WASH interventions help reduce waterborne disease rates in schools

Students at Lepolosi Comprehensive School take water and wash their hands using hygiene and sanitation facilities built by Amref Health Africa in Kenya, located in Narok West Sub County. [Nanjinia Wamuswa, Standard] Two students are huddled over their assignments in an imaginary classroom overlooking a jam-packed field at Lekanka Primary School. One is struggling to keep up with work. Her concerned colleague, noticing the discomfort, asks if she needs help. Agnes Nampaso, with a strain on her face, says she's unwell. The classmate holds and supports her to the head teacher, who immediately arranges for her to visit a health facility for examination. At the facility, diagnosis reveals Agnes has typhoid the World Health Organization (WHO) describes as a life-threatening infection spread through contaminated food or water. It is common in areas with poor sanitation and unsafe drinking water. The skit from Olenkuya Primary School concludes with a powerful message from actors, highlighting the importance of consuming clean and safe water. Students from 15 primary schools participated in celebrating Water, Sanitation and Hygiene (WASH) in Schools (WinS) through various fun and educational activities including skits, poems, songs, dances and essay writing to raise awareness and promote proper WASH practices and behaviours among learners and the school community. "It is not just a skit, but the reality we face every day. We rise before dawn to fetch water and return late, often missing classes. Many times, we fell sick from taking contaminated water," explains Agnes, who played the role of a sick learner. WHO warns that contaminated water and poor sanitation are linked to transmission of diseases such as cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio. In 2010, the UN General Assembly recognized that everyone has the right to sufficient, continuous, safe, acceptable, physically accessible and affordable water for personal and domestic use. Because safe and readily available water is important for public health. Yet, worldwide, 2.2 billion people still lack access to safe water. Data from United Nations Children's Fund (Unicef), says 59 per cent of Kenyans have access to safe drinking water than to basic sanitation at 29 per cent. That, since 2000, access to safe drinking water has increased by 12 per cent, while access to basic sanitation has fallen by five per cent. The fortunes of learners in various schools and communities in Narok began to change in 2021 when Amref Health Africa funded by the German-based Well: Fair Foundation started implementing 100 per cent WASH project in Narok County. The organization focused on securing the human rights to safe drinking water, safe sanitation and hygiene in underserved rural communities and schools. The project supports 42 schools and 281 catchment villages by providing WASH infrastructure and promoting proper hygiene and sanitation behaviours to have a direct positive effect on education and health for women and children. Amref has drilled boreholes and rehabilitated water sources that now provide enough water to schools and communities. It has built latrines, bathrooms, wash facilities, kiosks for fetching water and water troughs for livestock. On latrines and bathrooms, are messages showing critical times to wash hands, such as 'Wash our hands after using the toilets,' 'Clean hands save lives,' and 'Clean and safe environment is a right for every child.' Hundreds of learners who've benefited WASH project, confide they now have access to plenty of clean, safe water and even baths in schools. So far, they have covered 241 villages and over 65,000 community members have access to safe water, use toilets and wash hands. Agnes explains, "I used to miss bathing for several days for lack of water. Today, l bath once or twice at school. Thanks to Amref interventions, l now know there are solutions to water problems that negatively impact learners." Bathing in schools At Lepolosi Comprehensive School, as the bell tolls signalling lunch hour, Nosim Naisho quickly reaches into her bag and grabs a small soap, leso and hurries towards the bathrooms. She enters one of the bathrooms, shuts the door and turns on the shower. In around four minutes, she emerges wiping her face. Outside, a group of other girls wait to use the shower. And, a few metres away, boys queue at the boys' bathroom for their turn. "If l didn't bathe in school, l would go several days without bathing due to water scarcity at home," says Naisho 12, who comes from a distant village and dreams of becoming a doctor. Samuel Kisotu, head teacher at Lepolosi explains learners bathe at lunchtime because it's the only time they have a longer break and enough time to freshen up. He says, before interventions, learners would accompany their parents in search of water, often coming late or missing classes completely. "Curriculum-wise, there were delays in the progression of lessons and lack of uniformity because learners missed or came late for classes. But with WASH facilities available, lessons begin on a good time and students are moving at a consistent pace," he explains, adding, that the retention rate is also high. The availability of clean water has triggered the building of a kitchen for the school feeding program. Initially, learners just took water when thirsty, but teachers realized they also needed meals. Daniel Kurao, WASH Programme Manager at Amref Health Africa in Kenya explains using running water to wash hands can prevent so many diseases. Beatrice Naisho (l) a community member fetches water from a water kiosk located at Lepolosi Comprehensive School built by Amref Health Africa in Kenya in Narok West Sub County. [Nanjinia Wamuswa, Standard] "We have found this simple intervention effective in households, schools and markets. Handwashing can help us prevent up to 70 per cent of the diseases that affect us," he says. Kurao says Amref focuses on transforming community health through primary healthcare, emphasizing on women and youths. He says their interventions target schools because they gather hundreds of young people, ensuring they learn basic hygiene principles and practises. He says, "We expect children to take home these messages and have communities there also practise good hygiene practises to prevent waterborne diseases among them cholera, typhoid and scabies. UNICEF states, "When schools have safe water, toilets and soap for handwashing, children have a healthy learning environment and girls are more likely to attend when they are on their period. Children who learn about safe water, sanitation and hygiene habits at school can reinforce positive life-long behaviours in their homes and their communities." Sylvia Shetishoi, a teacher and Health Club patron at Lepolosi shares that initially they faced challenges because the club focused on water-related issues, but was solved with WASH interventions. "We're engaged in various activities, members are active, making their liquid soaps and distributing to classes for pupils to wash their hands. They are responsible for maintaining cleanliness throughout the school and its facilities including toilets. Members also distribute tissue papers to classes," she explains. Girls on menstruation can bathe at least twice a day, feel fresh, and comfortable and stay engaged in class. They no longer stay away from classes during their menses as they used to, without water. For Sammy Sarike from Olenkuya Primary, the installation of water troughs has reduced his need to search for water for their livestock, allowing him to attend school without interruption. "There's now plenty of water for livestock. I don't have to worry about where to get water for our cattle. I have all the time to focus on learning. I am also clean, for bathing every day in school," he says. Beatrice Naisho, a community member praises Amref for providing water. She recalls having to fetch water with the help of her eldest daughter, which often caused her to miss school. "We needed water for a family of six, this was difficult for me to carry enough alone, especially because we walked 10km to get water," she says. Lucy Kashu, Chief Officer of Health, Narok County says the county faces a high prevalence of top 10 diseases, among them upper respiratory tract Infections (like coughs), suspected malaria, skin diseases, urinary tract infections, pneumonia, diarrhoea and intestinal worms. "These diseases cause our children to miss school frequently. Or struggle to concentrate when they attend. Yet, these are preventable diseases," she explains.

WASH interventions help reduce waterborne disease rates in schools

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