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The top priority of FOTO is to eliminate water-borne diseases in Lower Nyakach. To accomplish this, FOTO has taken a three-pronged approach of:

  1. Using practical field methods involving community members to assess the bacterial quality of drinking water sources;
  2. Educating communities, including schools, about the relationship between faecal contamination of water and disease using evidence-based bacterial tests;
  3. Introducing readily available household water treatment and storage (HWTS) methods. In addition to improving the health of citizens in Lower Nyakach, this project aims to be an example of what can be accomplished by a community-based organization, at low-cost, to significantly decrease water-borne diseases and improve livelihoods.


PML items

The Metcalfs and FOTO Board Members with the donation of PML items

The main priority of FOTO is to eliminate water borne diseases to ZERO within the project area. To accomplish this,  FOTO conducts water testing activities in the locations to sensitize the community on the contamination of the few available water sources through testing with a simple Portable Microbiology Laboratory. This is a  household level water quality test that detects and quantifies E.coli in a 1 ml and 10ml. Using the PML, Water quality can be assessed in any setting by community members without formal education.

Water quality testing is performed using two commercially-available tests for the fecal indicator bacterium Escherichia coli: the Colilert 10 ml  test and the  Petrifilm quantitative test for 1 ml.  After incubation for 12-18 hours, the presence of E. coli is indicated by a fluorescent blue color in the Colilert tube, and by a blue colony with a gas bubble on the Petrifilm.

FOTO staff includes 2 women from each of the 13 Locations in Lower Nyakach. They are the link to their communities. They have been trained on:

  • basic microbiology
  • the choice of coli as the best indicator of recent faecal pollution
  • how to perform the two PML tests
  • incubate them at body temperature
  • to promote bacterial growth, and
  • correlate the next day results with WHO disease risk categories: low (< 10 coli/100 ml, moderate (10-99 E. coli/100 ml, high (100-1000 E. coli/100 ml), or very high (>1000 E. coli/100 ml) (WHO, 1996), that communities are aware of the state of their drinking water.

FOTO educates the community  on the relationship between fecal contamination of water and disease. This is done by mobilizing  community meetings, schools, organized women and youth groups, churches etc. The teaching component demystifies biology  and leads to an understanding that their contaminated drinking water sources must be treated every time to prevent water borne diseases like typhoid, cholera and dysentery. Also to help prevent high mortality rates especially among children under five years and adults that occur annually due to contaminated drinking water. People are often surprised that their water sources are so very contaminated and begin to understand why they suffer so much stomach problems and fever. They vow not to drink that water again before treatment. At this point, their question is,  What can we do?

FOTO then introduces two interventions. Two HWTS methods are used:

The first is a Aqua Guard, a 1.2% solution of sodium hypochlorite that comes in a 150 ml bottle. A cupful, 3 ml, is used to treat water in a 20 litre jerry can. A bottle of Aqua Guard treats 1,000 litres of water, sufficient to last most families at least two months.

In February, 2012, FOTO started distributing aqua guard at no charge to 4,800 families. By August, 2013, 7,200 families were given Aqua Guard every other month, providing 40,000 people with the ability to treat their contaminated drinking water sources.

FOTO distributes water guard to the community members for treating their drinking water every month. A total of 7,200 bottles of water guard are distributed in the twelve Locations every  month. With a total house holds being 15000, we ensure that as much as possible every family has a bottle of water guard to treat their drinking water all the time. This is done with partnership with the Ministry of Health. The community Units help to distribute the water guard to house holds under them and our FOTO Village Access Facilitators  do follow ups on all house holds in the locations to monitor uptake and impact of the use of water guard in the households.

solar cooking

Solar cooking demonstration

The second method is the use of a simple solar cooker that uses sunshine to pasteurize water. A wax-based, reusable water pasteurization indicator (WAPI) verifies that the water is pasteurized at 65°C thus enabling users to see when their water is safe to drink.  FOTO distributes safe water packages in the community and holds solar cooking and solar water pasteurization education in the locations twice every month. This enables the people to be able to use the solar cookit to ensure their drinking water has been treated for ecoli and is safe for drinking.

The treated water is then kept in a safe water pot with a tap and a very narrow mouth to avoid dipping cups in the water to draw drinking water. This helps keep the water free from contamination until it is finished. The people love to keep their water in this pot as they say the water is sweet, cold and very nice to drink. Many people now enjoy drinking water and are happy at the new development. 100 families per month receive a Cookit, WAPI, and ceramic safe storage container, enabling solar water pasteurization of 5-10 litres on sunny days.

The people are also taught on how, when and why to wash hands and the importance of keeping their environments clean and free from dirt and faecal matter. FOTO also teaches how to install Tippy Taps in homesteads so that people can wash their hands after visiting the toilet. FOTO staff does home visits to install the tippy taps and teach how to install.


  • The in-charge Pedo Dispensary in Kandaria West Location says No more cases of waterborne recorded in the patients’ register.
  • Joseph Ogwang the Chief of Kandaria West Location says nobody has been sick of waterborne related illness since FOTO project started distributing Aqua Guard to household for water treatment.
  • In East Nyakach Location, senior elder Samuel Obiero says FOTO project has touched and saved many lives from waterborne diseases because they drink clean safe treated water, he says”no more cholera, typhoid and other waterborne diseases in the Villages”.
  • Silpa Odundo a Community Health Volunteer (CHV) in the same Location says “No more referrals’ in regards to waterborne diseases in her community because they drink clean treated water always”.