Sanitation in schools

This blog, written by Wikichild co-ordinator Melinda Deleuze, is a part of the Wikiprogress September spotlight on "Education and skills". Also, in conjunction with the OECD's 2013 World Water Week, the post discusses the need for improved water and sanitation in schools and various organizations' efforts.

It is important to focus on improving school’s sanitation standards, because children are often the most vulnerable to diseases, according to wateraid.org. Children also take new ideas and habits back to their homes and families, increasing programs’ impact. 

Only 49% of schools around the world provide drinking water to its pupils and 11% of schools provide water for handwashing. In Kenya, although 63% of schools provided drinking water, only 27% had treated water. Also, while 63% of schools in Kenya have handwashing water available to its students, only 8% of schools have soap. Studies show that handwashing with soap can reduce the risk of diarrheal disease by more than 42% (Curtis and Caincross, 2003). 

Over the past few years, multiple organizations have been working hard to increase the number of schools with drinking water, sanitation facilities and handwashing stations. According to the Sanitation and Water for All project update (April 2013), in the past year, Nigeria mobilized private sector resources for provision of WASH facilities in over 700 schools.

Sustaining and Scaling School Water, Sanitation and Hygiene Plus Community Impact (SWASH+), also known as "WASH in schools", is a project established to identify, develop, and test innovative approaches to school-based water, sanitation and hygiene in Kenya. Funded by the Bill and Melinda Gates Foundation and the Global Water Challenge, the project has been running since 2006 with the help of CARE, Emory University’s Center for Global Safe Water, the Government of Kenya, Kenya Water for Health Organisation, Water.org, and SANA. SWASH+ has worked in 185 primary schools in four districts in Nyanza Province, gathering data, learning about challenges and testing solutions for school water, sanitation and hygiene (WASH). SWASH+ provides a base package, which includes:

1. Provision of water for drinking in safe storage containers
2. Daily treatment of drinking water with an appropriate technology
3. Provision of water for handwashing
4. Daily provision of soap

After the 5-year project, SWASH+ found that:

• Absenteeism is significantly reduced among girls, with an average of 6 days fewer absences per year.
• There was a 45% overall reduction of ascaris, and an even greater decrease among girls. Also, the intensity of hookworm infection significantly declined among boys.
• Unfortunately, there were higher quantities of E. coli bacteria on pupils’ hands who received hygiene, water treatment and sanitation facilities. A study by the European Journal of Tropical Medicine and International Health (2009) found that only 32% of Kenyans wash their hands after fecal contact.

Sapling handwashing, Malawi. Photo: Plan Malawi

Another program working towards increasing drinking water, sanitation facilities and handwashing stations in schools is the Pan African School Led Total Sanitation (SLTS) program. This program is targeting 742 schools in 6 sub-Saharan countries (i.e. Sierra Leone; Ethiopia; Uganda; Kenya; Zambia; Ghana; Niger; Malawi). In each country, the SLTS program follows the same process to facilitate the necessary activities to trigger the schools’ and communities’ progress:

1. Discuss with the government’s Health and Education sectors, plan at different levels and reach an agreement;
2. Train teachers who then train students how to use the school latrine and surrounding water and sanitation areas, as well as playing games which help internalize sanitation and hygiene concerns;
3. Register households for monitoring;
4. Conduct a school sanitation campaign, cleaning the whole school compound;
5. Group community into Development Units and establish these groups’ meeting places and times (meetings take place at schools);
6. Establish a committee of six for each Development Unit who facilitate discussion and prepare a report;
7. Monitor progress with these reports.

The SLTS program’s 5-year period runs through next year (2014), and this process can be reviewed and changed before the next Pan Africa program begins.

Water and sanitation needs to improve in schools in order to increase school attendance among girls and decrease sickness among all children. Top-down and bottom-up forces are needed to help children become more educated and safer around the world. 

  

 Melinda Deleuze

From the Bottom to the Top: One Step to Improving Global Sanitation

This article by Robbie Lawrence, Wikichild Coordinator, considers how global sanitation can be improved in the context of the International Federation of Red Cross’s ‘Getting the Balance Right’ report. This is part of the Wikiprogress #Health Series. 

"Communities in rural areas and urban settlements must be empowered to increase their resilience through access to safe water, improved sanitation and effective hygiene promotion." Getting the Balance Right, International Federation of Red Cross, 2013

This post follows on from Wednesday's blog on the dangers of diarrhoea by focusing on the disease’s chief causation: poor sanitation. Currently 3.4 million people die each year from water, sanitation and hygiene-related causes (Water.org). An estimated 2.5 billion do not have access to basic sanitation and 1.1 billion of those people practice open defecation. This is not only degrading but a severe health risk as fecal matter-oral transmitted diseases cause at least 1.5 million deaths per year in children under the age of five (Getting the Balance Right). As Gary White and Matt Damon so bluntly put it, by the time you’ve read this paragraph, another child will have died from something that is eminently preventable.  

In the same way that inequality has reared its head in the post-2015 discussions, forcing global leaders to consider how poverty reduction might be carried out more equitably in the future, it is evident that we need to address water and sanitation issues. The "Progress on Drinking Water and Sanitation 2012" report by the WHO and UNICEF highlights that, although the MDG target of halving the number of people globally without access to improved water source will be fulfilled by the MDG 2015 deadline, the target for sanitation is unlikley to be met.  

More often than not aid donors and development agencies have aimed at providing clean and safe water supplies rather than making sanitation a priority. As it stands, sanitation only receives 12 percent of global aid put towards combatting water and sanitation related issues. In the short term this trajectory make sense, since water is usually in more immediate demand, however, if diarrhoea and other hygiene related illnesses are to be dealt with, access to sanitation facilities must be increased. The ‘Getting the balance right’ report emphasizes that ‘neither water nor sanitations is more important: both elements are required to maintain and improve health and dignity.’

Water.org argues that the inability of philanthropic efforts to efficiently deal with the problem of poor sanitation has been a problem in the past. Even the money that has gone towards solving the issue has largely missed the goal of providing relief for those most in need. The organization recognized that if local communities were to make progress, independent of donors, then they must be viewed and view themselves as the owners of the project. Community ownership is the linchpin of Water.org’s philosophy. Without an active engagement from communities from the start of a project to its completion there is a strong likelihood that previously entrenched social norms such as public defecation will continue.

The ‘Getting the Balance Right’ report delivers a similar message, and uses a number of examples of community-based initiatives that have succeeded in improving sanitation. In Eritrea, a country where only three percent of its rural population has access to sanitation, the IFRC and the EU implemented a program focused on mobilizing and educating women in hygiene knowledge that reached a total of 145,000 people in 120 villages. By empowering these local women and providing them with  information, the program motivated them to become promoters of sanitation within their own communities. The Water.org website also lists various bottom to the top initiatives that have shown remarkable success rates. An Emory University review of a Water.org community based ventures in Lempira, Honduras reported that 100 per cent of the project sites were still operational after 10 years with 98 per cent of respondents satisfied with the system.

Since poor sanitation is now firmly in the crosshairs of policy makers and aid groups, it seems that the Water.org and IRFC have laid out a fairly effective framework for combating the problem. Changing intrinsic social norms from the routes of a community appears a far more effective means of catalyzing change than large, trickle down cash injections. The flow of international water aid must of course be rebalanced towards sanitation, but organizations, governments and NGOs need to go further and ensure that it reaches the right groups and individuals. The stark reality of IRCF’s report brings to light the vital role that sanitation plays in human health and dignity:  

"Let us speak clearly; the single largest cause of human illness globally is faecal matter. A society – regardless of how many clinics or water supply points it has – can never be healthy is human waste is not safely disposed of." Getting the Balance Right

Robbie Lawrence