In
the northern Pakistan village of Nawangran Sobrian, a young
woman washes cups and plates in a puddle of dirty rain water
– not an uncommon sight in this region, which was devastated
by last year’s earthquake and hard hit by flooding and
landslides over the past summer.
“A year after the quake, there is plenty of water to go
around but the problem is that much of it is contaminated by
debris and bacteria,” says Edoardo Casetta, the International
Federation’s water and sanitation coordinator in Pakistan’s
North West Frontier Province (NWFP).
Not far from the village, volunteers and staff from the Pakistan
Red Crescent Society (PRCS) work to dig out a water storage
tank that was covered in rocks and mud after a flash flood in
August.
Nearly two months on, the area still looks as if it witnessed
a volcanic eruption – a large swathe of sharp, flint-coloured
rocks and gravel scar the green landscape, where the water came
rushing down, mimicking the flow of molten lava.
The PRCS workers say the water storage tank will be up and running
soon. But hardware alone isn’t enough to ensure people,
like the young woman in Nawangran Sobrian, won’t use unsafe
water sources to drink and do dishes. Behavioural change and
knowledge are just as important as water supply systems.
That’s why hygiene promotion and proper sanitation are
so important, according to Charity Sikamo, one of the International
Federation’s water and sanitation delegates in the NWFP.
“After people started leaving the camps and returning
to their homes in March, we very quickly realised that we needed
to reach out to communities and boost their awareness of good
hygiene,” she says.
“It may sound very basic, but many people do not know
that the simple act of boiling water can kill bacteria and prevent
disease,” Sikamo adds.
“We also educate communities about where to put their
latrines and how to dispose of solid waste, and we encourage
mothers not to allow their children to play in courtyards if
there is garbage or excrement lying around.”
As it turns out, gaining access to women has proven key to improving
health and hygiene, especially in deeply conservative rural
areas.
“Women are the custodians of domestic life,” says
Sikamo. “They are the ones who draw the water, fetch the
firewood, clean, cook and care for sick children… so you
can see why we needed them to be involved.”
In order to reach out to women and girls, the International
Federation and PRCS decided to take a community-based approach
by working with Ministry of Health-approved “lady health
workers” and by training local teams of hygiene promoters.
The idea was to educate women, as well as men, within these
communities to spark change at the grass roots level. Community
members form committees to act as trusted and accepted facilitators
of behavioural change.
In turn, the committees pass on hygiene promotion messages and
lessons to the wider community – a concept that is not
only working but also gaining increasing acceptance in quake-affected
areas.
Today, local hygiene promoters, supported by International Federation
specialists, visit rural villages, like Nawangran Sobrian, every
two weeks to hold group question and answer sessions.
While women and girls gather in one house, the men and boys
meet in another, where male hygiene promoters talk to them about
safely burying waste and building latrines.
“The sessions make us realise we need to clean our homes
and latrines regularly,” says Shahjehan Bibi, an elderly
villager. “I now know that germs spread disease and that
if I bathe regularly, I will have a healthier life,” she
adds.
Sikamo says this kind of knowledge helped prevent many people
from getting sick during a recent outbreak of acute watery diarrhoea.
“We noticed that in places where we had done some hygiene
promotion, there were fewer cases of the disease… so even
if the overall impact of our efforts may not be measurable for
another year or two, we are already seeing tangible signs of
success.”
In addition to hygiene promotion, heavy emphasis has also been
placed on installing family latrines and culturally-appropriate
“rural bathrooms” over the past six months.
Following the disaster, men and boys often washed in the river
or at the mosque but women had no where to go, so the gender-specific
washrooms have given them a place to bathe in private.
According to Eduardo Casetta, communities have come a long way
compared to a year ago, when almost all water sources, including
natural springs, had been contaminated and an estimated 80 to
90 per cent of existing toilets were destroyed, forcing people
to use courtyards, bushes and fields instead.
Immediately after the disaster, the International Federation
deployed two emergency response units (ERUs) to the devastated
towns of Batagram and Balakot, each capable of purifying 240,000
litres of water per day, serving a total population of around
40,000.
The ERUs, which were supported by the Austrian, German and Swedish
Red Cross societies, as well as the European Commission’s
Humanitarian Aid Department, ECHO, supplied vulnerable communities
with fresh water for the first six months after the disaster.
Around 200,000 hygiene kits, including sanitary napkins, tooth
brushes, shampoo, nail clippers, bathing soap, and washing liquid,
were also distributed to families following the quake.
“During the emergency phase, our hygiene and water and
sanitation activities were very action-oriented and effective,”
says Casetta.
“Now we’re building on that success by taking a
very participatory approach, which encourages communities to
decide for themselves how they want to improve their health
status and what kind of facilities they need… and that’s
exactly how it should be.”
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A
year after the 8 October earthquake, it is not uncommon
to see women washing dishes in puddles and rivers, which
are contaminated with dirt and bacteria. (p14728) (Credit:
John Tulloch)
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Following
the earthquake, the International Federation sent two
emergency response units to Pakistan, which provided 240,000
litres of water per day to around 40,000 people during
a six-month period. (credit: Gerald Czech / Austrian Red
Cross)
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A
water storage tank near Balakot, which had just been completed,
was submerged by rocks and mud during a flash flood in
August. (p14726) (Credit: John Tulloch)
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Hygiene
promoters, Sadia Tanveer (left) and Nadia Sayeed (right),
use pictures to quiz women about the correct and wrong
way to wash dishes. (p14727) (Credit: John Tulloch)
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