Bangladesh—Sending Poo to its Final Address

Bangladesh_Poster_What to do with Infant Poo_WASHplus

WASHplus continued pioneering work developing a menu of small doable actions for the safe disposal of infant feces. Working with program partners, the project team further refined doable behaviors for four cohorts of infant and young children, and worked with designers to develop a set of job aids to integrate Essential WASH Actions into Feed the Future nutrition implementing partner work. The materials all work around the theme “Poo’s Final Address,” highlighting that whether the child defecates in the courtyard, potty, or infant wrapper cloth, the poo needs to end up in the family latrine. This poster provides an overview of the WASHplus approach to infant feces disposal along with examples of small doable actions for several age groups.

Download the poster here.

 

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WASHplus Presents at ETHOS 2016 Conference

The 2016 ETHOS Conference was held in Kirkland, Washington from Friday January 29th – Sunday January 31st, 2016. The conference aims to expand its reach from previous annual meetings, encouraging participation of Southern partners, international stoves experts, and development specialists with field experience in the transfer of cooking technologies.

At the ETHOS conference this year, WASHplus’s Household Energy Specialist Elisa Derby presented on the results of two consumer research studies on improved cookstoves in Bangladesh and Nepal, and the Cookstove Consumer Research Toolkit which is currently under development.

See the presentation here.

Derby ETHOS image

 

Voices from Bangladesh: Reflections on SACOSAN VI

Reblogged from PPPHW blog.

julia rosenbaumBy Julia Rosenbaum, Senior Behavior Change Advisor USAID/WASHplus Project

I recently attended the 6th South Asian Conference on Sanitation (SACOSAN VI), held in Dhaka, Bangladesh. Given the clear ties between sanitation and hygiene, I was asked to provide commentary on the prevalence and discussion around hygiene at SACOSAN. A commentary on hygiene, however, first begs the question, “What is hygiene?”, as it means many things to many sacosanpeople. To some, hygiene pertains exclusively to handwashing with soap. To others, it includes food hygiene and treatment and safe storage of household water. To others, still, it means any “software” or promotional aspect of within water, sanitation, and hygiene (WASH) generally, such as behavior change. It is fair to generalize that hygiene was comprehensively defined at SACOSAN including the “software” side of WASH, specifically regarding sanitation, handwashing, and menstrual hygiene management.

A major theme throughout the conference was a renewed call for representation and inclusion through the human right to sanitation. This was true in terms of hygiene, too.

Representation and inclusion were perhaps best represented in a session that highlighted a new publication and spotlighted issues facing women, adolescent girls, the elderly, persons with disabilities, and those in the sanitation workforce. Leave No One Behind, a stunning new publication of Freshwater Action Network South Asia and the Water Supply and Sanitation Collaborative Council, seeks to give voice to those too often neglected and excluded from both political processes and access to sanitation and hygiene services. The objective of the publication and the initiative is to assure inclusion and representation, considered essential to achieving the newly agreed upon Sustainable Development Goals.

The session corresponding with the Leave No One Behind report illuminated the tremendous obstacles and humiliation suffered by these individuals and the corresponding consequences—including indignities, poorer health, and safety concerns. Yet, despite the many conversations about access, what was most poignant to me was the overall inaccessibility of the conference center despite efforts to find a more accessible venue. Clearly, in many contexts, access needs to be better ensured and not merely discussed. While the focus of this session was to highlight the “voices” of those featured in the report, there was a striking absence of positive examples and best practices that have been refined over the past decade and do provide access to many who might otherwise be left behind. Showcasing ways that access can be achieved—for instance, displays of simple latrine and handwashing station modifications to allow access to the differently abled, the elderly, the deaf, blind, and mute—or outlining inclusion strategies and approaches gaining prominence could have prompted session participants to not merely discuss the need for inclusion but also inspired action.

While I wish that the accessibility issues faced by participants had been addressed, there were many highlights of the conference. It was heartening to see participants spontaneously organize a special side session on menstrual hygiene management (MHM), as it was not prominently included in the program. Facilitated by WaterAid and featuring a wide range of panelists including government officials, global leaders, and community representatives, this lively session filled a gap and helped to prioritize menstrual hygiene management in the SACOSAN declaration and commitments.

The meeting’s hygiene promotion session was coordinated by the Afghani Delegation. The four technical papers that comprised this session—including one co-authored by USAID/WASHplus—comprehensively defined hygiene promotion. As a result, there was a large focus on sanitation best practice and innovation, such as improving sanitation and hygiene (mostly handwashing) practices in geographically-challenged areas, fostering strategies to improve sanitation coverage and developing approaches to improving sanitation practice (i.e., latrine use) and consistent and correct handwashing with soap. A forth session focused on MHM, and boldly shared the failures attributed to not thoroughly consulting with school girls and administration, as well as successes.

Hygiene was also prominent in a plenary session chaired by BBC Media Action (formerly BBC World Service Trust). Via a provocative video presentation, behavior change specialist Dr. Val Curtis with the London School of Hygiene and Tropical Medicine, highlighted three elements—surprise, revaluation, and performance—as fundamental and effective at improving WASH. This video was followed by prominent national journalists who discussed how to get the public to engage in topics considered unpleasant and often taboo by capturing audience attention and greater media visibility.

The linkages between sanitation and hygiene are clear, and it is encouraging that hygiene was featured prominently in the meeting’s Declaration and Commitments where every mention of sanitation included “… and hygiene”. I am hopeful that the calls for representation and inclusion of the vulnerable and underserved that were made during SACOSAN will lead to a truly enabling environment, and that we will learn from our oversights and collaborate going forward to improve access to sanitation and hygiene for all.

Celebrating World Health Day: Why Food Hygiene Matters

You are what you eat

It is estimated that 2 million deaths occur every year from contaminated food or drinking water. Diarrheal disease alone kills an estimated 1.5 million children annually, and most of these cases are attributed to contaminated food or drinking water, according to the World Health Organization (WHO). 

In Uganda, the WASHplus project worked closely with USAID implementing partners including Community Connector, SPRING, STAR-SW, FANTA, and others to integrate WASH and aspects of food hygiene, among other interventions, into HIV care and support. WASHplus developed a series of job aids to support outreach workers and clinical counselors to integrate WASH into their home-based and clinical practice. The job aids are available in English, and two local languages, Rukiga and Rufumbira. Also, notable in WASHplus’s work in Uganda is the application of the small doable action approach to food hygiene to address local challenges of keeping food safe.

Resources developed by WASHplus are provided below.

Integrating Safe Water, Sanitation, and Hygiene into Infant and Child Nutrition Programmes. A Training Resource Pack for Uganda, 2014.

Integrating Safe Water, Sanitation, and Hygiene into Infant and Child Nutrition Programmmes

In Uganda, the WASHplus project is integrating WASH into to Nutrition and Feed the Future Programming. Integrating WASH into nutrition focuses on the importance of improving household sanitation and nutritional needs in a child’s first 1,000 days. By building capacity of implementing partners and district focal and community resource personnel, WASHplus facilitated the integration of WASH into clinical nutrition assessment, home visits with householders of small children and families affected by HIV, and through community mobilization campaigns. For example, Community Connector now not only includes WASH as part of the model homes in its 1,000 days campaign, the project included WASH in its community drama initiatives, radio talk show, behavior change communication materials, and field day exhibition, which emphasized the integration of nutrition, agriculture, income, and WASH. Integrating WASH into the District Nutrition Coordination Committees further emphasized the importance of WASH and nutrition integration during the budgeting process, implementation, and supervision of district efforts to fight undernutrition.

Small Doable Actions for Improving Household Water, Sanitation, and Hygiene Practices. Job Aids for Village Health Teams, Peer Educators, and their Supervisors (English, RufumbiraRukiga), 2104.

Small Doable Actions for Improving Household Water, Sanitation, and Hygiene Practices -Job Aids for Village Health Teams_Peer Educators_Supervisors

Small Doable Actions for keeping food safe

Working with SPRING, WASHplus created the first-ever job aids promoting small doable actions for food hygiene, based on the World Health Organization’s “Five Keys to Safer Food.” The job aids address issues of food safety during preparation, serving, and related to storage. This initiative directly addressed the contribution of poor food handling in spreading contamination that leads to diarrhea. Other job aids highlight safe disposal of infant and animal/poultry feces, which may be significant contributors of undernutrition and inhibitors of growth according to a growing evidence base. Feces from these sources find their way to a child’s mouth through food or water contamination or through direct ingestion, causing diarrhea, enteropathy, and contributing to the excessive growth stunting documented in the region.

Additional WASHplus Resources

You Are What You Eat: Why Food Hygiene Matters for Child Growth. Julia Rosenbaum, FHI 360/Deputy Director of the USAID funded WASHplus Project, and Merri Weinger, USAID/Bureau for Global Health/Environmental Health Team leader. A presentation at the USAID Mini-University, March 2015.

Why WASH Matters for Improved Child Health, Nutrition & Growth: A Knowledge Sharing Event. Julia Rosenbaum, FHI 360/Deputy Director of the USAID funded WASHplus Project, June 2014.

Hygiene Intervention Reduces Contamination of Weaning Food in Bangladesh, Islam et. al. Tropical Medicine and International Health, Volume 18, no 3, pages 250–258, March 2013.

WASHplus Presents at USAID Mini-University 2015

miniu-logo-nodate-sm

WASHplus collaborated with USAID counterparts on three presentations at the Global Health Mini-University in March, with topics that included: 1) Gauging Consumer Preferences on Improved Cookstoves in Bangladesh, 2) Food Hygiene and Child Growth, and 3) Infant Feces Disposal.

What to do with infant poo? The blind spot of the blind spot

Reblogged from http://www.communityledtotalsanitation.org/blog/what-do-infant-poo-blind-spot-blind-spot

infant poo

After a few years researching and working on sanitation, I feel (felt) that I have a good knowledge about the topic, or at least good knowledge of most of it and a clear picture of the areas I should learn more about. Moreover as a shit-worker I –and probably most of us in the sector– have developed a sort of pride or even vanity about being a herald of a neglected cause…

Last week at the UNC Water and Health Conference I was humbled and even slightly embarrassed when I ‘discovered’ the world of children’s faeces in an exciting side session: “What to Do with Infant Poo? Evidence-based Programming to support safe disposal of young children’s faeces”. Convened by WSP, UNICEF and USAID / WASHPlus Project, the session included presentations of experiences from Kenya, Bangladesh and Cambodia, followed by group work on ways forward.

It is not that I ignored everything about child faeces; I had read something, had had some coincidental observations while staying in Indian villages, where I also included the issue partially in household surveys by gathering information of individuals’ defecation practices. But overall my knowledge was limited to the fact that child faeces have more pathogens than adult shit, and therefore should be disposed of safely; I had not fully acknowledged the complexities of the issue and kind of took for granted that improvements in adult sanitation would automatically lead to better management of child faeces. I was thus struck by a study in Bangladesh (by ICDDR,B), a country where adult open defecation is minimal, that showed that only 11-14% of children’s faeces are disposed of in latrines.

I had also not reflected about of the different defecation practices by age groups (my nephew is still in the nappy-phase) which vary country to country and require specific approaches. In Cambodia, for instance, Watershed’s research has shown that children up to six months, not having control over their bowels, rely on nappies (either disposable or reusable –more or less rudimentary). From seven months to two years they generally defecate openly, mostly in the courtyard. From two to five years they start using the potty or the latrine if available.

Finally, I had not given much thought either to how the different choices impact the environment and the implications in terms of solid and liquid waste management. In Cambodia again, in villages with high latrine coverage, when potties are used, in 92% of the cases these are emptied in latrines. Faeces in the courtyard are removed with a scoop or an improvised tool, just to be thrown farther away or in the trash. Baby’s disposable nappies always end up in the trash, which is mostly burnt or buried. Cloth diapers –used by 30%– are emptied in the latrines and then cleaned, but the resulting wastewater is again disposed of in or near the courtyard.

So what to do about children faeces?

The Bangladesh experience was based in supporting caregivers in potty training and promoting the best potty after a test of different models available in the local markets. In Cambodia, efforts have been made to develop potty designs that are more stable than those traditionally used, which small children cannot use on their own. In parallel, WSP and UNICEF are developing 25 country profiles summarising available data on child faeces disposal and providing ideas to strengthen safe practices.

These emergent efforts are very interesting… but very scarce. We need more people and more organisations that engage in this topic and contribute take children faeces out of the blind spot. Please share your thoughts and any related experience you know about!

US Ambassador to Bangladesh visits WASHplus-WaterAid project

Ambassador Mozena 2

An official visit to water, sanitation and hygiene projects highlighted how USAID funds are transforming the lives of poor communities in Bhola, Bangladesh. This blog post is authored by WaterAid and first published here.
WaterAid was honored to receive a visit from His Excellency Dan Mozena, US Ambassador to Bangladesh, and Ms. Janina Jarulzelski, USAID Bangladesh Mission Director. The delegation came to see some of WaterAid’s water, sanitation and hygiene (WASH) projects in Bhola, Bangladesh that form part of the WASHplus program supported by USAID through FHI 360.
Bangladesh is one of the world’s most densely populated countries. Despite progress in recent years, infant mortality rates remain high, with preventable water-related diseases such as diarrhea claiming the lives of more than 7,000 young children every year. In addition to being contaminated with human waste, many water sources are unsafe to drink due to the presence of naturally-occurring arsenic.
HE Mozena and Ms. Jarulzelski spent time with members of the Community Development Forum (CDF), an organization set up to put local people at the heart of improving access to safe water, sanitation and hygiene within their communities.The CDF members explained how the health benefits of sanitation projects rely on 100% participation amongst villagers.
To stop the spread of disease, everyone has to agree to safely use latrines, so the community has to pull together to motivate each and every household to build a latrine and commit to becoming an Open Defecation Free (ODF) village.As in many other poor communities across Bangladesh, affordability of sanitation facilities is a real concern in Bhola. The delegation heard how the community was presented with a range of environmentally friendly sanitation options, which included very simple structures that could be constructed using low-cost, locally available materials.Local schools are actively involved in the projects. During the visit, students were happy to show off pristine new sanitation blocks and demonstrate how simple, cost-effective measures such as ‘tippy taps’ made from old water bottles can help encourage everyone to wash their hands after visiting the bathroom.CDF members also demonstrated the use of portable arsenic testing kits used to assess whether local drinking water sources are safe to drink.

Dr. Khairul Islam, WaterAid’s Country Representative for Bangladesh, who accompanied the visit commented: “WaterAid is very grateful for the support of USAID. We take great pride in the fact HE Mozena and Ms. Jarulzelski visited these projects and saw for themselves how safe water and sanitation are transforming the lives of local communities.”

Julia Rosenbaum, Deputy Director of WASHplus added: “Through USAID support, local governance is strengthened and communities are supported to find innovative solutions within resource constrained contexts, like fixing leaky latrines or using tippy taps to enable handwashing before cooking and eating. The Ambassador’s visit highlighted one of WASHplus’ key approaches, to make changes one small doable action at a time.”