Banjiram Trip -- March 30th

Tank and people waiting in line for water.

We had expected to leave for Banjiram at around 9 AM but it was closer to Noon before we left. Yakubu drove us to Numan and stopped there for a meeting of the Medical Board Staff. A church driver then drove us on to Banjiram. We arrived fairly late in the afternoon and did not have a long time there. Banjiram is town that was relocated when the Kiri Dam was built. It is the only place I have been to in Nigeria with streets laid out in rectangular blocks.

With only one Tap Stand working effectively, the lines are long.

Last year we visited here several times to try to determine how to get the borehole at the school to produce more water. It is a 300 meter deep borehole that is artesian but produces very little water except when pumped. They have gone through two solar powered pumps and one generator powered pump. Our involvement and Yakubu's on-going efforts has lead to having the solar panels tested, the bad ones removed and the total number increased from 12 to 18 and a new high temperature pump with controller installed. This was a collaboration of the town, the Guyuk Local Government, the school, LCCN Medical Board Water Team and Global Health Ministries. The new pump is producing a lot of water. But the new distribution system is not working and the tank is not filling. These are the main complaints. The distribution system sends water to three tap stands. There is one at the water tower with 10 taps (faucets) and two remote tap stands with 8 taps each. The remote tap stands do not get much water so most of the people walk to the tap stand at the tower and join the long lines.

View from the tower of the 10-tap Tap Stand

I am not sure who decided the sizes and locations of the pipes for the distribution system but they got it backwards.The largest and shortest pipes go the 10 taps at the tank and a smaller and much longer pipe run goes to the 16 remote taps that are at a higher elevation. Almost all of the water goes to the tap stand at the tank. The fix is relatively ease but will not be the optimum design because we are stuck with the pipes already buried in the ground. We are proposing to by-pass the tank and pump the water into the distribution system directly. Also we will add to flow control valves to the tap stand at the tank and to the lower of the two remote tap stands. We will let the tap stand at the highest elevation to determine the system pressure. Adjust the two new control valves until we get approximately the same flow from each tap.

When I proposed this the people said "but you have to fill the tank". To this I said "Why? The tank does not need water the people need the water." They argued that the tank provides the pressure for the system and I argued the tank takes pressure away from the system. That if we directly pressurize the distribution system we will give more pressure to the system and may actually fill the tank from the bottom more than it is currently be filled from the top. So far engineering is winning the arguments over "we have always filled the tank first". In many places they turn off the tap stands to let the tank fill and give less water to the people. The priority for me is to give water to the people not fill the tank. My fix may actually fill more water into the tank than the current system. This is a hard concept to understand.

Collection water at leaking joint.

One other costly fix is to replace all of the taps (faucets) with automatic closing valves (spring loaded). The current taps are turned on wide open all the time. Whether there is a bucket under it or not. Some water is wasted. I am sure that this will create complaints. We have a few other minor fixes (sealants on joints to reduce leaks, etc) and so improvements in sanitation but the main fix is the by-pass pipe, the control valves and the spring loaded taps.

March 14th - Day In Abuja

This morning Bishop Ben picked me up with his driver Joseph at just before 11am. We drove out past Nyanya into Nasarawa State to visit Kyungchum Drilling Services to find where they buy their borehole pumps. The technician that buys the pumps was out on a job site. We called him and he directed us to Senior Star Man International Limited. Kyungchum is owned by a South Korean company who does geophysical surveying, borehole drilling, water analysis, borehole maintenance, tank construction and other services. They have branch offices in Gwagwalada (near Pai) and Maiduguri (near the north end of Adamawa State).

After visiting with the driller for a few minutes we drove back to Nyanya to visit Senior Star Man International. The name is bigger than the shop. Bishop Ben requested the boss be summoned so we can talk. It turns out that the owner’s brother is an importer of pumps and according to him the pump sellers from Yola come to him for pumps. It is a little hard to believe because his retail costs are about the same if not higher than at Yola. His card claims he does boreholes and installation. The parts I could not get in Yola to repair the Mark II pump cylinder he had at his other shop in Abuja for 1000 Naira each ($6.40). It would only take 20 minutes to get them. Bishop Ben tried to talk him down on the price but he said he usually sells them for 1200 and had already given us a discount because we were doing God’s work. Having a white man in the room makes it hard to do the regular battering on price. We told him to get 20 of them and bring them over to the church. It was an easy walk from his shop to the church. The Nigerian 20 minutes is like the last minute of a basketball game. From his shop to the Nyanya church is a 5 minute walk or a 15 minute drive. Waiting at the church front porch was much cooler and a little quieter than waiting at his shop. The parts showed up about half a hour after we got to the church.

Nyanya church is now the Cathedral for the Abuja Dioceses. On the other side of Abuja out near the airport they have a bigger plot of land where they plan to build the Secretariat building. My talk with Bishop Ben was fairly wide ranging but we kept coming back to Pai. One thing that the Abuja churches want to do is to build a clinic at Pai. The chiefs have given them a plot of land a few hundred meters outside of Pai. They have started building a dispensary building and have walls part way up. They have run out of funds. After they build the dispensary they hope to add an overnight ward and staff house. When I asked why a clinic he told me that the child mortality rate is very high in the area. Most births are at home with traditional birth attendants. There is little or no prenatal care. If there are complications the nearest hospital is in Gwagwalada. During the rainy season the road can be very difficult to travel in anything less than a large truck or a four wheel drive. We discussed whether they should be looking for a maternity style ward rather than just a overnight holding ward. This will be a better discussion if there were medically trained people involved.

We discussed sanitation and building of VIP Latrines. (VIP is ventilated improved latrines). We encourage people to build and use sanitation facilities but many church facilities do not have them. If we seriously want to reduce childhood mortality we have to reduce intestinal/diarrheal diseases. Simple hand washing with soap will have a bigger impact than a new borehole or improved well. Using a VIP latrine and washing your hands after will have a huge effect on child mortality. This is a hard sell. People feel thirst and can equate thirst with illness. You cannot taste or feel the bacteria or viruses that cause a similar set of symptoms. The cause can be today and effect can be tomorrow the connection between sanitation and illness is not as obvious as water and thirst.
When a team from the church comes to a village and drills a borehole, installs a pump and teaches some people how to fix it when it breaks, the amount of goodwill that translates in evangelism is high. But the effect on childhood mortality is minimal. The water is collected in contaminated containers, stored in containers without protection from contamination. The big payoff for public health comes from maintaining the water clean as well as the food you eat and the hands you eat your food with.

Bishop Ben told me something new to me. That in the past the dispenser would greet their first patients in the morning with a short devotion, pray for their healing, and give a short class on prevention. The patients were pleased that they not only got some pills for their illness but someone prayed for their healing. In all the dispensaries I have visited I have never heard about this. Of course I have never been to one early in the morning and have never asked. The dispensers we have talked to probably thought the devotion as a routine not worth mentioning. But we had asked several about teaching out in the village and few have gone out. As I think about it I do remember something going on at the porch of the Numan dispensary as I walked to the guest house restaurant for breakfast. Note to self: Ask Fidelus if this is a common practice at dispensary.