Each year, two million children die before their fifth birthday from preventable diseases like diarrhoea and pneumonia.
Handwashing with soap is one of the most effective and low cost ways to prevent such diseases, and so in the last 10 years, Lifebuoy has taken its handwashing behaviour change programmes to millions of people around the world. It is now aiming to change the handwashing behaviour of a whole village in central India- Thesgora.
The programmes, directed at school children, new mothers, neo-natal nurses and community groups, aim to have a significant impact on the health of the community and consequently the futures of the children in the village.
This new film highlights the significant milestone of a child reaching their 5th birthday.
It’s common knowledge that prevention is better than cure; yet, every year an estimated 2 million children don’t reach their fifth birthday due to the largely preventable diseases diarrhoea and pneumonia. Prevention need not be complicated; for diarrhoea and pneumonia the simple practice of regular handwashing with soap is one of the most effective and low-cost public health interventions available.
From a health and hygiene perspective, the power of prevention is massive.
Saving 600,000 Lives Every Year
Research demonstrates that handwashing with soap reduces the risk of diarrhoea by 45 per cent, pneumonia by 23 per cent, and improves levels of school absenteeism by approximately 20 to 50 per cent. The London School of Hygiene and Tropical Medicine estimates handwashing with soap could save the lives of over 600,000 children every year - the equivalent of 10 jumbo planes of children saved every day [UNICEF].
While most people do have access to soap, the number of people who regularly wash their hands at the right times – such as before eating and after using the toilet – is worryingly low. For example, India is the leading market for Unilever’s health soap brand, Lifebuoy, in terms of soap penetration – 99 per cent of homes report having soap present - yet the country has the highest child mortality related to diarrhoeal disease. Further, across a global review of 11 countries, the average rate of handwashing after using the toilet is only 17 per cent. This dips as low as 3 per cent in Ghana and 1 per cent in rural India.
Addressing the Gap Between Hygiene and Prevention
Unilever’s health soap brand, Lifebuoy, is uniquely placed to address this gap and help reposition hygiene habits as new norms, especially where a new habit can mean a matter of life and death. Lifebuoy has set out a bold and ambitious challenge to positively impact the health and hygiene behaviour of one billion people by 2015, a commitment that was publicly stated as part of Unilever’s Sustainable Living Plan in 2010.
Whilst inspiring people to change their behaviour is not easy, getting them to integrate these new behaviours into their daily routine is even more challenging.
Influencing Behaviour: Affecting Social Norms & Commitments
Fear of diseases is not a motivator; peer pressure is crucial. Habits don’t come over night and need to be practised for a certain period of time before they become ingrained in a daily routine. Pledging in front of people that matter encourages people to hold themselves accountable and stick to their commitment. We also partner with leading hygiene, behavioural sciences, marketing and digital experts to ensure that our behavioural change programme continues to resonate effectively with mothers and children across the world.
Now we have taken this collaborative approach one step further by partnering with public organisations and governments to expand and deepen our expertise, maximise our resources, share costs and, most importantly, ensure greater scale and impact. This includes organisations like Populations Services International [PSI], Millennium Villages Project [MVP] and Water, Sanitation for the Urban Poor [WSUP].
Millennium Development Goal 4
This approach is going to prove crucial as we work with our partners to make handwashing with soap a reality for all and achieve Millennium Development Goal 4 to reduce child mortality levels by two thirds. However, there is so much more we can do.
We are increasingly pioneering new models of co-investments from both public and private sector resources to ensure the scale of hygiene promotion programmes is enhanced and targeted towards the most vulnerable demographics– under-fives and their families in most at need countries. Of course, there has been scepticism along the way. But it is diminishing as levels of scientific proof and the long-term commitment we put forward in our joint programmes show increasingly positive results.
As we celebrate this year’s Global Handwashing Day today, let’s put the spotlight on governments, international institutions, civil society organisations, NGOs, and the soap industry to push hygiene up on the global health agenda and unlock the true potential of handwashing with soap.
You can show your support and help more children reach their fifth birthday by pledging on our Facebook page. With every pledge, Lifebuoy and its partners will help more children receive hygiene education through their dedicated handwashing behaviour change programmes.
About the Author: Myriam Sidibe is Lifebuoy’s Global Social Mission Director and is one of the only people in the world with a doctorate in public health, focused on handwashing with soap. She has spent 14 years working with thousands of children understanding the most effective ways to get them to wash their hands with soap at key occasions like before eating or after using the bathroom. Myriam is one of the driving forces behind the creation of Global Handwashing Day.
Long ago it was said that ‘one half of the world does not know how the other half lives.’ That was true then. It did not know because it did not care. The half that was on top cared little for the struggles and less for the fate of those who were underneath…
In fighting extreme poverty, it's sometimes easy to lose sight of just how recently the conditions that we're seeking to combat existing in our own countries. That's why today, we're excited to review 'How the Other Lives,' an 1890 classic about slum life in New York, which offers lots of lessons and points of reflection for us today, four generations on.
Jacob A. Riis’ How the Other Half Lives (1890) is a factual, first-hand account of poverty in 19th century New York. Through his revolutionary use of flash photography, Riis takes us on a visual tour through slum life in Lower East Side Manhattan. Riis was writing during a time of immense social upheaval, when the city was experiencing a large influx of immigrants from Europe and many other parts of the world. This was creating a rapidly growing population which the city needed to accommodate. This was done through large scale tenements which would often house hundreds of people at a time in mostly squalid conditions.
He brought the plight of the New York working classes to the largely ignorant middle and upper classes, who often viewed their poverty as deserved or chosen. His use of hard facts, statistics and photographic evidence help guide us through the many overcrowded tenements, filthy streets, and exploitative sweatshops of the city. He was considered a great social reformer who was concerned with bringing about real change to attitudes and policy.
It is the conditions of the overcrowded tenements that serve as Riis’ central focus as, at the time, the tenements harboured three-fourths of the city’s population. Accompanied by visuals, he guides us through what the rooms look like at different rates and across different parts of the city: “The twenty-five cent lodging house keeps up the pretence of a bed-room, though the head-high partition enclosing a space just large enough to hold a cot and a chair and allow the man room to pull off his clothes…The ten-cent level the locker for the sleeper’s clothes disappears. There is no longer need of it. The tramp limit is reached, and there is nothing to lock up…” The unlicensed lodging houses of the city could even offer a small space on the floor for five cents or a squatting space in the hallway for three.
With the increase in demand brought about by the swelling population, the tenement apartments began to be portioned into several smaller rooms, often with no access to light or ventilation. In the pursuit of profit and with no regard to health, landlords would fill these rooms well over capacity with poor lodgers. “There are numerous examples of tenement-houses in which are lodged several hundred people that have a pro rata allotment of ground area scarcely equivalent to two square yards upon the city lot…” It was thought that the tenement houses in East Side Manhattan were once the most densely populated district in the world, not excluding China, as they were “packed at the rate of 290,000 to the square mile.” Riis saw how the poor had no voice to protest against the degradation of their condition, because the tenements were the only option open to them other than a life on the streets.
In such high density living the spread of diseases such as Cholera, Typhus fever, and Smallpox were inevitable. Riis reveals how the mortality rate of the city went up from 1 in 41.83 in 1815, to 1 in 27.33 in 1855 as a result of diseases associated with slum living. The Bureau of Vital Statistics commented that solely due to “suffocation in the foul air of an unventilated apartment…there are annually cut off from the population by disease and death enough humans to people a city, and enough human labour to sustain it.” The stifling air in the warmest of months was the cause of many cases of suffocation and ill health, particularly amongst young children.
The effect of slum living for children of the city is perhaps the most touching in all of Riis’ account. He uses facts and statistics to expose the scores of children dying before their 5th birthday. He also highlights how child mortality rates dramatically decline in cases where the same number of people are living together, but basic sanitary conditions are upheld. He uses examples like this through his account to remind us of the crucial relationship between sanitation and health.
With many children falling victim to vices such as alcohol and petty crime, young lives were often wasted outside of school and education. The use of child labour in the many sweatshops of the city is also brought to light. Sweatshops were created in tenements, so that the same law which applied to workers in the factories could be evaded. People would work long hours without any breaks for a wage that barely covered rent let alone food expenses. Families in these situations would be living on the very fringes of survival and close to starvation. Emigrating to America from Denmark in 1870, Riis struggled to find steady work for much of his early life in the new land. Without food or opportunity, he experienced first-hand the life of poverty documented in this account.
Although it has been described as more of a factual account than an emotive one, what Riis accomplished was to give a face to the under-represented issue of urban poverty in New York. His account uses real case studies from those experiencing the worst of the conditions. As the intimate portraits peppered through his account show, he documented everything from the clothing to the sombre expressions of those living in poverty. It is what makes this account of 19th century slum living so unique and compelling.
How the Other Half Lives also documents the changes and organizations brought about in 19th century New York to create changes in legislation. For example the birth of the Board of Health, and the Tenement House Act of 1867 and The Society for Improvement of the Condition of the Poor. Riis proposed real tangible routes to overcoming the overpopulation and tenement housing crisis. Many of his proposals were to be adopted in the years to come. The attention his work received led to reforms in laws, the tearing down of New York's worst tenements and sweatshops, reformation of the city's schools and the construction of new safer tenements. This work represents the importance of awareness - Riis not only shows how we each have a moral obligation to recognise the plight of the poor, but that real lasting change is achievable.
*All images from Jacob A. Riis’ How the Other Half Lives (1890)
On 19-22 March 2011, the world will come together to promote global water and sanitation rights for The World Walks for Water. As we’ve discussed previously, there are currently 884 million people lacking access to clean water, and 2.6 billion who don’t have a safe toilet. This means that 4,000 children die every day from diarrhoea contracted from contaminated water, 3,000 of which are in Africa alone.
The World Walks for Water is asking us all to walk 6 kilometres to stand in solidarity with those in developing countries who have to walk that distance each day just to access water. And even then the water is often dirty.
But this global event is about more than just bringing awareness to this devastating issue. The walk will also demand that politicians in the North and the South keep their promises and step up their efforts to ensure water and sanitation for all people, everywhere.
This effort is particularly essential in the UK where the Department for International Development’s (DFID) announcement recently of their aid review revealed that they are not making water and sanitation a priority.
WaterAid described in their newsroom that “in promising to provide access to drinking water and improved sanitation to an equivalent number to the population of Scotland, Wales and Northern Ireland over the next four years, the [UK] Government is set to reach only one percent of the world's poorest people without access to these basic human rights."
We need to continue pressuring our governments to accept that aid for these issues would provide a huge return on investment - for every £1 invested in water and sanitation, £8 is returned in economic returns through increased productivity (UNDP) and would prevent up to 1.4 million child deaths every year (UNICEF).
Join the Walk
You can still sign up to organise your own Walk for Water or you can join a walk in your area. Together this month we can help motivate others to take action in achieving a world where no one goes without clean water and adequate sanitation.
In the next few months, the world’s population will tick over 7 billion people. In this fantastic clip from National Geographic, we see how, why, and what that means for us.
The clip raises the challenges of water and sanitation, and leads us to ponder how the world will cope with an expected population of 9 billion by mid-century. But we would like to take these thoughts a step further to ask, “what can we do about it?”
As we’ve noted previously, around 884 million people lack adequate access to safe and clean drinking water and over 2.5 billion lack access to adequate sanitation. One of the targets of Goal 7 of the Millennium Development Goals is to halve these numbers by 2015. Below are a few ways we can make that happen.
Support organisations working to improve access to safe and clean water and adequate sanitation in a sustainable way. NGOs like WaterAid work with communities using a mixture of low-cost technologies to deliver lasting results. They also have projects that empower and provide a platform for local citizens in developing countries to hold their governments accountable on providing the adequate water and sanitation services they are entitled to.
Encourage governments to prioritise water and sanitation issues by committing good aid and resources. NGOs such as Pump Aid and End Water Poverty have global campaigns and events that the public can participate in that put pressure on governments to do their part to stop the water and sanitation crisis. This crisis is currently killing 4,000 children every day with diarrhoea, a completely preventable and treatable disease. Many would be surprised to know that this means diarrhoea kills more children every year than AIDS, malaria and measles combined.
Help advocate for a more sustainable use of water resources in agriculture. The FAO estimates that 70% of global water use is related to agricultural activity. Organisations like Water Footprint are trying to promote the idea of global water saving through trade by encouraging countries with low water productivity to import water-intensive products from sites with high water productivity and export commodities that are less water intensive. In plain language – don’t grow rice in deserts. We need to adopt more sustainable uses of water resources for agricultural activity if we want to avoid an eventual global water crisis.
Whether there are 7 billion or 9 billion people on our planet, seeing an end to extreme poverty is only possible if we improve access to safe and clean drinking water and adequate sanitation. This is because these issues not only threaten lives, but also effect education and livelihoods. WaterAid estimates that 443 million school days are lost each year due to water-related diseases, and that the average household in rural Africa spends an average of 26% of their time fetching water (taking away from work and leisure time).
We can each do our part to educate others on the importance of these issues so that we not only halve the amount of people lacking access to safe and clean water and adequate sanitation by 2015, but eventually see that number reach zero.