CYCLONE HAROLD RECOVERY & RESILIENCE SANITATION PROJECT on VAO, MALEKULA Final Report Cyclone Harold Recovery and Resilience WASH Project - Vao, North East Malekula Background on TC Harold affected areas in North Malekula – Vao Island and Mainland On Monday 6 April 2020, Category 5 Cyclone Harold (‘TC Harold’) cut a devastating path through the northern islands of Vanuatu. Parts of Santo, Pentecost, Malo, Ambrym and Malekula islands were among the worst affected. On Malekula, consolidated assessment data from the Malampa Provincial Emergency Operations Centre documented that areas in the North, North West and North East were seriously impacted. While these communities were spared the worst of large-scale destruction of infrastructure, damage to food crops and clean water sources was substantial in the immediate aftermath of the disaster. Over a 2-month period till the end of June, government coordinated food distributions and emergency water trucking to North Malekula communities took place with the assistance of the Red Cross. Schematic provided by Vanuatu Health Cluster Mainland Vao, and especially Vao Island in the North East of Malekula reported a surge in cases of waterborne diseases in the first 2 months following TC Harold. 2 The Malampa Provincial Health Surveillance Unit reported a rapid rise in numbers of cases of diarrhoea, conjunctivitis and flu-like illnesses in cyclone affected communities. In particular, the communities of Vao in the northeastern corner reported the largest cluster of waterborne infections, especially in the 4 sectors of Vao Island. Covid-19 related health awareness activities that began weeks before TC Harold refocused once again on disseminating basic handwashing and personal hygiene messages. According to the Malampa Provincial Health team, improved handwashing measures appeared to reduce the number of diarrhoeal cases. Rural communities without handwashing stations were encouraged to construct simple ‘tippy-taps’ made from bamboo or recycled plastic drink bottles. As the emergency relief phase transitioned into recovery mode, communities considered more permanent ways to improve toileting and handwashing structures. Many people are aware of the connection between poor hygiene and heightened risks of contracting diseases, especially when natural disasters strike. Population Statistics for Vao Mainland and Island Vao Mainland Sector Number of Households Population Males Females Total Labung 25 41 39 80 Lawor 20 42 38 80 Tokvanuaute 57 117 124 241 St Joseph 32 64 77 141 Veturah 76 213 214 427 210 477 492 969 Vao Island Sector Number of Households Population Males Females Total Beteul 59 150 140 290 Tokvanu 40 84 96 180 Beterihivenu 56 105 125 230 Noroure-Sigone 63 147 179 326 218 486 540 1026 TOTAL 428 1995 Figures provided by Vao Dispensary (June 2020) Strengthening hygiene and sanitation structures such as properly functioning toilets, handwashing stations and access to clean drinking water are ongoing challenges from the health education as well as implementation standpoints. Many households share toilets, some of which are poorly constructed, not well-maintained and are not cleaned regularly. Many toilets do not have proper handwashing facilities attached. The vast majority of toilets are not easily accessible by the elderly and disabled. The health impact of the latest cyclone combined with the threat of Covid-19 has brought home the urgent message to strengthen the WASH needs of individuals and communities. 3 The northern parts of Malekula experience sustained periods of low rainfall due to orographic effects. On mainland Vao, existing solar pump systems could benefit from upgrades and improvements, according to an independent survey recently commissioned by the Department of Water Services in May 2020. On Vao Island, 3 of the 4 sectors rely on wells as their primary source of water. Some households and communal areas have rainwater collection tanks as secondary sources for drinking and other uses. In the dry season, villagers from the small island frequently have to fetch water from the mainland when groundwater supplies turn brackish and tank water supplies are depleted. Objectives The core purpose of this project is to equip Vao communities on the mainland and small island with the necessary skills to construct a standard VIP (Ventilated Improved Pit) toilet that is affordable and accessible to everyone. The activity is aligned with the Ministry of Health’s Sanitation Guidelines as well as its TC Harold Response Plan. The latest guidelines recommend that over 2000 household VIP toilets are built in North East Malekula alone. • Objective #1: Recovery – to facilitate the reconstruction of properly functioning toilets for communities affected by TC Harold. 4 • Objective #2: Health Education – to reinforce key messages around sanitation and hygiene, focusing on the transmission of diseases due to poor hygiene practices. Covid-19 awareness and preparedness activities will be integrated during community awareness sessions. • Objective #3: Sustainable Development and Resilience – 1. Improvements to existing toilets according to Sanitation and Hygiene guidelines 2. Communities follow through by building their own toilets, including handwashing stations. 3. Communities gain the necessary skills to build their own improved toilets and knowledge on the importance of hygiene. • Objective #4: Menstrual Hygiene – special focus will be placed on the needs of women and girls. • Objective #5: Inclusiveness – modified design of VIP toilet that takes into account disability access. Design Refer to the Appendix A and B for design plans and sketches, and Bill of Quantities of Materials. The proposed design of VIP toilet Photos courtesy of Keith Jacob Gasi Sanma Environmental Health Officer 5 Implementation A: Consultation stage Who When Description PORT VILA: 2 – 30 June ▪ Checks conducted to ensure proposed activity is aligned with the Ministry of Health’s TC Harold Environmental Health Unit Response Plan for Sanitation and Hygiene. Sanitation Working Group ▪ Latest copy of Sanitation Guidelines obtained. Neglected Tropical Diseases Unit ▪ Advice sought on toilet design plans, types of toilets and bills of quantities. WASH Cluster ▪ Explored potential opportunity to integrate this activity with Neglected Tropical Diseases Unit. PORT VILA: 1 June ▪ Sought advice from WASH Cluster to coordinate activities with other agencies. Learned that Unicef is Unicef funding the training of 12 new Sanitation Officers who will be able to provide training to communities. Rota Mould Ltd. ▪ Consulted Rota Mould and Total Construction, both Total Construction Ltd. private businesses in Port Vila to find out about possible handwashing stations and alternative toilet designs. MALEKULA (Norsup, Lakatoro): 25 May ▪ Held discussions with Public Health Manager and 15 June Health Promotions Officer to ascertain gaps and Malampa Provincial Health priorities in cyclone affected areas. Department of Water Services ▪ Discussed the possibility of VIP toilets for various Aid Posts in the North, North East and North West Malekula. ▪ Obtained advice from Malampa Surveillance Officer on data relating to cyclone-related illnesses. ▪ Sought advice from Provincial Water Officer on proposed plans to improve water distribution systems to cyclone affected communities. ▪ Based on accumulated information above, provincial health authorities advised us to focus on the community of Vao. MALEKULA (Vao): 17 June ▪ Discussed proposal with members of the Health Committee which included the nurse, school Vao Community Health 30 June - principal and paramount chief. Committee present Malampa Disability Officer 6 ▪ Telephone consultations with Vao Dispensary Nurse in-charge to obtain population statistics and other data for planning purposes. ▪ Vao Health Committee team conducted awareness of the project in the various sectors. ▪ Nurse and Nurse Aid conducted a mini-survey of existing sanitation facilities in each sector – results currently being collated. ▪ Telephone consultation with Malampa Disability Officer to find out the details of specific individuals with disabilities on Vao. Learnt that there was a very recent survey conducted last month. Results will be published by mid-July and used to inform project planning. SANTO: 22 June ▪ Several meetings took place in Luganville with the Sanma Environmental Health Officer and Malampa Sanma Provincial Health 26 June - Health Promotions Officer. Both these health officers Sanitation Officer present will be in charge of training the community in the construction of VIP toilets. Malampa Health Promotions Officer ▪ Gathered information on: - Training material including practical steps for communities to prepare themselves for the hands-on component. - Location of toilets taking into account environmental impact and appropriate distancing to avoid contaminating water sources. - Design specifications including the riser moulds for the toilet seat. - Schedules and Timeline. - Possible integration of training and induction of newly appointed sanitation officers into this project. Outcomes of consultations with National, Provincial and Vao Community stakeholders: 1. Approval by the Vao community leaders for the project and agreement that the community will contribute local timber, natangura thatch, bamboo and other natural materials available locally for the construction of the frame, walls and roof of each model toilet. 2. Approval by the Environmental Health Unit of the Ministry of Health (MOH) for the