Our Community Action Guide

© 2007 MKFC Stockholm College

Our Community Action Guide


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contents

phase 1 – lessons learnt

Micro credit - role Model (piedar)

What

How

Description of activities

Why

Benefits for Our Community:

sanitation - QKaeMp

What

Why

Results

sanitation at school

What and How

Why

protecting Water

What

Why

How

Expected Results

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phase 2 – choose your coMMunity goals

1. clean hands – no More dirtyness

2. clean Water – sustainable systeM for Kitchen and hygien

3. clean sanitation – for all ZitiZens

4. Zero deaths of neWborn child or birth giving WoMan

5. iMMuniZation / vaccination saving lives – no More infections

6. Micro credit

phase 3 – our coMMunity activities

1. clean hands – no More dirtyness

1. Dispose faeces safely: Use a toilet

2. Wash the hands

3. Wash the face

4. Use water from safe source

5. Dangerous food

6. Store food right

7. Safe disposal of all household

2. clean Water – sustainable systeM for Kitchen and hygiene

Families and communities can protect their water supply by:

Families can keep water clean in the home by:


Sanitation is a Basic Human Need

The benefits of proper Water and Sanitation System in Our Community

How about us - what can we do?

Step by Step Plan

Our Goal

Why – Why Not?

There got to be a good plan: including

Yes Good Sanitation – For All Citizens

How to learn these skills – who are the councellors

Lessons Learned - Water and Sanitation Envolve Woman and the whole family – 5 reasons

Unsafe Sanitation system – how to improve?

Baby Deaths

Community Heroes make Better Sanitation

The installation of latrines and lane sewers brought 5 direct benefits to women and children.

Getting government support is not easy – Help from own community is needed

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How to build a latrine

Other latrine options include:

Cost examples

Working for 100% Sanitation

The approach is based on the following key principles:

Key aspects of the approach

Outcomes of the approach

Gender Aspects

Water Crisis; A Special Report

Water Use – how to get better practisces:

5. iMMuniZation / vaccination saving lives – no More infections

Woman Immunization

Immunization is urgent!

Age Immunizations to be given

Immunization protects

against several dangerous diseases

Why against measles – can cause death

Polio

Tetanus bacteria

Breastmilk protects

Vitamin A

Diarrhoea

1. Diarrhoea kills children

2. Immediate help from a trained health worker is needed.

4. The child needs at least an extra meal

5. Use Trained Health Worker to save life

6. To prevent diarrhoea

7. Good Hygiene = Wash your hands

6. Micro credit

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Examples of ifferent projects that gives benefits for Our Community

Micro credit - role Model (piedar)PIEDAR is a Non-Governmental Organization, NGO, working with practices and innovations for sustain--able development has been targeting the poorest of the poor of those households with incomes less than two thousand rupees per month. The loan amounts varied from 7000 to 15000. Community based organizations of men and women had suc--cessfully operated small saving and loan schemes. Program had distributed five million rupees to 463 individual, 34 solidarity groups of five to eight per--sons each and two community organizations. WhatTo improve household income, specially targeting women entrepreneurs and the object poor and to create a linkage between micro-credit and individu--al entrepreneurs.

HowTo improve the incomes of households, especially the women, by guidance in productive activities and credit secured through social mobilization.

Description of activities– Credit to individual poor under social guarantees– Credit to solidarity groups after requisite savings;

and– Promoting community organizations as Micro-Fi--

nance Operators.

• Identification of small male and female entrepre--neurs

• Formation and mobilizing lane committees in the area for saving

• Training of Fabric (Dupata) Painting, community mobilization skills and health and hygiene educa--tion to selected women of the same areas

• Video documentary on micro credit Urdu edition• Recovery and monitoring of the credit• Staff training in Enterprise Development

WhyTo demonstrate:• a successful micro-credit work• to develop and test a model promoting Govern--

ment and community partnership in the co-operative development and management of a sanitation system in the same areas.

sanitation - QKaeMpQKAEMP – The Quetta Katchi Abadies Environmen--tal management Program (QKAEMP) that works for local development and environmental manage--ment. In the project promotes self-help for environ--mental management at the community level. The approach relies on building up the institutional capacities of intermediate organizations for sanita--tion and related services.

Benefits for Our Community:Mobilizing our Community for local upliftment through a Micro-credit and an Enterprise Devel--opment Programme.

Benefits for Our Community:Mobilizing our Community for local upliftment through a Micro-credit and an Enterprise Devel--opment Programme.

phase 1 – lessons learnt

What Identify, Make a list of important issues and problems in Our Community

Why Why Not? Discuss why to do this.How Good Practice. How the problem can

be solved? Learn from others (Lessons learnt).

When Time and Follow Up Work. Decide how you are meeting the people and how to make follow ups.

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Community and lane organizations bring together households for installing lane level infrastruc--ture. Households contribute half the cost and are involved in all aspects of planning, designing and implementation.

• Preparing communications material: Awareness raising - door to door campaigns, lane film shows

• Social mobilization - local area workshops, walk-a-cause, and so on Participatory surveys and plan--ning - making area and lane maps

• Formation of Mohalla committees - male and female

• Providing technical support for laying drains, sewers, and for installing Pour Flush Latrines, PFLs. Joint oversight of construction.

What The project provides training in sanitation, solid waste management, social mobilization, and hy--giene.

WhyThe aim is to impart skills for operating and rep--licating without further external help. A simple, user-friendly computer programme has been de--veloped to optimize the design of lane sewers and generate transparent quantities and costs.

Results The project is on-going and has achieved the follow--ing results till December 2002:• Formed 187 lane organizations and 181 WLOs for

environmental management and lane level devel--opment;

• Lane organizations have laid 150,000 running feet of sewers;

• Nearly all the sewers are functional and well maintained by the communities;

• Households have constructed more than 5000

latrines, which has improved household environ--ment;

• Lane organizations established links with district government to pave 140 streets;

• Around 50,000 persons have benefited.

sanitation at schoolWhat and HowThe sanitation block in Simle school is encouraging girls to stay on in school.

The school is located in the foothills of the Himala--yas in Nepal. The most people here have farming as the main source of income and their crops fill the terraced slopes. But, because the villages are spread across the hills, schools tend to be built in lower, central areas where more pupils can reach them.

WhyFor those whose houses sit on the top of hills the journey to school can become a long trek.

Fifteen year old Sumita is one such pupil. Her fam--ily is from a marginalised group who live and farm at the top of a steep hill. ”I walk very fast on the way to school and it only takes 30 minutes,” she explains ”but on the way back up it takes two hours as it is steep and I get hungry and tired and so have to walk more slowly.”

In the developing world girls are less likely to get an education than boys. Nearly a quarter of girls worldwide do not complete primary school and many more do not complete secondary school.

While difficult journeys like Sumita’s or pressure to stay at home and help with chores like collect--ing water are all factors in keeping girls away from school, one simple reason for girls dropping out is that their schools don’t have latrines or separate facilities for girls and boys. Teenage girls are par--ticularly affected.

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Sumita explains the problem, ”We used to go to the bush where there were bamboo plants - we used to hide under the bamboo to go to the loo. It was really difficult especially during our periods or when we had diarrhoea. We wouldn’t come to school then and used to stay at home instead.”

Finding a private place to go to the toilet was a big issue for Sumita and her friends, especially with teenage boys around. ”We used to have to run when we saw the boys coming. Sometimes the boys used to see us defecating and then used to tease and embarrass us.”

Then, having raced up the hill to find some privacy the girls would have to get to their next class before the bell went, and they found this harder still. ”If you aren’t in time you miss the class and so when we had our period we often had to attend one class and then miss the next hour of class. We often had to leave class or go home early.”

”It used to make us sad to miss school because of this - if we had a toilet we could continue our classes instead. We could save our time and carry on our education as well.”

The girls not only faced problems at school, but at home too. ”Sometimes our parents didn’t understand the situation - sometimes when we came home early they just told us off” she continues.

protecting WaterWhatUpper Swat is known for its scenic beauty, pine forests, wildlife, rivers, lakes and trout fishing. How--ever the rapid growth of tourism has damaged the local environment. For example, unplanned resort development has lead to serious overcrowding and pollution at the confluence of Ushu and Utror rivers at Kalam.

Environmental problems associated with tourism have also emerged at some of the more accessible upstream lakes. These include fishing with small mesh nets, littering, open dumping of human ex--creta, and cutting down trees for fuel wood.

WhyParticipatory Rural Appraisal (PRA) exercises were undertaken with local men and women, and local priorities established. Communities were encour--aged to manage tourism around their common lakefront properties, to protect the fisheries from poachers, and to manage the demand for fuel wood.

HowProject programme funds were used in participa--tory manner to make culverts, restore a hydro power station, complete a water supply scheme and construct public toilets. The project also established links between the com--munities and a micro-finance agency for further self-help development.

The project trained 34 unemployed youth in the practical skills needed by an eco-guide. It provided certificates of training, and helped them secure start-up loans for tent, beddings and stoves. Most were able to re-pay the loan with earnings from the first season.

As a part of the project, an international expert trained five young professionals in the methods of environmental valuation.

PIEDAR conducted surveys with these trained staff to assess the carrying capacity for tourism and the willingness of tourists to pay for environmental values. The willingness of many tourists to pay for a pristine environment, for fishing with rod and line, and for guided wilderness tours were shared with local tribal groups.

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• Preparing communications material: Awareness raising - door to door campaigns, lane film shows

• Social mobilization - local area workshops, walk-a-cause, and so on Participatory surveys and plan--ning - making area and lane maps

• Skill and capacity development - training of staff and partners Formation of Mohalla committees – male and female

• Providing technical support for laying drains, sewers, and for installing Pour Flush Latrines, PFLs. Joint oversight of construction, and

• Lateral and vertical promotion of project experi--ence for scaling up.

Expected ResultsBy 2002, a successful project will improve environ--mental conditions in around 50-60 neighborhoods or sub districts within the Katchi Abadies of Quetta.

The project envisages that by 2002 these sub- CBOs and LOs in these areas will be well established, characterized by democratic rules of operation and financial solvency including self-confidence and self-respect among the communities. Such institu--tional development will result in higher prevalence of good hygiene practices, in safer disposal of excre--ta and sullage water, in effective solid waste man--agement, and more forestation on public spaces in unplanned settlements.

By 2002, all the target lanes will have their own organizations and own savings, all target lanes will have functioning sewers and access to filth depots. At least 85 per cent of age 5-plus children will regu--larly wash hands with soap after defecation, and around 60% of the saplings planted in the public spaces in Katchi Abadies will have survived. These selected indicators of the success of the Program may be supplemented by other similar measures.

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1. clean hands – no More dirtyness What needed - Step by Step PlanWhy needed – Why Not?Envolve EverybodyWho to Envolve – Role Models. Lesson learntHow- Good Practice PlanWhen – Time and Follow Up WorkersDecision: Yes / No

2. clean Water – sustainable systeM for Kitchen and hygien What needed - Step by Step PlanWhy needed – Why Not?Envolve EverybodyWho to Envolve – Role Models. Lesson learntHow- Good Practice PlanWhen – Time and Follow Up WorkersDecision: Yes / No

3. clean sanitation– for all ZitiZens What needed - Step by Step PlanWhy needed – Why Not?Envolve EverybodyWho to Envolve – Role Models. Lesson learntHow- Good Practice PlanWhen – Time and Follow Up WorkersDecision: Yes / No

4. Zero deaths of neWborn child or birth giving WoMan What needed - Step by Step PlanWhy needed – Why Not?Envolve EverybodyWho to Envolve – Role Models. Lesson learntHow- Good Practice PlanWhen – Time and Follow Up WorkersDecision: Yes / No» Give support to the health workers!

5. iMMuniZation / vaccination saving lives – no More infectionsWhat needed - Step by Step PlanWhy needed – Why Not?Envolve EverybodyWho to Envolve – Role Models. Lesson learntHow- Good Practice PlanWhen – Time and Follow Up WorkersDecision: Yes / No

6. Micro creditWhat needed - Step by Step PlanWhy needed – Why Not?Envolve EverybodyWho to Envolve – Role Model.s Lesson learntHow- Good Practice PlanWhen – Time and Follow Up WorkersDecision: Yes / No

phase 2 – choose your coMMunity goalsChoose your community goals and use lessons learnt – make an activity plan.

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1. clean hands – no More dirtynessMore than half of all illnesses and deaths among young children are caused by germs that get into their mouths through food or water or dirty hands. Many of these germs come from human and animal faeces.

Children are easily infected with worms, which deplete the body’s nutrients. Worms and their eggs can be found in human and animal faeces and urine, in surface water and soil, and in poorly cooked meat. Children should not play near the latrine, toilet or defecation areas. Shoes should be worn near latrines to prevent worms from entering the body through the skin of the feet.- Children living in areas where worms are common should be treated two to three times per year with a recommended antihelmenthic medication.

Prevent illnesses, especially diarrhoea by good hy--giene practices: • putting all faeces in a toilet or latrine;• washing hands with soap and water or ash and

water after defecating or handling children’s faeces, and before feeding children or touching food; and

• animal faeces are kept away from the house, paths, wells and children’s play areas.

Everyone in the community needs to work together to build and use toilets and latrines, protect wa--ter sources, and safely dispose of waste water and garbage.

1. Dispose faeces safely: Use a toilet All faeces should be disposed of safely. Using a toi--let or latrine is the best way.

2. Wash the handsAll family members, including children, need to wash their hands thoroughly with soap and water or ash and water after contact with faeces, before touching food, and before feeding children. Wash--

ing the hands with soap and water or ash and water removes germs. Rinsing the fingers with water is not enough – both hands need to be rubbed with soap or ash. This helps to stop germs and dirt from getting onto food or into the mouth. Washing the hands can also prevent infection with worms. Soap and water or ash and water should be placed con--veniently near the latrine or toilet.

It is especially important to wash the hands after defecating and after cleaning the bottom of a baby or child who has just defecated. It is also important to wash hands after handling animals and raw foods.

Hands should always be washed before preparing, serving or eating food, and before feeding children. Children should be taught to wash both hands after defecating and before eating to help protect them--from illness.

Children often put their hands into their mouths, so it is important to wash a child’s hands often, es--pecially after they have been playing in dirt or with animals.

3. Wash the faceWashing the face with soap and water every day helps to prevent eye infections. In some parts of the world, eye infections can lead to trachoma, which can cause blindness.

A dirty face attracts flies, spreading the germs they carry from person to person. The eyes may become sore or infected and vision may be impaired or lost if the eyes are not kept clean and healthy.

If the eyes are healthy, the white part is clear, the eyes are moist and shiny, and vision is sharp. If the eyes are extremely dry or very red and sore, if there is a discharge or if there is difficulty seeing, then the child should be examined by a health worker as soon as possible.

phase 3 – our coMMunity activities

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4. Use water from safe sourceOnly use water that is from a safe source or is puri--fied. Water containers need to be kept covered to keep the water clean.

5. Dangerous foodRaw or leftover food can be dangerous. Raw food should be washed or cooked. Cooked food should be eaten without delay or thoroughly reheated.

6. Store food rightFood, utensils and food preparation surfaces should be kept clean. Food should be stored in covered containers.

7. Safe disposal of all household Safe disposal of all household refuse helps prevent illness.

2. clean Water – sustainable systeM for Kitchen and hygieneFamilies have fewer illnesses when they have an adequate supply of clean water and know how to keep it free of germs. If the water is not clean it can be purified by boiling or filtering.

Clean water sources include properly constructed and maintained piped systems, tube-wells, protect--ed dug wells and springs.

Water from unsafe sources – such as ponds, rivers, open tanks and step-wells – can be made safer by boiling. Water should be stored in a covered con--tainer to keep it clean.

Families and communities can protect their water supply by:• keeping wells covered and installing a handpump• disposing of faeces and waste water (especially

from latrines and household cleaning) well away from any water source used for cooking, drinking or washing

• building latrines at least 15 metres away and downhill from a water source

• always keeping buckets, ropes and jars used to collect and store water as clean as possible by storing them in a clean place, rather than on the ground

• keeping animals away from drinking water sources and family living areas

• avoiding the use of pesticides or chemicals any--where near a water source.

Families can keep water clean in the home by:• storing drinking water in a clean, covered con--

tainer• avoid touching clean water with unclean hands• taking water out of the container with a clean

ladle or cup• having a tap on the water container• not allowing anyone to put their hands into the

container or to drink directly from it• keeping animals away from stored water.

If there is uncertainty about the safety of the drink--ing water, local authorities should be consulted.


Sanitation is a Basic Human NeedThe sanitation is poor. Only one of ten rural house--holds in Pakistan have any sewage collection and disposal system. In most villages, the narrow lanes between the houses are not properly surfaced. That means that rainwater, kitchen run off, animal waste and human waste accumulate in the streets.

The benefits of proper Water and Sanitation System in Our Community“Hygiene is more important than the sanitation and the sanitation is more important than the water.”The benefits of proper Water and Sanitation System in Our Community“Hygiene is more important than the sanitation and the sanitation is more important than the water.”

Only use water that is from a safe source or is purified. Water containers need to be kept cov--ered to keep the water clean.

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Families and communities can protect their water supply by:• keeping wells covered and installing a handpump• disposing of faeces and waste water (especially

from latrines and household cleaning) well away from any water source used for cooking, drinking or washing

• building latrines at least 15 metres away and downhill from a water source

• always keeping buckets, ropes and jars used to collect and store water as clean as possible by storing them in a clean place, rather than on the ground

• keeping animals away from drinking water sources and family living areas

• avoiding the use of pesticides or chemicals any--where near a water source.

Families can keep water clean in the home by:• storing drinking water in a clean, covered con--

tainer• avoid touching clean water with unclean hands• taking water out of the container with a clean

ladle or cup• having a tap on the water container• not allowing anyone to put their hands into the

container or to drink directly from it• keeping animals away from stored water.

If there is uncertainty about the safety of the drink--ing water, local authorities should be consulted.


Sanitation is a Basic Human NeedThe sanitation is poor. Only one of ten rural house--holds in Pakistan have any sewage collection and disposal system. In most villages, the narrow lanes between the houses are not properly surfaced. That means that rainwater, kitchen run off, animal waste and human waste accumulate in the streets.

The benefits of proper Water and Sanitation System in Our Community“Hygiene is more important than the sanitation and the sanitation is more important than the water.”The benefits of proper Water and Sanitation System in Our Community“Hygiene is more important than the sanitation and the sanitation is more important than the water.”

In the majority of rural areas, household, farmyard and small-scale industrial effluents flow into sur--face ponds, rivers or the canal irrigation system.

How about us - what can we do?To achieve a good solution to wastewater manage--ment and sanitation problems is to devise projects based on community requirements and to involve community members.

Step by Step Plan

Why – Why Not?There got to be a good plan: includingTo safely carry treated waste away from the village – either into the fields where it can be used as ferti--lizer or into a water channel.

The effects of cleaner streets and a proper wastewa--ter disposal system are clear andimmediate: • people can move about more freely in their daily

life• People can also engage in social and ritual events

with more comfort, when they no longer have to worry about staying clean.

• clean streets means fewer mosquitoes and other pests

• Fewer people fall ill and the children miss fewer days at school.

• People take more responsibility, and keep the streets clean.

• Better health for everybody and particulary for women and children.

Yes Good Sanitation – For All CitizensHow to learn these skills – who are the councellorsThere are wide gaps in knowledge and skills at each level in translating the provision of these services

into healthful home and community environments. Water is a basic need for survival, but convenient access to water contributes to human health only in conjunction with adequate sanitation and hygienic habits.

Nearly two-thirds of the government primary schools are without latrines. How important is it as a contributing factor for the low enrolment rates of the girl child? Many adolescent girls certainly drop out for lack of separate and secure washrooms.

Families are major beneficiaries of improved sanita--tion.

It has been established that improvement in water and sanitation services can lead to improved health, education, income, food production, employment, independence, and more security for women.

Lessons Learned - Water and SanitationEnvolve Woman and the whole family – 5 reasonsWomen need to be consulted when policies and plans are being drafted and projects implemented because they deal with water every day. The whole family benefits.

1. In many Pakistani communities, women‘s sur--vival and that of their households, depends on access to and control of natural resources, such as water.

2. Women and men have distinct responsibilities and different stakes in using and managing water and water systems. In Pakistani societies, women and girls collect virtually every litre of water for cooking, bathing, cleaning, and maintaining health and hygiene. They draw upand supply most of the water for raising small livestock and growing home vegetables.

3. Women carry out 80% of water-related work through out the world. They are often the manag--

Our Goal: No Dirty Water – Yes Good Sanitation

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ers of community water supply, have extensive knowledge and experience, and have learned to protect water resources in order to preserve them for future generations.

4 Women often spend four to five hours per day carrying heavy containers and suffer acute physi--cal problems – a burden that is made worse in drought-prone or polluted areas.

5. Travelling long distances from home in search of water sources increases the labour burden for women and limits time for other activities, in--cluding income-generating work and education. If water and fuel sources are scarce, time for girls to attend school and study is also curtailed. Girls may even be forced to drop out of school to assist in collecting water or because of limited facilities and water supplies for sanitation and personal hygiene.

Unsafe Sanitation system – how to improve?In rural areas, people also use ventilated pit latrine (VIP) and twin pit latrine and the latrine with the septic tank. More than half the human excreta and blackwater are not disposed off safely. This water stands in the streets or ponds, creating a bad smell and providing a habitat for mosquitoes and flies, which spread malaria and diarrhoea.

Baby DeathsThe infant death rate is very high in the area due to un-safe drinking water and un-hygienic practices. Women get to the water source after miles of walk--ing and stayed in the line for hours to get water from the open dugwell. The quality of water is very poor.

Women are not used to washing their hands after cleaning up their children‘s excreta and not wash--ing their hands before cooking food for the chil--dren. This unhygienic practice causes diarrhoea among the children.

Although women provide about 70 percent of the unpaid time spent for caring for family members, that contribution to the global economy remains invisible. Their diverse roles are not recognized. All household work (cooking, cleaning, baby sitting, water fetching, wood collection and cleaningof the sanitation place) is the responsibility of women.

Community Heroes make Better SanitationThe Local Government Ordinance, 2001 has de--volved a range of functions, including water supply and sanitation, to elected district and sub-district administrations. For women reserved one-third of local government representation. It has created a window for women in policy making and imple--mentation. It is always needed to explain the com--mon needs of males, females and children in this regard. Otherwise the old tradition with bad results is leading the new project.

Men may be the main actors in the installation of sanitation and policy making because of their strength, physical power to do it. And they can make two good systems for All in our village, one for women and one for men to begin with. This good practise can all inhabitants take over to their homes and schools.

The installation of latrines and lane sewers brought 5 direct benefits to women and chil--dren. 1. A great convenience of use at any time of day.

In fact, going out at night is a big problem for girls and women.

2. The health condition of the family improves and health related expenses go down as a direct result of sanitation.

3. The drainage of blackwater and smells from the street, the children could play there with--out getting dirty.

4. The savings in time in making the children and the house clean.

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Getting government support is not easy – Help from own community is needed“Help from community organisations such as OPP is an advantage” said Nisar Sario, executive district officer for work and services of the Karachi city district government. The Orangi Pilot Project or OPP is one of the world’s best-known non-government projects in the large-scale provision of sanitation for the urban poor, started 1980. It was not until 1991 that the Karachi Municipial government recognized the Orangi project´s work and integrated the model in its planning for the area. Before Water and sanita--tion was the work of residents in Karachi´s Orangi that initiated sanitation projects in the settlement in the 1980s.

Other latrine options include:Ventilated improved pit latrines have a vent pipe included in the design which takes away smells and insects. Insects are attracted to the light at the top of the vent pipe and then trapped at the top by a screen.

Pour flush latrines are built where people use water to clean themselves after they have used the latrine. In these the latrine pan is placed a few metres away from the pit and a pipe with a water seal in the u-bend stops flies and smells escaping the pit.

Eco-san latrines create a renewable source of fertile compost from human waste. At their simplest fami--lies simply plant a tree once the shallow latrine pit is filled, while the more permanent fossa alterna has two pits - one of which remains covered while the other is in use. Users add soil and ash after each use to help dry the contents, and once the first pit is full, it is covered and left to compost while the second pit is used. Then the first is dug out and the compost used for crops and the process is repeated.

5. Less mosquitoes and flies in the area.

Neighbouring villages can benefit of our work and good practice.

How to build a latrineThe most common type of latrine is a dry pit latrine. Here is a step by step guide on how to build one.

Find a suitable site and dig a pit that is at least three metres deep and completely above the water table.

Depending on the type of latrine, line the pit with bricks, concrete rings or other locally-available materials.

Build a squat slab to cover the pit, that has a keyhole shaped drop hole and foot pads. This needs to be strong enough to regularly hold a person’s weight and so is often made of con--crete (as pictured) which is pre-cast away from

the pit and then placed over it. These can be made by trained latrine builders in a village or through a central construction point set up by the project - where they can be bought at low cost. These are often called ’sani marts’.

Build a shelter of locally-available materials such as wood or bamboo around the latrine to provide privacy. In some places bricks are also used - depending on what each family can af--ford.

Place a hand washing facility outside - this could be a gourd filled with water, that has a small hole drilled in it and a twig for a plug.

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Sanitation blocks are built in urban areas where the higher population densities mean that differ--ent sanitation solutions are needed. Pit latrines fill too quickly and can pollute underground water sources. In some cases septic tanks are used but, where possible sanitation blocks, which are owned and managed by the community, are built that are connected to the city’s piped sewerage.

Cost examples• £8 pays for enough cement to

produce four latrine slabs in Malawi• £15 buys an ecological

sanitation latrine in Mozambique• £350 pays for a school sanitation

block for 150 boys and girls in India

Working for 100% Sanitation• No open defecation or open/hanging latrine use.• Effective hand-washing after defecation and be--

fore eating / taking or handling food.• Food and water are covered.• Latrines are well managed.• Clean courtyards and roadsides.• Garbage is disposed of in a fixed place, such as a

pit• Safe water use for all domestic purposes.• Water points are well managed.• Waste water is disposed of down drains or in a

fixed place.• No spitting in public places.• Sandals are worn when defecating.

The approach is based on the following key principles:• Integration. Safe water supply, environmental

sanitation and hygiene promotion are addressed simultaneously. Projects are appropriate, sustain--able and affordable for the community.

• Participation. The whole community, includ--ing the hardcore poor, are actively involved in project planning, implementation, monitoring and evaluation. Individuals in the community

are trained to become trainers; the community determines the best water supply and sanitation infrastructure option and hygiene promotion education inputs are facilitated.

• Empowerment. People’s capacities, skills and indigenous knowledge are recognised and valued. Support is provided in the form of capacity-build--ing to strengthen the ability of individuals who emerge as leaders to work as agents of change within the community. Communities act as facili--tating agents in their neighbouring areas. Em--powered communities increase their confidence to analyse and voice their needs constructively to local government agencies or other development programmes.

Key aspects of the approach• People’s skills, abilities and knowledge are valued• 0% subsidy for latrine construction• Whole community’ approach• Use of participatory research tools to analyse the

problems• Formation of Village Development Committees

- local engineering groups• Identification of potential community leaders

and involve them as community ‘catalysts’• Mobilisation of local resources• Involvement of local government • Involve micro credit

Outcomes of the approach• More than 300 villages are 100% sanitised• 20 innovative hygienic latrine designs have been

put forward by communities• A cultural shift from ‘top down’ to ‘bottom up’

approaches has happened in the organisation and at community level

• WaterAid Bangladesh and partners are providing training support to a number of local and inter--national aid agencies to integrate the approach

• The Government of India is replicating approach in the state of Maharastra

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Gender Aspects In Bangladesh there is a rigid division of labour regarding activity related to water, sanitation and hygiene promotion. Women and adolescent girls are disproportionately burdened by inadequate and poor quality water and sanitation services as they normally collect water, clean the household and care for the sick. Lack of privacy in sanitation facili--ties also exposes them to increased risks of urinary tract infection, reproductive health problems and physical attack.

Women have reported that improved access to water and sanitation services has resulted in a more productive use of time and resources. Traditional gender roles are being challenged as men and women recognise the direct contribution that wom--en’s participation is making to the community’s improvement and to household economic benefits. Through the process of forming and developing community institutions women have increased their confidence and capabilities in private and public spheres.

Water Crisis; A Special Report Experts predict that with consumption rates and a population growth of 4 million people a year, one out of three people in Pakistan will face critical shortages of water, ”threatening their very survival”.

Water Use – how to get better practisces:• Unsustainable acriculture practices are used

throughout the country. Many of the experts in Pakistan believes that the warning signs has helped people to ”wake up” and hepled them to learn and use more modern watering systems (drip irrigation and pivot sprinkling systems), which reduce the water requirement by 60 per--cent.

• The water resources are not unlimited. Most of the inhabitants think: ”Water is very cheap, and it is not a rare commodity. I don´t have to take care of it.” Although that a minimum amount of water should not be overcharged, the large consumers should be made to realise that potable water was not a free commodity.

5. iMMuniZation / vaccination saving lives – no More infectionsChildren who are immunized are protected from these dangerous diseases, which often lead to dis--ability or death. All children have the right to this protection. Every girl and boy needs to be immu--nized.

It is essential that all parents know why, when, where and how many times the child should be immunized. Parents also need to know that it is safe to immunize the child even if the child has an illness or a disability or is suffering from malnutri--tion.

All children, including those who are disabled, need to be vaccinated. A child is immunized by vaccines, which are injected or given by mouth. The vaccines work by building up the child’s defences against disease. Immunization only works if given before the disease strikes.

Woman ImmunizationAll pregnant women need to be immunized to pro--tect themselves and their infants against tetanus.

Immunization is urgent! Every child needs a series of immunizations during the first year of life. It is essential that infants complete the full number of immuniza--tions – otherwise the vaccines may not work.

Immunization is urgent! Every child needs a series of immunizations during the first year of life. It is essential that infants complete the full number of immuniza--tions – otherwise the vaccines may not work.

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• Immunization is urget!• Immunization protects against several dangerous

diseases. A child who is not immunized is more likely to suffer illness, become permanently disa--bled or become undernourished and die.

• It is safe to immunize a child who has a minor illness, a disability or who is malnourished

• All pregnant women need to be protected against tetanus. Even if the woman was immunized ear--lier, she may need additional tetanus toxoid vac--cinations. Check with a health worker for advice and tetanus toxoid immunization.

• A new or sterile needle and syringe must be used for every person being immunized. People should insist on this.

• Disease can spread quickly when people are crowded together. All children living in congest--ed conditions, particularly in refugee or disaster situations, should be immunized immediately, especially against measles.

Immunization protects against several dangerous diseases

A child who is not immunized is very likely to get measles, whooping cough and other diseases that can kill. Children who survive these diseases are weakened and may not grow well or may be perma--nently disabled. They may die later from malnutri--tion and other illnesses.

Why against measles – can cause deathAll children need to be immunized against measles, which is a major cause of malnutrition, poor men--tal development, and hearing and visual impair--ments. The signs that a child has measles are a fever and rash that have lasted for three days or more, together with a cough, a runny nose or red eyes. Measles can cause death.

PolioAll children, everywhere, need to be immunized against polio. The signs of polio are a floppy limb or the inability to move. For every 200 children who are infected, one will be disabled for life.

Tetanus bacteriaTetanus bacteria or spores, which grow in dirty cuts, can be deadly without a tetanus immuniza--tion.

A child who is not immunized is more likely to suffer illness, become permanently disabled or become undernourished and die.

A child who is not immunized is more likely to suffer illness, become permanently disabled or become undernourished and die.

Age Immunizations to be given

At birth BCG**, polio and, in some countries, hepatitis B

6 weeks DPT**, polio and, in some countries, hepatitis B and Hib

10 weeks DPT, polio and, in some countries, hepatitis B and Hib14 weeks DPT, polio and, in some countries, hepatitis B and Hib

9 months Measles (12-15 months in industrialized coun--tries) and, in some countries, yellow fever, mumps and rubella.

*National immunization schedules may differ slightly from country to country.**BCG offers partial protection against some forms of tuberculosis and leprosy; DPT protects against diphtheria, pertussis (whooping cough) and tetanus.

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• Immunizing a woman with at least two doses of tetanus toxoid before or during pregnancy pro--tects not only the woman but also her newborn for the first weeks of the baby’s life.

• At six weeks of age, the baby needs the first dose of DPT to extend the protection against tetanus.

In countries where hepatitis B is a problem, up to 10 out of every 100 children will harbour the infection for life if they are not immunized. Chil--dren who are infected with hepatitis B are likely to develop liver cancer when they are older.

In some countries, epidemics of yellow fever put many young children’s lives at risk. Vaccination can prevent the disease.

In many countries, pneumonia caused by the Haemophilus influenzae type B (Hib) germ kills many young children. The Hib germ can also cause childhood meningitis. This germ is one of the most dangerous for children, particularly for those under five. Hib immunization can prevent these deaths.

Breastmilk protectsBreastmilk and colostrum, the thick yellow milk produced during the first few days after birth, pro--vide protection against pneumonia, diarrhoea and other diseases. Protection lasts for as long as the child is breastfed.

Vitamin AVitamin A helps children fight infections and pre--vents blindness. Vitamin A is found in breastmilk, liver, fish, dairy products, some orange and yellow fruits and vegetables, and some green leafy vegeta--bles. In areas of vitamin A deficiency, children aged six months and older should be given vitamin A capsules or liquid when they are immunized or dur--ing National Immunization Days. Vitamin A is also an important part of measles treatment.

DiarrhoeaDiarrhoea is caused by germs that are swal--lowed, especially germs from faeces. This hap--pens most often where there is unsafe disposal of faeces, poor hygiene practices or a lack of clean drinking water, or when infants are not breastfed. Infants who are fed only breastmilk seldom get diarrhoea.

When families and communities work together they can do much to prevent the conditions that cause diarrhoea.

1. Diarrhoea kills children Diarrhoea kills children by draining liquid from the body, thus dehydrating the child. As soon as diarrhoea starts, it is essential that the child be given extra fluids as well as regular foods and fluids.

2. Immediate help from a trained health worker is needed.A child’s life is in danger if there are several watery stools within an hour or if there is blood in the faeces. Immediate help from a trained health worker is needed.3. Breastfeeding is safeBreastfeeding can reduce the severity and fre--quency of diarrhoea.

4. The child needs at least an extra meal A child with diarrhoea needs to continue eating regularly. While recovering from diarrhoea, the child needs at least an extra meal every day for at least two weeks

5. Use Trained Health Worker to save lifeIf the child is dehydrated with severe or persist--ent diarrhoea, only oral rehydration solution or medicines recommended by a trained health worker should be used. Other diarrhoea medi--cines are generally ineffective and could be harmful to the child.

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6. Micro credit Use micro credit system to build up, for instance, the needed sanitation. The healthy costs much more. Always.

6. To prevent diarrhoea To prevent diarrhoea, all faeces should be dis--posed of in a latrine or toilet or buried.

7. Good Hygiene = Wash your handsGood hygiene practices protect against diar--rhoea. Hands should be thoroughly washed with soap and water or ash and water after contact with faeces, and before touching food or feeding children.

Our Community Action Guide

Education

Transcript of Our Community Action Guide