Malakal — Malakal, on the banks of the world's longest river in Sudan's Upper Nile State, should have enough water to quench thirst and clean itself; instead the town was grappling with serious challenges as it marked the international week of sanitation in March.
"Towns along the rivers of Upper Nile, like Malakal, are areas inhabited by citizens who get water directly from the rivers," Peter Pal Riak, the state's minister for physical infrastructure, said on 25 April. "That water is a source of disease."
With the onset of the rainy season, aid workers worry that cholera could become a significant danger.
The river water, which is mostly consumed untreated by many town residents, is contaminated with clay, wood, vegetation, potential pathogens and micro-organisms. Many people bathe in the river, adding to the pollution.
Further contamination occurs during transportation, often in a metallic or plastic container pulled by donkeys through Malakal's dusty streets, and during storage or consumption with dirty utensils.
According to local residents, the town used to have a piped water supply system but it collapsed during the years of war between the Southern Sudan People's Liberation Movement and the Sudan national army. The war ended in 2005, but by then the pipes were blocked or had been looted.
Similarly, waste disposal and drainage systems collapsed - just as the population increased. The situation is compounded by a serious shortage of toilet facilities. As a result, say aid workers, Malakal, whose population has doubled from 10,000 in the last few years as those displaced by the war return home, has appalling sanitation.
River of waste
The town has virtually no public toilets and inadequate private facilities. As a result, many residents relieve themselves in open fields all over town - and rarely wash their hands.
"If you go into open places in the town, you can get discouraged," said Santino Olwak, director of rural water supply and sanitation in Upper Nile State's infrastructure ministry. "That is how Malakal is - and now with the rains, all the human waste is washed into the river."
A survey by the NGO Relief International in 2007 found that 80 percent of the residents had no access to latrines or any other toilet facilities. "The problem is just as serious in many other parts of Upper Nile State," Benjamin Majok, the organisation's community programme officer, told IRIN in Malakal.
The UN Children's Fund (UNICEF), quoting the findings of a 2007 household survey in Sudan, said only 7.5 percent of the population in Upper Nile practised improved sanitation.
"The poor sanitation is associated with low levels of knowledge on good hygiene, limited access to safe water and the flooding situation which Malakal has witnessed," Swangin Bismarck, UNICEF Southern Sudan communication officer, said.
Speaking at a workshop to discuss the problem on 25 April in Malakal, Olwak said: "We need to give priority to hygiene promotion to change people's sanitation and hygienic behaviour, practices and attitudes.
"Unfortunately, the civil war [decimated] the department of water supply and sanitation to a level where it is virtually non-operational," he added. "For example, we are planning to drill 30 boreholes, 15 school latrines and 1,000 household latrines in the state, but we do not even have a truck."
The war, according to a report of the 2007 work plan for the infrastructure ministry, also created a shortage of technical staff, making it difficult to conduct geophysical studies in some areas before boreholes could be drilled. In western Upper Nile, 22 water points constructed during colonial times were damaged.
Workshop participants, including NGO and government representatives, said lack of water management committees in all but one of Upper Nile's 12 counties, inadequate government support, open defecation, lack of awareness and lack of waste disposal systems were some of the major factors responsible for poor sanitation and lack of clean water in Upper Nile.
havioural change by the NGO Solidarités in El Luakat and El Mattar suburbs of Malakal found that latrine use went up from 16 percent in 2007 to 26 percent with an increase in facilities from 5 to 35 percent.
This was after the organisation had built 85 family latrines for more than 1,000 people, with a small water treatment plant. Dehu Carole, Malakal base manager for Solidarités, told IRIN: "Our experience shows that when latrines are [made available], people will use them."
Sanitation week, from 17 to 20 March, was intended to scale up hygiene and health information across Upper Nile and in Malakal town. School children were taught songs on hygiene and some parts of the town were cleaned, but aid workers say very little was achieved.
More urgently, the government and NGOs worry the wet season could mean Malakal being hit by acute watery diarrhoea or at the worst, cholera. "We are getting ready, in case of an outbreak during the rainy season that has started," Carole said.
UNICEF, which has provided core support to the water and sanitation sector in the state, has, with its partners, embarked on erecting seven 2,000-litre water purification points throughout the town.
It is also involved in hygiene and sanitation awareness, and encouraging improved waste management. Slabs are also being provided to help families erect pit latrines, along with construction of school and health-centre latrines.
Pal said his ministry was focusing on drilling boreholes and repairing other water points. "We considered the first two years after the CPA [Comprehensive Peace Agreement] an emergency phase; now we are changing to development programmes," he explained. "Soon we will drill 20 boreholes in eastern Upper Nile.
"Most of the population here is ... in dire need of sanitation and clean water," the minister added. "These people cannot realise the benefits that peace brought, unless they receive these services."
Other NGOs were providing kits to some locals to dig latrines, encouraging hand-washing and teaching improved sanitation and hygiene in schools. Chlorination kits were also being procured in case of a diarrhoea outbreak.
Another key challenge was how to use Malakal radio to create awareness on key hygiene and sanitation messages in different local languages including Dinka, Nuier and Shilluk; and how to ensure more government support.
"The problem is to change attitudes; even some of our educated people defecate in the open," one participant told IRIN. "And the government, which should lead this process, is giving very little to the water and sanitation sector despite this being the International Year of Sanitation."
Local residents say poverty is partly to blame. "Those who have money can buy bottled water," said Jacob Gatluak, a "tuk tuk" taxi driver. "But how many of us can afford a Sudanese pound [US$0.50] for a bottle of water, especially those with a family or who have just returned from a refugee camp?"
[ This report does not necessarily reflect the views of the United Nations ]