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The control of
waterborne diseases requires a safe water source of a high quality
and with enough water for the practice of general water
hygiene, which will ensure that the
water stays safe.
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The control of
water-washed diseases depends on easy access to large quantities of
water and the motivation to use more water for
personal hygiene, whereas the
quality of the water used is less important.
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The control of
vector-related water-borne diseases depends on improved
environmental hygiene and decreased exposure
to the vector.
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The control of
water-based diseases depends on elimination of contact with the
infected water source.
The availability of
water is essential for water hygiene and
naturally, an easy accessible water source facilitates the practice. But to
ensure that water hygiene is practiced daily the
water source must be reliable both in quantity and quality through out the
year. Problems of poor water quality or low quantity discourage improved
hygienic behaviors. E.g., in areas with corrosion problems
community members often prefer to use the
traditional water sources, as the brownish-yellow colour and the taste of
the improved water source are less attractive. An improved water source can
be contaminated if poorly maintained. The motivation of the
community to maintain and protect their water
source is, therefore, of critical importance to ensure a sustainable
reduction in not only water borne diseases, but also to prevent an increase
in the incidence of water-related vector-borne diseases, due to breeding of
mosquitoes in stagnant water around the water source. As all water-borne and
faecal-disposal-related diseases, as well as some water-based diseases,
depend on infecting agents from human excreta, the provision and hygienic
use of adequate sanitation are crucial for their control. Finally proper
refuse disposal is important for the control of some faecal-oral and
vector-related water-borne diseases, as it prevents the breeding of insects.
Planning and
implementation of hygiene education: The
Community outreach by district staff is the
essence of hygiene education, as an effective
interaction with community leaders and members
is important to ensure community participation
for hygiene education. To facilitate the
development of a functional, sustainable system for planing, management and
evaluation of a hygiene programme at community
level, there is a need to strengthen the capacity of the district personnel
trained in environmental health and community
development. They should be trained in teaching methodologies (how to design
and deliver messages) and learn to plan, manage and evaluate
hygiene education as an integrated part of
comprehensive Primary Health Care. Supervision and follow-up enhance
motivation and quality at all levels. Here, intra-and inter-sectoral
coordination is important to ensure cost-effective management and avoid
duplication of efforts.
Water-borne
diseases transmitted by water. Water is a passive transporter for the
infective agent, e.g., diarrhoea, dysentery, typhoid, giardiasis, cholera.
Water-washed diseases due to lack of water or insufficient use of water for
personal or domestic
hygiene, e.g., trachoma. Water-related
vector-borne diseases transmitted by insects breeding or biting in relation
to water, e.g., malaria, onchocerciasis. Water-based diseases caused by
infecting agents spread by contact with or ingestion of water. An essential
part of the life cycle of the infecting agent takes place in an aquatic
animal, e.g., schistosomiasis and Guinea worm. Faecal-disposal-related
diseases transmitted due to faecal contamination of soil. Human infection is
either through direct penetration of the intact human skin (e.g., hookworms)
or through ingestion, either with an intermediate host (e.g., tapeworm) or
without (e.g., roundworm).
When educating at the
community level, the messages should be as
simple as possible, ocally adapted and with the use of appropriate methods
of adult learning. It is the aim of hygiene
education that the community should understand
how human behavior and environmental factors influence health. Through
increased knowledge and awareness the community
should be motivated to; take better care of their water source and
practice better water
hygiene when collecting and storing water, use
more water for hygienic purposes, avoid traditional water sources, enhance
the hygienic use of sanitation facilities, dispose refuse and waste water
properly and improve housing. Hygiene education
will, if successful, improve the personal and
environmental hygiene within the entire
community. Hygiene
education should aim to actively involve the entire
community, but it is important to identify target groups and develop
specific plans of action, on how to reach them. An important target group is
women , as they play a significant role in rural family life and have a
prominent role in improving the hygiene within
the family. Children, as the future generation, caretakers of younger
siblings and water collectors, are an other important target group. Children
can be reached through their daily caretakers and, if in school, school
teachers.
School
teachers should be trained to promote hygiene
education, particularly in primary schools. Further to reinforce the
practice of better hygienic behaviors, all schools should have, and
encourage the use off hygienic latrines with hand-washing facilities close
by. Drinking water should be safely stored and refuse properly disposed.
Finally hygiene education should also be an
integrated part of the training of all personnel involved in the water and
sanitation programme; the extension worker, the drilling crew, the pump
mechanic, the caretaker and the driver. They all have a unique chance to
teach hygiene
education when in the communities.
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