 The next speaker is Dan Wolfe. I don't have a copy of the program here, so it's sort of like speaking from ignorance. But a title of, okay, Dan is the director of the International Lifeline Fund, and he will be speaking about his work in Uganda about mobilizing communities to improve water and energy and sanitation. And I believe that Daniel has a really interesting background in history. He might say just a few words about what brought him to this project. So, I'm Dan Wolfe. I'm the founder of the International Lifeline Fund. I'm a human rights lawyer. I'm a lawyer who's done a lot of work in human rights, I should say. I had been successful in a particular lawsuit, believe it or not, against the government of Iraq many years ago, several years ago, for taking Americans hostage during the First Gulf War. And as a result of that, I got a nice little legal fee, and I used that to start the International Lifeline Fund. Our goal is to promote sustainable interventions that would have the greatest possible impact in improving health and reducing human misery at the lowest possible cost. And when you're putting your own money into these things, that becomes a very important thing to you. We have projects in Uganda, Darfur, Kenya, Haiti, and Tanzania. At least we've had projects in those five countries during the years since we established the organization. We became operational in 2006, and initially we worked mainly with refugees and displaced persons. But now we work largely with impoverished communities. Our largest project is in Uganda, a country of 35 million, where 90% of the population rely on biomass for cooking. That means they are cooking with charcoal and wood. 40% of the population lacks access to clean drinking water, a significantly larger percentage lacks access to adequate sanitation. And this isn't a country of 35 million people. So over the last seven years, Lifeline has provided 270 clean water points. And we have distributed, and or sold, 120,000 stoves. Those are our two main projects, clean water and clean cooking. The stoves save 50% on fuel use and approximately 1 million beneficiaries during that period. In 2003, Lifeline began what is what we call the H2O Plus project. It is a holistic intervention that is designed to ameliorate the dire health and socioeconomic conditions confronting impoverished villagers throughout northern Uganda. And we are commencing this project in Apoch District. Now, the project is focusing on two particular interventions, clean water and clean cooking. With clean cooking, we are providing clean cooked stoves. So why water and why stoves? Well, in the time that I've gone out to impoverished communities in Africa, I can say that if you are in a rural village in Africa and you want to do two things that will most impact the lives of an African villager and the health and livelihood of that community, you will address the issues of clean water and you will address the issue of cooking. Clean water we all know about, that's what everybody is gathered here for. A few people know much, I would think, about the cooking issue. And when I try and promote what we're doing to people, this is what I have to spend all my time explaining because it's not immediately obvious, but you can imagine if you did not have a stove in your house and you did not have any way to get to cook things, what would you do? There's no fuel, there's no electricity, there's no gas, there's no propane, nothing. You'd have to go outside, you'd have to chop down some trees, you'd have to build a fire. Pretty soon if you're in a community with a few hundred people, there are no trees around, and you have to go further and further out. So you're spending a lot of your time collecting firewood and then cooking with it. It's a very, very time consuming task. So it's also a very dangerous task. So these are two things, if you look at Juliet's slides, that once you get past the infant mortality stage, these are the two major killers in Africa in village life. 22,000 children in Uganda under the age of five die due to waterborne disease. 20,000 Ugandans die every year due to injury or air pollution. That is what's causing the acute respiratory infection, the pneumonia, the high rates of disease, of morbidity and mortality. In terms of time, I think that it's no exaggeration to say that the engines of African village life are women. And the problem is, is that the typical household, and what I mean here really is the typical Ugandan woman, and you might say typical African woman, spends two hours of her time every day collecting water. Another two hours of her time every day collecting wood, and somewhere between maybe about five or six hours a day cooking. So that's 10 hours a day. That doesn't leave a lot of time for the engine of economic activity in the village to do other tasks. So that is why we are trying to challenge, to attack both of these particular problems. The other reason is that in the last two decades, and this is not just Uganda, but Uganda has lost over one third of its forest cover. And a very, very significant cause, if not the chief cause of that, believe it or not, is the use of wood for cooking. Literally, the average African family living in a village will consume 15 trees per day. And if you're cooking with charcoal, per year, excuse me, and if you're cooking with charcoal, you will consume an average of 50 medium sized trees per year. Now, as I mentioned before, we are focusing on a potch district with the H2 Plus project. Why a potch? Well, for one, it's only a few kilometers, 50 kilometers from our base. So we can get there easily. It's a manageable size of 370,000. 40% of the people lack access to clean water, making it a very typical Ugandan district. And there was a motivated local government in potch, which obviously makes program implementation a lot easier. And finally, there was the presence of a CLTS project. So we talked a little bit before about community-led total sanitation. This gives an opportunity to compare the CHC approach with the CLTS approach. Our goals for this district, number one, to achieve 100% water coverage throughout the district. Universal coverage, which will require the creation of 350 new water points by 2017. So far, we have, I think we're about 45 right now. In each village where we create a new water point, the goal is to create and establish a CHC, which we are doing. We want to sensitize 35,000 households, that's every single household in all of these villages, on improved hygiene and health practices. Elimination of open defecation in all 350 communities. Our goal is to achieve 60% fuel-efficient stove adoption rate. That means taking people away from open-fire cooking and transforming them into FES, fuel-efficient stove cookers. The reason why we have 60% and not 80 or 90 or 100 is the object here is to get people to buy stoves rather than to give them away. And so we won't sell them to everybody, but we believe that 60% is a reasonable goal. And in the process, create income-generating opportunities for about 3,000 micro-entrepreneurs, manly women. A total cost of $3.5 million, approximately $20 per person for beneficiary. This is just an example of creating a new water point in Apache District. So why CHCs? And why did we get involved in that? Now I have to say that when I first learned about community health clubs, with all due respect to Anthony and Juliet, I thought it was an exciting idea. But I was not 100% convinced it would work. Working in a place like Northern Uganda is a bit different than Rwanda and a bit different, I think, than Zimbabwe. We're talking about a community that is extremely fragile, that has been ravaged by 20 years of civil war, where there is a major dependency mentality. And what this concept of bringing people together in a community and having them sort of rise up on their own, take responsibility for their own health, and gather together every week for 26 weeks or 20 weeks, and that's just the start, is kind of amazing that that could possibly happen. And a little bit unbelievable. This is a dependency mentality community. And if you don't give them, this is my experience, if you don't give people what, no tea and biscuits, no incentive, nothing extra to go to these events, not necessarily that people are going to come. And then these were to be events that are led and orchestrated by local community leaders. In a village of 500 people, 100 households, I was skeptical actually that you could have the capacity in that community to find somebody that could actually run these CHCs, that could orchestrate the program in a way that would be successful and effective. So we started the program, I got some pretty good reports from the field, and just three months ago I went to Uganda. And I did what Anthony did. I didn't tell anybody where I was going. I showed up at the last minute. I didn't even tell my team where I was going because I didn't want to have any, I didn't want the community to have any prior knowledge. I didn't want anybody to know what was happening. I didn't want to see any type of, anything that wasn't exactly what normally happens. So it showed up out of the blue, and truly it was amazing. I was in the communities of about 100 households, I would say at each community, approximately 60 or 70, about 50 or 60 people showed up. Yet they were competing with two other major events during those days. There was a funeral going on in one of the communities, a major funeral. And then in another community there was a major anti-corruption initiative. And yet 60 households from a community of 100 households showed up. The session was mind-blowing, to say the least. I mean, I don't, the way this stuff, this is organized, and the way the women who led the club, communicated to the club, was extremely, extremely effective. There were songs, there were claps, there were, you know, just to get things interesting, there could be drama. And everybody was fixated on the message, and everybody was participating. I would say that 50% of the individuals who participated, who were at the club, actually spoke. Everybody was fixated on what was happening, and it was a single message that was being conveyed. So you couldn't possibly miss the message. And perhaps more than that, and this is something that Juliette and Andrew had never really communicated to me, is that this became the beginning of civic society in these villages, because there was no community organization prior to the establishment of the CHC. So you could see the pride that people had. You could see the sense of ownership was practically palpable. And this becomes a really excellent means of community empowerment. So what we wanted to do is expand the CHCs to cover an area that Anthony talked and Juliette talked about a bit, but is our core program, or one of our two core programs, and really our signature initiative, which is promotion of fuel-efficient stoves. And now one of the problems that we've had is promoting fuel-efficient stoves as an economically-based intervention in villages. And the CHCs are going to become a vehicle for that. Now, in order to be successful for a stove program, really you can give stoves away for free. You can train people, but ultimately how many can you train and how many stoves can you give? Not too many. If you really want to alter and transform the way people cook, you have to do this through private markets. And we have been trying to do that at Lifeline, and we've had some success doing that in towns where people cook with charcoal. We have sold 40,000 stoves since 2008, and it's possible to do this. It's difficult, but what makes it easier is that people are cooking with charcoal. And in literally six weeks, this stove, which costs us about six or seven dollars to produce, and we sell for about nine or ten, or eight, will pay itself back. So soon the individual who's buying the stove is literally making money off of their investment. The average family spends about, I think, in Africa, literally about eight dollars to ten dollars, and you've gone to about eight to ten dollars on charcoal a month. So if you save 50% of that, that's four or five dollars a month. If you're living on two dollars a day, that becomes a lot of money. The community liked this stove so much they called it the Akelo Kuch. They named it themselves, which means the peacemaking stove, the idea being that it brings peace to the household. So the challenge is how do we sell stoves in rural markets? Our initial goal was to sell them both in towns and in urban and peri-urban areas, but also in the rural areas where most of the people are and where the most extreme poverty is. And we had a real difficulty because while people value money, most people in African villages don't really value time in the same way. So if they don't value time, they're not going to spend their money on a stove. And the problem is you're not going to get somebody in a village, frankly, to spend ten dollars on a stove. So we needed to reduce the price. We needed to deal with the fact that people were not going to pay, that they didn't really have knowledge about the benefits of the stove, and that even if they did, the cost of getting the stoves to them and selling them one at a time makes the program cost ineffective and dwarfs even the price of actually producing the stove. So one thing we set out to do is we developed a new wood-burning stove that only costs us $2 to make. It's efficient, 50% fuel savings, and this is a durable product that could last two to three years. Plus, it's portable. You can take it from one place to another, put inside or outside the home. And this is the model that we have recently developed. I know it looks very simple, but believe me, I've been out there for seven, eight years on this kind of work, and it took a long time to get to this particular point. But this stove is quite good, and it's been tested internally by us. It's being externally tested, and we spent a lot of time and effort on it. We might put a metal top over the stove rather than using the clay one because the first thing that we'll deteriorate are those pot supports. So how are the CHCs going to help us solve this problem? Well, first of all, we'll be dealing with an audience that is already sensitized that already cares about their health, that has already been through the first stage of training. And so this is going to be a very receptive audience for us to sell these stoves to and to sensitize the community. We can sensitize everybody at once because everybody is meeting on a weekly basis anyway. And so everybody is there. We have a phenomenal facilitator, and I'll tell you, the two facilitators that I saw, it was kind of like, I would have thought that these were professional educators, and yet they emerged directly from the village. So we can do the training, we can market all at once, and this group that's formed becomes a collective group that we can sell the stoves to. So instead of doing one at a time, we can literally have a group purchase and bring the stoves in all at once, and that greatly facilitates our distribution problems. So I'm very hopeful we have not reached this stage yet in the project. We're still at the stage where we are providing the health and hygiene training. But from what I've seen, this stands a pretty good chance of working. Thank you. So if there are any questions? Do you want to do yours and then have questions for both of us? Okay. Questions? I think people want to come up here. Thank you, Dan. My name is Jen Navnyamurumba, and I'm from Uganda. I have two questions. How are you planning to work with the water source committees? Policy requires that each source should establish a water source committee. And then you're planning to establish community health clubs. How do you plan to link the two? Because that is a policy requirement. And the second one, how do you also plan to relate and link with the village health teams, the extension staff at the district level, at the sub-county level, at the parish level? Because that is within government requirement. So if you could clarify that for me, then I would be very happy. And then lastly, it's just a comment. I'm actually using the stove in my house. The calicooch? Yes. What do you think of it? It's great. Are you from Northern Uganda then? Oh, okay. Great. Well, it's good to know that the stove has gotten out there. So let me answer those questions. First of all, in every community where we establish a water point, yes, we do also establish a water user committee. We did that. That preceded the establishment of the community health club. So the water user committee, we have been creating separate from the health clubs. But if I'm not mistaken, do you in some instances actually have the health, the user committees established through the health club? Yeah. So we haven't done that before, but I'm sure that is going to happen. And I think also that the water user committees in some sense then become responsible, answerable to the health club. So the health club actually becomes an extra source of monitoring the effectiveness of the water user committee. Because if people don't perform, you now have a unified club that can take action. Whereas in the past, if a water user committee doesn't perform, there's really no one to go to. So I think that the two work hand in glove. Have I answered that full question? I think so. I'm sorry. The next part of the question concerning the relationship with government. So the reason, as I mentioned initially that we chose a posh district is that the government was, we worked with them before. They are extremely receptive to this particular intervention. And actually they have, we moved our water team to a posh district. They gave us a office within their headquarters out of which we work. They choose all of the water, we work with them in choosing each water point. And so we work with each level of government in doing all of those interventions. Okay. I think we should take one or two more questions. It's obviously Mr. Truba, I think at the back. We'd love to see your face. Thanks. Great presentation. At the beginning you mentioned, oh, I'm sorry, my name is Dave Truba. I'm with the Water Supply and Sanitation Collaborative Council. At the beginning you mentioned choosing a posh because there was also an ongoing community led total sanitation program. And by working there you have the opportunity to perhaps link with it or compare the CHCs. I wonder if you could just mention a little bit about how that worked if it went well or if there were challenges. Well, I should say that's a little early. So it's hard for me to answer that question. It's just that the government has been implementing those projects and in the villages where we've been operating, we're establishing the CHCs. So and all of those villages that I know of, there is not yet a CLTS established in the same villages where we have established CHCs. So side by side we'll be eventually we can compare results. But that wasn't, I wouldn't say that was a principal driver. So I don't really have much more to add to that. Thanks. It was sort of a side benefit. Hi, I'm Michael Davidson. I'm an agricultural consultant doing work on the catalyst program in Uganda. The question is this, as you go around the villages, you're working with CHCs, do you think they're a venue for educating population on agricultural techniques, irrigation, et cetera, et cetera, et cetera? That's an excellent question. I mean, I think the CHC has become an excellent vehicle for introducing all kinds of initiatives into the villages. Obviously it has to be one at a time. But I don't see why. The thing is you're dealing with a highly motivated group of people who are trying to better their lives. And so you have a receptive audience. Right now as at this point there hasn't been any program specific? No, no, not yet.