Project Background
Sumbawa is a remote island located in the east of Indonesia and is notorious for its high level of maternal and infant mortality and malnutrition.
In the sub-district of Parado, childhood malnutrition was found to be at unacceptably high levels. Child malnutrition is the single biggest contributor to under-five mortality due to greater susceptibility to infections and slow recovery from illness. The lack of household food availability, personal health, and ineffective health services put the children in Parado at risk.
Malnutrition can make a person more susceptible to infection, and infection also contributes to malnutrition, which causes a vicious cycle. The diarrhea rate amongst children below five is very high , with a clear link to unhygienic practices such as open defecation keeping livestock in/under the house and a lack of access to clean water and sanitation.
Project Activities
E-coli is a type of bacteria that causes diarrhoeal disease. The diarrhoea rate among children under-five in Parado used to be 35% (SurfAid baseline, 2014). Hygienic practices were needed to bring this rate down, alongside improvements to the water sources and properly designed toilets to stop waste water from contaminating the drinking water. The short-term solution was an intensive health promotion campaign to boil all water before using it. Then, using the Community-Led Total Sanitation (CLTS) approach, community members were encouraged to build their own family latrines. Communities were trained on health and sanitation issues, and learned how to create simple, safe and low-cost squat toilets. By October of 2016, the local government officially declared the villages as Open Defecation Free (ODF) villages. This would not have been possible without the construction and renovation of 46 hand-dug water wells, leading to clean water close to the houses of the communities of Kuta and Paradowane.
SurfAid provided the technical expertise and knowledge, but the community members of Paradowane and Kuta villages built the water facilities themselves. Based on experience, SurfAid has found that water facilities will only be, sustained if the following is in place: there is genuine demand from the community, the community participates in every key decision, and the community understands and agrees that the maintenance of the water facilities is their own responsibility. We have trained and coached a Water and Sanitation Committee (WSC) for each community. The WSCs play an important part in planning, managing, maintaining and coordinating the labour for the water facilities. The communities have provided local materials, such as 46 m3 stones, and 5,520 hours of labour in the process of construction.
With water in place closer to the homes, we were able to work on the next element to improve the health of mothers and children in Parado. Together with an expert in permaculture, SurfAid trained 55 community member in topics such as compost making, seed saving, garden design, and organic pest control. All of the training participants now have their own nutrition gardens, and they spread the word! They succeeded in coaching their neighbours to create permaculture nutrition gardens themselves. In total 98 households in Paradowane (11% out of total population) and 52 households (15% of population) in Kuta now have their own nutrition gardens with vegetables and herbs including tomato, spinach, bok choy, chilli, cucumber and basil. These are mainly used for their own consumption and have helped to increase the nutrition status of the children under five.
Project Outcomes
The support from Footprints has contributed towards the implementation of clean water facilities and the training of community members on the importance of nutrition and sanitation in Parado, Bima on the island of Sumbawa. As a result, the rate of diarrhoea among children under five has reduced from 34% to 0.4%!
This in turn contributed to a reduction in the rate of children under five who are underweight in the last year from to 27.4% to 20%. That is truly amazing. We still have a long way to go, but changing behaviour is an evolution, not a revolution. With most of the healthy behaviours now in place, we are looking forward to even more positive changes for the Parado communities.
Clean water is a scarce commodity in the remote area of Parado. People depend on hand-dug wells and periodically on the government’s old piping system. When SurfAid initially tested the water, 75% of the water from the traditional hand-dug wells and 65% of the water from the piping system were contaminated by e-coli.
Case Study: Rahmani Amin
Rahmani Amin (Ani) lives in Fo’oKompo hamlet of Paradowane village. She is a mother of 8 children, 2 of which are still under five years of age. She was inspired by a community health volunteer from her hamlet, who provided coaching in permaculture techniques for nutrition gardens. When Ani decided to start her own nutrition garden, the health volunteer shared some vegetable seeds with her. After she learned how to manage her own nutrition garden, Ani learned how to make her garden sustainable by producing her own organic seeds from her harvest.
“I am really grateful to have this little nutrition garden…I don’t need to spend any money for buying vegetables anymore. We have what we need for our daily consumption. We have tomatoes, bok choy, eggplant and chilies. This has also reduced our daily expenditures for food. I can feed my children more varieties of food to make them healthier.” - Rahmani Amin, 2016.
Project Overview
Sumbawa is a remote island located in the east of Indonesia and is notorious for its high level of maternal and infant mortality and malnutrition.
In the sub-district of Parado, childhood malnutrition was found to be at unacceptably high levels. Child malnutrition is the single biggest contributor to under-five mortality due to greater susceptibility to infections and slow recovery from illness. The lack of household food availability, personal health, and ineffective health services put the children in Parado at risk.
Malnutrition can make a person more susceptible to infection, and infection also contributes to malnutrition, which causes a vicious cycle. The diarrhea rate amongst children below five is very high , with a clear link to unhygienic practices such as open defecation keeping livestock in/under the house and a lack of access to clean water and sanitation.
Project Objectives & Activities
This malnutrition project will benefit 618 households in 2 villages of Parado, Sumbawa Island with a main focus on the 163 children under five.
To tackle malnutrition in Parado the program will tackle 2 interconnected objectives:
- Provide clean water and sanitation; 20 dug wells and latrines
- Create community nutrition gardens
The first step in the construction of clean water facilities is the identification of potential water sources together with stakeholders in the village and the water and sanitation committees (WSCs). The WSCs play an important part in planning the water facilities. This nurtures community ownership of the projects, leading to contributions and agreements on use of the land where the water facilities will be built and agreements on what the community and what SurfAid will contribute.
The communities will provide local materials such as stones, gravel, and labor for transporting the material to the project site and for construction. SurfAid provides technical designs, know-how, materials that are not locally available, technical labor, technical assisstance and training on basic water facility construction, operation and maintenance.
Once a reliable and sustainable water source is established, the water can also be used to water the nutrition gardens.
Technical agricultural training will also be part of this project with topics such as compost making, seed saving, garden design, and organic pest control. Most of the training is learning by doing, and in every village we will first establish demonstration gardens. In our experience, with careful guidance, these will inspire people to start their own vegetable gardens.
SurfAid will also help to foster the creation of family vegetable gardens by starting seed banks in each community. We use non-hybrid organic seeds that produce good quality seedlings. As families cultivate different seeds in their own vegetable gardens, surplus vegetables can be traded with other families or communities.
Seeds harvested from the community gardens will be used for cooking classes that demonstrate preparation of nutritious foods. In these communities, most mothers and caretakers have no knowledge of the nutritional values contained in the vegetables they are growing. The cooking classes will provide a fun way for families to learn how to prepare delicious and nutritious meals that children like to eat.
Each activity in this project will be used to improve nutrition status, especially for children under five. While SurfAid provides materials necessary for the vegetable gardens, seed banks, and cooking classes, it is capacity building of community members and government staff that lies at the heart of this project.
Success Story: Mrs. Ratnah, Paradowane village
Mrs. Ratnah, of Fo'okompo, Paradowane village, Sumbawa Island, Indonesia.
Mrs Ratnah was one of the first community members to enjoy clean water in the community. She and her husband worked tirelessly with SurfAid to help to build the dug well. Before that, Ratnah always had to queue to get water in the neighboring village, just to meet her basic needs such as cooking and drinking.
Within two weeks the dug well was completed and the community enjoyed the abundant water supply. The community started to flourish. And not just the people. Ratnah’s front yard, which previously was completely barren, is now fenced neatly and showcases various kinds of vegetables. “I need to spread out the harvest, as my family not able to consume all of them! I even gave some to the neighbors”. Ratnah said. “The whole family is healthier, with good water, and now with these big vegetables! I do not need to buy vegetables anymore and I can save money. In the future I’m going to sell whatever my family can’t eat!”
Ratnah had received training from SurfAid on nutrition gardening and seed production. But it was she and her community members who put in all the hard work to build the wells and create the gardens. Our dream is to support many more people like Ratnah in Fookompo, to build a better future.