter their drinldng water to protect against guinea worm disease This woman is using her head scarf as a filter
82 Photo 7 Focus group discussion held in Yamé
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Photo 8 One of the veny few latrines in the Dogon This ventilated impnoved double pit latnine in Tegourou is adjacent to the village mosque
83 ~ :T~’.
~. ~- -~--.~ .~ ~ ~
Pboto 9. Antiamba Tembely, Sea~etaryof SOda] and Cultural Affairs of the Harmonie du Sahel, at an India Mark II pump built by the Catholic Mission In 1985. The hollowed-out log serves as a watering lrough for animals The pump is about 15 minutes walk from the village. Passersby drink from it but the villagers prefer to drink from surface water sources. Th~water from the pump ~tastesbad”
84 App.iidI~A SCOPE OF WORK/REQUESTING CABLES
SCOP~OF WORK
MALI: TA TO EXA14IN~TRE HEALTH EBTECTS OF DANS IN THE DOGON COUNTRT
BACKGROUND
Nearly 100 danis have been constructed in the Dogon region over several years. Though waters in the dams were meant to be used for irrigation to increase traditional garden production, they are also used for drinking water. The dams are suspected of being responsible for some increase in water related diseases. This may be because the water stagnates for up to 11 months after the rainy season, and because the villagers use this water for personal and domestic needs, inciuding animal use. Africare, GTZ and other international donors involved in the financing and construction of the dams, are becoming increasingly concerned about their envirorimental health effects and in identifying what can be done to mitigate these effects. As a result, USAID has requested WASH Technica]. Assistance.
SCOPE OF WORK
Activities for USAID
The WASH consultant will be part of a three person team inciuding an environmental public health expert and a water resources engineer from AID’s Office of Hea].th of the Bureau of Science and Technology that will go to the Dogon region in Mali for a period of three weeks to do a rapid gualitative assessment of the extent of the problem, to identify obvious immediate and long term rernedial actions if possible and to make recomxnendations for further study if needed.
GENERAL TASKS OF THE TEAM WILL INCLUDE: (1) gather information on the prevalence of water related disease and existing local prograxns to combat them;
(2) assess the environmenta]. health effects of dai~s;
(3) identify mitigating measures for use in design and after construction;
85 for villages which have dams;
(5) consider and recommend other alternatives for providing drinking water such as water weils,, catchments, etc. with due consideration for groundwater avai].ability and cost of such alternat ives;
(6) submit draft report to AID/Baxnako’s Health Officer and discuss resulte with AID and other concerned parties and;
(7) finalize WASH field report.
The specific tasks of the social scientist will inciude:
(1) Conduct interviews with selected people (by age, sex, ethnic composition) onchanges of disease patterns as they relate to the construction of the dams. This task ciin be done in focus groups and then followed up by more in depth interviews. The information here should note differences between categories, e.g. are migrants more prone to disease than sett].ers?, men to women?, etc.;
(2) determine whether or not people view the environinental health effecta as resulting from the dazns;
(3) identify key indicators that will need changing if and when programatic action is taken to reverae effecta of dams and;
(4) outline additional reseach, if necessary, to develop the most appropriate interventions for health improvements and;
(5) assist with the writing of the WASH field report PERSONNEL
The WASH consultant will be a socia]. acientist with a public health background, fluent in French, with experience in French speakirig
Africa - prefarably in Mali.
END PRODUCTS
ANN - PLEASE FILL IN
SCHEDULE
Start: Auqust 11, 1991 Team Planning Meeting: Auqust 12, 1991
Field Work: Auqust 13 - September 5, 1991 End: December 30, 1991
86 (4) identify possible health training interventions and their costa for villages which have dams;
(5) consider and recommend other alternatives for providing drinking water such as water weils, catchxnents, etc. with due consideration for groundwater availability and coat of such alternatives; (6) submit draft report to AID/Bamako’s Health Officer and discuss resuits with AID and other concerned partjes and; (7) finalize WASH field report.
THE SPECIFIC TASKS OF THE SOCIAL SCIENTIST WILL INCLUDE:
(1) Conduct interviews with selected people (by age,sex, ethnic composition) on changes of disease patterns as they relate to the construction of the dams. This taak can be done in focus groups and then followed up by more in depth interviews. The information here should note differences between categories, e.g. are migrants more prone to disease than settlers?, men to women?, etc.; (2) determine whether or not people view the environmental health effects as resulting from the dams;
(3) identi.fy key indicators that will need changing if and when progranunatic action is taken to reverse effects of dams and;
(4) outline additional research, if necessary, to develop the most appropriate interventions for health improvements and;
(5) assist with the writing of the WASH field report.
PERSONNEL
The WASH consultant will be a socia]. scientist with a water and public health background, fluent in French, with experience in
French speaking Africa - preferably in Mali. The consultant should also be able and willing to travel under difficult conditions.
END PRODUCTS
WASH field report
SCKEDULE
Start: July 18, 1991 Team Planning Meeting: August 30, 1991
Field Work: September 2 - September 25, 1991 End: December 30, 1991
87 . . S • S S S S S S S • S S S S S S S S S S II S • 5 • 5 S S S U U 5 • • 5 • S S ACTION UNCLASSIFIED INCOMING COPY TELEGRAM AGENCY FOR INT’L DEV. TELECOMMUNICATIONS CENTER
PAGE 01 8AMAIÇO 02912 3012542 6609 028429 A104630 ACTION AIO-00
ACTION OFFICE STHE-04 INFO AFFW—03 AFCw-03 AFPO—04 AFTP-Ø5 SAST-Ol FVA-01 ES—0I SrFN—02 STEN-ri AMAD-Ol ATpc:-04 AAAF-03 7033 AS 30/1307Z
INFO LOG-OS AF-00 /002W 804728 3012542 /38 R 301208Z APR 91 Fl4 AMEMOASSY BAMAKO TO SECSTATE WASHOC 9693 AMEMOASSY ABIDJAN
UNCLAS BAMAKO 02912
AIOAC
AIO/W FOR ST/HEALTH JOHN AUSTIN AND i~FR/TR/llPN JOHN COURY; ABIDJAN FOR REOSO/WCA JOHN PAUL JAMES
E.O. I23S6:N~A SUOJECT: PROPOSED ST/HEALTH AND WA!H CONSULTANCY TO MALI IN AUGUST. 1991
RE~S: CA) ST/HEALTH TO USAID FAX 4d’l~2/91; ~) 90 BAMAKO 0704e; (C) 90 SrATE 24117. ~) BAMAKO 03237
1. WE APPRECIATE PROPOSAI. FOR FIELO ASSESSMENT MISSION. OUR ABILITY TO PROVIDE LOGISTIC SUPPORT (COMPUTERS. SECRETARY. ETC. 1 IS LIu1rEo OUT WE WILL DO OUR BEST. PEACE CORPS WILLING TO PFIOVIOE ASSISTANCE WITH LOCAL TRANSLATORS AND VILLAGE ]:NTRO0uCTIONS THROUGH THEIR VOLUNTEERS IN THE AREA. WE WLL UNOERTAKE
TRANSPORT ARRANGEMEP4TS OUT WILL HAvI: TO CONSULT ON TEAM SCHEOULE TO ENSURE COOROINATION WITU OUR OTHER REOUIREMENTS. TIMING OF ARRIVAL IS FINE.
2. LOCAL PRITECH REPRESENTATIVE WII.L 0E AVAILABLE FOR MEETINGS WITH TEAM 1F DESIRED OUT WOULD NOT 0E INVOLVEO WITH FIELD VISITS. WE RECOMMENO INCIL.USION OF LOCAL NIH MALARIA ADVISOR DR. RICHARO SAI~AI. IN THIS ASSESSMENT AS WELL AS HIS MALIAN COUNTERPAPT W14D IS FROM DOGON ETHNIC GROUP.
3 EARLIER COMPAJNICATIONS ~EF 0) REOUESTEO ST/HEALTH TO CONTACT AND BRIEF AFRICA BUREAU IENVIRONP.ENTAL OFFICER JOHN GAUDET. PLEASE ADVISE 1F THIS BRIEFING HAS TAKEN PL. ACE.
4. PI..EASE 0E AOVISEO THAT MISSION l~Ot.ICY REQUIRES THAT ALL NON-USOI4 TRAVELERS TO USAIO~MALl. MUST 0E COVERED BV * VALIO MEOICAL EVACUATION INSURANCI! POLICY AND NOT JUST A MEDICAI. HEALTH BENEFITS INSURANCE PLAN. UPOP’f ARRI VAL IN MALI. TRAVELERS WILL 0E REQUIRED TO PROVIDE THE NAME. ADORESS ANO TELEPHONE/TELEX. NUMOER OF THE INSURANCE COP.~ANY~ AS WELL AS THE POLICY NUMOER TO THE USAIQ/MALI MANAGEMENT OFFICE. VISITORS wITHOUT PROOF OF A VALIO POLICY MAY DE OENICO ACCESS TO EMOASSY HEALTH UNIT PACILITIES.
5. PLEASE PROVIDE ADDITIONAL INFOR~ATZON ON CONSULTANCY WHEN AVAILAØLE. BEST REGAROS. GEL OER
88 ACTION UNCLASSIFIED INCOMING COPY T EL EGRAM AGENCY FOR INT’L DEV. TELECOMMUNICATIONS CENTER
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SUSJCCI: 11*311 C00$ULTAIICY TO MALI 10 STUDT IIALTU (FICCIS 1tS0(11U6 F1011 SMALL 0011 CCISTIUCTIOI NOTE: P03510 TO 110V! A001CSSL(
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2. ALL (SMAL *IIMG(IENIS (OS LOOISTICI IIANSPOITAT lol TI*19.ATOOS CIC. WILL St MIII WIS TIL TEAM *111015 IS COUWTI!. 1151(0 *00 AIIICMI WILL *35157 TO TIL (111(07 TUAT DIA ItSOSCES PI1IIIT. USAIS CM P111101 DIIE V1IICtC (OS TEAM AlS 11(11 1101F *0 AFIICAAL Ii WILL III TO P000101 DIII VIlIUL VIII 10(11 PAITICIPIOT OUT (11101(5 01 (Uit 1011181 III IT Wil. LOCAL PIACL COV$ VOLVITEEII II 101101*611* ILCOVEISU *1 (RCLLLCN1 00605 TIAM51ATCI IN * PUVIOU$ VII, TO III — 116101 NS CII *00111 TIM II MIII 011(1 VATE 00 LOCAL CCIOITIO~.
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L’Am&horation do ~ vie en afsiquc 1111111e en dévetoppant ES 1E~0UICO1 hydtiuliques la production lI!~ico1eSt l~seivicos de ilnté BP 1792 Tél. :a2.37i3~Bimako Rêpubliqtre du Mali
Effects of Bandiagai-a Circie Water Retention
Structures on llealth — Need for Assessment
January 1990
90 l3ackg round
During 1989 Aft-icore and the villagers of Oufou-Oulou, 13~ndiag~*r~.a Circie, completed construction of a 90 meter long rock and masonry dam. The project bas allowed the 40 Dogon fami1ie~ associated with the project to e~pand their production of onions by increasing the nico under cultivotion from 2.0 to 3.0 hectazes and by permitting the planting of two, s-other th~n one, crops during the October to March growing season. The result is that the villagers now grøw nearly three timcs as many onions as before the dam and they have been able to grow additional crops such as (loating nee on the penimeter of the dam. This project. which is now in its laat. stage, is partially funded by a S30,000 grant from the United tiethodists Committee on Relief (UNCOR) and ~in part front Africare’s matching agribusinese project (Grant- No. ~PDC 0266-G-SS-5068—00) from AID. The project not only entailed 1the construction of a dam but also training in accounting and management for the gardeners to maximize their bcnefits and ~contribute to the sustainability of the project.
:The success of the Oulou-Oulou dam inspired the neighboring village ofYame, three. kilometers northeast of. Ou]ou-Ou]ou, to request that Africare help them construct a sCinilar dam. With
- ~searly 12,000,000 FCFA from the FED and S25,300 from the Jesse Bessen Foundation, Africare and the villagers begon this proicct in 1989. This nearly identicol replica of the Oulou-Oulou prO.ieCt is now fully underway with the excavation of the fourtdation completed and the first masonry work begun in January 1990. The Oulou-Oulou and Yame dam projects are among near]y 100 dams e.pnstructed os- being constructed in the Bandiagara Circie with most having been constructed by the Catholic t3ission, GTZ and the CRM’s Genie Rus-al. -Of the neanly 100 dams about one-third have fai]ed to hold water of fectively cnough to have much agricultural impact. The other two—thlrds of the dam have significantly helped the population increase their incomes and pr-oduction. The GTZ attnibutes 40% of the onion production in Bandiagara to these .dams.
Ppes~bleProblem As in other water retention programs it is possible that the dams constructed in the Circie have had negative health impacts by increasing the incidence of water borne diseases. Halaria, schistosomiasja and guinea—worm hav, all been identified as diseases found in Bandiagara and it is possible that the dams .h&ve.helped aggravate the problems..In the design of the Africar. projécts it had been anticipated that the Affairs Sociales ofth. GRH would provide health education and sanitation instruction to the village population. While some extension training -has taken place, Africare has noted that many gardeners in Oulou-Oulou continue to drink water from the dam rather .han from the for~ags well installed by the Catholic 1lission in1 conjunction with~.the
91 project. The gardeners presumably’ believe the convcnlence ot drinking watcv from the dom reservoir outweights the potenlia] lieul Lit b!lI1!fitS of drinking the ~e1l watcr. CTZ and CaLlii~iC .Mission workers have notcd the soine problem at other dam sites.
Unfortunately no baseline health data IJas ob~tained in Oulou-Ouloi.. or YaIIIe indicating the health situation prior to constructioti of the dams nor any survey taken after the construction of the Oulou—Ou]ou dam. Since we do not. know the jncider~ce of disease either before or~nfter constructjon of the dams, we do not know the degree of health problem (if any) caused by the Africare dams. Unfortunately no money is available at this time to conduct surveys in either Yame non Oulou-Oulou. To our knowledge. no other organization has collected data on the incidence ofwater borne dieeses in the Bandiagara region betore or after the constructjon of a dam.
Services iJeeded
These is and has been health training about water borne diseases in the area but these have not been conducted in • coniunction wjth any reliable data collection. To properly andes-stand ~rid potentiajly address any negative health problems caused by dam construction in the Bandiagara CirciLe, it would be useful to: 1) gather information regarding-the pnevalence of disease in
the. zone and the programs to combat. them; -.
2) assess the environmental health effects of dams in the -%Bandiagara Circie (a baseline stLldy could be conducted in Yame, which does not yet have a dam, an~L it could be compared to a similar study in the neighboring village of Oulou-Oulou which has adam); 3) potentlally identify and help plan a health training interventjon for villages which have dams.
92 DRAFT SCOPE OF WOR1~FOR NEW TASK MALI: THE HEALTH IMPACT OF SMALL DAMS version rturnber : 2 date; July 2, 1991 draftee: Eddy Perez
Background
Nearly 100 dams have been constructed in the Dogon region over several years. Though water in the dams were ineant to be used for irrigation to increase traditional garden production, they are also used for drinking water. The dams are suspected of being responsible for sotne increase in water borne diseases (guimea worm, schistosomiasis, and posily malaria). Africare , GTZ and other international donors involved in the financing and construction of the dains, are becoming increasingly concerned about their environrnental health effects and in identifying what can be done to mitigate these effects. As a result, AID has requested WASH
Technical Assistance. -
SCOPE OF WOP.~ Activities for USAID The WASH consultant will be part of a three persori team inciuding an environinenta]. public health expert and a water resources engineer from AID’s Of fice of Health of the Bureau of Science and Technoiogy that will go to the Dogon region in Mali for a period of three weeks to do a rapid qualitative assesment of the extent of the problem, to identify obvious imznediate and long term remedial actiona if possible and to make recomendatione for further study if needed.
General tasks of the team will inciude: (1) gather information on the preva]ence of water related disease and existing local programs to combat them;
(2) assese the environmental health effecte of dams ; (3) identify mitigating measures for use in design and after construction; (4) identify poesible health training interventions and their costs
93
Appendix B
SCHEDULE
September Actlvtty
4-5 Team Planning Meeting in Bamako 6 Briefing wlth USAID 6 Interviews In Bamako 7 Travel to Mopti 8 Travel to Bandlagara 9 Interviews In Bandlagara
Team Schedule
11 Visit Yam~,Ouolo-Ouolo (Envlronmental/Englneerlng Subgroup) Visit Dourou-tanga (Health/Soclal Subgroup) 12 Visit Yawa (Environmental/Engineering Subgroup) Visit Korou (Health/SoclaI Subgroup)
13 Interviews in Bandlagara - 14 VisIt Tegourou (Environmental/Engineering Subgroup) Visit Koundou (Health/Soclal Subgroup) 15 Visit Nandoli (Envlronmental/Englneerlng Subgroup) Visit Arou (Health/Soclal Subgroup) 16 Interviews In Bandlagara and market 17 Visit Songa 18 VtsttVaou 19 Visit Kort-kort 20-21 Return to Bamako 22-24 Write report 25 Deliver report to A.I.D. and Africare 26 Bneflng wlth AI.D. and Africare, depait
95
Appendix C
PERSONS CONTACTED
Dan Gerber Representative, Africare
Filedeger Stierle First Ald Care, Bandlagara Cirde, Deutsche Gesellschaft fur Technische Zusammenarbelt (GTZ)
Mamadou Traoré Chief of Community Health Divislon, Coordinator of the Schistosomiasis Program, Institut Natlonal de Recherche en Santé Publique (INRSP)
Karen Woodbury Director, Peace Corps
Fritz Etlenne Program Manager, Peace Corps
Douglas Steinberger CARE
M. Dlarrah CCA-ONG M. Sekou Toure
Soulelmane Awande Adjunct.Chief Doctor, Bandiagara
Mamadou Issa Tapo Commander of Bandlagara Cirde
Seyni Sidibe Chief Doctor
Mamadou Kelta Sanitary techniclan
Amadou Cisse Techniclan In cornmunlty development and sodal work
Siaka Diakite Project Chief, CRMT (Reglonal Center for Traditlonal Medicine)
Pierre Mounkoro Doctor
Wobig Coordinator, DED (Deutscher Entwicidungs Dienst)
Assana Diawara Commander of Dourou Circie
Abu Simala Medical Post Chief Segou
97 Antimbele Nango Medical Post Chief Pelou
Amadou Tepili Health Care Assistant Pelou
Awa Sagara Mldwife-Dourou
Amadou Andlé Sagara Village Chlef-DDurou
Amadou Ogueré Sagara Extenslon Agent-Dourou
Djibril Sagara Village Advisor Dourou
Amadou Sagara President, Doui~ouDam Management Committee
Salif Sagara Member, Dourou Dam Management Committee
Awa Sagara Extenslon Agent
Allaya Sagara Member, Dourou Dam Management Committee
Oumar Sagara Member, Dourou Dam Management Committee
Soumeyta Sagara Observer, Mlgrarrt, returned to Dourou on holiday (works on health and family planning In AMPPF, Mopti)
Mamadou Sagara Extenslon Ageni-Dourou
Mamadou Kedlu Member, Dourou Dam Management Committee
Ogopem6 Banou Chief of Korouna
Ahmadou Banou Counsellor of Korouna chief
Zachary Banou Counsellor of Korouna chief
Seguel Banou Extenslon Agent, first ald hyglenlst, Korouna
Ambako Banou Eldest person of Korouna
Fanta Sagara Women of Korcuna Kimbe Banou Asa Kassoge
98 Diko Yebedje Yama Sagara
Fatumatu Sagara Women of Douroutanga Alsata Sagara Alssata Sagara Derapin Sagara and Others
Nylme Tembely Women of Yamé Nyandou DJlgulba Merepe Karambe Isayl Yebelze Djendje Tembely Yande Yebedje Fanta Djlguiba
Valerle Flax Peace Corps Volunteers, Bandiagara Tom Zimmer Julle Donahue John Stultz
Agulbou Degoga Translator USAID/Land Tenure Center
Antiamba Tembele Secretary of Soclal and Cultural Affairs, Harmonie du Sahel (HDS), NGO
Amadou Basil Sumburu Permanent Secretary, HDS
Justin Sagara Accounts Secretary, HDS
Domlnlque Sagara Administrative Secretary, Adjunct to the Permanent Secretary, 1-IDS
Dicko Kassoghe Conflict Secretary, Secretary to the Organization, HDS
Mamadou Coullbaly Treasurer, HDS
Li Sumburu Local Committee Representatlve of 1-IDS, Pankass
Atana Sumburu Local Committee Representative of HDS, Korou
Sedou Samake Local Commlttee Representative of HDS, Mopti
99 lala Samaka Nurse, Sangha Nealth Post
Samba Coulibali Assistant Nurse of Sané
Anna Guerin Nurse, Sangha Health Post, member of Communky Ald Assoclatlon
Oumarou Coulibaly Commander of Circie of Sangha
Batarn Darrah State Committee Member, Koundou-da
Batagadja Darrah Secretary General of Youth, Koundou-da
Oumarou Darrah Ward chief, Kcundou-da
Ahmadou Darrah Koundou-da yDuth
Amperou Darrah Koundou-da youth
Anewe Darmah Elder, Koundou-da
Atanu Darrah Former State Committee Member, Koundou-da
Balele Kodjo Koundou-da women Ansi Darrah Sama Darrah Yabale Darrah Munyl Kalan Darrab Miriama Darrah
Hogon Arou
Ooyonidiou Din Son of former Hogon, brother of current Hogon
Alsata Tapili Nandoli women Djeneba Karambe Kadidia Tapill
Moktar Tapili Man of NandoEl
Karin Darame Head of small enterprise, Dafine filter and well bag makers, Bandlagara Market
100 Moussa SIdibe Apprentlces, Dafine filter/well bag maker Dakarija Senu
Oumou Karembe President Songo women
Eseta Yanoga Songo women Gado Karembe Misana Guindo
Alsata Tapili Vaou women Yamba Kansé Hawa Tapili Hawa Djlguba Yatimbe Kassonke unnamed Group of 9 Vaou children
Sunina DJIglba President of Kort-kort women’s assodatlon
Timbe Nap6 Kort-kort women Misiru Tembely Blntou Kasogue Assata Guindo Malmouna Tembely Arama Guindo Assata Anogue Assata Tapili Absatou Tembely Kadidja Tembely
Fatumata Karambe Midwife, Kort-kort unnarned Group of 33 Kort-kort chlldren
Tom Ponsloen Director, Catholic Mlssion, Bandlagara Antoine Spijkerman Englneer, Catholic Mission, Bandlagara Armand Kassogne Catholic Mission, Bandlagara
Mamodou Kefta Chief, Service d’Hyglene de Cercie Bandlagara
Oumer Sledibe Engineer, Chief, System Hydraullque - Bureau Barrages et Des Energies
101 Hamadou Tapily Nandoli Village Chief Amadou Tapily Men of Nandoil Hamadou Tapily Moctor Tapily Hamadou Tapily Immolou Tapily Mamadou Tapily
Kadilda Tapily Women of Nandoli Geneba Karainba Kadia Tapily Keneba Tapily Fatamta Tapily
Amacome Dolo School teachei - Kort-kort Saifourou Tembely Women of Kort •korl Bibe Karambe
Kortila Djljelbe Men of Kort-kort All Dierra Aobame Karambe Aboloulaye Kanambe
Alpha Djiguiba Yamé Village Chief Soulehrnane Djlguiba Yamé President of Committee Management Bourwelma Djlguiba Men of Yamé
Aboudou Djibuiba Ibrahama Djibutba Fontomata Djibutba Oumar Djlbutba Samba Djlgulba Mouneron DjIbulba
Fontonrnata Kjlbulba Yamé Woman
Mousa Sagara Yawa Village Chief
All Sagara Men of Yawa Aguib Degoga Amadou Sagara Amadou Sagara Adama Sagara
102 Ousseynl Sagara
Amadou Djlgtnba Village men of Tegourou Hassana Djlglnba All DjIglnba Brehlma Traoure HamidouDjiginba Bondary Djlgtnba Mamadou Dflglnba Baujeune Djtgtnba Koumdjon Banou Belco Kassogue Jailf Djibinba
Kogenma Djlginba Village women of Tegourou Alssanda Djlglnba Konno Karambe Yanibeme Karambe Yamldyn Karamba
Ylssa Djtglnba Tegourou Dam Commitee Members Alssn Karamba Yaba Kjiglnba Adjarotu Sagara Ogottmbelou Djlgfnba
Djondo Kjlglnba Men of Ouolo-Ouolo Houssn Djiglnba Amadou Sekou Djlnglnba Assana Ante Djlgtnba Seydou Djlgtnba Domino Djlglnba Bouruma Djlgtnba
Keme Djiginba Woman of Ouolo-Ouolo
Morissa Sagara Men of Yawa All Sagara Agrnlb Degoga Amadou Sagara Adama Sagara Ousseyml Sagara Ousseymi
103 Harnashan Sagara
Amadou Sagara Women of Yawa Fatimna Sagara Awa Sagara
Hilke Eberting Clvii Engtneer, IDED Noel Yebelze Anirnateur, DE.!)
Brendt Wobig Clvii Engineer, DED
Sdou Djibl Matga Staff, DED
Chrtstoph Kessier Service Agricole de Cerde Bandlagara
Antolne Spijkerman Engineer, Catholic Mission
Tom Ponsloen Director, Cathollic Mission
Keita Mamadou Director, Service d’Hyglene de Baridalgara
Oumar Disdibe Director and E.nglneer, Bureau Barrages et des Energles Systeme Hydraullque
104 Appendix D
ASSESSMENT QUESTIONNAIRE
Date:
Village: Ward:
Populatlon:
Persons Intervlewed In Village Name: Positlon: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.
105 Descriptlon of Wal:er Source
No. Source For what Dlstance/ When was It By whom? Type and purpose? Duratlon constructed? Conditlon 1
2
3
4
5
6
7 -
Access to Water Source
=~ No. Who owns the source? Who takes care of it? Any person om village that can’t use the water?
106 Types of Water Contact
No. Contact/Use Season of Use Time of Day/Frequency
Descrlbe the lmpacts the village percelves from dams (health, soclal, time saved by women, agriculture, nutritlon, economic, environment):
Drinking Water
No. Other Uses Protected Who collects? How stored? Quality
How much water Is used dally for domestic purposes?
107 Human W~.stes
Wbere do you do Is It near water How many latrines Who uses these your needs? sources or fields? and who built them? latrines?
108 Health
Diseases Present Cause Treatment Who! Perlod Morb. Age! Mort. Sex! Group Water Bome Dlarrhea
Guinea Worm
Water Washed Skin Diseases
Trachoma
Water Contact Schistosomlasis
Water Related Malarla
For crttlcal dlseases, please descrlbe village perceptions of the cause of the dlsease.
Possible health lmpacts from Lncreased water from dams:
Nutritlon, water-washed diseases (eg. skin, lice):
109
Appendix E
CATHOLIC MISSION SMALL DAM INVENTORY
Tableau récapitulatif des constructeurs de barrage3 et de leurs résultats COflflU5 ( *)
ETAT
Exécut.urs Hb. de barrages passablss détect bons
~ProjetHydrauliqul Rural• 27 1 9 17 de is Nissios catholiqu.
Cmie Rural 25 9 12 4
C.T.Z. / D.XU.E. 12 — — ‘~:
SIX 5N 7 ? ?
G. T. Z. / 0. T. E. R. 3 1 1 t
G.T.Z. / aL 2 1 — t
Psacs CorpS 1 — — i
Grisul. (per G.L) 1 — — 1
TOTAUI 78 12 iP 22 •? 38 +?
111
Appendix F
DED SMALL DAM INVENTORY
Explication pour le tableati ;
numero dii bue~u,~odi..rij l’irivuntuiie Année ana~o de con8truction
Financ e ment bailleur do £ond~ (voii abr~viut~on~)‘- Causes pertes d’eau
a mur d’ i.~taricheit~non .tunche b fondation mal con~trulte
0 failles verticaux ~iu c1o3LJoU~i du barra~e
d passa~e~d’et~uhorizontale t~utour des - alles du barra~c -4 t ~
Classification DED/GR : - -t A dernande un nouve~.ucr~isii~3ut~eou couche de ~oudron B demande un nouveau mur d1~ta~cheftc5ren.~ amont -,- -“S-. C de1..ande dec injecticxu do rnortiers aans
le 5oW3—col ~- F tiernande uno z par~t.i ~ ou r~i~lacemen~ç des L.artios r~ta1].i ~es bon .‘~tat 0 inuti]., muuvai~o aite ou corteeption.... :~3~ Phase rc~paration prevue ~.our itt ou 3 du 1)rot;ran*~e deQ r5parations ~
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Appendix 6
MAP INDICATING VILLAGES VISITED
119
• 1~0 ,— 3fl0-Dombörö Saba 1, oPatina o~
OSansè
t?Sarê-Faba-MOuo
‘ml. adial
2~1
Molél
Appendix H
DESCRIPTION OF VILLAGES VISITED
The following Is a brief descrlption of the villages visited and justiflcatlon for why they were selected. They cover three watersheds, roughly five rnajordialect dusters, three administrative zones, and all regional rellgions.
Dourou and Dourou-tanga
The village of Dourou, located at the center of an adrninistratlve “circie” of the same name, has benefitted from the presence of three dams and of numerous government and development services statloned in the vicinity. Among the most significant for this study were a Peace Corps volunteer working on Guinea worrn, a school, a dispensary, latrines, and a resident health and hygiene offidal. In spite of this infrastructure, Dourou also has a high rate of Guinea worm. This Is particularly true of one ward or ne~ghborhood,Dourou-tanga, where residents continue to drink from a sweet-tastlng walk-In spring ratherthan from the ~mproved well located several meters away. Dourou center was the subject of the pilot questionnaire conducted Jointly by both sub-teams, and Dourou-tanga was the focus of a more in-depth, follow-up study (with male and femalefocus groups) carried out bythe social-health sub-team.
Korou (Korou-na)
The team selected Korou as a case to be analyzed In conjunction with Dourou. Korou constitutes a strildng example of a village that has no dam, and thus has recelved none of Îts economic and agricultural benefits, but is located nearthe Dourou dam and uses the water for domestic and non-agricultural purposes, such as bathing and watering animals. Although the Dourou dam that abuts Korou is called “Korou,” the dam Is located just outside Korou territory and residents ofthat village have no rights to using the water for Irrigatlon. Our hypothesis was that Korou mlght be an example of a village that received the health costs, but not the beneftts provided by dams. Korou demonstrated that the health risk of dams could not be examined in an Isolated fashion. An Inspection of the undammed Korou stream revealed the presence of snails with the potential of transmlttlng schistosomlasis. In marked contrast to Dourou, Korou has relatively few services and yet has eradlcated Guinea worm since 1987, due to the constructlon of an Improved well by the Catholic Mission. Both sub-teams surveyed the major water points of the village and the social-health team conducted interviews with focus groups of men and women from one ward, Korou-na. The fact that men and women provided different answers about which water sources were employed for whlch ends demonstrated the strict separatfon between male and female domains and the fact that women are responsible for and generally more knowledgeable about domestic water suppties and hyglene.
123 Yamé
Constitutlng a separate dialect duster with Ouolo-Ouolo, Yamé Is a small village selected because ofthe presence of a damwhlch Africare constructed. Although the dam wasbuilt only recently (1989-90), the rate of schistosomlasis In Ihe sample of 31 children was 100 percent, suggestlng that the disease may have been enciemic to the area even prior to dams. A borehole-pump is located about 25 minutes walk from the settiement, 50 vlilagers tend to draw drinking water from an unprotected well and nearby streams and ponds. While the designers of the water supply system realized the tnconvenlence of the location, technically this locatlon was optirnal. These are all wallc-in sources, but açparently uncontaminated by Guinea worm since there have been no cases there since 1988. Nevertheless, the potential for recontaminatlon remains. The two sub-teams coriducted interviews and vlstted water points In Yamé separately.
Koundou (Koundou-da, Koundou-Andc() and Arou
Koundou represents a third dialect cluster and administrative zone, and was selected because one team member had lived and worked there sDme 15 years before, thus providing some Iongttudlnal data. This isolated village, which receFies no regular government seMces, was the site that Hans Guggenhelm selected to construct a dam In 1975. The dam hoids no water, even In the ratny season, but even so the schistos~,rnIas1srate appears to be very high (100 percent of a sample of 32 children). This Is probalbly because of the snail-filled, lily-covered fresh water ponds that form during the ralny season and furnlsh water for domestic uses, drinking, and dry season gardening. The popuIaflc~nappears to be typical of many of the more isolated villages of the plateau In that they suffer from severe water scarcity. Even in the rainy season, when water sources are relatively abundan±,women must dimb sheer rock faces over one kilometer away to get diinldng water for their household. Under these chcurnstances, isolation appears to be the major factor influencrng the absence of Guinea worm.
The social-health sub-team hiked for 15 Idiometers from Sangha to Koundou, along the escarpment of the plateau, and spent two days and one night on site. Although Koundou is made up of four wards, the team concentrated its Lnterviews In the chiefs ward, Koundou-da, and conducted briefer, Informal interviews and visrts In the ward of Koundou-Andd and Ln the nelghboring village of Arou whlch shares the sarna dam. Arou is a sacred place, the home of the highest spiritual chief of the Dogon, the hogon of hogons, and the paths to and from this sanctuary are surrounded by numerous prohibitlcns. Although contalning only a populatlon of 18, all of a single family, Arou was sign&ant In our sample of villages as the only site In which schlstosomiasls was entirely tacking. ThIs; populatlon relies exdusively on rain-fed agriculture (as opposed to gardening whlch dernands direct water contact), is small and isolated, and has restricted contact with the outslde due to its ritual significance. These factors undoubtedly contribute to the absence of schIstos~ornIaslsin Arou.
124 Nandoli
Nandoli was selected because of fts dam and the existence of a prior study on schistosomiasis (PLeah, 1976). There are two dams In Nandoil. The first, buik In 1973, wasImmediately found to be a failure due to leakage beneath the dam, through a fault. A second dam was built 200 meters upstream of the first in 1974. This dam, too, is not completely successful in that ft only hoids water from the end of the ralny season (September) until December. As with the first dam, the second experiences Ieakageunderneath the dam, through faults. The area between the dams Is di~and used for gardening. The second dam was not full, as would be expected, during the team vlsft. Once again, 100 percent of our sample of 12 children had schistosomiasis. Nandoli appears to have many cases of Guinea worm despite the presence of clean sources of drinking water. A borehole-cistem well located 20 minutes past the dam, which Is adjacent to the village, is a source of safe drinking water. However, for convenlence, the vlilagers prefer to use an unlmproved well located within the village or the dam for drinking water. Both teams interviewed residents of Ganda, whlch Is divlded into two wards.
Songo
As a village without a dam, Songo was studied as a controlled comparison. It was also the subject of a study on Guinea worm, conducted by one of the team members (Degoga, 1977) and providing long-term data on this disease. Furthermore, Songo belongs to a fourth group of Dogon dlalects and appears to have a rather sizeable Fulbe minority population. The sacTed grotto above the village contains spectacular cave drawings. Moving in accordance to water availability, this village was once located high above on rock outaops, but eventually moved to lower gTound as available water sources dried up. The high rates of Guinea wom~ documented In 1977 continued through 1984, when It was reported to have affllcted as much as 80 percent of the population (Interview: Cisse). Since the construction of an irnproved borehole, the health and hyglene service cites Songo as a success story, where Guinea worrn Is sald to be eradicated. 1-lowever, our fleld study suggested otherwise, revealing nurnerous cases of the disease. One probable explanation Is that the population has been reluctant to use the well because It is believed to be haunted: a child feil Inside and died when the cord snapped, shortly after it had been completed. The Fulbe herders resident in and visiting the village may also serve as a potential vector for Guinea worm tTansmlsslon.
Vaou
As a village without a dam but wfth a source of safe drlnldng water, Vaou was studied as a controlled comparison. Of all of the villages visited, Vaou was the most discouraging. The presence of an arteslan well provldes abundant seemingly dean drinldng water and makes It possible to cultivate vast areas of land all year round. Yet the water Is very poorly rnanaged and wasted: It Is allowed to flow uncontrollably creating new streams and providing numerous breeding sites for mosquitos. Water pipes donated to lmprove water management have been used as beams In house construction. Most disconcerting of all is the population’s passlve
125 attitude toward thefr good fortune. Women interviewed clairned that God had brought the water, and that God caused and treated all dlseae. It was thus unnecessary to intervene to try to cure diseases. Similarly, women said that to cover the household water storage bowi required too much effort, unless outsiders gave them the covers. Although the arteslan well shows some potential for a water bottllng plant, the attitude of the populatlon would be a major obstacle In any future development tntervenlion. The entire team visited Vaou together. Female team members conducted focus group dlcussions with women and chlldren, males with men.
Kort-kon
Koii-kor~Is a village whlch demonstrates the benefll.s of educatlon for health. With a dam that hoids water rougbly until February, schistosomlasis Is virtually universal. 1-lowever, there was a marked absence of the disease among chlldi~nof educated people (e.g. government ftmctlonartes, school teachers, etc.), since theserequlred their children to bathe and drink from well water and forbade themfrom swlmming in the dam. Educatlon, provided by a paiticularly active mid-wife, Is also instiurnental In that fact this was the only village that knew of Oral Rehydration Therapy and all 12 women tnteMewE!d could correctly descilbe how to prepare oral rehydratlon solutions. Although Guinea WOITfl is technically eradicated from Kon-kort, children sifed three currentcases of the disease In t~hevillage, possibly contracted during travel. This would suggest thatcontarnination ofunprotec~edwater sources Isa continuous possibility, and would cautlon against leaving weils untreated ovçr long perlods (the hyglene service has not treated the well in Kort-kon In three years). Despite the numerous tatilnes and other aforementioned benefits of the school in the villa~l!,several infants have severe malnutrttlon and girls appear to be suffering from kwashiorkor and stunted growth. The female members of the team intervlewed focus groups of 13 worn~nand 33 children of the ward Tabatondo. Male members met wlth village offidals and male focus groups.
Ouolo-Ouolo
Ouolo-Ouolo Is a village wtth a dam built by Africare and a safe drinking water source. It has a borehole-pump and one unlmproved well. Vlilagers also drink water from the dam. When the dam Isfull and overfiowing they drink the dani water; when Itts stagnant they do not. The vlilagers tndlcated when they began to drink watiar from the pump and well rather than the dam or other sources Guinea warm disappeared, and there are no cases now. In additlon to schlstosomiasls whlch affllcts mast children and also aduits, other urlnary problems of unspecified diagnosis were desciibed whlch the villagers said occurred after the dam was constructed (1987). The engineering sub-team ex,~rnInedthe dam and water sources and met with 13 vlilagers Inciuding men and women In a focus gToup.
126 Tegourou
Tegourou was chosen for study because It bas a dam with a canal irrtgatton system; dam modifications were designedto mitigate negative health lmpacts (Brinkman, 1990). It is located in a watershed not covered in this study by any other village. Tegourou also has a safe drinking water supply, a borehole-cistem well. The engineeiing team met in the field w!ith 15 men during a break from thefr work building compost piles. Inthe villagethe engineering team met In a focus group wtth men and women. For the most part, the technical modtflcations on the dam were not being used. The irrigation canals were operational and in use and would reduce water contact for the workers. In Tegourou the road crosses just downstream of the dam around whlch water was passing. This requlred wading through water released from the impoundment to cross the streambed. Guinea worrn was once considered a critical disease, but since the Installatlon of the borehole-well (1984) and the use of this well for drinking water, Guinea worm has been eradicated. All children were reported to have schlstosomiasls. The engineering team examined the dam, Irrigation structures, and water sources. Tbey met in the field with 15 men during a break from their work. In the village the engineenng sub- team met In a focus group whlch Induded the village dam committee and was composed of 10 men and women.
Yawa
Yawa is a village without a dam or a safe drinldng water supply and was studied as a controlled comparison. Yawa Is tocated high above the Yamé nver on a rocky outcTop. To reach the village by road and to collect water, one must traverse a steep passage. The villagers Identifled water scarcity as the most critical village problem. The cultivated fields are 25 kilometers away from the village. They have requested a dam and a well, but no action has been taken on their requests. Springs In the riverbed below the village are the primary water source for all purposes. A Peace Corps Guinea worm volunteer ilves In Yawa.
There were several cases of Guinea worm but villagers report decreased Incidence slnce they began to filter their water—using head ties—under direction of the Peace Corps volunteer. Schistosomlasis affflcts most chlldren as does dlarrhea. The engineering sub-team exam~ned the water source and met In a focus group wlth 13 men and 2 women.
127
Appendix 1
TABLES ON WATER SOURCES AND WATER CONSUMPTION
TABLE 1: WAT~SOURCES
Village Dam. Dame Stream. WeII./ Weils Pond./ irrigatlon (other borehole. (Tradi- sprlng./ uses) (Im- tional) puddies proved)
Dourou 3 bathe, fish, bathe yes yes bathe drink Korou 0 1 of Dou- 1 bathe in 2—drink 2—wash bathe rou bathe, ralny sea- (1 per utensil wash water son, water ward) clothes clothes aninials animals bathe utensils In cooldng In ralny di~season season
Dourou- 3 bathe, flsh, bathe, - 1—bathe 2—bathe drink tanga cultivate wash wash wash (best, lilles clothes clothes, dothes, sweetest); drink drink take water out to washin dry season
Yamé 1—new, drink, 1—drink, 1—drink, — drink, no effect water bathe, too distant bathe, yet animals wash wash dothes dothes utensils in lasts all rainy sea- year son, near- by
129 TABLE 1: WA1~]~SOURCES Village Dame Dame Streiuns Welle/ Welle Ponde/ irrigatlon (other boreholes (Tradi- sprlngs/ uses) (Im- tional) puddies proved)
Koundou- 1—does watering 1—water — — 1—drink- da not hold animals an1rn~J[s In Ing & dry water; rice ralny sea- season cultivated son irrigatlon down- (1.5 krn) stream 2—bath- (3 km) Ing, dry season Ir- rigation, animals (2~) NandoLl 1—not In ralny 1—too far 1 for drink- hold water season, (20) to ing & for long, drinking, drink, domestic l—holds washing passers-by use dry no water dothes drink here season utensils
130 TABLE 1: WATER SOURCES
Village Dam. Dam. Stream. Well.! Weils Ponde/ Irrigatlon (other boreholes (Tradi- sprlngs/ uees) (Im- tional) puddie. proved)
Songo 0 0 chlldren 1—drink 2—drink, 2—for swim & (far, bulk wash uten- drinking & bathe Catholic sils, dothes other Mission water domestic 1980) animals uses In (far) rainy season (near), have filled wkthsllt over the last 10 years; mariy others: (far) stag- nant where children swim
Vaou 0 0 due to 1—arteslan — before arteslan well: drink, well used well: Ir- irrlgate, all permanent rigatlon, domestic lowland waterlng uses, bath- puddie all animals Ing year, all bathlng purpose laundry
131 TABLE 1: WATER SOURCES
Village Dam. Dams Stream. WelIa/ Weile Ponds/ irrigatlon (other borehole. (Tradi- spring./ uses) (Im- tional) puddies proved)
Kort-kort 1—bulk children near 1—- — 1--puddie 1974, swlm, Yamé in uncovered dralns into hoids ralny sea- dry sea- Improved dam water until son: son: well, pre- where Jan. or women wornen ferred children Feb. wash wash drink, bathe; dothes & clothgs, domestic 2—hand bathe, water uses In dry dug holes water anIm~]Ls season; near dam animals 1—pump in drought drink (bad for drink- taste), Ing water domestic when use pump drles& well water too low
Oulou- 1—bulk by livestock, — 1—used 1—used — Oulou Afrlcare In Irrigatlon of for drink- for drink- 1987. onions, Ing, 5 ing Hoids drinking minutes water water 1f from vii- throughout dam Is lage, bulk the dry over- In 1987. season flowing, Water said chlldren to “taste drink water bad,” pre- all the fer the well time, to drink swlmmlng bathing
132 TABLE 1: WATER SOURCES Village Dam. Dam. Stream. Well.! Well. Ponds/ irrigation (other boreholes (Tradi- sprlng/ uses) (Im- tional) puddle. proved)
Tegourou 1—bulk in drinking, — 1—buik In — Some- 1981 by Irrigating 1984. times dlg GTZ gardens, Close to hole near flshlng, village dam site washing, &letltflll bathing, up wlth livestock, water cooldng. whlch Sometirnes they drink filter dam water to drink Yawa 0 0 Only in the 0 0 In the ralny sea- ralny
son - season, the sprlngs run “Like a river.” In dry season dig holes In the dry stream bed & use this water to drink, water gardens & all other domestic purposes
133 TABLE 2: WATER CONSUMPTION
Village Liter./- Filter # times Source- Storage day/ per day destinatlon house- hold liters/ person Korou 140-175 no 7 timas Improved well- ceramic bowls In drinking; house; drinking 17-23 tradltlonal well- water stored toilet, utensil separately • Dourou- 270 (1/3 women say 3 timas unprotected transfer from tanga drink; 2/3 they al- spring-drtnldng; buckets to cera- other dom- ways filter lmproved well- mic bowis; estic uses) household utenslis, bathing drinking water drinking stored separate. 27 water
Yamé 90-160 no 3-4 tlrries streams & unpro- in day bowis, (pref. all in tected spring—all water for all morning) domestic uses; domestic uses 15-27 Improved well stored together when other sources dry Koundou- 180 no 12 tlines pond 1—all In day bowis, da domestic uses, drinking water suppiemented stored separately 18-26 wtth ram water In rainy season; pond 2-batbing Nandoll 90-105 sometimes 6-7 tirnes dams—rainy In day bowis, use headtle season, all water for all domestic uses; domestic uses 15-17.5 weils—dry sea- stored together son (shared wlth another village)
134 TABLE 2: WATER CONSUMPTION
Village Liter./- Filter # times Source- Storage day/ per day destination hou..- hold
Songo 120-160 woman 4 times (2 tradltlonal wells In covered day (1/2 drink; sometlmes, people 2X near borehole, & bowis
1/2 other wlth metal per mom- Improved well— - domestic sleve or Ing & drinking uses) headtie (to evening remove 13-18 large Im- puritles)
Vaou 150-200 no 10 times arteslan well—all In day bowls; no (2 people domestic & agrl- covers & can 15-20 5X per cultural uses thlnk of nothing day) to use
KorI-korl 120 (1/3 no 6 times - Improved well & In day bowi, drink; 2/3 (4X toilet, pump—all sometimes co- other dom- utenslls; domestic uses vered estic uses) 2X drink (well pref. drinking) 24
Oulou- 120 for no 3 tlmes borehole & tradi- drinking water Oulou washing & tional well; dam stored in day drinking when it’s over- bowi, whlch flowlng, not should be when it’s stag- covered but lsn’t nant always Tegourou 80 yes— fl11 a day Improved well day bowi health bowl in for cooking & workers a.m. or drinking; dam for gave them p.m. Takes washing special 5-6 trips to materlal for f111 It. filter
135 TABLE 2: WATER CONSUMPTION
Village Liters». Filter # tinies Source- Storage day/ per day destinatlon hou..- hold
Yawa -. yes-use 4 wornen stream bed or filter water put head scarf to each springs. Use a In a day bowl~ day. Sx for spoon to fl11 a the village bucket
• Villages wlth Guinea worm • A Peace Corps Guinea worm volunteer living In Yawa says the villagers do not filter the water but are told to do so.
136 Appendlx J
TABLES ON HYGIENE PRACTICES AND
TABLE 1: HYGIENE PRACTICES
Village Urinate Defecate Age Clean wlth B~m
Dourou anywhere, endo- bush, lnfants In 7-8 yrs stlcks, stones, some- sure in compound, house or corn- times water fields pound Korou anywhere, endo- bush behind vii- 6-7 yrs stlcks, stones, some- sure in compound, lage tirnes water fields Dourou- anywhere, endo- closest place In 7 yrs stlcks, wash in near- tanga sure In compound, bush by puddie water or fields wlth water from spring In dry season Yamé anywhere, enclo- several hundred 7-8 yrs sticks, rocks, some sure In compound, meters to 2 kms. aduits use water fields downhlll from village away from water source; in uncultivated areas near fields Koundou- anywhere, endo- in rocks nearby 6-7 yrs stlcks, stones da sure In compound, above & betow the fields village, wherever one can hlde Nandoli anywhere, encio- In bush that Is 7-8 yrs wash with water sure in compound, dosest to house when return home behlnd frees near dam
Songo anywhere, encio- in bush uphIll & bush: 7-8 aduits wlth water, sure, woman wash away from village yrs chlldren wash wlth wlth water or In latrlnes latrine: 10- water when return 12 yrs home
137 TABLE 1: HYGIENE PRACTICES Village Urinate Defecate Age Clean with B~m Vaou anywhere, endo- anywhere where 6-7 yrs all people, even sure one can hide, cbildren always wash especlally In fields with water afterwards Kori-korl anywhere, endo- in bush, each to bush: 6-7 aduits wlth water sure different dlrectlon, yrs taken in container or or In latrincs~ latrlne: 14 when return home yrs
Oulou- enciosure In corn- In bush awa~ifrom — — Oulou pound, usually the dam anywhere but woman cannot urinate In the fields. They must urinate in a cul- tlvated area or they won’t get a husband.
Tegourou anywhere, endo- bush or latrines — — sure In compound
Yawa endosure In corn- an open area — — pound away from the stream Is dasig- nated for defeca- tion; men woman go on separate sldas
138 TABLE 2: LATRINE USE
Village # Used by Owner Advantage. Disadvan- latrine. tage. Dourou 5 family, chil- village chief, easy access expenslve, dren over 7 midwife, 3 shameful for merchants whole farrdly to share one latrine
Korou 0 — — privacy they fail convenience, down, rnessy, easy access badly main- talned
Dourou- 0 — — privacy, con- costly, too tanga venlence, labor inten- status sive, no materlals
Yamé 0 — — status unknown
Koundou- 0 — — - status, con- lack mater- da venient for lals; don’t elderly & In- have habit of firm use; bad for many people to defecate In same place
Nandoli 0 — — convenlent, smeils bad, easy access disinfectant costly Songo 10 + young fam- some convenlent for lnsufftclent ilies, migrants familles wlth old people; space in corn- wlth cash rnigrants have safer, qulcker pound, costly eamlngs, vIs- 2; faster than in cash & Itors guest house walldng & fal- labor ling on bad paths to bush
139 TABLE 2: LA1RINE USE
Village # Used by Owtier Advantage. Disadvan. latrineg tages
Vaou 0 — — none costly, unlike- ly that they would ever use thern decide Kon-kon 10+ teachers & all teachers; easler access too many thelr familles, school; fam- & more con- people using school files with venlent for same latrlne children, money sick people; can promote chlldren over good for contaglous 14 (otherwise health Illness miss the hole), many others
Oulou- 0 — — — — Oulou Tegourou 5 Some are 1—com- Easier & more expenslve prlvately munlly convenlent 1f owned (4); 1—c:hlef you are slck one located 1—c:hief’s wlth diarrhea; adjacent to asslstant It’s better to mosque Is 1— ~lovem- have a latnlne used by any- ment in proxlmlty; one who worker the bush Is wants 1—educated too far; form villa~ar lines to use latrines
Yawa 0 — — none too expen- sive, easler to use bush ~
140 Appendix K
TABLES ON DOGON PERCEPTIONS OF DISEASE
TABLE 1: WORST DISEASES (1 worst) Village G. worm Schisto. Dlarrhea Malarla Other Corn- ment Dourou 1 2 Korou 1 2 3— coughs Dourou- 1 2—skin none kIlis tanga infections most Yamé 2 1 schlsto. Idils most Koundou- 1 3 2— 2—klUs da measles most (1988 epid.) Nandoil 1 2—eye infections 3—sickie cell Songo 1 2—eye 3—major Infec- cause of tions; death; 3— 1—also measles causes death Vaou god kills, not lllness Kort-kort 2 1 1—ldlls most chlldren
141 TABLE 1: WORST DISEASES (1=worst)
Village G. worm Schisto. Diarilie. Malarla Other Corn- ment Oulou- 3 1 2 rheu- all child- Oulou mattsm ren get 1-2-3, in ralny season 1+2 Tegourou 1 3 2 Guinea worm was worst disease until they Installed the well. Yawa 3 2 1—pain Everyone Inthe old& sides of young has the stom- this. 1f ach coma to the point where you cough, you get better. Otherwise, you die.
142 1 TABLE 2: GUINEA WORM Cause Treatment Popul. Percelved Cominent Affected change drinking —drlnldng many people, decreased In sometimes Infected from treated especlally 1 recent years rash appears water, weils ward (Dou- 48 hours especially —puncture rou-tanga) before worm during first bllster wlth erupts rains hot needie, rub wlth shea butter & medlcinal leaves —soak In warm water drinking drink from no one eradlcatlon eradicated water lmproved since 1987 after con- well struction of Improved
- . Catholic Mlssion well told drinking filter everyone, decreased In sanctions for water, but certain fam- recent years drinking not con- files more from bad vlnced than others, source wonse for children unknown unknown no one absent since unexplained 1988 eradication unknown unknown no one absent since unexplalned 1983 eradicatlon
drinking dirty unknown, many people — — water, eg. puncture In both wards from the dam blister, worm comes out slowly on own
143 TABLE 2: GUINEA WORM
Village Cause Treatment Popul. Perceived Comment Affected change
• Songo god no preven- more men, — woman say tion, punc- resldents of men do not ture bllster, village chiefs filter water rub wlth shea compound butter, worm comes out slowly
Vaou unknown unknown no one — — Kori-korl drinking dlrty hyglene very few marked decrease diie water service treats cases, decrease to hyglene well arbitrary or since 1988 service water ~due to travel treatment
Oulou-Oulou drinking dirty none 1 none as soon as villagers not water drank well sure why and borehole G.W. Is
- water (1985 gone now & 1987), but note G.W. was connection eradicated wtth drinking water from an Improved source Tegourou from water; none 1 since drinking one man got eggs In water well water, G.W. you drink 1984, G.W. elsewhere & has been Is now living eradicated here Yawa drinking none 2 since filtering they thlnk stagnant water, no those water G.W. affllcted got G.W. else- where
• Villages wlth Guinea worm
144 TABLE 3: SCHISTOSOMIASIS Village Cause Treatment Popul. Percelved Cornment Affected Change
Dourou bathe In none children — children get water where rash after should not swlmmlng In stagnant water
Korou unknown none children — — Dourou- god none children lncrease In not consi- tanga recent years dered lllness, but people who bleed when young never get lat or big Yamé unknown none chlldren occurs when recognized settle in vii- Illness since lage from children other area suffer
Koundou-da god none chlldren — visiting nurses conflrm there Is no cure
Nandoli god plants & children — recognlzed herbs Illness
Songo unknown plants wlth children — recognized littie effect; Illriess since pils from children doctor suffer Vaou god none some chil- more corn- not consi- dren mon in past dered illness
145 TABLE 3: SCHIISTOSOMIASIS Village Cause Treatment Popul. Perceived Comment Affected Change Kort-kort bathing in herbal Infu- children who decrease In children of Infected slon to drink swlm in dam some paris of functionarles water populatlon & school diie to pump personnel do & well use not have schisto. Oulou-Oulou chlldren none aduits & none lots of child- washlng & chlldren ren urlnate swlmmlng in blood; 3 dam. 1f kinds of stagnant, urinary prob- water makes lems: 1) you sick urinate blood 2) can’t urinate 3) urinatlon contains pus Tegourou unknown none trad!- children & Iess now that all children tional. Go to young It can be have schisto. dlinic In treated in Bandlagara Bandlagara clinic Yawa unknown— none trad- chlldren, but after age 15 swlmmlng In Itional. Very not many are no one has It rlver Is palnful. Go affected suspected to Ban- dlagara for treatment
146 TABLE 4: DIARRHEA Village Cause Treatment Popul. Percelved Corninent Affected change
Dourou —drinking —medicine chlldren lncrease In — dirty water, or Injectlon 0-5 yrs. ralny season —bad nutij- from nurse tlon —drink dean cool water —eat cotton mixed wlth cooked millet & jackfrult Korou —unknown —drink water chlldren Increase at end usually —teething in —drink Infu- of rainy season accom- Infants slon of guava panled by leaves fever & —medicine vomitlng for children from Catholic
Mlssion - (ORT?) Dourou- unknown drink water varles by Increase In corrimon tanga family recent years cause of death especlally In aftemoon
Yamé unknown, drink water everyone lncreases in — possibly lack bolled with late ralny of nourlsh- medicinal season ment or herbs eatlng certain foods Koundou-da god drink water, everyone, but Increases in eat mashed especlally ralny season medlcinal wonnen & herbs children
147 TABLE 4: j)J~ppJ1~ Village Cause Treatment Popul. Percelved Cornment Affected change
Nandoli unknown drink water, children increases In accom- medlcinal especlally ralny season panled by herbs fever & gas Songo unknown eat heavy everyone all year rarely kills meals; drink fruit julce (sorrel)
Vaou god nothing; everyone, but — — sometmmes not common drink water or eat mashed herbs Kon-kon unknown ORT or drink everyone, all year major water cooked especlally cause of wtth guava children infant leaves death Oulou-Oulou don’t know drink water many small lncrease in in ralny cooked wlth chlldren have rainy season season leaves It contlnually everyone has It Tegourou don’t know —bali leaves mostly —fewer child- most In water & chlldren ren died (4) people die drink It this year of from ma- —drink a lot dlarrhea lania or of water —lncrease in diarrhea ralny season
148 TABLE 4: DIAERHEA Village Cause Treatment Popul. Percelved Cornment AffeCted change
Yawa don’t know boil leaves In chlldren —lncrease In — water & beginning at ralny season drink It age 2-3 —4 years ago chlldren died of dlarrhea. With treatment of boiling leaves & drink- ing this, the deaths have decreased.
149 TABLE 5: MALARIA
Village Cause Treatinent Popul. Percelved Cornment Affected change
Dourou mosqulto, medicine, everyone rainy season — bad nutritlon mosquito Insufficlent nets water, excesslve exposure to sun, fatlgue Korou unknown, sometlmes chlldren ralny season, causes In- maybe mos- medicine time of mos- fant’s head quito from dispen- qultos to rlse & fail sary & death
Dourou- unknown sometmmes everyone ralny season — tanga medicine from dispen-
sary -______
Yamé unknown sometlmes evenyone rainy season — medicine
Koundou-da unknown wash wlth everyone rainy season — warm water
Nandoli unknown Infuslon of evenyone ralny season — water & herbs
Songo god none everyone ralny season cbronlc fomm ~ kills
Vaou god god everyone rainy season —
Kort-kort mosqulto boil medlcinal everyone ralny season — bites herbs to drink & bathe
150 TABLE 5: MALARIA Village Cause Treatment Popul. Perceived Comment Affected change
Oulou-Oulou unknown none all children none when grass grows & It’s ralning, It’s season to get schisto. & malatla Tegourou unknown none everyone occurs in kills people rainy season Yawa unknown none everyone occurs In everyone rainy season gets It
151 TABLE 6: EYE 1:NFECTIONS Village Cause Treatment Popul. Perceived Comment affected Change
Dourou spontaneous eyedrops of everyone Increase In — warm water ralny heated wlth season medicinal herbs & ashes
Korou unknown unknown everyone — — Yam~ unknown sometimes everyone often won- present in cream from sens over 6 3 of 13 dlspensary month woman in- peniod tervlewed; severe cases affect 2 eyes
Koundou-da unknown unknown everyone, rainy — can lead to season blindness Nandoli uniknown unknown everyone rainy 2 eyes get season red
Songo unknown cream from everyone — 2nd worse dispensary disease
Vaou god eyedrops everyone In worse in — wlth medici- village in certain nal leaves some years years
Kort-kort unknown, unknown everyone — 3 of 39 contaglous? children interv.
Oulou-Oulou unknown none chlldren & — trachoma aduits present
152 TABLE 6: EYE INFECTIONS Village Cause Treatment Popul. Perceived Comment affected Change Tegourou unknown none —children & 5 years ago lots of aduits bllndness trachoma, —6 people got worse, much are blind unex- bllndness plalned
Yawa lack of vita- none children & — night vlslon mins or old aduits problems age
153 TABLE 7: OTHER ILLNESSES Village filnes. Cause Treatment Popul. Perlod/ affected Corninent Dourou skin Infecilon swlmmlng In wash In salt children ralny season stagnant water water, wear scratchy wool- en dothes
Intestinal unknown medidnal mostly aduits, — worms plant, Inclu- but also chil- ding spores of dren a musbroom
night blind- Iack of meat rub blood from people wlth — ness liver on eyes bad diet & eat liver
lice — wash hair & most women — crush lice who braid hair
Korou coughs unknown unknown everyone —
conslipation, unknown unknown everyone — hemorrholds
night blind- unknown unknown women & — ness children
red hair prolonged unknown children, rare 2 cases illness bladden/ unknown unknown adults 10+ cases uninary tract (due to schis- infeclions to.?)
Dourou-tanga skin Infection unknown unknown worst lllness — among children
154 TABLE 7: OTHER ILLNESSES Village ifines. Cause Treatment Popul. Period/ affected Coinment Yamê sldn Enfec- unknown unknown chlldren rainy season tion/rashes red hair natural among unnecessary very wide- disappears at chlldren spread among aduithood chlldren night blind- unknown none old people great dea~ease ness in recent yearS measles epidemic vacclne many chlldren, dry season, unexposed early ralny aduits season, epi- dem. 1988, 1984, 1981 rheumatism unknown none aduits & old increase wlth
. age Koundou-da measles unknown vaccine major cause of dry season, death In chil- hottest time, dren epid. 1988 skin Infections unknown unknown everyone all year night blind- unknown none everyone ralny season ness red halr illness unknown lnfants, rare all year worms unknown unknown everyone whlte, small flat
“rheumatism unknown unknown adults bones aches, accomp by vlolent head- aches, cur- vature of spine
155 TABLE 7: OTHIER ILLNESSES Village line.. Cause Treatment Popul. Penlod/ affected Cornment .______Nandoil siclde ceil unknown unknown a few people perlodic of all ages severe Internal pain, swelllng jolnts skin Infecilons unknown unknown everyone, often wlth common boils
redhair — — noone -
night blind- unknown none women, rare all year ness among men & children Songo measles unknown vacdnes children major cause of death
night blind- unknown wash with & many adults, — ness eat mutton some children ilver red hair natural for winecessary children not assoc. children with illness
worms unknown unknown everyone 2 kinds
Vaou red hair illness, diar- god infants — rhea
worms — — noone —
night blind- — — no one — ness Kort-kort measles epidemic vacclne children epid. 1991 fungus on skin unknown unknown a few people 1 of 39 & In mouth ec~ma unknown cream from a few people 2 of 39 chil- dispensary dren Interv. stomach aches unknown, unknown all ages sometlines bad food? accomp. by swollen sto- mach, blood In feces
156 TABLE 7: OTHER !LLNESSES
Village fllne.s Cause Treatment Popul. af- Perlod/ fected Comment Oulou-Oulou skin disease stay too long everyone In water rheumatlsm water traditlonal remedy urinary tract washing In none everyone problems dam Tegourou rheumatlsm generally think measles unknown none one child died mosqultos this year transrnlt diseases blindness see Table 6
Yawa pain In the unknown none everyone may kill you side of the stomach
157
Appendix L
TABLES ON DOGON DEVELOPMENT PRIORITIES, COMMUNICATION AND MIGRATION
TABLE 1: DEVELOPMENT PRIORITIES FROM VILLAGE PERSPECTIVE Village Male Female Korou dams; more cultivable land, grill to roast groundnuts; regular food supply; educa- transport of women & pro- tion; compost, fertilizer duce to market; regular & varled food supply Yamé nearby Improved well without purnp; gram miii; more cash to buy seed; better terms of trade (onlon prices have dedlned) Koundou-da repalred dam & irrigatlon health care; hlgher agricul- water; roads; school In tural production; weils French; dispensary; cereal bank
Nandoli child survival; nearby improved water supply (well); gram mlii Songo regular food supply (secure harvest); fuel wood; easler way to get household water; cash earning actlvttles, management training to buy condlments & medicine Kon-kon gram mlii; repair dam; labor- saving seeding techniques; transport of fuel wood
159 TABLE 2: COMMUNICATION AND MIGRATION
Village Radio. Inter- Intri- Migratlon Reason Destina- village villai~e tion Commu- Comrnuni- nicatlon catica
Korou 10 oral by select youth no food Office du messenger messenger since 1989 Niger, to notify Bamako, popuiation Katlola Abidjan Koundou- 12 oral by select ternporary: better Bamako da messenger messi! nger youth wlth opportun- Ivory to lnfann primary ities; Coast; each school nelghbor- educatlon; hood perma- land Seno nent: 7/45 Plain farnilles
Songo oral by select - wornen to feed messenger messenger migrate children to notify popuizitlon Vaou oral by select dry to earn Bandia- rnessenger messimger season: money gara, to notify most all Bamako popu]zitlon youth Kort-kort many oral by select messenger messi!nger to not1f~, popuiatlon
160 TABLE 2: COMMUNICATION AND MIGRATION Village Radio. Inter- Intra- Migratlon Reason Destina- village village don Commu- Communi- nication cation
Yawa — — — 100 young leave Bamalco; people last during Ban- year dry sea- diagara son be- cause there’s not eno- ugh to eat
161 1 1 1 1 1 1
Camp Dresser & McKee International Inc. Associates in Rural Development, Inc. International Science and Technology lnstitute Research Triangle Institute University Research Corporation Training Resources Group University of North Carolina at Chapel Hill
WASH Operations Center 1611 N. Kent St., Room 1001 Arlington, VA 22209-2111 Phone: (703) 243-8200 Fax: (703) 243-9004 Telex: WUI 64552 Cable Address: WASHAID
THE WASH PROJECT
With the launching of the United Nations International Drinking WaterSupply and Sanitation Decade in 1979, the United States Agency for International Development (A.LD.) decided to augment and streamlirie its technical assistance capability in water and sanitation and, in 1980, funded the Water and Sanitation for Health Project (WASH~.The funding mechanism was a multi-year, multi-million dollar contract, secured through competitive bidding. The first WASH contract was awarded to a consortium of organizations headed by Camp Dresser & McKee international Inc. (CDM), an international consuiting firm specializing in environmental engineering services. Through - two other bid proce~dingssince then, CDM has continued as the prime contractor
Working under the close direction of AIDs Bureau for Scier~c~andTechnology, 0ff ice of Health, the WASH Project provides technical assistance to A.l.D. missions or bureaus, other U.S. agencies (such as the Peace Corps), host governments, and non-governmental organizations to provide a wide range of technical assistance that inciudes the design, impiementation, and evaluation of water and sani- tation projects, to troubIeshoo~on-going projects, and to assist in disast~rrelief operations. WASH technical assistance is multi-discipli- nary, drawing on experts in public health, training, financing, epidemiology, anthropology, management, engineering, community organization, environmental protection, and other subspecialties
The WASH Information Center serves as a clearinghouse in watei and sanitation, providing networking on guinea worm disease, rainwater harvesting, and peri-urban issues as well as t~chnicalinformation backstopping for most WASH assignments.
The WASH Project issues about thirty or forty reports a year. WASH Field Reports relate to specific assignments in specific countries; they articulate the findings of the consultancy. The more widely appIic~bleTechnica! Reports consist of guidelines or “how-to’ manuals on topics such as pump selection, detailed training workshop designs, and state-of-the-art information on finance, community organiza- tion, and many other topics of vital interest to the water and sanitation sector In addition, WASH occasionally publishes special reports to synthesize the lessons t has Iearned from its wide field experience.
For more information about the WASH Project or to request a WASH report, contact the WASH Operations Center atthe above address