Ruhiira, Uganda
Ruhiira Cluster: 8 Millennium Villages | Approximate population: 40,000
The Millennium Villages in the Ruhiira cluster are spread over several hundred square kilometers with extremely poor or non-existent roads, making travel between the villages and commercial centers, such as Mbarara, very difficult. As a result, connecting villagers to schools, clinics, markets, electricity, communications, and local government is a significant challenge.
The Ruhiira cluster is situated in the Isingiro District of southwestern Uganda. The region is characterized as a highland region with elevations ranging between 1350m and 1850m above sea level. The hillsides drain into the valley bottoms creating a stream system. Ruhiira has a sub-humid climate with two rainy seasons. The first rainy season of each annual cycle begins in March and ends in May, while the second rains begin in August and end in December but sometimes stretch into following year. June, July and August are generally the driest months.
A significant proportion of the community, which is estimated at between 40-50%, still live in extreme poverty with an estimated annual per capita income of $250. Ruhiira and the neighboring area is a recent settlement, created after clearing a sub-tropical forest reserve in the early 1950s. Since then, extensive transformation of the landscape has occurred due to migration from other areas and natural population increase. Clearing of forest to open land for cropping is estimated to have left about 5% of the land under tree cover. As a result there is a serious shortage of wood products (firewood, poles and timber). Women and children spend many hours searching for firewood mainly from tree stumps. Most times they end up using sorghum and maize stalk, and banana rhizomes as cooking fuel. In addition, high population density and continued growth rates have contributed to land shortages and degradation; alongside the hilly topography, this has posed major challenges to development.
Village Characteristics by Sector

Food production in Ruhiira has been declining over the years. This is largely a result of mounting population pressure causing land shortage and a decline in soil productivity. Villagers cultivate their small plots without external soil nutrients. This coupled with soil erosion from unprotected hill slopes has led to decline in soil fertility.
Malnutrition especially among women and children is highly prevalent, further constraining agriculture productivity through reduced labor. About 30-40% of children below five years are underweight. The high levels of malnutrition are a result of decline in per capita food consumption and overdependence on banana as the main food source with little nutritional diversification.

Despite the flagship government policy on universal primary education, a large number of children don't go to school while a significant proportion of those that do go, never complete their primary education. Inadequate and poor school facilities, long travel distances, user fees in some cases, early marriages, and household work are some of the factors responsible for poor attendance in primary schools. 
Health-related problems are enormous in Ruhiira. The area is well known for having the highest tuberculosis prevalence in southwestern Uganda. HIV/AIDs prevalence is estimated at between eight to 10%. Malaria is endemic with preliminary results from the recent blood sampling showing 30% malaria prevalence. Most pregnant mothers deliver at home sometimes with the help of traditional birth attendants; only five percent deliver in health units. The referral hospital is located in Mbarara town 40 km from Ruhiira. Accessibility is limited due to hilly terrain and poor roads. Lack of medical personnel, adequate supply of basic drugs and medical supplies have made villagers shun health facilities and instead turn to unskilled health service providers for their health needs.

Despite the two rainy seasons, access to clean water remains a challenge. Most of the hills have been stripped bare of trees causing increased runoff and soil erosion. Most underground water sources like springs and boreholes are contaminated with minerals like iron and salts to such high levels that are not suitable for human consumption. Only one protected spring located about 3 km outside Ruhiira village has safe water. At this spring, people start lining up as early as 5 am to get a chance at drawing water. The long morning queues have contributed to absenteeism and tardiness in schools. The only good quality water comes from harvesting roof rainwater using movable containers, tarpaulin tanks, and concrete tanks depending on the income levels the household
Intervention Highlights
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