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Tanzania, 29 June 2015: Promoting hygiene, saving lives at camp for Burundian refugees

© UNICEF/Rob Beechey
A Burundian Volunteer assists with social mobilisation against cholera as part of the WASH program, using teaching materials provided by UNICEF.

By Anthea Rowan

29 June 2015, Nyarugusu camp, Kigoma, Tanzania – In Nyarugusu camp, the threat of cholera and other diseases is real, close and magnified as numbers in the camp have more than doubled since the recent influx of refugees fleeing a volatile situation in Burundi.

Threat of Disease Outbreaks

Nyarugusu camp is a 20 year old camp with – until recently – a population of 50,000 refugees from the Democratic Republic of Congo. The camp’s water, sanitation and hygiene (WASH) facilities were designed for 50,000 asylum seekers. Today the camp hosts more than 110,000. A population that continues to rise. The threat of cholera and other diarroheal dieseases is intensified because there are not enough latrines. The risk this poses is aggravated because of the ease and speed with which cholera, a virulent bacterial infection, is transmitted. Kiwe Sebunya, Chief Water Sanitation and Hygiene at UNICEF in Dar es Salaam, reminds: “The worst thing about cholera is that when people move, transmission of any disease is faster, but as refugees have to move, when cholera takes hold, it spreads like wildfire.”

Each week Nyarugusu welcomes more than 1,000 new arrivals and that number could rise substantially.

Promoting Hygiene, Saving Lives

UNICEF recognizes that the combination of over-stretched services and a growing refugee population creates a perilous gap that could lead to disease outbreaks. With their partners, the Tanzania Red Cross Society and UNICEF-funded Ministry of Health officials, UNICEF is supporting a Hygiene Promotion Task Force: a system of surveillance and social mobilization which is vital in creating public awareness of hygiene standards. Crucially, the task force is a system that is sustainable because it encourages community involvement which, by extension, helps keep people busy and promotes integration.

Community leaders within the camp are identified and help select individuals capable of communicating information; they must be willing, able to speak Kiswahili and Kirundi and know how to write in order to record their findings. The volunteers receive training and deliver their lessons via role play, dramatic productions and daily house calls when, armed with flip charts, they sit with families and illustrate their messages in hand washing at critical times (post latrine use, for example), safe water storage and handling, and maintaining clean homes.

It is evident, in witnessing a training session that volunteers are engaged. Sitting on a tarpaulin in the shade, they listen attentively as the flipchart is demonstrated. They ask questions and later – to the delight of a gathering crowd – deliver a lively roadshow to highlight the signs and symptoms of cholera.

Refugee volunteers

Nadine Ndabarushimana, one of the trainee volunteers, arrived in the camp from her native Burundi three weeks ago with her sister and – between them – 11 children. Nadine understands how important cleanliness is in terms of disease – and, especially, cholera – prevention. Many volunteers understand how dangerous diseases like cholera can be – if they haven’t witnessed it themselves, they’ve heard tell of it. Nadine has seen people suffer and describes the onset: “A person gets very cold, their skin changes colour, they become pale, their eyes roll up, they vomit and their diarrhea runs all the time.” She says she volunteered because she has time to spare, she noticed that some of the camp inhabitants are unaware of the importance of keeping clean and felt it was necessary to educate them. Nadine has attended, and enjoyed, training sessions: “I understood a bit about personal hygiene before but only the basics. I have learned now how to keep a latrine clean and how to make sure my water is clean. Some of the people I go to teach are happy to receive me and hear my message but with others I need to persevere. I won’t be discouraged, though, their needs are mine.”

UNICEF’s efforts in mobilizing refugees to assume some of the responsibility for hygiene promotion within their community is important for several reasons. Primarily it is a sustainable way to help moderate the risk of disease and it creates opportunities for groups to learn, engage and integrate.

But significantly, it has also granted women like Nadine, who have suffered untold trauma and loss, the chance the focus on something proactive and positive.



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