MUMUDA Water Project

Project Application Form for Life & Water Development Group – Cameroon Water Projects This form is for NGOs and Communities to submit new & existing water projects to LWDGC for review. SECTION 1: Project Information Today’s Date: ¬¬¬¬¬¬__23/3/2008_____ 1) Please check the following boxes: 0 New Project Submitted by NGO or community? (By a Community NGO) 1 Continuous Project Submitted by NGO or community? (By a Community NGO) 2) Country: _Cameroon -Africa___________________________________ 3) Region/State (Encompasses neighboring villages): Njinikom- North West Province of Cameroon 4) Location in Country ___Njinikom, 48 kilometers from Bamenda Cameroon_ 5) Community: _________Mungoangoa/Mugheff_______________________ 6) Project Title: ______Mungoangoa/Mugheff Water Project 7 Project Summary: provide a short overview summary of the scope of work of the proposed project. • One paragraph. Approximately: 75 words 8) Detailed Project Description: Provide a more detailed description of your project. What is the goal of the project? Why is this project necessary? Are there any proposed solutions for the project? What alternative designs or solutions have been considered? Why were they rejected? See example questions below: • One-Three paragraphs: Approximately 500 words • For Water Supply: o What are the possible sources of water? (e.g. type, location, distance from community); What is the elevation change?; How clean is the water?; Are there water rights issues that need to be considered? • Water Purification o What are the water quality associated diseases have been found in the community?; What quantitative and qualitative community health assessments have been done?; Has there been any testing of the water? What were the results? • Energy project o What will the electricity power?; How much power is required?; What possible methods are available? (E.g. wind, solar, biomass surveys, etc). • Construction: o What materials are available locally?; What are the typical local construction methods used in the area? 10) How many people will be affected by this project in a certain geographic region? a) Directly affected: _____3000 people_____ b) Indirectly affected: ______1000____ c) Geographic Area (5km radius, town, region etc): ____6km_________________ 11) Background: What is the cause and history of the problem? If any efforts were made, please describe the outcome. • One to Three Paragraphs: Approximately 200 Words 12) Check the specific services or needs addressed for this project. Check all that apply. ____ Water Supply ____ Water Treatment ____ Sanitation ____ Energy ____ Construction ____ Micro-Enterprise ____ Health and Safety ____ Agriculture ____ Alternative Fuels ____ Information Systems ____ Socio-Cultural ____ Environnemental ____ Ecosystem ____ Education Other: Describe: ___________________________________________ SECTION 2: Project Impacts 1) What potential impacts, both negative and positive, are anticipated or could possibly occur as a consequence of this project? Please consider health, economic, environmental, social, cultural, and ecosystem impacts. For any possible negative aspects, how can these negative impacts be diminished? Could any segment of society be marginalized excluded or lose their current societal function because of this project? Please explain POSITIVE: • One-Two paragraphs: Approximately 100 words NEGATIVE: • One-Two paragraphs: Approximately 100 words 2) In what ways do you envision LWDGC’s involvement in this project? What specific skills can they offer that are not available locally? How will this project lead to the long term sustainability of the community? • One-Two paragraphs: Approximately 100 words 3) Who is expected to own this proposed project? Will a committee need to be established? Who will manage and maintain the project? Who will cover the cost of maintenance? • One paragraph: Approximately 150 words 4) What education will be needed for this project to be successful? Who will educate and who will need to be educated? Will verbal or written translation be needed for this education? Who will do the translating? • One-Two paragraphs: Approximately 75 words 5) Will the proposed project be freely accessible to all persons in the local area, or will it be respect for use by certain groups? Will a fee structure be involved? Who will decide on the amount of the fees and who will collect the fees? • One-Two paragraphs: Approximately 100 words SECTION 3: Beneficiary Group(s) Information 1) Name of the Beneficiary Group: Mungoangoa/Mugheff Development Association (MUMUDA) 2) Describe the beneficiary group(s) in terms of ethnicity, tribal and religious affiliations, spatial organization, primary occupations and current income of all the sub-groups (if more than one). Are social relationships harmonious in the area where the beneficiary groups reside? • One paragraphs: Approximately 75 words 3) How are decisions made within the beneficiary group(s) – i.e., village elders, tribal councils, democratically-elected village representatives, etc? How do women participate in decision-making? • One-Two paragraphs: Approximately 75 words 4) Describe the relationship between the local project facilitator/Non-Governmental Organization (NGO) and the beneficiary group(s). • One- Two paragraphs: Approximately 50 words 5) Are people from the USA and aid from the USA welcome in the proposed project area? Yes or No 6) Have people from the USA worked in the area before? If so who and in what capacity? • One- Two paragraphs: Approximately 50 words Section 4: Roles of Partners & Funding LWDGC’s goal is to partner with developing communities to improve their quality of life by providing assistance for the development of projects. We expect community contribution to LWDGC projects because it has been found that this leads to greater project success. 1) What support both financial and/or non-monetary will be offered by the local community (housing, materials, continued education, etc…)? Will local labor and workmanship be offered free as part of the contribution from the beneficiary group(s)? Has a specific agreement been reached as to what LWDGC and the community will each provide? • One-Two paragraphs: Approximately 100 words 2) What support and funding will be offered by other local agencies and organizations, including governmental and non-governmental organization (NGO) (if any) facilitating the project? One-Two paragraphs: Approximately 75 words 2) Project Budget: If an estimated project budget has been developed, please include the figures below (Note: Costs may be listed in greater detail if desired) MUMUDA PROJECT BUDGET MUMUDA WATER PROJECT Materials Numbers Cost Total 1. Pipe 32mm 200 3.500frs 700.000frs 2. Pipe 25mm 200 2.200frs 440.000frs 3. Iron pipe 20 1.600frs 32.000frs 4. Rod 8.mm 30 3.000frs 90.000frs 5. Rod 6mm 30 3.000frs 90.000frs 6. Cement 100bags 7.000frs 700.000frs 7. 3 tins 10.500frs 31.500frs 8. Binding wire 4 roll 10.000frs 40.000frs 9. Hem 6 1.5000frs 90.000frs UPPER MUMUDA 1. Cement 100bags 7.000frs 700.000frs 2. Pipe 32mm 100 35.000frs 350.000frs 3. Pipe 25mm 100 2.200frs 220.000frs 4. Rod 8.mm 20 2000frs 40.00frs 5. Rod 6mm 25 1000frs 25.000frs 6. Gum 3 10.500frs 31.500frs 7. Hem 4 1500frs 6.000frs 8. Binding wire 4 rolls 2000frs 8.000fr 9 Technician’s cost 1 100.000 100.000frs TOTAL 3,658,000frs Total TRI contribution: Three Million, Six Hundred and Fifty Eight Thousand Francs CFA. Section 5: Travel Logistics 1) When is the best time for a visit to the area considering weather, transportation access, holidays, as well as availability of the beneficiary group(s) and NGOs facilitating this project? • One paragraphs: Approximately 50words 2) What local accommodations are available for the LWDGC team? What are estimated per day living costs for the visiting team? Will the team stay with the local community members? • One paragraph: Approximately 50words 3) What hazards may exist to persons from LWDGC traveling to this project location (health issues, transportation difficulties, weather, insects, diseases, snakes, etc.) • One-Two paragraphs: Approximately 100words SECTION 7: Contact Information Requesting Organization, Contact Information & Mission Name of Requesting Organization: Mungoangoa/Mugheff Development Association (MUMUDA) Mission of the Requesting Organization: To provide the people of this locality basic necessity that can improve their health situation and to bring down the dead toll which has eliminated so many of them. Providing clean portable water, electricity and health facilities are our prime objectives. Goal of the Requesting Organization: To ensure health for all by the year 2020 through the provision of such amenities listed above. Website of Organization (If applicable): www.lwdgc-africa.org Name of Individual Requesting Assistance: Peter Njodzeka Contact Email: info@lwdgc-africa.org Contact Phone: +237 77 71 62 88 Contact Address: P.O. Box 30370 Yaounde, Cameroon Name of on-site primary project facilitator (if different from requesting individual): Same 1) Please add pictures that may be helpful to understand the project. • Please add pictures as JPEG files • WE WILL NOT ACCEPT PROJECT APPLICATIONS FILES THAT ARE OVER 2MB. o (To add a picture as a jpeg, go to Edit  Paste Special, and choose “Picture (jpeg)”). 2) Please Sign and date this form: Peter Njodzeka 23/03/2008 Signature Date Peter Njodzeka info@lwdgc-africa.org Printed Name E-mail Address