Catch them young

It is becoming more apparent that working with children is the most effective way of improving hygiene practices among poor communities.

Credit: WaterAid / Somesh

By Libby Clarke, WaterAid's Communications Services Manager.

Catch them young is the new principle of WaterAid India. It is becoming more apparent that working with children is the most effective way of improving hygiene practices and hence combating disease among poor communities.

Libby Clarke reports on WaterAid's projects in schools in two south Indian states.

When eight-year-old Gantla Krishnaveni arrives at school in Rapaka village in Visakapattinam District in Andhra Pradesh, she's never really sure which of her classmates will be present. "Some of my friends are suffering with a fever now so they are not able to come to school. I had a fever too recently and had to stay in bed for four days."

Gantla reports this nonchalantly, as if it would be ridiculous to expect to see all of her friends every day. For the children of Rapaka disease is an every day occurrence, and it's not unusual for the diseases to prove fatal. Last year alone six children under the age of three died in the village from diarrhoeal diseases.

In Thimmapuram, everyone knows the importance of good hygiene practices.

Credit: WaterAid / Somesh

A short walk around Rapaka village reveals many possible causes of the diseases. There is no proper drainage, and wastewater is thrown out on to the streets. Stagnant water lays everywhere, turning the footpaths to mud, mixing with rubbish and attracting mosquitoes.

Wild pigs roam the streets eating human faeces and other waste. Only three of the village's 400 families have latrines, so the vast majority of people go to the toilet by the roadside or in the fields. One of the handpumps doesn't work at all and the other one has a broken platform, which means that stagnant water seeps into the ground.

A few miles along the road in the village of Thimmapuram, life is very different. On entering the village school you are greeted by neat rows of smiling children, with hardly a hair out of place, who can talk at length about the causes of water related diseases. "The diseases transmitted from one person to another are known as communicable diseases. Diseases are transmitted by flies from contaminated food and water," rattles off 10-year-old Laksmi.

But it's not just talk - when you walk around the village you see people using soakpits, washing platforms, drying racks, latrines and kitchen gardens, all of which are absent in Rapaka.

Everyone here knows the importance of good hygiene practices so human waste and wastewater are always safely disposed of. As a result fevers, diarrhoea and malaria have been virtually eliminated.

Thimmapuram's sanitation facilities are new. The community bought them recently after WaterAid's partner GSS raised awareness of the importance of good hygiene. This was done by introducing hygiene lessons into the school curriculum, building a school latrine block with a large hygiene promotion mural painted on the side, and simultaneously running health awareness camps for adults.

The community then decided it needed the facilities, but was unsure how to finance them. GSS helped the community establish a credit scheme - every householder contributed funds to a savings account, which allowed them to access credit from both GSS and the Government. They are now all repaying the amounts owed in affordable monthly payments and enjoying healthier, happier lives.

In Thimmapuram it is unclear what the key driving force was for the demand for sanitation facilities. The hygiene education for children and adults was simultaneous so it is not possible to measure the relative effectiveness of the different types of hygiene education. However, a study on WaterAid's projects run in six schools in the neighbouring state of Tamil Nadu indicates that it is children who are chiefly responsible for effecting improvement in hygiene behaviour across the community.

Udayakulamputhur Primary School is one of the schools covered by the study. Hygiene education began here two years ago when WaterAid's partner organisation Gramalaya helped the school establish a health club.

All the pupils are members of the health club, which is split into five committees with designated responsibilities: water maintenance, campus cleaning, toilet maintenance, food and classroom cleaning. The children learn the importance of good hygiene in hygiene education classes, and take their responsibilities very seriously. The duties are undertaken in break-times.

Ten-year-old Isabella is a member of the water maintenance committee, whose responsibilities include keeping the school water tank neat and clean and washing the drinking jugs and tumblers. Isabella enjoys her role and talks about it at home: "I like the school being clean.

I have talked to my family and told them to wash their hands after handling animal faeces in the field, before eating and after defecation. My mother is now practising all of this."

WaterAid's study shows that Isabella's story is the norm. The families of the 1020 children at the six schools were interviewed and it was found that 68% of them had built toilets with no external assistance since the school projects began. These are communities who had had no contact with WaterAid or any other NGOs except through the school projects.

The demand for sanitation was purely a result of children persuading their families to adopt good hygiene practices following their education at school. The study also found that after a year 96% of the children could remember how to prepare a diarrhoea treatment solution. Where WaterAid projects focus on providing hygiene education for adults it generally takes four to five years for the same messages to be absorbed.

WaterAid India's Country Representative Shunmunga Paramasivan was overwhelmed by the results of the study.

"I'm really excited about the study's results. It shows it can be much more cost and time effective to work in schools as it takes so much more time to effect the same changes when working with adults. I don't yet think this means we'll start working exclusively in schools, but we'll certainly try and integrate schools into more of our community projects."

It seems the old adage is true - catch them young enough and the possibility for change is endless.

Read more about our work in India