The Health through Sanitation and Water project (HESAWA) was first initiated in 1983/84, and was implemented from 1985 to 2002. The project covered three regions in northwestern Tanzania and strived towards improving the health situation in the area through improvements in the water and sanitation sector, as well as by providing health education to the local people. The aim of this research study is to investigate if the HESAWA project and its implemented structures have been sustainable for the local population in the affected villages in the Geita region in Tanzania. The Sida evaluation manual, Looking Back, Moving Forward, has been used as an analytical frame of interpretation to determine if these goals have been fulfilled. The research was carried out as a fieldstudy in two villages in the Geita and Mwanza region, just south of Lake Victoria. In total 42 interviews were conducted among families, Water Committees, focus groups of men and women, dispensaries, health clinics, schools, NGOs, and former HESAWA workers. The questions were centered on water, sanitation, and health issues. The most common diseases included diarrhea, bilharzia, worms, and malaria. Even though these diseases have decreased in the area, they are still present to a large extent. The conclusion drawn from this study is that the HESAWA project did make a difference in the Geita region. The health standard at large in the villages has increased today compared to during the beginning of the HESAWA project. However, the sustainability of the project was not as good as expected. This is mainly due to an increased population, creating a shortage in water supplies, lack of sanitary conditions including poorly constructed latrines, as well as lack of awareness among the local population in regard to health issues. Financial capital was further a main obstacle towards further development and improvement within the health sector in the villages, wherefore future work within this field is of great necessity.