people in Madagascar don't have access to safe water.

88% of people in Madagascar don't have access to improved sanitation

Almost 4,000 children under five die every year from diarrhoeal diseases caused by unsafe water and poor sanitation.

Improving hygiene behaviour is vital if the full benefits of access to water and sanitation are to be realised.
In Madagascar, traditionally, hard-working communities see clean hands as a sign of laziness. But poor hygiene is a killer. There are 4,000 child deaths from diarrhoea per year, something that simple hygiene education techniques could help prevent.  

Good hygiene habits are essential to maximise the benefits of clean toilets and waste disposal. In Madagascar, there is a lot of work to be done to raise the profile of good hygiene so that it is seen as equally important as safe water and sanitation. 

We work closely with the Scouting Association to publicly promote hygiene and the Ministries of Health and Education to shape national policies. Locally, we encourage simple solutions such as hand-washing and covering stored water.  

Find out more about how we tackle these issues in Our approach >

How it affects people

A woman looking away from the camera, holding a small child

Eliza Ngaiyaye, at home with her daughter Evelyn. Mwenyekondo, Lilongwe, Malawi.

"I think we have diarrhoea because there is a lack of hygiene. In the toilet there is a lack of hygiene. Also around the households there are puddles. In the puddles there are lots of flies, and the flies all come in the house. Also children don’t know how to use the toilet and they get faeces all around it."

Nurse taking the pulse of a woman

A nurse attends to a woman at Kaeweken Health Clinic, River Gee county, Liberia.

"We tell patients that hand-washing is very good, don't put hands straight into your mouth before food. A lot of the problems come from not washing hands and from mosquitoes. Most people drink water from the creek. If we had more handpumps, sickness would go down."

Family washing hands

Patricia Umariya with her children. Gatora village, Bugesera district, Rwanda.

My children usually miss school because their clothes are dirty, as I have no time to wash their clothes. I have to spend my time on the farm and they don’t know how to wash the clothes themselves. They get sent home if they go to school with dirty clothes on."