Improving child health through Community Led Total Sanitation

Waterloo, Sierra Leone - Ten-year-old Adama Kargbo always enjoys her moments of play under the warmth of the sun in Gbonkowaylay village, in Waterloo district of Sierra Leone.  From jumping rope to taking part in the spontaneous racing competitions, different fun activities form an important part of Adama’s childhood.

“I enjoy a lot of games with my friends and I always feel happy to be outside playing and laughing with my friends,” says Adama, as she smiles brightly to express the value she places in these moments of play. 

Alas, it is during these fun moments that Adama and her friends touch and rub onto different surfaces in their village courtyard, some of which are ridden with dirt and germs. 

“When we are playing, we do not always notice what we are touching.  If we do not wash our hands regularly, the germs which we pick up can easily make us fall sick,” says Adama, as she eloquently shares her basic, yet critical knowledge of the detrimental effects of being in contact with dirt and germs.

When sanitation is poor practicing handwashing becomes a challenge. Across Sierra Leone, only 16 per cent of households have access to improved sanitation and 23 percent have access to good hygiene practices. Open defecation is widely practiced – compromising the health and development of children who can easily come into contact with the faeces during play. Three years ago, Adama and other children from the village were vulnerable to regular episodes of diarrheal diseases, mostly a result of poor sanitation practices and the lack of handwashing facilities in their communities.  

The adoption of the community led Total Sanitation Initiative (CLTS) by the community of Gbonkowaylay in 2017, has helped to ensure that children such as Adama can enjoy their childhood adventures, without running the risk of falling sick.  With support from the Foreign and Commonwealth Office became the Foreign, Commonwealth & Development Office (FCDO) and UNICEF, a local Civil Society Organisation has also worked with the households to use practical, locally available and cheap materials to help improve sanitation and hygiene practices and making the environment safe for Adama and her friends to live and play in. 

This massive sanitation drive has included working closely with the community to ensure that all the 32 households in the village use locally available materials to build toilets, hand washing facilities, dish racks and laundry lines at their homesteads and to ensure that all members of their families are consistently using these facilities.

Taking advantage of the dense bamboo forests which surround the village, handwashing facilities have been crafted by curving bamboo poles, affixing them at the entrance of every household and ensuring that these poles are regularly filled with water from a nearby village water point, which was also erected through this intervention.

A small perforation, which is sealed by a stick, serves as a tap to let a clean gush of water out, while a bottle of soap is attached to the pole for using in the handwashing process.  

Washing hands with soap under running water, is one of the simplest, yet powerful and economical part of the CLTS programme. This practice is therefore being vigorously promoted across 40 targeted communities throughout the country, where different types of handwashing stations have been put up depending on the local materials available to communities.

“Hand washing with soap should be a life skill to be taken up by all children always,” says UNICEF Chief of Water and Sanitation, Bishnu Timilsina. “It is important that we work with every child to nurture this positive habit so that they can pass it on to their families, their friends and to their own children in the future.” 

Through regular community sensitization on the importance of improving hygiene and sanitation at community and household level, children are also becoming champions in promoting good hygiene and sanitation at home.

“I have to wash my hands after playing, after using the toilet and before eating. When washing my hands, I make sure that I remove the dirt which is in my nails too,” says Adama as she demonstrates how thoroughly she washes her hands.”