Since the start of the Ebola outbreak in Sierra Leone, there have been three major behaviour changes that have hardly left anyone in the country unaffected: the reduction of physical contact; the regular taking of temperatures; and the promotion of handwashing at schools, government buildings, and even in front of remote village huts.
The benefits of regular handwashing have long been known; correct handwashing with soap has been shown to reduce diarrhoeal disease by up to 43 percent. In a recent KAP (knowledge, attitude and practices) survey in Sierra Leone, 80 percent of respondents reported an increase in handwashing with soap since the Ebola outbreak began. The hope is that once Ebola subsidies, life-saving handwashing practices will continue.
As a WASH (Water, Sanitation and Hygiene) specialist with UNICEF Sierra Leone, I recently visited two UNICEF funded projects building up the capacity of community members to promote improved healthy behaviours long after the fear of Ebola subsides. UNICEF has distributed more than 3 million bars of soap since the first Ebola case was confirmed in May 2014, but when the free soap runs out, affordable, culturally acceptable soap needs to be widely available so that handwashing with soap can continue.
That’s what we’re working towards with local partner, MAPCO, who want to make handwashing sustainable, while at the same time creating livelihood opportunities by training small groups of committed community members to make traditional black soap; a low-cost, widely used soap made from local materials which they can sell at a small profit, as they promote good hygiene.
When I arrive at the soap making workshop in Pujehun, Hawa Kallon, a subsistence farmer is concentrating hard. “If I can really understand how to make it, I can sell it and get a small income,” she tells me. She had heard that soap could be made from local materials but never knew how to do it. Today she is learning the technique: burn a mixture of plants to ashes, filter them with water, and boil the liquid with oil until the mixture thickens enough to be made into balls of soap.
We take samples from their first production to the nearest UNICEF communal hand washing station for a test. I am concerned as the runoff water is like the soap; black. The soap, however, passes the test of cleaning dirty hands and returning my mud-stained t-shirt to its original white colour. Community members are used to using this soap and are happy to see it at the handwashing station. Now that the workshop participants feel confident making soap themselves, UNICEF and MAPCO will support them through the next stage of marketing and selling their product.
Children are at the centre of all UNICEF’s interventions and the development of School Health Clubs is a key activity in UNICEF Sierra Leone’s WASH programme. Children are trained and supported to be agents of change, promoting hygiene in both their schools and their homes. With local partner ADP, I visited a school club to test UNICEF’s Hygiene Promotion materials for children.
Having only returned to school on 14 April 2015, the children are excited to be in the classroom and easily adapt to the procedures of handwashing and having their temperature taken before entering the workshop. We start with a quiz, and then they in turn ask their own questions about Ebola transmission.
Next they draw maps of hygiene issues in their communities and their school, and – based on their maps – come up with a hygiene promotion plan. The groups agree on three main activities which they will carry out in their schools:
- help the teacher to prepare a cleaning roster,
- monitor the cleanliness of their school, and
- perform role plays and sensitisation activities with their peers to promote good hygiene.
The Back to School Ebola ‘Snakes and Ladders’ game is particularly popular with the younger children. When asked which exercises they liked best, the children chose the handwashing song, the Ebola signs and symptoms activity, and the food!
Sierra Leoneans and everyone working here hope Ebola will soon be a thing of the past. But let’s hope the handwashing can be made sustainable, and continue long after.
Helen Hawkings is a WASH Specialist at UNICEF Sierra Leone