A Practical Facilitation Handbook CHAST – Children’s Hygiene … · 2017-05-08 ·...

_A Practical Facilitation Handbook CHAST – Children’s Hygiene and Sanitation Training

Prepared by Esther Lowe, Nairobi, 2012

Based on original CHAST country specific guide for Somaliland and Somalia by Michael Bockhorn-Vonderbank, Esther Lowe and Abdi Aden (2004) and successive CHAST country specific manual for Southern Sudan by Esther Lowe and Julie Nandawula (first edition, 2008) and Dickson Omosa and Vincent Oluoch (second edition, 2010).

© Caritas Switzerland/Caritas Luxembourg, 2012, Second revised edition

A total or partial use of these materials is permitted only upon written permission by Caritas Switzerland/Caritas Luxembourg, New Rehema House, Westlands, P.O. Box 14954-00800, Nairobi, Kenya, [email protected]

Cover photo: Tanzania, Christoph StulzPhotos: Annatina Jäckle, Andreas Schwaiger, Susanne Peters, Christof Stulz, Sabine SchildIllustrations: Caritas Switzerland/Caritas Luxembourg Design Concept: Caritas Switzerland, Layout: Grafikbar, Lucerne

Acknowledgements

ThisCHASTmanualisapracticalguidewithstep-by-stepinstructionsonhowtoimple-mentthehands-ontoolsdevelopedfortheChildren’s Hygiene and Sanitation Training

programme.TheCHASTmethodologywasdevelopedbyCaritasinSomalilandbetween2002and2003.Thedevelopmentofthemethodologyandfirsteditionmanual(2004)wassupportedbytheEuropeanUnionandtheGovernmentofLuxembourg.ThecurrentmanualisbasedontheoriginalSomaliCHASTmanual(2004)andtheadaptedversionthatisusedbytheCaritasprogrammeinSouthernSudan(firstedition2008,secondedition2010).

Afterthespecificcountryversions,CaritashasnowproducedageneralguidethatcanbeusedforsettingupandimplementingCHASTprogrammeselsewhereintheworld.Toolscaneasilybeadaptedtocontextualisethemethodologytothelocalsituationsinothercountries.

OurgratitudegoestoalltheCaritasstaffintheSouthSudanandSomalilandcountryofficesandtheliaisonofficeinNairobifortheirassistanceinandcontributionstothedevelopmentofthemethodandthemanual,sincethefirstinitiativesin2002.

Secondly,wewouldliketothankallCaritaspartnerorganisationsandotherstakeholderswhocontributedinonewayoranothertothesuccessofthisprocess.

Weencouragereplicationofthecontentofthismanual.However,wewouldliketobeinformedaboutanyfurtheruseofthematerialforexperiencesharing.

Thankyouall!

CaritasSwitzerland/Luxembourg

Nairobi,June2011

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Table of Contents

Part I: Introduction to CHAST 5

Introduction 6 Children’sHygieneandSanitationTraining 6 HowCHASTWorks 7 UsingtheCHASTGuide 8 HowtheGuideisOrganised 9 Toolkit 9

The CHAST Methodology 10 CHASTStepsforLowerPrimarySchool 10 CHASTTopicsforUpperPrimarySchool 12 SchoolHealthClubs 13

CHAST Tools 14

CHAST Facilitation 18 TheroleoftheFacilitator 18 MethodsofFacilitation 19 CourseDuration 20 PreparationofSessions 20 MonitoringandEvaluation 21

Part II: Step-by-step CHAST activities for lower primary school 23

Step 1: Introduction 24 Activity1.1:Introductionofparticipantsandcharacters 24 Activity1.2:Everydaystories 26 Activity1.3:Initialevaluation 28

Step 2: Problem Identification 30 Activity2.1:Goodandbadhygienepractices 30

Step 3: Problem Analysis 33 Activity3.1:Memorisinggoodandbadhygienepractices 33 Activity3.2:Howgermsarespread 36 Activity3.3:Germsarespreadbyflies 38 ScriptoftheFliesRole-Play 39

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Step 4: Practising Good Behaviour 41 Activity4.1:Blockingtheroutesofgerms 41 Activity4.2:Handwashingexercise 43 Activity4.3:Toothbrushingexercise 45 Activity4.4:Latrineuseexercise 47 Activity4.5:Facewashingexercise 48

Step 5: Measuring Change 49 Activity5.1:Finalevaluation 49 Activity5.2:Closingceremony 49

Part III: Step-by-step chast activities for upper primary school 51

Topic 1: Clean is Beautiful 52Topic 2: I Drink … Safe Water 54Topic 3: Going To the Latrine 57Topic 4: My Beautiful School 59Topic 5: Germ Free Food 61Topic 6: How to Prevent Diarrhoea 63

Part IV: School Health Clubs 65

Guidelines for School Health Clubs 66 Introduction 66 TheStructureofaSchoolHealthClub 66 RolesoftheSHCmembers 66 ObjectivesandActivitiesoftheSchoolHealthClub 68 AdvantagesofusingSchoolHealthClubforhygienepromotion 68

Part V: Preparing the Materials 69

Preparing the CHAST Materials 70Materials needed for Lower Primary School 71Materials needed for Upper Primary School 75

References 76

TableofContents3

Part I:Introduction to CHAST

Introduction

Children’s Hygiene and Sanitation Training

TheCHASTapproachhasbeendevelopedbyCaritastopromotegoodhygienebehav-ioursamongchildren.Itisbaseduponthewell-establishedParticipatoryHygieneandSanitationTransformation(PHAST)approachthattargetsadultsusingtheprinciplesofadultlearning.CHASThoweverusesavarietyofexercisesandeducationalgamestotargetchildrenagedbetweenfiveto15yearsandtoteachthemaboutthedirectlinksbetweenpersonalhygieneandgoodhealth.Thechild-to-childapproachextendstheusualdefinitionoftheterm,ensuringthatchildren’strainingonhygieneandsanitationwillalsohaveanimpactontheirfamilies,peersandevenfuturegenerations.

Bygivingchildrenpracticallessonsandtipsonmeansofimprovingtheirowncleanliness

andhygiene,CHASTaimstocreateaneffectivechannelfordeliveringthesemessagesdirectlytolocalhomes.Thismanualisdesignedtoprovidecommunityworkers,teachersandotherfacilitatorswithadetailedmethodologyforChildren’sHygieneandSanitationTraining(CHAST),togetherwiththestep-by-stepinstructionsforfacilitatingeachsession,exerciseandtheaccompanyingfacilitationtools.Themethodusesdifferenttoolssuchasposters,puppetsandroleplays.Theensuingexercisesseektodeliverfundamentalhygienelessonsandinformationinafunandmemorableway.

CHASToriginallygrewoutofaseriesofsessionsheldwithschoolchildreninSomalilandin2002,duringwhichtheexercisesandlessonsofPHASTwerereviewedandadaptedtosuitthespecificneedsandunderstandingofchildren.Havingbeensuccessfullyimple-mentedinSomaliland,themethodologywasthenadaptedtouseinotherplacesamongthemSouthSudanandEthiopia.ThiswasachievedbytailoringittothelocalhygieneandsanitationneedsofSudanesechildren.Thisnewversionisbasedonthelessonslearntfromdifferentcountriesandismeanttobeusedasagenericmanualanywhereintheworld.

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How CHAST Works

CHAST isbasedontheprovenpremisethatpersonalhygienepracticesareusuallyacquiredduringchildhood–andthatitismucheasiertochangechildren’shabitsthanthoseofadults.BecausethePHASTapproachwasinitiallydesignedforadults,ithasbeencarefullyrevisedandadaptedtosuittheneedsofchildren.Itfollowsalearnerorchild-centredapproach:

“Tell me, and I forget” “Show me, and I may remember” “Involve me, and I will understand”

Whilechildrenhavelessknowledgeandexperience,fewerresponsibilitiesandadifferentconceptionoftimeandthefuture,theyarealsonaturallyinquisitiveandeagertolearn.TheCHASTapproachtakesadvantageofthesenaturalattributesandfocusesonthedevelopmentoflifeskillsbeyondtheinitialaimofhygieneandsanitationtraining.

CHASTencourageschildrentoactivelyparticipateinopendiscussionsand,whereverpossibletosharetheirexperiencesandideaswiththeirpeers.ThreecharactersRuby,NaughtyandSmartyhavebeencreatedtoencouragechildrentospeakoutonspecificsensitivetopics,whileapuppetnamedDollyispassedaroundtoencourageyoungorshierchildrentotakepartinthediscussions.

IntheCHASTexercises,childrenareencouragedtoworkindependentlyinpairsorinsmallgroups,andthentopresenttheirthoughtsandfindingstothelargergroup.Aboveallelse,CHASTtoolsaremeanttobefun–involvinggames,exercisesandroleplaysthatpromptthechildrentodiscussandgenuinelyunderstandthekeyissuesrelatedtopersonalcleanlinessandhygiene.

Theprocessofbehaviourchange isdependentonseveral factorsandhygieneandsanitationawareness is justoneof them.Theknowledgeofgoodhygienepracticeswithoutappropriatephysicalinfrastructurelikesanitationfacilitiesandwatersourcesmaygreatlyhindertheprocessofadaptinggoodbehaviours.

PartI:IntroductiontoCHAST7

Using the CHAST Guide

ThisCHASTguideisdesignedtobecomeaninstructivemanual.EachoftheCHASTsessionsisdescribedindetail,togetherwiththeaccompanyingtoolsandexercises.

Beforeusingthisguide,youmusthavereceivedtrainingintheCHASTmethodology.Aftertraining,theguidewillserveasareminderofhowtofacilitateeachactivity.Onceyouhavebecomefamiliarwiththesequenceofactivities,youwilldependlessontheguide.TheguidemayalsobeusefulforProgrammeOfficerswhoareresponsibleformonitoringandevaluatingCHASTprogrammes.

Beforeyoubeginworkingwiththechildrenyoumust: —Readthroughtheentireguidecarefullyandmakesurethatyouunderstandthepurpose

ofeachactivity —ReadPartV,payingparticularattentiontothelistofsampledrawingsandothertools

fortherespectiveactivities —Findanartisttodrawthesepicturesforyou.Makesurethescenesandpeoplethey

containwillappearfamiliartothecommunitywithwhomyouwillbeworkingwith —Gathertogetherallthematerialsyouwillneedfortherespectiveactivitiessuchas:the

posters,stickytape,pins,puppets,etc. —Practicetheactivitieswithfriends,colleaguesorfamilymembersbeforeyouimplement

themwiththechildren.

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How the Guide is Organised

PartIgivesanintroductiontotheCHASTmethodologyandhowtousetheguide.PartIIexplainsindetaileachandeveryactivityoftheCHASTsessionsforlowerprimaryschoolclasses.PartIIIelaboratesontheactivitiesthatcanbeusedinupperprimaryschool,whilepartIVexplainshowtheselessonscanbeinstitutionalisedthroughtheestablish-mentofSchoolHealthClubs.PartVgivesinsightinthedevelopmentofyourownCHASTtools,andwhatisneededforthedifferentactivities.

Toolkit

PartVprovidesguidelinestohelpyouprepareasetofyourowntoolsaswellassamplelistsofthetypesofposters,cardgamesandpuppetsthatyouwillneed.Pleaseremem-berthattheselistsareprovidedasaguideonly–toolkitsmustbedevelopedwithdraw-ingsthatmatchthepeopleandenvironmentyouwillbeworkingin.Thecustoms,religion,class,draw,interpersonalrelationships,lifestyle,typesofactivities,buildingsandfacilities(suchaswatersourcesandtoilets),vegetationandanimalsshownshouldbelikethoseofyourgroup.


The CHAST Methodology

TheCHASTapproachisbasedonthreedifferentmethodologies: 1. ParticipatoryCHASTsessionsforlowerprimaryschoolchildren 2. WASHrelatedlearningactivitiesforupperprimaryschoolchildren 3. EstablishmentofSchoolHealthClubs

Allmethodsaredescribedinthechapterbelow,withdetaileddescriptionsofeachstepandactivityinPartII,IIIandIVofthismanual.

CHAST Steps for Lower Primary School

Themethodologyconsistsoffivestepsinwhichvariousactivitiesandtoolsareemployedtoreinforcehygienemessages.Thestepsare:

1. Introduction 2. Problemidentification 3. Problemanalysis 4. Practisinggoodbehaviour 5. Measuringchange

Thestepsaredesignedinsuchawaythataschildrengothroughthedifferentsteps,theybuildtosteadilyincreaseawarenessandlifeskillsonimportanthygieneandhealthissues,withtheaimtoimprovetheirwell-being.

Step 1: Introduction Thisstep ismeant tobean icebreakerandallowschildren tobecome familiarwith

facilitatorsandthemethodstheywillbeusing. Duringthefirstactivity,theintroductionoffacilitatorsiscombinedwiththeintroduction

ofchildren,theobjectivesofthecourse,thethreeCHASTcharactersandthedifferenttoolsusedinthedifferentsessions.Thesecondactivityallowschildrentoreflectontheirdailylivesbytellingstorieswiththehelpofpictures.Tomakeitmoresuitableforchildren,thestorytellingcanbelinkedwiththecolouringofdrawings.Aninitialevaluationexerciseneedstobedoneonthechildrentounderstandthe‘baseline’situationsothatoncetheyaretakenthroughthewholeCHASTprocess;theoverallimpactcanbeassessedintermsoftheknowledgegainedduringthetrainingandmeasuretowhatextenttheirhygienebehaviourshavechanged.

Step 2: Problem identification Thisactivityfocusesonidentifyingthecommonsanitationandhygienepracticesthat

mayimpactpositivelyornegativelyonourhealth.

Step 3: Problem analysis Thefirstactivityisarevisionoftheproblemidentificationtorecallwhatwasdiscussed

previously.Itisperformedasacardgame:Memorygame.Thesecondandthirdactivi-tiesgiveanexplanationofsomeofthecommonhygiene-relateddiseasesthatchildrencansufferfromandhowtheyaretransmitted.

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Step 4: Practising good behaviour Thisstepdemonstratesdifferentactionsforblockingthespreadofdiseases,andcon-

centratesontrainingingoodhygienebehaviourscombinedwithsongs.Alltheactivitiesconnectknowledgeaboutthespreadofdiseasesandtheirpreventiontotherelevanthygienicpractices.Practicalexercisesinsmallgroupsarecarriedout.

Step 5: Measuring change Justlikeatthebeginning,anevaluationexerciseneedstobedoneonthechildrentaken

throughtheCHASTprocesstoassesstheimpactintermsoftheknowledgegaineddur-ingthetraining.Thefollow-upshouldprovetheimpactoftheCHASTtrainingandprovidesuggestionsonhowtoimproveitsmethodsandtools.Furthersystematicassessmentusingconventionalandparticipatorytoolsshouldbeconductedtogetindepthunder-standingoftheimpactonbehaviourchangeandprovidesolutionstoemergingproblemssuchaslackofsanitationfacilities.

Duringthefinalsession,alloftheparticipatingchildrenreceiveanawardforgoingthrough

thetraining.

The framework for Children’s Hygiene And Sanitation Training for lower primary schools

1. Introduction

2. Problem

Identifi cation

3. Problem

Analysis

4. Practising Good

Behaviour

5. Measuring

Change

1.1 Introductionofparticipantsandcharacters

1.2Everydaystories

1.3 Initialevaluation

2.1 Goodandbadhygienepractices

3.1 Memorisinggoodandbadhygienepractices

3.2Howgermsarespread

3.3Germsarespreadbyflies

4.1 Blockingtheroutesofgerms

4.2Handwashingexercise

4.3Toothbrushingexercise

4.4Latrineuseexercise

4.5Facewashingexercise

5.1 Finalevaluation

5.2Closingceremony

1.1PostersofcharactersandPuppetDolly

1.2Postersofeverydaystories

1.3Pocketchart

2.1 Two-pilesorting

3.1 Memorycards

3.2Shortstory

3.3The‘flies’roleplay

Alluse:

–Posters

–Practicalhygienedemonstrations

–Roleplays

–Songs

5.1 Pocketchart

5.2Awards

Steps Activities Tools

CHAST Topics for Upper Primary School

InadditiontothethreemainhygienethemesidentifiedbytheWorldHealthOrganization:(1)handwashing,(2)keepingwatersourcescleanand(3)safedisposaloffaeces,twoadditionaltopicswereidentifiedtobeofimportancefortheolderschoolchildrentolearnabout:(4)safestorageofdrinkingwaterand(5)theimportanceofkeepingtheenviron-mentclean.Supportingtheideathatupperprimaryschoolchildrencantakeresponsibil-ityforminimizingtheirexposuretodiseaseandsickness,thefocusofthisCHASTcom-ponentisonthefollowingtopics:

Topic Tool & Activity

Topic1:

“Clean is Beautiful”

Song:Singingabouthandwashing

Group discussion: Whatwillhappenifwedonotwashourhands?

Demonstration:Handwashing

Drawing:Atwhattimedowewashyourhands?

Topic2:

“I Drink … Safe Water”

Group discussion: Aboutfetchingwater,andthecleanlinessofwater

Exercise and expert presentation:Makealistofdiseasesthatcanbespreadthroughunsafewater.Healthworkervisittodiscussdiseasesymptoms,transmissionandhowtheycanbeprevented

Environmental walk:Observeyourwatersources

Drawing:Oncethewaterisdrawnfromthesource,howdowekeepdrinkingwatersafefromcontamination?

Group discussion:Discusswiththechildrenthefollowingactionstoimprovetheirhealth

Topic3:

“Going to the Latrine”

Group discussions:— Whyisitimportanttouselatrines?

— Howcanfliestransmitdiseases?

— Whydosomepeoplenotusealatrine?

Environmental walk: Visittheschoolfacilities

Topic4:

“My Beautiful School”

Group discussions:— WhatdifferencesdoyouseebetweenschoolAandschoolB?

— Whyisitimportanttoputourrubbishinabinorgarbagepit?

— Solidwastemanagement

Setting up School Health Club:HowtosetupaSchoolHealthClub

Topic5:

“Germ Free Food”

Group discussions:— WhatarethedifferencesbetweenpictureAandB?

— Whyisitimportanttocovercookedfood?

Story telling: Myfavouritefood

Exercise:Washinghandsbeforeschoolmeals

Topic6:

“How to Prevent Diarrhoea”

The F-diagram:Diarrhoealdiseasetransmission

Group discussions:— Whatarethesymptomsofapersonsufferingfromdiarrhoea?

— Howcantheabovementionedroutesoftransmissionbeblockedtopreventdiarrhoealdiseases?

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School Health Clubs

TheSchoolHealthClubisoneofthesignificantinstrumentsforsustainingthedesiredhygienebehaviourchangeamongschoolchildren.AsacomplimentarytotheCHASTmethodology,itservestocarryonwiththehygienemessagesevenafterthecompletionoftheCHASTtrainingsessions.Italsoservesasavehicletoreachtothechildrenwhodonotcome to theschooland thecommunityat largewithkeyhygienemessagesthroughoutreachprogrammes.

SchoolHealthClubsareusuallyformedtoencouragepositivehealthandhygieneprac-ticesamongststudentsandtheirfamilymembers.ActivitiesthatshouldbeundertakenbySchoolHealthClubsare:

Discussions to generate awareness on issues related to health, sanitation and hygiene

Preparinghealthmessagesandpresentingthesemessagesinschools;organisinglec-turesbyinvitingexperts;usingposterstospreadhealthmessagesinclassesandsettinguphealthcornersinschools;andorganisinghealthwalks,whichallowchildrentoobservenatureanddiscussissuesrelatedtohygiene,sanitationandotheraspectsofhealthylivingetc.

Forming healthy habits Thisisachievedthroughinvolvingthechildrenin:Keepingclassrooms,schoolsurround-

ingsandtheschoollatrinesclean;organisingcampaignstobuildhealthyhabitslinkedtowateruseandschoollatrines;maintainingschoolwatersources(includingtaps)andkeepingtheirsurroundingsclean;collectingdisposingofwastesgeneratedintheschools,keepingwastebins in theclassrooms,makingcompostpitsandusingpaperbags;campaignstodevelophealthyfoodhabitsandavoidfoodthatispreparedandkeptun-hygienically,sweepingtheeatingareaandsittingawayfromflies.

Dissemination of knowledge and practices Throughmeetingsandcampaignsorganisedintheschool:SHCmembersexplainhealth

messagesandotherissues;visitpoorneighbourhoodsandpeopleintheirhomes;par-ticipate incommunitycleaningcampaigns inselectedpublicplaces;andencouragechildrentodiscussthesetopicswithparentsandotherfamilymembers.


CHAST Tools

TheCHASTsessionsutiliseavarietyofenjoyableactivitiesandtoolstoencouragechil-drentoexploreanddiscussdifferentelementsoftheirownhygieneandsanitation.Themaintoolsinclude:

The CHAST Characters Threecharacters,Naughty,RubyandSmarty,havebeencreatedtoencouragechildren

todiscussspecifichygieneandsanitationtopics.Thesecharactershavebeencarefullydesignedsothatyoungchildrencanidentifywiththemandtheirattitudesandbehaviours.

Thenamesofthecharacterscanbeadaptedtothelocalcontextastowheretheses-sionsareapplied(thinkoflanguage,culture,etc.).

Puppet ThepuppetDollycanbesuccessfullyusedbybothfacilitatorsandchildrentocontribute

todiscussionsaboutimportanthygieneandsanitationissues,particularlybyyounggirlsandquietchildren,whomayotherwisebeshyabouttakingpartinsuchdiscussions.

Coloured Posters Around60postersareused,whicharegenerallyofA4sizeandarelaminatedtomake

themmoredurable.Colouredpostersaremuchmoreattractiveandeasiertorecognisethanblack-and-whiteones.

Thepostersareusedforthefollowingpurposes: —Tointroducethethreecharactersnamely,Ruby,SmartyandNaughtywhowillguide

thechildrenthroughtheCHASTcourse —To start the CHAST sessions. These are mainly posters showing the characters

involvedindifferentsituationswithineachtopic.Thepostersareusedtostarttheexerciseinafunwayandthenhaveadiscussiononthatspecifictopic

—Toshowhowchildrenareinvolvedingoodandbadhygienicbehaviours —Toillustrateshortstoriestoldbythechildrenabouthygienicproblemsandsolutions —Toillustratemorewide-ranginghygieneandsanitationpresentationsbygroupsof

children

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Role-plays Ingeneral,role-playsareusedinthecontextofawarenessraisingandinencouraging

interactionbetweenchildren.InCHASTsessions,theycanbeusedtoillustratesituationsfromeverydaylifeinordertoraiseawarenessaboutcommonhygieneproblemsandtocreateapositiveenvironmentforthediscussionofmoresensitivetopics.

Becauserole-playsdonotrequireobviousactingskills,theycansuccessfullybeused

tohelpchildrenenactandhonestlydescribereallifesituations.Role-playrules: —Role-playsshouldfocusonasingletopic,whichhasbeenagreedbeforehand —Ifpossible,therole-playshouldberehearsedbythemain‘actors’beforehand —Arole-playshouldbefollowedbyafreeandfrankdiscussionofthemainissuesthat

emerge —Therole-playitselfshouldnotlastmorethan10minutes —Althoughtheendoftheplaycanbeleft‘hanging’,thelastsceneshouldbeexciting

andmemorable

Drawings for Colouring Simpleblack-and-whitedrawingsillustratingsituationsrelatedtoeachexercisecanserve

asausefulandfunintroductiontoeachtopic–orbeusedasan‘ice-breaker’forchildrentointroducethemselvestothefacilitatorandtheotherchildren.Thefacilitatorshouldprintamastersetofthedrawingsforcolouring,fromwhichphotocopiescanbemade.Forthebestresults,colouringshouldbedonewithpastelcrayons–althoughordinarycrayonsorwatercolourswillalsoyieldsufficientresults.Theassistanceofacompetentlocalartistcanalsohelpwiththisactivity.

Card Games Aneasy-to-playcardgamehasbeendesignedtoreinforcelessonsaboutgoodandbad

hygienebehaviours.TheMemorygameisusedtohelpyoungerchildrenrememberandmemorisegoodandbadhygienepractices,whentryingtofindtwomatchingcardswiththesameillustrationsonhygienepractices.


Songs and Story Telling Asanimportantpartofmanytraditionalcultures,theactoftellingstoriesandsinging

well-knownsongsisanexcitingwaytoattractchildren’sattentiontohygieneandsanita-tionmatters.Insomesituations,itmaybepossibletouselocalsongs–ortocreatenewones–thatcarrymessagesrelatedtocleanlinessorpersonalhygieneandtheycanbeusedtobeginorendaCHASTsession.

Flipcharts Forthehygienetrainingforupperprimaryschool,aspecialhandbook,alsoreferredto

asflipchart,isused.Thedesignofthehandbookallowstheteachertoshowthedrawingstothegroup,whilehe/shecanrefertothebacksideofthedrawingforthescript,discus-sionquestions,gamesandanswers.Theteachercanthen‘flip’overtothenextsession/topic.1

Thetextprovides‘suggested’andnot‘strict’guidelines,whilethedrawingspresentdif-ferentstorylinesabouttheprincipalcharactersNaughty,RubyandSmarty.Thedrawingscompare‘good’and‘bad’behavioursthatinfluenceourhealthandwellbeing.Althoughitmaybeusefultointroducekeypointsforthegroupdiscussionduringthetellingofthestoryofthepictures,teachersshouldtrynottointerrupttheflowofthestorytoooften.Afterthestorytheyshouldintroducethekeypointsfordiscussionthatarealsomentionedontheflipsideoftherespectivepages.

Pocket Charts APocketchartisusedtohelptocollect,organiseandanalyseinformationonindividual

sanitationpractices.Tomakeapocketchartthefollowingmaterialsareneeded:Apocketchartorlocalalternative(tins,jars,envelopesetc.),drawingsofdefecationsites(latrines,openground,forest,bushes,riveretc.)andhandwashingpractices(withsoapandwater,withonlywater,nowashing),andvotingmaterialssuchaspebblesorseeds,andblankpaperforrecordingtheresultsobtained.

Placethepictureshorizontallyacrossawalloronthegroundandplacea‘pocket’beneatheachpictureforeachrow.Thepocketchartmustbesetupinsuchawaythatchildrencanplacetheirvotingmaterialswithoutbeingseenbyothers.Thiswayitcanbeusedtocollectinformationconfidentiallyonwhatchildrenareactuallydoingintheschool.Stresstheneedforchildrentobehonestwhenplacingtokens.

Giveeachchildavotingmaterial(thiscanbeasmallstone,seed,pieceofstickorany-thingtohandthatcanbecounted)andaskthemtoplacetheirvoteinthepocketunderthedrawingwhichtheyusemostoftentodefecateorwhichhandwashingpictureappliestothem.Onceallchildrenhavevotedaskavolunteertocountthepebblesineachpocketanddisplaythetotals.Thesefindingsarethenusedtofacilitateadiscussiononthemeaningofthetotals–whichhygienebehavioursaremostcommonlypracticedbychil-dren?Why?Howdothesebehavioursaffectthehealthofchildren?

Theresultswillalsoberecordedformonitoringpurposestomonitoringchangeinbehav-iourovertime.

1 This handbook came into being by combining similar experiences from AMREF in Kenya who developed the PHASE materials

(flipcharts) (1998) and from experience by IRC International Water & Sanitation Centre who developed the “The Joy of Learning:

Participatory lesson plans on hygiene, sanitation, water, health and the environment” (2005)

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CHAST Facilitation

The role of the Facilitator

TheCHASTfacilitator’sroleisacoordinatingandmoderatingone,focussedonhelpingthechildrentodiscusstheirhygienepracticesandtoparticipateinmemorableexercisesanddiscussionsongoodhygiene.

FacilitatorsshouldrememberthefollowingkeypointsaboutCHASTfacilitation: —Facilitatingisaboutinspiringandparticipating,ratherthandirectinstructionandfron-

talteaching —Facilitatorsshouldtrytositamongthechildrenthemselves —Thefacilitatorsshouldwhereverpossibleencourageyoungorshierchildrentotake

partinthediscussions;fungames,charactersandpuppetscanhelptoencourageshychildrentojoinin

Facilitatorsshouldonlyassistthechildrendirectlyiftheyareexperiencingobviousdiffi-culties,i.e.ifasmallchildishavingdifficultyreachinguptothepin-board.Forthesereasons,CHASTencouragesa“child-to-child”approachbyfocusingonbroaderlifeskillsthroughtheuseofthefollowingparticipatorytoolsandmethods:

—Thethreeleadingcharactersthatarementionedineverysession,allowingthechildrentoeasilyrecogniseandunderstandthecontinuityoftheprocess

—ThepuppetDollyencouragesyoungorshychildrentospeakinlargergroups —Thechildrenworkindependentlyinpairsorsmallgroups —Thechildrenpresenttheresultstothegroupthemselves —Thechildrenareactivelyengagedthroughcolouringdrawings,playinggames,and

doingexercises —Eachsessionendswithasong,whichischosenbythechildrenthemselves

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Methods of Facilitation

ThefollowingisanexplanationofhowtomakefacilitationeasierandefficientatdifferentstagesofCHAST:

Facilitating presentations by children: the ‘3 Ts’ MostCHASTactivitiescanbesuccessfullyconcludedwithapresentationofthemain

lessons learnedbythechildrenthemselves. Inmakingsuchapresentation,childrenshouldbeencouragedtofollowtheeasystepsdescribedasthe‘3Ts’:

—Turn:Facetheaudienceandlookdirectlyatthem — Touch:Pointtoaposterorflipcharthighlightingthepointsyouarepresenting — Talk:Takeadeepbreath,makesureyouspeakloudenoughfortheaudiencetohear

youandstartyourpresentationwithanintroductorysentence,suchas, “I / We want to explain to you this poster, which shows …”

Children’spresentationsshouldbepracticedbeforehandsothattheyareconfidentabout

thepointstheyaregoingtomake.Aftereachpresentation,thefacilitatorshouldreiteratethe‘3Ts’tothenextpresentinggroup.

Facilitatorsshouldtrytobesensitivetochildren’sneedsandshouldtakecarenottopushthemtoohard–particularlyyoungandshierchildren.Explainingeverydaylifeinpictorialformisnotalwaysastraightforwardtask!

Facilitating role-plays Role-playsareapopulartoolforparticipatorylearning.Theycanencouragechildrento

discusshygieneissuesbyaddressingseveralsensesatonce,includingtheiremotions.Indebatingwithmattersofhygiene,role-playscanprovideaperfectformulaforaddress-ingandexpressingopinionsoncommonhygienicpracticesandattitudes.Theycanalsobeusedforreviewingthemainissuesofadiscussionorfor‘breakingtheice’betweensessions.

Likeanyothertool,role-playsaremuchmoreconvincingandcompellingifyouincludeyourownideasandexperiences.Encouragingchildrentoactouttheirownexperiencescanbeaninterestingwaytoraisenewissuesandpersonalfears.

Aftertherole-play,thefacilitatorshouldstartoffthediscussionwithacoupleofcarefullychosenobservations.He/sheshouldalsohelpchildrento understand the messagethathasemerged,andtoreach a conclusionaboutwhattheyhavewitnessed.Theachieve-mentofthesegoalscanbeascertainedbyaskingoneortwokeyquestions,suchas:

Observations Whatdidyousee?Whatkindsofcharacterswereinvolved?Whatarethemaindifferences

betweenthesecharacters?

Understandingthemessage Whatarethereasonsfortheproblemathand?Whichofthecharactersisright?Which

iswrong?


Conclusion Howwouldyouhavebehavedinthissituation?Whatdoesitteachusaboutourown

situation?

Facilitating working groups Itismoreusefultodividechildreninto‘workinggroups’byarandommethodotherthan

accordingtoageorfriendship.Theeasiestwaytodivideagroupofchildrenrandomlyistomovethroughthegroup,allottingeachchildanumberfrom1to4(inthecaseofusingfourworkinggroups;thiscanbemoreorlessifneeded).Thechildrenaretheninvitedtositinfourgroupsaccordingtothenumbertheyweregiven.Thechildrencanalsobedividedaccordingtodifferentanimalse.g.camels,cattleorlions,tomaketheexercisemorefun.

Course Duration TheCHASTcourseswithonesessionoftwohourseveryweekmaytakeaboutoneto

twomonths,whilethefollow-upphasetakesanotheronemonth,withregularsupervisionatfixedintervals.WewouldstronglysuggestnotfacilitatingallstepsofCHASTwithinamuchshorterperiod.Anintensiveandlongcontactbetweenthechildrenandfacilitatorsisundoubtedlythebestbasisforasatisfactoryunderstandingandlong-termimpact.TheestablishmentofSchoolHealthClubswillensurethatthelessonslearntduringthesemonthswillbeprolongedandinstituted.

Preparation of Sessions

Ifnotalreadyintegratedintoschool(extra-)curriculumactivities,then,CHASTfacilitatorsshouldfirstcontactthelocalleadershipandprimaryschoolteacherstoagreeonthevenues,datesandtimesofeachCHASTcourseandlaterontheindividualsessions.Whilethelocalleaderswillnormallyonlywanttotakepartintheopeningsession,theteachersmayoftenbeinterestedinattendingthewholecourse.Thiscanbeveryusefulforsustaininghygieneandsanitationissuesonthechildren’sformaleducationcurricula.

ThetargetgroupofCHASTtrainingusuallyincludeschildrenbetweentheagesoffiveand15years.Becauseofitsparticipatorynature,eachsessionshouldideallybelimitedto30childrenorless.Experienceshowsthatlargergroupscanleadtoreducedinvolve-ment,especiallybytheyoungerandshierchildren.Ifthereisaverybiggroup,i.e.over40childrenitshouldbedividedinhalfalongagelinesanddotwosimilarsessionswitheachofthegroups.

Inaruralsetting,CHASTsessionswillusuallyrequiremoretime,asthechildrenaremorelikelytobeshyandhardtodrawintodiscussions.Sessionsinruralareascanalsobemademoredifficultbycrowdsofcuriousspectatorsorbystanders.

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Monitoring and Evaluation

OnlybyevaluatinghygienebehavioursbeforeandaftertheimplementationofCHASTcanyoubesurethatchangesareactuallytakingplace.However,suchchangesareverydifficulttomeasurebecausetheyoccurgraduallyandinvolvesensitive‘personalissues’,whichmostpeopledonotliketodiscuss.Inordertomeasurechangeaccurately,onemustfirstknowthesituationthatexistedbeforetheprojectbegan(seePartIIStep1Activity1.3‘InitialEvaluation’).

Monitoringandevaluationisonlypossibleifonefirstcollectsaccurateandrealisticbase-

linedata.Werecommendtwoindicatorsthatarecomparativelyeasytocollectandcheckandarethereforeneithertoocostlynortimeconsuming.TheindicatorspertaintothemostimportantmessagesofCHAST:

—Properhandwashing —Hygieniclatrineuse

Indicator for Hand-Washing Practices

Qualityandquantity: AfterhavingcarriedoutalltheCHASTsessions,atleastthree-quarters(75%)ofthe

childrenshouldadaptthepracticeofwashingtheirhandswithsoapafterdefecatingandalsodemonstrateanddescribegoodhandwashingtechniquesinorderforasignificantimpacttobefeltintermsofdiarrhoealdiseasereduction.

Monitoringintervals: AtthebeginningoftheCHASTsessions,abaselinesurveyisdonetoobtaininformation

onthecurrentknowledgeandpracticesofchildrenbeingtakenthroughthecourse;(seePartIIStep1Activity1.3InitialEvaluation).Accuratebaselineinformationisnecessaryinordertocomparehowmanychildrencoulddemonstrategoodhygienepracticesbeforeandafterthecourse.AsimilarexerciseisheldattheendoftheCHASTsessions;(seePartIIStep5Activity5.1forFinalEvaluationtomeasurechange).


Tools: Interviewsanddemonstrationsbyasampleofchildrenfromthevillage(samplesizeto

bedictatedbyvillagesize).

Remarks: The‘goodhand-washingtechniques’requireclearcriteria.Thisisdiscussedfurtherin

PartIIStep4,Activity4.2.Ifmorethanaquarter(25%)ofthechildrenarestillnotwash-ingtheirhandsproperlyornotatallatcriticaltimes,thisisusuallyasufficientindicationthatmorefollow-upworkisnecessaryinordertoprovidebetterhand-washingpractices.

Indicator for Latrine Use

Qualityandquantity: 75%ofthechildreninavillagestatethattheyusethelatrinewhenevertheyneedtorelieve

themselves,ratherthandefecatingoutintheopen.

Monitoringintervals: BeginningoftheCHASTsessions,(seePartIIStep1Activity1.3forInitialEvaluationto

obtainbaselinedata).Accuratebaselinefiguresarenecessaryinordertoshowhowmanychildrencoulddemonstrategoodhygienepracticesbeforetheprojectbegan.AsimilarexerciseisheldattheendoftheCHASTsession;(seePartIIStep5Activity5.1forFinalevaluationtomeasurechange).

Tools: Thisincludesapocketchartforanalysingthehygienebehavioursthroughvoting,together

withobservationsandinterviewsofpupils. Remarks: Inordertoachievethisindicator,theremustbeasufficientnumberoflatrinesinthevil-

lage.Thebaselinesurveyshouldalsoanswerthisquestionbeforehand.Ifnot,theexer-cisecanbepresentedinsuchawaythatitonlyfocusesonlatrineusewhenattendingschoolclasses.

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Part II: Step-by-step CHAST activities for lower primary school

Step 1: Introduction

Thisstepisan‘ice-breaker’,familiarisingthechildrenwiththefacilitatorsandthetoolstheywillbeusing.Thestepconsistsoftwoactivities,tobecompletedinonesessionofapproximatelyanhour’sduration.Thefirstactivityinvolvesthechildrenintroducingthem-selveswithhelpofthepuppetDolly,whilethesecondencouragesthechildrentoreflectonhygienehabitsfromtheireverydaylivesandthethirdisaninitialevaluationoftheir(current)hygienepractises(baseline).

Step 1 activities Activity1.1 Introductionofparticipantsandcharacters Activity1.2 Everydaystories Activity1.3 Initialevaluation

Step 1 objectives Bytheendofthisstep,thechildrenwillhave: —Knownthefacilitators,charactersinCHASTandtheirclassmates —Madepresentationsabouttheireverydaylives —Establishthecurrenthygienepracticesofthechildren

Activity 1.1: Introduction of participants and characters

Objectives Bytheendofthissession,thechildrenwillhave: —Knownthefacilitators,thepuppetDollyandthecharactersNaughty,RubyandSmarty

—Learnthowtousepuppetsasamethodofcommunication —Introducedthemselvestotheotherparticipants —BecomefamiliarwiththemainCHASTtools

Duration 25–30minutes

Materials —ThepuppetDolly

—AsetofpostersofthecharactersSmarty,NaughtyandRuby

—Presentationmaterials

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What to do 1. Makethechildrensitinacirclewiththefacilitatorsittingamongthem;

2. Thefacilitatorshouldstartbyintroducinghim/herself:“My name is … , my age is … , and my favourite colour is …”;

3. NowintroducethepuppetDollyandthespecialpositionitholdsastheallknow-ing,wiseandjust;andatrustedfriendtoidentifywith.DollyisthepowerbrokerandwhoeverhasDollycanleadintheactivitybeingcarriedout:“This is our puppet Dolly, whose favourite colour is [ red / blue / yellow / …].” Theanswerdependsonthecolourofthedressitiswearing;

4. Finally throw the puppet to a child and invite him/her to introduce themselves:“Please introduce yourself. Tell us your name, your age and your favourite colour”;

5. Whenthechildhasfinished,askthem: “Please throw the puppet to another person”;

6. Wheneverybodyhasbeenintroduced,introducethecharactersNaughty,SmartyandRuby.Withthehelpoftheposters,giveashortintroduction:“Here you can see Smarty. He is 10 years old and his favourite colour is blue. Watch how he is blowing his nose. This is a hygienic way of clearing your nose”. “Let me introduce Smarty’s friend, Naughty. He is nine years old and he likes the colour black very much. Look how he is clearing his nose. Isn’t it unhygienic?”;

7. Introducethelastcharacter,Ruby.Invitethechildrentofinishthelastsentenceofyourintroduction:“This is Ruby. She is the elder sister of Naughty. She is 10 years old and her favourite colour is …”;

8. Thechildrenshouldrecognisethebluecolourofherdressandshoutout “Blue!”Thefacilitatorshouldconfirmthis“Yes, it is blue”;

9. Thesessionisclosedwithasongproposedbythechildren.

Ifyouonlyhaveonesessionforbothactivities,skipNo.9andcontinuewithNo.6ofthesecondactivity.

Notes for facilitators

a)Thefirsttwointroductorysessionscanbeusedtogetheror,ifyouarerunningoutoftimeorthechildrenareveryshy,justthefirstsessioncanbeused.

b)Sitdownamongthechildren,whichwillencouragethemtobelessshyandmoreactive.Itwillalsogivethemthefeelingthattheyarenotbeinglecturedto.

c)Ifaproperpuppetisnotavailable,aversionofDollycanbeimprovisedfromaten-nisballoranotherballwrappedinasmallscarf.

d)Thepuppetgivesthechildrenaneasywaytocommunicatewitheachotherbythrowingittoanotherchildortothefacilitators.Thechildren’steachercanalsobeinvitedtotakepartintheintroductorysessions.

PartII:Step-by-stepCHASTactivitiesforlowerprimaryschool25

Activity 1.2: Everyday stories

Objectives Bytheendofthisactivity,thechildrenwillhave: —Presentedanddiscussedimportantissuesfromtheireverydaylives —Startedbuildingaspiritofteamworkandmutualunderstanding —Understoodtheobjectivesofthecourse



—Characters’postersofSmarty,NaughtyandRuby —Asetofcolouredpostersshowingleisureactivities —Black-and-whitedrawingsshowingleisureactivities —Crayons —Presentationmaterials

What to do Ifyouarerunningactivity1.1and1.2together,thencontinueatNo.5.

1. Seatthechildreninacirclewiththefacilitatorsittingamongthem.OpenthesessionbyintroducingyourselfusingthepuppetDolly:“Remember me from last time? My name is …, I am … years old, and my favourite colour is … This is Dolly and his favourite colour is …”Letthechildrencallout“Red”Dolly’sfavouritecolour;

2. Introduceanynewcomersbythrowingthepuppettooneofthem:“You’re a new face here! Tell me about yourself”;

3. Whenthechildhasfinished,askthechildto:“Throw Dolly to another child who is new to the course”;

4. Whenallthenewcomershaveintroducedthemselves,thefacilitatorshouldthengivethepostersofthethreecharacterstohis/herneighbouringchildrenandaskthemtoholdthemupsoallthechildrencanseethem.Thefacilitatorasks:“Do you recog-nise these boys and the girl? Do you remember their names and their favour-ite colours?”;

Withthehelpofthechildren,thecharactersNaughty,RubyandSmartywillbereintro-duced.

5. Thefacilitatorgivestwoofthecolouredpostersshowingleisureactivitiestothechildrensittingnexttohim/herandasksthemtoholdthemup.Nowaskthechildren:“What do you see in these posters?”Encouragethechildrentoexplaintheleisureactivitiesintheforeground.Atthistimedonotaskquestionsontheactivitiesillustratedinthebackground;

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6. Dividethechildrenintotwogroupswithpreferablyonefacilitatorineachgroup.Handoutcopiesoftheblackandwhitedrawings.Usedifferentdrawingsforeachgroup.“Find a partner and come forward to choose one poster with your favourite leisure activity”;

7. Oncepairshavebeenformedandeachhaschosenaposter,explaintheexerciseanddistributethecrayonstoallthechildren.Invitethemto:“Colour in the poster with your partner. Discuss with your partner what the people in the poster are doing.”Duringthisexercise,thefacilitatorsshouldspendtimewitheachpairofchildren,listeningandcontributingtotheirdiscussions.Whenmostofthepairshavefinished,announcetheendoftheexercise;

8. Askthechildrentodecidewhowillmaketheirpresentationandinvitethemtoprac-ticethepresentationquietly:“One of you will do the presentation of your draw-ing. Practise the presentation quietly without disturbing other children”;

9. Nowaskforvolunteerstocomeforwardandtellthegroupwhattheirpostershows:“Who wants to come forward and tell us what the people in your drawing are doing?” Ifnobodyiswillingtomakeapresentation,donotpressthechildren,buthelpthembylettingthemholduptheirdrawingsandyouaskspecificquestionstheycaneasilyanswer;

10. Afterfourorfivedrawingshavebeenpresented;bringtheexercisetoaclose.Iftheyallwanttopresenttheirdrawingsthenyoucantakesomemoretimetoallowformorepresentations;

11. Closethesessionwithasongproposedbythechildren.


— Duringtheintroductionoftheposters,itisnotintendedthatthefacilitatorsshouldmention theeverydayactivities in thebackground,which thechildrenwillbeobservingduringtheircolouring.

— Letthepairsmakeupthestoriesbythemselveswithminimalguidance.Invitethemtoaskyouquestionsabouttheactivitiesportrayedinthepictures.Donotmentionthequalityofthecolouringitself.

— Ifpossible,useabellinsteadofcallingouttosignaltheendofthisexercise–andallfurthergroupworkduringthecourse.

— Offerthechildrenassistanceontheirpresentations,usingthe‘3Ts’:Turn,Touch,andTalk.Emphasisethattheyshouldpractisetheirpresentationsquietly-soasnottodisturbotherpairs.

— Thepurposeofthisactivityistohelpchildrenexpressissuesthatareofconcerntothem.Donotbeworriedifthepresentationsarenotperfect.Atthistimewhatismostimportantistoenablechildrentocomeforwardandexpresstheirideas.


Activity 1.3: Initial evaluation

Objectives Tocollectandanalysebaseline informationaboutthechildren’scurrentkeyhygienepractices(handwashingandlatrineuse)beforestartingtheCHASTcourse.


Materials —Pinboardandpins —Posterofaboy,posterofagirl —3postersofhandwashing:washingwithwaterandsoap,washingwithwateronly

andnotwashing —Posterofachildusingalatrine/toilet,posterofachilddefecatingintheopen —3largeenvelopes —Colouredpaperclipsoranyothertypeoftokenthatcanbeusedforvotingexercise —Notebookandpenforrecordingresults

What to do 1. Greetthechildrenandexplaintheobjectiveofthesession;

2. Countandrecordthenumberofchildrenintheclass,notingthenumberofboysandgirlsseparately;

3. Pintheposteroftheboyandgirlontheboardwithanenvelopeundereachofthem;

4. Giveeachchildatoken(paperclip,asmallpieceofpaperorpebble).Givealltheboysonetypeandallthegirlsadifferenttype;

5. Tellthechildrenyouwanttogatherinformationandyouwillbeaskingseveralques-tions.Thefirstisaneasysamplequestion: “Are you a girl or a boy?”;

6. Instructtheboysandgirlstoputtheirtokenintheenvelopeundertheposteroftheirgender(boyorgirl);

7. Turntheboardaroundsothattherestoftheclasscannotseewherethechildputshisorhertoken;

8. Letallthechildrenplacetheirtokensintheenvelopes;

9. Oncetheyhavefinishedcastingtheirtokens,turntheboardaroundandemptyeachenvelope;

10. Alltheboys’tokensshouldbeundertheboys’pictureandthegirls’tokensunderthegirls.Ifyoucountmoreboystokens(orgirls)thanthereareboysintheclassroom,thensomechildrenmighthaveputtheirtokeninthewrongenvelope,gentlyexplainwhyitisincorrectandmakesuretheyunderstandhowtousethepocketchart.Youcanalsousedifferentcoloursorshapesforboysandgirls.

11. Nowcleartheboard,andpinthepictureoftheboyusingthetoiletatthetop.Under-neath,pinthethreepicturesofhandwashing(waterandsoap,wateronly,notwash-ingatall)sidebysidewithanenvelopeundereach;

12. Redistributethetokens;

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13. Tellthechildrenyouwanttoknowwhethertheynormallywashtheirhandswithsoap,withwaterornotatallafterusingthetoiletorthebush.Makeitclearthatyoudonotwanttoknowwhatthecorrectansweris;yousimplywanttoknowwhatthechildrencurrentlydoathome;

14. Turntheboardaroundagainsothatnobodycanseewheretheyputtheirtoken.Tellthechildrenthatitisasecretandtheycanthereforebehonest.

15. Afterallchildrenhaveplacedtheirtokens,turntheboardaroundandcountandrecordthenumberoftokensineachenvelope;

16. Discussyourfindingswiththechildren;

17. Re-dotheactivitybutwithonlytwooptionsonwheretheydefecate:thepictureoftheboyusingalatrineandapicturewithaboydefecatingintheopen/bushes.Thistimethequestionis:“Where do you normally go to the toilet?”;

18. Aftercollectingandrecordingalltheinformation,concludethesessionwithasong.


Step 2: Problem Identification

Thisisalongandimportantactivity.Itcomparesgoodandbadhabitsandfocusesonhygienebehavioursthatarerelatedtothespreadofdiseases.

Step 2 activities Activity2.1 Goodandbadhygienepractices

Step 2 objectives Bytheendofthisstep,thechildrenwillhaveidentifiedparticularhabitsaseitherhygienicorunhygienicbehaviour.

Activity 2.1: Good and bad hygiene practices

Objectives Bytheendofthisactivity,thechildrenwillhave: —IdentifiedthehabitsofNaughty,RubyandSmartyandclassifiedthemasgoodorbad

behaviour —Recognisedthe‘Smiley’s’assymbolsofgoodandbadbehaviour —Identifiedtheactivityontheirposterandclassifieditasgoodorbadhabit —Presentedtheiractivitytothegroup —Identifiedpositivecounterpartsfornegativehabits —Fixedthecorrespondingpostersoppositeeachotheronthepin-boardDuration 40–50minutes


—The‘Characters’setofpostersofNaughty,SmartyandRubyfromPartIIStep1Activity1.1 —The‘Naughtyisunwell’posterfromPartIIStep3Activity3.2 —Smiley’s —Thesetofpostersentitled‘Goodandbadhygienicpractices’(PartIIStep2Activity2.1) —Presentationmaterials

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What to do 1. OpenthesessionwiththepuppetDollycommenting:“Do you remember me? What is my name? What is my favourite colour?”;

2. Seatthechildreninacircle,withthefacilitatorsittingamongthem;

3. Dollypointstothefacilitatorholdinghim:“Do you remember his / her name and his / her favourite colour?”;

4. Ifthereareanynewcomersthenaskthemtheirnamebythrowingthepuppettohim/her:“Tell us about yourself. What is your name, your age and favourite colour?”;

5. Whenthechildhasfinished,tellhim/her: “Throw Dolly to another child who has not yet been introduced”;

6. Givethepostersofthethreecharacterstochildrenclosetoyou.Instructthechildrentoholdupthepostersandaskthem:“Do you recognise these boys and girl? Do you remember their names and favourite colours?”Withthehelpofthechildren,reintroduceNaughty,SmartyandRuby;

7. Thefacilitatorshouldnowexplainthepurposeofthissession:“Everybody has been sick some times, and nobody is healthy and feeling well all the time. Today we want to talk about diseases …”;

8. Holdupthe‘Naughtyisunwell’posterandexplainit:“Naughty is ill and cannot play outside because he has diarrhoea. What can you see in this poster?”ThechildrenidentifyNaughtylyingathome,SmartyvisitinghimandRubytakingcareofherbrotherNaughty;

9. ReadoutNaughty’squoteinaweakvoice:“I wish I were as strong as you Smarty and Ruby. The two of you are never ill”;

10. ThenreadoutSmarty’sanswer:“I try to avoid bad practises, which can make us sick”;

11. Pointtothepostersofthethreecharactersandaskthechildren:“Can you see a habit that can make a child sick?”ThechildrenshouldpointoutNaughtyeatingwithoutwashinghands.Checkthatthisposterisindeedavailable;

12. Nowshowthesmiley’stothechildrenandexplaintheirpurpose:“The green happy smiley symbolises a good hygienic habit which makes us happy and healthy and the blue sad smiley a bad habit that could lead to sickness”;

13. Fixthesymbolforgoodhabitshappysmileyononecornerofthepin-boardorwallandthatforbadhabits(sadsmiley)ontheothercorner;

14. BeginasortingprocessbyholdinguptheposterofNaughtyandaskingthechildren:“On which side of the board should we fix this poster of Naughty?”;

15. Askachildthatrespondscorrectlytofixtheposteronthepin-boardbelowthebluesymbolasitrepresentssicknessandunhappiness;


16. Nowaskthechildren: “What about Smarty’s and Ruby’s habits?”Thechildrenshouldrecognisethesehabitsasgoodhabits,andfixthembelowgreensymbol;

17. Remembertoenthusiasticallypraiseeachchildwhooffersarightanswer;

18. Distributethepostersof‘Goodandbadhygienepractices’tothechildren;

19. Thefacilitatorshouldnowexplain:“You have got a poster portraying either a good or a bad habit. Please explain your poster to us and then pin it to the board under the happy or unhappy smiley!”;

20.Organiseforeverychildtocometothefrontandexplainthehabitontheirposterandwhyitisgoodorbad.Aftereachpresentation,invitethemtopintheposterontotheboard.Remembertoencourageandpraiseeachchildinturn;

21. Thefacilitatornowtakesover,explainingthatformostgoodhabitstherearecorre-spondingbadhabits.Askthechildren: “For each bad habit there is also a good habit. Can you show us an example?” When one of the children identifies a corresponding pair, invite them to, “Remove the two posters. Please stay there and remove the corresponding pairs as they are identified”;

22. Helpthechildrentopintheirpostersbackintherightplacesonthepin-board;

23.Concludetheactivitywithasong.


—Whenfixingthesmiley’stothetopofthepin-board,allowsufficientspaceforalltheposterstobepinnedbeneath.Forthisreason,afacilitatorshouldassistwhenpinningupthefirstposterofNaughty.

—Carefullyselecttheposterstobeused,sothatallthosehabitswithacounterpartareincluded.

—Youngchildrenmaybetooshytocomeforwardandpresenttheirposters.Insuchcases,itmaybeusefultoinviteanolderchildorsiblingtoassistthem.

—Thewholesessionshouldnottakelongerthananormallessonatschool(i.e.40–50minutes).

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Step 3: Problem Analysis

Thisstepanalysestheproblemsidentifiedduringstep2andexplainssomeofthecom-monhygiene-relateddiseasesthatchildrencansufferfromandhowtheyaretransmitted.Itshowstherelationshipbetweenbadpersonalhygieneandtheoutbreakofdiseasesandputsextraemphasisonandexplainstheroleoffliesinspreadingdiseases.

Step 3 activities Activity3.1: MemorisingGoodandBadHygienePractices Activity3.2: GermsAreSpreadbyFlies Activity3.3: HowGermsAreSpread

Step 3 objectives Bytheendofthisstep,thechildrenwillhave: —Recognisedthefundamentaldifferencesbetweengoodandbadhygienichabits —Understoodthatfliestransmitdiseases —Understoodthattherearemanywaystostopthetransmissionofgerms —Learnedseveraleasywaysofprotectingthemselvesfromdiseaseslikediarrhoea,

suchaswashingtheirhandsandcoveringfood

Activity 3.1: Memorising good and bad hygiene practices

Objectives Bytheendofthisactivity,thechildrenwillhave: —PresentedpairsofMemorycardswithhygienicpractisestothegroupandexplained

them —Formedpairsof‘matching’habitsinthecardgameMemory —Learnedhowtoplaythegamewithoutassistance



—Thesetofpostersentitled‘Goodandbadhygienichabits —AtleastthreesetsoftheMemorycardgameWhat to do 1. Makethechildrentositinacircle;

2. OpenthesessionwithafriendlygreetingfromDolly:“Hello, how are you this morn-ing / afternoon? I am fine. My name is Dolly and my favourite colour is [dress

colour]. Please can you also tell me your name and your favourite colour?”;

3. Throwthepuppettooneofthestudents,especiallyiftherearenewcomersandaskthemtointroducethemselves:“Hi there! Why don’t you tell us your name, age and favourite colour?”;

4. Whenthechildhasfinished,tellhimorhertothrowDollytoanotherchildwhohasnotyetbeenintroduced;

5. Whenallthestudentshaveintroducedthemselvesinthisway,thefacilitatorasks:“Do you remember my name and my favourite colour?”Someofthechildrenwillremember;


6. YoushouldthengivethepostersofNaughty,RubyandSmartytothechildrennexttoyou.Askthemtoholdupthepostersandthenask:“Do you recognise these boys and the girl? Do you remember their names and their favourite col-ours?”Withthehelpofthechildren,Naughty,RubyandSmartyarereintroduced;

7. Thenaskthegroup:“Do you remember what we were discussing the last time we met?”Therewillbesomespontaneouscontributions.Ensurethatonlyonechildtalksatatime.ThiscanbedonebygivingDollytowhicheverchildisspeaking.Aftereachcontribution,thechildshouldthrowthepuppettothenextchildwantingtospeak.Whenallthecontributionshavebeenmade,collectthepuppet;

8. ThendisplaystwoidenticalcardsoftheMemorygame–eitherinthecentreofthecircle or on the pin-board – and asks: “Please tell me what you can see”;Thisrevisionofcorrespondinghygienichabitscanbedonewithsomeorallselectedpairsofcards.Again,youcanuseDollytoensurethatonlyonechildspeaksatatime.

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9. NowexplaintheMemorygame.Thefirsttimeplayademonstrationroundtogetherwith threebrightchildren,afteryouhaveexplained: “This isacardgamecalledMemory.Allcardsareshuffledanddisplayedinrowsfacedown.Allcardsarepartofanidenticalpair,sotherearealwaystwoofthesameinthegame”.Placethe36cardsfromthe18-pairpackfacedowninsixrows,andturnovertwo(hopefullydif-ferent)cards.Theninvitesthechildtoyourlefttoturnovertwocards,andexplain:“Ifyourcardsareanidenticalpair,youcantakethemandturnthemoveranothertwocards.Alltheplayersshouldlookatthemclosely.Iftheyarenotapair,theyareagainturnedfacedownandthenextpersongetsaturn”.Hethenturnstothechildleftofthefirstone:“Yourneighbourtotheleftcontinues:turnovertwocards,checktoseeiftheyformapair,andeitherkeepthepairiftheymatchorturnthemfacedownagain”;

10. Whenthedemonstrationgameisfinished,askthechildrentoformgroupsofabouteightchildreneach;-numberofgroupsdependingonthesizeofthetotalgroup.Whentheyareingroups,handoutthefourfullpacksofMemory:“Shufflethecardswellanddisplaythemfacedowninfourrows”.Movebetweenthedifferentgroupsandofferthemassistance,especiallytheveryyoungchildren.Makesurethattheturnedcardsstayfaceupforlongenough–andthatnobodytriestocheat;

11. Whenthefirstgameisfinished,changethecompositionofthegroupssothatthewinnersand runners-upareall together, the thirdand fourthplacedplayersaretogetheretc.Againmoveamongthedifferentgroupsofferingadviceandassistance;

12. Whentwoorthreeroundsofthegamehavebeenplayed,thesessioncanendwithasong,introducedbythechildren.


—YoungchildrenmayfindtheMemorygamedifficulttobeginwith,butshouldcatchonfairlyquickly.Ifsomechildrenarehavingtrouble,thefacilitatorscouldplaytwoormoreroundswiththem.

—Interestedchildrencouldbeallowedtostayonafterthesongtoplaythegameagain.


Activity 3.2: How germs are spread

Objectives —Bytheendofthisactivity,thechildrenwillhave: —BecomefamiliarwiththebehavioursofNaughty,RubyandSmarty

—Recognisedthedirectlinkbetweennotwashinghandsanddiarrhoealdiseases



—Postersfromtheseriesentitled‘NaughtyandSmartyareplayingfootball’ —Presentationmaterials

What to do 1. Dollythesessionwithagreeting:“How are you this morning / afternoon? I can again see some new faces ...”Dollygivesthenewcomersawarmwelcomeandasksfortheirnamesandfavouritecolours–asinthepreviousactivities;

2. Priortotheactivity,fixtheeightpostersofthestory‘NaughtyandSmartyareplayingfootball’insequenceonthewall.Beginthestoryinaninteractiveway,bypointingtothefirstposterandasking:“Who can you see in this picture?”OncethechildrenhaverecognisedSmartyandNaughty,askthem:“What are they doing?”ThechildrenwillexplainthatNaughtyandSmartyareplayingfootball.Pointtothesecondpictureandask:“Who can help me explain the second picture?”WiththehelpofDolly,chooseanapparentlybrightboyorgirltocomeforwardandpresentthisposter;

3. Whentheposterhasbeenpresented, invite thechildren to formpairswith theirneighbours;

4. Nowcontinue:“All the pairs sitting on my right hand side, you are Smarty and all those on my left are Naughty.”Makesureallthechildrenknowwhichcharac-tertheyaresupposedtoberelatingto;

5. Explaintheexercisecarefullyasfollows:“All the pairs come forward and explain what happens to your character. When you have looked at the posters care-fully, sit down again and work out with your partner exactly what happens to your character”;

6. Whenthechildrenhavefinishedanalysingtheircharacter’sstory,askthoseonyourlefthandside:“Can one pair of you come forward and tell us exactly what happens to Naughty?”Whenapairvolunteers,throwDollytothemandinvitethemtopresentthestoryofNaughtywiththehelpoftheposters;

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7. Whenthepairhasfinishedandanyadditionalcontributionsorquestionshavebeenmadeorasked,looktotherighthandsideandask:“Now it’s your turn. Can one pair of you come up here and tell us Smarty’s story?”Apairofchildrencomesforward,tellsthestoryandanswersquestionsfromthegroup;

8. Toconcludethestory,askthewholegroup:“What are the differences between the story of Naughty and the story of Smarty? Why does Naughty become sick? And why does Smarty stay healthy?”ThechildrenshouldexplainthatSmartywashedhishands,whileNaughtydidnot.ThedirtonNaughty’s handscausedhimtobesick;

9. Afterpickinguptheadditionalposters,nowinvitethechildrentocontinuethestory:“A week later, Naughty and Smarty are playing football again. How do you think Naughty will behave this time? Has he learnt his lesson?” Invitethechildrentodeveloptheunfoldingstorywiththehelpofthenewpostersonthepin-board.Theycanworkinpairsagain;

10. Whenmostofthepairshavefinished,invitethreeorfourofthemtocomeforwardandpresenttheirnewplotswiththehelpoftheposters


TheshortstorypostersshowingNaughtyandSmartyplayingfootballshouldbearrangedsuchthatthestorybeginsfromthetop,wheretheboysareplayingfootball,comingdownwards.Thepicturesdepictingthespecifichabitsofthetwoboysshouldhaveaspacingofatleast1maparttoalloweachofthetwogroupsofchildreninthesessionrepresentingthetwoboys,tostandinfrontoftheirpartofthestoryandvisualizeitwithoutdisturbingothers.

Note:ThereisnoPoster(4)bbecauseNaughtyisnotwashinghishands.


(1)

(2)

(7)

(6)

(5)a(5)b

(4)a

(3)a(3)b

>1 m

Activity 3.3: Germs are spread by flies

Objectives Bytheendofthisactivity,thechildrenshouldhave: —Recognisedthatfliescantransmitdiseases —Recognisedhowtheytransmitdiseases,e.g.bysittingonfaecesandthenonuncov-

eredfood —Discoveredhowcoveringfoodcanpreventthisrouteofdiseasetransmission


Materials —Propsfortheroleplay —ThepuppetDolly

—Apostershowingafootball —Theseriesofposterson‘NaughtyandSmartyareplayingfootball’What to do 1. OpenthesessionwithawelcomefromDolly:“How are you this morning / after-

noon? I can see some new faces ...”Givethenewcomersawarmwelcomeandaskfortheirnamesandfavouritecolours;

2. Introducetherole-play: “Today we want to show you a short play. We are short of actors and we need two of you to play Naughty and Naughty’s baby brother”;

3. Afterselectingthetwoplayers,takethemawayfromthesessionandexplainthecharacterstheyaretoplay.RemindthemofNaughty’spoorhygienichabits.Practicetheroleplaywiththematleasttwice;

4. Inthemeantime,theotherfacilitatorshouldrevisetheprevioussessionbyshowingsomeoftheMemorycards:“What happened during our last session?”Askthechildrentoexplainwhathappened,anddiscussthehygienebehavioursshownonthecards,whicharegoodandwhicharebad;

5. Whenthefirstfacilitatorreturns,therole-playcanbegin.Encouragethechildrenintheaudiencetofollowtheplotcarefully;

6. Withthetwochildren,performtherole-play;

7. Attheendoftheplay,encouragetheaudiencetoapplaudtheplayers.Thenaskthem:“What did you see?”,“What happened in this family?”,“What happened to the food?”and“What may happen to Naughty?”;

8. Afterthisdiscussion,pointtothepostersshowingthe‘Toolsofpersonalhygiene’andaskthechildren:“What do we need to keep germs like those affecting Naughty away from our hands and mouths?”

9. ThrowDollytowardsoneofthechildrenputtingtheirhandsup.Invitehim/hertocomeforwardwithDolly,removeoneoftheposters,andexplainitspurposetothegroup.Repeattheprocessuntilthe‘Tools’havebeenexplained.

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Script of the Flies Role-Play:

Characters Themother,Naughty,atoddlerandthefly(allplayedbychildren)

Materials —Posterofafly(toattachtotheclothesofthepersonplayingtheroleofafly) —Ahandfulofsandandsmallstones,symbolisingfaeces —Fourplates —Amat —Onionsorpotatoes(symbolisingfood)

Duration 10minutes

What to do 1. Naughtyandhismotherandhertoddleraresittingonoppositesidesofthemat,withtwocoveredplatesfilledwithonionsorpotatoesinfrontofthem.Theflycruisesslowlyaroundthemandsitsinacorner,buzzingquietly;

2. Themotheruncoverstheplateinfrontofherandstartsfeedingthetoddler;

3. Naughtyuncovershisplateandstartseating;

4. Naughtyleavesthematwithoutcoveringtheplate.Hesteps‘outside’,althoughhecanstillbeseenbytheaudience.Hesquatsdownandpretendstodefecate,lettingahandfulofstone/sandfallontotheground;

5. Naughtyreturnstothemat,sitsdownandcontinueseating;

6. Theflyfliestowardsthefaecesandsitsonit.Itcollectssomeofthesandfromthefaecesandfliesbacktowardsthemotherandthetoddler;

7. Theflytriestolandontheirplate,butitisswattedbythemother,whocoversthefood;

8. TheflygoestoNaughty,fliesaroundhim,andsitsontheunguardedplate.Naughtycontinueseatingandignoresthefly;

9. TheflydropsitssanduntoNaughty’splateandfliesbacktothemother,whoswatsitawayagain;

10. Theflyreturnstoitscorner;

11. Naughtypretendstoeatsomeofthesandfromhisplate.Suddenly,helooksveryanxiousandputshishandonhisstomach.Hebendshisbodysignifyinggreatpainandputhishandoverhismouth;

12. Naughtyrunsoutandpretendstovomitontheground;

13. Theactorsstandupinfrontoftheaudience,linkhandsandtakeabow.Thefacilita-torsthankthetwochildrenfortakingpartintheplay.



—Beforetherole-playcanbegin,thetwochildrentakingpartmustbe‘tutored’bythefacilitatorabouttheirroles.

—OneofthechildrenwillplayNaughty,acharacterwithnotorioushygienebehaviour.Thesecondwillplayatoddler,beingfedbyhis/hermother.

—ItmaybeimportanttostresstothecharacterplayingNaughtythathisrolewillnotreflectatalluponhisownpersonalhygienehabits.Boththechildrenshouldprac-tisetheirrolesseveraltimes,withpositiveandconstructivecriticismsfromthefacilitator/s.bothchildrenmustunderstandexactlywhatmessagestherole-playisdesignedtoconvey.

—Youcanplacetheserialisedpostersforrevisioninthecentreofthecircle,aslongastheyremainvisibletoeveryone.

—Therevisionexerciseshouldlastatleast15minutes,inordertoallowtheotherfacilitatortorehearsetheroleofNaughtywiththeboywhowillbeplayinghim.

40

Step 4: Practising Good Behaviour

Thisstepwillinvolvetrainingchildreninpracticalskillsthatareessentialforgoodpersonalhygiene.

Step 4 activities Activity4.1 Blockingtheroutesofgerms Activity4.2 Handwashingexercise Activity4.3 Toothbrushingexercise Activity4.4 Toiletuseexercise Activity4.5 Facewashingexercise

Step 4 objectives Bytheendofthisstep,thechildrenwillhaveanunderstandingofhowto: —Blocktheroutesoftransmissionofgerms —Washtheirhandsproperly —Brushtheirteethproperly —Usethelatrineinahygienicway —Washtheirfacesproperly

Activity 4.1: Blocking the routes of germs

Objectives —Bytheendofthisactivity,thechildrenwillhave: —Anunderstandingofhowgermscanbetransmittedbyflies —Knowledgeonvariouswaysofblockingtheroutesofsuchgerms


Materials —Dollythepuppet —Twosheetsofpaperpinnedtoeach,thepictureof‘Naughtyisunwell’inthecentre,

andthedifferent‘germroutes’cards(hands,food,mouth,faeces,fliesetc)arrangedaroundit

—Markerpens —‘Stop!’roadsigncardsforblockingthediseaseroutes


What to do 1. Seatthechildreninacircle,whileyousitdownamongthem;

2. OpenthesessionwithagreetingfromthepuppetDolly:“How are you today?”;

3. Explainthepurposeofthissession:“Today we are going to talk about how germs can make you sick.”;

4. Explainhowthedifferent‘Germroute’cardscancontributetoNaughty’ssickness,andhowthechildrenwillbeabletoassisthimbyblockingtherouteswithotherposters.Makesurethatthechildrenunderstandhoweachgermroutefunctionsandhowitcanbeblocked;

5. Dividethechildrenintotwogender-balancedgroupsbycountingoffalternatechildrenwiththenumbers‘1’and‘2’.Inviteallthosechildrenallocatedthenumber‘1’tositinonecircle,thoseallocated‘2’tositinasecondcircle;

6. Placethesheetsofpaperinthecentreofeachgroup;

7. Withafacilitatoroverseeingeachgroup,invitetwoofthechildrentodrawthe‘germroute’betweendifferentcards–withtheconsensusofallthemembersofthegroup;

8. Askeachgrouptochoosetheirpresenters,andinvitethemtopresenteachgroup’sresultstothewholegroup;

9. Fixathirdsheetofbrownpapertoapin-boardwith‘Naughtyisunwell’inthecentre,andinvitethewholegrouptobuildanothernetworkofgermroutesaroundhim.Askindividualchildrento identifywhichroutescanbeblockedbyparticularhygienicpractises,forexample:“Which of these routes can you block by thoroughly washing your hands?”;

10. Whenachildmakesacorrectsuggestion,invitehimorhertofixtherelatedposteroverthatroute.Repeattheprocessuntilalltheroutescanbeblocked;

11. Endwithasongintroducedbythechildren.


—Thetwogroupsshouldbegender-balanced,withroughlyequalnumbersofboysandgirls.Discussionsbetweenthegendersshouldbeencouragedduringthegroupwork.

—Thegroupworkshouldnotlastlongerthan15minutes.Thefacilitatorshouldtrytominimisehis/herassistanceinthesediscussions.Beforethepresentations,remindthepresentersofthe‘3Ts’andgivethemfewminutestorehearsetheirpresentations.

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Activity 4.2: Hand washing exercise

Objectives Bytheendofthisactivity,thechildrenwillhave: —Abetterunderstandingoftheimportanceofwashinghandsasameasureofdisease

prevention —Theabilitytowashtheirhandsproperlywithsoaporwashingpowder —Clearstepsforwashinghandswithsoaporwashingpowder —Black-and-whitedrawingstobackupthislessonDuration 30–40minutes

Materials —Dollythepuppet —‘Personalhygiene’posters —Black-and-white‘Handwashing’drawings —Crayons —Watercontainer,soaporwashingpowder —AsetofMemorycards —Presentationmaterials


Makesureyouteachthechildrenthatproperhandwashingshouldinvolve:1. Wettingbothhands2. Applyingsoap,orothercleansingagents,tobothhands3.Rubbingthepalmsandthefingersthoroughlyagainsteachother4. Rinsingoffthedirtwithenoughwateranddrythehandsonacleantowelorleave

themtodrynaturally


What to do 1. Seatthechildreninacircle;

2. OpenthesessionwithagreetingfromthepuppetDolly:“How are you today?”;

3. Askthechildrentolookatthepostersdisplayedonthepinboard.Usingtheposters,namethetoolsthatareimportantforpersonalhygiene(soap,washingpowderandwater).;

4. Invitecertainchildrentopickaposterandexplainthe‘hygieniclesson’itistryingtoconvey.Whentheyarefinishedtellthemtotakebacktheposterstotheirseats;

5. Whenallthepostershavebeenexplained,collectthemfromthechildrenandremoveothersfromthepinboard;

6. Youcannowannouncethetopicoftoday’ssession: “Today we are dealing with hand washing. Why is it so important to wash your hands regularly and thoroughly?”Thechildrenshouldbeencouragedtomentiondiseasesandtheirsymptoms–e.g.diarrhoea, stomachupsets – that can result fromdirty hands.“When should you wash your hands?”Makesuretheyhavementionedthemostcriticaltimes:afterdefecating,beforeeating&beforepreparingfood.“What do we need for washing hands?”Makesurethechildrenmention:awatercontainer,soap/detergent/ashes.Displaythesethingsastheyarementioned;

7. Nowdividethechildrenintomixed-gendergroupsoffiveorsixchildrenpergroup;

8. Explainthateachgroupwillpracticehandwashinginturn,whiletheotherchildrencolourtheblack-and-whitedrawings;

9. Takethefirstgroupoutsideandinvitethemtogettheirhandsdirtybyrubbingthemonthesoil;

10. Nowaskthem:“Do we have the necessary tools for hand washing?”Iftheydonot,sendthembacktocollectthem;

11. Demonstratehandwashingwithsoapand/orwashingpowderinaclearseriesofsteps.Invitethechildrentorepeatthesesteps;

12. Assistanychildwhoisnotwashinghis/herhandsthoroughly;

13. Whentheexerciseisfinished,complimentthechildrenontheirhandwashingskillsbeforereturningtocollectthenextgroup;

14. Givetheotherchildrenoneblack-and-whitedrawingeach,andinvitethemtocolourthemin.Aftertheyhavedonethecolouring,inviteeachchildtoreadoutthetextaccompanyingtheirdrawingandtoexplainwhatitmeans;

15. Whenallthegroupshavepractisedtheirhandwashing,thesessioncanbewrappedupbysingingapopularsong.


—Thecleaningoffingernailsshouldnotbeincludedinthisexercise,duetothecom-monunhygienichabitofsharingnail-clippers.

—Thefacilitatorscanalsomentiontheimportanceofwashinghandsaftertyinguporremovingone’sshoes.

—Thefacilitatorsshouldalwaysmakethemselvesavailabletoanswerspecificques-tionsfromindividualchildren.

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Activity 4.3: Tooth brushing exercise

Objectives Bytheendofthisactivity,thechildrenwillhave: —Anunderstandingoftheimportanceofregularandthoroughtoothbrushing —Theabilitytoidentifytheappropriatetree/susedfortoothbrushing(notapplicablefor

(urban)settingswhereuseoftoothbrushandtoothpasteiscommon) —Anabilitytochoosetherightbranchesandtocutthemproperly(notapplicablefor

(urban)settingswhereuseoftoothbrushandtoothpasteiscommon) —Knowledgeofthemosteffectivemethodsforbrushingone’steeth —Drawingstoremindthemoftheimportanceoftoothbrushing


Materials —Dollythepuppet —Black-and-whitedrawingson‘Toothbrushing’ —Crayons —Twoknives —Aplasticbag —Amat —Anumberoflocaltoothbrushes(optionaldependingonavailability) —Presentationmaterials


Makesureyouteachthechildrenthatpropertoothbrushingshouldinvolve:—Useofastickfromasuitabletree—Washingofthetoothbrush/stick—Chewingthestickuntilthebarkofthetopisremovedandthefibresaresoftlike

abrush—Brushingoftheupperfrontteethfromtoptobottomseveraltimes—Brushingoftheotherteethoftheupperjawfromlefttoright—Brushingofthebacksideoftheupperjawandthechewingsurfaces—Brushingofthelowerjaw—Brushingofthesurfaceofthetonguefromthebasetothetip

What to do 1. Makethechildrentositinacircle;

2. OpenthesessionwithanexplanationfromDolly:“Today we will be learning the proper way of brushing our teeth. What do we need for brushing our teeth?”Thechildrenshouldknowthattheyneedabranchfromasuitabletree;

3. Dollyshouldthenask: “Who knows where the nearest recommended tree is? Remember that we need trees with enough branches for all of us”;

4. Whentheyreachthetree,thefacilitatorinvitesthechildrentopointoutthebranchesofthecorrectlengthandsizefor‘toothbrushes/sticks’.Theythendemonstratehowthesestickscanbecutcarefullyandsafely.Ifthechildrenareoldenough,theycancutthesticksthemselves;

5. Collectthetoothsticksinaplasticbag;

6. Dividethechildrenintomixed-gendergroupsoffive.Invitethefirstgrouptopractisebrushingtheirteeth,whiletheothersstartcolouringtheirdrawings(SeesequencePartIIStep4Activity4.2onhandwashing);


7. Beforebrushingaskthechildren:“What is the first step, before we use our tooth-sticks?”Thechildrenshouldknowthatthestickhastobechewedfirst,untilthebarkisremovedandthinfibrescanbeseen.Youshouldexplain:“These thin fibres can clean even the smallest gaps between our teeth”;

8. Demonstratehowtobrushtheteethonthefrontofone’supperjaw.Invitethechildrentofollowyourlead–takingcaretocorrecttheirbrushingmethodswherenecessary;

9. Whenallthechildrenhavebrushedthefrontpartoftheirupperjaws,continuewiththebackpart;

10. Instructthemhowtobrushtheteethofthelowerjawinthesamemanner;

11. Ifagroupcompletesbothexerciseswithtimetospare,theycanbeoccupiedwithcolouringoneoftheblack-and-whitedrawings;

12. Whenallthegroupshavepractisedtheirtoothbrushing,thesessioncanbewrappedupwithasong.


—Beforeconductingthisexercise,thefacilitatorsmustdiscoverthewhereaboutsofthenearestsuitabletreeinthevillage,incasechildrenleadthegrouptoawrongtreeoratreewithoutsufficient‘sticks’.

—Makesurethatyouusefreshly-cutstickforeachgroup.

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Activity 4.4: Latrine use exercise

Objectives Bytheendofthisactivity,thechildrenwillhave: —Understoodtheimportanceofhygienictoiletpractices —Recognisedtoiletsassafeplaces —Identifiedwhattoolsarerequiredforhandwashing. —Learnthowtocleantheirfingernails —Takenhomedrawingstoremindthemoftheselessons


Materials —PuppetDolly

—Copiesofblack-and-whitedrawingson‘Usingthelatrine’ —Crayons —Awatercontainer —Soapand/orwashingpowder —Presentationmaterials

What to do 1. Seatthechildreninacircle;

2. Openthesessionwithagreeting fromthepuppetDolly:“How are you today, children? Are there any newcomers?”Anynewcomersshouldbegivenawarmwelcomeandbeinvitedtointroducethemselves,tellingeveryonetheirname,ageandfavouritecolour;

3. Dividethechildrenintogroupsoffourandgiveoutthedrawingsandcrayons.Then,onebyone,thefacilitatorshouldtakeeachgrouptothelatrineandexplainthepropermeansofusingthelatrine,andkeepingitcleanintheprocess;

4. Askthechildrentoexplaininturnthecorrectsequenceinwhichtheyshouldusethetoilet–demonstratingthecorrectpositionoffeetonthefootpads,howtosquatsothatallfaecesgodownthehole,etc;

5. Afterthisdemonstration,inviteeachchildtowashtheirhandscarefullywithsoap;

6. Ifagroupcompletestheexercisewithtimetospare,theycanbeoccupiedwithcolouringoneoftheblack-and-whitedrawings;

7. Whenallthegroupshavecompletedtheexercise,thesessionshouldbewrappedupwithasong.


—Makesurethetoiletyouareusingisverycleanandthatthereissufficientwaterforhandwashing.

—Neverclosethedoorofthetoiletwhenyouareinsidewiththechildren.—Thediscussioninsidethetoiletmaydifferconsiderablywithdifferentgroupsof

children.Bepreparedtodiscusseverythingfrompersonalfearstotheneedforshoesandthecleaningoftheanusafterdefecating.


Activity 4.5: Face washing exercise

Inthisactivitythefacilitatorwillaskthechildrentogivesomeofthereasonsastowhyitisimportanttowashtheirfacesregularly.Later,he/shewillexplainthehealthimplicationsofnotpractisinggoodfacialhygiene.

Objectives Bytheendofthisactivity,childrenwillhave: —Knownthehealthreasonsbehindthefacewashingpractice —Understoodsomeofthecausesofeyediseasesandhowtopreventthem —Learnthowtowashtheirfacesproperlytopreventeyediseases


Materials —Abasinwithcleanwater —Adipper —Atoiletsoap —Acleanfacetowel(optional)

What to do 1. Makethechildrensitinacirclewiththefacilitatoramongthem;

2. OpenthesessionwithagreetingfrompuppetDolly:“How are you today, children? Are there any newcomers?”Anynewcomersshouldbegivenawarmwelcomeandbeinvitedtointroducethemselves,tellingeveryonetheirname,ageandfavour-itecolour;

3. Askthechildrenwhytheythinkitisimportanttowashtheirfacesregularlyandnotetheirviewsontheflipchart;

4. Youmaynowdiscussfurthersomeofthediseaseswhicharerelatedtothefacialhygienee.g.trachoma,conjunctivitisetc;

5. Havinggatheredthenecessarymaterialsmentionedabove,callfortwovolunteersamongthechildrentocomeinfrontanddemonstrateproperfacewashing.Iftheareainwhichthetrainingisbeingdoneiswater-scarce,emphasisshouldbeputonusingwatercarefully.Therestofthechildrenshouldpaycarefulattention;

6. Oncethisactivityisdonetosatisfaction,thesessionmaybeclosedwithasongonahygienetheme.

48

Step 5: Measuring Change

ThisisthefinalstepoftheCHASTCoursewhichwillassistyoutomeasurebehaviouralchanges.Italsoincludesanofficialclosingsessionforchildrenwhoparticipatedthrough-outthecourse.

Step 5 activities Activity5.1 FinalEvaluation Activity5.2 ClosingCeremony

Step 5 objectives Toassessthechangethathasbeenbroughtaboutinthechildren’shygienepracticesaftercompletingtheCHASTprogramme.

Activity 5.1: Final evaluation

Objectives Toseewhatchangehasbeenmadeinthechildren’shygienepracticesaftercompletingtheCHASTcoursebycomparingthefinalevaluationresultswiththebaselineinformationaboutthechildren’sinitialkeyhygienepractices(handwashingandlatrineuse)beforebeginningtheCHASTcourse.


Materials —Pinboardandpins —Posterofaboy,posterofagirl —3posterswithahandwashingmessage(washingwithsoap,washingwithwateronly,

notwashingatall) —Posterofachildusingalatrine,posterofachilddefecatingintheopen —3largeenvelopes —Colouredpaperclipsorothertypeoftokenthatcanbeusedforvotingexercise —Notebookandpenforrecordingresults

What to do SameasStep1Activity1.3

Activity 5.2: Closing ceremony

Objectives Aftertheclosingceremony,thechildrenwillhave: —Realisetheimportanceofgoodhygieneandsanitationbehaviours —RecognisedtheimportanceoftheCHASTcourse —Receivedawards/stickersfortheirparticipation

Inaddition,theschool/communitycouldreceiveitsownCHASTCertificate,andthechildrencanposewiththeteachers,localleaders,facilitatorsandprogrammestaffforagroupphotograph.




—CHASTCertificatefortheschool/community —CHASTstickers,buttons,soaporotherawardsforthechildren —Closingceremonyposters —AcameraandfilmWhat to do 7. Seatthechildreninacirclewiththefacilitatorsittingamongthem;

8. OpenthesessionwithagreetingfromthepuppetDolly:“Helloeverybody!TodayisthelastCHASTsessionandweareheretoseeyouoffandwishyouaveryhygienicfuture!”Dollypointstotheinvitedguestandsays:“Today we have some very special guests. Most of them are well known to you.”ThepuppetindicatestheProgrammeOfficer[orotherimportantguestswhowillmakeaspeech]andsays:“May I introduce our Programme Officer to you; His/her name is [name of

Programme Officer]”;

9. TheProgrammeOfficermakesashortspeech;

10. TheProgrammeOfficerpresentstheCHASTCertificatetothechildren,andwhererelevanttotheelders,afterDollyaddressesthechildren:“We have a small reward

for you, children, to commemorate all the things you have learnt to improve your own

personal hygiene.”Dollyhandtheawardsouttothechildren,onebyone;

11. Thefacilitatorshelptoarrangetheparticipantsforagroupphotograph.ThechildrenshouldsitatthefrontwiththeirpostersofNaughty,RubyandSmarty,andofhandwashing,toothbrushing,latrineuseandfacewashing.ThefacilitatorsshouldholdaloftthepuppetDolly;

12. Theceremonycloseswithanothersongbythechildren–andanyoneelsewhowantstosingalong!


Thecommunityeldersshouldbegivenatimelynoticeinordertoensurethattheycanattendtheclosingceremony.ItisalsoveryimportantthattheProgrammeOfficerispresent.

50

Part III: Step-by-step chast activities for upper primary school

Topic 1: Clean is Beautiful

Objectives Bytheendofthesessionthepupilswill: —Understandthathandwashingpreventsthespreadofdiarrhoealdiseases —Demonstrateproperhandwashingprocedure —Describecriticalhandwashingmoments

Duration 45minutes

Materials —‘Bad’poster:Naughtyisusingthelatrineanddoesnotwashhishandsafterdefeca-tion

—‘Good’poster:Smartyisalsousingthelatrine,buthewasheshishandswithwaterandsoapafterdefecting

—Water,soapandtwowhitecloths —Whitepaperandcrayons

What to do Song:

Singingabouthandwashing Splittheclassupintwogroups.AskonegrouptosingasongaboutNaughty’sstory

andasktheothergrouptosingasongaboutSmarty’sstory.

Group discussion:

Whatwillhappenifwedonotwashourhands? Askthechildrenthequestionaboveandtrytofindoutwhattheyalreadyknowbefore

yougivethemtheanswer.Answer:Ifwedonotwashourhands,thegermsonthehandsandthegermstrappedinthenailswillgetintothestomach,andthenwillcausediarrhoeadisease.

MakesurechildrenunderstandtheProblem:“Diseaseorganismsonhandscanenterthebodywhenhandsorsomethingtouchedbyhands(likefood)comeintocontactwiththemouth.Theseorganismscanthencausediseasessuchasdiarrhoea”.

AndthendiscusstheSolutions:“Washinghandswithsoap(orash)andwaterremovesdiseasecausingorganismsfromhands,thuspreventingtheirspreadtothemouth”.

Demonstration:

Handwashing Asksomechildrentodemonstratehowtowashhandsproperly.Tounderstandthe

importanceofhandwashingwithsoap,asksomechildrentowashtheirhandswithonlywateranddrythemonawhitecloth.Askotherchildrentowashtheirhandswithwaterandsoapanddrythemonasecondwhitecloth.Analysethedifferencebetweenthetwocloths.

52

Drawing:

Atwhattimedowewashyourhands? Askchildrentodrawapictureofasituationwhentheymustwashtheirhands.Then

discussthedifferentanswersandmakethechildrenunderstandthatthese are critical

times we must wash our hands: AlwayswashhandsAFTERhandlingfaeces: —Afterdefecating —Aftercleaningthebottomofababyorchild —Afterdisposingachild’sfaeces

AlwayswashhandsBEFOREhandlingfood: —Beforecookingfoodorboilingwater —Beforeservingfood —Beforeeatingandbeforefeedingothers

AlwayswashhandsAFTERhandlingwaste: —Afterhandlinganimalsandcleaninganimalwaste —Aftercleaningliquidandsolidwastes —Afteranyworkinvolvingcleaning

PartIII:Step-by-stepchastactivitiesforupperprimaryschool53

Topic 2: I Drink … Safe Water

Objectives Bytheendofthesessionchildrenwillbeableto: —Understandthedifferenttypesofwatersources —Differentiatebetweensafeandunsafewatersources —Explainthefactorsthatdeterminewhetherwaterissafefordrinkingornot —Listandexplainvariousmethodsofwatertreatment

Duration 45minutes

Materials —‘Good’poster:Rubyisfetchingwaterfromaprotectedwatersource —‘Bad’poster:Naughtyisfetchingwaterfromtheopenwellwhileheisstandinginthe

water —Visitfromhealthworker —Paperandcrayons

What to do Group discussion: Askthechildrenanumberofquestionssuchas: Wheredoyoufetchyourdrinkingwater(borehole,river,dam,standpipe,well,etc)?

Listallthethingsyoucandowithwaterathome,inthecommunity,atschool,etc.(drinking,swimming,washing,bathing,etc);

Whatdoesthismeanforthecleanlinessofthewater? Whyiswaterwhichlooksclearorwhichhasagoodtastenotalwayssafetodrink?

Howcanwaterhelpus?Andhowcanwaterharmus?

Childrenshouldlearntounderstandthatwatercollectedfromunprotectedsourcesispollutedandcanleadtodiseaseslikediarrhoea.Weshouldonlydrinksafewaterfromsafe(protected)sources.Ifyoudonothaveaccesstosafewaterandmustuseunsafesourceofwater,thenmeasuresshouldbetakentopurifythewater(boiling,filteringetc).

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Exercise and expert presentation: Makealistofdiseasesthatcanbespreadthroughunsafewaterandfindoutabouttheir

symptoms,transmissionandhowtheycanbeprevented Thisexerciseisfortheolderchildren.Firstremindthemthatdirtywatercanbeanenemy

andthatmostcontaminationoccursduringthecollection,transportationandstorageofwater.Explaintheimportanceofhandlingwatersothatitremainsprotectedfromcon-taminationandthereforesafetodrink.Evenifwaterappearstosmellandtasteclean,itmaybecontaminated.Organismsthatcausediseasearetoosmalltobeseenbythenakedeye.Nowaskthechildrentomakealistofdiseasesthatcanbespreadthroughunsafewaterandfindoutaboutthem.Youcaninviteahealthworkertoexplainmoreaboutthediseases,theirsymptoms,andmodesoftransmissionandhowtopreventthem.

Environmental walk:

Observeyourwatersources Splittheclassupinsmallergroupsoffourtofivechildreneachandaskeachgroupto

gooutsideandwalkaroundtheschoolandthevillagetoseesomeofthewatersources.Givethematimeframebywhentheyneedtobeback.Backintheclassroomdiscusswhattheyhaveseen.Wasitcleanwaterordirty?Wasitfenced?Etc.

Drawing:

Oncethewaterisdrawnfromthesource,howdowekeepdrinkingwatersafefromcontamination?

Askthechildrentodrawapictureofasituationabouthowtoavoidwaterfromgettingpolluted,andthenorganisethedifferentpicturesinthefollowinggroups:“Collectionandtransportat/fromsource”and“Storageandhandlingathome”.

Possibleanswerstothequestionaboveare:

Collectionandtransportofdrinkingwaterat /fromsource: —Washhandsorhandsofchildrenbeforecollectingwater; —Cleanwatercontainersandropesbeforecollection.Containersusedtocollect,trans-

portandstorewatershouldbecleanedinsideandoutsideregularly.Aftercleaningthem,placewatercontainersinthesun(theheatandlightofthesunhelpstokillthegerms);

—Ensurethatwhilecollectingwater,thereisnowashingorcleaningactivitiestakingplacenearby,whichcancontaminateyourwateratthesource;

—Donotputhandsorotherobjectsinthewatercollected(childrenshouldespeciallybeinstructedontheimportanceofthis);alsonotwhileliftingorcarryingthejerry-canorcontainerasthiscancontaminatethewater;

—Coverthewatercontainerwhiletransporting


Storageandhandlingofdrinkingwaterathome —Storedrinkingwaterincleancontainersandkeepcoveredatalltimes.Coveringthem

willpreventgermsfromgettinginside; —Storedrinkingwaterseparatefromotherwaterusedforcleaning,laundryandcook-

ingfood; —Makeacleancupwithalonghandle(nohandsshouldbetouchingthewater!)avail-

ablefortakingwateroutofthecontainer.Thissamecupshouldbeusedbyeveryonetakingwaterfromthecontainer.Thisistopreventgermsfromspreadingfrompeople’shandstothewaterthatwouldthenspreadtootherpeoplewhodrinkthewater.Don’tdrinkwaterfromthesamecupbecausegermsmightcomefromyourmouthintothewater;

—Donotallowanyonetoputtheirhandsintothecontainerortodrinkdirectlyfromit; —Keepanimalsoutofthehouseandawayfromwatercontainers; —Keepfaecesandwastewater(especiallyfromlatrines)awayfromwatertobeused

forcooking,drinking,bathingorwashing; —Disposeofwastewaterbyguidingitintoagardenorsoakpit

Group discussion: Discusswiththechildrenthefollowingactionstoimprovetheirhealth: —Usethemostconvenientwatersourceforpersonalanddomestichygiene.Borehole

waterisusuallythesafesttodrink! —Drinkingwatershouldbecollectedfromthecleanestavailablesource.Safetyshould

bemadepriorityoverconveniencefordrinkingwater; —Inareaswherethere isnosafewater,peopleshouldpurifytheirwaterbyboiling,

chlorinating,orfiltering(throughsand/clayfiltersorcloth),usingSODISorthroughsedimentation.

Itisalwaysgoodtoboilwaterbeforedrinking:Boilingwaterkillsgerms.So,ifpossiblewatershouldbebroughttoboilandcooledbeforedrinking.Thisisespeciallyimportantforchildrenastheyarelessresistanttogermsthanadults.

Thereoftenmanyquestionsastohowlongwatershouldboiltodestroydiseasecausingorganisms.Inmanyoftheareaswheretheselessonsareimplemented,fuelandfirewoodaredifficultandexpensivetoobtain.Thecorrect length of time needed to boil water inordertodestroydiseasecausingorganismsandmakeitsafefordrinkingisactuallyzero minutes.Oncethewaterhas reached the boiling point(100°Cor212°F)ithasbeenhotenoughtodestroyorganismsforquitesometime.Afteryouremovethewaterfromtheheatsourceitwilltakeanotherperiodoftimeforthewatertocooldownenoughforyoutobeabletodrinkit,duringwhichitcontinuestoremainhotenoughtoeliminatepathogens.Evenatveryhighaltitudestheboilingpointofwaterishighenoughtohaveeliminatedthethreatofdiseasecausingorganisms.

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Topic 3: Going To the Latrine

Objectives Bytheendofthesessionthepupilswill: —Understandtheimportanceofusingatoilet —Knowthehealthrisksofopendefecation —Describetheroleoffliesintransmissionofdiarrhoealdiseases —Understandtheirrolesinmaintainingthecleannessoflatrines

Duration 45minutes

Materials —‘Good’poster:Smartyisusingoneoftheschoollatrines;healsobroughtwithhimsomewaterandsoaptowashhishandsafterwards

—‘Bad’poster:Naughtyisdefecatingoutintheopen.Hesquatsnearbyawatersource

What to do Discussion:

Whyisitimportanttouselatrines? —Askthechildrenwhytheythinkthatitisimportanttouselatrines.Afterhavingreceived

severalanswersofthechildren,explain/addthat: —Topreventthespreadofdiseaseorganismsfromfaecestopeopletheyshouldusea

latrineorburythefaeces; —Makechildrenunderstandthatmanypeopleknowthatfaecesaredirty,buttheymay

notknowthatfaecescancausediseases.Diarrhoea,worms,cholera,typhoidandpolioarespreadwhengermsarepassedfromourfaecestohandsandclothes,tothewaterwedrinkandthefoodweeat,makingusallill;

—Alsomakethemunderstandthatifitisnotpossibletousealatrine,adultsandchildrenshoulddefecatewellawayfromhouses,paths,watersuppliesandanywherethatchildrenplay.Afterdefecating,thefaecesshouldbeburied.Manypeoplethinkthefaecesofchildrenareharmless,buttheyareNOT!Thefaecesofbabiesandsmallchildrenarefivetimesmoredangerousthanthatofadults.Sotheirfaecesshouldbecleanedupimmediatelyandputdownthelatrineorburied.Alsokeepthefaecesofanimalsawayfromhomesandwatersources.Anddon’tforgettowashyourhands!!!

Howcanfliestransmitdiseases? —Askthechildrenhowtheythinkthatfliescantransmitdiseases.Afterhavingreceivedthe

severalanswersofthechildren,explain/addthatifwedefecateintheopen,fliescansitonitandspreadgermstothenextplacetheysiton,forexampletheirfoodortheirface.

Whydosomepeoplenotusealatrine? —Ask thechildren toexplain thisanddiscuss the reasons.Thenagreeonwaysof

encouragingtheuseoflatrines.


Environmental walk: Visittheschoolfacilities —Takethechildrenonanenvironmentalwalktovisittheschoolfacilities:dumpsites,

latrines,kitchenetc.Stimulatethemtoobservetheconditionofthefacilitiescarefullyandtonoteanybadsmells.Alternatively,pairoffyoungerandolderchildren,sothattheolderchildrencanhelptheyoungeroneobserve.

—Backinclass,askthechildrentodescribewhattheyhaveseenandsmelled.Inthecaseofolderchildrentheycanfirstwritedowntheirobservationsbeforeexpressingthem.

—Assistthemtoreflectonthebadandthegoodpracticesandonhowtheycouldmovefromthebadtogoodpractices.Forolderstudents,ortheSchoolHealthClub,youcanhelpthemtoprepareasimpleplanforhygienicuseandmaintenanceoffacilities.

—However,schoolchildrencannotdoallthemaintenanceforschoolfacilities.Maintain-ing,repairingandimprovingfacilitiesrequirecooperationbetweentheschool,theparents,thelocalauthoritiesandtheMinistryofEducation.

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Topic 4: My Beautiful School

Objectives Bytheendofthesessionthepupilswill: —Understandtheimportanceofkeepingtheenvironmentclean —Formulaterulesagainstlitteringoftheschoolcompound —Knowtheroleofschoolhealthclubinensuringtheschoolcompoundiskeptclean

Duration 45minutes

Materials —‘Good’poster:SchoolAisacleanschool.Theteachersandpupilsregularlycleantheschoolcompoundandtheydisposetheirrubbishingarbagepits

—‘Bad’poster:SchoolBisdirty,nocleaningistakingplace

What to do Group discussion:

WhatdifferencesdoyouseebetweenvillageAandvillageB? —Askthechildrentohaveagoodlookatthetwodifferentpicturesandletthemexplain

whatdifferencetheyseebetweenschoolAandschoolB.

Whyisitimportanttoputourrubbishinabinorgarbagepit? —Askthechildrenwhytheythinkitisimportanttodisposerubbishinabinorgarbage

pit.Afterhavingreceivedtheseveralanswersofthechildren,explainthevariousrisksandnuisances:

—Diseaseorganismsarespreadfromrubbishtopeoplethroughtheenvironmentandthroughflieswhenitisscatteredoutintheopen.Thesolutionthereforeistoproperlydisposeofgarbagetopreventdiseaseorganismsfromspreadingtopeoplethroughfliesandthroughenvironment.

—Thendiscusswiththegroupthateveryfamilyshouldhaveaspecialpitwherehouse-holdrubbishisburiedorburnedatleastonceaday.Itwouldalsobegoodiftheycouldreducethequantityofrefusetobedisposedofbycompostingandre-useofmaterialssuchasplasticbags.

Solidwaste —Alternativelytheteachercanbringsomeexampleshim/herselforaskthechildrento

collectsomeexamplesofsolidwastetheycanfindaroundtheschoolpremises. —Showtheitems(suchaspolythenebags,paper,sweetwrapper,andglassbottle/jar)

tothegroupandaskthemtosaywhateachitemisandwhereitcanbefound.Whyaretheseitemsfoundthere?

—Askthemwhathappensifeverybodykeepsthrowingalltheirrubbishoutintheopen.Thenfacilitateadiscussionaboutbettermeansfordisposalandreuseofwaste.Someofthequestionsthatyoumayaskinclude:

—Whatwillyoudoifyouseeafriendthrowingawayrubbish? —Whereshouldyouthrowwaste? —Whatwayscanyouusetorecyclepolythenebags,bottles,peelingsoffruit,etc? —Afterwardstakethechildrenonanenvironmentalwalkthroughtheschoolandask

themtonamethekindsofwastetheycansee.


Setting up school health club: —Studentsandteachersfromtheschoolhealthclubshouldmakeregularinspections

oftheschoolgarbagepits,latrines(bothboysandgirls)etc.Theyshouldcheckthatthefacilitiesareproperlyused,nowasteislyingaround,thelatrineholesarecovered,thetoiletsarecleanandthatwaterforhandwashingisavailable.Iftheyarenotclean,ornowaterisavailabletheycouldreporttothe(head)teacherandaskadviceonhowtoimprovethis.

—Theschoolhealthclubcanalsotakeupotherresponsibilitiessuchasorganisingcleaningcampaigns,checkingonchildren’spersonalhygiene(cleannails,etc).Schoolhealthclubsoftenorganisesanitationandhygienegamesandcompetitionsinschoolaswellaseventsforparents,families,andthecommunity.

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Topic 5: Germ Free Food

Objectives Bytheendofthesessionthepupilswill: —Understandtheimportanceofcoveringcookedfood —Formulaterulestoensureeverypupilwashesproperlyhis/herhandsbeforeeating/

handlingfood —Knowvariouswaysofensuringfooddoesnotgetcontaminatedwithgerms

Duration 45minutes

Materials —‘Good’poster:PictureAshowscoveredfoodinutensilsonatablewithnoflies —‘Bad’poster:PictureBshowsuncoveredfoodinutensilsonatablewithfliesalloverit

What to do Group discussion:

WhatarethedifferencesbetweenpictureAandB? Askthechildrentohaveagoodlookatthetwodifferentpicturesandletthemexplain

whatdifferencetheyseebetweenpictureAandpictureB.

Whyisitimportanttocovercookedfood? Askthechildrenwhytheythinkitisimportanttocovercookedfood.Afterhavingreceived

theseveralanswersofthechildren,explain/addthat: —Sincefliesbreedindirtandespeciallyfaeces,theynaturallyserveasameansof

transmissionofdiarrhoealdiseaseswhentheycomeintocontactwithourfood.There-fore,itisimportanttocovercookedfoodinordertokeepfliesfromcontaminatingitwithdisease-causingorganisms.Coveringfoodcanalsohelptokeepawayotherpestslikecockroachesandrats;

Alsodiscusswiththechildrenthefollowingactionsforgoodfoodhygiene: —Cleaningthekitchenorfoodpreparationarearegularly.Thiswillpreventbreedingof

cockroachesandrats —Washinghandswithsoapbeforehandlingfood —Washingrawfood,vegetablesandfruits —Propercookingoffoodintermsofdurationandtemperatures —Ensuringthatfoodstorageareaisclean —Useofcleanutensils/containersfortransporting,storing,preparingandservingfood

Story telling:

Foodhygiene Askthechildrentothinkof/writeastoryandgiveitaninterestingtitlee.g.“Myfavourite

food”,letthemtellwhentheyhaveit,howitispreparedandwhetherthepreparationprocessishygienicornot.

Askeachchildtosharehis/herstorywiththerestoftheclass.(Creativewritingand

speechskillswillbedevelopedinthisexercise.)


Exercise:

Washinghandsbeforeschoolmeals Thisisoftendifficulttoorganiseandagoodtopicfortakingupasaproblemsolving

exercise. —Askanolderschoolclassortheschoolhealthclubtothinkofwaysinwhichthey

couldgeteveryonetowashhandsbeforeeating–andhowtodosoquickly; —Askthemtothinkofwaystoensuretheavailabilityofsoaporsoapalternatives; —Askthemtothinkofwaystoensurethatthehandwashingareastayscleanandwaste

waterisproperlydisposedof; —Challengethemtocomeupwithmethodsthataresustainableandequitable

Helpthemtotryoutthemethodsandifnecessaryimprovethem.

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Topic 6: How to Prevent Diarrhoea

Objectives Bytheendofthesessionthepupilswill: —Understandvariousroutesoftransmissionoffaecal-oraldiseases —KnowthesymptomsofdiarrhoeaandhowtoprepareORSsolution —Understandhowtoblocktheroutesoftransmission

Duration 45minutes

Materials —Poster:F-diagram —Paper,crayons,tape

What to do The F-diagram: Diarrhoeal disease transmission Itcanbedoneinplenaryorbysmallgroupsofchildren.Inthelattercase,theteacher

comparestheresultsinplenaryandhelpstoaddanymissingrisks/connections.Thediagramscandifferfromeachother;whatisimportantisthateachdiagramdepictsallsixF’swithaccurateconnections.

—Firstaskachildtodrawapictureofachildwithdiarrhoeaandtoplacethisontheleft-handsideoftheblackboardoronthegroundontheleft-handsideinacircleofstandingorsittingchildren;

—Askanotherchildtodrawapictureofahealthychildandplacethisontheright-handside;

—Askthechildrenhowdiarrhoeamaybetransmittedfromtheillchildtothehealthychild;

—Asksomechildrentodrawapictureofeachtransmissionrouteorwritethewordconcernedonacard,slipofpaperorslateandplacethembetweenthepicturesofthechildren;

—Asktheotherchildrentoaddintransmissionlines,using,forexample,twigsortwine,untilthediagramiscomplete;

—Nowaskthechildrentodescribetransmissionroutesandhowtransmissioncanbeprevented


PB:PrimarybarrierSB:Secondarybarrier

Adapted from Kawata, 1978

Discussthefactthatmanypeopleuseopendefecationwithoutburyingtheirfaecesorusinglatrine.Thegermsthatexistinfaecescaneasilybetransferredthroughthefollow-ingroutesoftransmission:Fluids(water),Fingers,Flies,Fields,andFood.

Group discussion

Whatarethesymptomsofapersonsufferingfromdiarrhoea? Askthechildrenwhatthesymptomsareofsomeonesufferingfromdiarrhoea.Afterhav-

ingreceivedtheseveralanswersofthechildren,explain/addthat: —Childrenwhohavediarrhoeahavealoosestool(wateryfaeces)andthereforelosea

lotofwaterandsalt,especiallyiftheyarealsovomitingandhaveafever; —Childrenmaydieofdiarrhoea,usuallybecausetheylosemuchwaterandvitalsalts

fromtheirbodies.Thisiscalleddehydration; —Childrenshouldallknowaboutdehydrationeffectsandhowtopreventandtreatthem:

Givingthepersonplentytodrinktoreplacethewaterthatislost,assoonasthediar-rhoeastarts,andgivingthepersonenoughfoodtokeephimorherstrong(especiallyfoodthatcontainssaltasthisholdsthewaterinthebody);

—ORSiseasilymadebyaddingaspoonofsugarandapinchofsalttoaglassof(safe)drinkingwater.

Howcantheabovementionedroutesoftransmissionbeblockedtopreventdiarrhoealdiseases?

Askthechildrenhoweachtransmissionroutecanbeblocked.Afterhavingreceivedtheseveralanswersofthechildren,explain/addthatthesearethegoodbehavioursthatpeopleshouldfollowatalltimes:

—Handwashingatcriticaltimes(blockFingers) —Drinkingonlysafewater(blockFluids) —Usingalatrine(blockFaecesandFlies) —Safedisposalofwaste(blockFliesandFields) —Coveringfood(blockFood)

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Part IV: School Health Clubs

Guidelines for School Health Clubs

Introduction

TheSchoolHealthClubisoneofthesignificantinstrumentsforbringingthedesiredhygienebehaviourchangeamongschoolchildren.AsacomplimentarytotheCHASTmethodology,itservestocarryonwiththehygienemessagesevenafterthecompletionoftheCHASTtrainingsessions.Italsoservesasavehicletoreachtothechildrenwhodonotcome to theschooland thecommunityat largewithkeyhygienemessagesthroughoutreachprogrammes.

The Structure of a School Health Club

ASchoolHealthClubshouldbecomposedofapatron(preferablyateacherwhoisinchargeofsanitation),achairperson(apupiloftheseniorclass),asecretaryandrepre-sentativesfromdifferentclasses(ideallyfromp4top5).Whencomingupwiththestruc-tureoftheSchoolHealthClubinamixedschool,careshouldbetakentoensurethatgenderbalanceisobserved.Theclassrepresentativesmaybeselectedbasedonmeritoronvoluntarybasis.TheframeworkbelowsummariseswhattheSchoolHealthClubshouldlooklike:

Patron

Chairperson

Secretary

Various class representatives

Roles of the SHC members

Patron He/shecoordinatesactivitiesoftheSHCbygivingadviceaspertheoccasion.

Chairperson He/shechairsthemeetingsoftheSHCandmakesdecisionsinconsultationwiththe

patron.

Secretary He/shetakestheminutesofthemeetingsandorganizesmeetingsandevents.

Class representatives He/shecoordinateshis/herclassforhygieneandsanitationactivities,alsohe/shemay

channelanyproblemsorchallengesfacedbyhis/herclasstotheSHCduringthemeet-ings.Beingtherepresentativeoftheclasshe/sheshouldmonitorandensurethattheclassmatespractisegoodhygienebehaviours.

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Main issue

Activity Target Monitoring Indicators

When to measure

Respon-sibility

Expected output

Pre

ven

tio

n o

f d

iarr

ho

eal d

isea

ses

Useandmaintenanceoflatrines

Allschoollatrinesmaintainedandinuse

Clean,locked,clearpathtothelatrine,presenceoffliesandsmell

Daily Schoolhealthclub,patron,dutymasterandpupils

Wellmaintainedlatrinesinuse

Washinghandsaftervisitinglatrinesandbeforeeating

Ensureallpupilswashhandsafterusingthelatrineandbeforeeating

Availabilityofhandwashingfacility,soapandwater

Daily Patron,pupils,SHC,dutymaster

Allpupilswashhandsafterusingthelatrineandbeforeeating

Personalhygieneofpupilsintheschool

Allpupilsmaintainhighpersonalhygiene

Cleanclothes,trimmedfingernails,shortandneathair,cleanfaceandbody,cleanhandkerchiefs

Dailyduringtheschoolassemblies

Patron,pupils,SHC,dutymaster

Allpupilsmaintaintheirpersonalhygieneatadesiredlevel

Maintainingcleannessoftheschoolcompoundandtheclassrooms

Theschoolcompoundandclass-roomsarealwayscleanandfreefromlitter

Dutyrosters,regularobservations,availabilityofcleaningmaterials(brooms,dusters,wateretc)

Daily Patron,pupils,Schoolhealthclub,dutymaster

Theschoolcompoundandclassroomsarealwaysclean

Organiseschoolhygieneandsanitationevents

Allpupilsareinformedaboutgoodhygienepractises

Aprogrammeofthehygieneevents(interclasscompetitions,handwashingdaysetc)

Everymonth Schoolhealthclub,patronandschooladministration

Allpupilshaveadequateknowledgeofgoodhygienepractises

Communityvisitstargetingchildrenwhodonotgotoschool

Childreninthecommu-nityarereachedwithhygienemessages

Aprogrammeofoutreachvisitsandprogramme

Everyfortnight(aftertwoweeks)

Schoolhealthclub,patron,schooladministrationandcommunityleaders

Childreninthecommunityarereachedwithhygienemessages

PartIV:SchoolHealthClubs67

Objectives and Activities of the School Health Club

AsmentionedintheintroductionthetwomainrolesoftheSchoolHealthClubare: —TocarryonwiththehygienemessagesevenafterthecompletionoftheCHASTses-

sions,and; —Toreachouttothechildrenwhodon’tcometotheschoolandthecommunityatlarge

withthehygienemessagesthroughvisitations.

InordertoaccomplishitsobjectivestheSHCneedstoplancarefullywhatactivitiestheycanengagein,whenandwhatmaterialstheyneedtoexecutetheactivity.TheactivitiesframeworkbelowisanexampletoguidetheSHCinmakingaworkableplan:

Afterdevelopingsuchaframeworkofactivitiesastheoneabove,theSchoolHealthClubshoulddevelopamoreconcreteprogrammeofwhentodoitsvariousactivities.Theycanalsoorganiseregularmeetingseitheronceortwiceaweektoassesstheirprogressandplanmoreactivitiessuchashandwashingdays,interclasshygienecompetitions,practicesongs,dramaandpoemsforsuchevents.

Regardingtheinterclasshygienecompetition,allpupilsshouldbeinvolvedwithguidancefromthemembersoftheSchoolHealthClubineachoftheclassestheyrepresent.Someoftheactivitiesthatcanbechosenforthecompetitionincludehygienequizzes,hygienerelatedsongs,poemsandartisticdrawings.Allpupilsshouldbefacilitatedtocomeupwiththesecompositionsandpracticethembeforetheactualdayofcompetition.Cer-tificatesandotherawardsmaybegiventothebestpupilsineachcontesttoencourageactiveparticipation.

Asmentionedearlier,theSchoolHealthClubshouldalsoreachouttotheadjacentvil-lagestopassonthishygienemessages.Priortothesevisits,informationshouldbesenttothecommunityleadersregardingthevisittoensurethatchildreninthatcommunityaremobilisedfortheevent.Sucheventsmayinvolvetheuseofroleplays,songs,poemsandpracticaldemonstrations(properhandwashing).

Advantages of using School Health Club for hygiene promotion

BelowaresomeoftheadvantagesofusingSchoolHealthClubforhygienepromotioninschools:

—Itencouragesparticipationofallthestudentsintheschoolespeciallyintheopendayevents

—ItensurescontinuityofhygienepromotionactivitieslongaftercompletionoftheCHASTtrainingsessions

—Itoffersaneasyplatformforregularmeetingssincetheclubmembersarealwayspresentintheschool

—Itimbuesthestudentswithleadershipskillsandthusbeabletotakeresponsibilityoftheirhygienesituation

—Itservesasagoodmonitoringtoolforboththeschooladministrationandprogrammeplanners.

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Part V: Preparing the Materials

Preparing the CHAST Materials

Itisrecommendedthatthepostersandcardsarelaminatedtoprolongtheiruseinthefield.Boththepostersandplayingcardsneedtobecuttospecifiedsizesafterlaminat-ing.Itisalsorecommendedthatyoucutthecornersofthecardstoanangleof45°topreventthechildrenfromhurtingthemselvesonthepointedcorners.

Allthepostersshouldhaveaholeinthemiddleofthetopedgetoenablethechildrentofixthemtotheboardswithpins.Theseholescanbeproducedwithahole-punch.AtleastfourcopiesofeachsetofMemoryplayingcardswillbeneededtoallowforworkinginsmallergroups.Tomakeiteasiertosortoutthecardsaftereachsession,eachcopyshouldbeprintedonadifferentcolouredpaper.

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Materials needed for Lower Primary School

Step 1 Activity 1.1: Introduction of participants and characters PostersofCharacters: —Ruby,asmartlydressedgirlgoingtoschool —Smarty,blowinghisnosewithacleanwhitehandkerchiefonhiswaytoschool —Naughty,blowinghisnoseinanunhygienicwaywithoutahandkerchief

Activity 1.2: Everyday stories Setoftenpostersshowscommonleisureactivitiesoflocalchildren–bothforgirlsand

forboys.Black-and-whitedrawingsareusuallytakenfromthe“Everydaystories”touseforcolouringpurposes,butotherposterscanalsobeused.

Activity 1.3: Initial evaluation Materialsforthisactivityinclude: —Pinboardandpins —Pictureofaboyandapictureofagirl —3picturesofhandwashingoptions:washingwithsoap,washingwithwateronly,not

washing —2picturesofsanitationoptions:childusingtoilet,childdefecatingoutintheopen —6largeenvelopes —Colouredpaperclipsorothertypesoftokensthatcanbeusedforvotingexercise

(stones,twigs,etc) —Notebookandpenforrecordingresults

Step 2 Activity 2.1: Good and bad hygiene practices Aminimumof20posterswithgoodandbadhygienemessages(10each).Theposters

shouldbesortedintotwocategoriesnamelyGoodhabitsandBadhabits.

ThesetalsoincludesgreenandblueSmiley’ssymbolisinggood(green)andbad(blue)habits.Note:othercolourscanbechosen,basedonlocalculturesandbeliefs.

PartV:PreparingtheMaterials71

Step 3 Activity 3.1: Memorising good and bad hygiene practices Apackofcardscontainsaminimumof15identicalpairs.Theactivityrequiresatleast

threepacksofcardswithdifferentpatternsontheback(tomakethemeasiertoseparate),butthisdependsonthegroup/classsizes.

Activity 3.2: How germs are spread ‘Naughtyissick’isaseriesofninepostersthattellastoryaboutNaughtyandSmarty

playingfootballandhowNaughtydevelopsadiarrhoealdiseaseandlearnsfromhismistakeandavoidsitthesecondtime.

1. NaughtyandSmartyplayingfootball

2. Rubybringsthem(NaughtyandSmarty)drinkingwater

3. Naughtydefecatesinalatrinebutdoesnotwashhishands

4. Smartydefecatesinalatrine

5. Smartywasheshishandsafterwards

6. Naughtygoeshometoeat

7. Smartygoeshometoeat

8. Naughtybecomessick,whileSmartygoesbacktoplayingfootball

9. Ruby,SmartyandanotherfriendvisitNaughtyandadvicehimtowashhishandsnexttimeaftervisitingthelatrineandbeforeeating

Activity 3.3: Germs are spread by flies AnA4sizeposterwithdrawingsofafly,orflies,andsometapeorsafetypintoattach

thepostertothepersonplayingtheroleofa“fly”intransmissionofdiseases.Thereshouldalsobeasimulationoffoodservedonplatesandalatrine.

72

Step 4 Activity 4.1: Blocking the routes of germs The‘Germroutes’postersinclude: —‘Naughtyisunwell’ —Drinkingwater/watersource —Faeces/opendefecation —Flies —Food(uncovered) —Fingers —Mouth

Thefollowingpostersarerequiredtoblockthebadbehaviours: —Handwashing(withwaterandsoap) —Coveredfood —Alatrine —Containers(withcovers)fordrinkingwater

Activity 4.2: Hand washing exercise Thisactivityrequiresthefollowingmaterials: —‘Handwashing’drawings —Crayons —Watercontainer,soaporwashingpowder —Presentationmaterials

Activity 4.3: Tooth brushing exercise Thefollowingmaterialswillbeneededforthisactivity: —Drawingson‘Toothbrushing’ —Crayons —Toothbrushandpasteoralternative/localmethodoftoothbrushing(e.g.sticks) —Presentationmaterials

Activity 4.4: Latrine use exercise Inthisactivitythefollowingmaterialswillbeuseful: —Drawingson‘Usingthelatrine’ —Crayons —Awatercontainer —Soapand/orwashingpowder —Presentationmaterials —Alatrine

Activity 4.5: Face washing exercise Thefollowingitemswillbenecessaryforthisactivity: —Abasinwithcleanwater —Adipper —Soap —Acleanfacetowel(optional)


Step 5 Activity 5.1: Final evaluation Thematerialsforthisactivityinclude: —Pinboardandpins —Pictureofaboyandapictureofagirl —3picturesofhandwashingoptions:washingwithsoap,washingwithwateronly,not

washing —2picturesofsanitationoptions:childusingtoilet,childdefecatingoutintheopen —6largeenvelopes —Colouredpaperclipsorothertypesoftokensthatcanbeusedforvotingexercise

(stones,twigs,etc) —Notebookandpenforrecordingresults

Activity 5.2: Closing ceremony Theclosingceremonyneeds: —Awardsforthechildren —Certificatefortheschool/class —Severalpostersfromthedifferentsessionstosummarisesomeofthelessonslearnt

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Materials needed for Upper Primary School

TheCHASTupperprimaryschool topicsarenormallypresentedusinganA3sizedlaminatedflipchartwithcoloured illustrationsonthe foreand instructionsonhowtofacilitateeachtopiconthebackside.Thatwaytheteacher/facilitatorcanshowtheillus-trationstothestudents,whilereadinginstructionsattheback.

Justlikethelowerprimaryschoolsessions,thesesessionsarenormallyfacilitatedinaparticipatorymannerwiththeaimofimbuingthechildrenwithcreativethinkingwhileconveyingtothemcriticalhygienemessages.Thematerialsthatthefacilitatorneedstopreparebeforeeachsessionaresummarizedonthetablebelowaccordingtoeachtopic:

Topic Facilitation materials

Topic1:

“Clean is Beautiful”

—Acontainerwithwater,soapandtwowhitecloths

—Markerpen/chalkandboard

—WhiteA4paperswithcolouredpencils/crayons

Topic2:

“I Drink … Safe Water”



Topic3:

“Going to the Latrine”


Topic4:

“My Beautiful School”


—Samplesofsolidwastefromtheschoolcompound

Topic5:

“Germ Free Food”


Topic6:

“How to Prevent Diarrhoea”




References

Hubley,J.Communicating Health.London,1997.

Klipert,H. Methoden-Training.Weinhelm&Basel(Beltz),1997.

Bockhorn-Vonderbank,M.Children’s Hygiene and Sanitation Training (CHAST),CaritasSwitzerlandandCaritasLuxembourg,Hargeisa,2004.

Pretty,JN,Guijt,I,Thompson,J,Scoones,I.A trainer’s guide for participatory learning

and action.InternationalInstituteforenvironmentandDevelopment(IIED),London,1995.

Rohr-Ronendaal,P.Where there is No Artist.London,1997.

SanchezTorres,Aet-al.Draft Working paper on an Overview of School Sanitation and

Hygiene Education in Developing Countries.InternationalWaterandSanitationCentre(IRC),Delft,theNetherlands.2002.

UNICEF.A manual on School Sanitation and Hygiene.NewYork(UNICEF,3UnitedNationsPlaza,NewYork,N.Y.1017),1998.

Westphal,U.etal.Participatorymethodsforsituationanalysisandplanningofprojectactivities.Berlin,1994.

Wood,S,Sawyer,R,Simpson-Hebert,M. PHAST Step-by-step Guide.WorldHealthOrganisation(WHO),Geneva,1998.

We help people.

Caritas WASH [email protected]

Caritas Switzerland/Luxembourg OfficeNew Rehema House, Westlands, Nairobi, Kenya+254/204447699 or 7267

This edition is printed as part of the Swiss Water and Sanitation NGO Consortium project funded by the Swiss Agency for Development and Cooperation (SDC).

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