I am proud to say I helped organize a mission for Rotary Club of Baton Rouge to Belize as part of Rotary International’s efforts to save lives, improve environmental conditions and overall quality of life. It’s part of my personal and corporate commitment to put service above self. An inexpensive, easy way to combat disease is to increase awareness to the importance of handwashing and provide access to potable water to do so.
Question: what’s the most-effective, least-expensive way to reduce disease and save lives in Developing Nations?
Handwashing station. Photo courtesy of WASRAG.
In other words, what health intervention can give us the “biggest bang” for Rotary’s “humanitarian buck?”
Almost everyone is surprised to learn that handwashing:
>Can save 5% more lives than point-of-use water treatment, like water filters, chlorination, and solar pasteurization.
>Can save 12% more lives than latrines.
>Can save 33% more lives than treated public water.
In fact, some researchers say that “handwashing with soap could be thought of as a ‘do-it-yourself’ vaccine.” Others have concluded that handwashing is “the single-most, cost-effective, health intervention” known – bar none.
Pneumonia, a respiratory disease, is the world’s greatest child-killer. Diarrheal diseases follow right behind. In fact, these two account for 64% of all childhood deaths, globally. (And there’s still malnutrition.)
But international studies show that a well implemented handwashing campaign can:
>Reduce diarrheal diseases by over 40%.
>Reduce respiratory infections (including pneumonia) by 30%.
>Reduce substantially the deaths from malnutrition caused by diarrhea and nematod infections.
That’s three strikes against three killer diseases.
But wait. There are also some bonuses. Handwashing can also:
>Reduce death from infections at birth.
>Reduce skin infections.
>Reduce eye infections.
>Reduce co-infections and disease progression of HIV/AIDS victims.
It’s just a fact. What is on your hands can make you sick!
So what do we do?
We call it “The Big Three.” Wash your hands:
>After the toilet and after changing the baby.
>Before preparing food.
>Before you eat.
Simple! No rocket science required.
Well, it’s not quite so simple. Personal and cultural habits die hard. Changing public behavior is treacherous and takes time. So how are we going about it in District 4060 — Dominican Republic?
Our strategy is to leverage up Rotary’s efforts by using schools to teach students and penetrate communities. The work and funding that Rotary puts into a handwashing project through the schools puts into motion a process of training and behavioral support that can last for years. That’s real leverage!
There are 13 countries that have national handwashing campaigns. Mega millions of dollars are going into those campaigns from The World Bank, UNICEF, national governments, and the like. These campaigns tend to work from the top down. Rotary does not have mega millions to spend, but Rotary is very, very good at what it does – working from the bottom up. Person-by-person, family-by-family, school-by-school, village-by-village.
So with a “little” we can leverage up to get a “lot” of bang for the buck. How do we do that?
We start with the principals of individual schools. We convince principals that reducing diarrhea is good for the school and good for the families of the students. That’s not hard to sell. Then we enter into a contract with the principals: “here’s what we will do” and “here’s what you will do.”
Then the principals assign at least two teachers from their schools to be trained and certified to teach hygiene and handwashing to the classes in those schools. We conduct workshops to train and certify these teachers. And We provide classroom teaching materials. And we provide handwashing stations because most schools do not have lavatories and the lavatories in those that do rarely work.
The teachers return to their schools and set up a schedule with their principals to teach all the classes in a school. We have some schools with 16 students, but some have 3,000 students. The teachers file certified reports showing us what classes they have taught and how many students were in each class. This gives us documentation for project evaluation.
But, human nature being what it is, we also find it wise to have a monitor to visit the schools. First, we want to be sure we provide support and solve any problems they have. Second, we want to make sure they are in compliance with our contract with their school – that is, that they are, in fact, teaching students as they were trained to do in the workshops. Third, we want to see if there are qualitative improvements in student health.
This campaign started in November, 2012. Already we are getting good anecdotal evidence that absences from diarrhea are coming down and that some skin diseases are abating.
Where are we headed with this program?
Our goal is to make this a national campaign.Rotary literally has the opportunity to change the face of a nation by improving the health of its children – children who deserve to live, today, and who will be the nation’s adults, tomorrow.
The early phases of this Campaign are for building a successful model to launch it nationally. When we have a tested operational model and a stable campaign of broad scope in the Dominican Republic, then we plan to launch a similar campaign for our neighbor, Haiti.
The Rotary Foundation and District 6310 (N.E. Michigan, USA) have been pioneers with us in starting this Campaign. But it will take many, many clubs and districts to have a national program. We Need You!
If this approach to reducing disease and saving lives gets you excited, please let me know by commenting below or sending me an email.