The Living Earth Institute Dhanusha Community Development Project Mujeliya and Rajaul Villages Project Completion Report

General Background At the foot of the Himalayan range, the southern plains of Nepal are known as the Terai. Janakpur town is in the Dhanusha district in the Terai and lies southeast of Kathmandu. The Dhanusha district has 1180 sq. km area and has a gentle surface gradient towards south. Ground elevation in the north is 610 m while it is only 61 m above mean sea level near its border with India in the south. The Terai has a tropical to sub-tropical climate. Janakpur is the administrative headquarter of Dhanusha District (See Figure 1).

Figure 1. Map of Nepal showing the Project Area.

Janakpur has historic and religious significance, especially to Hindus. The town has a population of 70,000 people and is divided into16 wards. Although it is categorized as a municipality, Janakpur semi-urbanized with limited urban amenities only. The majority of the population live in rural settings, where even basic amenities such as drinking water, sanitation facility, sewage and drainage, health and educational facilities

are scarce or very limited. The lower caste people, considered by many as untouchables, have the least access to the basic amenities.

Figure 2. An Aerial View of Janakpur Town.

The communities of Mushahar, Dhankar, Chamaar, Dom, Paswan, and Mukhiya are lower caste communities, and they are the poorest among the poor in Nepal. They often do not own any land and survive on their daily labor earnings. These people are often omitted from normal development programs. The Dhanusha Community Development Project of LEI was developed specifically to serve the people from the low caste communities in Janakpur. Dhanusha Community Development Project Dhanusha Community Development Project is a community based project designed to assist the residents to improve their living conditions and their environment through sustainable and wise use of the natural resources. The project is guided by a set of principles such as social justice, equity, gender equality and community empowerment, particularly to the women members of the community, through education, skills development and community organization. The project is demand-based, and practices the principles of partnership with the community in all aspects and stages of project implementation. The Living Earth Institute strongly believes in the capacity of the local people, and therefore, uses locally available human and material resources to the greatest extent possible.

Figure 3. An Aerial View of a Village in Janakpur.

Project Area and the Target Community The Mujeliya and Rajaul villages in ward number 14 of Janakpur Municipality are the project areas of the Dhanusha Community Development Project. Within these villages, the Project targeted on the lower caste communities of Mushahar, Dhankar, Chamaar, Paswan, Mukhiya, and other poor families. Safe drinking water is scarcely available for these very poor communities. Many community members had to depend on nearby community water ponds for all water needs )drinking, cooking, bathing and washing utensils and clothes). Others were able to finding neighboring wells for drinking water. Water borne diseases in this situation are very common, and morbidity and child mortality rates are consequently high. Private or community latrines are non-existent in these areas making the village environment quite unhygienic. In addition, the literacy rate is very low, and women typically do not have any income generating skills besides occasional or seasonal domestic or farm labor. Implementation Arrangements The project concepts were initially developed after numerous field visits in the rural parts of Janakpur by LEI in consultation with Women Development Service Center (WDSC), the local partner Non-Government Organization (NGO) in Janakpur. These concepts were discussed with the local community leaders and then improved upon by incorporating community leaders feedback. A detailed project design was then developed and the implementation procedure was worked out together with WDSC officials. The most important strength of the project has been the flexibility in implementation procedures, which is guided by the principle of learning from experience.

Women Development Services Center in Janakpur is the prime organizer of the Project. WDSC works closely with the community and its organizations (PMC and WUG) to enlist their cooperation and active involvement in the Project. The LEI Project Managers supervised and monitored the project progress regularly, and made necessary changes, whenever necessary, in project design and implementation procedures as the project moved ahead. The LEI President and other Board Members made inspected in the field regularly and provided necessary guidance. Project Objectives The main objectives of the project are: Community management and empowerment. Community development through women empowerment and skills development. Improvement in access to safe drinking water Improvement in sanitation and health. Sustainability of community water wells and private latrines Partnership with the community and capacity development of the project partners. Project Components There are four main components in the Project. The project activities, in line with the above-mentioned objectives, are developed around the LEI principles. They are: 1. Community Drinking Water Wells This component is designed to develop community access to safe drinking water. This component is implemented at the demand and active participation of the community. The water wells are owned by organized Water Users Groups (WUGs), who bear the sole responsibility of operation, maintenance and repair on a sustainable basis. A group of 5 to 10 households forms a WUG and places request for a water wells to the project. The WUG members decide on the location of well, associated land issues and engage in a formal agreement on use and maintenance. The WUG members are take part in all stages of project implementation, including planning, designing, and construction. Each household of the WUG must make a cash contribution towards water well maintenance and repair in advance and provide labor service during construction. LEI uses improved well drilling and construction technologies in this project to assure the water quality and to protect the productive aquifer/s from contaminated from the surface percolation and from the polluted shallower aquifers. LEI staff train local technicians in the improved technology, while the WUGs and the technical personnel in the partner NGO monitor the compliance of this new construction technology. 2. Health and Sanitation Improvement The Project provided technical and material support to the community members for building their own private latrines. Community awareness about personal hygiene, health and environment has improved through the health and sanitation education programs. Intensive four-day trainings were provided to one women volunteer from each WUG, and she subsequently serves as the first resource person for consultation on common health related problems in the community. At the same time, the volunteers encourage community members to build private latrines through door-to-

door campaign. The project support is provided on the basis of the community demand only. 3. Community Development Community development through the empowerment of women is an important component of the Project. Women from the target communities were provided various skills development trainings such as literacy classes and sewing-cutting training (i.e. tailoring skills) classes run under this project component. 4. Capacity Building Capacity building of the community and the Project partners is important for the sustainability of the project products. The community is organized and is involved in every stage of the project such as planning, designing, and implementation. The local community forms a Project Management Committee (PMC). LEI and our partner NGO provided the PMC members training on various aspects of the project implementation and management. Similarly, the staff of the LEIs partner NGO was took part in various trainings such as PRA and Project Implementation Methodologies. The local water well drillers were trained in the improved technology for safe water well drilling and construction.

Implementation Procedure: The project followed a strong community-based implementation approach. Participatory Rural Appraisal (PRA) was used to assess the needs of the community and organize them for the project. The WDSC staff were trained in PRA tools for this purpose at the beginning of the project. A step-by-step procedural guideline was prepared and the LEI Managers trained the WDSC staff during a Project Orientation Training. Community meetings were organized to disseminate information about the project. The Community Workers (WDSC project staff) and the PMC members carried out doorto-door campaigns. The community members became fully familiar with the project rules, and the roles and responsibilities of all the stakeholders. To this end, the community development programs started well before the water well and latrine programs in order to maintain good communication with and enhance participation of the community. Regular community meetings were organized during the implementation phase, where various issues were discussed and problems resolved. The project strictly followed demand-based approach. The community strongly desired living conditions improvement, and therefore, their active involvement are preconditions for their participation in the project. Since the LEI strongly believes in community initiative, no physical targets and no deadlines were externally fixed for the project. However, information dissemination, community mobilization and organization activities were carried out continuously. The interested community members were guided through a stepwise implementation process of the project. The stepwise process involved a series of activities and benchmarks that provided safeguard to the integrity of the project process and increased community participation and ownership of the project. A number of specific activities and/or criteria were developed which the community had to fulfill before a next operational step is started. The project was implemented in three phases: Preparation, Construction, and Operation and

Maintenance Phases. The duration of each step and each phase depended entirely on the commitment, ability and willingness of the community to fulfill their part of the contribution and participation. 1. Preparation Phase During the preparation phase, numerous activities leading to improved project implementation and management capacity, better sanitation practices and enhanced capacity to sustain drinking water wells were completed. The WDSC staffs were trained in PRA tools (Box 1), and such tools were utilized in the assessment and analysis of drinking water and environmental sanitation needs, and also in community mobilizing and training of PMC members.
Box 1. Participatory Rural Appraisal Training A PRA training program was organized with the help of the Nepal Participatory Action Network (NEPAN). Mr. Rajendra Gupta, an PRA expert, conducted the training program from 15 to 19 March, 2001. The participants were trained in various PRA tools and tested those tools in the village of Mujeliya on the final day of the training. The trainees were (i) Madhuri Ale, (ii) Nila Poudyal (iii) Mina K.C., (iv) Sunanda Ghimire, (v) Binod Manandhar, and (vi) Sonali Giri from WDSC, and (vii) Meera Kansakar, (viii) Haseena Shrestha and (ix) Juliyana Kansakar from LEI. Box 2. Project Management Committee 1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 4. Mrs. Poonam Devi Paswan Chairperson* Mrs. Geeta Devi Paswan Secretary Mrs. Ram Dulari Paswan Treasurer Mrs. Sumitra Mahara Member Mrs. Tulfi Devi Mahara Member Mrs. Phuljhariya Devi Mahara Member Mrs. Lalpari Mukhiya Member Mrs. Sumitra Devi Mukhiya Member Mrs. Pabitri Devi Mukhiya Member Advisory Committee Mr. Ram Varan Paswan Immediate Past Chairman of ward no. 14, JNP Municipality. Mrs. Raj Kumari Thakur Mr. Moti Mahara Mr. Suresh Yadav

(*Mrs. Sumitra Mahara, replaced Mrs. Poonam Devi Paswan in 2003, because she had to move away temporarily to her husbands job.)

Community meetings were organized to disseminate information about the project. The community formed a Project Management Committee (PMC), with the main responsibilities of community mobilization, community organization, project implementation and management at the community level. The PMC members were trained in project implementation and management in December 21-23, 2002 (Box 2). The training program focused on methods of information dissemination, group leadership, conflict resolution, project management skills, and project procedures and implementation schedules. In March 2004, the PMC was reorganized and provided a refresher training (Box 3). Completion/ fulfillment of the following activities/criteria marked the end of the preparation phase: A systematic groundwater survey has established that the occurrence and quality of groundwater in the project area are suitable for safe drinking water supply. The community has agreed to participate actively and fulfill all the project criteria and the rules. The community has formed a Project Management Committee (PMC) by electing its office bearers, and they have undergone a capacity development training designed specially for them.

 The villagers have informed the local government that LEI is launching the project in their area. Interested households in a neighborhood forms Water Users Groups (WUG) and they have submitted request forms along with their contribution for Well Maintenance and Repair Fund to WDSC. WDSC has opened joint bank account of WDSC and WUG in a nearby bank and have deposited the fund in it. The community has agreed to mobilize its own resources, including human resources, to assume full responsibility for operation and maintenance of the water wells. The WUGs have unanimously agreed and decided the site for placing the water well. All the proposed sites have been inspected by WDSC technician and have found suitable from technical and social grounds. The households are willing to change their sanitary habits and have constructed and started using latrine.
Box 3. The Reorganized PMC Body 1. Mrs. Raj Kumari Thakur-Chairperson 2. Mrs. Mantoria Devi MaharaVice-Chairperson 3. Mrs. Ram Dulari Paswan-Treasurer 4. Mrs. Malati Devi Mukhiya Secretary 5. Mrs. Pabitri Devi Mukhiya Member 6. Mrs. Sumitra Devi Mahara Member 7. Mrs. Tulfi Devi Mahara Member 8. Mrs. Sanischari Devi Sada Member 9. Mrs. Draupati Paswan Member Advisory Committee 1. Mr. Ram Varan Paswan 2. Mr. Suresh yadav 3. Mr. Moti Mahara 4. Mrs. Ram Kali Devi 5. Mr. Ram Kripal Mukhiya

2. Construction Phase Latrine Program Latrine and water wells are the main physical construction activities under this phase. The community members have three types of household latrine designs to choose from. These designs are developed to suit (i) the available land space, and (ii) their affordability. The household contribution varied accordingly to the design; (i) Rs. 200.00 (US $3.00) for design #3; (ii) Rs. 500.00 (US $ 7.00) for design #2; and (iii) Rs. 800.00 (US $ 12.00) for design #1. A total of 176 private latrines were completed under this project, benefiting a population of over 1800 people (See beneficiaries list in Appendix 1). The toilet pans were manufactured in a factory in Kathmandu, and were custom designed with LEI logo. The pan is made of fiberglass (Figure 4), while the siphon (trap) and connecting pipes are made of High Density Polyethylene material. The WDSC staff directly supervised and controlled the quality of the concrete rings and cover slabs (for soil pit) manufactured in its plant (Figure 5). The project technician guided and controlled the quality of latrine construction works only up to the ground level, after which the owner decided on the supra-structure according to their likings and budget (Figures 6 & 7).

Figure 4. Custom-made project toilet pan.

Figure 5. Latrine pit ring manufacturing plant in Rajaul.

Figure 6. Supervision and monitoring of latrine program by WDSC and LEI Project Manager.

Figure 7. A LEI project latrine in Mujeliya.

In addition to the individual household latrines, the project also built a two-room latrine for community use in Rajaul in Rajaul Community Service Center, Rajaul. Water Well Program Under the Dhanusha Community Development Project, a total of 46 water wells were constructed. These wells are shared among 168 families (See beneficiary list in Appendix 2). Two of the wells were built in the lower secondary schools in Rajaul and Sohani, Mujeliya respectively (Figures 8 & 9).

Figure 8. Water well in the school at Rajaul.

Figure 9. Water well in the school at Sohani, Mujeliya

The LEI project places high emphasis not only on drinking water quality from its wells, but also on protecting the groundwater environment. The commonly practiced manual drilling and well construction methods in Nepal involved some serious water quality and environmental issues, such as, (i) cow dung is used during drilling operation as the lubricating agent. This causes foul smell in well water for a long time, and bacterial contamination of water as well as the aquifer/s. (ii) filter pack material (i.e. coarse gravel) is filled in the borehole space outside the casing and the screen pipes (annular spaces) all throughout the depth of the well interlinking all the aquifers occurring within the drilling depth. Groundwater from the near surface aquifers, which are vulnerable to contamination, may flow down the annular space into the lower clean aquifers, causing not only the contamination of the well water, but also the aquifer itself in the long run. (iii) sanitary seal of the well (i.e. concrete filling of borehole space outside the casing pipe near wellhead) is generally not provided, and the well head platform are not good. As a result, the water well and the aquifers are susceptible to contamination due to percolation of polluted water through the annular spaces. (iv) the hand pumps are generally of low quality and frequent breakdowns are common. Moreover, they need more pressure to pump and are hard for the children to pump.. LEI addressed these issues systematically and scientifically. The LEI project manager, Dr. Dibya Ratna Kansakar, himself being a groundwater professional, used his professional knowledge and experience in addressing those issues. The project procured a LS 200 rig machine for the project purpose. It is a light, low powered, standard well drilling rig machine manufactured by Lone Star Company in Texas, USA (Figure 10). Bentonite clay is the standard mud used in a machine drilling and therefore the need for cow dung eliminated completely. However, operation of this machine requires a sizable space which was not available in every well site. Therefore, local manual drilling was used when machine drilling was not possible (Figure 11). But, the method was improved as the drillers were trained in using bentonite clay and other proper construction methods.

Figure 10. Water well drilling by LS 200 Rig Machine.

Figure 11. Manual borehole drilling.

The project also made several other improvements in the well design and well construction practices. Only the aquifer/s that occurred under a thick layer of sticky clay (good impervious layer) is screed for obtaining water. The LEI wells are therefore much more deep (210 ft in average) compared to the villagers customary wells, which are less than 100 ft. Again, the filter pack material (coarse gravel) was filled in the annular spaces (i.e. the open space between the borehole wall and the casing/screen pipe) between the

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bottom of the borehole up to only about 3 ft above the top of the screen level. The remaining annular spaces above this were filled with a mixture of local clay and bentonite to provide a good seal to the filter pack layer (i.e. the screened aquifer layer). This seal protects the deeper aquifers from contamination by vertical percolation of surface water or intermixing with upper aquifer/s water which are more susceptible to contamination. Finally, the uppermost 6 ft of the annular space was filled with cement-sand mixture to provide a secured seal at the wellhead. A concrete platform with good drainage is built at the wellhead for protection from wastewater (Figure 12). The project trained local drillers on all these techniques before the well drilling program actually started. The project staff and the LEI project managers supervised and monitored the work regularly.

Figure 12. The wellhead platform is designed to have a good drainage outlet.

The project used PVC casing and the screen pipes of 1 inner diameter. The casing pipes have a wall thickness of 3.5 4.0 and the screen pipes have 4.0 mm. These are manufactured in Dharan in eastern Nepal and meets the DIN standard. A 10ft long galvanized iron pipe is used at the top most section of the well, and the hand pump fitted on this GI pipe. High standard suction type hand pumps are used in the LEI wells. It only takes a light pressure to pump water and gives good yield (Figure 13). These pumps are manufactured in Bhairawa, western Nepal, and the pump body and handle bear LEI logo (Figure 14). Finally, a plaque with donors name and message is fixed on the completed well (Figure 15).

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Figure 13. The project hand pump is light on operation.

Figure 14. The Project hand pump bears the LEI Logo.

Figure 15. The plaque on the well commemorates the donor.

Drinking water quality Assurance of good quality of well water is very important for LEI project. Before finalizing a project area, a systematic survey is conducted to determine the availability of groundwater and its quality. All important water quality parameters, as defined by the World Health Organization, are tested in the pre-existing water wells. Toxic elements such as Arsenic, which is known to occur in certain parts of the Terai, are also tested. Only upon finding satisfactory water quality is the project area selected. All necessary precautions are taken that no foreign substance known to contaminate groundwater are used during drilling or well construction period. Water wells are thoroughly developed and cleaned, and are disinfected by chlorination soon after their completion. Water quality testing is done in the project wells in an accredited water laboratory in Kathmandu. All the WHO prescribed water quality parameters including Arsenic are tested (Box 3). The community is permitted to drink water from a project well only if the quality is found to be satisfactory. Records of water quality testing are maintained in WDSC.
Box 3. The parameters used in water quality analysis.

1. pH; 2. Turbidity; 3. Total Hardness; 4. Electric Conductivity; 5. Chloride; 6. Ammonia; 6. Nitrate; 7. Nitrite; 9. Iron; 10. Manganese; 11. Calcium; 12. Magnesium; 13. Arsenic; 14. E. Coli
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3.

Operation and Maintenance Phase The operation and maintenance phase is open-ended for the community, while for the Project, it is a two year phase. The objectives of the O&M phase are: To ensure sustainability of the sanitation and drinking water facilities by providing necessary technical and human resource development support to the WUGs and the community members. To allow time to detect any technical or other defects in the construction works that may require improvements and/or modifications, and To monitor the programs effect and overall impact on the community. VMW Training To secure sustainability of the project structures, villagers were trained in the use and maintenance of their latrines and the water wells. Each Water User Groups appoints a Volunteer Maintenance Worker (VMW), who is made responsible for smooth operation, maintenance and repair of the well. The project trained the VMWs in repair and maintenance skills during a 3 days training program. These volunteers were familiarized with various parts of a hand pump, and their functions. The trainees also learnt how to overhaul a hand pump. At the end of the training, each VMW was provided with a set of basic maintenance tools. The first batch of VMWs from 15 water wells were trained in March 2004. Women were given the first priority in this training. A follow-up refresher training of 2 days was conducted for the same group in October 2004 (See Box 4 for the list of participants). The VMWs from the remaining 31 water wells, which were completed in 2004, will be trained in 2005.

Box 4. Participants in VMW Training Program (2004).

Participants Well #

1. Mr. Sakhara Dhankar 2. Ms. Pabitri Devi Sada 3. Ms. Ram Pari Sada 4. Ms. Reshma Devi Sada 5. Ms. Sanischari Devi Sada 6. Mr. Lal Dhari Sada 7. Ms. Mantoriaya Mahara 8. Ms. Saraswoti Mahara 9. Mr. Yogendra Mahara 10. Mr. Santosh Mahara 11. Ms. Shailiya Mukhiya 12. Ms. Amirti Devi Mukhiya 13. Mr. Ekbal Mukhiya 14. Ms. Ram Dulari Paswan 15. Mr. Mahadev Yadav

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

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Each WUG has contributed to a repair and maintenance fund, which is deposited in a bank. This bank account is jointly operated by the WUG and the WDSC. This fund is used for repair works, after verification of the need by the WDSC. The WUG members replenish this fund by a system of regular contribution from its members. Health and Sanitation Improvement Component Provision of physical facilities for clean drinking water wells and private latrines is integrated with the Health and Sanitation Education (HSE) Program. Women volunteers elected from each water well group underwent a four-day training on Health and Sanitation Education. They were trained on such important health and hygiene topics like, Causes and routes (vectors) of contagious diseases, Mosquitoes and the diseases transmitted by them, Personal hygiene, sanitation and local environment, Oral re-hydration, importance of breast-feeding, Methods of handling and safe storage of water, Eye diseases and their causes and treatments, Nutrition, malnutrition, food intake during pregnancy and baby cereal foods, Importance of latrines and the proper use of latrines, Cleaning and maintaining the tubewell area, and others relevant topics. The first batch of training was conducted in 2003, and Mr. Babu Ram Lamichhane, Chief District Office of Dhanusha District, gave away certificates and gift packages containing sanitary materials to the trainees on December 2, 2003 (See Box 5 for the list of participants).
Box 5. The HSE Training Participants (2002) Participants 1. Mrs. Ram Sakhi Devi Dhanukar, Mujeliya 2. Mrs. Pabitri Devi Sada, Mujeliya 3. Mrs. Ram Pari Devi Sada, Mujeliya 4. Mrs. Reshma Devi Sada, Mujeliya 5. Mrs. Sumitra Devi Sada, Mujeliya 6. Mrs. Bouki Devi Sada, Mujeliya 7. Mrs. Mantoriya Devi Mahara, Mujeliya 8. Mrs. Saraswati Devi Mahara, Mujeliya 9. Mrs. Sabitri Devi Mahara, Rajaul 10. Mrs. Runa Devi Mahara, Rajaul 11. Mrs. Shailiya Devi Mukhiya, Rajaul 12. Mrs. Amirti Devi Mukhiya 13. Mr. Ekbal Mukhiya, Rajaul 14. Mr. Ram Dulari Paswan, Rajaul 15. Mr. Mahadev Yadav, Rajaul Well # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

2.

3. Community Development Component Women Literacy Class The project conducted various skills development programs for women. Two literacy classes were run for women in Devpura-Rupaitha Village Development Committee (VDC). Classes were run in evening hours for six months beginning from December 2001. Forty women, selected by the PMC were taught Nepali, reading as well as writing, and also some basic arithmetic (See Box 6 for participants list). Two local

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women, Ms. Chandra Kala Bhandari (from ward # 8) and Ms. Asha Thakur (from ward # 9), were recruited as the teachers. WDSC provided 9 day training to the teachers in November, 2001. A 3-day refresher training was also given again in March 2002.
Box 6. Women Literacy Class Participants Batch II Batch I Instructor: Ms. Chandra Kala Bhandari Instructor: Mrs. Asha Thakur Ward no. 8, Devpura Rapaitha VDC Ward no. 9, Devpura Rapaitha VDC Participants Participants 1. Mrs. Asha Devi Bhandari 1. Mrs. Indu Devi 2. Mrs. Sanyogika Bhandari 2. Mrs. Radhika Kumari 3. Mrs. Nidha Bhandari 3. Mrs. Devaki Kumari 4. Mrs. Jamuna Bhandari 4. Mrs. Kalawati Kumari 5. Mrs. Raj Kumari Devi 5. Mrs. Shreewati Devi 6. Mrs. Sunaina Bhandari 6. Mrs. Radhe Devi 7. Mrs. Rita Devi Bhandari 7. Mrs. Ramjhari Devi 8. Mrs. Pinki Bhandari 8. Mrs. Sumena Devi 9. Mrs. Soshila Bhandari 9. Mrs. Geeta Devi 10. Mrs. Ekabari Devi Mahato 10. Mrs. Tetari Devi 11. Mrs. Bina Devi Bhandari 11. Mrs. Meera Devi 12. Mrs. Tetari Devi Bhandari 12. Mrs. Ram Dulari Devi 13. Mrs. Kushmi Devi Bhandari 13. Mrs. Lalita Devi 14. Mrs. Ram Dulari Bhandari 14. Mrs. Tetari Devi 15. Mrs. Somani Devi Bhandari 15. Mrs. Suryakala Devi 16. Mrs. Sudha Devi Bhandari 16. Mrs. Rina Kumari 17. Mrs. Rajwati Devi 17. Mrs. Indra Kumari 18. Mrs. Shanti Devi Bhandari 18. Mrs. Sumaina Devi 19. Mrs. Manju Mahato 19. Mrs. Kurela Devi 20. Mrs. Munni Pundit 20. Phul Kumari Devi

Sewing-Cutting Training for Women Two batches of sewing-cutting training classes were completed in the project area (Figure 16). The first training program was organized in DevpuraRupaitha VDC in February-July, 2001, and the other in Rajaul during MayNovember, 2004. Altogether 44 women, 20 from Devpura-Rupaitha VDC and 24 from Mujeliya and Rajaul villages together, took part in this program (See Box 6 for the list of participants). Local women, Ms. Meena Thakur in DevpuraRupaitha and Ms. Shashi Devi Dhungana in Rajaul, were recruited as the trainers. The trainees learnt to sew 35 different types of cloth items used by children and women in Nepal.

Figure 16. Sewing-Cutting Training Class.

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Box 6. Sewing-Cutting Training Participants Batch I Devpura-Rupaitha VDC, 2001 Batch II Rajaul, 2004 Participants: Participants: 1. Ms. Sudhira Devi Jha 1. Rekha Mahara, Rajaul 2. Mrs. Sandhya Kumari Jha 2. Kakulati Mahara, Rajaul 3. Mrs. Sujita Kumari Jha 3. Indra Mahara, Rajaul 4. Mrs. Kiran Devi Sah 4. Devaki Mahara, Rajaul 5. Mrs. Kari Devi Mahara 5. Shila Devi Mahara, Rajaul 6. Mrs. Rita Devi Jha 6. Phulo Devi Mahara, Rajaul 7. Mrs. Jyoti Kumari Jha 7. Pabitri Devi Mahara, Rajaul 8. Mrs. Kabita Devi Jha 8. Asha Devi Mahara, Rajaul 9. Mrs. Raj Kumari Mahara 9. Pawan Devi Sada, Mujeliya 10. Mrs. Sanju Devi 10. Geeta Devi Sada, Mujeliya 11. Mrs. Nirja Devi Jha 11. Rita Devi Mahara, Mujeliya 12. Mrs. Sunaina Devi Mahara 12. Reena Devi Mahara, Mujeliya 13. Mrs. Chanda Devi Jha 13. Siphala Devi Mahara, Mujeliya 14. Mrs. Renu Devi Jha 14. Urmila Devi Sada, Mujeliya 15. Mrs. Shivawati Devi Mahara 15. Shiva Devi Sada, Mujeliya 16. Mrs. Punita Devi Mahara 16. Sunaina Mukhiya, Rajaul 17. Hira Devi Jha 17. Shakuntala Poudel, Rajaul 18. Mrs. Lalita Devi Jha 18. Jiwachhi Devi Paswan, Rajaul 19. Mrs. Kamda Jha 19. Ram Dulari Paswan, Rajaul 20. Mrs. Nabina Khatun 20. Babita Yadav, Rajaul 21. Reeta Paswan, Rajaul 22. Sita Devi Mukhiya, Rajaul 23. Sumana Karki, Rajaul 24. Subhadra Pokharel, Rajaul

At the conclusion of the training program in Devpura-Rupaitha VDC, a certificate distribution program was organized in the VDC office building. Mrs. Meera Kansakar, the LEI Project Manager, gave away certificates to the trainees. Mrs. Nirmala Mishra, the PMC Chairman, chaired the program and Mr. Yogendra Sah, the immediate-past VDC chairman was the guest of honor. Mr. Indra Kant Mishra, the VDC Secretary was also present on the occasion . Similarly, Ms. Pamela Elardo, the LEI President, gave away certificates to the trainees in Rajaul amongst a function organized in Rajaul Community Service Center on February 25, 2005 (Figures 17 & 18). Along with the VDC officials and the community members, the LEI board members and LEI Project Managers, Dibya R. Kansakar and Meera Kansakar, were also present on the occasion (Figures 19 & 20).

Figure 17. LEI President, Ms. Pamela Elardo, giving away certificate to Sewing-Cutting Training participant in Rajaul.

Figure 18. LEI President, Ms. Pamela Elardo, speaking at the function.

Figure 19. Sewing-Cutting Training Participants with their certificates.

Figure 20. LEI President and the Board Members and Project Managers in Rajaul.

Health Impact Survey The LEI believes that public health is the primary requirement for the development of a community. Dhanusha Community Development Project therefore places high priority upon its safe drinking water supply and sanitation programs, addresses the problems of fecalrelated and water borne diseases, the most prevalent causes of morbidity and child mortality in the rural areas in Nepal, including in the project communities. The success of any project lies not only on the efficiency of its delivery mechanisms, but also on achieving its objectives effectively. Therefore, in order to evaluate the health status of the communities before and after the project, a household survey of the project beneficiary households has been conducted in collaboration with the Department of Epidemiology, University of Washington, USA in 2004/05 under a separate project, Health Impact of the Dhanusha Community Drinking Water and Sanitation Project: A Model for SelfSustaining Community-Based Development, Phase I. This project was funded by Puget Sound Partners for Global Health, Seattle, USA. The study was led by Dr. Annette L. Fitzpatrick, Research Assistant Professor, University of Washington, USA, and assisted by

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Meera Kansakar, Economist, Nepal and Pamela Elardo, President, LEI, USA. The research proposal along with the survey tools and the methodology were approved by the Human Subjects Review Committee of the University of Washington, and the Nepal Health Research Council. Specific Objectives of the Study: This health impact study project was designed specifically with the following objectives: 1) Develop field procedures to evaluate morbidity and mortality related to water and sanitation along with community perceptions of the Dhanusha Community Development Project (DCDP); 2) Implement a baseline survey to provide household enumeration and health status for each household member prior to completion of the DCDP project; 3) Estimate general health and rates of morbidity and mortality, focusing on water-borne illnesses, for the DCDP community; 4) Compare general health and rates of mortality/morbidity by subgroup of community members including demographics, number living together, and completion status of latrine/water well for the household; 5) Compare knowledge and behavior of basic sanitation learned during the projects Health and Sanitation Education (HSE) programs by demographics, time since training, and completion status of latrine/water well for the household; 6) Provide an evaluation of the project from participants perspectives and to identify areas for improvement in the future; 7) Develop materials for dissemination of the DCDP project as a model for self-sustaining community development of water supply and sanitation systems; and 8) Repeat the household survey as a post-test in 2007-2008. Methodology A survey instrument was developed initially in English. This was translated into Nepali, which is the national language of Nepal. But, since the mother tongue of most people in the project areas is the Maithili language, the actual survey was conducted in Maithili language. This was possible because the WDSC is a local NGO in Janakpur and all the people in this organization are all bi-lingual. A three-day training period was held in July 2004 with the Womens Development Service Center to train interviewers on survey techniques and to pretest the instrument. The instrument was revised based on the result of this effort. A second training, more intensive in nature, was organized for the interviewer once again in late August 2004 prior to implementation of the survey. A household survey of all the project beneficiaries was conducted by the WDSC between September and December, 2004. The survey was supervised and regularly monitored by Meera Kansakar and Dibya Kansakar. Interview method was used to measure mortality and prevalence of specific conditions (e.g. diarrhea, jaundice, intestinal worms) and diseases (e.g. typhoid, malaria, filariasis, pneumonia, skin and eye diseases, etc.), sanitation practices among the household members and the anthropometric indices of children were also measured to evaluate nutritional status. In order to reduce the burden of the survey, only the head of household were interviewed and asked to provide information on water and sanitation of the household as well as information on each members health. Children under 14 were measured for their weight (using standard bathroom scale), height, arm and head circumference (using standard tape measure).The study used the variables like demographics (age, gender, relationship to head of household, education, occupation), water source, presence of a latrine for the home, food and water storage practices, deaths in the household

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in the past five years, prevalence of specific health morbidities (diarrhea in past month, and other diseases in the past 6 months: jaundice, typhoid, malaria, kala-zar, pneumonia, fever, eye problems, skin conditions, intestinal worms and other diseases), knowledge of sanitation practices, programs and training issues for the future. In order to assess the nutritional status, children under 14 years were measured for their height, weight, upper arm and head circumference. A total of 336 households were surveyed and health data for 1789 members were collected for the study. The informed consent of the interviewees is an important part of the survey process. The interviewer explains in details the objectives of the interview, the content of the questions and the likely sensitivity to the person to be interviewed, before the actual interview begins, and only after obtaining his/her full consent in writing does the actual interview begins. Reliability of the instrument was determined during the test-pretest survey. Statistical methods such as Cronbacks alpha are used to construct and test inter-reliability parameters. Data were entered into computer using standard database software program. Standard methodology was used to check for errors in range of fields, logic, and skip patterns. Hard copies of interviews are maintained to check for problems whenever encountered. The survey data are being analyzed by the Principal Investigator at the University of Washington in Seattle, Washington using SPSS (Statistical Package for the Social Sciences) and other appropriate software programs. Preliminary result has already been prepared and is being planned for presentation in the annual conference of American Public Health Association to be held in December 2004 in USA. It is expected that the final report containing detailed analysis of the data is also ready by that time. It is expected that this study will result into a detailed information on the health status of the communities in the two project areas. The survey has also provided much needed input from the communities for improvement in the future project programs. An audio-visual describing the project procedure and its mission has already been prepared and has been shown to various groups of audiences within the University of Washington and donor communities in Seattle, USA and also in Nepal including in the Nepal Association of Humphrey Fellows in Kathmandu, Nepal. This documentary has been well received in all the showings and the audience has all appreciation for the works being carried out by the LEI, the PSPGH, and the WDSC. Future Program The present survey has provided a good picture of the current health status of the communities. Since the drinking water wells and the latrines were just installed or were being installed during the survey period, this present survey data provided the pre-project picture of the their health. The project plans to conduct similar health survey on exactly the same households in 2007, when the communities would have already used the project facilities for at least a two-year period or more. The future survey should reveal the impact of the project on their health. A comparison of the two results should provide a clearer picture of the impact of clean drinking water supply and sanitation facilities combined with effective health and sanitation education program on the communities. This should provide a basis for future investments in drinking water and sanitation programs in the future for all those who are involved in this sector.

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Summary Altogether 336 households and a total population of over nearly 1800 have benefited directly from the drinking water and sanitation program of the Project. Three hundred and thirty-three families have access to safe drinking water nearby their houses, and 226 families have their own latrines. The communities are now organized and have the capacity to implement and manage development projects, which will help with community projects in the future. The local technicians are trained in environmentally sound methods of well drilling and construction. The community is aware of their personal health and sanitary practices. In addition, two local schools and a community center have their own safe water wells, and the latter has two fully equipped latrines which is beneficial to the whole community in Rajaul. The Devpura and Rupaitha villages have now 40 newly literate women, which will have long term impact on them as well as their children. There are 44 additional women who have obtained sewing and cutting (Tailoring) skills. Among them, 7 women have already purchased their own sewing machines and are utilizing their newly acquired skills to meet their families tailoring needs as well as others in the villages to earn some money. A few of them have also started their own little enterprises by opening tailoring shops, adding valuable cash income into their families (Figure 21).

Figure 21. Success story of Asha Devi Jha, Rupaitha village. Asha Devi Jha from Rupaitha village has four children: three daughters aged 17, 12, 10 and a son, 7 years old. Her husband works as a peon in a govt. office. Her eldest daughter is already married. After completing the training, she purchased a second hand sewing machine for $25. These days, she sews 2 to 4 dresses a day, and earns up to Rs. 3,000.00 ($ 40) a month in the best seasons. The villagers appreciate her work. Now, her children go to school. Her son even goes to a Boarding School (An English medium day school is commonly known as boarding school in rural

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