The WASHplus is in Chapel Hill this week (October 26-29, 2015), presenting at the UNC Water and Health Conference organized by the UNC Water Institute. Conference presentations can be viewed on the WASHplus website. Here are presentation highlights, captured from conference attendees’ tweets!
October 15 marks the annual celebration of Global Handwashing Day. Over 200 million people will be promoting one simple behavior that can save lives all over the world—handwashing with soap. Every year, 1.7 million children are killed by diarrhea and pneumonia—two diseases that can be significantly prevented through good hygiene practices. Even with the knowledge that handwashing with soap can improve health and save lives, it isn’t practiced nearly enough, and resources geared toward its promotion, necessary supplies, or facilities are inadequate.
The WASHplus project, funded by USAID, is working diligently to address the lack of infrastructure that prevents access to handwashing with soap, and promoting simple messaging around washing hands with soap at critical times. This can reduce the incidence of diarrhea among children under 5 by 47 percent and respiratory infections by approximately 25 percent.
Hygiene is also critical to educational achievement, ensuring that students don’t miss school due to illness; economics, through increased worker attendance and productivity; and equity, which girls gain when they are able to safely manage menstruation at school. Given the broad impact of hygiene, it is essential that handwashing facilities and behavior change programs be prioritized.
Join us in raising a hand for hygiene on Global Handwashing Day and every day! Enjoy the joyful images of handwashing activities from our project activities, where we work to increase awareness and understanding about the importance of handwashing with soap as an effective and affordable way to prevent diseases and save lives.
By Ron Clemmer, Strategy and Business Development Manager, WASH, FHI 360.
About 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.
Last month at a PTA meeting at our local elementary school the teacher who leads the PTA Health & Wellness Committee announced the upcoming date for Global Handwashing Day. Several of the parents scrunched up their noses and looked at each other with befuddlement, as if to say “What?! Is there such a thing. Why is she talking about it?” So the teacher explained this day focuses on handwashing around the world and how it is important for everyone’s wellness, even in our school. But for my neighbors, handwashing was either taken for granted or its importance was a mystery or it was just silly. For my neighbors, handwashing was not valued.
This got me thinking about handwashing. I already think about handwashing a lot! I think about how to best facilitate the motivation of behavior change so people wash their hands properly even though they live in poor conditions. I also think about handwashing a lot in my own personal life. I think about handwashing when my daughter appears at the kitchen table ready to eat much too quickly after she went to wash her hands, and then my wife tells her to try it again using soap and some scrubbing this time. I think about handwashing when I am eating at a restaurant and I am trying to figure out how to navigate through multiple doors that stand as barriers between me and my hands which I just washed and the target of getting back to the table with my hands still being clean. And sometimes I think about how I wish I had never gotten into a public health profession because all of this concern about handwashing is just a huge bother! It is so inconvenient to make sure that our hands are clean! Much less thinking about everyone else’s hands around us! Did that waiter just touch the top of my glass with his hands; I’d better ask for a straw! Or better yet, I had better never eat out again! Can’t I just forget about hand sanitation for a while! Handwashing is an endless bother!
Last year, I was at a food security meeting in a session that was talking about the importance of handwashing as part of water, sanitation, and hygiene (WASH) interventions to prevent malnutrition increase from disease burden. One of the international development professionals said she found it too difficult to wash her hands at every one of the critical times now that she had a baby, as it just took too much time. But she said people in a village really have to do it because the risk is so much greater.
So handwashing take too much time. It is such a bother. And my neighbors do not really value it. But surely when I am with my WASH colleagues, I find the encouragement and reinforcement to stick with handwashing. Well… Actually… Maybe not always. One of my WASH colleagues has told me for years of how he has repeatedly sat through a morning of discussion of the critical nature of handwashing with WASH professionals, and then when it is time for lunch, he watches closely and sees hardly anyone going to wash their hands before eating. Do we think that if we live in the city or that if we are a professional working at a table then we do not need to wash our hands? Will anyone listen to us talking about the importance of handwashing if we do not practice the behavior we are promoting? Handwashing must be for someone else besides WASH professionals.
Here are the lessons that I take away from these personal experiences that helps me to think about my professional task of helping people to adopt better handwashing. For everyone, handwashing is a bother. For everyone, handwashing is inconvenient. For everyone, handwashing takes too much time. For everyone, some people in our communities will really think that handwashing is just plain silly. And for everyone, hardly anything we can do will protect our health and our children’s health as much as handwashing.
The inconvenience of handwashing is one of the issues which makes the small doable actions approaches of behavior change programming so compelling. The inconvenience of handwashing an issue which makes handwashing as being a core of being polite in your neighborhood to be such an important motivating factor. The inconvenience of handwashing is an issue which makes the need for marketing of the aspirational appeal of handwashing to be so important.
So it is a good lesson for me to remember how difficult handwashing and the social norm of handwashing is in the communities where we work, by looking at handwashing in the communities where I live. So Global Handwashing Day is for everyone! And since I don’t want my daughter to be sick too much this winter, I hope that my neighbors learn that the value of handwashing for their kids!
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.
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, Rufumbira, Rukiga), 2104.
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 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.
WASHplus Blog 