Inconvenience of Obtaining Water

Last week, I looked at some of the issues surrounding access to water… This week, I am seeking to highlight the inconvenience that those without a water connection go through on a daily basis in an attempt to obtain enough water for their families.

I find it’s common to hear about rural areas where children walk a long way to get water and may miss school as a result, but much less common to hear similar stories from urban informal settlements.

Residents collecting water in Kambi Muru

However, surveys in Kibera have indicated an average daily collection time of around 45 minutes each day for the urban poor – and the average rises to 55 minutes when considering those who use kiosks/vendors. This is a very significant amount of time for someone who is trying to run a small-scale business or bring up a family. In contrast, those with private connections report using less than 10% of that time (5 minutes). A more recent report paints a yet bleaker picture, stating that Kibera residents spend on average more than 2 hours a day waiting for water, which may be available for as little as 4-5 hours.

These figures are for average days. However, water is often scarce in Kibera; not all days are good. When there is a shortage, a person may have to walk a long way searching for a vendor who is open for business. Or they may know exactly where they can go (someone with a borehole, or connections to numerous pipes), but face enormous queues. This paper, talking of personal experiences suggests that the time taken on a day of shortages could be 5 hours or more – half of the working day gone. These are missed opportunities for income and can hit a family hard.

As highlighted last week, we aim to bring the water utility on board, encouraging to expand into such low-income areas as Kibera, and improve their service, including by NRW reduction, which makes rationing less necessary.

One of our kiosks in Naivasha, where queuing is less of a problem, partly due to lower population density

One of our kiosks in Naivasha, where queuing is less of a problem, partly due to lower population density

Again, in the shorter term, we have our own programme’s kiosks, which seek to make access more convenient – being open for at least around 10 hours each day, keeping queues relatively short (on any given trip, a person is unlikely to wait more than 5 minutes), and being able to supply in times of relative scarcity, due to sizeable storage tanks.

What I would like to hear more about is water access in strategic locations; it tends to be assumed that the distance someone travels to get water in an urban location is low, which it generally is. But on that day when a person is searching for water, it can be a serious issue, if they do not know of a place nearby, which will definitely be open and will not have hiked prices. This was something that struck me about the model NWSC in Kampala showed us when we visited for the WSUP Master Class (see here for more).

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Access to Water

One of the things that is increasingly important to us as our programme draws towards its end is to raise the profile of urban Water, Sanitation and Hygiene (WASH) – we’ve done great work over the past four and a half years, and it is key to ensure others take up the mantle.

So, over the next few weeks I hope to highlight some issues* that make urban WASH a vital, fascinating and challenging area of work – and highlight the issues that informal settlement residents face. I’m intending to tackle water first in a series of posts. If you find something particularly interesting or shocking, please do share it. If you have any questions about the post, or urban WASH in general, please comment.

The first issue to address is access. We can say everyone is accessing water somehow or other, but we take an MDG approach to access – improved water sources, implying safety and convenience, beyond merely obtaining something called water.

Non-Revenue Water reduction in Nairobi

Non-Revenue Water reduction in Nairobi

You might assume that access is ensured in urban areas and there is no reason not to connect. However, a connection charge of 5,000KSh to the utility is unattainable for most households in low income areas, such as Kibera (average household income around 3,000KSh/month**).

This means that these residents generally do not have what we could call improved access to water. An estimated 85% of Kibera residents rely on water vendors to obtain their water**. These vendors may charge high prices (post coming), whilst giving poorer services, because the vendors are unregulated.

There is another problem as well. Some vendors create illegal connections, leading to very high Non-Revenue Water (NRW) in low-income settlements (read about some of what we’ve done to combat this here). This in turn can make a utility reluctant to expand into such areas, so that even a household that can afford the connection fee may not be able to get a connection. This is a chicken-and-egg type problem, as the fewer people who are supplied formally, the more vendors and therefore higher losses expected and more reluctance to supply, even as the areas continue to expand rapidly.

One of our roles then, is demonstrating how to effectively reduce NRW in such areas, so as to convince a water utility that the area does not need to make heavy losses, but can indeed expand operations so that the entire city can gain access.

Alongside this, we also demonstrate models involving water kiosks – whereby those who cannot obtain a water connection are able to at least have access to a more reliable supply.

Accessing more reliable water in Kibera

Accessing more reliable water in Kibera

*Most of my examples will probably come from Kibera, Nairobi. There are very many other slums even in Nairobi alone, and it is not my view that Kibera should be given all the attention it receives while other areas are relatively neglected. However, it is an area I know better than any other, and it’s easier to get data, because of its high profile.

**Data comes from this paper.

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Building sustainability into the project in Kumasi, Ghana

As highlighted in the post on the 4th ACF Annual Report (Kumasi update), Operation and Maintenance (O&M) is a hugely important aspect of any sustainable project. It is increasingly recognised as vital, though it hasn’t acquired the appeal of ‘digging a new well’.

However, new wells can quickly become useless – according to this RWSN data from 20 African countries, 36% of hand-pumps aren’t working. I did my own calculations with their data, and I reckon those non-working pumps from 20 countries could serve 20,000,000 people – that’s 80% of Ghanaians that could be served by nailing O&M. And those pumps may have cost $750m-1bn (I’m NOT an expert on borehole/pump costing – but used figures here to estimate).

Storage tower in the project area, Kotei. This ensures water is available even in dry times, bringing convenience

Storage tower in the project area, Kotei. This ensures water is available even in dry times, bringing convenience

Now, that’s rural, and ACF is urban and works in different ways; we remain in contact with our beneficiaries long after initial installation, but programmes do end (ours will in September) – sometimes, as in the case of our Bamako project, unexpectedly – so it is key to ensure communities involved continue to realise the benefits of our work long after we are gone.

A helpful document on sustainability in the sector is WaterAid’s ‘Sustainability Framework‘. It mentions many factors, including demand, which we addressed here. Several other factors they list are inbuilt in our project in Kumasi, Ghana, including effective community-based management, external technical support, monitoring systems and appropriate tariff structure.

Some of the key things we are doing in line with those aims are:

The Kotei toilet facility.

The Kotei toilet facility.

  • A Community Management Committee (CMC) was established in the first year to enable dialogue between the community and the water utility, GWCL. This model enables community participation.
  • In the last year, work has been done on the communication between the CMC and GWCL and GWCL has committed to conducting major maintenance works. This technical support is valuable as the water utility is expected to have longevity.
  • For more minor O&M, the community have been trained, as less reliance on external parties is the ideal situation, ensuring community-based management is at the forefront.
  • From the project’s outset, facility designs have been discussed with the community, to ensure that they are culturally appropriate, as well as meeting the needs of the most vulnerable – unwanted facilities quickly stop working.
  • Clean-up campaigns have been key in gaining support from the community, as well as passing on key hygiene messages to continue raising demand.
  • The sanitation block built by the project conducts other businesses at the same time, which brings more revenues and brings more people to the toilet. This is another mechanism of raising demand.
  • Tariffs were revised based on the need for cost recovery. Full O&M cost recovery was achieved and there is even an excess which was re-invested for a borehole, which has improved the toilet block’s capacity to cope when the utility is not providing water.
  • In one way and another, the toilet block seems to have earned the community’s respect; throughout Year 4, the number of users per month increased from 5,333 to 8,650.
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Since the publishing of the 4th ACF Annual report, we’ve also updated the ‘Locations‘ section of this blog to reflect what we’ve been doing in each area.

If what you’re looking for is a full breakdown of our activities, the challenges we’re facing, what we’re learning, all packed into a thrilling report filled with photos and tables, the report is still the thing for you.

However, if you’re a more casual user, looking for an idea of what we’ve been doing and haven’t got the time to be leafing your way through a fairly chunky report, the Locations section may just be for you. It is up to date as of the end of Year 4 (September 2013) – for latest updates and interesting activity, the blog itself remains the place to be.

We’ve also been updating some broken links. Where possible, we’ve found the new web address, if not it’s indicated that the link is no longer available – we’re sorry about that. If you find a broken link, please leave a comment, so we can help you and others find that content.

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So, the Fourth ACF Annual Report is upon us. It has been exciting being part of the process of producing it and therefore hearing more than others about some of the great activities we’ve been doing.

AR Front Cover

Although there are now fewer ACF areas, there’s still a lot of great work going on in Nairobi and Naivasha (Kenya), Kumasi (Ghana) and Antananarivo (Madagascar). Picking out a highlight from each project area:

  • In Nairobi: Staff of Nairobi City Water and Sewerage Company (NCWSC) conducted an exchange visit to Uganda’s National Water and Sewerage Corporation (NWSC), in order to discover more about the way NWSC has been able to mainstream its pro-poor activities, emphasising upon both commercial and social mandates. Their pre-paid dispenser project which enables customers to purchase water through tokens (see blog post below) also attracted attention and has led to proposals to fund similar work in Korogocho and Mukuru, two of Nairobi’s informal settlements.
  • In Naivasha: Over 20km of water pipes were laid from source to the informal settlements of Kamere and Kwa Muhia, so that over 15,000 residents now have improved access to water. Eight kiosks were built, each with a storage tank and defluoridation units, so that customers can purchase water that does not cause fluorosis (see blog post below). A main storage tank ensures that even in dry times, water will remain available.
  • In Kumasi: Many issues were resolved – for example, the relationship between the water utility Ghana Water Company Limited (GWCL) and the community was improved through better communication, the cost of using a toilet previously built by the project was increased (to cover operation and maintenance and ultimately dig a new borehole) and through marketing and good service, the number of consumers for both water and toilets increased. These changes may sound like a small part of the project, but are essential to sustainability – arguably as important as the building of infrastructure.
  • In Antananarivo: A sanitation advertising campaign has been taken and expanded under the ‘Kabone Madio’ (Clean Toilet) brand (see also blog post below). The campaign has been multi-media and even includes a mobile advertising vehicle. A small revolving loan fund set up to help potential customers has been operating with 100% repayment rates. Around 5,000 people have benefited through sanitation improvements.

Beneficiary Table

And some key lessons learnt in the process:

  • Expose decision makers to appropriate and sustainable models for service delivery and institutional arrangements – but be prepared for it to be a challenge to bring such changes
  • Involve all of the stakeholders from the planning stages onwards and build partnerships through that – with formal and informal service providers, asset holders, CBOs and others
  • Personal contact is an important part of any marketing strategy for the uptake of toilets; active communication channels are essential to achieve sustainable change

Enjoy it!

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Sanitation Marketing in Antananarivo, Madagascar

In producing ACF’s fourth year annual report (watch this space – it’s coming very soon), one of the things that has struck me is the focus that ACF has had on marketing of toilets, particularly exemplified by the project in Antananarivo.

The Tana team's mobile sanitation marketing strategy

The Tana team’s mobile sanitation marketing strategy

It may seem odd, but marketing of toilets can be incredibly important in a low-income urban setting, because providing a product for which there is no demand is not the way to conduct a sustainable project and there is often little demand for improved sanitation initially. This is for several reasons, including high cost (perceived or actual), whereas many may be comfortable with open defecation/flying toilets, with no attached cost (at least at the point of use; medical costs arising from poor sanitation are unlikely to be known); and lack of knowledge on hygiene/cleanliness and their link to health. For all technological advances made, if there is no demand, the product cannot help anyone.

A sanitation marketer may initially assume that health is the key argument to use in convincing end-users to invest in sanitation. However, they may discover that other factors such as the prestige and improved status of having a new, clean toilet is more valuable to end-users and more likely to result in maintenance and cleaning of the toilet after investment.

Indeed, in a study in Benin, Jenkins & Curtis (2005) found that ‘at least one active drive… is needed to motivate latrine adoption. Drives involved prestige, well-being and situational goals. Health considerations played only a minor role’. Hence, any successful sanitation project must conduct serious research regarding what might motivate people to invest in their own toilet and develop marketing techniques accordingly.

In Antananarivo, the team has employed a multi-pronged advertising approach with advertisements on stickers, flyers and posters adorning product outlets, bus stops and buses and even a mobile advertising car. Schools and churches have been brought on board to teach and preach the messages. A famous artist, Francis Turbo, headed up the initial campaign, bringing out the idea of prestige in toilet ownership.

One of Kabone Madio's marketing leaflets, displaying some available and appealing sanitation options

One of Kabone Madio’s (literally ‘Clean Toilet’ – the branding name) marketing leaflets, displaying some available and appealing sanitation options

Advertising alone is generally insufficient to ensure commitment to purchasing or upgrading toilets, which is significantly more common where household visits were conducted. A carefully targeted explanation of the benefits of toilet ownership is more important to behaviour change than a widely dispersed message.

Finance has been a common problem, with toilets being difficult to afford for many, and this can be off-putting, but demand for improvements in sanitation at the household level has been rising. Some households have requested longer periods to repay the loan, suggesting that the advertising campaign is having success, but affordability needs to be addressed. The team is currently learning from other similar loan funds to see how they can assist the very poorest households.

Jenkins and Curtis (2005) Achieving the ‘good life’: Why some people want latrines in rural Benin. Social Science & Medicine, 61: 2446–2459.

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One of yesterday’s highlights for those in the LIC group was the Hard Talk-style debate on some of the key issues identified on Tuesday. The interviewer was our very own CEO Sam Parker and the panel consisted of Francis Lamptey of Ghana Water Company Limited (GWCL), Paul Mwarania of Nairobi City Water and Sewerage Company (NCWSC) and Elmer Largo of Manila Water.

The questions were broadly on two topics: how to ensure corporate commitment to LIC service provision when it is currently viewed as risky, difficult and non-profitable, and how to secure the finances which enable service providers to serve the poor at scale.


On the first question, Francis highlighted that the management need to be clear that it is ‘more risky not to take risks’, because ultimately low-income consumers need water and they will ‘feel cheated’ if it is not provided through the mandated authority, making them more likely to make illegal connections or even take more drastic action. For example, a water treatment plant in an LIC in his area of work has been repeatedly vandalised because it is viewed as using their land to treat water and then take it to the rich. Meanwhile, in Mozambique serious demonstrations led to a reduction in LIC connection fee by 50%. Francis again: ‘You never know what they will do because water is life’.

Since everyone will be served in one way or another, why not make sure the water company gets the revenues through them being served, rather than losing money to Non-Revenue Water (NRW) and to acts of vandalism and at the same time leaving low-income consumers to be over-charged?

Paul’s perspective was that demonstrating the commercial viability would bring top level management on side because, even though only a small proportion of revenue may be derived from LICs, the reduction in costs from severe NRW reductions is also very important. According to him, these savings could be ring-fenced for network expansion. From the floor, there was an experience that NRW can be reduced almost to zero with application of an appropriate model.

In the Philippines, corporate commitment has been gained and Elmer explained that this was achieved through bringing top management on side, by explaining their responsibility to reduce waterborne diseases as well as the gains that can be made through reducing the huge number of illegal connections. It was presented as a ‘win-win situation to give them water’.

Meanwhile, the Manila Water budget for LIC works has been around $1bn over 13 years. For other utilities represented, where could they access this level of funding? For Francis, it may be possible to secure donor grants, ‘but it’s not the way to go’; investments would ideally come from the company.


According to Paul, contribution of organisations like WSUP is small compared to the need, but it achieves (along with WSUP’s expertise) the vital step of demonstrating good models, after which scaling can be done with the company’s funds. He says there is not currently enough funding in NCWSC, but ‘the trend is good’ as the business case is being demonstrated. This experience was shared by delegates from LWSC, Zambia and JIRAMA, Madagascar, but DWASA (Bangladesh) representatives stated that their revenues were not enough to support LIC expansion activities.

Finally, Sam questioned whether companies were performing financial analysis of their programme. According to his back-of-the-envelope calculations, Return on Investment (RoI) in NWSC’s pre-paid metering programme is around 200%, so why is this not attracting investment? In general, it has been rare for LIC units to undertake rigorous financial analysis, but there was general agreement that doing so might enable high level management to invest more in LIC services.

So there you have it: More risky not to take risks; win-win to give them water; very commercially viable; external funding (and expertise) only needed to pilot effective models for service­­­­­ – what are we waiting for?


This article was also posted on the WSUP Blog.

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With the field visits safely navigated, the remainder of the Master Class will be spent in working meetings. WSUP has brought together staff from each of its country programmes and many key partners, such as key decision makers of Local Service Providers (LSPs), funders and other key stakeholders.

We have split into two, with one group focusing upon Low Income Community (LIC) units within water utilities and another group upon Faecal Sludge Management (FSM). It was recognised that WSUP has similar activities falling under both headings in all six of its countries, and so we have come together to share learning and make progress together. We are privileged to have with us representatives from Manila Water (Philippines) and the National Office for Sanitation (Senegal), as world leaders on, respectively, supplying water to low income areas and citywide FSM services. I have been listening in on the “LIC” discussions, where the debated has been fascinating and productive.


During day two, the focus was upon identifying what is needed in order to get LIC units right, what challenges are faced in sorting out these key ingredients and which WSUP country programmes have successeful models to share. Some of the most important things to come out of the day were:

• An LIC unit’s goal should be to ensure that everyone who lives in a low-income urban community has access to an affordable, sustainable and regular supply of good quality water which meets locally appropriate standards. Sanitation and hygiene may or may not be included here depending on the LSP’s context and mandates.

• Vigorously debated was the question of whether commercial viability should be expected from the LIC unit. The general consensus was that settling for below-cost-recovery tariffs might be necessary initially and, as service quality is demonstrated, increased revenues may be achievable. There were, however, dissenting voices, who considered that cross-subsidy was inappropriate – but the payment mechanism may need to be different to facilitate low income consumers. Experience of NWSC from Monday and other projects suggests the possibility of generating good returns (after all, LIC areas traditionally pay much more for their water than middle-high income communities).

• Corporate commitment to the LIC unit was unanimously considered the most important factor to the LIC’s success or otherwise. Clear plans and Key Performance Indicators (KPIs) were thought to be the next most important factors for success.

• A key challenge identified was the perception of LIC units and their work. Traditionally, it is considered to be risky, challenging and not commercially attractive and hence the budget may come from donors rather than being a core part of operations, so it may be seen as social work. This affects positioning and status within the LSP, where LIC units typically do not have the same responsibility as other utility departments such as new connection and non-revenue water targets. Interestingly, the ideal situation may be to have no LIC unit in the utility – as in Manila, for example, the pro-poor work has been so mainstreamed into operations that they have no need for an LIC unit.

• External interference was another (tricky to manage) challenge. This could come through political appointments of the key figures in a service provider, or through political and religious leaders stirring up opposition in target communities.

Uganda.03Some real strong points came out in the way our partnering service providers are already doing things in terms of their LIC work:

• In Nairobi’s water provider (NCWSC), water bills can be paid in ‘small bites’, through convenient mobile money applications (including M-Pesa), preventing customers reaching month-end and not being able to afford their bill, hence being cut off. Connection charges also generated interest, as 80% of the cost can be spread over the 24 months following the connection, making it more affordable to get a household connection. The defaulting on these payments is impressively low.

• In Lusaka Water, the LIC unit has around 150 staff in total, demonstrating a real interest in addressing the challenges. However, it could be argued that having so many staff is unnecessary if pro-poor work was streamlined and therefore an important part of every staff member’s work.

• In JIRAMA (Madagascar), the revenue generated by NRW reduction is ring-fenced for use in network expansion, thus ensuring financial sustainability and keeping the work at the heart of operations.

• In NWSC (Uganda) – not a WSUP programme country, but our hosts – there are two domestic tariffs; one for the pre-paid meters, which is cheaper than household connections. This makes sense in the light of the lower level of service delivery (requires walking). It was again highlighted that a key reason for NWSC’s success is the fact they have cut through all middle-men and achieved a direct relationship with the customers, who are reliable payers.

All in all, the discussions were vigorous and could only be briefly halted by our lunch and tea breaks (which yesterday included five different servings of banana – steamed, boiled, fried, fresh and fresh sweet – just to make sure we know we are in Uganda!). This post only captures some of the key learning to come out of the LIC session, and we look forward to more insights that will come out of the sessions today.


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The aim of the WSUP Master Class is to share learning across our country programmes and with our partners to develop action plans for how things can be done better in each programme. During the week, we will be focusing on water provision to low-income consumers (LICs) and faecal sludge management (FSM) systems.

The week kicked off with a day led by Uganda’s National Water and Sewerage Company (NWSC). They gave an introduction on their activities, with an emphasis on their pro-poor work. The highlight of the day was a field trip to two low-income areas of Kampala – Bwaise (pronounced BWYE-SAY) and Kisenyi (pronounced CHEE-SEN-YEE), in the heat of the equatorial sunshine.

In Kisenyi (the focus of this blog), we saw the way NWSC operates pre-paid meters, a technology which we are implementing in the WSUP Kenya programme in Nakuru through ACF funds. Pre-paid meters are one effective way of reducing revenue losses for the water company, since water can only be obtained by using an electronic token which has already had money loaded onto it.


  • Water is dispensed automatically when the token is inserted, which means that the consumer effectively deals directly with the water company. Since middle-man water vendors can raise the price of water by as much as 5-10 times, exploiting the customer, this direct relationship is important to enable low income consumers to access cheap water. This also ensures that no water can be bought from the company without paying, whereas vendors could, in the past, get to the end of the month and refuse to pay the water bill.
  • Water comes directly from NWSC. Previously, the source could be mixed or an illegal connection, so the quality is now likely to be improved.
  • NWSC still requires vendors, but these are now sellers of credit rather than water. Since the credit is a digital commodity, it is much easier to ensure accountability, rather than trying to regulate all of the water vendors, as could have been the case in the past.
  • The vendors are given training on marketing and given a 10% commission on the credit they sell, to help them make their profits without inflating the prices.
  • Credit vendors are carefully selected in strategic locations so that regular opening hours are ensured. Before, water sellers could simply close business at any time, but now the credit should be accessible any time of day, and anyone with credit can proceed without assistance to obtain water.
  • Dispensers of this kind are charged the lowest NWSC tariff of 25 Ugandan shillings for a 20l jerry can (approximately 0.6 UK pence, or 1 US cent) to encourage residents to use enough water for their daily needs, rather than being constrained by affordability.
  • NWSC pays for the dispensers and any necessary repairs, with no contribution from the community. The potential danger of the approach is that the community lacks any sense of ownership of the equipment as they have not invested in it, which can lead to ill-treatment of or a lack of care for it. However, NWSC’s belief is that the benefits to all – lower prices for more guaranteed quality water at any time of day – are so great (except perhaps to former vendors who lose a good income) that the community is incentivised to protect the technology even though they have not invested in it.
  • One of the drawbacks of this technology is that the water can come out very quickly while the token is inserted and may take a second or two after removing the token to stop. This can result in spillage which will be charged to the customer rather than to the water company.

NWSC gave a great demonstration of the importance of the service provider having a good relationship with their customers, through accountable middle men who sell credit rather than water. This has enabled the area of Kisenyi, and many other areas in Kampala, to receive better quality services (reliable, quality supply at any time) at much more affordable prices than were previously possible.


This article was also posted on the WSUP Blog.

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Global Handwashing Day!

This years Global Handwashing Day celebrations came and went successfully as the WSUP team was out in full force to make sure the importance of handwashing was felt, and what better way than to kick off Global Handwashing Day early than with First Lady Margaret Kenyatta and the CEO of Unilever, Paul Polman.

IMG_6474While there was a happy note to the events, it was important to recognize the need for a day such as this.

It is a fact that every year, 2 million children will never reach the age of 5 due to diarrhea and pneumonia, so to address this serious issue in a way that could be enlightening and celebratory, Global Handwashing Day has become a necessity.

WSUP in partnership with Unilever, Lifebuoy, and the Ministry of Health and Sanitation kicked off The Global Handwashing Day with an early start as it took place at Kilimani Primary School on October 4th but was a precursor for the annual Global Handwashing Day event that took place in Machakos County at the Makutano D.E.B. Primary School this past October 15th.


“We are gathered here today because our consciousness has been pricked into action, we are forced to act because families in Kenya and across the worlds continue to lose their precious children to disease that can be prevented by a simple hand wash,” stated First Lady Kenyatta at the Lifebuoy sponsored event.



The main event was held in Machakos County this past week and WSUP, in partnership with UNICEF, USAID, UKAID, Rain: Water for Africa, and the Coca Cola Africa Foundation was able to  host such guests as the Chief Officer of the Ministry of Health & Emergency Services Chief of Public Health, Dr. Kepha M. Ombacho, the Cabinet  Secretary of Health, Mr. James W. Macharia, as well representatives from UNICEF, USAID, the Ministry of Water, Environment & Natural Resources, and the Ministry of  Education, Science & Technology.

The main event however was the 10-15,000 children who came to wash their hands, it was a great moment for everyone who not only came to be a part of the celebration, but to also make a pledge in bettering their homes and communities through handwashing.  By demonstrating this year’s theme of the” power is in our hands”, we hope to empower communities through the simple act of handwashing.


Our own Gertrude Salano was there to not only represent WSUP but was a key speaker as well, and we’re proud of the work she’s done to help put this event together!

As First Lady Kenyatta has stated, “Healthy families, healthy communities, and healthy nations are central to an productive, economically stable, and prosperous world.”

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