Personal Hygiene
One-Hour Training
www.herproject.org
Trainer’s Tips
Start with the
introductory module:
This training is part of a
broader health training
curriculum. We
recommend starting with
the introductory module,
Our Health Is Important.
HERproject
Toolbuilder: Use the
pictures in the
HERproject Toolbuilder
to develop your own
personal materials
focused on personal
hygiene.
http://herproject.org/toolb
uilder
Overview
This is a guide for a one-hour training on personal hygiene. This training is best
used in groups of between 10 and 40 people and can be conducted with either
male or female participants. It is recommended that the trainer also speak with
workplace management to ensure that sanitary facilities are acceptable and that
training participants will be able to act on what they learn in the training.
What Is Included?
This packet will help you lead a session on personal hygiene. It includes a
proposed training agenda, the materials needed to conduct the training, key
messages to emphasize during the training, and examples of what to say while
training.
What if This Is My First Training on Personal Hygiene?
While it can be intimidating to give a training for the first time, everyone has
something to offer and something to learn. Preparing for the training by reviewing
the lesson and key messages before the training will help you to feel familiar and
comfortable with the content.
If someone asks a question during the training that you do not know the answer
to, it is important that you say “I do not know” and then follow up with a health
care professional in order to provide accurate information. No one trainer can
have all of the answers—it is okay to say “I don’t know.” Only provide information
that you are certain is accurate.
How Do I Use the Document?
How much time you
need for each
section is indicated
at the beginning of
every section.
Numbered items
show the order of
tasks to be
completed by the
trainer.
Trainer’s Tips provide helpful information about how to
conduct a session. Trainer’s Tips might provide guidance on
how to encourage participation or how to adapt a training to
respond to differences in beliefs or behaviors in different
places or among different groups of people. Trainer’s Tips
have been gathered from training professionals, including
HERproject implementing partners in many countries and
regions.
BSR | HERproject Personal Hygiene One-Hour Training Packet
Italics (slanted
letters) provide an
example of what a
trainer could say to
session
participants.
2
Trainer’s Tips
Prepare for the Training
Agenda
Be prepared: Before
starting the training it is
important that you
familiarize yourself with the
training agenda, review and
understand the key
messages, and gather
materials for the training.
Prepare the location:
Think about where you are
going to have the training.
To encourage participation,
it is important that the place
have enough privacy that
no one outside the training
can see or hear what is
being discussed. It also
helps for the training to be
conducted in a quiet
location without distractions.
Plan the timing: Consider
the best timing for the
training. If possible, it is
best to conduct the training
when the trainees are alert.
Having a training after work
or before meals may not be
as effective because the
trainees might be too tired
or too hungry.
Familiarize yourself with the agenda of the training. The one-hour training
agenda below provides guidance about how much time you should spend on
each section of the training.
Time
Topics
5 minutes
Open the Training
20 minutes
How Germs Spread
10 minutes
When to Wash our Hands
10 minutes
How to Wash our Hands
10 minutes
Additional Ways to Have Good Hygiene
5 minutes
Close the Training
Understand the Key Messages
Before starting the training, it is important that you understand the key lessons to
be emphasized during the training.
Personal Hygiene Key Messages
» Germs are tiny living things that can cause diseases. These germs can be
passed from one person to another.
» Practicing good hygiene can help us protect against these germs and
diseases.
» A good rule to follow is to wash our hands before preparing food, before
eating, and before breast-feeding. We also need to wash our hands after
going to the toilet and after changing diapers or otherwise having contact
with feces.
Gather Materials
The materials listed below will be used during the Personal Hygiene Training:
1. Flip chart (or large sheet of white paper that can be taped to the wall) and
markers
2. How Do Germs Spread Activity?: For this activity you will need a small bowl
of loose chalk or glitter.
3. Soap, and a pitcher or large bottle of clean water and basin to wash hands
in, or access to a sink or water tap.
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4. Create and print your own “When Should I Wash My Hands?” activity cards.
For this activity you will need pictures of the following activities or items:
»
Woman changing a diaper
»
Woman preparing food
»
Family eating
»
Woman breast-feeding
»
Toilet or latrine
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Trainer’s Tips
Personal Hygiene One-Hour Training Module
Open the Training
Introduce the trainer and
participants
When possible, use a fun
and interactive way to
introduce participants. For
example, you might divide
participants into two groups
and ask one person in each
group to identify all of the
people in their group. See
which participant can
remember all of the names
of the participants in their
group.
Ensure confidentiality:
Because the goal is to
enable everyone to speak
openly, explain that the
group must promise not to
talk about who said what or
asked which questions in
the training.
Communicate effectively:
Below are some tips on how
to communicate effectively.
Time: 5 minutes
TRAINER: Open the training by (1) introducing the trainer and participants
and (2) introducing the subject.
1. Introduce the trainer and participants
Open the training by introducing yourself and the participants. When
possible, use a fun and interactive way to introduce participants.
2. Introduce the topic
Discuss what the training is about. Today we are going to discuss why good
hygiene, or physical cleanliness, is such an important part of staying healthy.
How Germs Spread
Time: 20 minutes
TRAINER: During this time the participants will be introduced to what germs
are and how they spread from one person to the other.
3. Introduce the concept of germs
»
»
»
»
During the session, if
someone asks a
question, give him or
her your full attention.
Listen carefully to the
participants and ask
clarifying questions if
you do not understand
the question or
comment.
After participants have
answered a question,
paraphrase and clarify
answers so that
everyone in the room
understands.
Reassure the
participants that it is
good to ask questions.
Use introductory
questions: Introductory
questions help people
participate in a training in an
easy way for the first time.
Ask an introductory question: How do people get sick?
Write down all of the ways mentioned on a flip chart or large sheet of paper taped
to the wall.
One way that people can get sick is through germs. Germs are tiny living things,
like bugs too small to see, that can cause diseases. Germs come in a number of
different forms including bacteria and viruses. Some bacteria and viruses can
make us very sick. They can be passed from one person to another by touching
things with germs on them, by breathing germs in the air, or through sex. In this
training we will talk mostly about germs we get by touching things and that we
breathe through the air.
4. Do the How Do Germs Spread Activity?
SET UP THE ACTIVITY
For this activity you will need a bowl of chalk or glitter.
The purpose of this activity is to show how easily germs spread from one person
to another. The activity can use chalk or glitter to represent germs. As the
volunteers shake hands or touch the same objects, the “germs” are transferred
from one person to the other.
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Trainer’s Tips
Stress the importance of
soap: Participants might
ask if soap is necessary.
Soap can seem very
expensive. Ask participants
to compare the cost of soap
costs to the money they
lose from being sick and not
going to work.
If soap is not available or
affordable, people can use
ash, sand, or even mud as
an alternative to soap, as
long as they wash and rinse
(with running water)
thoroughly. The sand or ash
are rough and “rub off” the
dirt and germs.
Make the proper hand
washing techniques
activity (#6) more
interactive: Make this
exercise more interactive by
asking for 2 volunteers to
come and wash their hands
as the participants explain
the hand washing steps.
DO THE ACTIVITY
a) Select four volunteers.
b) Hold up the bowl of loose chalk or glitter. Explain to the participants that the
chalk represents germs. Also remind them that you cannot see germs the
same way you can see the chalk or glitter.
c) Asks the first volunteer to dip her hand into the bowl so that she has chalk on
her hands.
d) Ask the first volunteer to shake hands with the second volunteer. Ask the
second volunteer to show her hands to the group so they can see how the
chalk moved from the first volunteer to the second volunteer.
e) Ask the first volunteer to dip her hand into the bowl again so that she still has
chalk on her hands. Next, ask her to put her hand on a chair. The chalk will
leave a mark on the chair. Instruct the third volunteer to touch the chair
where the chalk is. The chalk will transfer from the chair to the third
volunteer’s hands.
f) Ask the fourth volunteer to grab a small handful of chalk or glitter. Then ask
her to blow on the pile of chalk or glitter to show how germs can be
transmitted through the air, for example through coughing.
g) Ask the whole group: What is the best way to get rid of the chalk? Ask the
fourth volunteer to wash her hands with soap and water so that the chalk
comes off.
DISCUSS THE ACTIVITY
Discuss how the activity shows the spread of germs
At the beginning of the activity, I explained that the chalk was like germs. We saw
that the chalk moved from one person to the next when they shook hands. We
also saw that the chalk could spread from one person to another if they touched
the same object. The germs that can cause diseases like diarrhea and other
infections are spread just like this.
Observe where women
dry their hands: Often,
women dry their hands on
their clothing. Clothes can
carry germs or dirt. Observe
where women generally dry
their hands after washing
and encourage them to airdry their hands instead.
5. Discuss the various ways that germs spread
Check factory facilities: It
is important that you know
what sanitary facilities are
available to workers in the
factory. If the available
facilities can be improved,
you should advocate for
these changes with
management.
»
Germs from feces can be spread in many ways—through fluids, fingers, flies,
and fields. Discuss with participants how germs can be spread and lead to illness
and disease. Use the F diagram to guide your discussion.
Diseases can spread in multiple ways. To demonstrate the different ways, we’re
going to focus on how diseases caused by germs from feces can spread from
one person to another and make people sick.
»
»
»
Fluids: One way is through water. Germs from feces on the ground can get
into water (fluids) and be drunk by you or someone in your family.
Fingers: The second way is through fingers, or hands that haven’t been
washed after going to the toilet. Even though they might not look dirty,
unclean hands can pass germs to other hands or onto food.
Flies: The third way is through flies. Flies land on feces and then can take
germs onto food the same way that the chalk went from your hands to your
colleague’s hands. That is why it’s important to keep flies and other insects
and animals off of your food or out of the kitchen area if possible.
Fields or floors is a fourth way. Germs can seep into crops and other
sources of food if feces are not disposed of properly. To prevent field
contamination, it is important that feces are disposed of in toilets or latrines.
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Trainer’s Tips
Regional adaptation:
Make sure you are using
the right words or slang for
words like toilet or restroom,
diaper, or feces. Making the
participants comfortable
with the words helps them
absorb the messages from
the training.
Make the When Should I
Wash My Hands? Activity
more interactive: You can
make this session more
interactive by dividing the
participants into small
groups. Give each group a
set of the activity picture
cards, and ask them to sort
the pictures into two
different groups (Before
and After). In one group,
put pictures of people doing
things that require them to
wash hands before they do
them and in the other group
put pictures of people doing
things that require them to
wash their hands after they
do them. Next ask each of
the groups where they
placed each of the pictures.
When to Wash Our Hands
Time: 10 minutes
TRAINER: During this time participants will explore when and why (before
and after certain activities) it is most important to wash their hands.
6. Do the When Should I Wash My Hands? Activity
SET UP THE ACTIVITY
The following activity will remind participants about when it is important to wash
our hands. Use the When Should I Wash My Hands? Activity pictures. During
this activity, participants will determine whether hand washing should come
before or after the activities illustrated in the pictures.
DO THE ACTIVITY
We all saw in the chalk activity how easily germs can be spread from one person
to another. We also learned through the F diagram that germs can be spread
when we accidentally get germs on food or touch unclean things.
One of the best ways to protect ourselves from sickness is by washing our
hands. Sometimes we need to wash our hands before doing something, and
other times we need to wash our hands after doing something—and sometimes
both!
a) Ask an introductory question: When do you wash your hands? When do you
wash your hands with soap?
b) Write down all of the answers on the flip chart.
c) Write Before and After on the flip chart.
d) Hold up each of the When Should I Wash My Hands? Activity pictures. Tell
the participants to sort all the images into two groups: In one group put
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pictures of people doing things that require them to wash hands before they
do them, such as preparing meals. In the other group put pictures of people
doing things that require them to wash their hands after they do them, such
as changing a baby’s diaper.
e) Tape the images of the pictures under the relevant category (Before or
After).
7. Discuss when we need to wash our hands
Once again, we can think of the timing for washing our hands as before doing
something or after doing something. A good rule to follow is to wash our hands
before preparing food, before eating, and before breast-feeding. We also need to
wash our hands after using the toilet and after changing diapers.
Rearrange the pictures on the flip chart so that the appropriate pictures align with
the appropriate time period (Before and After).
How to Wash Our Hands
Time: 10 minutes
TRAINER: Participants will learn good hand washing technique to get rid of
germs.
8. Introduce a good hand-washing technique
One of the best ways to protect ourselves against disease is to wash our hands
before and after certain activities. Here are the four steps to good hand washing.
»
»
Step 1: Wet hands and lather them with soap.
Step 2: Rub hands together for at least 20 seconds. Scrub the backs of the
hands, the wrists, between the fingers, and under the fingernails.
»
Step 3: Rinse hands.
»
Step 4: Let the hands dry by shaking or waving them in the air (air-drying).
Discuss all of the steps again. This time, ask each of the women to pretend that
they are washing their hands using the steps. At the end of the exercise, ask the
participants, how do you usually dry your hands? Discuss how towels and
clothes can also carry germs. If you do not know if a towel or cloth is clean, it is
best to let your hands air-dry after washing them.
9. Answer questions posed by participants
Encourage participants to ask questions about hand washing.
Additional Ways to Have Good Hygiene
10. Discuss other ways to have good hygiene
Time: 15 minutes
TRAINER: During this time the participants will be introduced to additional
ways to have good hygiene.
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In addition to washing our hands, there are other ways that we can protect
ourselves from disease.
»
»
It is important to keep the cooking area and the food that you eat clean.
It is important to keep the toilet area or wherever you go to the bathroom
clean.
»
It is important to keep your body and the inside of your mouth clean.
PROPER HYGIENE IN THE KITCHEN
In the kitchen:
»
»
Wash your hands with soap before handling food.
Clean dishes and utensils with soap, and make sure to rinse the soap off with
clean (boiled) water.
»
Keep animals and insects off of food and out of the cooking area.
PROPER HYGIENE IN THE TOILET
When using the toilet, proper hygiene is especially important:
»
»
»
Just as germs can be passed by shaking hands, we can also get bad
bacteria and viruses through our feet. This is particularly true in a toilet area.
Always wear shoes or slippers in the toilet area.
If you cannot dispose of paper in your toilet, make sure you use a trash bin
with a lid.
Make sure you wash your hands with soap after using the toilet.
PROPER DENTAL HYGIENE
Taking good care of teeth and gums is important because:
»
»
»
Strong, healthy teeth are needed to chew and digest food well.
Painful cavities (holes in the teeth caused by decay) and sore gums can be
prevented by avoiding sugary foods and drinks (sugar cane, candy, pastry,
tea or coffee with sugar, and soft or fizzy drinks like colas), and brushing your
teeth twice each day.
Decayed or rotten teeth and gum disease can lead to serious infections that
may affect other parts of the body.
In order to keep your teeth and gums healthy, brush your teeth from top to
bottom and side to side. Be sure to brush the front, back, top, and bottom of all
teeth.
Sometimes doing all of these things can be really difficult in the areas where we
live and work.
Ask participants: Will you be able to keep all of these areas clean? What could
be some of your greatest challenges to doing this?
Trainer should facilitate a discussion and try to offer suggestions to encourage
participants to overcome their challenges.
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Close the Training
Time: 5 minutes
TRAINER: During this time you will ask the group a series of questions that
help them summarize and reflect on the knowledge they have learned.
11. Review participants’ knowledge
Ask the group a series of questions to help them summarize together and reflect
on the knowledge they have learned.
QUESTIONS AND ANSWERS
Question: What are germs?
Answer: Germs are small living things that can cause disease.
Question: When do we need to wash our hands?
Answer: Before eating, before preparing food, before breast-feeding, after using
the toilet, and after changing a diaper.
Question: Why is it important to wash our hands?
Answer: Washing our hands can help prevent us from getting sick or from
spreading sickness to others. (There are a number of possible answers.)
Question: What are some other ways to get germs besides not washing your
hands properly?
Answer: Flies, contaminated fields, and water are other ways germs can be
spread.
12. Encourage the participants to act
Ask the participants:
» Now that we have talked about personal hygiene, who is one person you
would like to share this information with?
» What is one thing you have learned today that you will be able to put into
practice?
13. Test participants’ knowledge
Administer the Personal Hygiene Post Training Quiz immediately or shortly after
the training.
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Personal Hygiene and
General Health
Health Manual
Contents
Personal Hygiene
p. 2
Hygiene at Work
p. 5
Hygiene at Home
p. 6
Common Cold
p. 9
Severe Coughing and Upper
Respiratory Tract Infections
p. 10
Fever
p. 11
Diarrhea and Dysentery
p. 12
Conjunctivitis
p. 14
Avian Flu
p. 16
Swine Flu
p. 16
Personal Hygiene
One way that people can get sick is through germs. Germs are tiny living things,
like bugs too small to see, that can cause diseases. Germs come in a number of
different forms including bacteria and viruses. Some bacteria and viruses can
make us very sick. These can be passed from one person to another by touching
things with germs on them, by breathing germs in the air, or through sex. In this
training we will talk mostly about germs we get by touching things.
The world around us is full of harmful bacteria. Some bacteria are found on our
bodies.
The most effective ways to protect yourself and others from diseases is through
1
good personal hygiene, including :
»
Washing your hands and body with soap and clean water
»
Not coughing or sneezing on others
»
Not touching others when sick
»
»
Throwing away items that have germs (such as tissues)
Using protection such as face masks or gloves when you are in a
situation that puts you at risk of catching an infection
Hygiene is especially important in an emergency such as a flood, hurricane, or
earthquake.
How Germs Spread
Diseases can spread multiple ways. To demonstrate the different ways, we’re
going to focus on how diseases caused by germs from feces can spread from
one person to another and make people sick.
»
»
»
»
Fluids: One way is through water. Germs from feces on the ground can
get into water (fluids) and be drunk by someone in your family.
Fingers: The second way is through fingers or hands that have not been
washed after going to the toilet. Even though they might not look dirty,
unclean hands can pass germs to other hands or onto food.
Flies: The third way is through flies. Flies land on feces and then track
germs onto food the way we track mud inside with dirty shoes. That is
why it is important to keep flies and other insects and animals out of the
kitchen area.
Fields or floors is a fourth way. Germs can seep into crops and other
sources of food if feces are not disposed of properly. To prevent field
contamination, it’s important to dispose of feces in toilets or latrines.
1
“Hygiene and Hand Washing,” CDC, www.cdc.gov/healthywater/emergency/hygiene.
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Hand Washing
One of the best ways to protect ourselves from sickness is by washing our
hands. Sometimes we need to wash our hands before doing something, and
other times we need to wash our hands after doing something—and sometimes
both!
A good rule to follow is to wash our hands before preparing food, before eating,
and before breast-feeding. We also need to wash our hands after using the toilet
and after changing diapers.
Regular hand washing with clean, safe
running water is critical to preventing the
spread of illness and disease.
Soaping and rinsing should cover the areas
between fingers, the nails, and the back of
the hands. Dry your hands with a clean towel
after washing them.
Hand washing can also help prevent food spoilage and minimize contamination.
While handling food, avoid scratching or touching your ears, nose, and mouth.
Always wash your hands after blowing your nose, and keep your nails short.
It is particularly important to wash your hands:
»
Before and after preparing and eating food
»
Before and after using the toilet
»
After cleaning up a child who has used the toilet
»
Before and after tending to someone who is sick
»
Before breast-feeding
»
After coughing or sneezing
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»
After handling an animal or animal waste
»
After handling trash
»
Before and after treating a cut or wound
Here are four steps to good hand washing.
»
»
Step 1: Wet hands and lather them with soap.
Step 2: Rub hands together for at least 20 seconds. Scrub the backs of
the hands, the wrists, between the fingers, and under the fingernails.
»
»
Step 3: Rinse hands.
Step 4: Let the hands dry by shaking or waving them in the air (airdrying).
In some locations and for some people, soap might be very expensive. It is
important to emphasize in trainings that soap might cost less than the money lost
from being sick from improper hygiene.
However, if soap is not available or affordable, people can also use ash, sand, or
even mud as an alternative to soap, as long as they wash and rinse (with running
water) thoroughly. The sand or ash are rough and “rub off” the dirt and germs.
Body Washing
The best way to keep the body clean and free of infection is to wash daily, which
means taking a shower or a bath and using soap and hot water to wash away the
2
bacteria that build up over the course of the day. Body smell is natural and can
be a result of sweat, unwashed clothes, or wastes excreted through the skin,
such as alcohol. Washing the body is the most effective way to limit body odor.
It is important for women to wash their reproductive area daily. Scented products
can sometimes cause irritation and should be avoided if irritation occurs.
Proper Dental Hygiene
Good dental hygiene includes regular brushing. Taking good care of your teeth
and gums is important because:
»
»
»
Strong, healthy teeth are needed to chew and digest food well.
Cavities (holes in the teeth caused by decay) and sore gums can be
painful. Prevent them by avoiding sugary foods and drinks (sugarcane,
candy, pastry, tea or coffee with sugar, and soft or fizzy drinks like
colas), and brushing your teeth twice each day.
Decayed or rotten teeth and gum disease can lead to serious infections
that may affect other parts of the body.
In order to keep your teeth and gums healthy, brush the teeth from top to bottom
and side to side. Be sure to brush the front, back, top, and bottom of all your
teeth.
2
“Personal Care and Hygiene,” Body Basics, www.faqs.org.
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Hygiene at Work
Basic sanitary conditions for workplace washrooms or toilets are generally
guaranteed under law or required within international buyer codes of conduct.
For example, worksites are generally required to have separate toilets for women
and men, adequate toilet facilities based on the number of workers they employ,
and to maintain a basic standard of sanitation in those facilities.
The standard of sanitation in many facilities, however, is often below what it
should be. In trainings, participants may inform you of problems with their
workplace facility. To the extent that you are able to do so, you should engage
management on these types of issues in order to improve conditions.
Common challenges include:
»
Lack of soap
»
Lack of clean towel to adequately dry hands
»
»
Lack of sufficient bathrooms for number of workers
Lack of slippers or unclean slippers provided for use in the bathrooms (in
countries where working barefoot is common)
»
Inadequate cleanliness of the floor or other surface areas
»
»
Lack of space for disposal of sanitary napkins or other personal waste
Sewage blockage challenges as a result of improper disposal of sanitary
napkins, clothes, and other personal waste
»
Lack of time provided by floor supervisors for workers to use the toilet
It is important to focus your training on the areas that are within the workers’
control and to engage management on areas that are beyond the workers’
control. As workers become more attentive to their personal cleanliness from a
health perspective, they will demand improved sanitation of workplace-based
facilities. Trainers should inform management of their workers’ likely changing
expectations and encourage them to improve their facilities to support their
workers.
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Hygiene at Home
Preparing and Storing Food
Sickness can be spread by germs and worms that enter our bodies through the
3
food we eat. To avoid getting sick from food :
»
»
»
»
»
»
»
»
»
Wash your hands before touching food or cooking.
Cook meat products well before eating them. Wash cooking surfaces
after preparing meat so that germs from uncooked meat, seafood, and
eggs do not spread to food that is already cooked or to food you eat raw.
Wash or peel fruits and vegetables, or cook them well before eating
them. These precautions kill germs from the soil where they were grown
and any germs that got on them during transportation.
Eat food right away, or keep prepared food covered and safe from flies
and dirt until it is ready to be eaten.
Reheat street food or any food that has been left out until it is hot. Doing
so will kill any germs before you eat it.
Store food in a way that keeps it safe from insects and rodents, which
can spread germs.
Keep the cooking area clean. Wash dishes, cutting surfaces, and
utensils after each use and allow them to dry well.
Feed leftover food scraps to animals, or put them in a compost pile so
that they do not attract insects.
Keep food cold, which prevents it from spoiling as quickly.
A cooler to keep food cold can be made using two unglazed clay pots of different
sizes. Place one inside the other, and fill the space in between the pots tightly
with sand. Keep the sand wet by pouring water on it twice a day. Put the food
you want to keep cool in the smaller pot, and keep the pots covered.
KEEP FLIES OFF FOOD
Flies spread germs and cause illness by landing on human and animal feces and
then landing on the food we eat. Cover food and make fly traps to prevent flies
from spreading germs.
How to make a fly trap:
1. Tape or glue paper to make an open cone, then fit the cone inside a jar or
bottle.
2. Seal the opening of the bottle so that there is no space between the cone
and the bottle.
3. Hang the bottle from a string or attach it to a stick in the ground.
4. Put fruit, fish, or some other bait just under the trap. Flies will land on the
food and then fly through the cone and into the bottle.
3
“Where There Is No Doctor,” Chapter 32: Water and Sanitation: Keys to Staying Healthy, Hesperian
Foundation.
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5. To empty the trap, turn it mouth up, remove the cone, fill with water to make
sure the flies are dead, and then dump it out.
Toilets for Health and Sanitation
Cleanliness in the community is just as important as cleanliness for individuals
and families. Sanitation means public cleanliness—using clean and safe toilets,
keeping water sources clean, and disposing of garbage safely. Poor sanitation
causes a great deal of unnecessary sickness and death.
When human waste (feces) is not managed well, it pollutes water, food, and soil
with germs and leads to diarrhea and other serious health problems. Using toilets
prevents germs from getting into the environment and protects the health of the
whole community.
Important qualities of a toilet related to health:
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»
»
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Safety: For a toilet to be safe it must be well built and in a safe place. No
one will use a toilet if they are worried about it collapsing. And if the toilet
is far from the home or in an isolated place, women may not feel safe
using it.
Cleanliness: If a toilet is dirty and smelly, no one will want to use it. A
toilet also must be clean to prevent the spread of germs. Sharing the
task of cleaning will help make sure that toilets are properly used and
cared for.
Privacy: A toilet can be as simple as a deep hole in the ground. But the
need for privacy makes it important for a toilet to have a good shelter
with a door or curtain. Shelters can be made from local materials, or they
can be made from concrete.
Comfort: People are more likely to use a toilet if it has a comfortable
place to sit or squat and a shelter large enough to stand in. They are also
more likely to use a toilet that is near the house and is sheltered from
wind, rain, or snow.
WHERE A TOILET SHOULD BE LOCATED
A toilet should be located where it will not pollute any water sources such as
rivers, wells, or springs. A toilet should be at least 20 meters from all water
sources.
Also be sure the toilet will not pollute the groundwater. Groundwater flows at
different depths underground in different places. The risk of groundwater
pollution depends on the type of soil, the amount of rain or moisture in the area,
and the depth of the groundwater. Keep in mind that water levels are much
higher in the rainy season than in the dry season. General rules include:
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»
»
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The bottom of the pit should be at least 2½ meters above the
groundwater.
If you dig a pit for a toilet and the soil is very wet or if the pit fills with
water, this is a bad place to put a toilet. Germs from the human waste
will contaminate the groundwater.
Do not build pit toilets on ground that gets flooded.
When there is a risk of groundwater pollution from pit toilets, consider
building an aboveground toilet. If you have no choice but to build a toilet
in a place where there is a risk of groundwater pollution, place the toilet
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downhill from nearby wells so that the germs will flow away from the
wells.
Garbage Disposal for Health
Get rid of garbage in a safe way. If possible, bury, compost, or burn garbage. If
you bury it, make sure the pit is deep enough to keep animals and bugs away. If
the garbage is aboveground, fence off the dump and cover the garbage with dirt
to reduce flies. Also, find safe ways to get rid of dangerous and toxic materials.
For example, do not burn plastic because the fumes can be toxic, especially to
children, old people, and sick people.
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Common Cold
Colds and the flu are common virus infections that may cause a runny nose,
cough, sore throat, and sometimes fever or pain in the joints. People with a cold
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or the flu may also suffer mild diarrhea, especially in young children .
Symptoms
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Sneezing
»
Stuffy or runny nose
»
Sore throat
»
Coughing
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Watery eyes
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Mild headache
»
Mild body aches
Prevention
»
»
Getting enough sleep and eating well helps prevent colds. Eating
oranges, tomatoes, and other fruit containing vitamin C may also help.
Avoid close contact with people who have colds or other upper
respiratory infections.
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Wash hands frequently with soap in warm water.
»
Practice good personal hygiene.
Treatment
Resting and drinking water help to overcome the common cold. Medicines such
as aspirin or acetaminophen can help reduce symptoms and provide relief.
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“Common Cold and Running Nose,” CDC, www.cdc.gov/getsmart/antibiotic-use/URI/colds.html.
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Severe Coughing and Upper Respiratory
Tract Infections
Coughing is not a sickness in itself but is a sign of many different sicknesses that
affect the throat, lungs, or bronchi (the network of air pathways that connect the
trachea and the lungs). Below are some of the problems that cause different
kinds of coughs:
Dry cough with little or no phlegm:
» Cold or flu
»
Worms (when passing through the lungs)
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Measles
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Smoker’s cough
Cough with much or little phlegm:
»
Bronchitis
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Pneumonia
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Asthma
Cough with a wheeze or whoop and trouble breathing:
»
Asthma
»
Whooping cough
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Diphtheria
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Heart trouble
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Something stuck in throat
Chronic or persistent cough:
»
Tuberculosis
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Asthma
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Chronic bronchitis
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Emphysema
Coughing up blood:
»
Tuberculosis
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Pneumonia (yellow, green, or blood-streaked phlegm)
»
Severe worm infection
»
Lung or throat cancer
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Fever
When a person’s body temperature is too hot, he has a fever. Fever is not a
sickness, but a sign of many different sicknesses. A high fever (over 39°C or over
102°F) can be dangerous, especially in a small child.
When a person has a fever:
1. Uncover him or her completely. Small children should be undressed
completely and left naked until the fever goes down. Fresh air or a
breeze will not harm a person with fever. On the contrary, a fresh breeze
helps lower the fever.
2. Take aspirin to lower fever. It is safer to give small children
acetaminophen, but be careful not to give them too much.
3. Anyone who has a fever should drink lots of water, juices, or other liquids.
For small children, especially babies, drinking water should be boiled first
(and then cooled). Make sure the child passes urine regularly. If she
does not pass much urine or her urine is dark, give her a lot more water.
4. When possible, find and treat the cause of the fever.
Very High Fevers
A very high fever can be dangerous if it is not brought down soon. It can cause
seizures (convulsions) or even permanent brain damage (paralysis, mental
slowness, epilepsy, etc.). High fever is most dangerous for small children.
When a fever becomes very high (higher than 40°C), it must be lowered at once:
1. Put the person in a cool place.
2. Remove all clothing.
3. Fan him.
4. Pour cool (not cold) water over him, or put cloths soaked in cool water on
his chest and forehead. Fan the cloths and change them often to keep
them cool.
5. Continue to do this until the fever goes down (below 38°C).
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Diarrhea and Dysentery
When a person has loose or watery stools, he or she has diarrhea. If mucus and
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blood can be seen in the stools, he or she has dysentery . Severe diarrhea leads
to fluid loss and may be life-threatening, particularly in young children and people
who are malnourished or have impaired immunity.
How Diarrhea Spreads
Infection is spread through contaminated food or drinking water or from person to
person as a result of poor hygiene.
Types of Diarrhea
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Acute watery diarrhea lasts several hours or days and includes cholera.
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Acute bloody diarrhea is also called dysentery.
»
Persistent diarrhea lasts 14 days or longer.
Dehydration and Diarrhea
The most severe threat posed by diarrhea is dehydration. During a diarrheal
episode, water and electrolytes are lost through liquid stools, vomit, sweat, urine,
and breathing. Dehydration occurs when water and electrolytes are not replaced.
Persons suffering from diarrhea should increase their intake of water and juices
to help replenish lost liquids.
Children and Diarrhea
In children under five years old, diarrheal disease is the second leading cause of
death. In developing countries, children under three years old experience on
average three episodes of diarrhea every year. Each episode deprives the child
of the nutrition necessary for growth. As a result, diarrhea is a major cause of
malnutrition, and malnourished children are more likely to fall ill from diarrhea.
Children who die from diarrheal disease often suffer from malnutrition. Each
diarrheal episode worsens malnutrition because of lost fluids and nutrients
experienced during the episode. Diarrhea is a leading cause of malnutrition in
children under five years old.
Causes of Diarrhea
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Infections caused by a host of bacterial, viral, and parasitic organisms,
most of which are spread by human or animal feces-contaminated water
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Poor personal hygiene
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Poor nutrition
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Worm infections
Infections outside of the gut (ear infections, tonsillitis, measles, and
urinary infections)
“Diarrhoeal Disease,” WHO, www.who.int/mediacentre/factsheets/fs330/en/index.html.
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Malaria
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Food poisoning
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HIV
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Digestion problems
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Food allergies
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Eating too much unripe fruit or heavy, greasy foods
Prevention
Key measures to prevent diarrhea include:
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Access to safe drinking water
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»
Improved sanitation
Breast-feed only for the first six months of
life
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Good personal hygiene
Health education about how infections
spread
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Safe and clean food preparation
»
Rotavirus vaccination
Treatment
Prevent or control dehydration: A person with severe diarrhea or signs of
dehydration must drink a lot of liquids that include water, salt, and sugar. Even if
he does not want to drink, gently insist that he do so. Have him or her take
several swallows every few minutes.
Meet nutritional needs: A person with diarrhea needs food as soon as he will
eat. This is especially important in small children or persons who are already
poorly nourished. Also, when a person has diarrhea, food passes through the gut
very quickly and is not all used. So give the person food many times a
day—especially if he only takes a little at a time.
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»
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A baby with diarrhea should continue breast-feeding.
An underweight child should get plenty of energy foods (cooked
bananas, crackers, potatoes, and applesauce) and some body-building
foods (chicken, eggs, well-cooked meats, beans, lentils, peas, or wellcooked fish) all the time he has diarrhea—and extra when he gets well. If
he stops eating because he feels too sick or is vomiting, he should eat
again as soon as he can. Keeping the child hydrated will help the
child eat. Although giving food may cause more frequent stools at first, it
can save his life.
If a child who is underweight has diarrhea that lasts for many days or
keeps coming back, give him more food more often—at least five or six
meals each day.
Often no other treatment is needed.
Zinc supplements: Zinc supplements reduce the duration of a diarrheal episode
and are associated with a reduction in stool volume.
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Conjunctivitis
This infection causes redness, pus, and mild “burning” in one or both eyes. Lids
often stick together after sleep. It is especially common in children.
Causes
Viral: Caused by a number of different viruses, many of which are associated
with an upper respiratory tract infection or cold. This type of conjunctivitis usually
only affects one eye, is characterized by excessive watering instead of
discharge, and is usually associated with tender lymph nodes around the ear and
neck.
Bacterial: Caused by infection of the eye with certain bacteria. This type often
spreads to both eyes, has heavy discharge from the eye, and makes it difficult to
open the eyes in the morning.
Symptoms
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»
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Pink or red color in the white of
the eyes
Swelling of the thin layer that lines
the white part of the eye and the
inside of the eyelid(s)
Increased tearing
Discharge from the eye, especially
yellow-green
Itching, irritation, and/or burning of
the eyes
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Symptoms of a cold, flu, or other respiratory infection
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Sensitivity to bright light
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Enlargement and or tenderness of the lymph nodes in front of the ears
Prevention
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Wash hands often with warm water and soap.
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Avoid sharing towels, blankets, and pillowcases.
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»
Wash towels, sheets, and pillowcases in hot water and detergent.
Remove any discharge from around the eyes several times a day with a
clean washcloth or tissue.
»
»
Avoid touching or rubbing your eyes.
Don’t share makeup, drinking glasses, eyeglasses, or personal hygiene
items.
Keep your child home from school or childcare if he or she has
symptoms.
»
Treatment
Viral conjunctivitis: Most cases of viral conjunctivitis are mild, and the infection
usually clears up in 7–14 days without treatment and without any long-term
consequences. Make sure you clean pus from the eyes with a clean cloth
moistened with boiled water.
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Bacterial conjunctivitis: Antibiotics can used to treat bacterial conjunctivitis and
stop the spread to others. Artificial tears and cold compresses can relieve some
of the dryness and inflammation.
See a health care provider if:
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You have moderate to severe pain in your eye(s).
»
You have vision problems, such as sensitivity to light or blurred vision.
»
»
You have intense redness in the eye(s).
Your symptoms become worse or persist; you may have a severe form
of viral conjunctivitis.
You have a weakened immune system from HIV infection, cancer
treatment, or other medical conditions or treatments.
Your bacterial conjunctivitis is being treated with antibiotics and does not
begin to improve after 24 hours of treatment.
»
»
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Avian Flu
Avian influenza (H5N1) is an infection caused by avian (bird) influenza (flu)
viruses, and can make some domesticated birds, including chickens, ducks, and
turkeys, very sick and cause death. The risk of contracting avian influenza is
generally low for most people because the viruses do not usually infect humans.
Most cases of avian influenza infection in humans have resulted from contact
with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces
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contaminated with secretion or excretions from infected birds .
Symptoms
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Fever
»
Sore throat
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Muscle aches
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Eye infections
»
Cough
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Severe respiratory diseases
Swine Flu
Recently, swine flu (H1N1) was the first global pandemic in more than 40 years.
The virus resulted in substantial illness, hospitalizations, and some deaths. Flu
viruses are spread mainly from person to person through coughing, sneezing, or
talking. Sometimes people may become infected by touching something—such
as a surface or object—with flu viruses on it and then touching their mouth or
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nose .
Symptoms
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Fever
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Coughing
»
Sore throat
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Runny or stuffy nose
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Body aches
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Headache
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Chills
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Fatigue
Prevention
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7
»
Wash hands frequently with soap in warm water.
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Practice good personal hygiene.
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Avoid close contact with infected people.
“Avian Influenza,” CDC, www.cdc.gov/flu/avian/gen-info/avian-influenza.htm.
“H1N1 Flu,” CDC, www.cdc.gov/h1n1flu/.
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The above F diagram shows how diseases from fecal matter can be spread—through fluids, fingers,
flies, and fields.
Water: One way is through water. Germs from feces on the ground can get into the water (fluids) and
be drunk by someone in your family.
Fingers: The second way is through fingers, or hands that haven’t been washed after going to the
toilet. These dirty hands can transmit the germs on to foods, which are then eaten.
Flies: The third way is through flies. Flies can transfer germs from feces to food, so it’s important to
keep flies and other bugs out of the kitchen area.
The fourth way is through fields or floors. Germs can seep into crops and other sources of food if
feces are not disposed of properly. To prevent field contamination, it’s important that feces are
disposed on in toilets for latrines.
General Hygiene Post Training Quiz
1. What can bad germs do? Circle all that apply.
a. Cause diseases
b. Make you feel sick
c. Spread to your family or other people with whom you have contact
d. Contaminate your water or food
e. All of the above
2. How can germs be spread? Check all that apply.
a. By shaking hands
b. By touching an object that was
touched by someone else
c. Through the air
d. Through water
e. Through flies
f. Through fields and floors
g. None of the above
3. Why is handwashing important? Check all that apply.
a. To stay clean
b. To prevent the spread of germs
c.
It is not important.
d. Don’t know
4. When is it important to wash your hands? Check all that apply.
a. Before eating
b. Before preparing food
c. Before breast-feeding
d. After using the toilet
e. After changing a diaper
5. What are the proper steps for washing your hands? Place the numbers 1 through 4 next to the
steps below to indicate the correct process.
a. Rub your hands together for at
least 20 seconds. It is important
to scrub the backs of your hands,
your wrists, between your
fingers, and under your
fingernails.
b. Let your hands air-dry.
c. Wet your hands and lather them
with soap.
d. Rinse your hands.
6. Do you think wearing slippers or shoes is essential?
a. Yes
b. No
c. Don’t know
7. What is necessary for proper hygiene in the kitchen? Check all that apply.
a. Washing hands with soap before
preparing food
b. Cleaning dishes and utensils in
boiled water rather than dirty
water
c.
Keeping bugs and insects out of
the cooking area
d. None of the above
8. When is the ideal time to brush your teeth? Check all that apply.
a. Early morning
b. Before bedtime
c. Before each meal
d. After each meal
9. Why is good dental hygiene important? Circle all that apply.
a. Strong and healthy teeth are needed to chew a digest food well.
b. Cavities and sore gums can be prevented with good tooth care.
c. Decayed or rotten teeth caused by lack of cleanliness can lead to serious infections that may
affect other parts of the body.
d. All of the above.
10. What does taking care of your skin include? Check all that apply.
a. Daily bath
b. Oil massage
c. Makeup
d. None of the above