A Gender Dialogue

By Ron Clemmer, Strategy and Business Development Manager, WASH, FHI 360.

photoAbout the author: Ron Clemmer joined FHI360 in May after working with World Vision as Senior Technical Advisor for WASH for six years. Ron is passionate about building sustainable water and sanitation services through the public and private sectors, hygiene behavior change that becomes habit, and integrated programming of WASH with nutrition, HIV, neglected tropical diseases, education, and women’s empowerment.

“I was fortunate to attend last week’s World Water Week 2015 in Stockholm which included, among many other activities, attending three different water, sanitation, and hygiene (WASH) and gender sessions. Having five hours of presentations and discussion on WASH and gender issues in one day was remarkable. Great that gender had so much focus! One of the presentations I found fascinating was research on the psychosocial stress of women and girls related to WASH, presented by Robert Dreibelbis, from the University of Oklahoma. WASH programming can provide a good entry point for working with communities for many development goals, including empowerment of women and gender equity, was one of the conclusions of the session.

At World Water Week, I shared how the USAID-funded WASHplus project, implemented by FHI 360, is strengthening girl’s and boy’s education by integrating and embedding WASH in Schools and providing support for menstrual hygiene management.

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Photo Credit: German Toilet Organisation

World Water Week was part of two weeks of intense dialogue of women empowerment for me. The week before, I had multiple communications on women’s empowerment surrounding WASH with my FHI 360 colleagues working on the WASHplus project, as we have begun discussing how to support the representation of WASH issues at Women Deliver 2016 Conference. We discussed how WASH not only addresses health issues, but also influences safety, time poverty, and dignity for women and girls.

If you are not familiar, Women Deliver is a leading global advocate for girls’ and women’s health, rights, and wellbeing and brings together diverse voices and interests to drive investments and progress, particularly in maternal, sexual, and reproductive health and rights. The focus of the Women Deliver 2016 Conference will be on how development can best support girls and women, with a specific lens on health, rights, gender equality, education, and economic empowerment.

As the father of two young girls, I often think about girl’s empowerment and what that means for society at large. I am fortunate to work in an organization which empowers women and girls through not just the provision of improved WASH but also the integration of WASH into other development sectors to strengthen girls and women’s rights, health, and wellbeing.

Before I ran to the airport to catch my flight to Stockholm, I was involved in women’s empowerment in an entirely personal way. My 12 year old daughter was participating in her 3rd triathlon while my wife was enjoying listening to my younger daughter’s piano recital. We are grateful for the opportunities that our daughters have to flourish into empowered young women, as I strive in my work to contribute to the empowerment of less privileged girls around the world.”

WASHplus Pilots Integration Program for WASH and NTD Interventions in Burkina Faso

NTDsWASHplus is implementing a pilot program in Burkina Faso that is designed to develop an integrated WASH–NTD model that can be scaled up in-country and replicated elsewhere. Burkina Faso is a country with very little latrine coverage, relatively poor hygiene practices, and pockets of high burden of disease related to water, sanitation, and hygiene. Without a serious focus on face washing and environmental cleanliness.

WASHplus is working in Burkina Faso to partner with stakeholders at district and provincial levels to implement a comprehensive WASH–NTD integrated program in one district. We will then document and disseminate the learnings gained through this pilot program. WASHplus will also engage multiple stakeholders inside and outside of government, including working with existing government structures at multiple levels, such as local government that has the mandate for water and sanitation at the local level. Typically, WASH and NTD programs have not worked together in Burkina Faso, though some precedence exists for inter-sectoral collaboration through the WASH-Nutrition group that has been spearheaded by UNICEF and embraced by government stakeholders.

To learn more about the pilot in Burkina Faso read this brief prepared by WASHplus: “WASHing Away Worms and Other Neglected Tropical Diseases .”

To learn more about WASHplus work in NTDs visit the WASHplus website (http://www.washplus.org/wash-ntds).

WASHing Away Worms and Other Neglected Tropical Diseases

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More than 1 billion people worldwide suffer from one or more painful, debilitating neglected tropical diseases (NTDs). These diseases disproportionately impact poor and rural populations, causing severe sickness and disability, compromising mental and physical development, contributing to childhood malnutrition, reducing school enrollment, and hindering economic productivity. Soil-transmitted helminths (STH), including round worm, whip worm, and hook worm, as well as schistosomiasis (bilharzia) and trachoma, are all clearly linked to inadequate sanitation and poor hygiene, indicating a need for water, sanitation, and hygiene (WASH) interventions to battle these NTDs. Although mass drug administration is key to reducing NTDs, reinfection will remain a problem if WASH behaviors are not addressed.

WASHplus is documenting the links between WASH and NTDs and exploring ways to integrate WASH into NTD programs. WASHplus has conducted a global desk review that highlights integration in eight countries. The team assessed the possibilities for integrating WASH into NTDs in two countries: Bangladesh and Burkina Faso, and ultimately chose the latter in which to implement a pilot program. WASHplus is piloting an integration program for WASH and NTD interventions in Burkina Faso, designed to develop an integrated WASH–NTD model that can be scaled up in-country and replicated elsewhere (Click here to learn more about the Burkisa Faso WASH-NTD pilot intervention).

Globally, WASHplus is collaborating with organizations already engaged in WASH–NTD integration such as the International Coalition for Trachoma Control and the SHARE consortium, which are developing tools and indicators to facilitate WASH–NTDs integration.

Want to learn more about WASHplus’s NTD work? Visit the WASHplus project website.

For more information on what WASHplus is doing regarding integration of WASH and NTD programming, contact Renuka Bery (rbery@fhi360.org) or Ron Clemmer (rclemmer@fhi360.org).

Sarah Fry – What Does WASH in Schools Have to Do with Building Bridges?

by Sarah Fry, SPLASH WASHplus Project, August 2015.

That’s literally, not figuratively, building bridges. Two weeks ago I would not have been able to even understand that question, but today I have a story to share with you. First of all, hello from Zambia. As the WASHplus activity manager for the USAID funded activity called SPLASH (Schools Promoting Learning Achievement through Sanitation and Hygiene), I have been here since early July working with our team to see this activity to its end on September 30th.

The author on the road in Chadiza District
The author on the road in Chadiza District

SPLASH began in early 2012, and since then has built over 3,000 school toilets, drilled, equipped or rehabilitated over 400 water points for schools, provided permanent handwashing and drinking water stations, and worked with teachers, the national government and local government to ensure that good hygiene practices and stronger systems for operating and maintaining school WASH facilities are put in place, and will stay in place. These activities have taken place in Zambia’s Eastern Province.

Before SPLASH started, Chief of Party Justin Lupele and I went on a “Road Show” out to the districts, where we introduced SPLASH to the government officials and local committees and started to build ownership and participation. The last three years have been a whirlwind of activity – construction, training, community mobilizing, monitoring, publicizing, documenting. Justin and I thought that as the project nears its end, it would be good to go on another grand tour to get a solid sense of what has happened, what has changed, and maybe, what does it all mean. The only requirement we set was to not alert any schools that we were coming to visit.

Zambia is a vast, not densely populated country. Visiting schools requires spending a lot of time in vehicles riding on rough and dusty country roads. These distances impressed upon me how much staff and building contractor time and effort it took to reach the schools to carry out SPLASH activities. Bumping along, I had a chance to think and look forward to what we would find. I certainly expected to see positive changes and improvements at SPLASH schools. However, nothing prepared me for the sea of change that unfolded before us as we made our way to about 20 schools, mostly rural, but a few urban ones as well.

A school in Chipata
A school in Chipata

In 2012, we heard many complaints from schools about how communities were misusing their boreholes and denying any responsibility when they broke down. Now, every school has active WASH committee and pupil WASH Club and all are engaged in some form of joint school-community fundraising for maintenance and repair of the borehole. Handwashing after toilet use and before eating was a nearly universal practice by pupils, a habit acquired even if group handwashing hadn’t been inaugurated yet.

A major achievement was the presence of soap at almost all handwashing stations – stealing soap is a thing of the past, we were told, because pupils want and like to wash their hands. Through the WASH Clubs peer education, they feel that the stations and the soap belong to them. Going beyond peer education, some WASH Clubs are visiting local health centers and performing hygiene skits and poems for women gathered for pre-natal and under-five clinics. In addition, Teachers were delighted with drinking water stations close to the classrooms because time away from lessons was reduced.

Possibly the biggest change was the universal acceptance of Menstrual Hygiene Management (MHM) as a necessary and welcome part of the school program. Zambia, like many African countries, has taboos, myths and restrictions around menstruation, which is almost never discussed openly. Facilities and support for menstruating girls in schools is nearly absent, causing girls to stay home and miss weeks of lessons during the school year. Girls at SPLASH schools were thrilled with their beautiful washrooms –shower/toilet structures built to accommodate MHM.

However, no one had anticipated the envy of the boys, who are now demanding their own washrooms to clean up after sports. MHM has entered into the vocabulary and into the culture, to the point where one WASH Committee was holding pad making parties for the girls, but then headed out into the community to distribute them to women in need. The taboos around menstruation seem to have melted away.

While the news from schools is very good– and we will soon be able to quantify what kind of effect SPLASH had on the schools the – we encountered even more good news during this visit, outcomes that I can only call “unexpected consequences” of WASH in schools, and that frankly, I was unprepared for. The big apparent message is that WASH in schools can lift an entire community up and can bring about changes that were previously not possible.

Launching SPLASH with School Led Total Sanitation “triggering” shifted social norms in surrounding communities around open defecation practices to such a degree that we heard of headmen ordering all households to build latrines or pay a fine! Over a thousand household latrines have been built as a result.

In one school receiving a water point, a new classroom block was built where previously there was only a thatched shelter. Teachers’ houses have gone up, and a new water source at another school enabled a clinic to be built nearby.

Classroom before SPLASH in Mambwe District
Classroom before SPLASH in Mambwe District

Every single school stocked soap and toilet paper – a miracle right there – and consequently local shops were seeing a rise in sales of hygiene products. Some schools have a “one child one bottle” policy, leading local businesses to stock up on drinks to satisfy the demand for bottles.

One of the best “unexpected outcome” is the engagement of artisans in building the latrines and washrooms, and who, in the process, have gained marketable skills.

They have found work on road crews (may the work be speeded up!) and other local construction projects and in one case were solicited by a health center next to a school that has decided to build an exact replica of a SPLASH toilet.

New classroom block built after SPLASH provided access to a new water source
New classroom block built after SPLASH provided access to a new water source

Leading the parade of successful new entrepreneurs is the ex-SPLASH artisan who proved so competent that once the latrine construction was done, he was hired to oversee the building of a new bridge. And that’s what WASH in schools and building bridges have in common!

Improving the quality of drinking water in schools: students take the initiative

By Armand AGUIDI AMOUSSOU, WASHplus Benin Coordinator, July 2015

Benin_WASH friendly schoolThe Benin peri-urban program has taken a new turn by including schools in its efforts to fosteri mproved hygiene practices. Lack of latrines, drinking water and hygiene is acutely felt by the schools. The 10 schools in the pilot neighborhoods of Enagnon and Agbato showed great enthusiasm and engagement after intensive sessions with ABMS school activities coordinator Victoire Mongbo. Together, they agreed on criteria and terms for becoming a WASH Friendly School, and are now engaged in a WASH Friendly competition. Handwashing with soap and nicely maintained school yards are becoming the norm, however, the need for classroom drinking water containers stirred up controversy as the schools have no money and teachers in the public schools are not allowed to ask parents for financial contributions. Instead, the teachers gave lessons in the importance of safe storage and treatment of drinking water. To her surprise, one enterprising 10 year old, Claudine, proclaimed that the students should contribute to the purchase of containers for their classrooms. The students organized a committee and decided on a level of 25FCFA (pennies) each. Fourteen students promptly contributed. They eventually raised 1, 025F, by using snack money and also asking parents who were more than willing to help. This experience has reinforced the idea that children can be powerful motivators of parents when they themselves are convinced of the right action. WASHplus is also working with the school directors to come up with alternative solutions to school WASH challenges.

Learning Brief: Integrating WASH & Nutrition

WASH & Nutrition

This first in a series of learning briefs WASHplus is producing in its final year documents the project’s WASH and nutrition integration programming efforts to stimulate the discussion and improve the evidence base as well as share experiences and approaches to integrating the two sectors at the global and country level. Download the Integrating WASH & Nutrition Learning Brief.

Break the silence: Talk about Menstruation

Break the silence- talk about menstruation

By Justin Lupele, Chief of Party, USAID ZAMBIA SPLASH PROJECT / WASHplus / FHI 360

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This year on May 28, the world commemorates the second Global Menstrual Hygiene Day under the theme “Let’s end the hesitation around menstruation.” The world is being urged to break the silence and talk freely about menstruation as a normal biological process and a key sign of reproductive health.

Some cultures in Zambia and elsewhere treat menstruation as something negative, shameful, or dirty. It is shrouded in taboo and secrecy. In addition, girls’ rights to education are being violated through inadequate menstrual hygiene education, insufficient water and sanitation facilities, and poor access to sanitary menstrual materials. Menstrual hygiene facilities and services keep girls in school where they can reach their full potential.

Speaking at the inaugural World Menstrual Hygiene Day at Kabulonga Girls Secondary School in Lusaka last year, USAID/Zambia Mission Director Dr. Susan Brems urged Zambians to break the silence, to start the conversation, and follow up with positive action for menstrual hygiene management (MHM).

She observed that taboos on the disposal of used menstrual hygiene products and challenges associated with limited access to disposal facilities make it very difficult for girls and young women to participate freely in academic, economic, and social activities.

Head of Economic, Social, and Cultural Rights Dr. Jyoti Sanghera of the UN’s Office of the High Commissioner for Human Rights observes that “stigma around menstruation and menstrual hygiene is a violation of several human rights, most importantly, of the right to human dignity… and the right to freedom from inhuman and degrading treatment from abuse and violence.”

USAID/Zambia has over the last four years invested about US $20 million in Schools Promoting Learning Achievement through Sanitation and Hygiene (SPLASH) to support 616 schools in the Eastern Province through the WASHplus project, implemented by FHI 360, CARE, and Winrock International.

SPLASH and the Ministry of Education Science and Vocational Training and Early Education (MESVTEE), in collaboration with other line ministries, provide girl-friendly sanitation facilities and access to menstrual products.

In the last four years, SPLASH and the MESVTEE have built 263 toilets and ventilated improved pit latrines with shower stalls for girls’ MHM. More than 30,000 girls have benefited from these improvements. These features make it possible for adolescent girls to bathe and change their sanitary pads at school with privacy.

A total of 816 teachers (598 males and 218 females) have been trained as advocates for menstrual hygiene education. The trained teachers share their MHM knowledge with other teachers and members of the community in addition to teaching their pupils. SPLASH has also been working with traditional civic and church leaders to break the silence and taboos associated with MHM. Parents and pupils are talking freely about menstrual hygiene.

At school, both girls and boys are involved in making menstrual pads. Educating boys and men helps dispel myths, stigmas, and negative perceptions about menstruation. Bringing them into conversations about menstruation helps to create a supportive environment for girls and women.

After participating in an MHM exhibition at Kanjala Primary School in Chipata District, one boy had this to say, “As a boy, I have a role to play in MHM. These girls are like our sisters so I’ve learnt that I need to treat them with respect. I was also excited to learn how to make a reusable pad.”

Men and boys are encouraged to participate in pad-making and MHM education to open lines of communication and raise awareness about this once-taboo subject.
Men and boys are encouraged to participate in pad-making and MHM education to open lines of communication and raise awareness about this once-taboo subject.

SPLASH has also forged partnerships with other nongovernmental organizations and private companies to make commercial and local reusable pads. Two of the organizations that have responded to this call are YASH Pharmaceutical Ltd. and Project Luangwa. YASH Pharmaceutical Ltd has produced an eco-friendly washable pad dubbed the pink pad, which is yet to be launched on the Zambian market. According to Mr. Shiva Shankar, YASH Pharmaceuticals Ltd General Manager, the pads can be washed for over 50 times and it is made of eco-friendly textiles, with minimum leakages.

Project Luangwa, in the Mambwe District of Zambia, has established a pad-making project with 60 sewing machines. The project has employed out-of-school girls and women to produce the sanitary pads. Project Luangwa Director Karen Beattie confirms, “Production of the pads is surging ahead and we have four ladies whom we have trained to sew, a cutter and a manager. The pads are definitely helpful to women, and we hope to record their thoughts for an on-line ad.”

Girls from Kamuna Primary School examine reusable pads produced by a public-private partnership between SPLASH and YASH Pharmaceutical. The pads were developed to last for five years, or more than 65 washes.
Girls from Kamuna Primary School examine reusable pads produced by a public-private partnership between SPLASH and YASH Pharmaceutical. The pads were developed to last for five years, or more than 65 washes.

These efforts aim to ease the challenges that adolescent girls face during menstruation. Most of them cannot afford disposal sanitary pads. Some girls miss up to five days a month of learning time due to inadequate sanitation facilities and the lack of sanitary products at school as well as physical discomfort due to menstruation, such as cramps. Others may feel ashamed and embarrassed to go to a school that does not provide menstrual management facilities, and they may simply stop coming to school altogether.

In addition to supporting sanitary pads, SPLASH has produced a number of materials on MHM, including an MHM Toolkit, an MHM brochure, and an MHM success story. SPLASH has also been working with teachers to integrate menstrual hygiene into the curriculum at school, district, and national levels.