Global

 

Safe drinking water for children

 
PUR Purifier of Water, developed by Proctor & Gamble (P&G) in collaboration with the US Centers for Disease Control and Prevention (CDC), is a powdered product that turns contaminated drinking water into purified water that meets World Health Organization standards for potable water and Environmental Protection Agency (EPA) standards for a water purifier. PUR uses the same ingredients used in municipal water treatment in a 4 g packet. The coagulant and flocculants in PUR removes dirt, greater than 98 percent of arsenic, and more than 99.9 percent of parasites like Giardia and Cryptosporidium. The chlorine disinfectant in PUR kills greater than 99.9999 percent of the bacteria and more than 99.99 percent of the viruses that cause cholera, typhoid fever, and dysentery. Results of five randomized controlled health intervention trials, conducted by the Center for Disease Control (CDC) and Johns Hopkins University, show that PUR reduces diarrheal illness by an average of 50 percent, with up to 90 percent reduction among particularly vulnerable people.
 
In 2004, P&G created the not-for-profit Children’s Safe Drinking Water Program and has committed to provide three billion liters of water from 2007 to 2012.To date, more than 1.5 billion liters of purified water have been provided in more than 50 countries during emergencies and for sustained efforts focused in Africa. This effort has focused on helping people during emergencies, reaching mothers at health clinics, providing safe drinking water to people living with HIV/AIDS, educating school children as positive catalysts for community change, and providing of safe drinking water to malnourished children. 
 
Community Driven Water, Sanitation, and Hygiene program
 
 
Nature Healing Nature’s Community Driven Water, Sanitation, and Hygiene program, (CDWSH), a 501(c)(3) nonprofit, was created as a dynamic solution to eliminate water related illness on earth. 
 
Nature Healing Nature begins by working on logistics with local nongovernmental organizations (NGOs) already in the area. They then visit the remote villages and city slums, talking briefly with the leadership to get permission to come back for a meeting with the community as a whole.  Taking at least 20 local NGO staff with them to train and certify as CDWSH teachers, they discuss their problems and their dreams for their community.
 
Invariably they say they do not want to be sick with diarrhea or stomach worms.  Typically 40 percent to 60 percent of the people admit they have runny diarrhea that day. As discussions move forward, they become curious, motivated, and inspired to do something about it-right now.  It is a beautifully powerful moment when they demand, “So what can we do?” 
 
Only now does Nature Healing Nature talk with them about pragmatic solutions, empowering the villagers to resolve their water-related illness using materials and skills they already have on hand:
 
  • Clean their water using sunlight and a clear bottle, a homemade biological sand filter, or by simply storing the water for a while.
  • Make latrines out of what is on hand; then use ashes and dirt to control flies and odor. 
  • Safely use the latrine-collected feces and urine as fertilizer to increase crop yield.
  • Make homemade rehydration solution for their sick children and themselves out of water, sugar, and salt.
  • Use ashes or homemade soap with micro amounts of water to inhibit the spread of disease.

Utilizing new vaccine momentum and community engagement to strengthen pneumonia and diarrhea control

UNICEF

Today, pneumonia and diarrhoea remain the leading child-killers, especially in disadvantaged communities with limited access to sanitation, clean water, good nutrition and health services.

Newly available vaccines against pneumococcus and rotavirus, the leading causes of pneumonia and diarrhoea, offer new hope in saving children’s lives. However, as the new vaccines will not protect children against all causes of pneumonia and diarrhoea, the combination of immunization with other interventions including intensified nutrition, hygiene and sanitation is what will maximize their impact.

Communication is key to ensure that individuals and communities will not only rely on immunization to protect children against pneumonia and diarrhoea, but that they also engage in the desired healthy practices that have been shown to offer essential protection to a child’s health such as timely attendance at routine immunization sessions, early and exclusive breast-feeding, hand-washing with soap, provision of appropriate home-care, and prompt care-seeking in response to ‘danger-signs’.

In partnership, UNICEF is developing a new framework, based on programme goals for pneumonia and diarrhoea control, to guide countries in developing technically coherent communication strategies that support caregivers, communities, and healthcare personnel to adopt appropriate healthy actions while facilitating coordination across programmes and strengthening communication capacity. The framework is supported by an ongoing partnership of communication and programme experts representing leading NGOs, bilateral and multilateral institutions, public health partnerships, UNICEF and WHO. The framework will be tested in-country and developed to include key practices and lessons learned. 

 

For more information, see "Consultation on Communication for Pneumonia and Diarrhoea Control and New Vaccine Introduction" (available on the UNICEF website)

Get re-acquainted with tensteps.org  

The Mother and Child Health and Education Trust takes great pleasure in presenting the new website Ten Steps to Successful Breastfeeding and the new 10 step video series, in association with UNICEF Maharashtra, to support the 2010 World Breastfeeding Week campaign.

Research shows that the best feeding option globally is initiation of breastfeeding within the first half-hour of life, exclusive breastfeeding for a full six months, safe, age-appropriate and adequate complementary foods from six months, and continued breastfeeding through the second year or beyond. Breastfeeding improves short- and long-term maternal health; and can contribute to the attainment of the Millennium Development Goals (MDGs) 4: Reduce Child Mortality and 5: Improve Maternal Health (www.un.org/milleniumgoals).

The Baby-Friendly Hospital Initiative (BFHI), launched in 1991, is an effort by UNICEF and the World Health Organization to ensure that all maternity facilities, whether free-standing or in a hospital, become centres of breastfeeding support. A maternity facility can be designated “baby-friendly” when it does not accept free or low-cost breastmilk substitutes, feeding bottles or teats, and has implemented 10 specific steps to support successful breastfeeding. The process is currently controlled by national breastfeeding authorities, using global criteria that can be applied to maternity care in every country.

In an effort to revitalise and expand the initiative, the 2010 World Breastfeeding Week (WBW) highlighted Ten Steps to Successful Breastfeeding. The WBW is the greatest outreach vehicle for the breastfeeding movement, being celebrated in more than 170 countries worldwide. It promotes, protects and supports breastfeeding. For more information on the theme for this year’s event, exciting activities, and materials for download, please visit the WBW website.

Action at community level is particularly important, since globally only 56% of women deliver their babies in a health facility (only 33% in the least developed countries), and they may be discharged within a day or two. Women need ongoing support in the community whether they deliver in hospital or at home.

The full video series is available for viewing and download at http://tensteps.org.

Submitted by The Mother and Child Health and Education Trust

Using new vaccine momentum and community engagement to strengthen pneumonia and diarrhea control

Today, pneumonia and diarrhea remain the leading child killers, especially in disadvantaged communities with limited access to sanitation, clean water, good nutrition, and health services.Newly available vaccines against pneumococcus and rotavirus, the leading causes of pneumonia and diarrhea, offer new hope in saving children’s lives. However, as the new vaccines will not protect children against all causes of pneumonia and diarrhea, the combination of immunization with other interventions including intensified nutrition, hygiene, and sanitation will maximize their impact.

Communication is key to ensure that individuals and communities will not only rely on immunization to protect children against pneumonia and diarrhea, but that they also engage in the desired healthy practices that have been shown to offer essential protection to a child’s health, such as timely attendance at routine immunization sessions, early and exclusive breastfeeding, handwashing with soap, provision of appropriate home care, and prompt care-seeking in response to “danger signs.”

In partnership, UNICEF is developing a new framework, based on national program goals for pneumonia and diarrhea control, to guide countries in developing technically coherent communication strategies that support caregivers, communities, and healthcare personnel to adopt appropriate healthy actions while facilitating coordination across programs and strengthening communication capacity. The framework is supported by an ongoing partnership of communication and program experts representing leading NGOs, bilateral and multilateral institutions, public health partnerships, UNICEF, and WHO. The framework will be tested in-country and developed to include key practices and lessons learned. 

For more information, see "Consultation on Communication for Pneumonia and Diarrhoea Control and New Vaccine Introduction" (available on the UNICEF website).

Water, sanitation, and hygiene

Mobile technology for water interventions

Community-driven water, sanitation, and hygiene

Nature Healing Nature’s Community Driven Water, Sanitation, and Hygiene program, (CDWSH), a 501(c)(3) nonprofit, was created as a dynamic solution to eliminate water-related illness on earth. 

Nature Healing Nature begins by working on logistics with local nongovernmental organizations (NGOs) already in the area. They then visit the remote villages and city slums, talking briefly with the leadership to get permission to come back for a meeting with the community as a whole.  Taking at least 20 local NGO staff with them to train and certify as CDWSH teachers, they discuss their problems and their dreams for their community.

Invariably community members say they do not want to be sick with diarrhea or stomach worms.  Typically, 40 percent to 60 percent of the people admit they have runny diarrhea that day. As discussions move forward, they become curious, motivated, and inspired to do something about it—right now.  It is a beautifully powerful moment when they demand, “So what can we do?” 

Only now does Nature Healing Nature talk with them about pragmatic solutions, empowering the villagers to resolve their water-related illness using materials and skills they already have on hand:

- Clean their water using sunlight and a clear bottle, a homemade biological sand filter, or by simply storing the water for a while.

- Make latrines out of what is on hand; then use ashes and dirt to control flies and odor. 

- Safely use the latrine-collected feces and urine as fertilizer to increase crop yield.

- Make homemade rehydration solution for their sick children and themselves out of water, sugar, and salt.

- Use ashes or homemade soap with micro amounts of water to inhibit the spread of disease.

Contributed by Nature Healing Nature

 

The Power of FLOW

Water For People recently made international headlines when it launched a Droid mobile phone application to monitor the long-term sustainability of water and sanitation facilities—cutely named FLOW, for field level operations watch.

Water For People has come a long way in the past few years, refining its monitoring process to take advantage of new technology. FLOW allows researchers to collect data and seamlessly transmit to a publicly-viewed website—integrating the GPS, camera, and data collection tools within a one little cell phone. It’s a far cry from the days of lugging around Trimbles (GPS devices), cameras, copious paper copies of surveys, and body incubation of water quality samples!

But what is neater than the technological advancements is what the technology has allowed Water for People to do. The “check-up” of water and sanitation systems is not simply an evaluation— the benefits extend to impact on women’s lives and fewer cases of diarrhea among their children. But with hard data, Water for People can speak to the sustainability of investments over time; modify programs that aren’t providing long-lasting solutions; and conduct more in-depth evaluations that are informed from the data collected with FLOW.

FLOW allows quantitative documentation of the sustainability of efforts over several years.  With sanitation programs, for example, sustainability basically means that toilets are being used and hygienically maintained. Data gathered through FLOW during the most recent India monitoring of communities working with Water for People showed that 91% of toilets were being used and hygienically maintained. These toilets were all purchased by households with micro-loans from local institutions, and more research is currently underway on the effectiveness of the loan mechanism. But a 91% success rate is something to be celebrated in a sector where failure rates are often unknown because of lack of sustainable monitoring.

Take the case of sanitation in Malawi. A few years ago, Water for People’s  monitoring team visited 482 toilets, powered by volunteers assisting with FLOW (now that’s an interesting way to spend your vacation).  Monitors reviewed sanitation use (measured by evidence of use confirmed with observation and input from users on which family members use the unit) and sanitation hygiene (measured by the presence or absence of urine, feces, and flies. FLOW data from Malawi showed that nearly all of the units were still being used, but the largest category of non-users was children. This piece of knowledge allowed Water For People to modify its programming, which now includes a simple child-sized and child-friendly slab that creates a barrier to keep the kids’ poop from the kids’ environment, yet is not dark, scary, or otherwise inappropriate. 

In eastern Bolivia, FLOW allowed Water for People to identify issues that might need further exploration through an evaluation, plus local successes to be celebrated. Monitors discovered that owners of some eco-bathroom facilities were not using enough dry material—or not using it at all—and their toilets were prone to odors and the presence of flies, thus being qualified as ‘red’ or poorly managed with weak sustainability.  FLOW also recorded that most people were not aware of the potential uses of composted feces and urine and/or  where to go for assistance when their units were full. The majority of people interviewed were not using either the liquid fertilizer produced by fermented urine or the solid fertilizer produced by the composted dry wastes, and several emptied the vaults after only 4-6 months, when it is highly doubtful enough time had passed to convert the compost into a safe, manageable substance.

Those  interviewed expressed positive feelings about having improved their sanitation facilities from an unimproved, flood-prone pit latrine to a more secure ecological toilet. It should not be discounted that over 50% of the units were being hygienically used, equating to approximately 1,000 people safely and appropriately using their sanitation facilities in a sustained manner.

At its foundation, FLOW is a tool, and the power of most tools, no matter what their purpose, is what it allows one to do. Water for People can now rapidly evaluate programs, identify gaps, and refine strategies. Visit their website for more information on FLOW and the data referenced here. 

Contributed by Water for People

The Power of FLOW
Water For People

 

Water For People recently made international headlines when it launched a Droid mobile phone application to monitor the long-term sustainability of water and sanitation facilities —cutely named FLOW, forfield level operations watch.

Water For People has come a long way in the past few years, refining its monitoring process along the way to one that takes advantage of the newest technology, allowing researchers to collect data and seamlessly transmit to a publicly-viewed website—integrating the GPS, camera, and data collection tools within a one little cell phone. It’s a far cry from the days of lugging around Trimbles(GPS devices), cameras, copious paper copies of surveys, and body incubation of water quality samples!

But what is neater than the technological advancements is what the technology has allowed Water for People to do. The “check-up” of water and sanitation systems is not simply an evaluation— the benefits extend to impact on women’s lives and fewer cases of diarrhea among their children. But with hard data, Water for People can 1) speak to the sustainability of investments over time; 2) modify programs that aren’t providing long-lasting solutions; and 3) conduct more in-depth evaluations that are informed from the data collected with FLOW.

FLOW puts Water For People’s money where its mouth is and allows quantitative documentation of the sustainability of its efforts for years to come.  With sanitation programs, for example, sustainability basically means that toilets are being used and hygienically maintained. Data gathered through FLOW during the most recent India monitoring of communities working with Water for People showed that 91% of toilets were being used and hygienically maintained. These toilets were all purchased by households with micro-loans from local institutions, and more research is currently underway on the effectiveness of the loan mechanism. But a 91% success rate is something to be celebrated in a sector where failures are often unknown because of lack of sustainable monitoring.

Take the case of sanitation in Malawi. A few years ago, Water for People’s  monitoring team visited 482 toilets, powered by volunteers assisting with FLOW (now that’s an interesting way to spend your vacation).  Monitors reviewed sanitation use (measured by evidence of use confirmed with observation, and questioning users on which family members use the unit) and sanitation hygiene (measured by the presence or absence of urine and feces in the toilet, and the presence or absence of flies). FLOW data from Malawi showed that nearly all of the units were still being used, but the largest category of non-users was children. This piece of knowledge allowed Water For People to modify its programming, which now includes a simple child-sized and child-friendly slab that creates a barrier to keep the kids’ poop from the kids’ environment, yet is not dark, scary, or otherwise inappropriate for a kid to use. 

In eastern Bolivia, FLOW allowed Water for People to identify issues that might need further exploration through an evaluation, plus local successes to be celebrated. Monitors discovered that owners of some eco-bathroom facilities were not using enough dry material—or not using it at all—and their toilets were prone to odors and the presence of flies, thus being qualified as ‘red’ or poorly managed and weak sustainability.  FLOW also recorded that most people were not aware of 1) the potential uses of composted feces and urine; and/or 2) where to go for assistance when their units were full. The majority of people interviewed were not using either the liquid fertilizer produced by fermented urine or the solid fertilizer produced by the composted dry wastes and several emptied the vaults after only 4-6 months, when it is highly doubtful enough time had passed to convert the compost into a safe, manageable substance.

Those  interviewed expressed positive feelings about having improved their sanitation facilities from an unimproved, flood-prone pit latrine to a more secure ecological toilet. It should not be discounted that over 50% of the units were being hygienically used, equating to approximately 1000 people safely and appropriately using their sanitation facilities in a sustained manner.

At its foundation, FLOW is a tool, and the power of most tools, no matter what their purpose, is what it allows one to do.  Water for People can now rapidly evaluate programs, identify gaps, and refine strategies. Visit their website for more information on the data referenced here. 

[Page] Why Defeat DD?

Each day, diarrhea kills more than 1,500 children under five. 90% of these child deaths happen in poor countries of Asia and Africa, where safe water, sanitation, and access to urgent medical care are limited.1 But this crisis can be solved: Diarrheal disease is preventable and treatable.

[Page] The Diarrhea Crisis

Diarrheal disease is the most common illness among children in the developing world and can lead to dehydration and death. In 2012, 600,000 children under five years old died as a result of severe diarrhea.1

1 UNICEF. Committing to Child Survival: A Promise Renewed. 2013 Progress Report. New York: UNICEF; 2013.

UNICEF. Committing to Child Survival: A Promise Renewed. 2013 Progress Report. New York: UNICEF; 2013. - See more at: http://defeatdd.org/understanding-crisis/diarrheal-disease#sthash.2bFWdZmG.dpuf

[Page] Multimedia

Diarrhea is a global crisis with proven solutions, but it’s rarely front page news. If we can’t talk about it, we can’t defeat it!

 

[Topic Page] Oral Rehydration Therapy

Oral rehydration therapy (ORT) treats dehydration caused by severe diarrhea through the replacement of lost fluids.

oral rehydration for childhood diarrhea

Elements of ORT include oral rehydration solution (ORS), breast milk, soups, cereals, and rice water mixed with salt.

ORS is the cornerstone of diarrhea treatment in low-resource settings. Sugar, water, salt – This simple mixture has saved millions of lives and costs just pennies. Easy to prepare and administer in the home, ORS empowers parents with the first line of treatment for children suffering from diarrhea. If all parents could access and use ORS, diarrhea deaths would drop by a staggering 93%!1

An improved ORS formula with lower sodium and glucose makes it more efficacious than ever. This low-osmolarity ORS lowers stool output, reduces vomiting, and minimizes the need for expensive emergency IV therapy.1  The World Health Organization and UNICEF recommend low-osmolarity ORS and zinc as essential to clinical treatment of acute diarrhea.2

At ORT corners in rural clinics in Africa and Asia, nurses combine treatment with education, giving mothers immediate access to ORS and clean water while teaching them about hygiene, breastfeeding, and nutrition. We had the opportunity to visit ORT corners in Kenya and Zambia to see the vital role they play in a comprehensive strategy to defeat diarrhea.

We are also working to improve the current formulation of oral rehydration solution—a proven defense against diarrhea—so that it also promotes fluid and electrolyte absorption, reducing diarrheal symptoms and motivating caregivers to use this lifesaving treatment. Though ORS is a simple, inexpensive, and highly effective means to prevent deadly dehydration, less than half of children with diarrheal disease receive it. This is partly because it does not treat the diarrhea itself, so its effect is not easily seen by caregivers. By adding a diarrheal treatment element to ORS that reduces fluid loss and treats dehydration, we hope that a new formulation will motivate caregivers to see an improved ORS as crucial treatment for their child’s diarrhea. - See more at: http://www.defeatdd.org/understanding-crisis/prevention-treatment/drug-development#.dpuf

PATH has worked in Kenya, Malawi, Cambodia, and Vietnam to implement an integrated approach to diarrheal disease control that incorporates new technologies with proven interventions like ORS and ORT corners. We are also helping national governments set policies that will remove the threat of diarrhea for future generations.

We are also working to improve the current formulation of oral rehydration solution—a proven defense against diarrhea—so that it also promotes fluid and electrolyte absorption, reducing diarrheal symptoms and motivating caregivers to use this lifesaving treatment. Though ORS is a simple, inexpensive, and highly effective means to prevent deadly dehydration, less than half of children with diarrheal disease receive it. This is partly because it does not treat the diarrhea itself, so its effect is not easily seen by caregivers. By adding a diarrheal treatment element to ORS that reduces fluid loss and treats dehydration, we hope that a new formulation will motivate caregivers to see an improved ORS as crucial treatment for their child’s diarrhea.

We are also working to improve the current formulation of oral rehydration solution—a proven defense against diarrhea—so that it also promotes fluid and electrolyte absorption, reducing diarrheal symptoms and motivating caregivers to use this lifesaving treatment. Though ORS is a simple, inexpensive, and highly effective means to prevent deadly dehydration, less than half of children with diarrheal disease receive it. This is partly because it does not treat the diarrhea itself, so its effect is not easily seen by caregivers. By adding a diarrheal treatment element to ORS that reduces fluid loss and treats dehydration, we hope that a new formulation will motivate caregivers to see an improved ORS as crucial treatment for their child’s diarrhea. - See more at: http://www.defeatdd.org/understanding-crisis/prevention-treatment/drug-development#.dpuf
We are also working to improve the current formulation of oral rehydration solution—a proven defense against diarrhea—so that it also promotes fluid and electrolyte absorption, reducing diarrheal symptoms and motivating caregivers to use this lifesaving treatment. Though ORS is a simple, inexpensive, and highly effective means to prevent deadly dehydration, less than half of children with diarrheal disease receive it. This is partly because it does not treat the diarrhea itself, so its effect is not easily seen by caregivers. By adding a diarrheal treatment element to ORS that reduces fluid loss and treats dehydration, we hope that a new formulation will motivate caregivers to see an improved ORS as crucial treatment for their child’s diarrhea. - See more at: http://www.defeatdd.org/understanding-crisis/prevention-treatment/drug-development#.dpuf
We are also working to improve the current formulation of oral rehydration solution—a proven defense against diarrhea—so that it also promotes fluid and electrolyte absorption, reducing diarrheal symptoms and motivating caregivers to use this lifesaving treatment. Though ORS is a simple, inexpensive, and highly effective means to prevent deadly dehydration, less than half of children with diarrheal disease receive it. This is partly because it does not treat the diarrhea itself, so its effect is not easily seen by caregivers. By adding a diarrheal treatment element to ORS that reduces fluid loss and treats dehydration, we hope that a new formulation will motivate caregivers to see an improved ORS as crucial treatment for their child’s diarrhea. - See more at: http://www.defeatdd.org/understanding-crisis/prevention-treatment/drug-development#sthash.oyrqQp84.dpuf

Resources
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References

1 Munos MK, Fischer Walker CL, Black RE. The effect of oral rehydration and recommended home fluids on diarrhoea mortality. International Journal of Epidemiology. 2010;39(suppl1):i75-87.

2 WHO, Unicef. Clinical management of Acute Diarrhoeal Disease. New York: Unicef and WHO; 2004.

Photo: PATH/Tony Karumba

[Press release] Bottom billions miss out on life-saving aid

Wed, 04/21/2010

 

"Poor targeting of aid for sanitation and water is undermining all development efforts, leaving the poorest of the poor entrenched in poverty. The UN-Water Global Annual Assessment of Sanitation and Drinking Water (GLAAS), shows that just 42% of aid given to water and sanitation actually goes where it is needed - to low income countries."

Read the full press release here.

[Page] UN Assessment of Sanitation and Drinking Water

On April 21, 2010, the UN launched its Global Annual Assessment of Sanitation and Drinking Water (GLAAS), which analyzes the funding streams poured into these issues and illuminates some surprising statistics. The report shows that funding for water and sanitation has not only declined, but that the majority of donor investment is not reaching the low income countries where it is most needed.

 

[News & Event] Giving Children like Emon a Shot at Life

ONE, May 2010

Tachi Yamada, President of the Gates Foundation's Global Health Program, outlines how the Foundation will focus its resources on providing vaccines that will prevent children like Emon from dying of major childhood killers like rotavirus.

Read the full article.

[News & Event] Breast Milk is Best for Babies, Here's Why

EmaxHealth, May 2010

Scientists have long known about the benefits of exclusive breastfeeding for infants, but new research has taken our understanding one step further: “For the first time, we can see that breast milk induces genetic pathways that are quite different from those in formula-fed infants.” The genes showed that infants who were breastfed have a healthier intestinal tract, making breastfeeding all the more vital as a preventative measure for diarrheal disease.

[News & Event] Rotavirus vaccine keeps kids out of the hospital

Reuters, May 2010

A new government study shows that the number of children hospitalized for rotavirus infection dropped sharply after the U.S. introduced rotavirus vaccines in 2006.

Read the full article.

[Blog post] Improving health: Changing the global game

Baby looking up at a health care worker holding a vaccine

At the highest levels, the US Government is taking a close look at what brings the greatest return on its investment in foreign aid. 

We agree with the Global Health Technologies Coalition (GHTC) that the best investment is a health investment.

An alliance of more than two dozen non-profits, the GHTC is at its heart an educator, bringing evidence and expertise to US policymakers about the innovations that will change the face of health worldwide—innovations like new vaccines, microbicides, drugs, and diagnostics that will make their greatest impact in poor countries where health is a right, but not always a reality.