contemporary issues and challenges related...

CONTEMPORARY ISSUES AND CHALLENGES RELATED TO WATER, HEALTH AND ENVIRONMENT IN UGANDA

BY

DR EDWARD MUKOOZA KIBIKYO (MBCHB,DHA,MBL)

UGANDA CHRISTIAN UNIVERSITY/INTERNATIONAL CHRISTIAN MEDICAL INSTITUTE

&

DR FREDERICK KAKEMBO (PHD)

SCHOOL OF RESEARCH & POSTGRADUATE STUDIES UGANDA CHRISTIAN UNIVERSITY

1

Copyright 2010 Mukooza/Kakembo

Location of Uganda in Africa 2


Country is along the equator 1 to 4 then 29 to 35 latitudes and longitudinal respectively

Map of Uganda showing some of the water bodies

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Fresh water – about 18% of land cover

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SOME STATISTICS • Surface area of Uganda: Approximately 241,000

Square Km

• Approximately 18% of land cover is water

• Current population: 32.7m (WB)

• Population growth rate: About 3.3% (WB)

• Life expectancy (total years): 52.7 (WB)

• Uganda per capita income: Estimate -US$418 (WB)

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HEALTH INDICATORS Source: Uganda Ministry of Health HSSPIII

• Infant Mortality Rate (IMR): 79/1000

• Maternal Mortality Rate (MMR):435/100,000

• Child Mortality Rate (CMR):137/1000

• Total Fertility Rate (TFR): >6.5

• 50% of the population is children under 15 years

• Proportion of people living below poverty line:>32%

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Water and health-i • About 60% of Ugandans have access to safe drinking water –

or improved water sources(MWE)

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Source of statistics: UNBS 2002 Census

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Sanitation

• Less than 50% of the Ugandan Population uses improved sanitation

• Less than 2 % use water borne toilets (Tasyobya and Ogwal 2004)

• Pit latrine coverage in some areas is as low as 4%!

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Water and Health • Water and sanitation diseases are among the top ten killer diseases

in Uganda:

“Intestinal worms, diarrhea and asthma topped the list of the most prevalent diseases in

Kampala city between 2006 and 2009. Kampala City Council's health division says these diseases jointly contribute to more than 80 per cent of the disease burden in the city” (By Lirri of the Monitor Publications, 6 April 2010 )

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Obstacles to safe water access (i. Poverty) • One of the poorest countries

• Uganda ranked 157th of the 182 countries ranked on the HDI (2008) by UNDP

• >32% living below poverty line

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Obstacles to safe water access ii- Political instabilities • Northern Uganda has been unstable for more than 20 years;

Safe water access and sanitation is much worse in that part of Uganda

• On a positive note, all boarders of the country are now stable and safe

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Obstacles to safe water (iiia. Urbanization) • More than 80% of the population is rural – but currently,

increasing numbers of people are moving to the urban areas.

• Rate of urban growth is estimated to be 5.1% per year – creating large slums with limited water supplies and sanitation facilities.

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Obstacles to safe water (iiib. Urbanization/slums) • The slums tend to be located in wetlands where safe water

supplies and sanitation is very poor.

• Slum areas are unplanned and service delivery is usually just reactive.

• About 40% of urban dwellers in Uganda are in slums.

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Typical slum in Uganda

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Obstacles to safe water access (iv-Rapid population growth) • According to UNBS, population of Uganda was 9.5m in 1969.

Now it is >32m! Projected to be >68m by 2035!

• Over 50% of the population are children <15yrs

• A lot of pressure on the land and other resources- leading to land over use, deforestation and development of slums with very poor sanitation conditions

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Obstacles to safe water access (iva. Environmental degradation and pollution)

• Rapid population growth is leading to slums development with serious sanitation consequences and contamination of water sources with human waste!

“All the samples had faecal coliform counts above the WHO guideline…Water from the ten protected springs studied is unsuitable for drinking without treatment” (Kabagambe,Ejobi &Haruna, 2005)

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Obstacles to safe water access (ivb. Environmental degradation and pollution)

• According to UNDP Uganda, deforestation in Uganda is up to 2000 sq km per year ( translating to loss of up to 2.2% forest cover per year )

• One of the contributing factors; 95% of Ugandans use wood or charcoal for fuel!

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Obstacles to safe water access (ivc. Environmental degradation and pollution)

• Settlements- more than 30 million people are settled in the lake Victoria basin in East Africa

• There are several cities on lake Victoria shores and untreated sewage is often deposited directly in the lake!

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Obstacles to safe water access (va-Climate change) • Since the early 1990s, rainfall has been erratic. The incidence,

duration and amount of rainfall have all exhibited abnormal departures from long-term means.

• There are shorter but sharper rain seasons with serious storms and flooding and land slides – flooding and land slides lead

property and life destruction as well as an increase in water borne diseases such as cholera & typhoid

• Dry seasons are longer, dryer and unpredictable Increasing

temperature have led to higher incidences of malaria especially in highlands (as much as 30 times what it was >50 years ago)

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Source: UN-WATER/WWAP/2006/9

Trend of malaria morbidity

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Obstacles to safe water access (vb-Climate change) • Climate changes lead to floods and their consequences

• Longer dryer seasons lower water table, makes agriculture difficult for the peasants

• Higher temperatures have lead to increase of malaria especially in highlands

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Obstacles to safe water access (vi-Other obstacles) • Inadequate capacity to plan and implement water sector

activities- true especially at district level.

• Limited private sector capacity to cope with demand for water

• Inadequate involvement of local communities

• Corruption – resources diverted for personal gain of some officials

• Almost all of Uganda’s water resources are trans-boundary in nature and shared with her neighbors.

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Opportunities (i-Growing economy) • Improving growing economy and increasing government

budget towards water sector

• The economy of Uganda has been growing at >5% per year for the past 10 years and

• Inflation is less that 10% since 1992

• Tax revenue collection as a percentage of GDP increased from about 5% in 1989 to more than 14%

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Source : UN-WATER/WWAP/2006/9

Revenue collections 1989-2002

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Opportunities (iia. Policies, legal and institutional reforms )

• Poverty Eradication Action Plan (PEAP) – Which gives high priority to water supply and sanitation

• Policy and Legal Framework – which guides the planning, implementation and monitoring of water supply and sanitation activities.

• Commitment from government and development partners for continued support of water supply and sanitation activities.

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Opportunities (iia. Policies, legal and institutional reforms )

• Private Sector Participation (PSP) which has brought in expertise and financing from the private sector

• Development of regional water resources management

and development initiatives including – Nile Basin and Lake

Victoria Basin initiatives. Within these initiatives, countries

agree on a shared vision of how to use these water resources.

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Progress towards MDG

• Safe water access in rural areas was 25% in the early 1990s. Now it is about 60%. The target is 77% by 2015.

• According to Ministry of Lands, Water and Environment, target for safe water is within reach but, not for sanitation.

• Government of Uganda is currently funding up to 75% of the water sector budget (up from 20% in the early 1990s)

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Water education and capacity building-i

• Literacy levels (>70% but lower for female) are improving as a result of introducing Universal Primary Education in 1997

• Basic knowledge on water, sanitation, hygiene and health education now included in the primary and secondary school curriculum

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Water education and capacity building-ii

• UCU has this basic water and sanitation knowledge taught to all undergraduates in a core course – Health and Wholeness.

• Sanitation and water issues are also taught in the Bachelor of Community Health and Masters of Public Health Leadership courses at UCU

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Water education and capacity building-iii • Directorate of Water Development signed a Memorandum of

Understanding (MoU) with Makerere University for collaboration in applied research in support of the water sector activities. (Source: UN-WATER/WWAP/2006/9)

• Makerere and Kyambogo universities offer degrees in Civil Engineering, with options for students to specialize in Water Resources, Engineering and other Water related Sciences.

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Post graduate training and Research • Masters programs -Engineering and Water Resource

Engineering at MUK.

• At PhD level, different water related research is being undertaken at MUK and by MLWE

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Other sources of capacity building

• There are several other tertiary institutions offering water related courses at certificate and diploma level

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References Haruna.R, Ejobi, F, Kabagambe, E (2005) The quality of water from protected springs in Katwe and Kisenyi parishes, Kampala city, Uganda.

African Health Sciences Vol 5 No 1 March 2005

List of Countries by Human Development Index (HDI). Available at en.wikipedia.org/.../List_of_countries_by_Human_Development_Index

Safe Drinking Water Coverage and Poverty. Available at : pdf.wri.org/mapping_a_healthier_future_water.pdf

Syngellakis ,K & Arudo,E. Water Sector Policy Over View. Available at : www.enable.nu/publication/Water_Policy_Overview_Uganda.pdf

Tashobya.K.C, Ogwal.O.P. (2004) .The effort to achieve the millenium development goals in Uganda: reaching for the sky? HEALTH POLICY AND DEVELOPMENT; 2(1) 33-39 UMU Press 2004

The Republic of Uganda. Ministry of Health. Health Sector Strategic Plan III

2010/11 – 20014/2015

Uganda National Bureau of Statistics (UNBS). Available at http://www.unbs.go.ug/

Uganda Ministry of Health. Available at: http://www.health.go.ug/

UN-WATER .(2006). National Water Development Report: Uganda . Available at: unesdoc.unesco.org/images/0014/001467/146760e.pdf

Water, Sanitation and Hygiene. Putting Little BIG Africa Projects into Perspective:

Water, Sanitation and Hygiene. Available at: www.littlebigafrica.org/resources/Water%20facts.pdf

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http://www.health.go.ug/

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