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Why Water, Sanitation and Hygiene Are Vital for Eliminating Neglected Tropical Diseases

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Why Water, Sanitation and Hygiene Are Vital for Eliminating Neglected Tropical Diseases WASH Why water, sanitation and hygiene are vital for eliminating neglected tropical diseases Brief Now is the time to say goodbye to neglected tropical diseases © Sightsavers/Jason Mulikita © Sightsavers/Jason Children from Ngangula Primary School carrying water to school in Chikankata, Zambia. Contents 4 14 Introduction Using WASH data to combat NTDs 5 17 WASH: the facts Social behaviour change communication: the practices that underpin WASH 6 WASH: our key programmes 18 Preparing for the future 8 Working with communities: helping neighbours and friends stay 19 trachoma free References 9 The challenges of delivering WASH 10 Why WASH is worth the investment 11 Encouraging collaboration between the WASH and NTD sectors Cover image 12 Peace Kiende, 11, a student at Developing tools to support Antuaduru Primary School sings a WASH programmes song that helps her remember how to wash her hands and face, as part of the Sightsavers’ WASH project in Meru, Kenya. ©Sightsavers/Andrew Renneisen 3 Introduction In communities where water is scarce, supplies are often reserved for drinking or farming, meaning hygiene and sanitation are sidelined. Poor hygiene is linked to people in people’s habits, community, culture or contracting and spreading bacterial and national tradition, but these practices are parasitic infections, including a number potentially harmful because they help of neglected tropical diseases (NTDs). trachoma and other NTDs to spread. Improving access to clean water, good sanitation and hygiene (often referred Closely linked to some of our WASH work to by the acronym ‘WASH’) is critical in is the WHO-approved ‘SAFE’ strategy preventing and treating these diseases. for eliminating trachoma. This stands for Surgeries, Antibiotics, Facial cleanliness Sightsavers works on five NTDs and and Environmental improvements. The WASH initiatives play an essential role in progress that has been made on eliminating controlling and eliminating three of these trachoma has helped to push WASH up due to the way they are spread. These the NTD agenda through the large-scale diseases are trachoma – an excruciating implementation of ‘F’ and ‘E’ programmes. eye disease that can cause irreversible blindness – intestinal worms and In this brief document we highlight our schistosomiasis, both of which can lead to work in WASH, which is focused primarily chronic illnesses and can even be fatal¹. on social behaviour change, cross- sector coordination and data systems Some of the key WASH-related behaviours strengthening. We also outline our major that prevent these NTDs are using latrines WASH programmes, global progress to and washing hands and faces with water date and our plans for the future. and soap. Other protective measures include boiling or filtering water for drinking or bathing, and safely handling fruit and vegetables. Many sectors have a crucial part to play in WASH programmes, including ministries Did you know... of health and water, affected communities, non-governmental organisations, Neglected tropical diseases are academics, public and private funders and a group of parasitic and bacterial consumer goods companies. This is why infections that affect more than multi-sectoral collaboration lies at the heart one billion people worldwide. of successful WASH programmes. They became known as ‘neglected’ because historically they did not Social behaviour change underpins many spark the same public attention WASH initiatives. This aims to improve or investment as other tropical people’s health by influencing their diseases such as malaria. They also knowledge, attitudes and social norms. affect some of the poorest and most For instance, open defecation or sharing neglected, communities in the world. living space with livestock may be ingrained 4 WASH brief WASH: the facts Water, sanitation Sightsavers works on and hygiene (WASH)² WASH in 19 countries. We help support: billion people 2.2 lack access to 7 safe, clean water countries in social behaviour change interventions billion 4.2 people do not have basic sanitation facilities 12 data-strengthening projects million 673 people defecate in the open billion 19 people multi-sectoral 3 WASH partnerships lack basic handwashing facilities at home 5 © Sightsavers/Andrew Renneisen © Sightsavers/Andrew Charles Mwiti, 12, stands by a toilet at his home outside Meru, Kenya. Through a Sightsavers’ WASH initiative, Charles helped build the toilet and learned proper sanitation techniques to prevent trachoma and other NTDs. WASH: our key programmes Ascend West and Central Africa support where requested from national COVID-19 plans. Sightsavers is supporting This is UK aid’s flagship NTD programme, the COVID-19 response in 10 of the and Sightsavers’ largest multiple disease Ascend countries. We’re working alongside programme to date. The three-year ministries of health and other partners to initiative will make major progress towards roll out hygiene-related behaviour change eliminating five NTDs by working with campaigns, for instance by creating COVID- communities, ministries of health and 19-related radio advertisements in local partners in Benin, Burkina Faso, Central languages. We are also supporting the African Republic, Chad, Côte d’Ivoire, strengthening of health systems to deal Democratic Republic of Congo, Ghana, with COVID-19 by training contact tracers, Guinea, Guinea-Bissau, Liberia, Niger, community health workers, and healthcare Nigeria and Sierra Leone. WASH activities facility staff. A key focus is ensuring people focus on strengthening cross-sector know correct hygiene behaviours in order coordination, data systems and design and to avoid transmission; another is to stamp implementing well-informed behaviour out misinformation. We are also working change interventions. For more on how to ensure programming is inclusive of Ascend is helping to coordinate WASH and vulnerable groups. M&C Saatchi is our main NTD expertise, see page 11. partner in the hygiene-related behaviour change work happening under Ascend. Sightsavers is flexing the Ascend programme to support countries in Accelerate trachoma elimination responding to the COVID-19 pandemic. Sightsavers has worked with ministries of Sightsavers has embarked on a remarkable health and national task forces to identify journey with some of the most trusted areas of need, ensuring we’re providing names in modern philanthropy in a bid to 6 WASH brief support the elimination of trachoma as The Trachoma Initiative and DFID SAFE a public health risk in Benin, Botswana, programme built the capacity of local Burkina Faso, Cameroon, Guinea-Bissau, partners and ministries to implement Guinea, Namibia, and Senegal, and make NTD-related WASH programming. significant progress towards trachoma Technical working groups were set up in elimination in Côte d’Ivoire, Ethiopia, Kenya, Kenya, Ethiopia, Tanzania, and Uganda Nigeria, Tanzania and Zimbabwe. where WASH and NTD personnel came together to analyse data and plan trachoma Led by Sightsavers, this huge collaborative interventions. Capacity was built through effort is helping to ensure WASH services sub-national technical working groups and reach some of the most disenfranchised county trachoma task forces, some of which communities in trachoma-endemic areas. are still operating, despite the programmes The programme supports intensified coming to an end. WASH committees were hygiene-related behavioural change set up, which were predominately designed in seven countries to help break the to move people away from open defecation, transmission of trachoma. Sightsavers helping to rid communities of trachoma is also supporting the utilisation and and intestinal worms. Many WASH sector coordination of WASH and NTD data in projects in these countries now place 12 countries to more effectively allocate greater emphasis on communities’ role in resources and plan future programmes eliminating trachoma.⁵ through cross-sector collaboration. © Sightsavers/Andrew Renneisen © Sightsavers/Andrew Accelerate is funded by The Audacious Project, which is hosted by TED. Major donors include the Gates Foundation, ELMA Foundation, Children’s Investment Fund Foundation, Virgin Unite, and UK aid. Learning from past programmes Between 2014 and 2019, The Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative³ (The Trachoma Initiative) and the UK aid-funded DFID SAFE programme helped to pioneer the SAFE strategy in seven African countries. As a result of these programmes, around 150 districts in seven countries benefited from facial cleanliness and environmental improvement activities.⁴ The programmes also advanced understanding about which trachoma elimination activities are most effective, generating key insights and data that is being put to use in our current WASH work. Both programmes were led by the ministries of health in each country, coordinated by Charles Mwiti shows his grandmother, Sightsavers, and delivered by members of Lucy Kinoti, how to wash her face at the International Coalition of Trachoma their home outside Meru, Kenya. Control, of which Sightsavers is a part. 7 © Sightsavers/Tommy Trenchard © Sightsavers/Tommy Community health volunteers travel by motorbike through a remote area of Turkana, Kenya. Working with communities: helping neighbours and friends stay trachoma free John Ekutan is from Turkana in Northern Kenya. This vast county is full of open desert and is home to some of the country’s most remote populations. In 2019, Turkana reached a huge milestone: “When the chiefs have meetings, they
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