Hand washing: more than just soap and water
(This story was published in the Bangkok Post newspaper on August 20, 2009)
By Nattha Keenapan
KRABI, Thailand, August 2009 – It was not until recently that 10-year-old Chanwimol Ginglek, a student at Baan Khao Tang School in southern Krabi province, realized that proper hand washing involved a lot more than just soap and water.
With the A/H1N1 influenza virus spreading rapidly in Thailand, schools are rushing to teach students the first line of defense against the virus: proper and thorough hand washing.
“Now I know there are seven steps I need to follow to wash my hands properly,” said Chanwimol, a bright fourth-grade student. “And it takes me a lot longer to wash my hands now than it did before.”
As of 19 August 2009, Thailand had 13,019 cases of A/H1N1, including 111 deaths, according to the Ministry of Public Health. The first two cases were reported on May 12. So far, the virus has spread to all of the country’s 76 provinces.
On a recent visit to the primary school, health workers from the district showed the students how to protect themselves from the spread of A/H1N1 virus as well as the Chikungunya virus, which is carried by mosquitoes and causes a dengue-like fever that has infected tens of thousands of people in Thailand’s southern provinces over recent months.
In addition to following the seven steps when washing their hands, the Baan Khao Tang students were told to cover their mouths and noses when they cough or sneeze, drink lots of clean water and eat well cooked food, and to go to the doctor immediately if they become ill. All of these behaviours are aimed at protecting the children from A/H1N1 and other illnesses.
Although the southern provinces are popular tourist destinations and have numerous luxury hotels, many people living in Krabi and other southern provinces lack access to clean water and proper sanitation facilities, and many schools suffer from the same problem.
The health and hygiene classes at Baan Khao Tang are part of a 43 million baht project supported by UNICEF Thailand to upgrade water and sanitation facilities at 121 schools in the tsunami-affected provinces.
“Many schools lack safe water supplies, especially in the dry season,” said Rangsun Wiboonuppatum, Chief of Education for UNICEF Thailand. “Without adequate water and proper sanitation facilities, students are more likely to become ill and to be absent from school.”
Drinking water systems at many schools in the provinces lack water filtration systems, meaning the water may not be safe to drink, Rangsun said. At some schools, children only have unfiltered rain water to drink, while at others children have to bring their own drinking water from home.
Some schools even lack sufficient water supplies for cleaning, which results in toilets becoming unsanitary and a threat to children’s health. Many schools also lack the minimum number of toilets required to serve the student population. Toilets are also often dark and far from classrooms, which can be dangerous for young children and girls.
“Not having enough water led to many problems at our school,” said Jintana Sukyoi, the principal of Baan Khao Tang School, which has 109 primary school students. “Many students were having bladder problems because they did not want to go to the toilets since they were dirty. Some children had head lice and scabies because there was not enough water to clean themselves with during the school day.”
Under the UNICEF-supported project, the school recently was provided with new water storage tanks, and this has ensured that the school has sufficient water supplies year round. Also installed under the project were new toilets and hand-washing basins, which have helped to significantly improve the children’s hygiene and health.
Jintana said the children no longer have to bring water from home or take their lunch dishes and utensils back home to wash. More importantly, students no longer suffer from bladder problems.
At Baan Tung Kor School, in the nearby Trang Province, students were provided with safe drinking water after a water filtration system was installed in January under the project. A cooler with clean water is now placed in all classrooms every morning. In the past, the children said they usually drank tap water from the wash basins near the toilets.
“I think filtered water tastes better than tap water,” said Nethipong Siemmai, 12, a Grade 6 student at Baan Tung Kor School. “I like it better and I know it’s clean.”
But the most popular water and sanitation facilities at the school are the child-sized toilets and wash basins installed for kindergarten students. They are just the right height for young children, who can easily reach and use the toilets and wash basins with no help from adults or older children.
“In the past, the kindergarten students had to walk a long way from their classrooms to use the older students’ toilets,” said Mulliga Chongsombut, the principal at Baan Tung Kor School. “But now it is the older students who want to use the young students’ toilets.”
Teachers said new and upgraded sanitation facilities at schools also help promote active participation from the communities. Apart from the basic seven-step hand-washing exercise and other hygiene lessons, students are involved in other activities, such as learning how to make natural liquid soaps to clean the new water and sanitation facilities.
“Parents and relatives always join us for these kinds of activities,” said Renu Chauymuang, a teacher at Wat Nampud School in Trang Province. “We have started a lot more of these activities since the new sanitation facilities were installed. It helps create more opportunities for the community to participate in the school’s activities.”
UNICEF’s Rangsun said community participation is a crucial part of hygiene education, and that schools need to promote the knowledge to parents and community members in order to sustain good hygiene behavior.
“Good hygiene practices cannot be taught and practiced only at school.” Rangsun said. “They must be taught and practiced at home and everywhere.”