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Program Studies Effect of Hand-Washing Education Among At-Risk Children in Kenya

We keep our kids home from school if they have a fever, an upset stomach, or the flu. Sometimes we even declare it a sick day if the tyke has the sniffles or a little cough.

Why?

There are a variety of reasons, but near the top of the list is the idea that we don’t want it to get any worse. Intuitively, most parents know a child is better off resting at home for a day or two than having something like a simple upper respiratory infection turn into pneumonia. Because if that common cold becomes something worse, then it might mean a week or more at home on the couch instead of in the classroom. An occasional sick day is far better than being out for an extended period.

But what if those “minor illnesses” weren’t occasional? What if your daughter or son was on an illness roller coaster with viral and bacterial infections coming and going on a regular basis? That down time can be a major hindrance to educational success.

Those excessive sick days are a problem in many developing countries, including Kenya. According to a report from Susan T. Njau of Kenya’s Ministry of Education, hygiene-related illnesses affect education in the country at a staggering rate. One-quarter of Kenyan student absenteeism is due to abdominal pains, which are likely a result of intestinal helminths infections. Also, older children may miss school to look after siblings sick with helminths infections.

At Clean the World, we know long-term solutions require improved water, sanitation, and hygiene (WASH) programs in at-risk communities. That’s why we recently launched a year-long pilot program in Kenya that will serve as a model as we roll out to other locations around the world.

Soap in Schools

Soap distribution in Kibera
Soap distribution during a previous trip to Kibera.

To implement the inaugural Soap in Schools program, Clean the World teamed up with Helping Hand for Relief and Development (HHRD). We have a history of cooperative soap distribution with HHRD, having worked with them in Pakistan, Tanzania, and Somalia.

In this new program, we take things to the next level by providing soap and hygiene education to more than 4,000 children in 12 communities in central and northern Kenya. Together, we will measure the effect of ongoing hand-washing education and soap supplies on two specific indicators:

  • The incidence of hygiene-related illnesses, specifically diarrheal disease and pneumonia
  • School attendance, which we hope will increase as children get healthier

Right now we are conducting a baseline study in these Kenyan communities to determine how often children in the study group get sick and how much school they miss due to illness. After completing the baseline study, we will work with HHRD to provide the students with soap and continuing hand-washing education. Then we will conduct the same survey with the same group of kids every 90 days for the rest of the year to see if illness decreases and school attendance increases.

Intervention Evaluation

One of the great things about a study of this magnitude is that it allows us to test a few types of intervention. With 4,000+ students across a dozen or more communities, we can experiment with age groups, the frequency of hygiene education, and time of day to see what combination is most effective.

Is it more beneficial to spend 30 minutes twice a week with a group of kindergartners, or an hour once a week?

We don’t know yet. But by the time we finish collecting data and crunching numbers in early 2017, we will have the answer for you.

The Kenya program will also give us some insight into whether or not hand-washing education is more effective in urban areas vs. rural communities. About half our study locations are in Kibera, which is the largest slum in Nairobi, and the largest urban slum in Africa. Despite extreme poverty, poor sanitation, and confined spaces, residents of Kibera benefit from their location in some ways because they have access to clinics and other public services.

The other evaluation groups will be in rural areas where some of the residents are pastoralists and tend to be more tribal. While they may not have access to many of the services available in cities, they have a higher quality of life and live in less extreme conditions.

Although our first Soap in Schools program in Kenya will run for nearly a full year, you won’t have to wait that long to find out how things are going. We will provide frequent updates here on this blog and in our newsletter. Be sure to subscribe now if you don’t already receive the newsletter.

Case Study: Family’s Health Improves Dramatically With Soap and Hygiene Education

ruthDid you know that diarrhea and pneumonia are the leading causes of death among children in the developing world? Combined, they claim the lives of nearly 6,000 kids every day – more than AIDS, malaria, and TB combined.

Fortunately, there is a simple “vaccine.” Hand washing with soap is the most efficient way to prevent those deaths and can cut death rates in half. Through the Global Soap & Hygiene Initiative, a Clean the World cause, we focus on getting soap and hygiene education to those who lack access to it. In the past six years, we’ve distributed more than 30 million bars of soap to millions of people in 100 countries.

One person who received our soap is Ruth, a young mother living in rural Malawi. When we started working with Ruth, we learned that although she was familiar with soap, her family wasn’t buying it or using it. Like so many people living in poverty, Ruth had never been taught why soap and proper hygiene are so important for maintaining good health.

As a result, Ruth and her children were sick quite frequently. Several family members and neighbors had died from hygiene-related diseases. Ruth’s kids were falling behind in school and were about to drop out, and she was often unable to work and earn money to keep her family fed and nourished.

That changed when Ruth started participating in one of our projects, where she attended a local clinic each month with other parents to receive a free bar of soap and hygiene education. After nine months of participating in the program and using soap regularly, Ruth and her family no longer get sick. Better still, she and the other parents in the program see the value of soap and are buying it for themselves regularly as an investment in the health of their children.

To us, that’s success.

Global Health Starts at Home

Boy in Ecuador washing his hands

Guest Post by Julie Potyraj

Clean the World is one of a dozen groups working to promote WASH (water, sanitation, and hygiene) programs globally. However, it is among a smaller number of organizations starting to do this on a community and household level. Why? Because global change is anchored in community efforts. Improvements in infrastructure and policy begin with changes in the beliefs and behaviors of individuals. Programs at a local level are integral in laying a strong foundation for global public health achievements.

Global Importance of WASH Programs

WASH programs are a key strategy in achieving several of the United Nations Millennium Achievement Goals. Specifically, WASH programs aid in the reduction of child mortality, improve maternal health, help to combat disease, and increase environmental sustainability. The Centers for Disease Control and Prevention has extensively noted the health effects of poor water sanitation and hygiene practices. Currently, 780 million people do not have access to an improved water source and 2.5 billion people lack access to improved sanitation. Nearly 88 percent of deaths from diarrheal diseases can be traced back to a combination of unsafe drinking water, unsanitary conditions, and a general lack of water for hygiene purposes. WASH Programs could ostensibly prevent 9.1 percent of the global disease burden and as much as 6.3 percent of all deaths.

Risk to Children

Children are especially vulnerable to the effects of poor sanitation and hygiene. According to the World Health Organization, WASH programs can improve children’s nutritional status by preventing diarrheal diseases, intestinal parasites, and environmental enteropathy. Specifically, improved WASH resources could prevent as much as 361,000 (58 percent) of total deaths attributed to diarrhea in children under the age of 5. This is an incredible number considering that the CDC claims that around 801,000 children in this age group die each year from these causes. This represents 11 percent of the children younger than 5 who die each year.

Community-Based Prevention Programs

WASH programs have shown to make a significant impact on the health and well-being of those affected. In terms of reducing just diarrheal deaths, better water sources (21 percent), better sanitation (37.5 percent), improved drinking water quality (45 percent), and hand-washing (35 percent) have significant impacts. Expanding the reach of WASH programs requires a multi-pronged approach, including community-based interventions like soap distribution as well as demonstrations in hand-washing, safe household water management, and food preparation. According to US AID’s Maternal and Child Survival Program, “Hand-washing is the single most cost-effective intervention to prevent pneumonia and diarrhea in children, and reduces infections in mothers and children during pregnancy and childbirth.” If these programs have sufficient resources and are conducted with respect to the community, they have been shown to positively affect health in these communities.

Small Changes, Global Impact

Improved hygiene and sanitation practices are ultimately about changes in beliefs as well as behaviors of individuals. Workers are needed on the ground to provide demonstrations and positive reinforcement along with creating hand-washing stations and supplying soap, which reinforce the taught behaviors. Community- and household-level interventions are necessary to identify barriers as well as possible enablers to WASH behaviors in the home. Community-level workers are able to troubleshoot specific action steps for a given household or community to promote desired WASH techniques in the long term.

Supplies needed for these ventures are easily manufactured locally, which makes such community-based programs sustainable and cost-effective. As the saying goes, “Give a man a fish and he eats for a day. Teach a man to fish and he eats every day.” Organizations like Clean the World provide resources in addition to building skills, habits, and infrastructure from the ground up. Individuals are able to learn a set of skills that can have a lasting impact on their health as well as the health of their families and community. Once enough of these local-level actions take root, that’s when we will start to see global change.


Julie Potyraj is the community manager for MPH@GW, the online master of public health program offered by the Milken Institute School of Public Health at the George Washington University. For several years, she served as a community development specialist in Zambia coordinating youth empowerment programs and reproductive health education. She is currently an MPH@GW student focusing on global health and health communications.

Clean the World to be Featured on Univision News in Orlando and Tampa

Noticias Univision Florida CentralOn Monday, Feb. 8, and Tuesday, Feb. 9, Univision affiliates in Orlando and Tampa will air a two-part feature report on Clean the World during the 6 p.m. “Noticias Univision Florida Central” newscast. Viewers can watch the feature on either WVEN-Channel 26 in Orlando, or WVEA-Channel 62 in Tampa.

Emmy-winning news anchor Samuel Rivera recently visited Clean the World to learn more about the social enterprise. In the report, founder Shawn Seipler describes Clean the World’s mission and how it has contributed to a 30 percent reduction in pre-adolescent deaths since 2009.

Samuel learned about Clean the World in December when he attended the 18th Annual Don Quijote Awards in Orlando. Shawn received the Excellence Award that night and gave an overview of our organization after accepting the award.

Please be sure to tune in or set your DVR if you live in the area.

Guest Supply: An Invaluable Partner and Model of Corporate Social Responsibility

guest_supply_logoSomething we realized early on at Clean the World is that there was no book out there explaining exactly how to operate a social enterprise focused on international soap recycling and hygiene education. We discovered a lot of things by trial and error. And one of the things we learned early on was the importance of forming great partnerships.

Such as our affiliation with Guest Supply.

Since shortly after we founded Clean the World in 2009, Guest Supply has supported our mission with generous assistance across every area of the organization:

  • Much-needed recovery and distribution logistics for discarded soap and shampoo products from many worldwide lodging partners
  • Donating surplus soap from Guest Supply manufacturing facilities
  • Manufacturing consulting and expertise
  • Sales and marketing support
  • Supplies for hygiene kits

And there is a multiplier effect as Guest Supply offers those same services to bolster our expansion in Asia and Europe.

This ongoing assistance from Guest Supply is a testament to its commitment to corporate social responsibility. President Paul Xenis and his team play integral roles in Clean the World’s quest to eliminate needless hygiene-related deaths. Since we founded Clean the World in 2009, hygiene-related deaths among children under the age of 5 have decreased 30 percent, from an average of 9,000 a day to less than 6,000, a day.

That would not have happened without the combination of in-kind and operational donations we receive from Guest Supply. This year we are creating new programs to improve hygiene, reduce illness, and increase school attendance in developing regions. Support from Guest Supply allows us to focus more of our resources on that effort.

Thanks, Guest Supply!

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