Ruth Ansah Ayisi
NHAMATANDA, Central Mozambique, Aug 29 2007 (IPS) – A swelling crowd of people has gathered at the rural health centre at Monte Xiluvo in Nhamatanda district, in the central Mozambican province of Sofala. Most are mothers with young children who try to protect themselves from the gusty winds as they wait for their consultation with Caetano Mendosa, the nurse responsible for the centre.
Fina Miguel (left), performing her daily chore of collecting water. Credit: Ruth Ansah Ayisi
As he opens the door for the next patient, swirls of dust blow into the consultation room. It is a credit to the health centre that it s kept as clean as it is, because there is no running water there.
The lack of piped water is the biggest problem we face at the health centre, says Mendosa, who sees an average of 1,000 patients every month. It has become even more difficult now that our worker who fetched our water supply has left. We have to ask relatives accompanying the sick to fetch water for us.
He adds, It is especially hard for the midwife to conserve water. Imagine assisting deliveries with little water.
The midwife, Emilia Ofece, delivers around 50 babies a month most at night , she says. Ofece must ensure the large water container she makes use of is always full before she returns to sleep at her home, conveniently situated next door to the health centre. I ask those accompanying the pregnant women to help with more water, if necessary.
The lack of piped water in certain health centres reflects the reality in rural areas of Mozambique. Few in these regions have the luxury of piped water, and even safe water sources are unavailable to most. An estimated 57 percent of the rural population some nine million people do not have access to potable water, according to official figures.
People resorting to unsafe water supplies contribute to the country s high child mortality rates, with diarrhoea being one of the main killers. An estimated 152 children out of every 1,000 live births do not live to celebrate their fifth birthday, in stark contrast to the situation in developed countries. In Norway, for example, the mortality rate for under-fives is four per 1,000 live births, according to the 2006 United Nations Human Development Report .
Juvenaldo Amos, Sofala s co-ordinator of malaria, tuberculosis, leprosy, sexually transmitted diseases and HIV/AIDS, acknowledges that the lack of water in health centres is a serious problem .
He adds that there is a renewed drive to improve the situation. Soon there should be no health centre without a water supply, he says: the government has a policy to build new health centres only where it is possible to install piped water, and efforts are being made to ensure that all existing health facilities will have running water shortly.
Providing homes with accessible, safe water is also a government priority. Nationally, the aim is to ensure that at least 55 percent of the rural population has access to potable water by 2009, the end of the present government s term and to have 70 percent with access by 2015. This is to enable Mozambique to meet its commitments under the Millennium Development Goals (MDGs), according to Joaquim Jorge, head of the Rural Water Department in the Ministry of Public Works and Housing.
Eight MDGs were agreed on by global leaders at the Millennium Summit in 2000 in a bid to raise living standards around the world. Goal seven, on ensuring environmental sustainability, states that the number of people without sustainable access to potable water should be reduced by half by 2015, the MDG deadline.
Although there has been gradual progress in 2001 only 36 percent of the rural population had access to safe water supplies Jorge concedes that it is a major challenge to meet the targets.
One of the main obstacles is financial. Jorge points out in an interview with IPS that some 10 million dollars is needed annually to dig boreholes and fit handpumps, or install small piped water systems to meet the goals: We re dependent on our partners. Although funds are not guaranteed, there is interest.
As government can contribute only 10 percent of the total amount of money needed, the hope is that donors such as governments of the Netherlands, India, Switzerland and Sweden as well as the African Development Bank and the United Nations Children s Fund will cover remaining costs.
Even if the funds are forthcoming, there is a challenge to find good quality water. In some areas such as in the southern provinces of Inhambane and Gaza and in parts of Sofala, like Nhamatanda, the water is brackish and so more costly alternative technologies are needed to ensure water provision.
In addition, maintenance of water sources is a constant battle, says Jorge. The ministry is in the process of decentralising all of its structures right down to community level. There is a policy to use local workforces to dig boreholes and build the handpumps, as well as repair them. Local people are being trained to maintain the equipment and local business people are being encouraged to stock spare parts.
Community members pay a small amount to use the wells, so that they have a fund to buy spare parts when needed, although the very poor and vulnerable such the elderly, orphans or those sick with HIV/AIDS should be exempt, adds Jorge.
Fina Miguel, 14, has been waiting for most of the morning near an electrically operated water pump that does not work very often. She lives in Monte Xiluvo, near the health centre. However, there are frequent power cuts, most probably due to people stealing electrical cables.
Fina says she usually tries to be at the well by four in the morning to avoid the long queues that form there. Already, many people have left their water carriers lined up unattended, hoping that they can maintain their place in the queue when the power comes back.
I need to fetch water in the morning as I have school in the afternoon, Fina adds. As she talks the power returns, and she is able to fill one of her carriers with water.
She looks relieved as she puts the full 25-litre water carrier on her head.
