"The leader needs
to be in touch with the employees and to communicate with them on a daily basis."
HOW TO SAVE 1 MILLION CHILDREN A YEAR
The following news on hand-washing appeared in the July 6th issue of The
"The second-biggest killer of children in the world is neither malaria, nor
tuberculosis, nor AIDS. It is the runs. Diarrhoea kills the equivalent of a jumbo-jet
full of children every four hours. Development experts have known this for years,
and have struggled to prevent it by diverse means: easier access to water for
washing, better health education, oral rehydration therapy, and so on. Now, it
seems that the best solution may also be the simplest: persuading people to wash
their hands with soap.
"....a literature review carried out by Valerie Curtis and her colleagues
at the London School of Hygiene and Tropical Medicine finds that appropriate hand-washing
can cut diarrhoeal diseases by 43%. It may have an equally big impact on respiratory-tract
infections, the biggest child-killer of all. A huge study carried out for the
American Army found that sniffles and coughs fell by 45% when troops washed their
hands five times a day.
"But how to persuade people to scrub? Two years ago, at a World Bank forum
on hygiene and health, Dr. Curtis suggested a global partnership between soap
makers and sanitation experts. Development officials had always tended to emphasize
the role of the public sector in improving public health. But it is the private
sector that builds most of the world's toilets and sells its soap. A previous
public-private partnership, involving three big soap companies, had worked well
in Central America. Dr. Curtis began with a trial in two places: Ghana in West
Africa, and Kerala, a relatively developed state in southern India.
"Bringing together all those concerned with encouraging hand-washing turned
out to be a revelation. The private sector soap companies and the government officials
found it hard to understand each other at first. The ponderous bureaucracy of
officialdom dismayed the soap companies. The bureaucrats mis-judged the difficulty
of getting rival companies to work together.
"Now the World Bank is backing a programme in Ghana to promote hand-washing.
The Indian and Keralan governments are raising $8-10 million for a similar three-year
programme in Kerala. The soap companies think sales could grow by 40% in each
"The health experts are bowled over by the marketing prowess that the companies
are bringing to the project. Together they have, for instance, understood that
Ghanaians prefer liquid to solid soap for hand-washing and are more likely to
wash their hands before eating if he soap does not smell too strong (since Ghanaians
often eat with their hands). They have also calculated that an ideal time to change
a mother's habits is when a new baby arrives (because she is then more receptive
to new ideas and also in more frequent contact with health workers). They have
learned when and how often to show advertising to have maximum impact. And they
have realised that families may want to buy soap in very small quantities because
some dislike sharing toilet soap and others cannot afford to buy big bars.
"Once the programme has been rolled out in the first two places, it will
be extended to China, Nepal, Peru, parts of Central Asia and Senegal. According
to Dr. Curtis, soap is a sort of do-it-yourself vaccine. And profitable and affordable
Watch for Dr. Susan Aronson's advice on health and safety in early childhood programs
in Child Care Information Exchange. For subscription information
go to www.ChildCareExchange.com.