Making the link between toilets, hygiene and health

Yael Velleman, WaterAid UK’s Senior Policy Analyst, reports back on a meeting in Malawi where experts discussed the impact of sanitation and hygiene on blinding trachoma.


13 Oct 2014

On 1-3 October, water, sanitation and hygiene (WASH) and health NGOs and government representatives met to agree on a joint action plan for eliminating blinding trachoma in Malawi, to be funded by the Queen Elizabeth Diamond Jubilee Trust Trachoma Initiative. The Initiative’s aim is to eliminate blinding trachoma from Malawi and Kenya, using the SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvement), and move towards this in Uganda, Mozambique and Nigeria over five years.

The meeting was a step forward in bringing together governmental and non-governmental stakeholders, and establishing concrete collaborative activities around facial cleanliness and environmental improvement (F&E). Through group workshop discussions, five main activities emerged that the participants felt should be prioritised in future work: behaviour change communication; capacity building; school-led total sanitation (SLTS); community-led total sanitation (CLTS); and advocacy.

Boy from Madagascar washing face in clean water
Credit: WaterAid/ Marco Betti

This meeting was exciting for several reasons. Trachoma is a disease of poverty and suffering; it affects the very same people that WaterAid aims to serve through our programmes – the poorest and most marginalised communities. It has also been neglected historically, as one of a group of neglected tropical diseases. But things are changing. With the World Health Organization target to eliminate trachoma by 2020, there is renewed momentum to global efforts. While surgery and antibiotics have often been prioritised, the sanitation and hygiene aspects of trachoma prevention have not been addressed. The funding from the Trachoma Initiative can help reverse this neglect. More broadly, it is also creating an opportunity for organisations and government departments to work collaboratively.

WaterAid Malawi Country Representative, Mercy Masso, told me:

"The meeting was great because it provided us with the opportunity to begin interrogating the extent to which water, sanitation and hygiene programmes and interventions in Malawi are helping to resolve nagging public health problems, such as trachoma and other neglected tropical diseases that are prevalent in marginalised communities, characterised by poor access to basic services. For WaterAid, we need to look out for partnerships that will challenge us to work in more creative ways to achieve our goal of achieving universal access to water, sanitation and hygiene."

At WaterAid, we were really pleased to see a shift in focus to the connection between good sanitation and hygiene and the reduction of blinding trachoma, which is resulting in real action. We hope to be able to look back to this day in a few years’ time, when blinding trachoma is only mentioned in Malawi’s history books.