Asia
Promoting the basics to save children
Pon Team is a 25-year-old mother in Cambodia’s Teuk Phos district. Her daughter Thairy was frequently sick with diarrhea when she was one year old,. Touch Sokya, a 24-year-old farmer’s wife in Teuk Phos, also struggled to keep her first-born healthy.
Team and Sokya’s cases are not unusual. Nearly 9 million children under five years old die every year worldwide, two out of three of these from easily preventable diseases like diarrhea and from conditions like malnutrition.
International Relief and Development (IRD) sent trainers into rural Cambodian villages to teach families the essentials of health and hygiene. Mothers, and some fathers, learn about the importance of early breastfeeding; the value of exclusive breastfeeding until six months of age; nutrition; the importance of using clean water and how to obtain it; and methods of proper hygiene.
Following IRD’s child health campaigns, there have been few cases of diarrhea in this village, and Team’s own child is healthy. Sokya began applying the lessons she learned from IRD prior to the birth of her second child. She proudly reports that she breastfed her son 30 minutes after giving birth. Her family now only consumes boiled and filtered water. She and her children wash their hands with soap. Her children have received all of their scheduled immunizations, regular vitamin A supplements, and deworming tablets at the local health center’s outreach campaigns. As a result, her younger child, now 14 months old, has never experienced diarrhea or vomiting.
Contributed by International Relief and Development
Synergy between human and ecosystem health
The Baodinggou Nature Reserve in Sichuan Province, China, is home to the giant panda. The communities surrounding the reserve belong to the Qiang minority group. Due to their remote location and poor access to markets, these villagers rely heavily on forest resources; main sources of income are collection of herbal medicines and employment on the Sichuan pepper plantation. The World Wildlife Fund (WWF) works with communities to improve their wellbeing and promote sustainable development in order to conserve the giant panda.
In 2008, an earthquake devastated large areas of the province, and in particular, hit areas within the Reserve where WWF was working. The earthquake worsened villagers’ access to clean water for cooking, drinking, and good hygiene. In response, WWF was able to divert funds from a Johnson & Johnson funded project for installation of a water pipe and water cisterns that a village-level management group and local NGO organized to build and sustain.
As a result, clean water is now available in two villages, and waterborne disease has been well controlled. People in one of the villages were so pleased that they set aside a large forested section of their water catchment and now protect it in order to continue to have clean water. Monks demarcated the boundaries in a large ceremony with the villagers. Everyone respects the boundaries: people are keeping cattle out and no one is cutting down vegetation. This is a great example of synergy between human and ecosystem health.
Contributed by World Wildlife Fund
Household water strategies for sustainability
PATH’s Safe Water Project is conducting a model project in Andhra Pradesh, India, to enable commercial enterprises to produce, distribute, sell, and maintain household water treatment and storage products for low-income populations. The first steps aim to develop commercial strategies and demonstrate their effectiveness. Ultimately, the project will provide strategies and tools for scale-up, replication, and sustainability for a range of settings and countries.
Contributed by PATH
Pairing zinc and water intiatives to save lives
In India, 25 percent of annual deaths caused by diarrheal disease occur in Uttar Pradesh, one of the country’s most populous and impoverished states. One of the main causes of diarrhea is the lack of clean drinking water.
The US Agency for International Development and Academy for Educational Development (AED) stepped in with a household water treatment program known as Point-of-Use Water Disinfection and Zinc Treatment (POUZN) to reach more than 1 million poor residents in the region. By combining these two important treatments, POUZN expects to halve the number of instances of diarrhea among children under age five. Self-help groups and grassroots organizations are working together with POUZN to provide households with water products and systems to create clean drinking water. Not only are the tools made available, but the families are also given information on why water disinfection is so critical.
Community members are shown the contaminants in their water before water disinfection practices begin. Water samples from wells, lakes, and rivers, as well as from water stored at home, are publicly tested to demonstrate contaminated water and how important it is to disinfect water before drinking it. POUZN also trained and engaged grassroots organizations to promote improved diarrhea treatment to the Rural Medical Practitioners, who are the community’s first recourse for advice and treatment when a child is sick.
Contributed by Point of Use Water Disinfection and Zinc Treatment
2008: The International Year of Sanitation
On March 24, 2008, World Water Day, UMCOR Indonesia kicked off the “International Year of Sanitation,” as declared by the United Nations. At the event, UMCOR recognized local students who demonstrated leadership on sanitation issues and broke ground for a new water and sanitation facility. This facility will serve 21 schools in the Bireuen District—a tsunami-affected community in Aceh Province—and provide improved access to sanitation for nearly 5,000 children. The new facilities will include latrines and handwashing sinks that will be connected to the local water supply or newly-dug wells. The project is funded by both UMCOR and UNICEF.
“UMCOR has greatly improved my school’s sanitation and hygiene,” said one school principal. “I hope UMCOR can expand [these] programs to other needy schools.”
Contributed by the United Methodist Committee on Relief
Clean water and renewed hope in Indonesia
The United Methodist Committee on Relief (UMCOR) has helped nearly 20,000 people over the last three years to have better access to clean water and sanitation . In the next three years, UMCOR anticipates helping 75,000 more with this basic need.
Nusret Osmanspahic, UMCOR Indonesia’s former head of mission, emphasizes the importance of these programs, saying, “80 million Indonesians live without proper sanitation facilities, which contributes to the diarrhea-related deaths of over 100,000 Indonesian children each year.”
UMCOR’s past water and sanitation projects included rehabilitating two water treatment plants, providing water access for two UMCOR-constructed schools and installing septic tanks and water connections to nearly 550 UMCOR-constructed or repaired homes.
Contributed by United Methodist Committee on Relief
Ceramic water filter success
One year later, Cyclone Nargis raged on–but in a good way. Thirst-Aid edirected one of the most successful Ceramic Water Filter (CWF) interventions in the world. Currently, Myanmar has the greatest CWF production capacity in the world, with eight private CWF producers who directly employ over 143 people. In the year following Cyclone Nargis, these suppliers worked with NGOs to produce, sell, and distribute over 90,000 CWFs, providing a population of nearly half a million with a sustainable source of safe water and hence improved health.
The Thirst-Aid staff also trained over 300 Community Health Educators on how to use Thirst-Aid's educational materials to train villagers on CWF use and good hygiene practices. Education first ensures that recipients receive comprehensive instruction that encourages sustained use of safe water technology and better health habits. Thirst-Aid’s template of changing the currency to education has granted the poor a means to purchase safe water technology, giving them a means to buy in. Thirst-Aid presented on the success of education as currency at the WHO Household Water Treatment conference in Dublin in September 2009. Thirst-Aid is proud that its pre-education and quality assurance programs are encouraging CWF recipients to sustain use. In future years, they hope to do even better.
Contributed by Thirst-Aid
After the quake, restoring a community's water supply
Before the devastating 2005 earthquake, the six villages of Pateka in northwest Pakistan enjoyed a stream that provided an abundance of clean and fresh water. But with movement of the earth's plates, the stream dried up and the village suffered from a water scarcity. Working with the local community and the Diocese of Peshawar, Episcopal Relief & Development located and improved a small natural reservoir, allowing water to be pumped to Pateka Chak, where two concrete water reservoirs were constructed. Now, the reservoirs provide clean water for more than 2,000 people in the six villages. Episcopal Relief & Development continues to work in these villages on long-term projects to rebuild the infrastructure and find solutions for a stable water supply.
Contributed by Episcopal Relief & Development
Strengthening national planning and re-prioritizing diarrheal disease
At the National Pediatric Hospital in Hanoi, Vietnam, one in ten pediatric inpatients are admitted due to complications from diarrhea—and sometimes this number is even higher. Ten times as many are treated as outpatients, making diarrheal disease and the severe dehydration that comes with it among the hospital’s top two pediatric concerns (the other is pneumonia).
Through the early and mid-2000s, awareness of the threat posed by diarrheal disease and the simple solutions to prevent and treat it stood stagnant. Clinical progress was stymied by outdated guidelines for physicians and nurses that hadn’t been updated in more than a decade.
Through our existing relationships with health officials in Vietnam and bringing to bear our in-country presence and partnerships, PATH recognized an opportunity to develop a strategy that bridged policy with community health delivery. A multi-faceted effort catalyzed immediate impact and ensured sustainability by bringing the national guidelines up to date, training and equipping health workers, and raising community awareness nationwide. A model project put it all into practice, while gathering lessons learned that would inform national rollout and, ultimately, expansion of enhanced diarrheal disease efforts throughout the Mekong region.
Contributed by PATH
Update: After a two year effort, zinc is now officially listed as an essential drug by the Ministry of Health in Vietnam, meaning that zinc must be provided for free to children under 5 by both the public sector and private insurance companies. Learn more about the process from our blog, "Zinc in Vietnam: from policy to practice."
Better sanitation and health through education
Implementing activities in schools has always been essential to EAST Vietnam’s commitment for people living in difficult socio-sanitary conditions. Since its establishment in Vietnam in 1994, EAST has implemented five several-year school programs in four Vietnamese provinces. These programs benefit pupils from 165 primary and secondary schools. Every school program implemented aims at improving sanitary conditions in schools, in order to lower water-related diseases among children.
To achieve this objective, EAST Vietnam implements several complementary activities. First, they provide schools with water supply and sanitation systems by improving drinking water systems, building latrines with septic tanks, and setting up cement pits for solid waste.
Moreover, they train school teachers on a new and participative health education method. Based on the use of drawings and active participation of pupils, this method teaches students about safe water, hygiene, and health to children. Conceptual lessons are completed by practical exercises, so that children can adopt best hygiene practices, such as handwashing with soap.
Finally, in order to reinforce the supervision of children’s health within the school, an infirmary equipped with basic medicines and small equipment is implemented or rehabilitated in each school. School health agents are trained on basic interventions and medicines stock control. They have the responsibility of renewing the stock of medicines when needed, and they are able to provide children with basic medical care in case of simple diseases or incidents. In case of more complicated troubles, they bring children to the communal dispensary.
Contributed by EAST Vietnam
Dhaka's Challenge: A Megacity Struggles with Water, Sanitation and Hygiene
In 2010, the Pulitzer Center of Crisis Reporting launched Dhaka’s Challenge: A Megacity Struggles with Water, Sanitation and Hygiene, a project spearheaded bythe Executive Director of the Pulitzer Center Jon Sawyer and Emmy Award Winner Stephen Sapienza.
Bangladesh is considered the world’s most densely populated country with 2,639 people per square mile. And its capital, Dhaka, is expected to add five million people in the next ten years, straining already inadequate infrastructure.
As this megalopolis grows, clean water supplies and effective sewage removal will be critical to the health and success of Dhaka. Today, some 4 million squatters who live in slums do not have legal access to basic services, such as safe water and toilets. Almost two-thirds of the Dhaka’s sewage is untreated and left to seep into waterways and the ground. The results of life in these filthy and sub-human environs are not surprising: each year thousands upon thousands of people in Bangladesh, including 50,000 children, die of cholera, diarrhea, dysentery, typhoid, and other waterborne diseases.
This reporting project looked at the water, sanitation and hygiene problems that Dhaka is facing today, as well as the people and grassroots projects who are pioneering simple, effective life-saving solutions to the mounting sanitation and hygiene challenges of this mushrooming megacity.
Read dispatches from Bangladesh on the Pulitzer Center’s website, and subscribe to the RSS feed to receive the latest articles, multimedia and blog posts from this project.
Contributed by the Pulitzer Center on Crisis Reporting
Asian studies show potential of vaccine against deadly diarrhea
Because oral vaccines often perform differently in varying settings, the World Health Organization (WHO) called for specific studies on the use of new rotavirus vaccines in the developing world, particularly among impoverished populations of Africa and Asia. Rotavirus is the most common cause of severe diarrhea among children and claims more than 500,000 young lives each year.
The GAVI Alliance, the public health community, and vaccine manufacturers made an unprecedented commitment to understand how these vaccines would work in developing-world conditions. Initiated in 2006, clinical trials conducted by PATH, the US CDC, WHO, and manufacturers evaluated the safety and efficacy of RotaTeq® (Merck Sharp & Dohme Corp.) in Bangladesh and Vietnam. The populations studied represented low-income, high-mortality settings in which diarrheal disease is a major cause of child deaths. (Rotavirus vaccines were also evaluated in several African countries.)
Data from the studies revealed that rotavirus vaccines had a significant impact toward reducing severe rotavirus episodes, and illustrate the potential of rotavirus vaccines to have a dramatic impact on child mortality in the developing world.
Contributed by PATH
I've been traveling the past three weeks in Bangladesh and West Bengal visiting water, sanitation and hygiene (WASH) organizations and their field programs.
I've covered a fair amount of ground and have seen the work of international as well as local NGOs.
Check out new blogs posted today by our partners at the Bill & Melinda Gates Foundation and the ONE Campaign.
New blogs posted today by our partners at the Bill & Melinda Gates Foundation and the ONE Campaign offer insight on the dramatic difference that rotavirus vaccines can make.
With the devastating flooding in Pakistan, health and aid officials are once again sounding the global alarm to prevent outbreaks of diarrhea.
WHO projects that up to 1.5 million cases of diarrheal diseases could occur in Pakistan over the next three months.
This same problem emerged quickly following the Haiti earthquake in January of this year, and appears every time cyclones, flooding, or earthquakes decimate a community. These crisis outbreaks of diarrhea tend to get attention, but what about the common tragedy of children dying from diarrhea every day?
This week, PATH is co-hosting a symposium – along with the Vietnamese Ministry of Health and Vietnam’s National Pediatric Hospital – on the importance of taking an integrated approach to defeating diarrheal disease.
The gathering will bring together health professionals from around the Mekong Delta region.
In July, zinc for the treatment of diarrhea was officially listed as an essential drug by the Ministry of Health in Vietnam. This capped a two year effort of policy consultations, evidence review and advocacy. As a result of this listing, by law, zinc must now be made available free of charge to children under five through both the public sector and the private insurance systems. This should tremendously increase the coverage and availability of this critical intervention.
Rivann and I are on way to Baray Health Center in Kampong Thom province to observe and speak with health center staff and Village Health Support Group (VHSG) members. We’ll learn from them the effects of childhood pneumonia and diarrheal disease in their villages and how integrated training on the two biggest killers of children is crucial in improving the health of their communities. VHSG are volunteer village health workers in Cambodia who educate community members on pertinent health issues and also refer patients to seek proper care at health centers or hospitals.
A young inpatient recovers from severe diarrhea, a bandage on his small hand the remnant of emergency IV rehydration.
By the second open-air hospital, I knew better than to look for water fountains. The sealed plastic bottles conspicuously tucked into each cup-holder in our Ministry-provided, four-wheel-driven convoy were a pretty strong hint, too. Where we were headed, running water was a luxury. This was not my norm. I was a stranger here, warmly welcomed but still alien.
It was just a conference room in Delhi, not the Taj Mahal by any means. No lapis lazuli or other luxuries. (Although many would consider the flush toilets, hot water, and soap in the bathrooms down the hall as luxuries).
Author: World Bank
Published: December 2010
Link to PDF
Asia
Southeast Asia is among the regions hardest hit by childhood diarrheal disease. Every year, nearly 335,000 children lose their lives to the severe dehydration caused by diarrhea.1 Sanitation and malnutrition remain major issues, as does access to lifesaving care in rural communities.