Between November 2022 and August 2023, WellFound participated in the US Ambassador’s Special-Help Programme to tackle Guinea-Bissau’s widespread issues with water, sanitation, and hygiene (WASH). The project focused on well installation, hygiene education, latrine construction following our Community-Led Total Sanitation (CLTS) model. The project supported four villages in Oio region.

Reflecting on this project, it is important that we explore current WASH issues facing Guinea-Bissau and reflect on how this project made strides towards improvement.

Background:

Safe drinking water, sanitation and hygiene (WASH) are all crucial to human well-being. Safe WASH not only benefits health, but also contributes to livelihoods, education and dignity. However, all three components of WASH across Guinea-Bissau are dangerously below world safety levels.
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Why Guinea-Bissau ranks 172nd out of 180 countries tested for water quality?

Water quality has several measurable variables; the pH must fall within the range of 6.5 to 9.5, a 100 ml sample must present no detectable E.coli and the quantity of iron must not exceed 200ugFe/l (1) . Any levels outside of these ranges present unsafe levels of water quality, causing numerous health risks. However, according to an independent Quality Assessment of water (2020) (2) Guinea-Bissau does not meet any of these standards. Firstly, all samples in the study came out as acidic, with pH values between 4.89 and 5.59, outside the suitable range for drinking water (3) . Such low pH values could lead to dental erosion and various stomach issues, especially those linked to bacterial infections, as the bacteria present in acidic water is well-adapted, making the natural hydrochloric acid in our stomachs unable to overcome certain pathogens and cause disease.

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The study also found that various bacteria were identified across all samples, including fecal coliforms, intestinal enterococci and specifically E. coli. The presence of these bacteria indicate that the water is contaminated with human or animal waste, which could cause short-term illnesses, such as diarrhea and nausea, and in the longer term could be fatal (4) . Furthermore, the study revealed that “Iron (Fe2+) contents were above the recommended values for drinking water” (5), which could lead to an iron overload causing “diabetes, hemochromatosis, stomach problems, and nausea [and can] also damage the liver, pancreas, and heart” (6). For these reasons, it is clear why Guinea-Bissau ranks 172nd out of 180 countries tested for water quality (7).

Sanitation fundamentally consists of the access to and the withdrawal of water. Access to piped water means people can spend less time and effort physically collecting water, allowing them to be productive in other ways. However, in Guinea Bissau only “13% of the population has access to the piped water distribution system” (8) , leaving most of the people having to physically collect water from rivers or ponds, which are often unsafe and polluted. Yet, a piped water system does not necessarily mean better water quality; the Quality Assessment also concluded that “fecal contamination was detected in the piped water”, and the pipe system increased the levels of microbes from the water source to the consumer (9), proving poor efficiency and safety of Guinea-Bissau’s piped water distribution, as well as their water quality. Sewage systems are the main way of withdrawing water, they have multiple roles such as waste-water management. A successful sewage system allows for the removal of contaminants away from inhabited areas, preventing diseases from forming. However, across Guinea-Bissau, less than 20% of the population have access to sewage or a septic tank (10) , meaning that the majority of contaminants stay within inhabited areas, leading to disease development and the spread of sickness.


Hygienic conditions and safe sanitation practices:

Hygienic conditions and practices are conducive to maintaining good health. Hand-washing in particular, is one of the most important disease-prevention and cleanliness practices, with the presence of a handwashing facility with soap and water being a primary indicator for global hygiene monitoring (11) . However, only 20% of the population in Guinea-bissau has a handwashing facility with soap and water available at home (12).

This low result clearly indicates the poor level of personal hygiene amongst the Bissau-Guinean population. Another indicator of the cleanliness of a population is analyzing whether they practice open defecation. Open defecation is particularly unhygienic due to limited access to handwashing, but also being more exposed to fecal contaminants. In rural areas of Guinea-Bissau, it was recorded that 30.2% of the rural population practice open defecation (13) . Such high levels of open defecation are linked to widespread diseases and in particular high child mortality.


WellFound and US Ambassador Self-Help Programme:‍
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It is apparent that Guinea-Bissau is experiencing very low levels of WASH and is in desperate need of improvement. However, country wide change requires large scale planning and masses of investment, so our small organisation was tasked with finding the best and most efficient way to help with all aspects of WASH, with the limited funding, materials and staff available. WellFound ensured to make use of 100% of the donations given to us for the project ($6,392); funding from the Ambassador Special Self-Help Programme ($16,500) and contributions from the communities engaged ($7,038).

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From November to August, WellFound helped a total of 4,135 people gain access to clean and safe drinking water by installing 4 wells across the 4 remote villages of Tepde, Cabame, Biambi Abrigo and Rossum. The wells tap into underground aquifers where water is naturally clean and safe to drink, as the soil acts as a natural filter.

Groundwater from aquifers differs as it is usually free of micro-organisms that may cause disease due to not being open and susceptible to contaminants. Furthermore, all 4 wells are solar-powered and are situated within 500 meters of all households, meaning that less time and effort is spent collecting water by the community, allowing them to focus on other productive means like education and work.

The Project Manager (Joao Ie) and his team visited and worked closely with all villages to ensure the success of the wells. They also taught each community about sanitation practices (such as handwashing) and promoted hygiene awareness, thereby nurturing healthier living conditions alongside the water-focused interventions.

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The project also led to the construction of 127 pit-latrines across all villages using CLTS approach. These latrines allow all families to have a personal and private defecation space, restoring people’s dignity and modesty. This is especially important for women who are pregnant or menstruating and the elderly who struggle with mobility. These latrines are also much more hygienic in comparison to open-defecation, as they keep all the waste in a covered underground pit, where the contaminants cannot lead to the spread of diseases.

This approach encourages people to take action to improve their situation by utilizing local knowledge, technology and innovation. It facilitates communities to conduct their own analysis of open defecation and mobilizes people to identify and find solutions to their sanitation and hygiene needs (14) . A crucial part of CLTS is that the want to change behaviour comes from within the community, making the change more impactful and longer lasting. WellFound ensured that in the creation of latrines, the community made their own contributions to the project and helped with the planning and construction.

This also taught village members valuable skills which they can use to create more latrines in their own and other communities. The WellFound team resided in the villages for prolonged periods to support the communities with taking active roles in the project.

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Outcome of the project:‍

The overall success of the project was astonishing. With the total investment of $29,930, a total of 4,135 people has close and dependable access to safe drinking water as well as personal and private access to one of 127 latrines constructed. Communities have not just changed their cleanliness practices temporarily but have actively become more proactive regarding their hygiene. They have also showed strong initiative in being their own driver of change and innovation through CLTS. These results are incredible and truly benefit those individuals who need help the most. Through the WASH problems of Guinea-Bissau are immense, small strides in the right direction have a huge impact on communities long term. There is always more work to be done, so help us in our mission to improve WASH across Africa. We guarantee that 100% of your donations go directly to our projects in vulnerable communities!

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References:‍

Reference (1) Reference (8)
Reference (2) Reference (9)
Reference (3) Reference (10)
Reference (4) Reference (11)
Reference (5) Reference (12)
Reference (6) Reference (13)
Reference (7) Reference (14)