Nikbakht, a 40-year-old mother of four children, lives in one of the poorest districts in central Kabul. Here in Chindawol, an average of three families cram into each small house. The sanitary conditions are horrendous. The traditional drop toilets are typically in a poor state of repair, with very few having a cover.
It is not surprising then that, according to the United Nations Children Fund (UNICEF), nearly 50,000 children die from diarrhoea in Afghanistan every year.
In an attempt to address this, the country’s public health ministry joined forces with the Afghan Red Crescent Society and the International Federation of Red Cross and Red Crescent Societies to launch a four-day sanitation campaign.
The idea for the campaign was sparked by seven suspected cases of cholera in Kabul in July 2007. It was implemented by more than a hundred Red Crescent volunteers, who travelled from house to house in order to pass on potentially lifesaving hygiene information.
Each volunteer group contained one male and one female Red Crescent volunteer, which made it easier for them to be welcomed into the houses of strangers and to pass on their message to all members of the household – particularly the women.
Nikbakht is one of many women to be reached by the campaign. She listened intently as Afghan Red Crescent volunteer Sakina Mohammad Hassan showed her a series of photographs showing good hygiene practices.
“In this picture you see that a woman is washing her son’s hands not only with water, but with soap as well. I want to ask you and your family to do the same, like the woman in the photograph, if you want to be healthy,” Sakina told Nikbakht.
Nikbakht is happy that the Red Crescent volunteers came to her house.
“I learned the importance of washing hands with soap after using the toilet and before eating,” she said. “My children often fall ill, particularly in the summer. This technique is quite impressive in reducing disease, particularly among children.”
Although there are water systems and pipes in Chindawol district, the water supply is restricted to only two hours a day. Because of this restriction, the residents have to collect enough water for their daily needs within that timeframe – usually in large containers. These are not very hygienic, as very few have covers that will prevent flies and mosquitoes from settling into the stagnant water.
The residents of Chindawol are not the only ones who are vulnerable to diarrhoea and cholera because of a limited supply of fresh water and a lack of awareness of basic sanitation.
This is also the case in the western Kabul district of Dashte Barchi, However, the major difference between these two districts is that there is no system for safe water in Dashte Barchi, where residents must dig wells. Before this water is safe for drinking, it must be boiled or have chlorine added to it.
“When the weather gets warmer, our children become more vulnerable to disease - particularly diarrhoea. It is not just my trouble, all mothers who have small children are in the same position,” said Rabea Abdul Zahed, 35-year-old woman who lives in Dashte Barchi with her five children.
In total, 8,656 families in eight districts of Kabul were reached by the house-to-house sanitation campaign. The public health ministry has acknowledged the key role played by Afghan Red Crescent volunteers in the success of the programme, which was supported financially by the International Federation.
“Preventing outbreaks of disease is a prime concern of the International Federation. We have been working to improve the health status of vulnerable people in Afghanistan,” said Pitambar Aryal, International Federation health delegate.
“Acute diarrhoea could kill many people and we have to take immediate action before the situation gets worse. Prevention can be done through this kind of campaign, promoting hygiene practice and education, and using appropriate medicine for the disinfection of water. Since the Afghan Red Crescent has good human resources, it can mobilize its community-based volunteers to make the campaign a success,” he added.
The Red Crescent volunteers who took part in the campaign found it to be a useful as well as rewarding experience.
“The sanitation messages we spread within the four-day campaign were not only useful for the people but also for us. I will teach these methods to my family as well,” said Sakina.
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Heshmat Aman, a Red Crescent volunteer, sticks a poster on a wall. The poster shows the simple steps that Kabul residents can take to minimize the threat of diarrhoea. (p17085)
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Chindawol’s residents typically store water in large containers like the one pictured. These are often not particularly hygienic, as few of them have covers to prevent flies and mosquitoes from settling in the stagnant water. (p17082)
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Sakina Mohammad Hassan (on the left) and her fellow Red Crescent volunteer, Heshmat, speaking with Rabea Abdul Zahed, a resident in Dashte Barchi district in western Kabul. Access to clean water is particularly challenging for residents of this part of the city. With no water supply system, people are forced to dig wells. Before this water is safe for drinking, it must be boiled or have chlorine added to it. (p17081)
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Red Crescent volunteers gather at the Afghanistan Red Crescent’s Kabul headquarters at the start of a four day hygiene promotion campaign. According to the United Nation’s Children Fund (UNICEF), nearly 50,000 children die from diarrhoea each year in Afghanistan. Many of these deaths could be prevented through improved hygiene. (p17084)
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Red Crescent volunteer, Adela Abdul Khaleq, speaking with two women in Chindawol, one of Kabul’s poorest districts. Sanitary conditions in the district are terrible, a problem compounded by insufficient access to clean water. (p17083)
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