Trachoma is the world’s leading cause of preventable blindness. Young people with trachoma are unable to go to school, while adults are unable to work or care for themselves and their families. According to the local health department, Simanjiro district in the Manyara region of Tanzania has a trachoma prevalence rate of 65%.
The biggest causes of trachoma’s continued existence are: 1) open defecation, which is partially practiced due to low latrine coverage (an average of 23.7%); 2) traditional norms and customs that don’t encourage good sanitation (e.g. toilet use use of toilet and good hygiene practice). Once contracted, the disease spreads due to poor sanitation and hygiene practice. The situation is further complicated by a limited water supply. Due to prohibitively high running costs, the most common source of water is boreholes.
To prevent the further spread of this fast growing tragedy, the trachoma elimination strategy we have adopted, SAFE (Surgery, Antibiotic, Face Washing and Environmental Sanitation), needs more stakeholders to shift their focus from curing the disease to preventing it. Our SAFE Project will focus on prevention through a comprehensive WASH programme that will emphasise the importance of facial cleanliness, hand washing and environmental sanitation.
To prevent the spread of trachoma by changing community behaviour towards good personal hygiene and environmental sanitation practices within the project areas. We will do this by implementing the WHO strategy on eradicating trachoma in an integrated WASH intervention.
- To improve sanitation and hygiene practice at schools and in the community through education and campaign programmes to minimize the spread of trachoma.
- To build community capacity and strengthen managerial competency to sustainably manage the existing water scheme,
- To build community capacity and raise awareness of trachoma prevention and control measures at early case identification for treatment.
Together with local partner CBHCC, Simavi implement the Trachoma SAFE Communities programme to prevent the further spread of trachoma by changing community behaviour towards good personal hygiene and environmental sanitation practices within the project areas. We will do this by implementing the WHO-implemented SAFE strategy on eradicating trachoma in an integrated WASH intervention.
The SAFE-strategy stands for Surgery, Antibiotic, Face Washing and Environmental Sanitation. Within our programme, Simavi will specifically focus on the Facial cleanness (F) and Environmental sanitation (E) components of the SAFE Strategy.
There are eight main strands to our approach:
- Create awareness amongst stakeholders at different levels to facilitate achievement of the project’s core objective.
- A baseline survey on hygiene practice in the community.
We’ll use different tools to identify environmental sanitation and hygiene practice in schools and the community. For example, pupils will be given a checklist to fill out under the supervision of school health teachers.
- Identification and Training of Community Owned Resource Personnel (CORP).
CHBCC will recruit CORPs who will be responsible for raising awareness of facial cleanliness and environmental sanitation information among their fellow community members. They will also contribute to eliminating trachoma disease within project areas by using different approaches, including Community Led Total Sanitation (CLTS), Participatory Hygiene And Sanitation Training (PHAST), and a Rights Based Approach (RBA). CORPs will be carefully selected and must be literate, locally resident and acceptable to the community.
- Identification and Training of Artisans.
Together with the community, CBHCC will select artisans to be trained in two wards. These artisans will be responsible for the construction and rehabilitation of latrines in his/her community. In addition, the artisans will also disseminate personal hygiene behaviour and environmental sanitation information so that every household in the projects areas has access to a latrine and knows how to use it properly.
- Training of school head teachers and health teachers.
In cooperation with head teachers and school committees, CBHCC will select health teachers, who will in turn select health club members to be role models and ambassadors for personal hygiene and environmental sanitation in schools. These school health club members will use different approaches to scale-up personal hygiene and environmental sanitation messages to other pupils (and the rest of the community). These will include Child Hygiene And Sanitation Training methodology and a Child-to-Child approach. The school health club members will contribute to eliminating trachoma disease within, and outside, school by ensuring every pupil is a watchdog for personal hygiene and environmental sanitation.
- An inter-school personal hygiene and environmental sanitation competition.
In collaboration with ward education officers, ward health officers, school head teachers, school health teachers and school health club members, CBHCC will organize an inter-school personal hygiene and environmental sanitation competition based on school personal hygiene and environmental sanitation status.
- Participation towards a WASH commemorative calendar for advocacy.
In cooperation with Simanjiro District CBHCC will participate to an exhibition of a WASH commemorative calendar for advocacy at different levels, including water week, hand washing day, toilet day and trachoma disease events. This will scale up trachoma prevention, raise awareness among different groups at different levels and increase networking between stakeholders.
- Identification of community role models for advocacy
Together with the community CBHCC will identify individual role models in two wards who will scale up trachoma prevention and control practices in their community for eliminating open defecation. These volunteers will also collaborate with selected CORPs and artisans to share ideas and scale up positive personal hygiene and environmental sanitation practices in their communities.
The implementation phase of this programme will fully start in 2017. We conducted some activities in 2016, but spent most of the time in inception phase and preparing baselines.
# trainers trained to include WASH and trachoma sensitisation in their school curriculum (target 2016: 16, realisation 2016: 16)
# hand washing facilities built or rehabiliateed at schools (target 2016: 8, realisation 2016: 8)
# school health ckubs that have been established or activated to provide hygiene promotion and education (with a focus on facial and environmental cleanliness to prevent trachoma) (target 2016: 10, realisation 2016: 8)
# schools where WASH sensitisation campaignes are organised (with a focus on facial and environmental cleanliness to prevent trachoma) (target 2016: 10, realisation 2016: 8)