UNICEF/Malawi: CLTS Triggering Tools: How to Trigger for Hand Washing with Soap

UNICEF/Malawi: CLTS Triggering Tools: How to Trigger for Hand Washing with Soap, March 2013.

• Link to full-text, pdf

An Excerpt: The tools outlined by this document were developed based on actual field research in testing, done as a collaborative effort between UNICEF and Salima District Council. Salima was selected for the research and testing of new hand washing triggering tools because they already had experience attempting to incorporate hand washing into their triggering process, and also have data showing high numbers of new hand washing facilities being built after CLTS. Also, Salima was selected because they implement CLTS continuously as part of their routine extension staff work.

Nine different tools were tested for how well they instilled a realization of the importance of hand washing with soap (HWWS). When these tools were used, hand washing practice increased by 69% and soap availability at hand washing facilities increased by 15%, compared to when CLTS didn’t include specific
tools to trigger HWWS. However please take these guidelines with a grain of salt, as they are based on a small sample size, overall only a few villages.

THE 10 FIELD-TESTED HAND WASHING TRIGGERING TOOLS OUTLINED IN THIS DOCUMENT:

• Anal Cleansing Materials
• Shit and Shake
• Cassava/Egg Demonstration
• Charcoal
• Smelly Hands
• Charcoal Smearing
• Scratch & Smell
• Wall Contamination
• Food Sharing
• Dirt Under Fingernails

Kenya, Nairobi: Unilever enrols 100,000 schoolchildren in handwashing drive

Unilever through its Lifebuoy soap brand has reached 100,000 students in over 80 schools across Nairobi County its hand washing campaign. The “School of Five” campaign aims to get over one million people across Kenya to pledge to the habit of washing their hands with soap on five occasion throughout the day with the help of trained school children and teachers. The campaign is being jointly implemented by Lifebuoy Kenya and Water and Sanitation for the Urban Poor (WSUP).

Lifebuoy School of Five poster

Unilever contracted popular Kenyan singer Esther Wahome, in a two-year “multi-million shilling” deal, to act us brand ambassador  for the Lifebuoy School of Five campaign. In line with the campaign. Mrs Wahome has released a handwashing jingle dubbed Osha Mikono (Wash your hands) to accompany the campaign.

A 2010 clean hands study conducted to check the hand washing habits of Kenyans found that only 15 per cent are aware of the proper hand washing techniques.

Visit the Lifebuoy Facebook page

Source: Stanley Njenga, Nairobi Star / allAfrica.com, 09 Jul 2011 ; Hot Secrets, 25 Apr 2011

WASHCost reveals higher capital costs for sanitation than water, and high expenditure on soap

Most sanitation costs in rural and peri-urban areas are borne by households and when these are taken into account, the per capita costs are actually higher than those for water. State expenditure on capital maintenance, operation and maintenance, and direct and indirect support costs for sanitation is minimal in all four research countries of the WASHCost project. Households in Africa are spending surprisingly high amounts on soap. These are some of the findings that were presented at the IRC Symposium in The Hague on 16-18 November 2010.

The WASHCost project is working with partners in Burkina Faso, Ghana, Mozambique and in the Indian State of Andhra Pradesh to collect and analyse cost data for water and sanitation services in rural and peri-urban areas. The overall aim is to build better cost data into country systems to increase the quality of services, especially targeting issues of poverty, equity and cost-effectiveness.

Global Handwashing Day: 200 million lather up for clean hands

More than 200 million schoolchildren, parents, teachers, celebrities and government officials in 80 countries lathered up in the third annual Global Handwashing Day on 15 October 2010. This year’s celebrations revolved around schools and children, and the theme “more than just a day“ aimed to make the simple, life-saving practice of washing hands a regular habit.

To ensure that efforts go far beyond one single day, the Global Public-Private Partnership for Handwashing with Soap launched several tools including a “100 School Survey” questionnaire, a monitoring toolkit, the More than Just a Day brochure, and the “Get Bubbly” children’s game.

Effect of water quality, hygiene and sanitation in preventing diarrhoea deaths

Researchers propose diarrhoea risk reductions of 48, 17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the Lives Saved Tool (LiST) model [1].

LiST is a new computer-based planning tool to help estimate the impact of scaling-up maternal, newborn and child health interventions. LiST was developed by a consortium of academic and international organizations, led by Institute of International Programs at the Johns Hopkins Bloomberg School.

Researchers led by Prof. Sandy Cairncross of the London School of Hygiene & Tropical Medicine, drew on three systematic reviews, two of them for the Cochrane Collaboration, to determine the estimated effect on diarrhoea mortality of the three interventions.

The striking effect of handwashing with soap (48% reduction) was found to be consistent across various study designs and pathogens, though it depended on access to water. The effect of (household) water treatment appeared similarly large, but was not found in few blinded studies, suggesting that it might be partly due to the placebo effect. The researchers found very little rigorous evidence for the health benefit of sanitation; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese.

While most of the evidence was found to be of poor quality and more trials were required, the evidence was nonetheless strong enough to support the provision of water supply, sanitation and hygiene for all.

[1] Cairncross, S., Hunt, C., Boisson, S., Bostoen, K., Curtis, V., Fung, I.C. and Schmidt, W.P. (2010). Water, sanitation and hygiene for the prevention of diarrhoea. International journal of epidemiology ; vol. 39 (Suppl. 1) ; p. i193-i205. DOI:10.1093/ije/dyq035

The complete issue of the April 2010 supplement of the International journal of epidemiology is devoted to the development and use of the Lives Saved Tool (LiST). Other articles deal with rotavirus vaccine, zinc treatment for diarrhoea, antibiotics for dysentery, and oral rehydration solution. All articles are free to download.

Walt Disney World Resort Joins Clean the World to Recycle Soap

Walt Disney World Resort Joins Clean the World in an Innovative Program to Recycle Soap

ORLANDO, FL–(Marketwire – February 21, 2010) – Walt Disney World Resort hotels are working with Clean the World to recycle all the partially used amenities from their nearly 28,000 Central Florida hotel rooms. Clean the World sanitizes the soap and shampoo that would be discarded and distributes these amenities to people in need around the world.

“With the support of Walt Disney World, even more supplies will reach those in desperate need,” said Paul Till, co-founder and managing director of Clean the World, who is responsible for recruiting new hotels to join the “Clean the World Hospitality Recycling Program.” Through this program, hotels financially contribute a tax-deductible recycling fee in exchange for collection, recycling and free redistribution of partially-used amenities to those suffering due to a lack of available hygiene products. In 2009, Clean the World distributed more than 230 tons of hygiene products to countries worldwide including Haiti, Mexico, Honduras, El Salvador, Nicaragua, Uganda, Mali, Zimbabwe, Swaziland, Mongolia and Romania.

By participating in this program, Walt Disney World Resort hotels are showing a commitment to saving lives and protecting the environment.

Clean the World in Haiti – In the wake of the devastating earthquake in Haiti, Clean the World has stepped up its commitment to provide basic necessities to the impoverished people of the island nation, and has included medical supplies, food, water and other essentials as well. Since January 2010, Clean the World has delivered over 150 tons of supplies directly to Haiti.

In 2009, Clean the World delivered 200,000 bars of soap to schools, orphanages, clinics and churches in Cap Haitien, Haiti. Though its Haitian partnerships and distribution network, Clean the World is providing free soap to people in desperate need for proper hygiene. In Haiti alone, 8,000 children die annually from diarrheal disease, which is preventable by up to 62% with proper hand washing.

About Clean the World, Inc.
An Orlando-based charitable organization, Clean the World, Inc. is committed to the prevention of illness and death caused by acute respiratory infection and diarrheal disease in countries across the globe. In an effort to prevent these needless deaths from occurring, Clean the World collects discarded soap and shampoo from hotels to be recycled and distributes these soap products along with appropriate educational materials to domestic homeless shelters and impoverished people worldwide. In 2009, Clean the World collected, recycled and distributed over 230 tons of soap and other bathroom amenities to impoverished people worldwide. With the donations of these discarded soap and shampoo products, Clean the World is a step closer to reaching their goal of preventing the millions of lives lost each year — and they’re doing it one bar of soap at a time. Clean the World Foundation, Inc. is a non-profit, 501(c)(3) tax-exempt charitable organization.

Source – http://www.marketwire.com/mw/rel_us_print.jsp?id=1119800&lang=E1

Afghanistan, Kabul: toilet tribulations

For Kabul’s estimated population of 4-5 million there are only 35 public toilets, according to the municipal authorities.

“We need at least 65 extra public latrines in Kabul immediately,” Nesar Ahmad Habibi, head of Kabul’s waste management authority, told IRIN, adding that the lack of government action and limited resources had prevented the construction of sufficient public toilets in the city.

“We have even sent proposals to the president’s office but to no avail,” he said.

Many people are forced to defecate and urinate in the open: “It’s not that we don’t want to use a latrine, it’s because there is no latrine,” said Arifullah, a local man.

“If you have a pain in your stomach and there is no toilet how long can you wait?” asked another man.

Only five of the 35 public toilets have facilities for the disabled – well below what is needed given the large number of disabled people resulting from three decades of turmoil.

People who use the latrines have to pay a small fee to cover maintenance and cleaning – 5-10 Afghanis [10-20 US cents], a sum that the large number of extremely poor people in the city would prefer to avoid paying.

A rapidly growing population, lack of modern sewage systems, significant waste management problems and the lack of public toilets in Kabul are causing environmental and health risks, according to experts.

No soap

“I don’t use the latrines because they are extremely dirty,” said Abdul Jamil, a young man. “There is also no soap to wash your hands.”

None of Kabul’s public toilets provide soap or hand-drying facilities.

Whilst hand-washing is crucial for disease prevention, soap is also not available in toilets in most Kabul schools, officials in the Ministry of Education said.

“Inappropriate latrines, open defecation and poor waste management cause serious diseases and damage the environment,” Hassan al-Sayed, country director of the French NGO Solidarités, told IRIN.

Waste management

In September 2008 Kabul Municipality said that up to 90 percent of the 3,000 tons of solid waste produced in the capital every day was managed and dealt with.

However, officials say waste management capacities have deteriorated sharply in the past year: “Now we collect only about 50 percent of the solid waste produced in Kabul on a daily basis,” said Habibi, citing dwindling resources, staff reductions and broken-down trucks as major problems.

“For waste management in Kabul we need 17,500 staff but we have only 3,000; and we need 2,500 trucks but we only have 119.”

Rapid population growth and unregulated housing developments have created serious social and environmental challenges in Kabul, according to government officials.

Al-Sayed, whose organization has been helping households in Kabul to build hygienic latrines, emphasized the importance of public awareness about sanitation and hygiene.

“What if there are hundreds of safe latrines but people don’t use them,” he said, adding that people should know the risks of open defecation and unsafe latrines.

Only 12 percent of Afghans have access to improved sanitation and less than 25 percent have access to safe drinking water, according to the UN Children’s Fund (UNICEF).

Most Afghans use the traditional dry vault toilet systems which were ranked the worst toilets in the world by WaterAid’s State of the World’s Toilets 2007 report.

Source: IRIN, 16 Nov 2009

IFH – Use of ash and mud for handwashing

Use of ash and mud for handwashing in low income communities. 2009. (pdf, 480KB) Professor Sally F. Bloomfield; Professor Kumar Jyoti Nath. International Scientific Forum on Home Hygiene (IFH).

Epidemiological and microbiological data show that, in low income communities, as elsewhere, handwashing is particularly important in reducing the burden of infectious and parasitic diseases. These data also suggest that the efficacy of the handwashing process itself has a significant impact on the risk of disease transmission. A key factor is the extent to which pathogens are detached from the skin surface, by rubbing with appropriate materials prior to rinsing. In low income communities in developing countries, soil, mud or ash are still frequently used as an alternative to soap.

In using mud, soil or ash as an alternative to soap, it is important to weigh the potential benefits, against the fact that these materials can become contaminated with pathogens and helminths, and can themselves act as a vehicle and source of gastrointestinal, parasitic and other infections. These materials can also contain potential toxic heavy metals such as arsenic, lead and chromium, as well as pesticides.

The objective of this review is to bring together the available scientific data on the benefits and potential risks of using mud, soil and ash, as against soap, as against water only, for handwashing, and evaluate the factors which inform choice of the most appropriate agent in relation to the needs and constraints in different communities. The review was prepared by Professor Sally Bloomfield and Professor KJ Nath. The report was peer reviewed by Dr Stephen Luby (International Centre for Diarrhoeal Diseases Research, Bangladesh) and Dr Bilqis Hoque (Environment and Population Research Centre, Bangladesh).

Haiti – Non-Profit Helps Combat Spread of Disease With Soap Donations

(CBS News) With all this worry over the H1N1 flu virus, there’s a lot of talk about hygiene. Even President Obama has urged us to wash our hands. But this simple act is a global problem when one in five people live without clean water, and 5 percent live without adequate sanitation.

It’s too often the case in Haiti where a worldly offering sets off a scramble. It’s not for free food or medicine but soap.

Precious here, the handouts would’ve been trash in the United States if not for Shawn Seipler.

“I thought there would be anxiety or desperation for it, but not nearly to the degree I just saw,” Seipler told CBS News Correspondent Seth Doane.

This mission to Haiti was born almost a year ago, when Seipler and his colleague Paul Till were salesmen sporting six-figure salaries.

They got to wondering about those little bars of hotel soap, which most of us use just once.

“There are 4.6 million hotel rooms across the United States,” Seipler said. “We started doing the math and figured that’s a lot of soap that’s being tossed out.”

He estimates that’s 1.5 million bars hitting American landfills every day, a number so staggering it inspired them to quit their jobs and launch a non-profit called Clean the World.

They collect soap from 80 Orlando, Fla., hotels, use restaurant steamers to remove impurities and repackage the bars for shipment. Most hotels jumped right on board.

“We had this 900 room hotel that needed a place to put its slightly used amenities,” said Marshall Kelberman, director of the rooms department for Orlando’s Peabody Hotel. “It just felt like it was a match made in heaven.”

It’s a shoestring operation with an ambitious goal.

“Yes, it’s about recycling,” Seipler said. “It’s about preventing landfill waste … but it’s also about taking those items … and handing them to people who are dying because they don’t have soap.”

In Haiti, the poorest country in the Western Hemisphere, disease spreads easily.

Garbage clogs gutters, fills rivers and seems to suffocate life.

Worldwide, 2 million people die every year from diarrhea, often caused by poor sanitation. Most are under the age of five, 8,000 children in Haiti alone.

Studies suggest simple hand washing could cut those deaths by up to 30 percent. But that’s not as simple as it sounds.

In a market in Cap-Haitien, a woman sells soap for a little less than a dollar a bar, which doesn’t sound like much, but you’ve got to consider that three-quarters of Haiti’s population lives on less than $2 a day.

Some students here may sing about soap, but their school’s headmaster says those lessons are often lost at home.

“Because it’s just too expensive?” Doane asked headmaster Jayce Dortelus.

“It is; they can’t afford it,” Dortelus said.

So far, Clean the World has distributed 60,000 bars.

While it’s only a dent, it’s had a big impact on Seipler’s spirit.

“It was crystal clear,” Seipler said while tapping his head. “But it wasn’t until we came here until it really got into the heart.”

Hope by the handful in a place where just a sliver is reason to cheer.

Source – CBS News

Donating soap: Clean the World partners with U.S. hotel industry

Clean the World (CTW)™, a non-profit, charitable organization, headquartered in Orlando, has just got its newly-formed hotel industry partnership off to a flying start. The organization recently completed its first airlift of more than 2,000 pounds (21,000 bars) of donated hotel soaps to churches and orphanages in Cap Haitien, Haiti, the poorest region of the poorest country in the Western Hemisphere.

“It’s amazing that our industry hadn’t thought of this before,” said Alan C. Villaverde, president, Peabody Hotels and general manager of The Peabody Orlando, one of CTW’s first hotel partners. [...] “I encourage all hotels, whether independently owned and managed, or major, big-name chain properties, to contact Clean the World and become partners in this truly outstanding program. The U.S. hotel industry has the power to do untold good where it is most needed.”

CTW, which partners with Central Care Mission, is primarily committed to providing personal hygiene products to Third World countries where the simple act of washing hands in soap and water can reduce the millions of deaths of little children due to respiratory and diarrheal illnesses. “We were astonished to learn that 3.5-million children die annually due to acute respiratory and diarrheal diseases,” said Shawn Seipler, the organizations executive director. [...] “ There are 4.6-million hotel rooms in the United States alone, and it is estimated that some 2.6-million bars of soap are discarded every day, enough to supply each of those 3.5-million children with a bar of soap every three days.”

The unique recycling of “gently-used” hotel soaps and shampoos, results in thousands of pounds of sterilized soap being shipped to under-privileged Third World countries, such as Haiti. The program creates jobs, ten new paying jobs have been created since March, 2009, saves lives because of improved personal hygiene, feeds the homeless, and helps save the planet by reducing the thousands of tons of hotel soaps and shampoos dumped into landfills every day.

[...] CTW operates two recycling methods: Re-batching and Sterilization. Re-batching is applied to 30 percent of moderately- to heavily-used bars. Soap is “cooked” to remove all impurities and is re-formed into two-ounce bars. Sterilization is applied to 70 percent of the slightly used bars. Soap soaks in sterilization solution then is shock treated. (Patent Pending). This process completely eliminates the pathogens (Listeria monocytogenes, Escherichia coli, Pseudomonas aerogenes, Salmonella typhymurium, Staphylococcus aureus) as verified by Tri-Tech labs, an environmental testing facility in Orlando, FLA.

CTW reports that currently 100 hotels in Central Florida are active participants in the program. [...]These hotels|–|and others|–|represent 10,000 rooms serviced each day, providing 500 pounds of soap daily, 3,500 pounds weekly. Clean the World is busily expanding operations in Boston, Las Vegas, New York, Houston and Chicago. For more information visit the Clean the World web site.

Source: Hospitality Newsmaker Alert, July 2009

See below the video: The Clean Haiti Project — by Clean the World