Often the Greatest Needs are Also the Most Basic in Tanzania

In Tanzania, often our greatest needs are also the most basic.

In Mosaic’s international program, often our greatest needs are also the most basic. It’s one of the mental and emotional challenges of doing international development work. How is it that getting basic nutrition and clean water can be so hard? Yet achieving these goals makes such a deep impact and sets the foundation for all our other work.

There is a 12-year-old girl that attends one of Building a Caring Community (BCC)’s day centers. She has cerebral palsy and uses a wheelchair. She has a smile that lights up the room. Her speech patterns are difficult to understand, but she loves to greet visitors in her carefully practiced English. The spasticity in her hands and arms makes writing a challenge, but she proudly shows off how she can write her name, numbers and letters.

Even though she lives in an area that has a school with a special education classroom, she does not attend, because that school does not have accessible bathroom facilities. Special education classrooms are a rarity in Moshi; not all of our center have access to one. And here is a smart girl who loves to learn who is denied access simply because of a bathroom.

To make matters worse, the BCC day center she attends does not have an accessible bathroom either. Until recently, this girl used a plastic toddler’s toilet behind a screen in the corner of the center. When she reached an age where this became truly unacceptable, the staff began helping her to the facilities used by everyone else.

In a classroom with 14 kids with different disabilities and two to three staff, one teacher has to leave the room for a minimum of 20 minutes to help one person use the toilet.

In order to reach the toilet, a teacher must push the girl in her wheelchair across a rough dirt path about 20 yards. The wheelchair does not fit inside the toilet block, so a teacher has to carry her through the entrance, across the bathroom, into the stall, and place her on the toilet. There is no toilet paper in the bathroom, so staff put a bucket of water in the stall each morning so people can clean themselves. When the girl is ready, she calls the teacher to come and carry her back out and the process repeats itself in reverse.

This young girl represents the enormous basic need of children with disabilities. Lack of access to a bathroom means lack of access to education and increased rates of infectious diseases. And the lack of dignity and basic hygiene perpetuate stigma.

For the last two years, Mosaic and BCC have been looking closely at the need for a WASH program. WASH stands for Water, Sanitation and Hygiene and is a standard acronym in international development. A strong WASH program provides clean water, clean toilets and sanitation facilities, and good hygiene throughout a community.

The needs of BCC are both simple and complex. We need accessible bathrooms. But we also need these to be designed according to available resources. And we need them to be built by someone who has never seen a wheelchair-accessible bathroom before. We need taps that provide clean water in each center. And not only do we need the infrastructure, but we also need the knowledge. We need accessible WASH educational materials that will teach our staff and kids about the importance of good hygiene and how to keep themselves healthy.

Kimber Bialik, Mosaic’s International Fellow, recently wrote about a pilot program to increase water intake by BCC kids in an effort to reduce the high rate of urinary tract infections.

Dehydration is only one piece of the puzzle. Poor hygiene is a huge contributor, as well. A strong WASH program could reduce the rates of intestinal parasites. A kid with ongoing gastrointestinal issues has trouble absorbing nutrients, so improving WASH would also impact the rates of malnutrition. Lastly, we cannot truly address the issue of menstrual health for our young women without providing them with accessible spaces so that they can manage their periods. If we want girls to attend the centers all month long, they need clean water, soap and privacy.

WaterAid estimates that it costs only an additional 8 percent to make a school latrine accessible. Of course, that is only one piece of a comprehensive WASH program, but it is a start.

That is such a small price for infrastructure that would have such an impact on people’s lives: from health, to education, to reducing stigma. Just imagine how one little girl’s life could change.

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