17.6% of children born in Burkina Faso do not live to reach the age of 5, according to the UNICEF statistics for 2010. Burkina has the 3rd highest under-5 mortality rate in the world. High infant mortality rates directly influence family planning, since it is part of the reason why so many Burkinabe women decide to give birth to more children than they expect to care for in the long-term. In short, it is assumed that at least one of their children will die young.
Many people know that malaria is one of the leading causes of death for small children in developing countries. However, many do not attribute infant mortality to diarrhea. Did you know that, worldwide, more children die of diarrhea than of malaria, AIDS, and the measles combined? Or that 1.5 million children in Africa die from diarrhea every year?
The statistics are scary, but also hopeful when you consider that diarrhea is largely preventable if food preparers take necessary precautions and children learn healthy habits at a young age, namely hand-washing.
In the Western world, diarrhea is inconvenient and even amusing at times, inspiring funny jingles like the Pepto-Bismol song. In developing countries, diarrhea can be serious and fatal if not properly treated, especially among children under the age of five.
During my feasibility study, I noticed that none of the small children in my village defecated in latrines, even if there was one available in the courtyard. When I asked people about it, they said that children just weren’t used to them. When small children have to use the bathroom, they just squat and go wherever they please. Also, although people washed their hands before every meal, they did it in a communal bowl and without soap. Most people in my village do not have a primary school education and therefore do not understand germs or disease transmission, ideas that are drilled into us from a very young age in the United States. If you don’t know what a germ is, it’s hard to make the connection between these kinds of behaviors and getting sick. Furthermore, proper hygiene is even more important here where modern means of dealing with human waste are non-existent and farm animals are always in close proximity.
Donc, I set out to try to instill some healthy habits and some simple infrastructure in my community to make it a healthier place for children and their families.
The first step was finding and motivating some counterparts, so I brought two masons from my village with me to a USAID training on latrine construction and hygiene. We learned how to build latrines from start to finish and how to educate others on healthy hygiene practices. I applied for a USAID grant to build private latrines in my community and, as a result of the training, Peace Corps also gave us some additional USAID funds to make hand-washing stations and a model latrine which is currently being constructed at the community health center. Afterwards, health center employees will be educated on the importance of latrine usage and hand washing as a means of disease prevention.
The infrastructure component of the project, which provided a latrine for each of six different courtyards in six different neighborhoods in my village, is now finished. The grant paid for cement, rebar, wire, the mason’s labor and transport of materials. My village contributed the gravel, the sand, the water, the labor to dig the pits, and hygiene presentations to each of the families receiving a latrine (conducted by the two masons).
The education aspect of the project specifically targeted the primary school students since younger children are more likely to adopt behavior change and also the most vulnerable to death as a result of dehydration from diarrhea. Fortunately, the primary school closest to my house recently had latrines built by an NGO, but many students still weren’t using them and definitely weren’t washing their hands afterwards. So I put together three hand-washing stations with recycled oil jugs donated by the parents’ association of the school. All that was required was a small tap, a washer, and a hot iron rod to get the job done. There are 6 classes, the equivalent of kindergarten through 5th grade, with two classes sharing each hand-washing station. The students take turns filling the containers with water and making sure that there is soap (donated by the parents’ association). I went into each class and talked with the students about why it’s important to wash our hands after using the latrine. The kindergarten-aged students were very enthusiastic and really loved the hand-washing song in Jula, their local language. Since the very little ones don’t speak much French yet, I had my neighbor Yakouba with me to translate into Gouin and the director of the school translated into Jula. When I asked the kids what they do after they finish in the latrine, one kid yelled (in Jula) “I poop!” Everyone started cracking up and then I clarified and said “Yes, but after you poop?” He stood up and yelled again, “I leave!” It was funny and also very true. I asked them to raise their hand if they had ever had diarrhea or a stomach ache and everyone raised their hand. I asked them if they liked diarrhea and everyone shook their head no. Then we explained that if you wash your hands you won’t get diarrhea. We also told them to be responsible for one another and to remind others nicely if they forget to wash their hands. With the older kids, we incorporated a science lesson about germs, what they are and how they spread. This was really helpful because they understood the reason behind washing their hands, and also the importance of using soap and running water. Since we set up the hand-washing stations, I’ve been visiting the school during class hours to observe. If I see a kid properly wash his or her hands, I give them a little sticker. The teachers and director have been great at follow up as well so I’m confident in the sustainability of the project. Also, since the masons live in the village, they can meet the demand for new latrines.
The evaluation of the project will involve interviews with each beneficiary family to figure out just how many men, women, and children are using the latrines. Also, six months from now we will look at the health center statistics to see if there has been a reduction in the number of patients who come in diagnosed with a serious case of diarrhea. Just one example of how small behavior change can lead to a huge difference in the lives of individuals and the well-being of a community!