Comments on the Matunda Health Center Water Project

Lugari District, Community of Matunda, Kenya

Matunda Health Center Water Project

Project Description: This project is to provide a water supply for the Matunda Health Centre. It is hoped that this water supply will also provide a watering point for the surrounding community of Matunda Market.

· Could the applicant please provide a comment to EWB that gives some idea as to the type of clinic this is, or is intended to be? Please give an approximate number of staff, size of the clinic and an estimate of the number of patients or people seeking medical attention. Please also comment on the types of services that are anticipated to be made available at this clinic if the water supply challenge is met. These comments that you provide will give us some insight into the amount of water that you feel is necessary in order to make this clinic a viable, workable clinic.

· Upon first reading of the clinic's creation itself, I find it very odd that the application can even state, "The recently improved clinic is operating with no adequate water supply." I mean, how "improved" can it be if it still does not have adequate water supply? Furthermore, the application states, "The Matunda Clinic was started in 1999 in a rented house. Through donations from various Kenyan and international sources, the clinic has expanded to include a maternity ward and an outpatient clinic." However, suffice to say that through the clinic's creation and all improvements over the past 7 years, the concept of "water" to the clinic seems to have never been addressed. This is extremely odd.

· With regard to the concept of feasible scope, the application states, "The clinic serves the residents of Matunda Market, the whole of the Nzoia and Sinoko locations of the Lugari District and people from the adjacent districts for a total population near 60,000 – 70,000 people." I believe that many applicants feel that if their project can embrace a huge population of people, that it stands a better chance of acceptance. This is not true. The EWB model does not lend itself beneficially to projects that have a direct bearing on a group this large. Then again, I find it difficult to believe that this clinic, with all of its limits, can actually have a direct effect on a group this large.

· The application does not conclude that the only source of water is a well. The application is clear in that it asks for a study to be conducted first. This is wise.

· If rainwater catchment is a viable solution, even in part, see http://www.eng.warwick.ac.uk/ircsa

· Linked information about other endeavors in Kenya that deal with water well drilling can be seen at http://www.globalwater.org/projectlist.htm#kenya

· Some EWB experience in this field from Montana State University, see http://www.ewb-usa.org/modules/news/article.php?storyid=52

· Since a study must be done first, it is difficult to comment on the appropriateness of technology for the community b/c no solution has yet to present itself. Suffice to say that any solution would most likely be appropriate.

· The basis of the application is that water is needed for a viable clinic. There should be some language offered by the applicant as to how to measure what amount of water is considered to result in a viable clinic. Are we creating a full fledged hospital? Are we creating just a clinic? Somewhere in between? This is a question that the applicant should be presented and asked to comment upon. An answer to this question could go a long way in selling this project to any potential EWB chapter that wishes to adopt it.

· Ms. Agnes Usagi, Chairperson, Matunda Health Centre Committee is listed on the application as the individual who will be the on-site primary project facilitator. She is part of an elected committee called the Matunda Health Centre Committee. The credentials of this organization are unknown at this time. No web site is offered.

· The Matunda Health Centre Committee, with support from the Kenyan Ministry of Health, would own, operate and maintain the clinic and the clinic's water supply. This would seem like a viable model, and as such, would seem to be a "contribution."

· The application leads one to believe that there is widespread community support and they are able and willing to contribute as best they can with some labor and some materials and the like.

· No budget has been put forth in the application. I suppose this is understandable b/c without benefit of the proposed study, one might not know what to cost. Given the language of the application, I would find it difficult to conceive a budget that would be any less than perhaps $40,000.00 or more than $75,000.00 based upon budgets I see from similar type projects in Kenya and surrounding countries.

· If those rudimentary guesses, on my part, are to be believed, then this seems to be in the ballpark for expenses that most EWB chapters can accommodate.

· It does not appear as though the community just wants financial support. Financial support is one of many needs.

· No known U.S. State Dept. travel warnings that I can find.

· I recommend that the application be placed on hold until the applicant can comment upon their concept of the clinic/hospital in the future. The hope is to gain insight into just what sort of water needs is going to be presented. Water for a 500 sq. ft. clinic for a staff of 3 and potentially 10 patients a day or a 7,000 sq. ft. hospital for a staff of 25 and potentially 75 patients at any one time? Some sort of description would be helpful in determining the magnitude of the scope or challenge.

· They currently transport their water from sources 1 mile away ("Water must be hauled from the Mtoni-Polisi River 1.7 km from the site, from rainwater catchments, or other unsanitary sources.") However, their goal is to service a clinic, which seems like a facility that would be more effective with readily accessible potable water. Finally, it seems like the first trips to Lugari would only involve water-source testing... so perhaps the concerns that came to light in the previous project I mentioned can be overlooked.