Safe pair of hands

In Kenya, a powerful mix of improved access to sanitation and better hygiene education is helping clean up slums and protect the people who live in them.

Active Project

The Challenge

Kisumu is Kenya’s third largest city. Most residents live in informal settlements without access to clean water or toilet facilities, causing serious health problems.


  • Many landlords only provide a single toilet for multiple families to use. These are often in poor condition, rarely cleaned and don’t include hand-washing facilities.
  • Lots of people go to the toilet outside, so everyone has to live with poo everywhere.
  • All this poo attracts flies who spread diseases like typhoid and dysentery.
  • The pipe network is old and in need of repair, so the water supplied is often contaminated.
  • Diarrhoea is a common problem for children. It stops them getting vital nutrients, and causes malnutrition and stunted growth.
  • With nowhere to wash hands safely, diseases are easily passed between people and outbreaks are common.

“Children would suffer from diarrhoea and stomach aches. There was a time when there was a cholera outbreak, and one of our staff members passed away.”

Rose Odero, school teacher, Obunga

The Ingenious Solution

We improved sanitation and hygiene practices by supporting the local community to take the lead in creating new systems and services to ensure clean, safe water and toilet facilities for everyone.

These are some of the project’s activities:

  • Design sessions were conducted with locals before fixing 3kms of water pipeline extensions, and constructing 2500 new water points alongside supporting 2750 households with children under 5 to build handwashing facilities.
  • We showed families, teachers and those caring for children how to practise good hygiene and how diseases were spread. Keeping children safer.
  • This was supported by the creation of a ‘hygiene promotion and early childhood health working group’ to conduct public health campaigns and provide educational materials to spread the word within the community. Increasing awareness.
  • We trained up community water operators to take charge of resource management, infrastructure maintenance and payments.
  • Supporting local artisans to manufacture low-cost soap and other handwashing facilities.

“We teach people how to wash their hands properly before and after eating to avoid communicable diseases. I’m passionate about sanitation. I was born and grew up here and want to change it. That is why I volunteer. We must do something to help.”

Maurice Ongawo, Community Health Champion, Kisumu, Kenya

  • Josephine’s Story

    Josephine Muhonja, a 36-year-old mother of three children (1 boy and 2 girls), has been struggling with looking for remedies to help her youngest 30-month-old daughter recover from persistent bought of diarrhoea. During her pregnancy, Josephine attended all the antenatal clinics and made sure that she gave birth at Kisumu District General Hospital. Giving birth in a government hospital doesn’t guarantee mothers that their children will survive early mortality in rural areas. Mothers are often plaque by high levels of poverty and limited basic services such as adequate and clean water supply and poor hygiene practices.

    In August 2019, Josephine’s daughter started experiencing sleepless nights due to constant diarrhoea. Her daughter became a poor feeder, yet children her age, as Josephine observed, had no such feeding difficulties. She took it upon herself to inquire what the problem might be from her neighbours.  A common practice in the African community, whereby advice for health, financial or spiritual guidance is sort from one’s neighbours. “I decided to confront some of my friends who advised me to be patient with her as it was the teething process that affects babies”, she explains.

    However, Josephine wasn’t convinced with their answers as each day her daughter kept losing weight. During this time, one of the project’s community health volunteers who was doing routine household follow-ups in her neighbourhood identified her and introduced her to the project nurse and nutritionist who booked her for an appointment.

    When I went over to the clinic, my baby was found to be underweight, and she had started developing stunted growth-related complications. She was immediately put on nutrition supplement, and I was enrolled for hygiene and sanitation training where I realized that I always have to wash my hands when preparing food for my daughter, changing her nappy and boiling her drinking water,” Josephine narrates.

    Practical Action through its Kisumu Urban Apostolate Programmes’ (KUAP) Safe pair of hands project has set up interventions within the County to address diarrhoea causes whereby many children are caught in a cycle of malnutrition.

    After several months of training at the clinic, Josephine has mastered proper hygiene and sanitation practices. She washes her hands before attending to her babies, washes food before cooking and treats her drinking water and stores it in clean containers.

    Cases of diarrhoea among children under five reported in the health facilities managed by Practical Action’s implementing partner – KUAP have in the last one year reduced by 2.5% in Nyalenda and Obunga informal settlements in Kisumu, where the Safe Pair of Hands (SPOH) project is being implemented. Through this project, Practical Action aims to improve lifelong health and nutrition for under-five children by improving access to clean water and handwashing facilities by facilitating community-led design and management of these services and health promotion to facilitate proper handwashing by young children and their caregivers.

Our ingenious approach combines different solutions that act together to bring about an enormous and lasting change.

All public donations were matched pound for pound by the UK Government.

Donations from the UK public supported Practical Action’s work with communities around the world.

Donations matched by the UK Government were used to help families in Kenya.

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