Community sensitization on hygiene and sanitation

Community sensitization on household hygiene and sanitation in the villages in Pader district, North Uganda

 

 The importance of sensitizations

Community sensitization in rural communities on health and sanitation is very important because it creates awareness in the community on the benefits of having, using and maintaining sanitary facilities, like latrines, in the homes. Not all the population in this area has latrines in their houses, and they use open spaces for defecation. Through the sensitization the community members can be aware of methods needed to promote health in their households as well in the entire community. They also become aware that they have important roles and responsibilities for the construction of these sanitary facilities in their households for their own benefit. This underlines the difference from the time of emergency, when most of this population was displaced in camps and facilities, like latrines, were constructed by different NGO's in the camps for community use. 

When households members use latrines and drink safe water, they avoid suffering from water borne and sanitation diseases which still represent a common problem in Uganda, especially in Northern Uganda, which was the area affected by insurgency in the 80s and 90s. The water borne diseases can be controlled and prevented by good hygiene practices, good household sanitation and drinking safe water.

By sensitizing community to construct their own sanitary facilities and have ideal home steads, they will feel the ownership of these actions and related results and the individual household members will be able to use and maintain the facilities well. It is our role, as health workers, to make the community aware!!!!

During the sensitization sessions, the following topics are discussed:

• The advantages and benefits of having an ideal homesteads, including homes with latrines, hand washing facilities, bath shelters, refuse pit, protected water source, drying rack, animal house, and birds houses;

• The negative consequences of poor hygiene and sanitation on health;

• Skills and knowledge on sanitary facilities construction like latrines, refuse pit, protection of water sources and many others; 
• maintenance of water sources, in order to establish the safe water chain; 

• Formation of village sanitation task-forces, as well as establishment and enforcement of by-laws.

The photo above shows the community in Wii Raa village, Laguti sub-county, Pader district, selecting the sanitation task-force at village level for household sanitation improvement, guided by Geoffrey Kilama, Health Inspector in Pader District. The selected members are the ones standing on the left hand side of Geoffrey.

The photo above shows Geoffrey Kilama holding community sensitization meeting, standing amidst community. The man talking is a community member providing his ideas on how to improve sanitation especially latrine coverage in the village. 

The situation on sanitation in Northern Uganda

The target of Government action on sanitation is all the house holds, villages, parishes, sub-counties and districts in Uganda have an ideal home steads. The national report on sanitation shows a latrine coverage of only 41% in the country, which is a poor indicator, calling for further action. This situation is particularly serious in villages of Northern Uganda, an area which was affected by insurgency and civil war for a number of years in the 80s and 90s. As a matter of fact, in this area in the past years, there has been a series of disease outbreaks, such as cholera, hepatitis E, polio and others, due to poor hygiene and sanitation.

 The situation in this village

As per the district report, district latrine coverage was at 46.8% only in 2013. When Geoffrey was in this village, there were only 17 households with functional pit  latrines out of  84 house holds, which account for 20.2% latrine coverage only in this village. This indicates that 78.8% of the households in this village defecate in the bush; this feace (fecal matters) is then washed to water points and contaminates water sources, where people draw water for domestic use. There are many water points in the villages, such as unprotected well, springs, streams, rivers, ponds and many others, which are likely to be contamined in this way. As well, flies carry these fecal matters and bring them to peoples houses, thus contaminating food, which results into health problems such as diarrhea and other more serious diseaase, leading to economic loss and sometimes to death. 

The objectives of sensitization is to create awareness on the benefits of using sanitary facilities like latrine in the houses and the consequences of not using them. The latrines should be constructed as guided by the Ugandan law "Public health act, rural sanitation rule".

Sensitization sessions

As Geoffrey's effort to improve on sanitation in order to prevent diseases related to poor sanitation, he managed to visits 6 villages over the last two months in order to provide them with health education sessions on the prevention and control of hygiene and sanitation related diseases. 

The communities were encouraged to use different methodologies and approaches to improve and increase sanitation coverage at household level, including PHAST (participatory hygiene and sanitation transformation), CLTS (community let total sanitation), HIC (Home improvement campaign) and Community meetings. 

The aim of these approaches is to make the village "Open Defecation Free" which means: nobody in the village who declared ODF should defecate in the bush. As a follow up, the number of pit latrines constructed in the village are counted and compared to the number of households. 100% latrine coverage is the target ratio to achieve.

Steps involved in CLTS are community mobilization and village triggering which includes mapping (as shown in the picture below), "walk of shame" for those still defecating in the bush, food and water bottle demonstration, shit calculation, medical expense calculation, problem identification and analysis, developing village sanitation work plan, formation of village sanitation task force and lastly formation of by-law and follow up of triggered villages. 

The photo below shows community drawing their village map in a participatory way and Geoffrey is looking at what they are identifying in their villages as problems in relation to poor sanitation, which need to be addressed.

The photo below shows community drawing the map of their village locating all the negative factors that are found in the village, including identification of  household without latrines, and later giving way forward to address the situation to make sure all those households have pit latrine within the agreed period of time.

What is your effort as health worker, leader, stakeholder or community member to combat this controllable and preventable sanitation situation in our communities in order to reduces the morbidity and mortality? Let's work together and be committed citizens to promote health in our communities!!!!! Speak out and engage yourself in improving health situation within our communities, its our duty!!!