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Pakistan: Promoting hygiene among earthquake survivors by encouraging healthy behaviours and providing hot water

© UNICEF Pakistan/2005/Marroquin
Mohammad Ishfaq, 7, in front, sings to children in the Havelian camp for earthquake survivors in Pakistan during a hygiene promotion session with a public health assistant, Shana Hal.

By Julia Spry-Leverton

MUZAFFARABAD, Pakistan, 15 February 2006 – In Pakistan-administered Kashmir and North West Frontier Province (NWFP), where more than 136,000 earthquake survivors are living in camps, UNICEF is engaged in two major new projects to promote healthy hygiene practices. The first is an education programme to encourage clean habits; the second is the introduction of hot water to keep people washing themselves during the winter months.

Conditions in the camps are difficult. Families of up to 10 people live in one tent. Many are displaced mountain villagers who have lived isolated lives. Among the many changes they face is the need to use latrines, formerly not part of their cultural practices. The fear in situations like this is that communicable disease will strike – prompted by poor hygiene – and swiftly spread to reach epidemic proportions. Children are the most vulnerable – and always the first to succumb to illnesses, such as cholera.

Fauzia Minallah, a young artist and graphic designer from Islamabad, has been working in the Havelian camp, Mansehra district NWFP, assisting with one innovative campaign using her photographic skills.

“I capture pictures of people demonstrating bad hygiene practices,” says Minallah. “For example, cooking with unwashed hands or leaving the latrines without using the soap and water provided there. When we’re talking to communities we see how they empathize more if they are shown pictures with people they recognise.”

© UNICEF Pakistan/2005/Marroquin
Artist and graphic designer Fauzia Minallah walks around the camp with her camera, photographing good and bad hygiene practices to discuss with camp residents.

Another programme – one focusing specifically on children – is in place at nearby Jaba camp, which is home to 2,990 people. Muhammad Ishfaq, 7, takes a megaphone and sings out the words of a well-known poem, Murgha. The children clap their hands in rhythm.

Hygiene questions come next: “Why is it necessary to wash your hands?” calls out Shana Hal, a public health assistant. Most of the children raise their hands and a young girl answers clearly: “So we can get rid of germs.” Then she mimes to show how hands should be thoroughly washed using soap and water.

“With children it’s easier to influence their attitude, since practices aren’t ingrained at their age,” explains Shana. “Plus we know they can make a difference when they take new knowledge and behaviours home to their parents.”

Hot water to encourage washing in winter

"Unlike most complex emergencies that happen in the tropics, this earthquake occurred where the winter weather gets very cold indeed,” says Bent Kjellerup, UNICEF Project Officer for Water and Sanitation, adding that this means there are limited standard practices for hot water provision in emergency situations.

© UNICEF Pakistan/2006/Kulkarni
A woman in Thori Park camp near Muzaffarabad adds water to a prototype hot water barrel – the first of 60 which UNICEF hopes will encourage earthquake survivors to continue washing during the cold winter months.

Thori Park camp near Muzaffarabad will be the first camp where the communal washrooms have a supply of hot water. Previously the areas for washing – screened off by tarpaulin – had only a cold tap. With winter at its height and temperatures dropping well below freezing at night, the camp’s residents had been bathing less and less using just the frigid water.

Two warm bath shelters have also recently opened in Hassa, Afiz Abad.

Dr. Herbert Raaijmakers, UNICEF’s Project Officer for Health in Muzaffarabad explains, "Skin disease is a major concern here. The itchy rash caused by scabies is one of the major problems people report. Providing hot water will help them recover from the rash – plus we’ll also be showing people how better hygiene can improve their family’s overall health.”

UNICEF is experimenting in developing an effective, low-cost method for hot water provision using local materials. The Thori Park tank is a prototype which uses a wood fire to heat a barrel of water. It is the first of 60 that UNICEF and partner organizations are working on.

After bathing with half a bucket of hot water each Sajid, 12, and Michel, 4, head off damp-haired and shiny-faced towards the camp’s tented school. “We used to have hot showers quite often at home before, but this is our first since the earthquake” says Munir, 12, as he mops his face and neck with a towel.

Based on field reporting by Javier Marroquin and Amita Kulkarni.



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