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Final Programme Report

Project Title Emergency Public Health Response in Eastern Congo

Goal Increase access to clean water and sanitation facilities and improve hygiene practices in eastern DRC.

Geographical areas

DR Congo/Eastern DRC

Beneficiaries Targeted: 250,000 (190,000 IDPs and 60,000 host communities) Achieved: 338,452 (174,269 IDPs and 164,183 host communities)

Project Period 1 May 2013 – 31 March 2014 PROGRAMME PERFORMANCE, SUMMARY OF ACTIVITIES

Sub sector name: Water Supply Infrastructure

Various technical designs were applied to provide water to IDP sites and host communities:

- The geography of Masisi is generally suitable for water supply systems through gravity flow with simple technical designs and low operations and maintenance costs. 3 new gravity systems were completed between May and December 2013 in Mianja, Kahanja and Buporo camps

- Rehabilitation of existing gravity systems was done in Kahandja villages and Rubaya IDPs Camps: old gravity system was rehabilitated and an extension of the system was carried out, a refresher training of local technicians was organized;

- Spring sources catchment was done in the 5 localities. This option was the preferred one due to absence of gravity flow options

- Bucket chlorination: one spring source in Rubaya was contaminated with more than 90 E-colis/100ml. The spring source was protected but the area was also heavily congested. Latrines were built up-stream of the spring source, which leads to contamination. Oxfam has initiated the bucket chlorination to treat water collected by the IDPs. Oxfam stopped this activity in early November 2013 when extension of the existing Rubaya water system was completed by Oxfam and was also covering the areas of the camps where IDPs were collecting water from this spring source.

107,353 persons benefitted from the interventions provided by this sub-sector.

In general, Oxfam - with an average of 5 – 15 litres of water per person per day (LWPD) 96 % of beneficiaries - is in line with Sphere standards; aiming to provide a minimum of 10 litres per person per day (LWPD) once a water supply system is completed. This average is based on a lowest average of 5 LWPD in first phase emergency situation, and a highest of 15 and over LWPD in stable contexts. Oxfam involved communities (both IDPs and host communities) in each step of the design and implementation of the project: the assessment of water sources, topographic surveys and the

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identification of tap-stand locations. Community meetings were organised to discuss roles and responsibilities of each stakeholder before the decision to implement the project was taken. Generally, communities elected their water committees representatives, which in turn linked Oxfam to the communities as a whole. The committees had among their responsibilities to mobilise the community to participate and contribute to the project activities, including the digging of pipeline trenches, securing construction materials, the transport of construction materials from the warehouse to the project site, and the maintenance of the water system and sources. Sometimes mobilising communities was a bit challenging, especially in North Kivu were communities are used to being provided with services by international non-governmental organizations (INGOs). For spring sources, a water committee was typically composed of 2 to 3 women and 2 to 3 men. For gravity systems, an average of 14 persons were elected per committee, composed of 5 to 7 women and 5 to 7 men. Local technicians were trained in minor repairs and maintenance of the water system. Support was provided by the technician from the local health department in case of more serious breakdown issues. Water quality testing:

Water quality was systematically tested before the construction of the water sources and periodically after construction had been completed. Both bacteriological and chemical testing was conducted. Fecal coliforms were tested for the bacteriological test, a range of chemical elements such as: conductivity, PH, Temperatures, turbidity, hardness, Fluoride, sulphur, copper, manganese, nitrite, potassium and chloride. In general, Oxfam has noticed during water testing activities, that the quality of the water is within the agreed international standard. In most cases, especially for unprotected sources of water, the bacteriological quality of water was below the standard. Nobili

Total number of beneficiaries: 5076 HH or 25,379 persons IDPs or host families

Site 1: Kombo Primary School

A water pumping station with a 500m pipeline, a pump and a 10m3 bladder was installed near Lamia River with one distribution tap stand of 6 taps at the end of September 2013.

Site 2: Kahondo

A 1.5km pipeline extension was completed by Oxfam end September 2013 by connecting the Kamango water gravity system to an Oxfam Tank of 45 m3 capacity, allowing for the distribution of 45,000 litres of water per day at that site. Two tap stands have been installed. Though this water is from a gravity water system, water sourced from springs was also being treated, and residual chlorine was at 0.3-0.4g/l at the tap stands. The total yield of the system was increased by 100% (from 0,7 Liters/second to 1,8 liters/day) as the result of the rehabilitation of the spring source. This was an important achievement as it increased the quantity of water provided to IDPs and host community. Site 3: Nobili centre

Installation of a tap stand for Nobili’s gravity system A new tap stand was installed at the system allowing for the distribution of 6,000 litres per day. A bladder was installed to store water for people to access during the day at the water distribution stands. Training was provided to 5 site attendants early October: 3 guards and 2 water chlorinators. Training was covered chlorination, residual chlorine testing with pool-testers, as well as the monitoring of

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water collection. 46 Community Health Volunteers have been trained and 2 awareness raising campaigns conducted. Training focused on safe water chain, water-borne diseases and hygiene promotion messages on hand-washing and defecation practices. South Kivu

Kamituga

Cholera response activities were started in September 2013 and ended in November 2013. Total beneficiaries: 36,374 direct beneficiaries, and about 70,000 indirect beneficiaries who were reached through mass campaign, hygiene message related to cholera broadcasted on local radio 3 times per day. Main activities: Bucket chlorination near surface water sources at rivers and springs sources and distributions of Aquatab. • Monitoring of bucket chlorination:

27 chlorination sites were operational to ensure beneficiaries’ access to treated water to prevent the outbreak of Cholera. 54 chlorinators selected by their community worked daily from 6 a.m. to 7 p.m. at selected sites. An average of 940,000 liters of water was treated per week; Distribution of Aquatab to households who were provided water from the existing water distribution system

• Monitoring of mobilisers: Dissemination of hygiene messages and other cholera-prevention awareness-raising;

• Radio messages and theatre groups were used for mass campaigns: 12 mass cholera prevention and other water born diseases campaigns were organised in publics places and diffusion of 180 spots and 120 educative messages on 2 local radio stations;

• Residual chlorine testing at household level: testing of residual chlorine was conducted randomly on a regular basis. The challenge was ensuring that the residual chlorine at household falls within the acceptable range.

Katanga

Various water supply activities were carried out with the following achievements:

• In Pweto town and Mutabi approx 28,1 million litres was chlorinated through bottled liquid chlorine distribution for 12,500 households; and individual chlorination at chlorination points next to the lakeside.

• 11 wells have been rehabilitated with 1.0 m3/hour yield by placing new hand pumps in Kabulembe (2), Mubalanga (2), Lwantete 1&2 (2) and Pweto town (5)

• Protection of 2 springs in Kabulembe and Lwantete was finalised. • In Nzwiba Oxfam finalised a gravity flow system with a total length of approx. 12 km of

pipeline and with a yield of 2,8l/sec what makes a total of 242.000 liters of water per day. Water is distributed through 14 tap stands with a total of 84 taps. A storage tank of 70m3 was installed as break pressure tank and to guarantee buffer storage capacity in case of high demand at the tap stands. A planned gravity system in Kiboa needed to be cancelled because the foreseen spring has a fluctuating yield and is not reliable (the actual yield is only 0,3 liters a second and does not justify the investment of several kilometres of pipeline for a target population of 3750 people only). There are no alternative springs in the direct vicinity.

Water quality testing:

Chlorination was done in the jerrycans at the household level by distributing a liquid chlorine solution of 0.5% for household water disinfection. A total of 12,500 families that benefited were trained on how to make use of the supplied liquid chlorine.

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Daily FRC monitoring was done to ensure FRC levels were maintained within acceptable levels between 0.3mg/l and 0,6 mg/l at household level in the camps. Cholera response in Pweto town and Mwashi site:

Oxfam responded to a cholera outbreak in Pweto town and Mwadingusha site by implementing chlorination points at essential water collection points starting November. Bucket chlorination was started at 44 water collection points mainly along the lake and along the river at Mwashi site. From January 2014 this number was reduced to 20 chlorination points due to observed reduction of cholera cases. The 20 chlorinations points were concentrated in the areas where cholera was still being reported. From 1st of February 2014, the INGO Solidarite will take over this cholera response program in Pweto town as part of Oxfam’s exit strategy. Sub sector name: Sanitation Infrastructure

North-Kivu

Masisi

Latrine Construction

1,345 latrines were constructed as of end February 2014 in both IDP camps (630) and host community villages (716). All latrine blocks are equipped with hand-washing facilities. Latrine cleaning kits are provided for cleaning and maintenance of sanitation facilities. Communities were involved in the identification and location of the latrines. The design was discussed with the community; gender and protection issues were especially taken into consideration as well such as the distance between shelters and sanitation facilities and ensuring that locks are placed on the inside of latrines. In Rubaya and Buporo, other NGOs (MSF-B, NCA and Solidarites) constructed latrines at different intervals as well. A total of 674 showers were constructed: 304 in IDP camps and 370 in host communities. Construction of Communal Washing Slabs:

A total of 15 new communal washing slabs were constructed. These are constructed in blocks of 10 or 6 using stones. Each block is installed with a drainage system per each and waste water management. Location of the laundry blocks is made as close as possible to water points. Katanga

Construction in IDP camps

638 new communal latrines were constructed bringing the total up to 666 for the project period. All the constructed latrine superstructures are made of mud wall using local materials and roofed with Galvanised Corrugated Iron sheet. The slab is made of timber and a mud plaster finish. Using mud reduced the need for procurement of expensive materials with longer lead times – wood is extremely difficult to procure in larger quantities in Haut Katanga. In some sites superstructure latrines were constructed with iron sheeting. In Katanga a standard of 25 people per latrine cubicle was adopted due to recommendations resulting from focus group discussions conducted on latrine management, use and maintenance.

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A total of 354 new communal showers were constructed over the project period. Shower superstructures are constructed with plastic sheeting and corrugated iron zinc on a wooden frame work. The floor is lined with a concrete slab. A total of 15 new communal washing slabs were constructed during the project period. These were done in blocks of 10 using stones with each block installed with a soak-away pit for drainage and waste water management. Siting of the laundry blocks was made as proximate as possible to water points and in areas where water points were further away, appropriate extensions of new water points were made where possible. Seventy-three (73) communal waste collection pits were constructed during the project period. Community involvement:

The displaced population was involved at every stage of the project implementation. Beneficiaries participated in the siting of all the WaSH facilities including latrines, laundry blocks, waste pits, spring sources, water points and bathing shelters. The community was consulted on their views on the various designs of sanitation facilities that were proposed. Labour for construction of these facilities and some of the materials were directly sourced from the community at no cost. All communities have been extremely responsive to Oxfam’s request for their participation. In Mihandja (in Masisi), IDPs and host communities walked more than 15 km from their village to the main road in order to transport and carry the different constructions materials such as pipes, timber and cement since trucks cannot access their village due to the appalling condition of the road. Hygiene committees (with women, men, girls and boys, see below) were established, these committees work closely with the block leaders to oversee proper use and maintenance of all WaSH facilities. Regular meetings for review of what has worked well and what needs improvements are conducted in all sites. Oxfam provided the committees with tools, materials and supplies required for maintenance, e.g. daily cleaning of latrines, collection and disposal of solid waste at homes, and routine water container cleaning. Child-to-child activities, with children acting as agents of change, have contributed to hygiene promotion activities geared towards behaviour change on a voluntary basis. Beneficiaries also maintained latrines, bathing shelters, existing tap stands and the waste disposal pits ensuring that they remained in hygienic conditions. Sub sector name: Environmental health

Katanga

Camp Cleaning:

Working with the hygiene volunteers, the PHP team organized 22 public health campaigns in public areas. Collected waste was disposed in appropriate ways at the Oxfam provided solid waste disposal points. Most of the waste is comprises soil, ash, food remains and uprooted weeds which decompose to form humus. Solid waste and drainage:

Waste management was done by distributing empty garbage sacks at household level. The collected waste was then transported to the waste disposal pits. In total 73 waste collection pits were completed. These were situated strategically to afford beneficiaries easy access for dumping. The waste disposal pits were designed by digging a circular pit with a fence for protection. Soil was used for banking around the pits to shelter them from rain water.

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The 354 communal shower blocks that were constructed had a small drainage pit built behind each shower block. These were filled with stones to keep away mosquitoes and allow seepage of the waste water. In order to channel away rain water, drain trenches were dug in Mwashi IDP Camp. Consideration was given to having appropriate drainage around all WaSH facilities and each laundry block (10 washing slabs) has a soak away pit. North Kivu

Masisi

Camp Cleaning:

Working with the hygiene volunteers, the PHP team organized 19 cleaning campaigns in public areas. Collected waste was disposed of appropriately at the Oxfam provided solid waste disposal points. Most of the waste is comprises soil, ash, food remains and uprooted weeds which decompose to form humus. Solid waste and drainage:

Empty garbage sacks were distributed at household level. The collected waste was then transported to the waste disposal pits. In total 35 waste collection pits have been completed. Placement of the waste disposal pits was done at strategic places to the beneficiaries to be able to easily dump their garbage. In addition, for each of the 674 communal shower blocks that were constructed, a small drainage pit was dug. Consideration was given to having appropriate drainage around all WaSH facilities, including the laundry block (10 washing slabs). Sub Sector: Hygiene Promotion

Katanga

Hygiene promotion volunteer committees were formed in all project sites. In total 548 persons (136 men and 412 women) were recruited and trained as hygiene volunteers. Sixteen child-to-child (CTC) clubs were formed in order to mobilise and work with children in hygiene promotion. The CTC clubs have 868 members (413 boys and 455 girls) who have been recruited and trained as monitors. There are ten clubs within the six IDP camps and six for children of IDPs in Pweto and Kiboa. Safe Water Chain

A water container cleaning campaign was conducted once a month. A total of 85,962 water containers were cleaned over the project period. The breakdown for the containers cleaned. Hand-Washing

A bi-monthly hand-washing campaign with soap distribution was conducted in the five camp areas, benefiting a total of 13,738 persons.

• Knowledge of Handwashing

In Katanga, 87% of the 420 household visited in both camps and host communities were aware of good hand washing practices. As in Masisi, the main problem in this area is lack of soap in the house. Oxfam is promoting hand washing using soap or alternative solutions such as ash, where there is no soap distribution in the camps and host community villages because non-food items (NFI) are not being distributed in most sites by the NFI Cluster. However, water for hand washing facilities installed close to latrines is mixed with soap powder.

Cholera Preparedness, Control and Prevention

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A total of 996 household visits were conducted by the Public Health Promotion (PHP) team. During these visits monitoring of various sanitation and hygiene aspects was done. The household visits were also enriched by having the PHP team discuss and share messages on safe hygiene practices with the family members present. During these visits printed information, education and communication (IEC) materials were distributed with key messages. A total of 4,199 persons (781 men, 1,157 women and 2,261 children) were reached. In order to prevent cholera transmission, over 12,500 families benefited from a blanket liquid chlorine distribution. Each family received a 250ml bottle of liquid chlorine able to provide for 20 litres of treated drinking water per day for a period of one month. This distribution was completed in four health zones in Pweto where water is collected from Lake Mweru. The health zones are cholera endemic and the risk of an outbreak is further increased by the IDP influx. Ensuring access to potable drinking water has served to reduce significantly the likelihood of a cholera outbreak. At the end of the response, only isolated cases of acute water diarrhea were reported by the Pweto hospital. Latrine use and maintenance:

A total of 666 latrines were monitored through household visits to camps and sites. Latrines were checked for cleanliness (absence of fecal matter on the floor) as evidence of regular cleaning and proper utilization. In general the latrines were well used and maintained: 531 (80%) were clean while 135 (20%) were dirty at the time of visit. With the help of the hygiene volunteers, daily cleaning was done following a cleanup schedule that was put in place, so that the latrines were used and maintained properly on a daily basis. Hand washing facilities exist in 95% of latrines. The challenge is the maintenance of hand washing facilities in some areas/blocs of the camps where taps or hand washing stands were stolen or broken. Of the 666 latrines that were visited for monitoring in February 2014, 520 (78%) had a 60l hand wash station placed outside the latrine block with water, 113 (17%) did not have water and 33 (5%) of had no hand washing stations (due to theft). Masisi

63 hygiene promotion volunteer committees were formed. Twenty-eight (28) child-to-child (CTC) clubs were formed in order to mobilise and work with children in hygiene promotion. The CTC clubs have 2,165 children (941 boys and 1,224 girls) who have been recruited and trained as monitors. Safe Water Chain

A water container cleaning campaign was conducted once a month from July through December. A total of 566,695 water containers cleaned in the project area.

Handwashing

Bi-monthly hand-washing with soap campaigns were conducted in the three camps.

• Knowledge of Hand-Washing

The results KAP survey showed that 96% of 450 surveyed households in both camps and host communities in Masisi were able to mention the 3 key moments for hand washing (after visiting a latrine, before eating, and before preparing food). The challenge related to this activity is the lack of soap in the camps. Oxfam is promoting hand washing using soap or alternative solutions such as ash, where there is no soap distribution in the camps and host communities villages because most of the NFIs distributed by the camp managers or NFIs cluster didn’t include soap and are not being conducted in most sites. However, water from hand washing facilities installed close to the latrines is mixed with soap powder.

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Nobili

Monitoring of hygiene practices was done at the Catholic Church site where good hand-washing practice was observed among 79% of a random sample of 62 households with 172 persons (83 men and 89 women). Latrine use and maintenance:

The result from the KAP survey conducted at household level indicated that 96% of the 450 visited households are using and maintaining their latrines well, 95% are equipped with hand washing facilities. Household Water Consumption

Masisi and Katanga

A monitoring vistis of 450 households conducted in December 2013 in Masisi, showed that 96% of the targeted beneficiaries were consuming between 5 and 15 LWPD, and 4% had access to more than 15 LWPD. In Katanga, analysis from the 457 households visited in the same period, showed that 14% (66 households) were consuming less than 5 LWPD, 53% (244) were consuming between 5 and 15 LWPD, and 32% (147) had access to more than 15 LWPD. The families using less than 5 LWPD generally have few or no containers and therefore could not store water. They did most household chores beside the river and families could only fetch small amounts of water for cooking and other basic uses.

PROGRAMME PERFORMANCE, SUMMARY OF ACTIVITIES

Geographic Area(s):

Masisi IDPs camps and host community villages, Nobili host community villages, North- Kivu, City of Kamituga (Cholera response) South Kivu province, and Pweto territory (Katanga province)

Sub-Sector: Water Supply Infrastructure

Beneficiary numbers: 250,000 (cumulative total across all sub-sectors)

Actual numbers reached: 338,452 beneficiaries (174,269 IDPs and 164,183 host communities)

Objective: Increase access to clean water and sanitation facilities and improve hygiene practice.

Indicator 1

80% of 250,000 displaced people living in camps and with host families have access to 5 litres of water (LWPD) per person per day;

The result from CAP survey shows that 96 % of 450 household interviewed and visited during the CAP survey have access to water in the range of 5- 15 liters/person/day in Masisi. Nobili: 15 LWPD Kamituga: 5 LWPD Katanga: Following the completion of water supply activities in Katanga, a total of 12,500 families (75,000 persons) accessed safe drinking water, making those accessing 10-15 litres of water per day 93% as per the end of project KAP survey.

Indicator 2

No more than 250 IDPs per communal tap

Achievements: Results from the KAP survey show: Masisi: 98% are in the range of 100- 150 persons/taps while

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2% are between 150 to 200 Katanga monitoring reports show that the project added 84 taps in the locations were tap water supply systems were constructed (Nzwiba which previously had only one tap). This led to about 208 users per tap easing the pressure experienced by the residents when only one water point existed. According to the final KAP survey report, the ratio of tap to users was 1:150 for 84% of the respondents surveyed in all project locations.

Indicator 3

Maximum distance between the water and the furthest household is not exceeding 250m

Achievements: Masisi: According to the final KAP survey, 16% of water points are in the range of 150m to 200m from the furthest household and 84% in the range of 100m to 150m Katanga: 83% of target population access water not further than 150m, with the remaining 17% are between 150m to 200m from their closest points.

Indicator 4

Time that people spend in collecting water does not exceed 15 minutes

Achievements: Masisi: The KAP survey shows 98% of the beneficiaries can access water in 10-15 minutes; with only 2% of beneficiaries fetching water in 15 minutes and more. In Katanga, 26% of the beneficiaries are accessing water in 10-15minutes; 44% of beneficiaries are fetching water in 15-20 minutes; 30% of the beneficiaries are accessing water in 20-25 minutes.

Indicator 5

Residual Chlorine of 0.5 mg/l at all delivery points and 0.3 mg/l at the household level

Achievements: Achieved in the area where emergency systems are operational: Masisi, Nobili, Kamituga and Pweto. For gravity systems and wells and spring sources, water is not treated. However, storage tanks are cleaned at regular intervals with chlorine solution. Katanga: Trainings on bucket chlorination and aqua tabs use was carried out by the PHP team in close collaboration with BCZ. Bucket chlorination was carried out, and according to household samples analysed and reported in the KAP survey report, 54% of all the sampled water had residual chlorine of 0.3mg/l; 18% had 0.2mg/l; and 8% had 0.4mg/l and 20 % with no mg/l (However, the test of Total chlorine in the samples indicated the presence of chlorine) at the household level. 100% of samples analysed at collection points had residual chlorine between 0.3mg/l and 0.5. 44 water collection points mainly along the lake in Pweto town and along the river at

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Mwashi site, were operational during the cholera outbreak responses In Kamituga, South Kivu, 27 chlorination sites were operational to ensure beneficiaries’ access to treated water to prevent the outbreak of cholera

Indicator 6

At least 200,000 IDPs and host community members have access to safe and reliable water supply in adequate quantities

Achievements: 273,052 IDPS and host community members (105,630 in Katanga and 167,422 in North and South Kivu) have access to safe and reliable water supply. Masisi: 23 springs source constructions completed and functional. Nobili: 3 water systems installed in three sites including storage tanks, bladders and tapstands completed; Kamituga: 27 chlorination points near stream and spring sources are operational: 940,000 liters of water are treated per week. 56,000 Aquatab tablets distributed to families using water from the existing gravity system; Katanga: As part of short term emergency water supply solution, a 10 cubic meter water bladder was installed at an IDP camp to supply water. Further, 44 chlorination points were established, producing 28.1 million liters of water treated at household level. The more sustainable water supply systems effected by the end of the project include construction of 1 gravity-fed system, rehabilitation of 11 shallow wells, protection of 2 spring sources; and construction of 4 boreholes. A total of 105,630 people are benefiting from these water supply systems.1

Geographic Area(s): 250,000 Masisi IDPs camps and host community villages, North- Kivu, and Pweto territory (Katanga province)

Sub-Sector: Sanitation Infrastructure

Beneficiary numbers: 250,000 (cumulative total across all sub-sectors) Actual numbers reached: 100,055

Objective: Increase access to clean water and sanitation facilities and improve hygiene practice.

Indicator 1

90% of the population use sanitation facilities correctly/absence of open excreta in 90% of the camp

Achievements: According to the end project KAP survey, 94% of the population interviewed utilized the latrines correctly In Katanga In Masisi, there was a 96% correct use rate.

Indicator 2

No more than 50 IDPs use shared communal

Achievements: Katanga: During the reporting period, the project

1 Oxfam monitoring report,

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latrine constructed 666 latrines. A few repairs were done as necessary. According to the KAP survey report, 98% of the respondents reported that about 35-45 people shared a latrine while 2% of the respondents reported sharing a latrine between 45-50 people. The project therefore did much better than envisaged: 50 people per latrine. Masisi: 100% achieved in IDPs camps IDPs living with host families living with IDPs. According to the KAP survey report, 96% of the respondents reported that about 30-40 people shared a latrine while 4% of the respondents reported to share a latrine between 40-50 people. The ratio of latrines per person is higher than the figures above suggest since on the Rubaya axis other WaSH actors have also constructed latrines. In addition, latrines are only constructed for host families living with IDPs.

Indicator 3

No more than 100 IDPs use one shared communal bathing shelter

Achievements: Katanga: The project constructed 354 bathing shelters benefiting a total of 23,718 IDPs at a ratio of 1:67. According to the final project KAP survey report, 71% respondents reported that 80-90 people shared a bathing shelter, while 29% reported that, 90-95 people share a bathing shelter. Masisi: 100% achieved with 674 showers completed. In some areas, other NGOs have built showers as well. For villages with IDPs, the ratio is lower as only those families actually with IDPs are targeted for construction. According to the final project KAP survey report, 98% of respondents reported that 80-90 people shared a bathing shelter, while 2% reported that 90 to 95 people share a bathing shelter.

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Indicator 4

Latrine and shower facilities located not more than 30m from dwellings. Clothes washing facilities are located not more than 100m from dwellings.

Achievements: Katanga: 92% of the respondents reported that latrine and shower facilities were located 10m to 20m from their households, while 8% reported them being within 20m to 30m from their households Washing facilities: 69% of the respondents reported that facilities were 70m to 80m away, while 31% reported them being located 80m to 90m from their households. Masisi: According to the final KAP survey, 81% of sanitation facilities are located between 10m and 20m in host communities while in the camps the ratio is 99%. Latrine and shower facilities were sited well within 20m and washing slabs within 50m. However, there is a problem of lack of space for WaSH facilities in some areas in Masisi due to the high population density, which may lead to longer distances in some cases (especially on the Rubaya axis).

Indicator 5

At least 90,000 IDPs will have access to safe excreta and waste disposal facilities.

Achievements: Katanga: During the project period, 666 latrines and 73 waste collection pits were constructed reaching over 28,120 IDPs.

Masisi: 1,345 latrines have been constructed for 100,789 IDPs and host communities. The gaps were covered by other agencies in Masisi camps and host communities. The project anticipated constructing 1,600 latrines and achieved close to 2,000 units/doors (1,982).

Geographical area: Masisi IDPs camps and host community villages, Nobili host community villages, North Kivu, City of Kamituga (cholera response) South Kivu province, and Pweto territory (Katanga province)

Sub Sector: Hygiene Promotion

Beneficiary numbers: 250,000 (cumulative total across all sub-sectors)

Actual numbers reached: 338.452 (174,269 IDPs and 164,183 host communities)

Objective: Increase access to clean water and sanitation facilities and improve hygiene practice.

Indicator 1 80% of people are able to mention main contamination of water containers and vectors in faeco-oral transmission.

Achievements: According to the final KAP survey, 62% of the sample population reported that diarrhea was caused by poor hygiene practices and 38% population indicated that diarrhea was caused by not covering food. When asked what should be done to prevent diarrhea, 54% reported safe excreta disposal, 24%

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reported hand washing during critical moments, and 22% reported drinking safe water. This was a result of the trainings conducted during the project on faeco-oral transmission routes through the use of IECs messages, radio messages, child-to-child training, mass hygiene campaigns and other methods which required participation.

Indicator 2 70% of the targeted IDPs know at least 3 critical times of hand washing.

Achievements: In Katanga, 87% of the sampled 420 respondents reported knowing more than the 3 critical times of washing hands (after the use of latrine, before eating, after cleaning the baby’s faeces, and before preparing food), while in Masisi, the response was 98%. The project therefore achieved its target. This was made possible through hygiene campaigns carried out in all areas throughout the project period. A total of 6 campaigns were run. Radio messaging was employed in this project as part of communication for behaviour change strategy. 20 cholera prevention messages were aired on Radio Tele Pweto (RTP). Additionally, 168 recorded messages were made and broadcasted on the radio in the majority of the project operational areas. All these were designed and implemented by Oxfam hygiene promotion team in close collaboration with Bureau Central du Santé (BCZ), the government health partner in Pweto. The radio campaign was carried out from September through December 2013.

Indicator 3 At least 50% of the population wash their hands after using sanitation facilities.

Achievements: Hand washing practice was reported at 93% during the KAP survey conducted in December 2013 in Katanga, while in Masisi, the rate was 97%. This was as a result of the many sensitizations carried out during the project. In addition to hygiene sensitizations which applied participatory methods, volunteers performed a critical role in spreading the hand washing trainings. Child-to-child activities were carried out wherein children trained on hand washing formed a change mechanism ensuring the spread of the practice. The child trainings were conducted once a week. The camp management committees benefited from these trainings as well. They have continued to be very instrumental in ensuring continuation of the hand washing practice. In addition, all latrine beneficiary sites were provided with hand washing stations: plastic buckets with a tap. Soap was distributed in all the sites. In anticipation of the situation after the project were the beneficiaries might not afford soap on their own, the hygiene trainings discovered and reinforced the

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knowledge and practice of ash usage in effective hand washing. Nobili: Out of 102 households interviewed and observed, 80 households or 78%, washed their hands after using a latrine.

Indicator 4 Formation of extra 200 hygiene volunteers (1 volunteer for 500 IDP’s) in the camps with 50% representation of women. Committees are involved in making decisions about locations, programme activities and management structures in place.

Achievements: Katanga: During the project period men and women from the displaced community were recruited and trained to constitute hygiene promotion committees. In total, 548 persons (136 men and 412 women) were incorporated in the hygiene promotion committees; about 75% female participation. They continue to play a critical role in the management of the WASH facilities in their sites. For example in Kipeto IDP camp, the committee is headed by a female. Supporting the committees are the volunteers who are involved in the daily operation and maintenance of the various WASH facilities. Together with the committees, volunteers were involved in site identification and selection throughout the project period. The community capacity building contributed a lot to the continuation of the public health activities in spite of the small number of staff assigned to this project. This has led to sustainability of the activities and the benefits realised by the project beyond the project period. Masisi: Host communities and camps selected 391 hygiene volunteers - 299 women and 92 men – who were trained and incorporated in hygiene promotion committees.

Indicator 5 90% of latrines are well maintained/absence of excreta in the latrine commodities, on the slab.

Achievements: Katanga: 666 latrines cubicles were monitored for proper use and maintenance, of which 531 (80%) were clean/had no faecal matter, while only 135 (20%) were found not to have been well maintained. During the KAP survey, it was observed that, 94% of the latrines were clean (without feaces on the floor, no,bad smell, and no flies) and were being used correctly. This was as a result of the trained volunteers and their WASH committee management teams. Masisi: The KAP survey showed 96% of monitored latrines to be clean, well-maintained and correctly used.

Indicator 6 90% of the population correctly use sanitation facilities.

Achievements: Katanga: 666 latrines cubicles were monitored for proper use and maintenance, of which 531 (80%)

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were clean/had no fecal matter, while only 135 (20%) were found not to have been well maintained. During the KAP survey, it was observed that, 94% of the latrines were clean (without feaces on the floor, no,bad smell, and no flies) and were being used correctly. This was as a result of the trained volunteers and their WASH committee management teams. Masisi: The KAP survey showed 96% of monitored latrines used by 420 household to be clean, well-maintained and correctly used.

Indicator 7

At least 64,000 men and women will be reached by hygiene volunteers directly with messages of safe excreta disposal, safe water chain and hand washing at critical times

Achievements: According to the monitoring report and KAP survey, an average of 96% of targeted population of 64,000 persons was directly reached by the hygiene volunteer with hygiene messages activities in all project areas. Hygiene promotion activities included home visits, mass hygiene campaigns and environmental cleanup campaigns. This was a concerted effort by BCZ, Oxfam GB field hygiene promotion teams, hygiene promotion volunteers, WASH management committees and the child-to-child teams.

Indicator 8 160,000 men and women are able to define at least three critical time of hand washing

Achievements: Katanga: From the last monitoring reports, 21,089 people were reached with messaging on hygiene and environmental health in IDPs camps. Of these, the KAP survey reported 84% of 420 surveyed IDPs and Host community were able to define at least three critical time of hand washing. Masisi: The KAP survey showed 98% of 420 surveyed households able to define at least three critical times of hand washing.

Indicator 9

At least 14,000 household visited will be free from open defecation

Achievements: Katanga: 97% of 420 households surveyed were free from open defecation according to the final KAP survey. Masisi: According to the KAP survey, 97% of 420 surveyed households in both camps and host communities were free from open defecation. In both areas no fecal matter was found in the inhabited areas. Latrines were used by most of the beneficiaries. Children faeces were collected by adults and disposed in the latrines.

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Geographic Area(s): Masisi IDP camps and host community villages, Nobili host community villages in North Kivu Province, and Pweto Territory in Katanga Province

Sub-Sector: Environmental Health

Beneficiary numbers: 250,000 (cumulative total across all sub-sectors)

Actual numbers reached: 48,475 reached in Katanga

Objective: Increase access to clean water and sanitation facilities and improve hygiene practice.

Indicator 1 80% of camps show absence of domestic waste in the premises and surroundings (HH & public areas)

Achievements: 84% Katanga: 97% of all areas sampled and visited during KAP survey were clean, and the solid waste collection facilities were regularly used. 91% of the respondents confirmed having access to information on the management of solid waste and disease prevention. According to follow up monitoring done at the beginning of April, all the sites were clean. In many IDP camps where collection pits were full, they had taken it upon themselves and dig new ones. Masisi: According to the monitoring report of the 450 home visited, 99% had no observable domestic waste

Indicator 2

80% of camps show absence of vector breeding due to stagnant water in their surroundings.

Achievements 100% Achieved Katanga and Masisi: All newly constructed bathing shelters and laundry slabs are installed with soak pits to manage waste water generated when the community makes use of these facilities. There was no evidence of stagnant water near the homes as observed during the 457 home visits. According to the final KAP survey, 97% of the respondents in Katanga reported absence of disease carrying vectors in their surroundings, while in Masisi this response was from 94% of those surveyed. Further, all the WASH facilities constructed during the project period have good drainage, leaving no opportunity for vector breeding.

Indicator 3

40,000 HH will benefit from solid waste management, drainage, and/or vector control activities.

Achievements Katanga and Masisi: Katanga: 97% of all areas sampled and visited during KAP survey were clean, and the solid waste collection facilities were regularly used. 91% of the respondents confirmed having access to information on the management of solid waste and disease prevention. According to follow up monitoring, all the sites were clean. In many IDP camps where collection pits were full, they had taken it upon themselves and dig new ones. Masisi: According to the monitoring report of the 450 home visited, 99% had no observable domestic waste. There was no evidence of stagnant water near the homes as observed during the 457 home visits in Katanga and 450

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Masisi IDPs camps According to the final KAP survey, 97% of the respondents in Katanga reported absence of disease carrying vectors in their surroundings, while in Masisi this response was from 94% of those surveyed. Further, all the WASH facilities constructed during the project period have good drainage, leaving no opportunity for vector breeding.

CROSS CUTTING THEMES

Gender

In recognition of the critical role played by women on the overall impact of the WaSH activities and with women being the main beneficiaries of the programmes (the result from KAP survey showed that 55% of IDPS are women in North Kivu emergency response programme, while in Katanga this percentage is 63%), a specific emphasis was placed on consulting women on the design, management and placement of WaSH facilities. Women-only focus group discussions were organised, and transect walks in villages and camps took place, where women and men were separately consulted on issues such as the location of water points and sanitation facilities. Women reported that they did not feel safe using Oxfam’s previous of latrine and shower design in the camps, whose walls were made of plastic sheeting. After further discussion, it was agreed to change the design to iron zinc sheet or local materials (mud) for superstructures with proper doors. Latrines were segregated by gender especially in the camps, providing privacy to women, men, girls, and boys, with signs on the door to differentiate latrines. All latrines and bathing shelters are further equipped with internal locking mechanism. Gravity water points are located in the area where women and children feel safe. However, spring sources are generally located more than 500m from the camps or villages, posing a threat to IDPs, especially women. Where possible Oxfam did construct small gravity systems to bring water points closer to the beneficiaries, and where this was not possible, community works were organised to ensure safe access to water points. Women, men, boys, and girls all formed part of the different committees responsible for maintenance of WaSH facilities in both camps and host communities. With women playing an important role in mobilising communities for the cleaning and maintenance of wash facilities especially in the camps, they reported feeling empowered by the project, especially with the opportunity for addressing problems they face during community meetings. According to KAP survey report, 79% of respondents reported that women were actively involved in fetching water, with only 21% reportedly being fetched by men. Oxfam facilitated peer orientation of 264 volunteer women (all of whom were IDPs from Mutabi, Lwantete, Mwashi and Kipeto camps). This was in response to a request by volunteers living in the camps to be supported to understand simple tallying and literacy. Oxfam carried out mobilization of all the teachers in the camp; something that led to their voluntary service in giving simple literacy skills. Following this activity, some of those trained ended up being instrumental in project monitoring and reporting. Some took up volunteer roles such as hygiene promotion and water chlorination. Protection

Protection has been mainstreamed and integrated in the WaSH programming through active involvement of the community in the programme design and implementation, as mentioned above. Oxfam has protection staff as part of the Rapid Response Team, with a protection officer permanently

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based in each location (Masisi and Pweto), systematically working with the WaSH teams to ensure safe programming. See also gender section for examples of safe programming. Oxfam, through the protection staff permanently based in each location (Masisi and Pweto), systematically worked with the WaSH teams on mainstreaming protection. Water points were carefully sited in locations where security could be maximized for safe access for women and children. Separation of the women and men’s facilities further enhanced protection. All latrines and bathing shelters were equipped with internal locking mechanisms to enhance privacy and security. Capacity building was done for Oxfam staff, volunteers, hygienists, and children’s clubs, about self protection mechanisms and mapping of protection service providers.