2. ! 2!
!
Table of Contents
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1.0 EXECUTIVE SUMMARY …………………………………………………………………P. 3
2.0 INTRODUCTION ………………………………………………………………………...P. 4
2.1 OBJECTIVE ……………………………………………………………………...P. 4
2.2 PURPOSE ………………………………………………………………………..P. 4
2.3 COMMUNITY DESCRIPTION ……………………………………………………..P. 4
TABLE 1 ………………………………………………………………………...P. 5
GRAPH 1 ………………………………………………………………………..P. 6
2.4 SITE DESCRIPTION AND FEATURES ……………………………………………...P. 6
2.5 PEACE CORPS RELATIONS ………………………………………………………P. 6
3.0 PROJECT DESCRIPTION ……………………………………………………………….P. 7
3.1 WASH INDEX ……………………………………………………………………P. 7
3.2 COMMUNITY MEETING ………………………………………………………….P. 7
3.3 COMPOSTING LATRINE DESIGN AND BUILDING PROCESS ….....………………...P. 8
3.4 PILOT COMPOSTING LATRINE PROGRAM ………………………………………...P. 9
3.4.1 CAPACITY BUILDING …………………………………………………...P. 9
3.4.2 RESULTS ………………………………………………………………..P. 9
3.5 COMPOSTING LATRINE PROGRAM ……………………………………………….P. 9
3.5.1 HEALTH COMMITTEE …………………………………………………...P. 9
3.5.2 PHASE 1 …..…………………………………………………………...P. 10
3.5.3 PHASE 2 …..…………………………………………………………...P. 10
3.5.4 MONITORING AND EVALUATION ………………………………………P. 10
3.6 SUSTAINABILITY ……………………………………………………………....P. 10
4.0 BUDGET ………………………………………………………………………………P. 12
4.1 BUDGET NARRATIVE ………………………………………………………….P. 12
4.2 BUDGET PROPOSAL ……………………………………………………...PGS. 12-13
5.0 CONCLUSIONS …………..……………………………………………………………P. 14
6.0 REFERENCES …………………………………………………………………………P. 15
7.0 APPENDICES
3. ! 3!
1.0 EXECUTIVE SUMMARY
Globally, 2.4 billion people lack basic sanitation systems such as latrines (WHO 1). According
to the United Nations Children’s Fund (UNICEF), 88% of diarrheal related diseases manifest
from “poor hygiene and lack of access to sanitation systems.” In effect, roughly 1.6 million
people die annually from diarrheal related diseases (WHO 1). Furthermore, diarrheal diseases are
cause to approximately 760,000 child deaths under the age of five, per year (WHO 2).
The Peace Corps has initiated a global effort, parallel to that of the United Nation Millennium
Development Goal (MDG) 7, target 10: “halving by 2015 the proportion of people without
sustainable access to safe drinking water and basic sanitation” (UN 2). Both the United Nations
(UN) and the Peace Corps believe that with improved sanitation systems and hygiene education,
diarrheal diseases in low-income countries will decrease while promoting proper hygiene
practices.
Nonexistent sanitation systems and poor hygiene practices are present in the Panamanian
community, Kuite. 194 people currently reside in Kuite and each person utilizes the Mananti
River for all sanitary activities, including open defecation. Although the community has access
to potable drinking water, many villages down river use the Mananti as their main water supply.
The prevalence of diarrheal diseases and deaths is an issue for those in Kuite as well as
communities downstream, given the uses of the Mananti River. Yet, the most alarming issue in
these river communities is the high infant mortality rate. Sub-standard hygiene practices,
behaviors, and access to sanitation facilities are threatening the health of Kuite’s youth
population. Kuite’s lack of sanitation systems and proper hygiene education is in effect creating
a public health hazard; however, this dilemma is preventable and can be improved.
In order to improve the sanitation efforts in Kuite and contribute to the MGD 7, the Peace Corps
plans on facilitating the construction of eighteen (18) composting latrines. Composting latrine
systems, also referred to as ecological sanitation, are aboveground cinder block structures that
convert human excrement into a soil amendment (Mihelcic, Fry, Myre, and et al). With proper
implementation of these composting latrines, in conjunction with hygiene education, Kuite’s
state of public health can improve significantly.
The Peace Corps has recently developed and implemented a pilot latrine program that introduced
the composting latrine and its concepts to participating families. With the success of the pilot
latrine program, and the positive response towards the new sanitation system, the Peace Corps
and the people of Kuite are prepared to initiate the composting latrine project.
In order to begin construction in Kuite, the community is seeking the funding of $4,817.38
towards of the first eight (8) composting latrines. With this funding, the community members of
Kuite will be able to purchase the necessary materials and equipment to construct these
composting latrines, effectively improving the overall public health in Kuite.
4. ! 4!
2.0 INTRODUCTION
2.1 OBJECTIVE
The core objective of the Kuite’s sanitation improvement program is the construction and proper
implementation of composting latrines for each household. This objective will be reached
through capacity building and reinforcing education concerning community, household, and
personal hygiene. The sanitation improvement program will be divided into two construction
projects. This grant is associated with the first eight (8) composting latrines that are scheduled to
be built during July of 2014.
2.2 PURPOSE
The purpose of this project was created to meet Kuite’s request in creating a cleaner environment
and a strengthening public health. This project will also contribute to the goals set by the UN’s
MDG 7 target 10, but more specifically the Peace Corps’ second goal assigned to environmental
health Peace Corps Volunteers: Rural community members will adapt behaviors and practices to
improve access and use of sanitation systems.
In addition, pursuant to Peace Corps Panama and the Panamanian Ministry of Health (MINSA)
sanitation improvement goal, “By September 2017, 7,500 community members will benefit from
rehabilitated or constructed sanitation systems.” By implementing the construction of this
project, Kuite will contribute 2.59% towards this goal.
Improved sanitation will also foster strength in areas of social, community, and economic
development. For example, education is highly correlated with levels of sanitation in a
community. In low-income countries, girls are more likely to attend schools that have water and
sanitation systems. Girls who menstruate are less likely to attend a school that does not have a
proper bathroom, and parents are also less supportive in sending them (UNICEF). In addition,
the World Health Organization (WHO) estimates that with the implementation of the MDGs
regarding improved sanitation, approximately 194 million school days will be added in result of
lowering diarrheal diseases. The WHO estimates, across countries, a 10% increase in female
education is associated with a 0.3% increase in economic output. Educated females are also
“more likely to raise healthy, well-nourished, educated children, to protect themselves from
exploitation and HIV/AIDS in addition to developing skills to contribute to their societies”
(UNICEF). By creating sanitation systems and hygiene education, we are in effect laying a
foundation for improvements in education, fiscal security, social progress, and public health.
2.3 COMMUNITY DESCRIPTION
Kuite is a small indigenous community located within the Comarca Ngöbe-Buglé (CNB): a
region of land acknowledged by the Panamanian government for the indigenous groups, the
Ngöbe and the Buglé. Kuite is located within the province, ÑoKribo (Translated as, “Of Big
Water”). The community’s name, Kuite, is derived from the word Kui, or Chicken, in the native
spoken language: Ngöbere. According to the local citizens of Kuite, nearby communities, and
former Peace Corps Volunteers (PCV), the community was established roughly 30-40 years ago.
5. ! 5!
Currently, the community of Kuite includes 194 individuals and 22 households. This is an
average 8.82 persons per household. According to the data collected by the previous PCV
during the years of 2011-2013, Kuite included 178 individuals and 22 households. This was an
average of 8.09 persons per household. Based on a recent census complied by the current PCV,
Kuite is in the midst of population expansion. According to Table 1, 77.3% of Kuite’s
population is between the ages of 0-29 years of age. 40.7% of the population is between the ages
of 10-29: the age group most likely to reproduce based on social norms. This table is graphically
represented in Graph 1
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6. ! 6!
The main source of income for the majority of Kuite’s citizens is by government welfare. There
are currently few sources of income besides government well fare. Most welfare money is re-
circulated throughout the community by means of small stores, buying and selling of livestock,
and home-improvements. Although most citizens of Kuite play the role of subsistence farmers,
some do sell their agricultural products outside the CNB. Other forms of economic opportunities
include cutting lumber, making or hemming of clothing, designing local artisan crafts, and boat
driving which is the most lucrative occupation.
2.4 SITE DESCRIPTION AND FEATURES
Kuite is located adjacent to the Mananti River: a tributary that flows north towards the Chiriquí
Lagoon. Because of the Kuite’s proximity to the river, many areas are marshy and saturated. On
average, the depth to water is approximately 0.5’. The local geology of Kuite is generally
comprised of clay and silts, with traces of sand and gravel near the riverbanks.
2.5 PEACE CORPS RELATIONS
The Peace Corps has had a presence in Kuite for eight (8) years. Between the years of 2008 and
2013, PCVs and the community members of Kuite constructed a chlorinated aqueduct system
that now services every household. The water system now supplies potable, chlorinated water to
each household for drinking and bathing purposes. The system is now fully functioning and is
no longer maintained by the Peace Corps.
Kuite and the Peace Corps have developed a strong relationship over the years. The
collaboration between the two parties has contributed towards successes in creating access to
potable water in addition to strengthening Kuite’s public health. Recognizing the approach the
35 30 25 20 15 10 5 0 5 10 15 20 25 30 35 40 45
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10-19 years
20-29 years
30-39 years
40-49 years
50-59 years
60-69 years
70-79 years
80-89 years
90-99 years
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7. ! 7!
Peace Corps views regarding development, community members are taking more initiatives on
projects, and management roles are being transferred to community members.
3.0 PROJECT DESCRIPTION
The construction of a sanitation system in Kuite will help engage the community in
strengthening its public heath while reducing diarrheal related illness. The ultimate goal of this
project is to give the citizens of Kuite an improved understanding of sanitation and hygiene, in
addition to creating a sustainable sanitation system for present and future needs.
The core objectives of this project are as follows:
1. Identify and understand the current sanitation systems and potential sanitation issues in
the community
2. Work with the community in identifying the best possible solution in creating a stronger
sanitation system
3. Facilitate a pilot program to analyze the progress and commitment to a rehabilitated
system
4. Initiate the construction phase of the project
5. Determine the effectiveness of the project through monitoring and evaluation
3.1 WASH INDEX
The WASH Index is a Peace Corps tool adapted from a UN program that is used to analyze
hygiene and sanitation on community and household levels. In order to better grasp the hygiene
and sanitation levels in the community of Kuite, the former and current PCVs observed every
household’s sanitation practices, in addition to the community’s general sanitation practices.
Observations were made and recorded based on the Peace Corps’ WASH Index outline
(Appendix A).
After reviewing the data from the former and current PCVs’ observations, it became apparent
that the lowest scores in the WASH Index concerned latrines and sanitation systems (Appendix
B). Currently, each household in Kuite uses the local Mananti River for defecation and no
functioning latrines are in existence.
3.2 COMMUNITY MEETING
Once the Peace Corps was able to understand the degree of sanitation practices in Kuite, several
meetings were organized with community members to address the current behaviors, issues, and
possible solutions. Community members in Kuite understood the risks surrounding their
sanitation practices.
According to the community members, nothing was done to change the current sanitation
practices for the following reasons:
1. A lack of education surrounding sanitation practices and sanitation systems
2. A lack of funding to support a project to install modern flush toilets
8. ! 8!
3. The existence of a high water table limited the use and functionality of commonly used
pit latrines
In order to better understand the wants and needs of Kuite, community members were asked why
they would want an improved sanitation system. The following points were exclaimed:
1. To reduce the pollution and bacteria released in the Mananti River
2. To reduce the amount of diarrheal related illness and deaths
3. To create a safer area for sanitary practices. It can be a very dangerous for the young and
elderly when the river is flooded
4. To create a more private space
After understanding and addressing the issue, the community concluded that a composting
latrine project would best meet their needs in sanitation improvements. Although composting
latrines have a higher initial cost compared to pit latrines, they can be constructed where water
tables are high. If used properly, composting latrines have a longer lifetime in comparison to pit
latrines: approximately ten (10) years Composting latrines are also more resourceful than flush
toilets, as they are not reliant on water.
The program would include the construction of a composting latrine for each participating
family, and also educational support surrounding proper hygiene and sanitation practices. Before
the project could begin, the Peace Corps created a pilot composting latrine program to first test
the preparedness and education of the community.
3.3 COMPOSTING LATRINE DESIGN AND BUILDING PROCESS
The Peace Corps works with each community in deciding which sanitation systems are most
appropriate based on local geology, available funds, practicality, and social acceptance. Based
on Kuite’s high water table, the materials accessible, and the agricultural workforce present,
composting latrines are considered the best option for the Kuite’s new sanitation system.
Although composting latrine designs are tailored to meet the need of each community, the Peace
Corps in Panama uses a standard design that is already successfully implemented in the CNB.
The design includes a two (2) chambered, aboveground cinderblock structure. Each chamber is
used alternatively. While one compartment is being used, the inactive compartment houses
human excrement that is being composted as pathogens are eliminated. Pathogens are killed by
proper use, decomposing temperature, and the dry additives applied. A seat is stationed above
each chamber, and each seat is designed to divert urine by a polyvinyl chloride (PVC) pipe to a
separate receiving container. The illustration in Appendix C shows a visual description of a
composting latrine and how they function.
Due to the aboveground design, composting latrines can be built in areas with high water tables,
flood plains, and near water-bodies. Since composting latrines separate wet and dry excrement,
bad odors are not produced which in turn does not provide a breeding ground for insects.
Composting latrines also reduce the need for resources such as water, but create a resource such
as compost for the purposes such as soil amending.
Each participating family will be trained by the current PCV on how to construct a composting
latrine. Training sessions and materials will include the following:
9. ! 9!
1. The use of visual diagrams taught in a classroom-like setting
2. Written and visual guides on building composting latrines will be given to each
participating family
3. The building of small composting latrine models will be implemented in order to
practice building techniques
4. A hands-on group project, including each participating family, of the construction of
the first composting latrine in Kuite
After members of each participating family receive a background in composting latrine
construction, the health committee will assemble work groups. Each work group will include
four (4) people that will consist of various families. Work groups will implement the
construction of the composting latrines, and a PCV will be on site for guidance if needed.
3.4 PILOT COMPOSTING LATRINE PROGRAM
The pilot composting latrine program is an assessment implemented by the Peace Corps in order
to evaluate the understanding, functionality, practicality, and acceptance of composting latrines
on a community and household level. The former PCV that served Kuite completed a pilot
composting latrine program to assess the community’s preparedness.
3.4.1 Capacity Building: After several meetings and educational seminars
regarding the use and maintenance of a composting latrine, each
participating family used the pilot composting latrine for one (1) week.
After each week, the former PCV observed and recorded the effectiveness
based on a standard outline. Once the data was collected from each
participating family, each group was given a grade based on the latrine use
during their given week.
3.4.2 Results: Based on the information gathered from the pilot latrine program,
eight (8) families were deemed ready for the next level of the composting
latrine project. This readiness will include the support and construction
facilitation of eight (8) composting latrines: one per family. The remaining
participating families will receive further educational support, in addition
to a second pilot latrine analysis. Once the remaining families are
considered educationally prepared, they will then be considered for the
second round of composting latrine construction.
3.5 COMPOSTING LATRINE PROGRAM
The composting latrine project is currently seeking funding to transition to the construction
phase of the project. To make the process more streamlined, steps and goals have been taken to
organize the community and the project.
3.5.1 Health Committee: In hopes of better empowering the people of Kuite
and strengthening the composting latrine project, a health committee was
established. The health committee, along with other duties and
responsibilities, will help coordinate and assist in the management of the
10. ! 10!
composting latrine project. The committee is made up of elected
community members from Kuite. The officers and their duties were
determined by the community during a community meeting facilitated by
the current PCV.
3.5.2 Phase I: The first phase of the project will include the preparation and
fundraising of eight (8) composting latrines. The health committee with
the oversight of the current PCV will determine the work groups and
coordination of the project. During the fundraising period, workdays will
be scheduled to move sand and stones from the river to each construction
location. The current PCV will work with the school in producing an
advertisement geared towards raising support and funds for Kuite’s
composting latrine program.
3.5.3 Phase II: The second phase of the program will include the construction
portion of the project. Through preparations with Kuite’s Health
Committee, work teams will be assembled on scheduled workdays to
construct the composting latrines. Each work team will be assigned to
construct a single composting latrine at an individual time. One person
from each work team will be trained as the “group technician”, or leader
of the specific composting latrine construction. A PCV will supervise
each work team, and guide the construction if any problems or questions
arise during the process.
3.5.4 Monitoring and Evaluation: In order to evaluate the functionality of
each composting latrine, the health committee and the current PCV will
inspect each composting latrine on a bi-weekly basis. Based on standards
regarding proper use, cleanliness, odor, and overall appearance, each
composting latrine will be given a grade made visible to the citizens of
Kuite. Through proper monitoring, the health committee and the PCV can
locate functional flaws in the composting latrines, or provide additional
education support as needed.
3.6 SUSTAINABILITY
Creating a sustainable project and a sustainable system is a priority concerning Peace Corps
supported projects and programs. The lifetime of the composting latrines, the implementation,
the application of compost, social acceptance, and behavioral change are all aspects in whether
or not the sanitation improvement program will be successful and sustainable in the community.
From the choosing of the proper sanitation system in Kuite, to the formation of the health
committee, the community and the PCV has made efforts in bringing longevity to the program.
One reason composting latrines are more beneficial than pit latrines, is because they can be used
for a longer amount of time. Based on past projects, the Peace Corps’ projected lifetime of a
composting latrine is approximately 20 years when maintained appropriately. The current
training and capacity building concerning composting latrines will prepare the participating
families to build an additional composting latrine in the future if need be. The current PCV is
working with the health committee in creating a more affordable composting latrine that utilizes
local resources.
11. ! 11!
Through the composting latrine project it is expected that diarrheal illnesses will decrease,
sanitation behaviors will improve, and transmission of fecal-oral diseases will lessen. There is
however the risk of unintentional consequences. Because behavioral change is often a coercive
process, there is the risk that the new sanitation practice will not be implemented. There is also
the risk of misuse and a lack of proper maintenance that can lead to various sanitation household
issues. Although these potential consequences are possible, steps are being taken to ensure the
resiliency of the program.
The directives that will most support a sustainable system have already been completed through
capacity building, composting latrine education, and the pilot composting latrine program.
Preparing the community was the largest step towards laying a foundation for a successful,
sustainable program; however, there are many directives that will be created to ensure a
maintained system including:
1. Health committee support: One of the main purposes behind the creation of a health
committee will be to monitor the progression or potential issues with the composting
latrine program. Bestowing education, knowledge, and power to the community will
bring support from within Kuite.
2. Inspections: A continuation of bi-weekly inspections and grading to rate the functionality
of each individual composting latrine
3. Additional PCV support: An additional PCV will be requested to assist Kuite is the area
of Sustainable Agricultural Systems (SAS). A SAS PCV will be able to assist and guide
community members in using compost in a healthy and proper manner.
12. ! 12!
4.0 BUDGET
This budget was prepared with the assistance of community members of Kuite and the guidance
from the current PCV. This budget reflects the funds necessary to continue with Kuite’s
sanitation improvement project. The funds necessary to complete this project total $ 4,817.38.
4.1 BUDGET NARRATIVE
To achieve the funding required to continue with Kuite’s sanitation improvement program, the
current PCV is applying for a Peace Corps Partnership Program (PCPP) grant. The PCPP
program gives projects, such as Kuite’s composting latrine project, the opportunity to seek
funding through private sector donations (individual or organization). This is an imperative step
in terms of funding. Families in Kuite do not currently have the financial capabilities to venture a
project of this sum; however, pursuant to the Peace Corps’ standard regarding funding PCPPs,
each participating community must contribute at least 25% of the total cost of the project. This
25% does not necessarily need to reflect monetary support, but can be offered through labor and
local resources.
Although the participating families will not be able to contribute monetarily, each family will
support the project through labor support, in addition to the local funding though the local
resources of wood, sand, and gravel. Through labor and material support, the community
members will be contributing approximately 57.57% towards the composting latrine project.
4.2 BUDGET PROPOSAL
Community ContributionGrant
Contribution
Cash In-Kind
Total ($US)
Labor ~ ~ 5,712.00 5,712.00
Materials/Supplies 2,236.10 ~ 825.60 3,061.7
Equipment 1,141.28 ~ ~ 1,141.28
Material Transport 1,200.00 ~ ~ 1,200.00
Travel/Food 240.00 ~ ~ 240.00
Total $4,817.38 6,537.60 $11,354.98
% Contribution Cost ($US)
PCPP’s Contribution 42.43 4,817.38
Kuite’s Contribution 57.57 6,537.60
Total Cost of Project 100% $14,721.68
14. ! 14!
5.0 CONCLUSION
The Peace Corps has implemented sanitation projects throughout Panama in reaction to
preventable illness and deaths associated with fecal-borne related diseases. The Peace Corps has
worked alongside several communities in creating and rehabilitating sanitation systems, in hopes
of reducing preventable diseases. Kuite has worked effortlessly alongside the Peace Corps in
creating a health initiative such as the proposed sanitation improvement. Through the
implementation of the composting latrine project, community members hope to make a
difference in their hygienic lifestyle and health practices. Furthermore, citizens realize the impact
this can make in protecting the health of Kuite’s youth. In reaction to Kuite’s expanding
population and large youth cohort, in is imperative that sanitation improvements are
implemented now in hopes of curbing future sanitation issues.
Kuite’s sanitation improvement program is the next necessary component in promoting and
protecting Kuite’s public health. Parallel with improving access to potable water, creating a
functioning sanitation system can contribute towards a decrease in diarrheal related illnesses and
deaths, a stronger public health, and can also lead to fewer sick days associated with work and
school. Yet, this project has even broader implications for the entirety of Kuite.
Through the composting latrine project, a wider understanding of related topics will help
empower the community as well as prepare them for future projects. Through leadership and
management roles, community members will practice communication and organizational skills.
By establishing a health committee, this group can begin a professional dialogue with
organizations, such as the Ministry of Health, in gaining support for additional health initiatives.
Members of Kuite will also have an increased knowledge of construction for future projects;
however, the most essential goal of this program is protecting the health of Kuite.
There is a stigma in Kuite and the surrounding communities regarding the naming of infants
younger than the age of one. Some locals attribute this to cultural, socials, or religious norms.
Others claim this is in direct relation to a high infant mortality rate (IMR). Many infants in Kuite
and surrounding communities have succumbed to diarrheal related deaths due to a lack of
potable water and proper sanitation systems. This composting latrine project can extinguish such
a stigma and will ensure the protection of Kuite’s children, Kuite’s public health, and Kuite’s
potential to succeed in future projects concerning health and education.
15. ! 15!
6.0 REFERENCES
Mihelcic, James, Lauren Fry, Elizabeth Myre, et al. "Composting Latrines." Field Guide to
Environmental Engineering for Development Workers. Reston:
United Nations (UN1)"Tackling water, sanitation, energy nexus key to sustainable future â!“
UN officials." UN News Center. UN, 18 Feb. 2014. Web. 20 Mar. 2014.
<http://www.un.org/apps/news/story.asp?NewsID=47165&Cr=development+agenda&C
r1=#.UyKUWVFdVWb>.
United Nations (UN2). "The Millennium Development Goals Report." United Nation. UN, n.d.
Web. 4 Mar. 2014. <http://www.undp.org/content/dam/undp/library/MDG/english/mdg-
report-2013-english.pdf>.
United Nations Children Fund (UNICEF). "Why Improved Sanitation is Important for Children."
UNICEF. UNICEF, n.d. Web. 17 Mar. 2014.
<http://www.unwater.org/wwd08/docs/kids-sanitation.pdf>.
World Health Organization (WHO 1). "Health through safe drinking water and basic sanitation."
WHO. World Health Organization, n.d. Web. 19 Mar. 2014.
http://www.who.int/water_sanitation_health/mdg1/en/.
World Health Oganization (WHO 2). "Diarrhoeal disease." WHO. World Health Organization,
n.d. Web. 18 Mar. 2014. <http://www.who.int/mediacentre/factsheets/fs330/en/<
17. Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3
First
Observation
Second
Observation
Third
Observation
Household water treatment No treatment
Occasional treatment by chlorine,
boiling or SODIS
Consistent treatment by chlorination,
boiling or SODIS
Household water storage
Water is stored in unsanitary
containers on the floor or within reach
of children or animals
Water is kept off of the ground but
containers to not appear to be
cleaned regularly
Water is kept off the ground in regularly
clean containers.
Household water use
Water is used for washing, drinking
and cooking out of any container.
Anyone can access the water.
Drinking water is separated from
wash and cook water but anyone can
access it. Wash water isn't offered
before eating.
Drinking and cooking water is
separated from wash water and is
managed by an adult with clean hands.
Water is offered to wash hands before
eating.
Household faucet area
Faucet area is dirty/muddy, there is no
tap stand. Faucet leaks and tube is
not buried.
Tap stand present and relatively
clean. Tap may leak or tubes
exposed.
Tap stand area is clean and cared for.
Faucet is clean and does not leak.
Tubes are buried.
Total Points Section 1 0 0 0
Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3
First
Observation
Second
Observation
Third
Observation
Waste disposal
Leave trash out and do not dispose of
trash appropriately (burn plastics while
cooking food).
Burn all trash or occasionally deliver
trash to nearby dump site, if available.
Members bury and burn their waste
appropriately or take it to a dump site, if
available.
Drainage/Standing water
Frequent standing water and mud.
Mosquito larvae are present.
Some drainage, but some standing
water
No standing water and there is good
drainage around the house
Mosquito control
Mosquito nets are not used. Fire and
smoke is used to deter mosquitoes.
Mosquito nets are used for infants or
coils are used regularly.
Mosquito nets are used by several
family members, and coils are used.
House Structure
House is in need of much repair, mud
is visible in the house, uneven floors,
leaking, and other issues are visible.
House is in need of some repair but in
decent condition
Well built house that keeps out weather
and pests, relatively new roof, hard
packed dirt, wood, or cement floor
Placement of fire hearth/kitchen
Kitchen area is close to sleeping/living
area and has very poor ventilation
with a lot of smoke.
Kitchen is in the same building but far
from living/sleeping area, with decent
ventilation.
There is a separate building for kitchen
with good ventilation. May have a fire
hearth that is above floor and/or
contained, improved stove, or use a
gas stove.
Total Points Section 2 0 0 0
PEACE CORPS/PANAMA ENVIRONMENTAL HEALTH PROJECT
Section 2: Home Sanitation
Section 1: Household Water
HOUSEHOLD LEVEL WASH INDEX (Water - Sanitation - Health - Hygiene)
18. Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3
First
Observation
Second
Observation
Third
Observation
Distance from House
Latrine is far too close to a house
(within 10 feet)
Latrine is 15-30 feet from a house. Latrine is 30 to 50 feet from any house.
Distance from Water Source
Latrine is far too close to the water
source (within 30 feet).
Latrine is 30- 50 feet from the water
source.
Latrine is 50 to 70 feet downhill from
the water source.
Covered Hole
Latrine has no top and is left
uncovered most or all of the time
Latrine has a top but is frequently
uncovered
Hole has a top and is always covered.
Privacy/enclosed area
Latrine does not have a door, walls or
roof that are well built or is not
enclosed, allowing frequent entry from
animals and others creating unsafe
and unhealthy access
Latrine has a door, walls and roof, but
they are somewhat decayed and
sometimes allow entry of animals.
Latrine has a door, walls and roof that
are well enclosed, provide privacy and
are safe from the entry of animals or
children.
Pit Latrine:
Appropriate depth/maintenance
Latrine is below the water table, fills
up when it rains, overflows, or is near
to full (within three feet of surface)
Latrine is above the water table and
does not fill up when it rains. It may
be near being full and needing to be
topped off (within five feet).
Latrine has appropriate and proper
depth; it does not fill up with water
when it rains and is at least five feet
below the top (fill)
Pit Latrine:
Ventilation
Latrine does not have proper
ventilation; there is either an enclosed
space with no ventilation, or
ventilation due to a lack of enclosure.
Latrine has piping and moderate
ventilation within some kind of
enclosure.
Latrine has appropriate and proper
ventilation through PCV pipes within
well enclosed areas
Composting Latrine:
Appropriate use/maintenance
Foul odor is present, no dry material is
available, both chambers are being
used, liquid is present in the
chambers, the seat is dirty/urine tube
clogged.
Dry material is present but the
chamber shows inconsistent dry
material use, some odor is present,
not everyone in the family is using the
latrine, compost is not harvested on a
regular basis.
Latrine is used properly by the whole
family, the seat is clean and covered
when not in use, there is no odor, dry
material is available and present in the
chamber, compost is harvested and
used properly.
Total Points Section 3 0 0 0
Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3
First
Observation
Second
Observation
Third
Observation
Pens and Enclosed Spaces
There is no penning of any animals.
Animal feces are present in the yard.
Pigs are penned most of the time.
Chickens may have pens, but are free
range much of the day. Some pens
may be near water sources.
Chickens and pigs and other livestock
are kept in enclosed areas or pens
most of the time, including chickens.
Homes may have perimeter fences.
Pens are not near a water source.
Animals in the House
Animals roam freely in and out of the
house. Animal feces are present in
the house.
There is no barrier to keep pigs and
chickens out of the house, but most of
the time they shoo animals out, other
than the roosting fowl.
There is a barrier to keep pigs and
chickens out of the house at all times.
When animals get in, families shoo
them out. Some families may keep
dogs and cats out.
Animal disease
Dogs and cats, and other animals
appear diseased and sick.
Dogs and cats are relatively disease
free.
All animals, especially dogs and cats,
are visibly disease free.
Total Points Section 4 0 0 0
Section 3: Human Waste Disposal
Section 4: Animals Around the Home
19. Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3
First
Observation
Second
Observation
Third
Observation
Keeping food
Leftover food is kept out and
uncovered, flies are present
Leftovers are kept in kitchen area and
covered.
Leftovers are covered and disposed of
before they go bad.
Food preparation
Hands are rarely or never washed.
Food may not be cooked thoroughly.
Vegetables are not cleaned before
cooking.
Hands are sometimes washed. Food
is thoroughly cooked. Most
vegetables are rinsed with water
before cooking.
Hands are washed prior to cooking,
food is thoroughly cooked, vegetables
are washed before cooking, ideally with
bleach, meat is clean, separate utensils
and surfaces between meat and
vegetables, or cleaning between use.
Cleaning of dishes and utensils
prior to cooking
Rinsing dishes in non-potable water
without soap, or reusing water to rinse
dirty dishes. Leaving utensils and
dishes uncovered most or all of the
time.
Wash without soap or bleach. Dishes
and utensils are usually covered.
Utensils and dishes are kept in covered
containers most of the time and
overnight. Wash using soap or bleach.
General cleanliness of kitchen area
Floors and surfaces are not kept
clean. Insects (flies or cockroaches)
are visible.
Floors and surfaces are sometimes
clean. Just water is used to clean.
Floors and surfaces are kept clean.
Bleach, soap or lime is used frequently.
Clean drinking water
Drinking water is unclean or not
available.
Clean drinking water is usually
available, but may not be kept
covered.
Clean drinking water is available in
covered containers, or potable water is
available and safe to drink.
Total Points Section 5 0 0 0
Section 5: Kitchen Habits
20. Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3
First
Observation
Second
Observation
Third
Observation
Tooth brushing
No visible toothbrush. Teeth are visibly
unhealthy.
At least one toothbrush is visible.
Teeth may sometimes look healthy.
Multiple toothbrushes visible,
Toothbrushes. Are kept clean and/or
covered. Teeth look healthy.
Hand washing
No water, or soap is visible. Family
rarely or never offers water for hand
washing.
Water is available and visible. Family
offers water to wash hands.
Soap is available. Water is available,
clean and covered. Family offers clean
water to wash hands.
Latrine use
There is no latrine, or if there is one, it
is clearly not being used for its
intended purpose.
There is a latrine. It seems to be
used.
Latrine is available for use and is
clearly used by family members on a
regular basis. Family member will
frequently wash hands after using the
latrine.
Footwear
Most family members don't wear
shoes. Shoes may not be available.
Some members of the family wear
shoes. Shoes are available for wear.
Most members of the family have and
wear footwear (including flip flops)
Bathing and Personal Appearance
Most family members appear unkept
(don't wear clean clothes), and do not
smell fresh most of the time. Members
of the family are not seen bathing
daily.
Many family members bathe daily, but
without soap. Children may not be
washed thoroughly. Many members
of the family wear clean clothes most
of the time. Children may be dirty.
Most or all family members bathe daily
with soap. Children are washed. Most
members wear clean clothes, have
clean hair, and smell fresh most of the
time.
Illness
Family members appear to be sick:
coughing, sneezing, mucus and
general malaise. No one goes to the
clinic when ill. No medicine or
treatments are present.
Some of the family appear to be sick.
Will visit clinic when symptoms persist
or illness becomes grave. Knowledge
on disease and illness is low.
Family members appear healthy with
not complaint of malaise. When they
are sick they will go to the clinic and
receive treatment. General knowledge
on disease and illness is shared.
Total Points Section 6 0 0 0
Outcome Indicators Capacity Building Needed = 1 Capacity Developing = 2 Strong Capacity = 3
First
Observation
Second
Observation
Third
Observation
Quantity
Family members are hungry and
appear malnourished. Children are
thin and look too small for their age.
Family members usually eat two
meals a day or the meals are not
quite enough, do not appear
malnourished.
All members of the family eat three full
meals a day and appear nourished
Sweets & Snacks
Family members feed sweets and
snacks as a meal or let children eat
them very frequently.
Family members give kids sweets
and snacks but not every day or as a
meal.
Family members don't regularly give
children sweets and snacks and
discourage eating them frequently.
Quality/Balanced Diet
Families rarely or never eat fruits and
vegetables.
Families occasionally eat fruits and
vegetables.
Families regularly serve a balanced
diet, including proteins, fruits and
vegetables.
Total Points Section 7 0 0 0
Total Points 0 0 0
Section 6: Personal Health and Hygiene Habits
Section 7: Nutrition
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