What I learned about hygiene promotion and when it can make a difference

by Erika Bozzato

Since I came to Lebanon, I started to tag along GVC hygiene promotion team, whose work was especially interesting to me. On paper their work consist mainly in visiting refugees’ settlements and informing adults and children about good hygiene practices and health services available to them in North Bekaa. But of course in reality is much more complicated than this.

First of all, there is no hygiene promotion without proper Water and Sanitation. People who cannot count on latrines nor have access to safe water can hardly adopt any behaviour they would normally apply or they have been suggested. Therefore hygiene promotion action must be sided by the provision of water tanks to store water, jerry cans to transport it without contamination inside homes, decent latrines with pits that prevent soil and aquifers contamination and – when needed – product for personal and house hygiene, called hygiene kits and cleaning kits.

Second, hygiene is a very sensitive issue. Refugees from Syria are of course a very heterogeneous group and not all of them can be addressed in the same way, and hygiene promoters must develop very good analytical skills in order to tailor the message in an effective and incisive way. It is very important to keep the communication open, without offending anybody.

Many of them need suggestions to adapt to the emergency situation and to the lowering of the living standards they had to cope with after fleeing Syria. We all know basic hygiene practices, but what happen if we are suddenly deprived of drinkable water from the tap and toilets connected to the sewage system? How to maintain basic hygiene standards and avoid spreading of diseases? Others who can afford better accommodation just need some information about health services available for free or reduced price, also considering that a big share of health services in Lebanon are private and many people cannot afford them. Sometimes it can be very frustrating, when you see that families could not but settle down in a very unhealthy place, too close to stables, or with no access to drinkable water, or in some areas infested by flies or other insects.

Third, hygiene promotion, like every education activity, does not happen in a day. It is a slow process, where it is important to focus on a handful of crucial information and discuss them with people, also relying on their personal experience and levering on key-reasons for behavioural change. Once there was this old lady discussing about lice and how she would deal with them decades ago with her young children. Or this woman lecturing the others about leishmaniasis – a disease caused by protozoan parasites and spread by the bite of certain types of sand flies – for having seen some cases earlier that year.

From what I could see, hygiene is mainly a women’ and children’s matter. Whereas the activity with the first is mainly based on discussions and Q&A session, the activity with children is of course mostly based on games and songs. Adult men are of course welcome, but usually they prefer to sit aside and show up only for the final greetings.

Finally one thing to be kept into account is the context and all the troubles that people went through. Light heart and a laugh sometimes are very much needed. After listening and discussing all the information about hygiene a woman told my colleague:

‘Yes, we are happy you are here telling us these useful things, but can we talk about something more cheerful now??’