In my hotel room I had two wash basins, a separate shower, an enormous bath and a huge collection of towels, shampoo bottles and bars of soap, all of which were replaced as soon as I had used them once.
Diarrhoea causes around 1.5 million children to die each year (UNICEF / WHO, 2009) and one of the most cost-effective interventions is hand washing with soap. In the local township, a project to improve hygiene and hand washing had been undertaken by Dettol which had shown through interventions of educational programmes, cascade training and provision of soap and cleaning materials, that there had been a significant decrease in morbidity. There are plenty of other studies giving the same evidence of the benefits of hand washing.
In the townships where there was no running water, the women in the programme had rigged up an ingenious washing station with a pair of old tights to hold the soap and an old 2L fizzy drinks container with water and a tube coming out of the top. Squeeze the bottle, water comes out, use the soap and squeeze again for more water and a final rinse. So hygienic and simple – a no-touch system after the washing process and air dry in the hot sun.
One aspect of changing behaviour is that people will undertake some form of cost-benefit analysis – what is in it for them? do the benefits outweigh the cost? One thing that struck me was how much trouble it was to wash your hands when there is no running water or soap, and yet in countries where these things are in abundance, a high percentage of the population fails to wash their hands after using the toilet.
In the townships, a main driver for the women to implement change of behaviour for themselves and their families was not just the threat of disease, it was the fact that to get to a hospital with a sick child could involve a 4 hour walk, where rape was a likely consequence on the way; even when they arrived, if the hospital had seen its quota of patients that day, then they faced a return trip with equal perils and would need to repeat the whole thing the next day.
We live in a culture in the developed world where we have become complacent – we think we are invincible – not likely to get ill, or if we do we have confidence in the antibiotics that for so long have saved us from severe illness or death from infectious diseases. But things are changing -more and more antibiotic resistant organisms are emerging, not only in hospitals but throughout the community and at the same time fewer new antibiotics are being created. Basic hygiene skills will be needed even more than ever.
At the end of June I am visiting an Aids Orphanage in Kabwe, two hours drive from Lusaka in Zambia where I am running a hand washing programme for all the children and will talk about the importance of hand washing and to provide them with some soap to start them off. We will also be making hand washing stations using recycled materials for those who live in the nearby shanty town to take back home with a bar of soap. Maybe it’s a shot in the dark but perhaps one or two people may take some notice.
I am hoping to raise £2000 for the school before I go – this will pay for four children to be housed and educated for a year – can you spend a penny (or 20,000)? I am paying for all my expenses so the money goes directly to the school – you are not funding a mid-life crisis trip!
To find out more about the Orphanage and Zamcog click here and watch the video.