Melissa Sieffert Etude de Milieu 12/20/16 Kaonguin-Sanrgo, Kaya, Centre-Nord

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1 Kaonguin-Sanrgo (K-Sanrgo) is located in the Center-North region, in the district of Kaya, 12Km due north of the capital of the village commune, Pibaoré. K-Sanrgo is a dissected village with a combined population of 4,194 inhabitants. K-Sanrgo was formerly one large village until a neighborhood of the village, now referred to as Kaonguin, requested a separation from the reset of the village in Because Kaonguin had its own market and school, it considered itself independent from what is now known as Sanrgo. The chief of the village of Sanrgo, Naaba Belemwende, peacefully granted the separation, and Sanrgo went on to start its own market. K-Sanrgo has had 14 village chiefs, all of whom came into power through family lineage except the current village chief, Naaba Belemwende, who was voted into chiefdom through new laws instituted by Upper Volta in According to historic-village documents, a man named Tampogo, from Biogo, a village near Fada, founded K-Sanrgo. Tampogo was fleeing with his brother from his brother s failed chiefdom when they found themselves in a populated area in the northeast. Tampogo was hiding behind an Acacia tree, known in the local language as Kaonguin, when one of the people from the area approached him and told him that he was safe and did not need to hide anymore. Tampogo then went on to tell his brother, there is no worry now, it is safe, which is translated as Sanrgo. Thus the village was founded with the name Kaonguin-Sanrgo: derived from the fact that Tampogo no longer needed to hide behind the Acacia tree because he was safe in the new village. K-Sanrgo has three traditional village holidays: Kitoaga, Kinoodo, and Tangana. Kitoaga is the end of the year celebration meant to help bring in the New Year in November. It is usually celebrated by making offerings of chickens, goats, and other animals, which are then eaten by families. Kitoaga is celebrated over the course of three days. Kinoodo is celebrated one month after Kitoaga. Kinoodo is the equivalent of Thanksgiving in the United States, in which the people of the village give thanks, and celebrate by preparing a variety of food. After Kinoodo, people celebrate general funerals, in which funerals for people who passed away during the cultivating season are finally held, and families honor their ancestors and the dead. It is during general funerals that masks are brought out to dance and perform. Masks are only used

2 in K-Sanrgo to celebrate funerals. Tangana is the last local celebration, and occurs one month after general funerals. During Tangana, the people ask the ancestral spirits and the spirits of the ground to bring a good rain for better crops in the coming year. After Tangana, the rainy season begins, and people begin to farm again. K-Sanrgo makes up a landmass of about 50Km 2, all of which is characterized by dry-brushy peneplain terrain. K-Sanrgo sits in a transitional zone, just south of the Sahel Desert, and has a semi-arid climate. The rainy season begins in July, and abruptly stops at the end of September, with precipitation yields between 600mm and 900mm. According to documents provided by the mayor s office in Pibaoré, between 2008 and 2012, there was an annual average of 39 rainy days in Pibaoré, which resulted in 732mm of rainfall. K-Sanrgo experiences a cold season from November to February, in which temperatures can drop to 60 F at night. The Harmattan, a warm, dry wind that blows down from the Sahara Desert, also occurs during the cold season, and lifts fine particulate matter into the air. At the end of February, the climate shifts into the hot or dry season. The dry season lasts from the end of February into June. K-Sanrgo is an isolated village. It is located 12Km north of Pibaoré and 22Km south of Pissla. The road from Pibaoré to K-Sanrgo varies in quality both along the route and depending upon the season. It is difficult for three and four wheeled motorized vehicles to traverse the road throughout the year. During the rainy season, the road is washed out and virtually impassible to all vehicles. The road from Pissla to Pibaoré is superior in that it is wide and well maintained up until the last 10Km into the K-Sanrgo Aire-Sanitaire. This is due to the fact that Pissla is one of the main stopping points along the paved road from Kaya to Dori. Because of consistent and robust commercial activity from passing travelers, Pissla has the developmental capability to support the construction of reliable roads. Bush taxis depart and return to larger villages farther southeast to K-Sanrgo, such as: Pibaoré, Boala, and Bourba. The main road from Kaya to these villages is a dirt road, and takes two hours to traverse during dry seasons, and up to 4 hours to during rainy seasons. Bush taxis depart from Kaya and return to Pissla almost hourly, and the journey takes minutes along the paved road.

3 As of 2016, there is a total of 4,194 permanent residents living in K-Sanrgo according to Centre de Santé et Promotion Sociale (CSPS) documents, and an estimated 250 households in Sanrgo. Children under the age of five comprise 19% of the population, with children between 0 and 11 months making up 22% of the under-five population. For 2016, there were 1,001 women of reproducing age, 259 expected pregnancies, and 215 expected births. During cultivating seasons, the population remains steady; however, during the dry season, many families migrate to Côte d Ivoire to farm. K-Sanrgo is a subsistence farming community. Families own their own farms and live off what they can grow each season. Families typically do not sell yields from their farms, as the amount produced is typically less than can sustain the family through the dry season. Families only sell their own produce if looking to pay for school tuition, a wedding, or a funeral. In K-Sanrgo, preparation for cultivating season begins during mid-june. Families then maintain their fields throughout the rainy season, and begin harvest in October. Harvest lasts until the third week in November with the construction of granaries for food storage. The most commonly grown products are: millet, corn, peanuts, beans, sesame, watermelons, sambala, gumbo, petite pois, potatoes, and sweet potatoes. Families also raise livestock such as: chickens, guinea fowl, goats, sheep, pigs, donkeys, and cows. These animals are used for sustenance, sale, and labor. Though K-Sanrgo does not collectively produce any commercialized products sold outside of the community, Sanrgo has a small local market populated by a variety of venders both from within and outside of the community. There are five permanent shops that are open daily, and the rest of the market recurs every three days. Generally, venders at the market sell soap, sugar, cigarettes, gateau, seasonal fruits and vegetables, meat, clothes, shoes, plastic-ware, and a variety of services. Additionally, there is a Groupment Épargne, or savings group, comprised of eight smaller women s groups, which grow and sell peanuts and beans at the market. The Savings Group saves about 500,000 CFA each year. There used to be an equivalent men s group, which grew sesame and peanuts for sale at the market; however, this group is now defunct.

4 K-Sanrgo is characterized by dry, bushy peneplain terrain. Most land is dedicated to farming, but un-utilized land is populated by a variety of bushes and trees. The most common trees include Neem, Baobab, and Tamarind. The semi-arid climate results in a lack of water related resources such as marshlands, rivers, streams, or lakes. K-Sanrgo has one large reservoir (Le Grand Marigod), which is filled during rainy season and is depleted by March. The population of K-Sanrgo, as well as inhabitants of surrounding villages, uses this water for drinking, washing, cooking, cleaning, farming, and livestock watering. There are two smaller reservoirs north of Le Grand Marigod, and another located south of K-Sanrgo, next to the road to Pibaoré. Some families construct their own small reservoirs next to their homes to make fetching water and farming easier during the rainy season; however, these reservoirs do not hold more than five cubic meters of water. There are a total of seven pumps in Sanrgo; however, three are broken, three are in danger of becoming inoperative due to overuse, and the CSPS pump is not available for general use. There is one well in the community. Reliable and facile access to proper water resources are difficult due to the number of pumps out of commission. Additionally, the problem is further exacerbated after Le Grand Marigod dries up. Families must travel two to three kilometers to Magdgo to use the well there during dry season. The president of the Community Development Committee oversees the individuals that manage each of the pumps, but none of the community members know how to fix the pumps, or the part that is needed to fix a pump is difficult to find and costly. Most water used for drinking, cooking, and cleaning are derived from groundwater sources and not treated before use. Aquatabs, water-cleansing tablets, are available in village and sold at the CSPS for twenty-five CFA a packet. Almost none of the residences in K-Sanrgo have personal latrines, and it has been reported in early assessments of the village by the CSPS that it is the people s habit to use the wilderness for defecation. There are fourteen latrines with four accompanying hand washing stations surrounding the CSPS that were built by Save the Children, but patients or their families do not use them. People prefer to use the area surrounding the latrines instead. The primary

5 school also has latrines that are used by the school children, but there are not any hand washing stations, though poles for a Tippy-Tap are erected and unused. The typical method of waste disposal is to throw trash on the ground. Families typically keep their courtyards clean and trash-free, but public spaces such as the market and the CSPS accumulate a lot of waste in the form of plastic bags and product packaging. It should be noted that Burkinabé village culture is essentially a zero waste society as the people derive most of what they eat and use from the land. The most polluted areas are those with high commercial activity. K-Sanrgo is the host village for the area s or aire sanitaire s CSPS. The aire sanitaire serves five major villages: Kaonguin, Sanrgo, Wendboulgo, Nasrtenga, and Kossoguin. Many people from outside these villages use the K-Sanrgo CSPS as it is more easily accessible to them. Currently in residence are the Infermier Chef de Pose (ICP), Souleimane Youma, and an Infermier Brevetè (IB), Issaka Kiemde. A birthing attendant was formerly employed at the K-Sanrgo CSPS, but she recently left for further schooling. In order to assist with the growing number of births occurring at the CSPS, the maternity ward will be receiving a Sage Femme. The CSPS is comprised of a main building, a maternity ward, and a depot. The main building is used for consultations, small injury care, vaccine storage, and treatment of patients who must receive overnight care. The main building has a gas-powered refrigerator, four beds, two consult tables, two hand washing stations, and equipment to sterilize medical tools. The maternity ward has a consultation room with a consultation table, a birthing room, and a recovery room with four beds. The K-Sanrgo CSPS is highly active. General consultations occur daily with a special emphasis on malnutrition Monday, Wednesday, and Friday. Baby weighing take place on these days as well, and every two weeks, children identified as at-risk cases, are given Plumpynut as supplied through government contracts with Save the Children. Maternal consultations occur on Tuesday and Thursday. Vaccinations occur in tandem with baby weighing on Fridays, and can result in the attendance of over 100 mothers with their children to receive health services.

6 The K-Sanrgo CSPS has employed six Agents de Santé a Base Communautaire (ASBCs) to help with population-level outreach and aire-sanitaire-wide health campaigns. As of September 2016, ASBCs received a five day training program which informed them of major health issues, and instructed them how to help families identify and access help for such issues. Topics covered included maternal and child health, pregnancy, contraceptives, malaria, tuberculosis, sexually transmitted diseases, pneumonia, and malnutrition. Though ASBCs are not taught animation techniques, they are taught how to make productive and informative house visits. ASBCs also aid in the completion of health campaigns such as those for the prevention of Trachoma, Malaria, and Meningitis. All of which have occurred in the K-Sanrgo aire-sanitaire this past year. The main health issues in K-Sanrgo are Malaria, diarrheal disease, and pneumonia. These are the three main afflictions of the majority of the population.

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8 There are two animators who come to K-Sanrgo to teach essential health practices. Miriam Ouedraogo, an animator for OBCE, comes to K-Sanrgo during the rainy season to teach malaria prevention. Diallo Rama, who works for Marie Stopes International, conducts sessions about family planning. There is no consistent person in village who conducts animation sessions throughout the year on a variety of health topics. The only person who provided such services in the past was a former Peace Corps volunteer, Maria Santamaria. K-Sanrgo has a Village Development Committee (CVD), of which Mathias Ouedraogo is president. The CVD focuses mainly on female empowerment through resource and livestock management. The CVD helps women appropriate farming produce as well as gifts livestock to certain women to raise.

9 The only Non-Governmental Organization (NGO) currently partnered with K-Sanrgo is Marie-Stopes International, which sells discounted contraceptives and informs the community about family planning methods. K-Sanrgo worked with Save the Children UK in the past to build the CPSP pump, hand washing stations, latrines, and incinerator. Additionally, funds from Plan International were used to construct the CSPS in There are three places of worship in K-Sanrgo: a Protestant church, a Catholic church and a Mosque. Protestants make up the majority of the population with an attendance of over 250 people at services on Sunday. With respect to aid-work through religion, the priest of the Catholic Church and his brother oversee the association, Association D Tuum Maneg Tenga, which focuses on development through formations for women. The health of the population of K-Sanrgo hinges on three key factors: health education, water security, and food security. By primarily addressing health education, the successful management of infrastructural-based projects in water and food security is more likely. The families of K-Sanrgo have demonstrated their awareness of the importance of modern health practices by consistently attending CSPS events such as baby weighing days, vaccination days, and national health campaigns. While the motivation to improve health is present, a similar resource to help families not only learn proper healthcare practices, but also understand why they are necessary, is lacking. Thus, the main focus of projects in K-Sanrgo should be based in education with a special emphasis on hygiene, water sanitation, nutrition, family planning, and disease prevention. Project 1: The CSPS of K-Sanrgo has a unique opportunity to promote the health of the community because it is exceptionally well used. Because the people of K-Sanrgo trust and rely on the CSPS to help improve their health, the CSPS can further serve the community by not only serving as the center of health education, but by also serving as the ideal of health practices for families to learn from.

10 One of the long-term and continuous projects that can be implemented is a CSPS beautification and health idealization project. This project which has already been initiated, involves the cleaning and organization of consultation rooms. Consultation rooms are where face-to-face interactions between health agents and the community take place to determine care. Consultation rooms have clutter in the form of boxes filled with papers, old medications, and various medical minutia. Apart from taking up valuable space and lacking a professional air, the clutter further acts as nests for bugs, mice, and lizards. By sorting through and removing this clutter, the consultation rooms will be better organized, make better use of available space, and retain the practice of dignified health service. The second aspect to the CSPS beautification involves using screened doors as well as loose screens to cover open windows and doorways to keep insects, birds, and other pests out of the healthcare facilities. These doors and screens already exist and were simply never installed. A third aspect of CSPS beautification involves making available hygiene tools. Due to a lack of education and maintenance, the large number of latrines and handwashing stations are not used. If the latrines and handwashing stations can be restored to acceptable levels and such things as soap, water, and teapots made available, the use of latrines can be improved. Additionally, if the CSPS makes a No Open Defecation policy around the CSPS, the use of such latrines and washing stations is assured. The last aspect of CSPS beautification involves using the newly open spaces for health education. Murals demonstrating health practices appropriate to K-Sanrgo can be painted on free walls. Additionally, seasonally appropriate health topics can be displayed on one of the two boards available but currently unused in the CSPS. This way, the CSPS will not only serve as a constant source of education, but also become a place people enjoy spending their time. The CSPS beautification and health idealization is a small and continuous project that will require very few external inputs besides labor and small cost for paint and installation, but will result in the transformation of how care is carried out. Additionally, through this transformation, the CSPS will serve as an example of good health practices to help prevent diarrheal disease, malaria, and skin infections.

11 Project 2: By making the CSPS an example of health as well as an educational resource, people can expect to come to the CSPS for more than just care. Thus, the second potential project that can be implemented to promote health through education is by developing a modified Maman Lumieer program. K-Sanrgo and the satellite villages in the aire sanitaire are isolated and difficult to access; however, he CSPS is well used by everyone in the community. Most Fridays, over 100 women with their children attend for vaccinations, baby weighing, and consultations. The CSPS can take advantage of this large number of motivated and health conscious women and hold sensibilizations. In discussions with the major of the CSPS, it has been decided that a woman from each of the satellite villages will be chosen to become the leaders of the Maman Lumieer program. The core four women will undergo training with the Peace Corps volunteer and her community homologue to develop effective sensibilizations techniques focusing on the most relevant health topics in the community at the time. The women will be trained to work independently after a certain period of time such that they are not only able to design and execute sensibilizations with one another, but also train women to help them as well. The expansion of this program will depend on the progress and success of the women over the first six months of training. This is a project that requires very few monetary inputs besides small costs for demonstrations including food, soap, and miscellaneous items for teaching purposes. This project will hopefully serve as a sustainable and regenerative base for health education throughout the K-Sanrgo aire sanitaire. Project 3: The final possible project that can be pursued in K-Sanrgo is a water revitalization project. K-Sanrgo is located at the southern edge of the Sahel desert, and has a semi-arid

12 climate. There are no natural water resources, and the one large reservoir that serves the community is filled and used over the course of 5 months. A lack of water security results in economic and nutritional instability, but one of the more direct effectors of health. As three pumps in K-Sanrgo are unusable, people do not have access to proper sources of water for drinking and cleaning. People have been known to drink directly from the small reservoir, which can result in a variety of water-borne diseases. Diarrheal disease as well as hygiene related skin infections are linked directly to water access and potable water education.