Hello Rewati and all other Neighbours,

I am the new Facilitator for Sikharpa. I have made changes in the Steps and Tasks and I invite you all to make a contribution to one or more of them! :-D

I will be away for 2.5 weeks for a trip to India. In the meantime Romina Oliverio (romina@nabuur.com) will take over my duties. Sorry, trip was already planned before I became Facilitator... :-?

Rewati is also available for any questions you have about the project. I will be back on september 25th and hopefully I can close of a Task or two and post a result!

To all of you Neighbours, if you come across a result.....you can post it on our results-page!

Bye for now

Claudia Vijge

Dear Claudia Vijge and all other neighbours,

I want to warm welcome to Claudia Vijge as a facilitator for Sikharpa village behalf of Sikharpa villagers and myself.

I am trying to find out any organisations or is information available about hygiene awareness campaigns in Sikharpa. Hopefully I will sucsess in this work. I will always welcome to all of your contributions. :lol:

Regards,
Rewati

Dear Rewati

Some questions, to help us with a 'baseline':

[1] is there any filtering of water? Is there great shortage of water, or general pollution of water generally, or both?

[2] are there issues of food storage or cooking that present disease issues?

[a] storage while exposed to flies, etc
[b] inadequate cooking resources or skills
[c] sharing of food in ways that convey disease from mouth to hand (or spoon or fork) to plate to another person

[3] what are the main vectors of health problems and disease?

[a] water or soil borne, entering the skin of feet, etc
[b] via the mouth, from water of food or just dirtiness
[c] via the air (sneezing, spitting)
[d] other

[4] what are the main diseases o:
[a] children
[b] working adults
[c] older people

[5] What proportion of health problems are linked to:
[a] nutritional deficits
[b] harsh environment, exposure to weather and hard work, etc
[c] poor work practices
[d] other

[6] How does the general health of this community compare with others nearby? What do you see as the health successes and failures locally.

[7] are there any entrenched local cultural (in the broad sense of all behaviour and belief and routine and ritual) practices that are detrimental to health. (Spitting would be one, eating from one bowl would be another, etc)

I know these are many questions, but I think that if we can go through this kind of information we can all be much more focused on helping you sensibly, relevantly... and with maximum local enthusiasm. Better always to work from the inside of life than make rules from the outside!

best wishes

Dennis

Dear Dennis,

I am posting something regarding your questions.
(1)There is no any filtering of water. There is no
shortage of water. But general pollution of water is
increasing day par day.

(2)There are issues of food storage and cooking that
present disease. I thing Pahari people are not maintaing
proper way to food storage and cooking habit.
(a)In food storage while opene it exposed to flies and
other insect contaminated to food.
(b)Yes, Pahari peoples are inadequate cooking resources or
skills.
(c)Yes, They are not mentaining proper higienic way to
sharing of food in ways that convey disease from mouth
to hand to plate to another person.

(3)These are are the main vectors of health problems and
disease in priority basis:
(a)water or soil borne e.g. Amoebiasis, Helminthiasis,
Typhoid, Hepatitis, Diarrhoea, Skin disease etc. Via
feet Hook worm.
(b)Via the mouth, from water of food dirtiness e.g.
Helminthaisis, Typhoid, Diarrhoea, Skindisease, etc.
(c)Via the air (sneezing, spitting)e.g. common cold,
T.B.,etc.
(d)Pahari peoples are not mentaining basic hygiene,e.g.
hand washing after toilet and before food,
bathing,cleaning of cloths,Brushing, etc plays a vital
role to spraid communicable disease.

(4)These are the main diseases:
(a)children:Diarrhoea,Amoebiasis, Helminthiasis, Common
cold,RTI,Pneumonia, Malnutrition,Typhoid, Skin disease,
etc.
(b)working adults:Skin disease, Diarrhoea and dysentery,
RTI, T.B.,Common cold, Typhoid,Hepatitis, etc.
(c)Older people: Asthma, Pneumonia,Cough and common cold,
Diarrhoes, etc.

(5)There is no actual data of Sikharpa village to find out
the propertion.We can only asumption. So deficulty to
say proportion of health problems are right now. We
have to do basiline study in future. Now I can only
prioritise the list. these are:
(a)Harsh environment.
(b)Nutritional deficiencies.
(c)Poor work practices
(d)Other-Lack of Knowledge.

(6)In comparision of the general health of this community c with others nearby. There are different. Because most of the pahari peoples are illetresi. So they dont know any basic thing about health. They are still belief with Traditional healers. The others thing there is no any awareness program regarding health issues.

(7)I think there are no any entrenched local cultural (in the broad sense of all behaviour and belief and routine and ritual) practices that are detrimental to health. (Spitting would be one, eating from one bowl would be another, etc.

If there are any these type of cultural things exist,I will find out and will post leater.

Best Regards,
Rewati

Thanks Rewati

This is excellent material for us to try to begin... are you happy to brainstorm this here?

I will find a design for making a very simple water filter using clay and a choice of rice hulls, tea leaves or coffee grounds - old coffee grounds are best. The research at Australian National University shows that the best temperature for baking a clay pot of 50:50 clay and one of those items is the temperature at which cow manure burns. So it is easy to make a filter for little or no cost... I will find the document.

BUT - that will not solve the general problem. It is a substantial mix of problems. To protect the feet, boots... ? To protect the hands. gloves? Would people wear such things, if they had them, working in the fields? There were good results in South Korea working on those diseases, I will look for the results.

NEXT: latrines and hand washing. Is it possible to provide clean water near toilets? Any running water? If you can make composting toilets, exclude flies from them, and have hands washed after, we have a huge step. What style of toilet/latrine is needed - for how many homes/people... If you could make small toilets for small numbers of people, how many people... if nothing being buried, all being removed as healthy compost? This to me may be lifestyle + land space question. For a single home a toilet could be a seat arranged in a room above a plastic 44 gallon drum or such. Are drums like that available? If larger needed, then different structure. Is there dry matter (similar to coconut husk, peat moss) that can be added to the toilet wastes day by day? Note that food scraps can go in a toilet like this too.

NEXT: Are there any natural disinfectants available for handwashing? Neem trees?

NEXT: Food storage. Is it possible to describe the situation (sometime) so we can think together about that problem.

NEXT: Cooking: is there enough fuel to cook meat thoroughly?

NEXT: Eating: if we can get hands clean, that would be a good start. Do people have enough plates for food dishes, plus one per person.

I SUGGEST THESE AS PLACES TO INTERVENE: You will understand that we are talking about interrupting the cycles of disease at strategic points. Some are easier than others. The water and soil borne the hardest. As mentioned I will look for the Korean information. Is there a WHO program for this in Nepal?

best wishes

Dennis

Dear Dennis,

Thanks for contribution. I think we have to teach the villagers about how to prevent communicable diseases. We have to run awareness program as well as latrine construction program.

Yes, there are natural disinfectants available for handwashing, e.g. ash. All family used fire wood to cook. So enough ash in every home.

Food storage. Ok,it is possible to describe the situation (sometime). After few weeks I will visit the village and I will collect some facts and post leater.

Cooking: Yes, there is enough fuel to cook meat thoroughly.Sikharpa peoples are using fire wood for cooking. Nowdays some of them (Only few family)used biogas for cooking.

Eating: Yes, I am fully agree if we can get hands clean, that would be a good start. I think people have enough plates for food dishes.

Regards,
Rewati

Dear Rewati

I promised to get you the story of the water filter. Here it is.

This, however, only makes a small amount of drinking water.

What do you think is a way to tell local people about bacteria and other vectors of disease?

Would there ways of doing this using popular entertainment - plays, etc?

best wishes

Dennis

Dear Dennis,

I think there is a lot of way to tell local people about bacteria and other vectors of disease. These are: group discussion, qoestion answer, street drama, role play, story, puppet show, demonstration,case presentation, speech, etc.

Yes, there is lot of ways of doing this using popular entertainment - plays, etc.

Regards,
Rewati

So, Rewati, you are the chief of operations, you are the one in charge, where should this all start?

We have vectors of disease

We have issues of intervention

We have ways of introducing information.

===

Can you make a selection among those things? We need to focus in...

best wishes

Dennis

After all said and done,
where is funding going to come from, which like-minded people are you going to engage to have a successful sensitization with the issues at hand ?
And finally, are the affected inhabitants ready to participate and cooperate?

Hope things go well
Best of regards,
Clint

Dear S Clint and All,

The affected inhabitants are ready to participate and cooperate.

Regards,

Rewati

Hello Rewati and Neighbours,

I am back from my trip to India, tired but satisfied.

I would like an update on what has happned in this Task and more so, who will take responsibility for this Task.

please let me know

warm regards

Claudia
Facilitator Sikarpha

Hello Claudia Vijge and All,

Welcome back to you from India trip.

I am thinking to go my village Sikharpa and meeting with villagers. But nowdays it is raining continiously from few days. When wheather will improve I will go and discussion and sharing with Sikharpa villagers about.

Regards,
Rewati

Hi all,

Here is a diagram that explains in short was are the possible ways for disease vectors to go from feaces to mouth. I have added in red what barriers can protect human from getting hill. You will see that latrines blocks some routes and, that, added with proper handwashing, all faeco-oral diseases are blocked in theory.

This diagram dates back from 1958! So I won't go over was has been said over the past decades but in short:

Handwashing - Most importantly after going to toilet and before eating. But also after having cared of babies and before preparing food. Handwashing is efficient only if done at proper time (it is not so much a question of how much times in a day). Ideally is washing + soap + drying hands, but washing + soap is very good and washing alone is better than nothing.

Changing behaviors is one of the most difficult things to do. That is why participation in every step is so crucial. One good methodology has been developed: it is called PHAST. It is very simple to use. I have used it for 2 years with illiterate adults. The nice thing about it is that it empowers people to take action and improve their health by themselves through a better understanding (very intuitive) of how disease can be prevented. You can download the manual from this site.

http://www.who.int/water_sanitation_health/hygiene/envsan/phastep/en/ind...

Note that you can find a nicer F-diagram in page 12-13 of this document. The PHAST methodology has been used in Nepal by several organizations such as Nepal Red Cross Society and other NGOs (A training was done at the Empowerment and Learning Development Center in Lalitpur this last June). It would be good to discuss with them to get their feedback and potentially training materials such as pictures and posters.

Best,

Martin

F-diagram.JPG

Hello Martin and others,

thank for your contributions. Martin, your information is very useful.

I'm thinking that maybe we can make of find posters that explain about hand washing. there must be some organisations that already have this kind of information or posters.

Maybe the Nepali government has this kind of information?

Which Neighbour can help us find this information. So Rewati can start the awareness campaign in sikharpha?

let me know

Claudia V.