Learning skills for family health
Improving access to sanitation through promoting hygiene practices
OPUWO DISTRICT, Namibia, 5 August 2015
With elaborate braids hiding her face and entire body; and a calfskin skirt covered in a paste of rich red ochre pigment and buttermilk, 14-year-old Kataeko Ndiaombe goes about her domestic chores with gracefulness and determination.
A member of the indigenous Himba community in Kunene Region, northern Namibia, Kataeko is the last born of a family of 10 children and helps her aging 63-year-old mother to take care of the home. Home is a cone-shaped structure made from branches, mud and cow dung, and around it is the barren sandy earth of this remote and arid part of the country.
Kataeko is not resting. Her tall and slender frame leans to the right as she lugs a 20-litre jerry can of water to the homestead. She musters the strength to tip the jerry can and pour some water into a metal food bowl, which she washes carefully. This ritual, which also involves collecting water, preparing food and keeping the surroundings of the home clean, is part of her day-to-day life as a young Himba female.
Kataeko’s life is far removed from the basics of modern living. Facilities as simple as clean water and toilets are difficult to come by in Himba communities. In a modern home, a five-minute shower would use 35 litres of water, but today Kataeko’s household only has 25 litres for the 11-member family.
Kataeko knows this is not enough to cook, bathe and clean the home with but has to make do. Water is scarce in this region of Namibia, which is also prone to drought.
Access to improved sanitation and hygiene remains low in many rural communities throughout the country.
The 2013 Demographic Health Survey showed that 77 per cent of rural households, compared to 27 per cent of urban homes, use ‘non-improved’ sanitation facilities such as the open bush, buckets and open pit latrines. Only 22 per cent of the poorest households have soap and water for hand washing. A fifth of rural children suffer from diarrhoea, which can lead to malnutrition and even death.
Twenty-eight-year-old village health extension worker Kapi Pomundu, is making a routine visit to Kataeko’s homestead. She talks with the group of women about how they can hygienically use the little water that is available.
“I teach my community about the importance of washing their hands to prevent diseases," says Kapi.
"I tell them to wash their hands with water and soap or ash. I teach them how to wash their plates, how to store their water,” she says
Kataeko, as a young agent of change, plays a critical role in keeping herself and all other household members healthy. This is why Kapi pays special attention to her today, making sure that Kataeko is coached on how to prevent diseases caused by lack of hygiene.
Kapi invites Kataeko to follow her to the camp fire from the night before. Both women bend down and grab some ash, the alternative to soap in poor communities.
“First of all they have to pour the water on their hands, and use ash, which is available in the community. They must rub their hands with ash and water. When they finish washing their hands, they must dry their hands in the air,” explains Kapi, outlining the basic method that she teaches Kataeko and her friends.
The health extension worker also advises Kataeko about critical times for hand washing – specific times when everyone should wash their hands to prevent the spread of germs and diseases. To make hand washing water readily available, Kapi takes an opportunity to demonstrate how to put up a tippy tap, a simple hands-free apparatus made of sticks and a plastic container and operated with a foot lever to run the water.
“I teach them to wash their hands before milking the cows, after playing in the soil, when they are preparing food and before and after eating. When they come from the toilet, they must also wash their hands, and after attending to a child who has passed stools,” says Kapi.
Kataeko also reveals that her family sometimes has no choice but to collect water from a pit in the dry riverbed. When the borehole powering the water point breaks or when the community runs out of fuel for the running of the pump, the river becomes the only point to fetch water. This warrants the need to teach her to always boil water or use water purification tablets before drinking. Efforts are also being made to encourage the community to build pit latrines and change the habit of open defecation, which is one of the most unsanitary practices and can lead to disease outbreaks.
“We are encouraging the community to build pit latrines so that they don’t just go in the bush,” says Jason Ndahepele, Senior Health Programme Officer for the Ministry of Health and Social Services. We are aware that this area is prone to cholera outbreaks, so it is essential for the community to be educated, to use facilities rather than just go anywhere. The rivers here are contaminated, which is a reason for cholera.”
Health and hygiene education is critical to help adolescents like Kataeko and their families to practice good hygiene and sanitation.
UNICEF works with the Namibian Red Cross Society to assist families in the northern regions in treating and safely storing water, washing hands with soap, and eliminating the practice of open defecation.
