WASH in Schools Manual - Lifewater International › wp-content › uploads › 2018 › 10 › ... · the power to kill bacteria, and other germs, which cause diarrhea and other

Fourth Edition

Our Mission We are Christians committed to ending the global water and sanitation crisis.

Our Vision Thousands equipped, millions served, and a movement of transformed people serving together to end the global water and sanitation crisis.

About Lifewater International Lifewater is a non-profit, Christian water development organization dedicated to effectively serving vulnerable children and families by partnering with underserved communities to overcome water poverty. With experience in more than 40 countries over 37 years, Lifewater serves all people of all faiths. Our programs strategically prioritize vulnerable children and families living in remote, rural, and hard-to-reach regions of our world. As a Christian organization, we are called by Jesus to love the poor in an empowering and transformational manner. While some Christian organizations are called to feed the hungry, shelter the homeless, or plant churches, Lifewater International is called to bring water, health, and hope to the world’s most vulnerable people using our community-focused approach. We believe, as Jesus taught, that when we serve the poor, we are serving Him. We treat each family, and person with dignity and respect. We view every interaction as an opportunity to reflect God’s love in world and in deed. “But in your hearts revere Christ as Lord. Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect.” 1 Peter 3:15 (NIV) Lifewater International is a 501(c)(3) non-profit.

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Table of Contents Copyright ....................................................................................................................................... 5 Introduction to Steps for Better Health .......................................................................................... 1 Overview of Steps for Better Health Manual ................................................................................. 2 Glossary ........................................................................................................................................ 3 Step 1a: How the Human Body Needs Water ............................................................................... 4 Step 1b: We Are Change-Makers! ................................................................................................ 7 Step 2: Know the Difference Between Safe and Unsafe Water .................................................... 9 Step 3a: How Germs Travel in Feces and Make Us Sick ........................................................... 13 Step 3b: Diseases Caused by Poor WASH Behavior ................................................................. 16 Step 4a: Six Steps of Handwashing ............................................................................................ 19 Step 4b: Important Times to Wash Hands .................................................................................. 22 Step 4c: Washing Our Whole Body ............................................................................................. 25 Step 4d: Tippy Tap ...................................................................................................................... 28 Step 4e: Clean Hands, Clean Heart ............................................................................................ 32 Step 5: Keep Safe Water Safe .................................................................................................... 34 Step 6: Keep Food and Utensils Clean ....................................................................................... 37 Step 7a: Current Sanitation Behaviors ........................................................................................ 40 Step 7b: Latrines ......................................................................................................................... 42 Step 7c: Using a Latrine .............................................................................................................. 45 Step 7d: Cleaning the Latrine ..................................................................................................... 47 Step 8: Keep Our Schools and Homes Clean ............................................................................. 51 Step 9: Use Safe Water When Caring for Sick People! .............................................................. 54 Appendix ..................................................................................................................................... 58 Appendix 1: WASH Statistics ...................................................................................................... 58 Appendix 2: Drink Safe Water Action Song ................................................................................ 59 Appendix 3: Alternative Water Purification Methods ................................................................... 60 Appendix 4: SODIS Diagram ...................................................................................................... 62 Appendix 5: Sugar Salt Solution ................................................................................................. 63 Appendix 6: A Small Yet Dangerous Fly ..................................................................................... 66 Appendix 7: Wash, Wash with Soap and Water Drama ............................................................. 67 Appendix 8: Tippy Tap Diagram .................................................................................................. 68 Appendix 9: Tippy Tap Instructions ............................................................................................. 69 Appendix 10: Pocket Chart Lesson ............................................................................................. 70 Appendix 11: Pocket Chart Construction .................................................................................... 72 References .................................................................................................................................. 73 WASH in Schools Training Materials List .................................................................................... 75

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Introduction to Steps for Better Health Every journey begins with a single step in the right direction. For this reason, Lifewater International has focused this school curriculum on taking Steps towards better health. The goal of Steps for Better Health is to encourage children to take steps to improve their personal health, and the health of their school and community through improved WASH (water, sanitation, and hygiene) behavior. Lifewater International believes that children can be change-makers in their schools, homes, and communities. Because of this, the curriculum is student-centered with the goal that students will actively participate in their own learning, and lessons will be made richer by their participation. If healthy hygiene and sanitation habits are formed as children, entire societies can be changed in a generation. Lessons share important information and methods to improve water, sanitation and hygiene behaviors. Each can be adjusted for different cultures and ages. Likewise, facilitators are encouraged to add to lessons when appropriate. This could be done through discussion questions, song, dance and other fun activities. Throughout the curriculum, students will learn that they are change-makers who can make a difference in the lives of others. While Lifewater International and partners work together to provide water points and latrines in rural schools, they both recognize the great need of school-specific WASH education to supplement the provision of water and latrines. One cannot be sustainable without the other. This curriculum will help primary school Health Clubs and classroom teachers build on their current approaches to WASH education and facilitate age-appropriate, interactive lessons. Will you join us in being a change-maker? Steps for Better Health

1. Drink, Drink Safe Water! 2. Know the Difference Between Safe and Unsafe Water! 3. Stop the Spread of Disease! 4. Keep the Inside and Outside of Our Bodies Clean! 5. Keep Safe Water Safe! 6. Keep Food and Utensils Clean! 7. Use Latrines Always! 8. Keep our Schools and Homes Clean! 9. Use Safe Water When Caring for Sick People!

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Overview of Steps for Better Health Manual CURRICULUM LAYOUT: Each lesson will begin with the materials, preparation and time needed. These can all be adjusted depending on what is available and appropriate for each school or community. Additionally, each Step has a Bible verse to go with it. It is suggested that the Steps and verses be displayed where students can see to remind students. BACKGROUND: Each lesson will have Background information to support the facilitator. Each facilitator may decide which points to share with the class. DISCUSSION QUESTIONS: These questions are to encourage dialogue with the students. Facilitators are encouraged to change or add to these as needed. APPENDIX: The appendix is located at the end of the manual. It contains supporting information, optional dramas and activity ideas for facilitators. RESOURCE PACKET: The resource packet contains posters and other materials required for lessons. BIBLE VERSION: Unless otherwise stated, this manual uses the International Reader’s version for all Bible Verses.

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Glossary Dehydration: when a plant or a person loses a lot of water; if you are dehydrated, you do not have enough water in your body Diarrhea: the passing of loose, watery feces three or more times per day Feces: waste from the human body; often referred to as ‘poop’ in this curriculum HIV/AIDS: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Hygiene: actions taken by people to stay healthy and clean; washing your hands before eating is an example of good hygiene Magnifying Glass: a glass lens that makes things look bigger than they actually are Germs: very small living organisms that can cause disease; also called “microbes”; many of the germs cannot be seen with our eyes Microscope: an instrument with powerful lenses; a microscope magnifies very small things so that they look large enough to be seen and studied Nutrients: something that is needed by people, animals, and plants to stay strong and healthy; proteins, minerals, and vitamins are all nutrients which are found in the food we eat ORS: Oral Rehydration Solution; a factory-produced packet containing a mixture of exact measurements of salt and sugar to be mixed with water; used to rehydrate the body so that it has enough water to be healthy Rehydration: replacing lost water and salt in a dehydrated person Safe Water: water containing few germs; water that is good for our bodies and keeps us healthy Sanitation: safe disposal of waste; sanitation protects people from disease SODIS: Solar Disinfection; a method of disinfecting water using solar (sun) energy. The sun has the power to kill bacteria, and other germs, which cause diarrhea and other water-borne diseases Sugar Salt Solution: Sugar Salt Solution; a home mixture of water (250-300ml), salt (.61ml) and sugar (5 ml) that can be used to rehydrate the body so that it has enough water to be healthy Storing Water: keeping water while waiting to be used Transporting Water: taking water from its source to where it will be used Unsafe Water: water containing many germs; water that makes us sick and causes disease Virus: a tiny organism that cannot be seen with our eyes that causes illness in the body such as polio, measles, the common cold, and AIDS

WASH: Water Access, Sanitation, and Hygiene; access to and use of safe water sources, safe disposal of waste; cleanliness behaviors

Step 1a

Drink, Drink Safe Water!

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Step 1a: How the Human Body Needs Water1

Background

• Human beings can live about two months without food, but less than a week without water. • Our body needs 2.36 liters of water a day - 1/3 from drinking and 2/3 from the food we eat. • A person 1.5m and 20cm tall weighing 68 kg will have over 45 liters of water in his/her body at any

given time. • Dehydration: see Glossary for definition • The amount of water in our bodies varies according to our age and body type. An infant is typically

75% water. A pregnant woman is typically 80% water. An adult is typically 60% water. An elderly adult is typically 50% water.

• Water in our body is renewed every six weeks primarily by the water we drink, so choosing safe water is important.

• Phosphoric acid is an active ingredient found in some sodas. Large amounts of phosphoric acid can remove calcium from our bones and does not hydrate as well as water does. Water is a healthier choice.

• More than 5 million people die each year from diseases caused by unsafe drinking water, lack of sanitation (see Glossary for definition), and insufficient water for hygiene (see Glossary for definition).2

• “84% of water-related deaths are in children ages 0-14.” 3

Step 1: Drink, Drink Safe Water Verse: Psalm 139:14a

God, “How you made me is amazing and wonderful. I praise you for that.” Objectives:

• Identify different ways the human body needs and uses water Materials:

• One fresh and one dehydrated plant (or food such as fruit) • Scissors or knife • Chalkboard or flipchart paper • Step 1 poster from Resource Packet • Psalm 139:4a poster from Resource Packet • Tape • WASH Acronym lettered where it can be seen • Paper or exercise books (one per student) • Optional: Heavy string or rope (6 meters) & 42 clothespins for hanging the Step Posters

Preparation: 1. Cut one plant a few days before and allow it to dry. Cut another plant of the same kind and keep it in

water until class time. Select something that shows a big difference between a dried and a fresh sample. 2. Draw an outline of a child on the wall, chalkboard, ground, or large paper. 3. Write WASH acronym where it can be seen. 4. Optional: Attach rope or string across the room from top of door to window above students’ heads for

hanging the steps. 5. Optional: Create your own Drink, Drink Safe Water Action Rhyme (See original rhyme, and tips for

creating one in the Appendix). 6. Optional: On flipchart paper, write the Leader lines of Drink, Drink Safe Water Action Rhyme (found in

Appendix). Time: 40 minutes

Step 1a


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1. Introduce Hold up two examples of a plant, one that is fresh and one that is dehydrated. Lead students in a discussion of the differences between the two plants. Explain that most plants have a large amount of water in them. You may also want to add information from the Background section. Activity Questions:

• What are the differences between these two plants? • Why do you think they look so different? • What are some things plants need to survive? What about people?

2. Add Information Introduction Learning Questions:

• Can you see the water inside your body? • Can you feel the water in your body moving around?

Show outline of a child hanging on the wall. Draw one line vertically through the middle of the length of the body. Draw another line horizontally, making a “t” shape, across the width of the child’s body. The two lines will divide the body into four parts. Students choose three of the four parts of the drawing to fill with raindrops. This will fill approximately 3/4 or 75% of the body with water. Students at their desks fold or draw a smaller piece of paper into four squares, and fill in three of the boxes with water drops to represent 3/4. This represents our bodies, which are also close to 75% water. Discussion Questions:

• Why do you think your body needs so much water? 3. Optional Activity: Drink Safe Water Action Rhyme

Lead students in the Drink Safe Water Action Song, or create your own, which explains different parts of the body needing water, starting with the brain. Students stand and repeat lines and actions after teacher. The song is found in the appendix. Activity Questions:

• What are some ways we use water? • What are some ways our body uses water?

4. Apply Lead students in a discussion of different body parts that need water. As different body parts are named and labeled, see if students can guess why that part needs water. Add background information provided below as needed. (Not necessary to identify all parts.) Brain: Our brains are 75% water. Water keeps the brain active and alert.4 Even a 2% drop in water can cause poor memory, trouble with basic math, difficulty focusing and tiredness. Eyes: Water washes away any dirt that gets in our eyes and gives us tears when we cry.

Step 1a


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Respiratory System: Water carries oxygen to body parts and helps remove carbon dioxide from them.5 Bones and Joints (Knees/Elbows): Bones are only 20% water, but between our bones we have joints that have more water in them. Water in special fluids in joints helps bones move more smoothly.6 Stomach: Water is a part of a healthy diet. It helps digest food for energy.7 Muscle: Water helps maintain muscle strength and keeps the skin soft and full. Our muscles are 80% water. Skin: Water keeps the skin soft and smooth. Our skin is 65% water. Blood: Water in body fluids, such as blood, carries nutrients (see Glossary for definition) throughout the body.8 Nutrients are needed to keep our bodies healthy and strong. Kidneys: Water cleanses the blood in the kidneys. About 15 times a day all our blood passes through our kidneys, where water helps to wash or purify it.9 Body Temperature: Water controls body temperature and transports waste out of the skin.10 Healthy human bodies have a temperature of 37 degrees Celsius (98.6 Fahrenheit). 1. Spiritual Application Read Psalm 139:14a from poster. Explain that God gives us water and designed our bodies to use water in many wonderful ways. Discussion Questions:

• Who made us? • How are we made?

2. Close Introduce the Steps for Better Health to the students. Be sure to explain the WASH acronym and the first Step the students will be learning about. Explain that as we learn and practice the steps, we are “walking” toward better health. Ask students to create an action to represent Step 1. Hang Step 1 on the wall. Attach Psalm 139:14a poster to bottom of Step 1. 1 Lesson adapted from Project WET Dennis Nelson et al., Project WET Curriculum and Activity Guide. (Bozeman:The Council for Enviromental Education, 1996), 63-71. 2 Johannesburg Summits; World Summit on Sustainable Development, United Nations Secratery-General Calls for Global Action on Water Issues, (2002), http://www.johannesburgsummit.org/html/media_infoprossrelease_prop2/global_action_water_2103.pdf. 3 Annette Pruss-Ustun et al., “Safer Water, Better Health: Costs, Benefits and Sustainability of Interventions to protect and Promote Health,” World Health Organization, http://esa.un.org/iys/does/WHO_CB_eng.pdf. 4 John Etgen et al., Healthy Water Healthy People (Bozeman: The Water-course, May 2003), 3. 5 Marilynne and Wallace Homitz, and Bob Johnson, The Official Captain Hydro: Water Conservation Workbook (Oakland: East Bay Municipal Utility District, 1992), 18. 6 Etgen et al., 3. 7 Ibid. 8 Ibid. 9 Homitz and Johnson, 18. 10 Etgen et al., 3.

Step 1b


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Step 1b: We Are Change-Makers!

Background:

• “Children should be considered as building blocks in program development.”11 John 6:1-13 Some time after this, Jesus crossed to the far shore of the Sea of Galilee (that is, the Sea of Tiberias), and a great crowd of people followed him because they saw the signs he had performed by healing the sick. Then Jesus went up on a mountainside and sat down with his disciples. The Jewish Passover Festival was near. When Jesus looked up and saw a great crowd coming toward him, he said to Philip, “Where shall we buy bread for these people to eat?” He asked this only to test him, for he already had in mind what he was going to do. Philip answered him, “It would take more than half a year’s wages to buy enough bread for each one to have a bite!” Another of his disciples, Andrew, Simon Peter’s brother, spoke up, “Here is a boy with five small barley loaves and two small fish, but how far will they go among so many?” Jesus said, “Have the people sit down.” There was plenty of grass in that place, and they sat down (about five thousand men were there). Jesus then took the loaves, gave thanks, and distributed to those who were seated as much as they wanted. He did the same with the fish. When they had all had enough to eat, he said to his disciples, “Gather the pieces that are left over. Let nothing be wasted.” So they gathered them and filled twelve baskets with the pieces of the five barley loaves left over by those who had eaten.

Step 1: Drink, Drink Safe Water Verse: Psalm 139:14a

God, “How you made me is amazing and wonderful. I praise you for that.” Objectives:

• Read and discuss the story of Jesus feeding the 5,000 • Identify the young boy as a change maker • Prepare a plan to be a change maker for Step 1

Materials: • Step 1 poster and Bible verse • Optional: Chalkboard or flipchart paper • Optional: Bibles

Preparation: 1. Optional: Copy John 6:1-13 onto a flipchart and cut script into 6 strips. 2. Prepare six students to read John 6:1-13 out loud to class; each student reads 1 part of the script.

Time: 20 minutes

Step 1b


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1. Add Information Have students say Step 1 together with the hand motions they created in Step 1a. Have students read the story from John 6:1 – 13. Afterwards, lead students in a short discussion of the story. Discussion Questions:

• What happened in the story? • How much food would it take to feed 5,000 people in our village? • Who had the food? • Who caused the change from hungry to full? • Did the young boy know his little bit of food could feed so many? • How do you think the boy felt about being asked to share his small lunch?

5. Apply Jesus was the one who caused the change, but the boy also had a part. We might call the young boy a “change maker” because he gave what he had to Jesus and a big change happened for the people who were hungry. Share with the students that by being part of these lessons, they too can be change-makers. They can use the information they learn about water, sanitation and hygiene to help others. Be sure to note that God can use them to make changes in their communities.

6. Close Discussion Questions:

• What did you learn in our last lesson about water that you could share with others as a change maker?

Have students stand up, then explain the “Change Maker Cheer” Everyone point to him or herself and say together, “I am a change maker!” Each student points to another and says, “[Their name] you are a change maker!” “We are change-makers!” After class discussion, suggest closing in prayer, thanking God for letting us be change-makers and asking for God’s help. As a class, answer the “I Am a Change Maker” questions listed below.

• What is today’s Step? • The most important fact I learned about this Step is…. • How will we share this Step?

11 HE Khabibullo Boboer, First Deputy of Education Government of Tajikistan, (paper presented at the Water, Sanitation, and Hygiene Education for Schools Roundtable Meeting for UNICEF/IRC, Oxford, UK, January 24-26, 2005).

Step 2

Know the Difference Between Safe and Unsafe Water!

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Step 2: Know the Difference Between Safe and Unsafe Water

Background: • Safe Water: water containing few germs; water that is good for our bodies and keeps us healthy. • Unsafe Water: water containing many germs; water that makes us sick and causes disease • Water from boreholes and protected springs is usually safe but can become contaminated and require

treatment. • Originally safe water can become re-contaminated if it is stored too long in a closed tank. Bacteria and

viruses (see Glossary for definition) can continue to grow in containers once they have been cleaned. Clean storage containers and replace water every 1-2 weeks.

• How to know (with reasonable accuracy) if water is safe: o We cannot tell by looking at water whether it is safe for drinking and cooking. We must look

at the source of the water or where it came from. o Sealed water sources are good, surface water sources are not. o For example, a working borehole that is sealed with cement protects the safe groundwater

as it brings it to the surface. A broken borehole may have cracks in the seal that allow germs from the surface to get into the safe groundwater, making the water unsafe.

• Filtering/boiling

Step 2: Know the Difference Between Safe and Unsafe Water Verse: Revelation 22:17b

“ ’Come!’ Anyone who is thirsty should come. Anyone who wants to take the free gift of the water of life should do so.”

Objectives: • Discover and demonstrate the steps for making unsafe water safe using one or more of the following

methods: filtering and boiling, SODIS, PUR, and/or Water Guard. Materials:

• 3 clear containers that can be seen through • Poster Set A: Safe and Unsafe Water Sources from resource packet • “Mama Teaches Safe Water” story book from resource packet • Materials for filtering and boiling:

o Bucket with lid and a cooking pot with lid o Water and soap, sand, or ash o Clean, tightly woven cotton cloth (large enough to cover cooking pot) o 2-3 feet rope, string, or a belt o Optional: Fire source (wood, small stove, etc.) o Chalkboard or flipchart paper o Tape

Preparation: 1. Collect water from 3 different sources in clear containers: one is from a dirty source so that the

water looks very dirty, one is from an unsafe source that looks clear, and one is from a safe water source.

2. There are many ways for making unsafe water safe. This lesson teaches filtering and boiling. In the appendix there are other methods that can be added to this lesson, depending on what is appropriate for this area. Other methods include SODIS, PUR, and Water Guard

3. Determine which of the water purification methods to teach and gather materials needed. 4. Write out steps for the methods taught, and cut them apart so each step is separate. 5. Tape Unsafe and Safe Water definition posters from lesson 2a to the wall for review.

Time: Varies depending on methods taught.

Step 2


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o Benefit: This filtering/boiling method is very effective in removing and destroying most of the small organisms, which cause waterborne diseases. It also can produce large quantities of safe water at one time.

o Challenge: One disadvantage with this method is the problem of deforestation or lack of available fire source and the possibility of burns while boiling. The World Health Organization estimates that it requires 1 kilogram of wood to boil 1 liter of water. In some areas this method is simply not possible.

o Process: § Water should come to a rolling boil for 1 minute if elevation is under 2,000m. § If elevation is higher than 2,000m, boil for 3 minutes. § Cover pot and let cool to room temperature. § Safe water should also be used when possible for cleaning dishes, vegetables, cooking, and

washing hands. • Pots and buckets used for transporting, boiling and storing water need to be washed in soap and water

and dried in the sun before and after each use. • Water containers used for storage can become re-contaminated if the storage time is longer than a

week. Wash or change storage containers every 3-4 days. Store the water in a dry, cool place away from sunlight and heat.

• See Appendix 3 for alternative water treatment methods

Step 2


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1. Introduce Have students say Step 1 (from posters) with hand motions. Show the class the three containers of water you have prepared. Activity Questions:

• What do you notice about these containers? • Which containers do you think are safe for drinking and cooking? Why? • Is there a difference between water that is safe for cooking but not drinking? • Do you know for sure whether this water (in the unsealed bottle) is safe?

2. Add Information Uncover and read descriptions of safe and unsafe water. Share with the students what kind of water is in each container. Be sure to share some of the background information from this lesson. Introduction Learning Questions:

• What methods are common for making unsafe water safe? Read the “Mama Teaches Safe Water” story together. *Option for small children: look through the pictures with the children and ask the questions below, before reading the actual story Activity Questions:

• What do you see happening in this picture? • Who do you think are the main characters? • What do you think will happen next? • What supplies does Mama need to filter and boil water?

After reading, ask students to listen for the steps involved in filtering and boiling water. Record the steps on the chalkboard or on large flipchart paper with bullets so they can be cut apart later and used in Lesson 2c. Demonstrate, using available supplies, the filtering and boiling method of making water safe. Let the students read the steps of the process as you do them or have individual students do each step. If possible, let the children sample the water when it cools. Activity Questions:

• What is good about this method? • What is bad about this method? • Could the filtering and boiling method work in our school or homes? Why or Why not?

3. Optional Activity: Alternative Water Treatment Methods Continue the lesson demonstrating the alternative methods you have chosen to teach. Information and instructions for each method are found in Appendix 3.

Step 2


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4. Apply Divide students into teams. There should be 1 team for each safe water method learned. Give each team a set of steps for the safe water methods they have learned. If possible, each student should hold a step. Challenge the students to put themselves in the correct order as quickly as possible. As a class, review each team’s steps to make sure they are in the correct order. If only one method was learned, choose one team of students to hold the steps and have the class put the steps in order. 5. Optional Activity: Spiritual Connection Read together Psalm 139:14a, and Revelation 22:17b

• What have you learned in Step 2 that you, as a change maker, could share?

6. Close Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.

• What is today’s Step? • The most important fact I learned about this Step is….

Step 3a

Stop the Spread of Disease!

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Step 3: Stop the Spread of Disease Verse: Mark 1:33-34a

“All the people in town gathered at the door. Jesus healed many of them. They had all kinds of sicknesses.”

Objectives: • Drawn pictures of the different shapes of germs • Created stories of how germs travel from poop to mouth and make us sick

Materials: • Step posters 1-3 & Bible verses • Picture of microscope from resource packet • Poster Set B: Disease Paths from Resource Packet • Chalkboard or flipchart paper • Optional: magnifying glasses (see Glossary for definition)

Preparation: 1. Create a story, using the posters for this lesson, that shows one way germs can make people

sick. A sample story is in the appendix. Time: 50 minutes

Step 3a: How Germs Travel in Feces and Make Us Sick

Background: • The word germ, or microbe, is used to describe many very small organisms (living

things) that can cause disease. Germs can be bacteria, viruses, and protozoa. • Usually, germs are too small to be seen with our eyes. Scientists use

microscopes (see Glossary for definition) that allow them to view these tiny germs.

• Germs have different shapes: round, spherical, rod and spiral shaped. • Flies carry germs on their feet and legs. This can spread disease. • Infectious diseases caused by bacteria, viruses, and parasites (e.g., protozoa

and helminthes) are the most common and widespread health risk associated with drinking water.12

• Bacteria are one-celled organisms that can survive on their own in soil, water and other places but often live in other organisms. They can only be seen with a microscope.

• Viruses are even smaller than bacteria and cannot be seen with normal microscopes. Although they can survive many places, they can only reproduce and grow inside another organism. Example: HIV

• Protozoa are one-celled organisms that are larger than bacteria. They act like little animals and may seek out other germs as food, so they are considered more complex than bacteria or viruses. They live in other organisms but may also be found in other places such as soil, water, and insects. Malaria is caused by a kind of protozoa that is carried by mosquitoes.

• Worms/ Helminthes that cause disease can be very small or large. The worms or their eggs can enter the body many different ways, including drinking water or through the skin. Examples include tapeworms or hookworms.

• Parasites also cause disease. A parasite is an organism that lives on or in another organism. The parasite gets its food from the other organism. Bacteria and viruses may sometimes be called parasites, but usually they are not included in this category. Protozoa and worms are often called parasites.

• Not all germs and parasites cause disease. The focus for this curriculum is organisms that cause water-related diseases and are often found in feces (see Glossary for definition).

Step 3a


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1. Introduce Say the first 2 Steps together with hand motions. Share Step 3 with students: “Stop the spread of disease!” Create an action to go with the Step. Lead a short discussion about how it feels to be sick. Introduction Learning Questions:

• What are some ways we become sick? • How do we feel when we are sick? • What happens when we are sick? • What are some of the things we can’t do when we are sick?

2. Optional Activity: Add Information Lead an introduction to germs using relevant information from the Background section (the facilitator may choose which information to share). If needed, use the posters of the glasses and microscope. Draw pictures of germs using the images in the Background section where they can be seen by the class. Students can copy these in exercise books if available. Discussion Question:

• How do you think these little tiny germs can get in our stomachs to make us sick? 3. Apply Use Poster Set B: Disease Transmission to show how sicknesses causing diarrhea (see Glossary for definition) are spread. Lay the feces and the mouth posters about two meters apart on the ground. Arrange the rest of the posters in the order that is shown in the reference picture. Have strings or sticks available to show the pathways from the feces poster to the mouth poster that germs could travel to make someone sick. Show the students one pathway that germs can travel. Let the students complete the rest of the pathways.

• How can poop travel from the ground to our mouths? 4. Optional Activity: Younger Students Let students work together to tell a story that follows one of the disease pathways. 5. Optional Activity: Older Students Have students form groups and create a drama or song that follows one of the disease pathways.

Step 3a


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6. Close

• What are some Steps we know already that could keep us healthy and stop the germs from spreading?

The first two Steps are connected with the WA on our WASH poster, but our third Step (Stop the spread of disease) involves all of the letters of WASH - water, sanitation, and hygiene. Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


12World Health Organization, “Guidelines for Drinking Water Quality”, WHO; http://www.who.int/water_sanitation_health/dwg/GDW3rcv/and2.pdf.(accessed October 19, 2009).

Step 3b


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Step 3b: Diseases Caused by Poor WASH Behavior

Background: • There are many diseases related to poor WASH habits: drinking or playing in unsafe water, not using

latrines, or not washing. These are called WASH-related diseases. • Dehydration: When a plant or a person loses a lot of water. If you are dehydrated, you do not have

enough water in your body. • Signs a person has dehydration:

• Becomes limp • Sunken eyes • No tears when crying • Dark yellow urine or no urine • Dry, wrinkly skin around the mouth • Cracked lips and dry mouth • When skin is pinched it stays pinched or recovers slowly • Abdomen can be sunken • On an infant, the soft spot on head is depressed

• Diarrhea can lead to death if not treated. • People with diarrhea should drink more water to keep their bodies hydrated. • Directions for the Sugar Salt Solution (SSS) to rehydrate someone are in Appendix 5.

Step 3: Stop the Spread of Disease Verse: Mark 1:33-34a

“All the people in town gathered at the door. Jesus healed many of them. They had all kinds of sicknesses.” Objectives:

• Learn characteristics of diseases related to unsafe water, not washing, or not using latrines • Create a poster on how to stop one of the diseases related to poor WASH habits

Materials: • Step 1-3 posters & Bible verses • WASH-Related Disease Characteristics from Resource Packet • Paper for nametags • WASH-Related Disease Drama directions and script from Resource Packet • Chalkboard and chalk • Optional: Poster Set C: Healthy and Dehydrated Child • Optional: Clear plastic bag • Optional: Dirty water • Optional: Clean water • Optional: Something to make a small hole in the bag • Optional: String or tape name tags

Preparation: 1. Determine which WASH-related diseases are most common in the area you are working and only

teach these; do not use the materials and background information for diseases not common your region.

2. Cut apart the appropriate WASH-Related Disease Characteristics for small groups. 3. Make a nametag for each appropriate disease character (Ex: using string or tape and paper). 4. Cut apart character scripts or have students copy them, and attach to back of nametags. 5. Assign disease nametags to a group member from small groups created for Lesson 3b. 6. Have disease characters practice parts (script found in Appendix). 7. Assign students to hold up student posters from Step 3b of characters introduced in drama.

Time: 50 minutes

Step 3b


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1. Introduce Say the first 3 Steps together with hand motions. Introduction Learning Questions:

• How have you been a change maker? • Who can share one of the ways germs travel? • What are some common diseases in our communities?

Briefly introduce the lesson and the concept of WASH-related diseases. 2. Optional Activity: Dehydration and Diarrhea Show posters of a healthy and unhealthy child. Activity Questions:

• What do you see in these pictures? • What do see about this child that makes him or her look healthy or unhealthy?

Hold up the poster with the unhealthy child, and explain that the child is suffering from diarrhea. Use a plastic bag to demonstrate why diarrhea can be so harmful to the body. Instructions below: Show a plastic, see-through bag filled with brown water. The bag represents a child who has diarrhea. Hold the bag over a container and make a small hole in the bag. All the water will drain out. This represents the child going to the toilet. Activity Questions:

• What happened to the bag? • If this were a child, what would happen to the child?

If needed, share the definition and signs of dehydration found in the background section. Refill the bag with clean water, and watch the brown water drain out. Stress the importance of drinking safe water when ill with diarrhea because the body needs to stay hydrated. 3. Optional Activity: Add Information Divide class into ten groups. Hand out one WASH-Disease card to each group. Ask the groups to take 5 minutes to 1) read about the disease on their card, 2) create an action to represent the disease, and 3) discuss the following questions:

• What body parts are affected? • Is this disease common in our community?

Give groups about 5 minutes to do these three tasks, and then ask each group to present its action and share its answers to the two questions above with the rest of the class. Draw 5 columns on the chalkboard. Label them: Diarrhea, Pneumonia, Blindness, Death, and Prevention. As a class, list which diseases lead to which result. Under the word “Prevention”, list student answers to this question:

• What are some actions we can take to stop these diseases?

Step 3b


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4. Optional Activity: Apply In the same groups, give students the drama for the disease they were learning about as a group. Before the drama begins, ask the students to pay close attention to the following things:

• What is the name of the disease? • How is it related to WASH? • How can it be stopped?

Ask students to share their drama with the class. After each student shares, the students puts their hands up and say, “Stop the spread of (name of disease)!” It may be helpful to demonstrate this to the class. After all the groups have presented, ask the class to answer the questions listed above. Activity Questions:

• What have you learned about stopping diseases? • What changes will you make knowing that God loves you and wants you to be healthy?

5. Optional Activity: Spiritual Connection Read Mark 1:33-34a together. Discuss Jesus as a change maker. Discussion Questions:

• What do you think of this verse? • What are some ways Jesus was a change maker in this verse? • How can this verse encourage us to be change-makers?

6. Close Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 4a

Keep the Outside and Inside of Our Bodies Clean!

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Step 4a: Six Steps of Handwashing

Background: • Six Steps of Handwashing:

1. Wet your hands with water. 2. Add some soap. Ash or sand will work if soap is not available. 3. Rub hands together quickly for 20 seconds. 4. Clean between fingers and under nails. 5. Rinse with water. 6. Dry your hands. Shake them in the air. A handkerchief or shirt is not good because it can

add germs back onto your hands. • The six steps of handwashing will help students wash their hands properly each time. • 20 seconds is longer than we think it is. It is important to wash for 20 seconds so the soap can get

germs off our hands. • If soap is not available, ash or sand will work as well. • A pocket chart is a tool for gathering information; pocket charts offer a private way to answer difficult

or embarrassing questions

Step 4: Keep the Outside and Inside of Our Bodies Clean Verse: Psalm 51:10

“Create in me a new, clean heart, O God, filled with clean thoughts and right desires.” Adapted from New Revised Standard Version, (1995).

Objectives: • Demonstrate the six steps of handwashing • Draw the six steps of handwashing

Materials: • Steps 1 - 4 and Bible verses • Chalkboard or flipchart paper • Pocket chart (See Appendix for directions) • Poster Set D: Pocket Chart Labels from Resource Packet • Rocks, bottle caps, or beans for voting • Watch or clock with second hand • If a watch is not available for step 2, count to yourself • 6 sheets of flipchart paper, each cut into 6 smaller pieces for each small group of six or more

students • Tippy tap or other handwashing device with soap and water • Optional: Item for cutting fingernails

Preparation: 1. Write six steps of handwashing on flipchart paper or chalkboard; keep covered until

needed. 2. Memorize the six steps of handwashing. 3. Attach posters for pocket chart (girl and boy down left side; wash with water and ash, did

not wash hands, wash with soap and water, wash with water only, across the top pockets.) Use mini-poster set that is most familiar to students at your school. (Tippy tap set or hands-in-basin set.)

4. Find a private place to hang pocket chart for vote. 5. Draw a pocket chart on the chalkboard to record results. 6. If needed, review pocket chart information in Appendix.

Time: 60 minutes

Step 4a


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1. Introduce Review the first three Steps to Better Health using hand motions. Introduction Learning Questions:

• How have you been a change maker since our last lesson? • In your community, is it easy or difficult to talk about WASH behaviors? Why or why not?

2. Introduction Activity Hang the pocket chart where all can see it. Attach the labels as desired, based on the information you want to capture. For example, you can make a row for girls and a row for boys, using poster D1 and you can make four columns our of poster D2. Introduce the pocket chart to the class. Be sure to explain the privacy of voting using this method. Demonstrate many times with different students showing how different answers would be represented until you think that the students fully understand how to vote. Ask students to take turns voting. Students should answer this question:

• Last time you washed your hands, what did you use? Give each child one rock to place in a pocket. Hang the chart where other children cannot see the voting. Dismiss children one at a time so each can vote privately. After all students have voted, record the votes on a hand-drawn graph similar to the pocket chart. Add each column together, totaling the boy and girl results. Activity Questions:

• Which way of handwashing was most common? • Which way of handwashing was least common? • How many students washed their hands using ash or soap altogether? • How many students did not wash their hands at all? • Why do you think they did not wash their hands?

3. Add Information Introduce Step 4: Keep the outside and inside of our bodies clean! Introduction Learning Question:

• How many steps do you think it might take to wash your hands?

Introduce the six steps of handwashing by demonstration. You may want to do this many times with students repeating the steps. Time 20 seconds. While you are timing, have students close their eyes and raise their hands when they think 20 seconds has passed. This shows that it can be hard to know exactly how long 20 seconds is.

• What could we do to help us remember how long 20 seconds is?

Step 4a


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Repeat steps, this time including counting or singing at step 3. 4. Apply Review or have students share some reasons why handwashing is important. Have students form groups of six or more. Ask each group to draw the six steps of handwashing on separate pieces of paper. Or, students could act out the steps by making up a song. 5. Optional Activity: Nail Clipping Have the students look at their hands and ask them where the best hiding place for germs are? Keep asking until several ideas have been mentioned. If no one has mentioned it, ask if germs might hide out under fingernails. Activity Questions:

• Why is it helpful to keep nails short? • Does anyone need his or her nails clipped today?

Help students clip their nails. 6. Close

• How can we share these handwashing steps with the other students?

Follow through on one or two of these ideas to share handwashing with other students Do the “Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 4b


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Step 4b: Important Times to Wash Hands

Background:

• The two categories for handwashing are after contact with germs and before contact with food. • Washing your hands at these two times stops the spread of diarrhea directly after you come into

contact with feces and prevents germs from entering your when handling food. • There are four critical times for handwashing, which fall into the two categories above. The most

critical times to wash hands are: o After defecation o After contact with a child’s feces o Before eating o Before handling food

• There are other times when it is good to wash hands, but handwashing at these four critical times will have the biggest impact on health.

• Even though your hands might look clean, there may be tiny germs on them that you cannot see. • Children’s feces contain more germs and are more dangerous to people’s health than adult feces.


“Create in me a new, clean heart, O God, filled with clean thoughts and right desires.” Adapted from New Revised Standard Version, (1995).

Objectives: • Discover 4 or more items/activities that could leave germs on hands • List important times to wash hands • Categorize the above list into BEFORE touching food and AFTER contact with feces • Act out important handwashing times

Materials: • Step posters 1-4 & Bible verses • Chalkboard or flipchart paper • Poster Set E: Handwashing Times in the Resource Packet • Several tippy taps or other handwashing devices • Paper for students to draw their hands

Preparation: 1. Draw large hand on chalkboard. 2. Cut the ‘appropriate times to wash hands’ pictures in half.

Time: 50 minutes

Step 4b


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1. Introduce

Review the four Steps with hand motions. Introduction Learning Questions:

• What have we learned about Step four so far? • What part of WASH do you think Step four is related to? • Are your hands clean? Do they look clean? Do they smell clean? Do they feel clean?

Ask students to think about times when they wash their hands. Do not have them share yet. Introduce the idea that hands may look clean, but they may not be. Trace your hand on the chalkboard. Give three or four examples of things you have done before the lesson. Draw on the hand to show this. For example, if you swept the house there may be dust on the hand. Have students trace their own hands on paper and brainstorm different items they may have touched earlier today either at school or home.

• What have you touched with your hands since you last washed them? 2. Optional Activity Have students discuss this question with a partner:

• What have you touched with your hands since you last washed them? Have some students volunteer to draw their hands on the chalkboard and share what may be on them. 3. Add Information Give a brief review about germs or have students share what they remember from past lessons. Discussion Questions:

• What are some of the things you’ve touched that could have left germs on your hands? • What should we do when we have all these germs on our hands? • When is it important to wash our hands?

Share with the students that it can be difficult to wash hands every time they need to. Use Posters E1 and E2 to introduce the two most important categories of times to wash hands: BEFORE touching food and AFTER contact with poop. Then introduce the 4 critical times for handwashing, which fit into these categories.

Step 4b


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Introduce the four most critical times to wash hands. As you mention each, lay the related picture down on the ground.

• Before eating (Poster E3) • Before handling food (Poster E4) • After defecation (Poster E5) • After contact with a child’s feces (Poster E6)

Hand out the remaining posters from Poster Set E to groups of participants (posters E7—E11). Ask groups to share the poster they have, and place it under one of the four labels. Help participants if they have trouble placing a poster. Ask the following discussion questions. You may want to write student responses where the class can see. Discussion Questions:

• When are times we need to wash our hands before touching food? • Why is one of the most important times to wash our hands before touching food? (one

answer: because it is a time when germs easily enter our bodies and it is a frequent time for all people)

• When are times we need to wash our hands after touching food? • Why is the other most important time to wash our hands after contact with poop? (one

answer: because it is a time when germs easily enter our bodies and it is a frequent time for all people)

4. Apply Pick up all the posters. Explain that there are many times we should wash hands to keep us and others healthy, and the four times we listed are the most important. Hand out posters E3-E11. Students act out the activity on their pictures without using words. The rest of the class tries to guess the activity being acted out. When a student guesses correctly the activity being acted out, the whole class says, “Stop, wash your hands!” The class will then identify which action the student is acting out and say whether to wash their hands before or after doing this action. 5. Close Review background information as necessary. Encourage students to think back to the times they wash their hands. Ask them to think about a time to wash hands that they are not doing very often. Have students choose a time to wash hands that they can practice at school or at home this week. If appropriate, have them share their choice with a partner. Do ”Change Maker Cheer”. Close lesson by having students wash their hands. This can be done at school handwashing stations or tippy taps. As a class, answer the “I Am a Change Maker” questions listed below.


Step 4c


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Step 4c: Washing Our Whole Body

Background:

• It is good to bathe regularly with soap and water. If it is not possible to bathe regularly, it is good to at least wash with a small c lean towel or cloth. This will only take a few minutes and use very little water.

• Why use soap? o The soap suspends the dirt and soils so they come off the skin. o The friction from rubbing hands together helps pull dirt and greasy or oily soils from the skin. o Water washes away suspended dirt and soils that trap germs. o Final friction of wiping hands removes more germs.

• Tooth brushing: Brushing with fluoride toothpaste is best to prevent disease, but brushing with tooth sticks, common in developing countries, is as effective as brushing with toothbrushes to reduce plaque and gum disease. The most common causes of tooth loss are dental cavities and gum disease. Some trees are chemically more effective at preventing oral disease: Salvadora persica also known as Miswak, the gum tree, tea tree, and cinnamon all help chemically clean and protect teeth.13

• Washing the face with soap and clean water every day helps prevent eye infection including trachoma. It is important to keep all materials and cloths clean that are used to wash or dry the body.14

o How to clean the materials/cloths used for washing the body: § Rinse in running clean water (use soap if available) § Immediately hang somewhere to dry, in direct sunlight if possible.

13 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545237/ 14 http://www.wsscc.org/sites/default/files/publications/panamerica_handbook_for_a_safe_and_healthy_school_2005.pdf


“Create in me a new, clean heart, O God, filled with clean thoughts and right desires.” Objectives:

• Analyze body washing behaviors • Summarize the importance of washing one’s body parts

Materials: • Step posters 1-4 & Bible verses • Chalkboard or flipchart paper • Wash, Wash with Soap and Water drama (in Appendix) • Optional: create a drama that shows the importance of washing parts of the body. • Sample tooth stick/toothbrush, toothpaste and salt • Samples of 3 or 5 liter sized jerry cans for making tippy taps

Preparation 1. Rearrange each handwashing poster set created by students in Lesson 4a so they are out of

sequential order (students will need to arrange them in correct order). 2. Assign drama parts to students. Have them practice before the lesson. 3. Read the student assignment at the end of this lesson. Decide whether the tippy taps made

during the next lesson will be for individuals, groups or the school. Time: 50 minutes

Step 4c


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1. Introduce Have a student lead a review of the first four Steps with hand motions. Introduction Learning Questions:

• How have you been a change maker since our last lesson? • What are the six steps of handwashing? • Why are these handwashing steps important?

Briefly introduce the topic of this lesson. 2. Optional Activity: Review Six Steps of Handwashing Have students form groups of six or more. Give each group a set a set of handwashing drawings from lesson 4a; they should be in a random order. Have groups compete to put the drawings in order the fastest. If you instructed students to sing a song about the steps in lesson 4a, have them repeat the song they sang. 3. Application Discussion Questions Discuss the importance of bathing regularly for good personal hygiene using information from the background section. Use the discussion questions below if needed. Discussion Questions:

• What does it mean to wash regularly? • Why would it be important to wash your body regularly? • What are some challenges to washing your body regularly? • Does anyone remember diseases we learned about that can be caused by not washing

your body or washing with unsafe water (scabies, trachoma) 4. Apply Perform a song or drama that shows the importance of washing your body with safe water. You may use the provided drama, Wash, Wash with Soap and Water, found in the Appendix. Use the discussion questions below to emphasize the importance of washing the face and brushing teeth Activity Questions:

• Why is it important to wash your skin? • Teeth? (See background for more information) • Face? (See background for more information on face washing and trachoma)

Step 4c


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5. Assignment Show sample tippy tap. Show several samples of 3 to 5 liter sized, locally available, and inexpensive plastic bottles, or jerry cans, which could be made into tippy taps.

• Have you ever seen this type of device before? • What do you think it does? • How many of you have made a tippy tap before?

Inform students that they will be making tippy taps during the next lesson. Ask students to each bring a clean plastic 3 to 5 liter container for making a tippy tap. 6. Close Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 4d


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Step 4d: Tippy Tap



• Create and demonstrate a tippy tap for handwashing Materials:

• Whole group • Step posters 1-4 & Bible verses • Pre-made Tippy tap • One jug of water and basin • Flipchart paper or chalkboard • Optional: measuring container for comparing amounts of water used

• For each student or small group • 3 to 5 liter plastic bottle or jerry can with lid • String (several pieces for each group. The Hanging String should be double the height from where you

want the tippy tap to hang to the branch or object it will hang from, perhaps the length of your arms spread wide from tip to tip. The Soap String should be approximately the length from your finger to elbow for hanging the soap. The Pull String, should be about the same length as the Soap String if used as a hand pull, or should be able to reach from the tippy tap to the ground if used as a foot lever.)

• Metal can or small plastic bottle for soap cover • Soap • Candle, nail, matches, pencil • Scissors or knife

Preparation: 1. Make an example tippy tap for students to practice using. 2. Decide whether to make tippy taps in small groups or each student individually. 3. A diagram for making a tippy tap is found in the Appendix and detailed instructions are in the Background

section of this lesson. 4. Write steps for making a tippy tap on chalkboard or flipchart paper; keep this covered during first part of

lesson. 1. Assemble materials 2. Cut smaller bottle or can for soap cover 3. Mark where to place holes on jug, soap, and soap cover 4. Light candle 5. Heat nail 6. Make the marked holes in jug, soap, and soap cover 7. Thread Hanging String 8. Thread Soap String. Attach to Hanging String 9. Tie Pull String around neck of bottle 10. Fill jug with water, hang on to use

Time: 50 Minutes

Step 4d


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Background: • Tippy taps can be helpful tools for handwashing when other devices are not available. • Benefits of using tippy taps:

• Tippy taps use less water than most handwashing devices • They are inexpensive • They are easy to construct

• Tippy taps should have soap with them; however ash or sand can also be used if soap is not available. • Tippy taps must be maintained in order to be effective. They must have safe water and some kind of

washing agent such as soap, ash or sand. • Detailed instructions for making a tippy-tap:

1. Assemble materials 2. Mark where to place holes:

o One third from top on jug handle • Two larger holes on the back of the jug, about one-third from top on upper back side

and two fingers apart. These holes are parallel with bottom of the jug. 3. Mark a hole in middle of soap 4. Cut smaller bottle or can for soap cover and mark hole in middle 5. Light the candle 6. Heat the nail over the candle. CAUTION: DO NOT touch the hot nail. Hold the nail with a

piece of paper or cloth. 7. Use the heated nail to make the marked holes in the jug, soap, and soap cover 8. Thread string through back two holes and out through the top of the jug. Tip jug upside

down for easier threading. Tie ends together, making a knot, and pull knot back into jug. 9. Thread bar of soap and soap cover with another piece of string. Attach this string to

supporting string 10. Tie last string around the neck of the bottle for pulling the tippy tap down. 11. Fill tippy tap with water, hang on a tree and use

Step 4d


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1. Introduce Repeat the four Steps with hand motions. Introduction Learning Questions:

• How have you been a change maker? • Why is it important to wash our whole body? • What kinds of handwashing devices do we have in our community? • What challenges are there to washing our hands?

2. Optional Activity: Review Handwashing Ask a volunteer to demonstrate the six steps of handwashing using the tippy tap. Have students say the six steps as the volunteer is demonstrating. 3. Add Information Introduce the tippy tap to students and allow them to practice using it. Then ask the following question. If needed, add information of the benefits of using a tippy tap from the background section. Discussion Question:

• Think about the other devices we use to wash our hands. What are some benefits of using a tippy tap?

Allow students time to examine the tippy tap, then create a class list of all materials needed to make a tippy tap. Show the steps for making a tippy tap to the class. Have the class read each step out loud. 4. Apply Help students make tippy taps with the available materials. This can be done in small groups or as individuals. Afterwards each group can demonstrate the correct method of handwashing with its tippy tap. Activity Questions:

• What have you learned today? • Would this be difficult to do in your communities? Why or why not? • What do these tippy taps need to have in order to be effective? • How can we make sure these tippy taps stay in good working order? • Where do the dirt and germs from our hands end up after being washed with a jug and

basin? With a tippy tap? • What are advantages of using a tippy tap? • Where is a good place to hang a tippy-tap?

Step 4d


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5. Optional Activity: Compare Water Used Measure the amount of water used by 5-10 students using a jug and basin to wash hands or other locally standard method of handwashing. Compare this to the amount of water used by 5-10 students washing with a tippy tap. Suggest that students dump water on school garden or use for cleaning a latrine. 6. Close Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 4e


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Step 4e: Clean Hands, Clean Heart

Background: • It is important to keep our hearts and bodies clean. • We cannot clean our hearts by ourselves; we need Jesus.



• Discover that clean hearts are as important as clean hands • Practice and share the Clean Hands, Clean Heart story

Materials: • Step posters 1-4 & Bible verses • Clean Hands, Clean Heart story from Resource Packet

Preparation: 1. Optional: Color Clean Hands, Clean Heart posters 1-6. 2. Practice reading the physical application and spiritual application of the story.

Time: 50 minutes

Step 4e


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1. Introduce Review four Steps with hand motions. Introduction Learning Questions:

• How have you been a change maker since our last lesson? • What are the four most important times to wash hands? • What are the six steps to handwashing? • Why is it important to wash our bodies regularly? • Who has made a tippy tap for your home since our last lesson? Where did you hang it?

2. Add Information Choose either the physical or spiritual application story from Clean Hands, Clean Heart to share with the class. Introduce and read the application story you choose for Clean Hands, Clean Heart. Have the class divide into groups and have 1 student from each group retell the story to his or her group. You may want to walk around and help students remember the story. If you read the spiritual application, place Psalm 51:10 where students can see it. Read it out loud as a class. 3. Apply Discussion Questions:

• What did you learn from these stories? • What does this story teach us about keeping our [hands or hearts] clean? (Depends on

which story was read) • How could we share these stories if we didn’t have posters? • Who could you share this story with?

Encourage students to find time outside of class to share either the physical or spiritual application of Clean Hands, Clean Heart. 4. Optional Activity: Practice Clean Hands, Clean Heart Divide students into groups and have them practice telling Clean Hands, Clean Heart without posters. 5. Close Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 5

Keep Safe Water Safe!

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Step 5: Keep Safe Water Safe

Background:

• Keeping safe water safe involves transporting and storing water safely, and using clean drinking containers.

• Water needs to be transported and stored in clean, covered containers at all times to prevent germs from making the water unclean and unsafe.

• It is important to clean storage containers often. Germs can re-grow inside the containers; so do not store water for long periods of time. Wash them and refill with fresh water every 1 to 2 weeks.

• Plastic or glass containers are suitable for storing water as long as they are completely cleaned. Wash in hot, soapy water, and rinse well. Let dry in the sun. Sand or ash can be used when soap is not available. Plastic containers such as jerry cans and 1-2 liter soda containers with a narrow mouth and lid provide safe storage and help prevent recontamination if washed thoroughly and often. Wash lids thoroughly as well.

• Store water in covered containers in a cool, dry place away from direct sunlight.

Step 5: Keep Safe Water Safe Verse: Psalm 62:8

“Trust in [God] at all times, you people. Tell him all your troubles. God is our places of safety.” Objectives:

• Consider water containers for transporting, storing, and drinking for cleanliness • Demonstrate how to clean cups for drinking

Materials: • Step 1 – 5 & Bible verses • Poster Set F: Keeping Water Safe from Resource Packet • Tape • Optional: 1 sheet flipchart paper cut in half for Transporting and Storing Water Definitions • Optional: Real water transport, storage, and drinking containers could be used instead of posters • Optional: Cup for drinking demonstration

Preparation: 1. Write definitions for transporting and storing water where they can be seen by the class. 2. Optional: Make a sample plastic water bottle cup by carefully cutting a empty plastic bottle

in half and using the bottom as a cup (be sure the edges are smooth). Time: 50 minutes

Step 5


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1. Introduce Review first four Steps with hand motions. Introduction Learning Questions:

• How have you been a change maker since our last lesson? • Step 5 says: Keep safe water safe! What do you think this means?

2. Add Information Give a short introduction on the idea that keeping safe water safe involves transporting water, storing water, and using clean drinking containers. Split the class into three groups. Give one group posters F1-F4 (Transportation), give the second group F5-F10 (Storage), and give the third group F11-F13 (Use). Ask the students to look over their posters and be ready to describe each to the class. Have the students read the definition of “transporting water” together. TRANSPORTING WATER: Taking water from its source to where it will be used. Ask the group with transport posters to describe each to the class. Then ask the class the following discussion questions. Discussion Questions:

• What are some of the different containers we use to transport water in our community? • Do you think these containers are clean? Why is it important to make a container clean

before putting water in it?

Read the definition of “storing” together. STORING WATER: A place for keeping water while it is not being used. Ask the group with storing posters to describe each to the class. Then ask the class the following discussion questions. Discussion Questions:

• Where do we store water at our school? • Where do you store water at home? • What kind of containers do we use here at school and at home? • How can we make sure our containers are clean? What about our covers?

Stress that water needs to be transported and stored in clean, covered containers at all times. You may want to have the class repeat this for emphasis. It is also important to clean storage containers often. Germs can re-grow inside the containers; so do not store water for long periods of time. Wash them and refill with fresh water every 1 to 2 weeks.

Step 5


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Ask the group with drinking posters to describe each to the class. Stress these two points: o Drink from clean cups o Never dip a cup someone has drunk from back into the water storage container.

Discussion Questions:

• Why do you think it is important not to dip a used cup into a storage container? • Why do you think we should not drink from storage containers? • How can we keep our cups clean?

3. Apply Draw two columns on blackboard and label one ‘SAFE’ and one ‘UNSAFE’. Ask each group to hold up their posters one by one. Ask the class to vote on whether or not the poster is safe or unsafe. For each poster, come to an agreement and have a student give an explanation of why the poster is safe or unsafe. Place each poster in the appropriate column. 4. Optional Activity: Safe Water Drama As a class, act out drinking water from a cup and cleaning the cup. Use large, dramatic motions. You could also choose different items to model cleaning. 5. Optional Activity: Spiritual Connection

Sometimes all these Steps seem like hard work, but God is our helper. Read Psalm 62:8 as a class. Discussion Questions:

• How is God our helper? • How can we help each other?

6. Close As a class, choose a new hand motion for Step 5. Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 6

Keep Food and Utensils Clean

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Step 6: Keep Food and Utensils Clean

Background: • Fruits and vegetables often come from places where human or animal feces are present. In order to

make sure food is clean and free of germs, it is important to wash fruits and vegetables before eating them.

• Since eating soap can make humans sick, it is best to wash fruits and vegetables with clean water and to rub them with your hands to remove germs.

• When sharing food with others, it is especially important to wash hands before eating. This way, people do not pass on germs that may be on their hands. It is also a good idea not to lick fingers before handling food because this could transfer germs from our mouths to the food.

• Germs can be on hands and fingers. If we don’t wash hands before eating, we could spread germs to others and make them sick.

• We should not be afraid to encourage others in good health habits. Even if it is scary to tell someone to change, you are helping to keep them and yourself healthy by doing so.

• A drying rack helps keep utensils clean by keeping the utensils away from dirt and animals on the ground. When drying racks are placed in direct sunlight, the sun helps kill any germs on the utensils.

Step 6: Keep Food and Utensils Clean Verse: Psalm 51:6

“I know that you wanted faithfulness even when I was in my mother’s body. You taught me wisdom in that secret place.”

Objectives: • Distinguish between good and bad ways to handle food and utensils • Learn or create a song, which summarizes ways to handle food and utensils

Materials: • Steps 1-6 & Bible verses • Poster Set G: Clean Food & Utensils from Resource Packet • Flipchart paper or chalkboard • Optional: Dramas 1 and 2 from Resource Packet

Preparation: 1. Create or have students create two dramas that emphasize the following:

i. Drama 1 should show the importance of washing fruits and vegetables before eating. The drama should highlight the fact that food often comes from fields with human and animal feces, and flies. There should be a character in the drama that reminds others of healthy behaviors. Example Drama 6A is found in the Appendix. Prepare some students to act out drama for the class.

ii. Drama 2 should show the importance of washing hands before eating, and not licking fingers while eating with others. There should be a character in the drama that reminds others of healthy behaviors. Example Drama 6B is found in the Appendix. Prepare some students to act out drama for the class.

Time: 50 minutes

Step 6


38

1. Introduce Review first 5 Steps with hand motions. Introduction Learning Questions:

• How have you been a change maker since our last lesson? • What might be some ways germs spread when people share food?

If necessary, review the steps to handwashing and the two most important times to wash hands. Briefly introduce Step 6: Keep food and utensils clean!

• What are utensils? • Why do we use utensils to eat?

2. Drama 1 Have students perform a drama about washing fruits and vegetables before eating. Then lead class in a discussion; you may use the questions listed below if needed. Afterwards, discuss important reasons why washing fruits and vegetables is important. Activity Questions:

• What did you see in this drama? • Why do you think it is important to wash fruits and vegetables before eating them?

3. Drama 2 Have students perform a drama about washing hands before eating. Then lead the class in a discussion; you may use the questions listed below. Activity Questions:

• What did you see in this drama? • What do we need to do when sharing food with friends or accepting food from friends in

order to stay healthy and keep our friends healthy? • What can you do when you see someone with bad habit that can cause sickness to

yourself and others? 4. Add Information Show the class poster from the Clean Food and Utensils poster set. With each poster discuss the following questions. Show Poster G1 of children washing fruits and vegetables. Discussion Questions:

• What do you see in this picture? • Why is washing our fruits and vegetables a good idea?

Step 6


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Show Poster G2 of washing dishes. Discussion Questions:

• What do you see in this picture? • How can we make sure our eating utensils and dishes are clean?

Show Poster G3 of dishes drying in the sun on a rack. Discussion Questions:

• What do you see in this picture? • Why do we dry the dishes on a rack in the sun after they are washed?

Show Poster G4 of covered food. Discussion Questions:

• What do you see in this picture? • How can flies contaminate the food we eat? • Why is it important to cover food?

Show Poster G5 of handwashing with soap. Discussion Questions:

• What do you see in this picture? • How can our hands contaminate the food we eat? • Why is it important to wash hands with soap and water?

5. Apply Attach all five pictures from poster set to the chalkboard or wall or lay them on the floor. Divide students into groups and ask each group to create a song that shares information about washing food and utensils. Students may also come up with a dance or hand motions to go with their song. Have students share their songs with the whole class. 6. Optional Activity: Spiritual Connection Ask a student to read Psalm 51:6 aloud. Discussion Questions:

• Who teaches us truth and helps us to be wise? • As change-makers, what truths can we share from this lesson with others?

7. Close Review Step 6: Keep food and utensils clean! Create a hand motions for this Step. Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 7a

Use Latrines Always!

40

Step 7a: Current Sanitation Behaviors

Background:

• It is important to use latrines so that feces and urine can be contained in a covered place. This will keep disease from spreading.

• When we eat, our bodies take what they need for life from food and then we have to poop to get rid of the waste in our bodies. Another word for poop is feces.

Step 7: Use Latrines Always Verse: Deuteronomy 23:12-14

“Mark out an area outside the camp where you can go to relieve yourselves. . . After you relieve yourself, dig a hole with a stick and cover your excrement. . . .Keep your camp holy; don’t permit anything indecent or offensive in God’s eyes.”

Eugene Peterson, The message: The Bible in Contemporary Language, (Colorado Springs: NavPress Publishing, 2002) Objectives:

• Identify their own current sanitation practices • Analyze current sanitation practices for their primary school

Materials: • Steps 1-7 & Bible verses • Pocket chart from Step 4a • Poster Set H: Latrine Vote Pocket Chart Pictures from Resource Packet • Paper clips, pins, or tape for attaching pocket chart pictures • Rocks, beans, or other voting tokens • Flipchart paper or chalkboard

Preparation: 1. Color and attach pictures to pocket chart. (Boy and girl in left hand column of pockets,

across the top place pictures of bush, latrine, river, latrine with line through it). 2. Locate a private voting location. 3. Make copy of pocket chart on flipchart paper for recording results.

Time: 30 minutes

Step 7a


41

1. Introduce Review all 6 Steps with hand motions. Introduction Learning Questions:

• How have you been a change maker since our last lesson? • Today we will be talking about feces. Where are some places people use to go poop?

Wait until the end of the lesson to introduce Step 7. It is important to wait to introduce the Step so that students will feel that they can answer honestly to the pocket chart vote. If needed, you might introduce the word “feces” to students or have a short discussion to help them feel comfortable talking about this topic. 2. Add Information Lead the students in a pocket chart vote of where they last relieved themselves. If needed, remind them of how to use the pocket chart and review the pictures used with the pocket chart. You may also remind them that the vote is private, so they can answer honestly. Give each child one rock for voting. Dismiss students one at a time so they can vote privately. 3. Apply After all students have voted, record the votes where the class can see. Add each column together totaling the boy and girl results. Activity Questions:

• Which place was used the most? • Which place was used the least? • Why do you think this is so? • Which place are the girls using most often? Which place are the boys using most often? • What did you learn from this activity?

4. Close

Discussion Questions:

• Why do you think we have or need latrines on our school compound? • What is in our poop that can cause disease?

Introduce Step 7: Use latrines always!

• What letter of the WASH poster do you think represents Step 7? • Who can think of an action to go with this Step?

Choose an action and repeat it together. Do ”Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 7b


42

Step 7b: Latrines

Background: • The three main parts of a latrine are the pit, slab and superstructure. A diagram of the parts of a latrine

can be found on the next page. • The pit is usually underground, and has a lining of brick or wood around the inside. This lining supports

the walls so they do not collapse. It also keeps animals out of the pit. All feces and urine go into the pit. • The slab can be made of different materials like concrete or wood. Slabs will often have footrests on

each side of the hole. These help people aim when relieving themselves. A wooden slab will often be covered in packed dirt to make it easier to clean. Sometimes a latrine will have wooden slab with a smaller “Sanplat” made of concrete. The sanplat has a hole and foot rests to make it easier to aim and clean. Some slabs will have a cover for the keyhole to keep flies away from the pit. Slabs are important because they cover the pit and provide a safe and clean place for people to go to the toilet.

• A superstructure has walls, a door, a roof, and a vent. The superstructure’s main purpose is to provide protection from weather and privacy. The structure can also help keep flies away from the pit and help stop the spread of disease. The superstructure can be made out of any available materials.

• Vents come in different shapes. Some vents are holes in the wall with screens over them; others are shaped like a pipe. In latrines with pipe vents, it is important to keep the door closed and to not cover the keyhole. Air will flow from the hole into the pit and out the vent. This will help stop bad smells and reduce the amount of flies.




• Draw the three main parts of a pit latrine to help reduce fear of latrine use • Generate ideas to promote latrine use at school

Materials: • Steps 1-7 & Bible verses • Pit latrine pictures from the Resource Packet • Chalkboard or flipchart paper

Preparation 1. Select one of the pit latrine pictures to draw. Practice drawing the latrine and its parts. 2. Write “We Are Change-makers” on flipchart paper or chalkboard.

Time: 50 minutes

Roof

Vent

Door

Pit

Latrine Slab

Sludge

Hole(for defecation

and urination)

Super Structure

DirtMound

Step 7b


43


• How have you been a change maker since our last lesson? • Who can remember what part of WASH Step 7 relates to? • Why do you think we should always use latrines? • What are some reasons why people don’t use latrines?

2. Add Information Draw a latrine where the class can see it. If students have paper or exercise books, have them draw with you. If students do not have paper, invite them to draw with their finger in the air, on the desk, or on the ground. As you draw each part, discuss each with the students using the key points in this lesson. Activity Questions:

• What do the latrines at our school look like? o What are the slabs made of? o What are the superstructures made of? o Do they have vents?

• Why do you think slabs are important? • What other hole shapes have you seen in the slab for the feces and urine? • Why are vents necessary in a latrine?

3. Apply Erase or cover the labels on your latrine drawing. Point to each and choose a student or two to say the name of the part and one important thing about that part. Continue until all parts have been discussed. Draw two columns on the chalkboard. Label one with a happy face and the other with a sad face. Divide students into small groups and have them discuss the following questions:

• Why is it good for people use latrines? • What are some reasons why our friends may not be using a latrine?

List student answers in the appropriate column. Ask a student to read Deuteronomy 23:12-14 out loud. Activity Questions:

• Where does it say to relieve oneself? (If needed, explain that a camp is like a village or community in our time)

• What does it say to do after people have relieved themselves? • What might be the benefits of going outside the camp? • How does a latrine help keep our school compound clean and our waste covered?

Now may be a good time to talk about changing old habits. With the class, look at the list of reasons not to use a latrine. As students make suggestions of how to change these things, mark or write them next to the corresponding reason.

Step 7b


44

Activity Questions: • Which of the above reasons for not using latrines is it possible for us to do something

about? • What can we do this week to encourage more people to use latrines at our school and at

home?

4. Close Do ”Change Maker Cheer”. As a class, think about solutions for some of the problem areas for which the Health Club could promote change or provide education. Write “We Are Change-makers” on the chalkboard and list student suggestions: (Example)

WE ARE CHANGE-MAKERS… • Organize latrine cleaning in pairs or by classes • Organize contests between classes for latrine cleanliness • Keep the door closed • Older students assist younger students in latrine use

Step 7c


45

Step 7c: Using a Latrine

Background:

• Below is one possible list of instructions for using a latrine. Add or note important steps if students do not. 15

1. Wear shoes 2. Knock on door before entering 3. Close door 4. Squat above hole with feet in footprints if available 5. Direct urine and feces into hole, not on floor 6. Wipe with safe leaves, paper softened by crinkling in your hands, tissue, or wash with water.

Throw tissue and leaves into hole. Girls wipe from front to back. 7. Leave the latrine clean 8. Close the door behind you 9. Wash hands with soap and water using the six steps




• Generate, list, and order the steps to using a latrine • Decide with whom to share the information

Materials: • Steps 1-7 & Bible verses • Chalkboard or flipchart paper • Optional: Tape for creating latrine outline

Preparation: 1. Decide whether to teach this lesson as whole group, or separate boys and girls. Make

arrangements accordingly. 2. Draw footprints and hole to look like floor of a latrine on flipchart paper. Alternatively: Using chalk

or tape, draw footprints and hole on ground in the dirt. 3. Create or have students create a dance about using the latrine. Each student should have a turn

practicing with the footprints during the dance. Time: 50 minutes

Step 7c


46


• What are the three main parts to a latrine? • What are some benefits to using a latrine?

2. Add Information Ask students the following question and give them time to discuss with a partner.

• If you were going to teach a younger brother or sister how to use a latrine, what do you think would be very important to tell them?

Ask students to give you the steps in order and record their comments on the chalkboard or flipchart paper. Discuss keeping the latrines clean while using them. Activity Questions:

• Why is it important to leave the latrine clean after using it? • What can you do if you miss the hole? (Scrape it with stick or leaves; rinse area with water)

3. Apply Create or have students create a latrine dance that uses the steps listed by the class. Separate the boys and girls into two different groups. Lay out the previously prepared latrine outline where there is lots of space. Allow each group to do the dance until everyone has had a chance to practice. Afterwards, ask the following questions: Activity Questions:

• As change-makers, who can you share the steps of using a latrine with today? • What would you tell people about the importance of using a latrine?

4. Optional Activity: Latrine Practice Walk to a latrine with the class. Bring steps for latrine use with class to the latrine. Students repeat the steps and information they would teach a younger child at the latrine site. 5. Close Do ”Change Maker Cheer”. As a class, answer the “Change Maker” questions below. Discussion Questions:


15 Adapted from conversations with Kenya Primary School Teachers and Kenya Institute of Education, Kenya Early Childhood Health Education Series, Personal Hygiene and Environmental Sanitation, Book 1, (Nairobi: Kenya Literature Burcan, 2006), 36.

Step 7d


47

Step 7d: Cleaning the Latrine

Background: • It is best to clean latrines daily. At school it might be necessary to clean them two times daily because so

many people use school latrines. • Students and teachers who clean latrines must follow the listed steps carefully in order to protect

themselves and others from spreading disease. • A hard-bristled brush or broom (rather than one with soft bristles or fibers) with a long handle is best for

cleaning a latrine. • Teach students not to use the latrine as a rubbish pit for throwing away trash. Trash should to be burned

or buried and NOT put in the latrine. If these items are put in the latrine the pit will fill faster and will attract flies and animals. However, if trash is found in the latrine it should be thrown down into the pit because it likely has germs on it.

• Young children need much instruction and supervision when learning to clean a latrine. Children’s immune systems are still developing and therefore weaker than most adults. Children can be exposed to many diseases when cleaning.

• As change-makers, teachers are an important part of modeling the steps of cleaning latrines. Teachers need to be available to MODEL and SUPERVISE the process of cleaning latrines.

• Cleaning latrines properly will reduce disease and even death in this generation. Cleaning latrines properly saves lives– do NOT use it as a punishment for children.

• Cleaning a latrine for people with disabilities requires special attention. Consider the width and condition of the path students with disabilities will take to reach the latrine. The path should be wide enough for 2 people to pass each other and the surface should be even, void of puddles, and include ramps if the slope is steep1.

1 http://wedc.lboro.ac.uk/resources/briefnotes/BN001_School_Latrines.pdf

Step 7: Use Latrines Always Verse: Deuteronomy 23: 12 – 14



• Examine the steps to cleaning a latrine • Draw pictures to go with each step • Sequence the steps to cleaning a latrine

Materials: • Step 1-7 & Bible verses • Chalkboard or flipchart paper • Latrine cleaning supplies: Soap or ash, bucket, water, and a broom. It is recommended to use a

long-handled hard-bristled broom or brush Preparation

1. Make Steps for Cleaning a Latrine chart appropriate to your school (See Background information).

2. Write steps for cleaning a latrine on the chalkboard or flipchart and cover. Time: 50 minutes

Step 7d


48

Steps to Cleaning a Latrine: Cleaning a latrine or urinal without cement floors • Sweep all trash in the latrine down into the pit. • Sprinkle ash on the floor. (Ash kills germs and dries any urine that has been left on the floor.) • Leave ash on the floor for a few minutes. • Use a long-handled hard brush to clean the floor. • Sweep away the extra ash into the latrine starting at the back of the latrine and moving to the front. • Wash your hands with soap and water thoroughly when finished cleaning. Cleaning a latrine or urinal with cement floors • Sweep all trash in the latrine down into the pit. • Mix soap with water in a bucket. • Pour water and soap on the cement floor. • Scrub the floor (starting from the back of the latrine and moving to the front) with a long-handled, hard

brush to remove dirt. If there is any soapy water left over, pour it outside the latrine. Keep bucket low to the ground.

• Rinse. Remove soap by pouring clean water on the floor. • Wash your hands thoroughly with soap and water when finished cleaning. • If using a pour flush latrine, do not wash trash or large objects down the trap. Also, do not attempt to

clean trap with a stick or sharp object; this could break the trap. Make sure to flush the trap well after cleaning. This will avoid clogs in the trap.

Step 7d


49


• Who’s had a chance to teach someone the steps for using a latrine since our last lesson? Tell us about your experience.

• Why is important to keep our latrines clean? • How often do you think latrines need to be cleaned?

Depending on student answers, you may want to share information about how often to clean latrines. Information about this can be found in the Background section. 2. Cleaning Latrines with Cement Slabs: 10 minutes If the community has latrines WITH a cement slab, use this section to teach participants how to properly clean a latrine with a cement slab. Explain that we will be learning a simple and effective way to clean a latrine. As you describe each step in cleaning a latrine act it out and have participants stand up and act out the step with you. Use the Activity Questions in each step to draw out the understanding of the purpose of the step. Refer to the Background section for answers to the questions. The first step of cleaning a latrine is to remove all the trash that is inside the latrine structure. Have participants act out sweeping trash down into the pit. Activity Questions:

• What are some negative results of people using the latrine like it is a rubbish pit and throw rubbish in the latrine frequently?

• What are the risks of picking up trash to burn or bury instead of sweeping it down into the pit?

The second step is preparing soapy water to clean the slab with. Fill a bucket with water, add soap and mix the water. Pour this soapy water from a bucket onto the floor of the latrine. Scrub the floor with a long handled, hard brush. Start at the back of the latrine and move towards the front. Have participants act out this step. Activity Questions:

• What would you recommend mixing with water if no soap is available? • Why a long-handled hard brush?

Next, rinse the soap off of the slab by pouring clear water on the floor. This will keep germs from being swept to the back of the latrine. Have participant act this step out. Activity Questions:

• What do you think is the last step? • Why?

Step 7d


50

The last step is to wash your hands thoroughly with soap and water. This will ensure you do not get sick by any feces you may have been in contact with during cleaning. 3. Cleaning Latrines without Cement Slabs: 10 minutes

The first step of cleaning a latrine is to remove all the trash that is inside the latrine structure. Have participants act out sweeping trash down into the pit. Activity Question:

• What are some negative results of people using the latrine like it is a rubbish pit and throw rubbish in the latrine frequently?

• What are the risks of picking up trash to burn or bury instead of sweeping it down into the pit?

Next, sprinkle ash on the floor of the latrine and let it rest for a few minutes in order to kill all the germs and dry up the urine. Use a long handled, hard brush to sweep the extra ash into the pit. Sweep from the back to the front. This will keep germs from being swept to the back of the latrine. Have participants act out sprinkling ash and brushing from back to front. Activity Question:

• What would you recommend mixing with water if no soap is available? • Why a long-handled hard brush? • What do you think is the last step? • Why?

The last step is to wash your hands thoroughly with soap and water.

4. Apply Walk to a latrine and ask different students (older students only) to demonstrate each step for cleaning the latrine. Each child should wash their hands after demonstrating their step. 5. Optional Activity: Step Mix Up Cut the steps to cleaning a latrine on the flipchart paper apart. Cut off numbers and mix steps up. Ask for six volunteers to hold one of the steps. Have the rest of the students arrange the steps in order. 6. Close Discussion Questions:

• God enjoys clean places; what are some of the places we can keep clean for Him? Do “Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 8

Keep our Schools and Homes Clean!

51

Step 8: Keep Our Schools and Homes Clean

Background: • It is important to have a clean compound because:

o When an area is clean there is less chance for disease to spread o Fewer flies around the compound o People can be proud of their area or community o Less chance of getting hurt from trash or other items lying around

• Rubbish pits can be important because: o All rubbish is kept in one area and not spread around the compound o Rubbish can be easily burned, buried, or collected if it is in one place

• A rubbish pit should be located a safe distance away from any water sources or food preparation areas. Waste that cannot be recycled for other uses should be put in the pit. These items include tins, glasses, plastic bags, and other containers. Once the pit fills up, it should be covered with dirt and a new pit should be dug.

Step 8: Keep Our Schools and Homes Clean Verse: Psalm 24:1-2

“The earth belongs to the Lord. And so does everything in it. The world belongs to him. And so do all those who live in it. He set it firmly on the oceans. He made it secure on the waters.”

Objectives: • Collect and analyze student opinions on the cleanliness of the school compound • List positive areas and areas of needed improvement in our school environment

Materials: • Steps 1-8 & Bible verses • Poster Set I: Clean and Dirty School from Resource Packet • Flipchart paper or chalkboard • A4 paper or flipchart paper cut into quarters (10-16 pieces) & markers

Preparation: 1. Choose 3 symbols that represent clean, dirty, and in-between/neutral (‘happy face’,

‘neutral face’, and ‘sad face’ are used as an example in this lesson, but choose a symbol that students can identify and understand)

2. Draw 3 selected clean / dirty/ neutral symbols, 1 each, on half-sheets of flipchart paper

3. Draw graph on flipchart paper (“How Clean is Our School”) using selected clean / dirty/ neutral symbols

How clean is our school?

Clean

In between

Dirty Total votes: Total votes: Total votes:

Time: 50 minutes

Step 8


52

1. Introduce Review the first 7 Steps with hand motions. Briefly introduce Step 8: Keep our Schools and Homes Clean! Show and compare two posters of a very clean school compound and a very dirty school compound from poster set. Introduction Learning Questions:

• What do you see in these two pictures? • What makes this school compound (point to clean poster) look clean? • What makes this school compound (point to dirty poster) look dirty? • Why is it important to have a clean compound?

2. Add Information Give the students an opportunity to compare their school to the schools in the posters. This can be done using a standing vote. Hang the dirty and clean school posters on opposite walls. Tape the picture of the happy face next to the clean schools and the sad face next to the dirty school. Place the “in between” face in between the two schools. Ask students to stand next to the poster they think is most like their school. If they feel their school is in between the two, they can stand next to the “in-between” face. It is their opinion, so there is no right or wrong answer. Count the number of students under each poster. Create two lists. Label one, “Good things” and the other “Improvements needed”. Ask the students to list things for each. Make sure that rubbish pits are discussed during this lesson. Add information on rubbish pits from the Background Section. Use the questions below to discuss the importance of rubbish pits or bins both in homes and at schools. Discussion Question:

• Do you know any families who use a rubbish pit or rubbish bin to dispose of rubbish? • How would rubbish pits help stop the spread of disease? • How could our school improve the way we dispose of rubbish?

3. Apply Ask a student to read Psalm 24:1-2 out loud. Discussion Questions:

• If our schools and homes belong to the Lord how should we care for our surroundings? • What are some places we need to keep clean? Why?

Praise the students for all the items on the “Good things” list. As a Health Club, the students may have the opportunity to work on improving their school. Divide students into groups or pairs and give each an item from the “Needs improvement” list. Have each group make a drawing of their item. Collect the drawings; they will be used in the next lesson.

Step 8


53

4. Close Decide on a hand motion for Step 8. Do “Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


Step 9

Use Safe Water when Caring for Sick People!

54

Step 9: Use Safe Water When Caring for Sick People!

Background: • Safe water may not stop a non-water related disease, but drinking safe water may keep a sick person

from getting sicker. • Airborne Diseases:

‘Airborne’ diseases are diseases carried in the air. Examples include pneumonia, cold, flu, and tuberculosis. If someone has one of these diseases and coughs or sneezes, the germs enter in the air and pass through the air and are breathed in by others. These diseases spread very easily. It is important to cover our coughs and sneezes so they do not spread. Covering a cough or sneeze with an arm, shoulder or handkerchief will help stop the germs from spreading.

• Bloodborne Diseases: ‘Bloodborne’ diseases are diseases carried in the blood. HIV/AIDS (see Glossary for definition) and hepatitis are examples. Blood isn’t the only way these diseases are transferred, but it one of the ways.

• Safe water will not stop AIDS, but people with AIDS need to be cared for with safe water. • There are over 34 million people in the world living with AIDS. 2,500,000 of these are children under 15

years of age.16 • If a person with Tuberculosis drank unsafe water, they could become sicker from the water because

their immunities are down, which makes their bodies weak and unable to fight illness. This makes germs even more harmful to them than to healthy people.

• All people need safe water, good sanitation, and hygiene, but it is extremely important for a person already suffering from disease to use safe water because his or her body’s ability to fight further disease or infection is very weak. When we take care of sick people, we should also be careful to wash our hands with safe water.

Step 9: Use Safe Water When Caring for Sick People Verse: 1 Peter 4:8a

“Above all, maintain constant love for one another.” New Revised Standard Version, (1995)

Objectives: • Evaluate statements concerning common air- and bloodborne diseases • Brainstorm why and when safe water is important to sick people and those who are caring for sick

people Materials:

• Steps 1-9 posters & Bible verses • Chalkboard or flipchart paper • Tape • Picture of sick person drinking safe water from Resource Packet

Preparation: 1. Study answer materials for student true and false quiz. 2. Cut flipchart paper in half. Write ‘TRUE’ on one piece and ‘FALSE’ on the other. 3. Tape “True” and “False” signs to opposite sides of the room. 4. OPTIONAL: Write each quiz statement on cut sheets of flipchart paper. 5. Draw a large sun with several rays on flipchart paper. In the middle of the sun write “Caring for Sick People with Safe Water”.

Time: 50 minutes

Step 9


55

1. Introduce Review the first 8 Steps with hand motions. Introduction Learning Questions:

• Who here knows someone who cares for a person that is sick, or has cared for a sick person themselves?

• What are the names of some water-related diseases we have learned about? • What are other diseases that are common in our communities?

Briefly introduce Step 9: Use safe water when caring for sick people! Be sure to explain what airborne and bloodborne diseases are, and the proper way to cough or sneeze so germs do not spread. Information on these is found in the Background section of this lesson. Discussion Questions:

• Why might it be important to use safe water when caring for sick people? • Why do you think sneezing into our arm or shoulder would be better than sneezing into

our hands? Let’s all practice coughing or sneezing into our arms or shoulders. • Why might this be an important lesson for our community members to know about?

Write out 34,000,000 where the students can see, and count the zeros together as a class to recognize the largeness of the number. You may want to share that 2,500,000 of these are children under 15 years of age. 2. Add Information The students will be taking a true/false quiz. Write or tape up the words “true” and “false” on opposite sides of the wall. Divide the class into groups of 4. Read one of the following statements to the groups. Ask the students to decide within their groups if it is true or false. They then move to the appropriate side of the room. After each has moved, ask the groups to share why they chose their answer. Give the correct answer and provide any background material that might help the students understand. Background material is provided in the quiz below. TRUE/FALSE QUIZ Statement: Washing cuts and sores in the river is very healing for a sick person. FALSE: River water is filled with many disease-causing germs. These germs can infect the cuts and sores, causing the sick person to get sicker or a healthy person to become sick.

Statement: HIV/AIDS is a waterborne disease. FALSE: HIV/AIDS is a bloodborne disease. It can be transmitted through sharing needles, razor blades, blood transfusions and other ways of coming into contact with an infected person’s blood; it is also commonly transmitted through sex. An HIV-infected woman can pass the virus to her baby before or during childbirth or after birth through breastfeeding. This virus cannot live long outside the body.17

Statement: Doctors need their tools washed and cleaned in safe water. TRUE: Doctors’ tools need to be washed and sterilized in safe water immediately after use. This will remove blood, bone, tissue, germs, or human fluids. If these are not removed, the next patient or the doctor him/herself may contract a disease left on the tools.33

Statement: Mosquitoes can cause HIV/AIDS.

Step 9


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FALSE: Studies indicate there is no evidence of HIV being transmitted by any insects. Even in areas infested with many mosquitoes no connections have been shown between mosquitoes and getting HIV.18 Mosquitoes do carry malaria.

Statement: Malaria medicine will kill any germs in unsafe water. FALSE: Malaria medicine will not kill the germs in the water. All medicines, including malaria medicines, need to be taken with safe water so the person does not become infected with other diseases from germs in the unsafe water.

Statement: Tuberculosis is one of the world’s deadliest diseases. TRUE: Each year almost 2 million people around the world die from tuberculosis-related deaths. It is spread through the air from one person to another. When a person with TB coughs or sneezes, it puts the bacteria in the air for others to catch. Many people who are infected with HIV are also infected with tuberculosis. TB is the leading killer of people who are HIV infected. Since people with HIV cannot fight other diseases, they can be easily infected by TB.35

Statement: It is important that all sick people, and particularly people with HIV/AIDS, drink safe water. TRUE: Sick people already have a disease and so have a hard time fighting other diseases. The immune systems of people with HIV/AIDS are particularly weak. It is very important for them to drink safe water, especially when they take their medicine.19 People with AIDS can die from diarrheal disease they got while taking their medicine with unsafe water. 3. Apply Show the class the poster of a sick person drinking safe water. As a class, discuss the following questions. You may want to add questions of your own or add information from the Background section of this lesson. Discussion Questions:

• What do you see in this picture? • How do you know this water is safe? • Why is it important that this person be drinking safe water?

Draw a sun with several large rays on the chalkboard. In the middle write, “Caring for Sick People”. As a class, brainstorm uses for safe water for people who are caring for the sick. Write each suggestion on a ray. 4. Optional Activity: Spiritual Connection Read I Peter 4:8a. Discussion Questions:

• What does this verse say we are to do above all else? • What do you think it means to “maintain constant love”? • How should we treat the people who are sick? • What are some actions that show, or maintain, constant love and kindness?

Step 9


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5. Close Repeat Step 9 together. Choose an action and repeat it together.

• What letter of the WASH do you think represents Step 9? • Who can think of an action to go with this Step?

Do “Change Maker Cheer”. As a class, answer the “I Am a Change Maker” questions listed below.


17 Department of Health and Human Services, “Rumors, Myths, and Hoaxes”, CDC, http://www.cdc.gov/hiv/resources/qa/hoax/.htm. 18 Department of Health and Human Services, “Can I get HIV from Mosquitoes?” CDC, http://www.cdc.gov?hiv/resources/qa/qa32.htm. 19 Department of Health and Human Services, “Safe Food and Water,” CDC, http://www.cdc.gov/hiv/resources/brochures/food.htm.

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Appendix

Appendix 1: WASH Statistics • More than 5 million people die each year from WASH-related diseases.20 • 84% of water-related deaths are in children ages 0-14.21 • 98% of water related deaths occur in the developing world.22 • Every 15 seconds, a child dies from a water-related disease.23 • At any one time, more than half the poor of the developing world are ill from causes related to hygiene,

sanitation, and water supply.24 • 1.8 million children die each year from diarrhea – that is 4,900 deaths each day.25 • 88% of cases of diarrhea worldwide result from unsafe water, inadequate sanitation or insufficient

hygiene.26 • Handwashing at critical times can reduce the number of diarrheal cases by up to 35%.27 • The majority of the illness in the world is caused by fecal matter.28 • Of the 120 million children born in the developing world each year, half live in households without a

proper toilet.29 • Children in poor environments often carry 1000 parasitic worms in their bodies at a time. This often

makes children sleepy and have difficulty paying attention.30 • It is estimated that improved sanitation facilities could reduce diarrhea-related deaths in young children

by more than one-third. When combined with handwashing, deaths could be reduced by two thirds. It could also help accelerate economic & social development, where sanitation is a major cause of lost work and school days because of illness.31

• In Alwar District, India, a school sanitation program increased girls’ enrollment by one-third, and improved academic performance for boys and girls by 25%.32

• Estimated economic benefits of investing in drinking water and sanitation: 320 million productive days gained each year in the 15 to 29 year age group, an extra 272 million school attendance days a year, an added 1.5 billion healthy days for children under five years of age, together representing productivity gains of US $9.9 billion a year.33

20 Johannesburg Summit, World Summit on sustainable Development, United Nations Secretary General Calls for Global Action on Water Issues,(2002), 21 Ibid. 22 Annette Pruss-Ustun et al., “Safer Water, Better Health: Costs, Benefits and Sustainability of Interentions to Protect and Promote Health,” World Health Organization, (2008), 12, http://esa.un.org/iys/does/WHO_CB_eng.pdf. 23 Number estimated from statistics in the 2006 United Nations Human Development Report. 24 Water Supply and Sanitation Collaborative Council (WSSCC), 2008, “A Guide to Investigating One of the Biggest Scandals of the Last 50 Years.” 25 World Health Organization (WHO), 2004, “Water, Sanitation and Hygiene Links to Health FACTS AND FIGURES.” 26 Ibid. 27 Ibid. 28 Water Supply and Sanitation Collaborative Council, (WSSCC). 29 UN Water, “Tackling a Global Crisis: International Year of Sanitation 2008,” http://esa,un,org/iys/docs/IYS_flagship_web_small.pdf, 16. 30 Ibid, 17. 31 UN Water Newsroom, “UN Launches International Year of Sanitation to Address Global Crisis,” New York, November 21, 2007. 32 UN Water, 22. 33 Annette Pruss-Ustun et al., 21.

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Appendix 2: Drink Safe Water Action Song Sing or say together the song below, and model actions while saying words. Have students repeat each line after the facilitator. Drink, drink, drink safe water (HOLD “glass” and “drink”) Drink, drink, drink safe water I need water in my brain to think, think, think (TAP finger on head) I need water in my eyes to blink, blink, blink (PUT hands by eyes and “blink” w/ hands) I need water in my nose (PULL and WIGGLE nose) I need water in my elbows (BEND elbows) I need water in my skin to make it soft and smooooth (SLIDE hands on arms) I need water in my bones to help me moooove (JOG quickly in place) Water helps me not be too cold or hot (HUG self and shake like cold) Drink unsafe water? I will not! (RAISE hands above head) Drink, drink, drink safe water Drink, drink, drink (PAUSE and SAY “What?”) Safe Water! (Last lines together, JUMP and SHOUT out last line) Tips for Re-Writing the Drink Safe Water Action Rhyme The purpose of the Drink Safe Water Action Song (from lesson Step 1a) is to create a fun way for children to learn how water is used in our bodies. For use in other languages create a similar song that teaches how the body uses water. Suggestions:

1. This activity can be done as part of training for teachers. Consider having small groups develop their own, then vote on the best. The winning song is then written down and taught to all to be used in future trainings.

2. Be sure the chorus still teaches Building Block 1: “Drink, drink safe water!” 3. Include some or all of the following body parts:

a. Brain b. Eyes c. Nose d. Lungs e. Bones f. Joints (knees and elbows) g. Stomach h. Muscles i. Skin j. Blood k. Kidneys l. Body Temperature

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Appendix 3: Alternative Water Purification Methods WaterGuard Method: 10 Minutes Before teaching this lesson:

• Make sure this method is appropriate for the area. If WaterGuard is not available in the area, this method may not be appropriate.

• It is important to teach the instructions that come on the package of WaterGuard. If these instructions differ from the instructions below, follow the package’s instructions.

Instruct students that if the water gathered is muddy or not clear, one must first let the water stand undisturbed for 12-24 hours. This will allow all the material to settle to the bottom of the container. Pour the clear water into another container and discard the muddy water that settled to the bottom. Then, pour the correct amount of WaterGuard into the cap of the bottle. The correct amount is listed on the WaterGuard container. Pour this amount into a water container with 20 liters of water. Stir the water. Wait 20 minutes before drinking the water. Discussion Questions:

• Do you have any questions about WaterGuard? • Would this method be easy or hard to do in this community?

PuR Method: 10 Minutes Before teaching this lesson:

• Make sure this method is appropriate for the area. If WaterGuard is not available in the area, this method may not be appropriate.

Use a PuR packet from the community in order to demonstrate how to make water safe. Pour entire package into 10 liters of water. Stir well for five minutes. If the water is not clear, stir again. Cover the top of another clean water storage container with thick cotton cloth without holes. Use a small rope to tie the cloth down. Pour the water through the cloth. Collect the material on the cloth and dispose of it away from children and animals. Wait for twenty minutes before storing or drinking the water. Discussion Questions:

• Do you have any questions about the PuR Method? • Would this method be easy or hard to do in this community?

SODIS Method: 10 Minutes See Appendix 3: SODIS Diagram Before teaching this method:

1. Make sure this method is appropriate for the area. If 2 liter, clear, non-tinted water bottles are not widely available in the area, this method may not be appropriate.

Get a 2-liter, clear water bottle with no labels from the community in order to demonstrate how to make water safe through the SODIS method (see Glossary for definition). If collected water is not clear, filter the water through a cloth. This can be done by pouring water into a container covered by a clean, tightly woven cloth folded in half. The cloth will catch all the large material and the water that passes through will be clearer. Demonstrate how to wash the 2 liter plastic bottle with soap and water. Fill the bottle almost full with the filtered water. Close the bottle and shake it. Then, fill the bottle completely with water. Set the bottle out in the sunlight for six hours. Make sure to put the bottle in a place where there will not be any shade at any

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time of day. A good place is a metal roof. If the sky is cloudy, leave it out for two days instead. After this amount of time, the water is safe to drink. Discussion Questions:

• Do you have any questions about the SODIS Method? • Would this method be easy or hard to do in this community?

Filtering Water to Reduce Cholera or Guinea Worm: 10 Minutes Before teaching this method:

1. Make sure that large parasites in the water like cholera or guinea worm are a problem in this community. If these diseases are not common in the community, do not demonstrate this method.

This method of filtering water will only remove large parasites like cholera or guinea worm from the water. This method alone will not clear the water of most diarrhea causing germs. Using a cloth, water container and rope, demonstrate the process of filtering water. First, cover the top of a water container with a tightly woven cloth folded in half. Use a rope to tie the cloth down. Pour the collected water through the cloth. The cloth prevents large germs and particles from passing through. Only the water and smaller germs will be able to get through the cloth. Take the cloth off and clean it with soap and water. Let the cloth dry in the sun to kill all the germs left on it. Discussion Questions:

• Do you have any questions about filtering water? • Would this method be easy or hard to do in this community?

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Appendix 4: SODIS Diagram

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Appendix 5: Sugar Salt Solution Background34 • Diarrhea: the passing of loose, watery stools three or more times per day. • Dehydration: when someone loses a lot of water. If you are dehydrated, you do not have enough water

in your body. • Rehydration: replacing lost water and salt in someone who is dehydrated. • During or after treatment of dehydration, whatever is causing the diarrhea, vomiting, or other symptoms

should also be treated. • Sugar Salt Solution – a homemade mixture of water, salt, and sugar used to rehydrate the body. • ORS: Oral Rehydration Salts – a factory produced packet containing a mixture of exact measurements

of salt, sugar, potassium and a base (bicarbonate or citrate) that is mixed with water to rehydrate the body.

• Be sure to wash your hands before preparing solution! • To prevent dehydration, give Sugar Salt Solution or ORS at the first sign of diarrhea. This will not cure or

stop the diarrhea, but will prevent or treat dehydration caused by diarrhea. • Sugar Salt Solution is a good general treatment in most cases of diarrhea. For severe diarrhea get ORS

packets from a health care worker. Follow the instructions on the packet carefully. The sick person may also need to go to a hospital or other health care facility to get intravenous fluids (fluids given directly into the veins through a needle) if possible.

• Drink sips of the Sugar Salt Solution or ORS slowly (about every 5 minutes) until urination becomes normal. (It's normal to urinate four or five times a day.) A conscious dehydrated person can be given sips of Sugar Salt Solution or ORS in a cup or with a spoon.

• Adults and large children should drink at least 3 liters of ORS a day until they are well. • Even if someone is vomiting, they should continue to take the Sugar Salt Solution or ORS. Your body will

still be able to use some of the fluids and salts. • Even if someone has diarrhea, they should continue to drink the Sugar Salt Solution or ORS. It will not

increase your diarrhea. Sugar Salt Solution Recipe Recommendations • Water: use boiled, cooled water when possible, but if it delays treatment use the safest water available • Sugar: honey, brown sugar, the juice of a mango, orange, or other fruit can be substituted for sugar • Salt: too much salt can be dangerous. The solution should not be saltier than tears. Too much salt can

cause the body to become more dehydrated. • Adding sugar to the salty water helps your body use the salt. Salt will not be absorbed correctly if taken

alone. • Prepare the solution fresh daily and cover Non-sugar Sugar Salt Solution Recipe If sugar is too expensive or unavailable, the following solution can be used when boiling staple foods such as rice, root tubers (yams and potatoes), or grains (wheat, etc.): • Pour off some of the rich, starchy solution when it’s almost finished cooking • Allow liquid to cool • Add a two-finger pinch of salt for every cup of liquid (should taste no more salty than tears) • This technique may be less effective for children less then 3 months old. When to Get Help from a Hospital or Health Clinic • If it is an infant less than two months old • If the child/person vomits everything • If the child/person has a high fever

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• If the child/person is physically incapable of drinking • If the child/person becomes sicker • If the person does not answer clearly when spoken to • If the child/person loses consciousness • If the child/person has blood in his/her stools (indicates very serious condition) • If the child/person has no urine or tears (indicates very serious condition) • Note: Continue using the Sugar Salt Solution or ORS solution until help comes Characteristics of dehydration: • Lose water in their body • Body becomes limp • Sunken eyes • No tears when crying • Dark yellow urine or no urine • Dry, wrinkly skin around the mouth • Cracked lips and dry mouth • When skin is pinched it stays pinched or recovers slowly • Abdomen can be sunken • On an infant, the soft spot on head is depressed Steps for Sugar Salt Solution

1. Always wash your hands first. 2. Fill a cup with 250-300ml of water. 3. Add a two-finger pinch of salt to a clean glass of the safest water you have available.

Demonstrate picking up the salt using your thumb and second finger; add about .60ml. salt to 250-300ml. of water.

4. Taste the drink. If it is saltier than your tears, throw it out and start over. Too much salt is dangerous.

5. Add a palm of sugar – no bigger than your thumb. Demonstrate putting sugar in your cupped hand, about 5ml. to salty water.

6. Mix until you cannot see the salt and sugar anymore. Stir with stir sticks or pour back and forth between two clean containers.

7. Drink slowly. Finish the whole cup or glass. 8. Make and drink another glass after each runny stool.

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Follow these instructions for drinking the solution: For INFANTS- use a cup or spoon to slowly feed them 1/4 to 1/2 cup (125-150ml) after every time they have diarrhea.

For CHILDREN- slowly feed them one cup (250-300 ml) after every time they have diarrhea.

For ADULTS- slowly have them drink 2 cups (500-600ml) after every time they have diarrhea.

34 Information for background material adapted from TALC (teaching Materials at Low Cost) P.O. Box 49, St Albans, Herts, AL15TX, UK. and Kenya Institute of Education, Some Common Childhood Diseases and Health Records, Book 3 (Nairobi: Kenya Institute of Education, 2006) 12-19. and “ORS Solution: A Special Drink for Diarrhoea.” FRESH Tools for Effective School Health http://portal.unesco.org/education/en/files/37769/11056656723FOL_ORS_Solution.doc/FOL%2BORS%2BSolution.doc (accessed 16 August 2011)

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Appendix 6: A Small Yet Dangerous Fly Directions: TAPE picture set B on floor or chalkboard while telling the story. Page 1: Picture of poop in the field What do you see in the field? How do you think this poop got there? You know, poop has germs in it. Have you ever stepped in poop? What was it like? It sticks on your shoe and follows you home. Page 2: Picture of a fly How many feet does a fly have? What would happen if the fly landed on the poop with all six of those feet? Now it is not only small, but also dirty and dangerous. Page 3: Picture of food. Where are those small but dangerous flies now? What might they be leaving on the food? Yes, germs. Remember germs are too small for us to see on the food with our own eyes. Page 4: Picture of a mouth Where does the food go next? If we get these germs in our mouths or swallow them inside our bodies, they make us sick. The last time you were sick with a stomachache or diarrhea do you think it could have been because the small but dangerous flies were carrying germs on their feet and legs?

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Appendix 7: Wash, Wash with Soap and Water Drama Directions: Practice with students before the drama. The role of the teacher can be played by an older Health Club student. Student 1: (enters scratching head) My head itches so badly. What shall I do? All: (pretending to wash their heads) Wash, wash with soap and water. Teacher: Our heads can get very dirty and greasy. White flakes in our hair can make our head itch and look dirty. A dirty head might also get ringworm. Scratching can keep us from doing our schoolwork well. We need to wash our heads often. Student 2: (enters scratching skin on legs, arms, and abdomen) My skin itches so badly. What is on my skin? (Student smells arm) Hmm, it smells badly. What shall I do? All: (pretending to wash their skin) Wash, wash with soap and water. Teacher: Germs can enter our body through our skin if it isn’t washed. When we are hot, our skin sweats and collects dirt and dust. Scabies like to live on dirty skin and cause us to itch a lot. We need to wash our skin to get rid of the itchiness, dirt, and smell. Student 3: (enters rubbing feet together) My feet and toes are itching so badly. I feel like there is something crawling between my toes. What shall I do? All: (pretending to wash their feet) Wash, wash with soap and water. Teacher: Germs can get between your toes when they are dirty and wet. Sometimes your foot can even begin to rot like old fruit! Foot rot can be very smelly and itchy. Always keep your feet clean and dry and avoid wearing other people’s shoes. Student 4: (enters holding jaw and mouth) My teeth ache so badly. It is hard to chew my food. Teacher says I’m eating too much sugar. What shall I do? Teacher: Do we use regular soap in our mouth? (No) It is best to use water with toothpaste or salt (show samples) to clean teeth. This time let’s say, “Wash, wash with salt and water.” All: (pretending to brush teeth) Wash, wash with salt and water. Teacher: It is best to clean our teeth with a tooth stick or a toothbrush. (Show samples) Teeth are used to grind and break down our food. When food gets left between our teeth, germs can grow and cause our teeth to hurt. So you see that “wash, washing with soap and water or salt and water” every day can help us prevent pain, itching, and infection. Let’s say Step 4 together: Keep the outside and inside of our bodies clean!

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Appendix 8: Tippy Tap Diagram

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Appendix 9: Tippy Tap Instructions

Pierce a hole on top of the jug handle.

Tie the two ends of the string to a stick to suspend the jug.

Pierce two holes about three fingers apart.

Turn the jug around so that you are facing the opposite side from the handle.

Run a string between the two holes.

Thread a string through a piece of soap and hand that from the jug handle.

Tie a string around the neck of the bottle and make a loop at the end of the string.

Fill tippy tap with water and pull loop to begin washing hands.

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Appendix 10: Pocket Chart Lesson

Background: • A pocket chart is a tool for gathering information • Pocket charts offer a private way to answer difficult or embarrassing questions • People can use rocks, sticks, leaves, or any small item to vote using the pocket chart

Objectives: • Identify their own current handwashing practices • Analyze current handwashing practices for their school

Materials: • Pocket chart • Pocket chart mini-poster set 4a: girl, boy, water, ash and water, soap and water, no washing

(Use either tippy tap set or optional hand washing in basin set – do not use both) • Chalkboard or flipchart paper • Rocks, bottle caps, or beans for voting

Preparation: 1. Attach posters for pocket chart (Girl and boy down left side; wash with water and ash,

did not wash hands, wash with soap and water, wash with water only, across the top pockets.) Use mini-poster set that is most common to your school. (Tippy tap set or hands in basin set.)

2. Find a private place to hang pocket chart for vote. 3. Draw a pocket chart on the chalkboard to record results.

Wash with Water and Ash

Did not Wash Hands

Wash with Soap and

Water

Wash with Water Only

Girl

Boy

Totals

Time: 30 minutes

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1. Introduction Discussion Questions:

• In your community, is it easy or difficult to talk about WASH behaviors? Why or why not? • Are people ever embarrassed to talk about their WASH behaviors? • Do people ever lie if you ask them about their personal WASH behaviors?

2. Add Information

Hang the pocket chart where all can see it.

• What do you notice about this chart? Introduce the pocket chart. Be sure to explain the privacy of voting using this method. Give an example of questions that can be answered using a pocket chart. For example:

• Remember the last time you defecated. Think about whether you washed your hands after. Did you use just water, soap and water, no washing, or water and ash?

• If you are a boy and you used water only, you would place your pebble here. If you are a girl and you did not wash your hands, where would your pebble go?

• ALTERNATIVE Voting Question: If you think the students may not be comfortable answering the above question truthfully Ask: What do you think most of the students at our school do after using the latrine or bush? Do they wash their hands after relieving themselves?

Demonstrate many times with different students showing how different answers would be represented until you think that the students fully understand how to vote. Ask students to take turns voting. Students should answer this question:

• Last time you washed your hands, how did you do it? Give each person one rock to place in a pocket. Hang the chart where the class cannot see the voting. Dismiss people one at a time so each can vote privately. 3. Apply

After all students have voted, record the votes on a hand-drawn graph similar to the pocket chart. Add each column together totaling the boy and girl results. Activity Questions:

• Which way of handwashing was most common? • Which way of handwashing was least common? • How many students washed their hands using ash or soap altogether? • How many students did not wash their hands at all? • Why do you think this happened? • What information might you learn from using this tool?

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Appendix 11: Pocket Chart Construction Materials: • Cloth • Solid colors are best for main material • Contrasting color or non-busy pattern is best for pockets

Dimensions: Hemmed solid material size, length 1.5 m x width 1.25 m Pockets: 6 hemmed contrasting material strips, each 1 m long x 18 cm high Sew each pocket every 18 cm. making 5 pockets across each of the 6 rows Margins: 18 cm across top and along left side Top

• Folded over & sewn with a 5 cm space so a stick could be put through in order to hang it up • Grommets on each end with rope so it can be hung by tying to an object

k listed

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References

Berluti, Guy, John Njenda, and Henry Embeywa. 2006. Science in action 5, 2nd ed. Oxford: Oxford University Press. Boboer, HE Khabibullo. 2005. Water, sanitation and hygiene education for schools. Paper presented at the UNICEF/IRC Roundtable Meeting, January 24-26, in Oxford, United Kingdom. Centers for Disease Control, http://www/cdc/gov. Centers for Disease Control and Prevention. Tuberculosis: data and statistics. CDC. http://www.cdc.gov/tb/statistics/default.htm. Centers for Disease Control and Prevention. Water treatment methods: boiling water. CDC. http://wwwcn.cdc.gov/travel/content/water_treatment.aspx. Davis, Robert. 2007. Learning to listen-learning to teach: An introduction to dialogue education. Workshop presented to Lifewater staff, February 5-9, in San Luis Obispo, USA. www.GlobalPartners.com. Department of Health and Human Services. Can I get HIV from mosquitoes? CDC. http://www.cdc.gov/hiv/resources/qa/qa32.htm. Department of Health and Human Services. Rumors, myths, and hoaxes. CDC. http://www.cdc.gov/hiv/resources/qa/hoaxl.htm. Department of Health and Human Services. Safe food and water. CDC. http://www.cdc.gov/hiv/resources/brochures/food.htm. Embeywa, Henry E., Rose W. Mbiyu, and Celestine B. Mwakio. 2004. Science in action 3. Oxford: Oxford University Press. Etgen, John, Sandra DeYonge, Dennis Nelson, and Sally Unser. Ed. Anne Taylor. May 2003. Healthy water healthy people. Bozeman: The Water Course. Fundacion SODIS. Bolivia: Universidad Mayor de San Simon Casilla. http://www.sodis.ch/Test2002/T-Howdoesitwork.htm. Hein, Celeste. Mr. Soap. U.M.C.A. Hillsborough County Public Schools. Proven teaching strategies. Tampa, Florida: Student teacher observation instrument. Hornitz, Marilynne and Wallace, and Bob Johnson. 1992. The official captain hydro: Water conservation workbook. Oakland: East Bay Municipal Utility District. Hurtado, Elena. 1997. The tippy tap. Footsteps 30: 20. Johannesburg Summit. 2002. World summit on sustainable development: United Nations Secretary-General calls for global action on water issues. http://www.johannesburgsummit.org/html/media_infopressrelease_prep2/global_action_water_2103.pdf.

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Joint United Nations Programme on HIV/AIDS and World Health Organization. AIDS epidemic update December 2007. http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf. Kenya Institute of Education. 2006. Diseases and health records. Book 3. Nairobi: Kenya Literature Bureau. Kenya Institute of Education. 2006. Personal hygiene and environmental sanitation. Book 1. Nairobi: Kenya Literature Bureau. Kenya Institute of Education. 2002. The primary education syllabus. Vol 2. Nairobi: Ministry of Education. Nelson, Dennis, Susan Higgins, Alan Kesselheim, Jennie Lane, and Sandra and George Robinson. 1996. Project WET curriculum and activity guide. Bozeman: The Council for Environmental Education. Population Services International. PSI. Preventing diarrhoea: Viki finds out how… Harambee: Ministry of Education. Pruss-Ustun, Annette, Robert Bos, Fiona Gore and Jamie Bartram. 2008. Safer water, better health: Costs, benefits and sustainability of interventions to protect and promote health. Geneva: World Health Organization. http://esa.un.org/iys/does/WHO_CB_eng.pdf. 1997. Recommended practices for the care and cleaning of surgical instruments and powered equipment. AORN Journal. January. http://www.BNET.com.findarticles.com.healthcareindustry. Sawyer, Ron, Mayling Simpson-Hebert, and Sara Wood. 2000. PHAST step by step guide: A participatory approach for the control of diarrhoeal disease. Geneva: World Health Organization. Unpublished document WHO/EOS/98.3. Scholastic Inc. 1996. Scholastic children’s dictionary. USA: Scholastic Inc. Teaching Materials at Low Cost. TALC. P.O. Box 49, St. Albans, Herts, AL15TX, UK. United Nations Human Development Report. 2006. http://hdr.org/en/reports/global/hdr2006/ UN Water Newsroom. 2007. UN launches international year of sanitation to address global crisis. New York, November 21. http://www.unwater.org/res-archive.html. UN Water.2008. Tackling a global crisis: International year of sanitation 2008. http://esa.un.org/iys/docs/IYS_flagship_web_small.pdf. Vosniadou, Stella. 2001. How children learn. Brussels: International Academy of Education and Geneva: International Bureau of Education. http://www.ibe.unesco.org. Water Supply and Sanitation Collaborative Council. WSSCC. 2008. A guide to investigating one of the biggest scandals of the last 50 years. http://dwrm.ciren.vn/en. Wells,Jane. 1995. The principles and practices of dialogue education card 25. San Francisco: Jossey-Bass. World Health Organization Guidelines for Drinking Water Quality. WHO. 2009. http://www.who.int/water_sanitation_health/dwg?GDW3rev/and2.pdf. World Health Organization. WHO. 2004. Water, sanitation and hygiene links to health facts and figures. http://www/who.int/water_sanitation_healthpublications/facts2004/en/print.html.

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WASH in Schools Training Materials List

• 2-3 Flipchart paper pads of 25 -30 sheets each

(approximate size 64x76cm) • Markers • Tape • 3 clear containers for water (for example empty 500

mL to 2 L bottles) • Large bucket for carrying water • Clean tightly woven cotton cloth, large enough to

cover cooking pot • 1-2 meter twine, rope, or belt for filtering water • Soap, ash, or sand for washing hands and dishes • Fire source (for example wood, propane, cooking

stove, etc.) • Cooking pot with lid • Magnifying glass • Small plastic see through bag for diarrhea

demonstration • Sample tippy tap • Salt • Sugar • Pocket chart • Rocks or other token for voting • Nametags • Razor or clippers for cutting nails • Toothstick or toothbrush • Toothpaste or salt

• 3-5 liter jerry can or 2 liter clear plastic bottle for

tippy tap construction (determine # needed for demonstration purpose; minimum 1)

• Jug and basin • String for tippy-taps • Candles • Nails • Matches • Scissors or knife • Local fresh vegetable, two or more of the same

kind • 6 paper clips • Long handled hard broom • Ball or crumpled paper for tossing • Resource packet • Optional: Heavy string/rope (4-5 meters) if using

Step string • Optional: 40-50 Clothespins if using Step string • Optional: Bibles • Optional: PUR packet, ORS packet • Optional: Watch with second hand for counting

20 seconds

Documents

WASH in Schools Manual - Lifewater International › wp-content › uploads › 2018 › 10 › ... · the power to kill bacteria, and other germs, which cause diarrhea and other