A girl’s tale on how clean living saves lives
A girl’s tale on how clean living saves lives
Khongmany, age 4, grew up healthy. Her mother Ti breastfed her exclusively for six months, took her regularly to the district hospital for vaccinations, gave her complementary feeding of vegetables and rice porridge after the age of 6 months, and continuously followed through with her immunization.
But when she was just one year old, all that took a drastic turn for the worse: she had a severe bout with gastritis and recurring bloody diarrhoea, along with stomach parasites. She lost her appetite, shed weight, and was diagnosed with severe acute malnutrition (SAM).
Doctors could only treat her with medication as a response to her condition, but could not precisely point their finger to a cause. Luckily, Ti did not relent; she continued breastfeeding Khongmany, fed her nutritious food, treated with ORS (oral rehydration solution), and continued medication until the girl pulled through. Khongmany has now bounced back to her healthy, jolly and playful self – excited to start schooling.
Looking back at that worrisome experience, Ti surmises it was more than just common diarrhoea: admittedly, her family is only one of the three in Arlaiya village that have a toilet. The lack of toilets in the village means the rest of their neighbours have been defecating in the open.
She also says Kongmany did not have a good habit of washing her hands before her meals or afternoon snacks and shared and passed food around with her friends while playing by the bushes. “She played a lot with the children in the neighbourhood, and got her hands on almost everything – including soiled toys,” Ti recalls.
“We could not be sure whether that was a factor in Khongmany’s sickness, but now we will not take any chance,” Ti and her husband Konti said, adding that buying medicine and taking their little daughter to the district hospital for treatments cost them a lot of their family budget.
They have since imposed strict handwashing habits among their three children before having their meals and after using the toilet. At times when young Khongmany playfully refuses to wash her hands, Ti says she would do the washing for her.
The family’s primary water source is pumped from a well in the ground – which makes it also susceptible to e-Coli contamination that can cause diarrhoea and serious infections such as gastritis – even more reason they insist on regular handwashing with soap and boiling their water before cooking or washing the dishes.
Ti and Konti have learned a great deal from Khongmany’s illness. “Now our children don’t get sick frequently, just some fevers and cough at the change of weather,” Ti says, adding that keeping their environment clean is an essential part of their life. They are also glad that in addition to a strict handwashing rule they have at home, their two older children Malaythong and Sompong are taught to wash their hands, brush their teeth, and to properly use the toilet in school.
Across Xepone town, over in Saleo Village, multi-grade school children converge by the handwashing facility right outside their classroom – as they prepare for their morning snack. As their teacher switches open the faucet and water gently drips, they eagerly cup their hands and rub their palms together with soap.
“This is fun,” one of them exclaims to the other while passing the soap over to their friends. One child playfully splashes water on her friend’s face, and she responds with smothering his face with foam. They rinse the soap off vigorously until it is time to dry their hands.
While the multi-grade classroom is not part of the formal primary education system, handwashing has become an integral part of the children’s learning activities – to start them young on developing the habit. Just next to the faucet is a toilet facility for girls, boys, and a ramp included for children with disabilities.
Dr. Siphong Saiyavong of the Savannakhet Provincial Health Office, who is on a programme monitoring visit, eagerly captures photographs of the children’s group activity. He had just come to learn of Khongmany’s previous bout with gastritis, and says “handwashing and proper use of the toilet are essential lessons to be taught in schools, especially among young children, so they are aware of the positive health implications of keeping a sanitary environment.”
There is a very close link between Khongmany’s severe illness and that unsanitary environment in which she used to play. Particularly common in rural areas, open defecation, the lack of sanitation facilities, and poor handwashing habits can trigger outbreaks of diarrhoea and other infections – particularly among children.
To this end, UNICEF and the Provincial Education and Sports Department, Provincial Health Department (NAMSAAT) have begun investing in facilities such as restrooms and drip water washing faucets in schools, to institute the habit among school children to keep their hands clean and use toilets early on. Teachers are also reinforcing these habits as regularly as possible, to keep children healthy and ensure they do not miss school because of illnesses.
With the Government’s move to test water samples in various provinces and determine the prevalence of e-Coli contamination, there is also a growing call among health professionals to intensify testing. Currently, there is 86 per cent national average of e-Coli contamination from water samples tested.
UNICEF has also started implementing triggering activities, including consultations with local governments, across four provinces, including Savannakhet, Phongsaly, Xieng Khouang, Saravane and Bolikhamxay, to further raise awareness on the harmful impact of open defecation, and to provide poor communities with more latrines. Health workers also promote sanitation practices among their patients, especially those from poor rural villages, in order not to aggravate their health issues.
Khongmany is now safe and healthy. She cheerfully washes her hands with soap in a basin, along with her siblings, just before their mother serves their lunch. “I like when my hands are clean and smell good,” she says, smiling.
Khongmany may have been fortunate to get past that experience three years ago, but many more children from low-income families across the country still need to be taught that clean hands does not only mean they look and smell good – it can save them from an illness that requires medical treatment, and it can save lives.