by Mwakamubaya Nasekwa and François Kiza The Democratic Republic of Congo, a country coming out of a long war, faces many challenges, including that of improving the living conditions of its population through the promotion of sanitation and hygiene. Studies suggest that fewer than one in ten people in the Democratic Republic of Congo (DRC) have adequate access to sanitation and hygiene.

These Bible studies are designed to use in small groups. They may provide a useful introduction to a meeting where different topics from the Guide…

Jesus has taught us clearly that it’s not outer dirt or cleanliness that matters to God, but the cleanness of our hearts. So what is the importance of hygiene?

This Bible study helps us to think about how we should live responsibly and set a good example to those around us.

In this issue we have been looking at water. In the Bible, water is used as a symbol to show several different aspects of God’s power.

Water for life. The Bible has a surprisingly large number of references to water – over 300 in my concordance, not to mention another 80 on rain. Which is the first verse that comes to your mind when you think about water?

Biosand filters purify dirty water so that it becomes safe to drink. They are very useful, both in rural and urban areas which lack safe piped water. Calgary University, Canada, developed an innovative low-cost design using concrete.

‘Community-led total sanitation’ was pioneered in Bangladesh by Kamal Kar (a development consultant from India) and the Village Education Resource Centre while they were evaluating an NGO’s traditional subsidised sanitation programme. They wanted to convince the NGO to stop subsidising toilet construction because subsidies in the past had not led to community ownership and toilet usage. Instead, they suggested that the NGO should encourage people to help themselves. They developed an approach ...

by Vidya Gorakshkar. The watershed of a river includes all the land which drains into a river, the upland and wooded areas where streams begin, as well as areas nearer the river itself. Managing this watershed area may involve soil and water conservation, afforestation, fodder, animal husbandry, fuelwood, community development and indeed most aspects of rural life. Some villages in the Ahmadnager District of Maharashtra State in India are participating in the Indo-German Watershed ...

Adequate sanitation is rarely considered by communities when preparing for disasters. However, without it, there is no doubt that many more people…

Action in low-income communities  by Professor John Pickford of the Water, Engineering and Development Centre at Loughborough University of Technology.

In this issue we look at the three related subjects of Water, Sanitation and Hygiene. It is now realised that these three must go hand in hand to achieve real improvements in health. Richard Franceys and Paul Dean have helped to provide articles and practical instructions for each of these three key areas. Issues for both rural and urban situations are considered. We show how to build a water tank for use alongside a home, school, health centre or church. (We know from your letters that some ...

Encourages changes in practice and understanding attitudes, with practical ideas to encourage hand washing, to keep food safe, to provide safe drinking water and maintain good health. It also includes advice on improving water supplies and building different types of latrines.

Ferro-cement water tanks can be used to store rainwater collected from roofs. They use wire mesh to reinforce the walls. This means that the walls do not need to be thick, so less cement is needed. If mesh is not too expensive, the tanks can be much cheaper than ready-made alternatives.

Compiled by Rachel Blackman When considering sanitation and hygiene, it is important to consider the different needs and preferences of both men and women.

chlorine bleach a strong chemical that can be used to make water safe for drinking. cholera a serious disease causing severe diarrhoea with vomiting…

ANAL relating to the anus, through which faeces pass DEFECATION passing faeces from the body

Targets include the need to protect the environment, to reduce by half the number of people without access to safe drinking water and basic sanitation, and to significantly improve the lives of slum dwellers.

Even if our hands look clean, they can still be covered with millions of germs. Washing hands with soap is one of the most important ways to keep ourselves healthy and stop these germs from spreading from one person to another.

by Anne McCulloch Knowing the best way to keep yourself and your family healthy is important. This is especially the case for the people of Darfur in Sudan, who have been displaced from their homes due to fighting and are living in cramped basic conditions in camps or with relatives. Tearfund is working to provide safe water and sanitation in these areas and give appropriate health messages so that people use the resources effectively.

We asked community facilitator Pratikchya Khadka of Share and Care Nepal about her sanitation and hygiene work. We hope you will be inspired by her experience of respectfully helping people to change their behaviour.

Why do sanitation programmes often fail? Here are some common myths about improving household sanitation, followed by explanations of why the reality is different.

In rural areas, the main water sources are normally groundwater borewells or surface water, rivers and lakes. However, an often overlooked, easily…

by Sue Yardley. Reducing child and maternal mortality are targets within Millennium Development Goals 4 and 5. In 2010 many donor governments and international agencies are focusing on these issues. There has been some encouraging progress in meeting these goals, but greater effort is still needed to achieve them. Improving access to water, sanitation and hygiene education (WASH) can help significantly to improve the life chances of children and ...

Dowsing or water divining, can mean different things to different people. To the scientific community it is superstitious nonsense; to many farmers in Britain and elsewhere it is a useful method of finding good water for their livestock; to many it is something of a mystery. Finally, some Christians believe it to be dangerous and linked with satanic powers. However, due to its widespread use in many parts of the world it is a phenomenon worthy of investigation.

by Awoyemi Olawale  Sanitation is not a priority in schools because people do not realise the need for a safe and clean environment. This attitude means that when there are many competing priorities, resources are allocated to academic activities while sanitation is neglected. But good sanitation facilities, such as latrines, safe drinking water supply, and hand-washing facilities, are important for the success of basic education.  

by Yudith Contreras Veloso

A collection of ideas on storing and using it.. Moulds for water jars The water department in the Diocese of Kigezi, Uganda uses specially shaped wooden moulds which fit together to form the shape of a small water jar. Clay is used to smooth any gaps before plastering over the moulds with layers of cement. Once the mortar has set firm (within a day) the moulds can be removed through the lid of the jar. The Department has about ten similar sets of moulds which can be reused over and ...

Many homes, particularly in towns and cities, have little or no room for growing vegetables. However, outside many homes is an area of ground that…

Good personal hygiene plays an important part in good health. We should wash ourselves, and our clothes, regularly with soap and water to prevent the…

This Guide helps communities to consider improving their lifestyle to reduce disease and infection. Promoting effective and low-cost sanitation,…

It is widely accepted that the success of a Community-Led Total Sanitation (CLTS) process depends mostly on the skills of the facilitator. This is because in most cultures defecation is considered a private, personal activity, which should not be publicly discussed.

Compiled by Brian Skinner, Richard Franceys and Isabel Carter

Tearfund’s partner in Ethiopia, Kale Heywet Church, has supported work in water and sanitation over many years in Ethiopia. They have a team of health educators who work with communities, raising awareness of hygiene, sanitation and capacity development. Water and Sanitation committees are elected and the educators train the committee members in hygiene and management. Many of these committees are now well organised and effective. However, changing attitudes is a slow process. The Water, ...

Sanitation and cleanliness for a healthy environment (2005) by J Conant. Hesperian Foundation and UNDP Encouraging change: Sustainable steps in water…

A selection of books, websites and training material on the subject of hygiene and sanitation.

by Jennifer Organ HIV is affecting communities across the world, especially in sub-Saharan Africa. People living with HIV often suffer from diarrhoea and tiredness. Diarrhoea increases the need for easy and frequent use of a toilet, while weakness reduces people’s mobility and access to sanitation facilities.

by Frank Greaves and Laura Webster

by Frank Greaves Why do so many latrine programmes not have their intended impact on the health of the community? In recent years there has been more emphasis on changing attitudes towards sanitation and hygiene, hygiene education and community ownership. But sometimes this has meant that little attention has been given to selecting appropriate latrine technologies. This article looks at how we can guide communities to select technically appropriate latrines, while at the same time ensuring ...

Latrines are commonly made with reinforced concrete slabs, as shown in article 'Planning a pit latrine.' However, this method uses a lot of cement and can be too expensive for many. This means that people either do not build latrines or build them with mud floors which are hard to clean. Here are two methods of building latrine covers which are easy to keep clean but which use much less cement. Eight sanplats, for example, can be made from one bag of cement.

Making simple plain soap is relatively easy and involves basic equipment. This article describes how you can make simple hard soaps that are suitable for many uses around the home, including hand washing.

In the past 15 years, climate extremes such as flooding, drought, cyclones and mud slides have caused about 85% of deaths related to natural disasters and over 60% of the financial damage. Extreme weather events unfortunately are becoming more common due to climate change, so we need to be better prepared.

by José Vidal Lanza

by Jeff Woodke

In Footsteps No.12 we reported that people living near Mengo Hospital in Uganda preferred to drink dirty river water instead of the clean water offered to them because of their fear of spirits.

A useful idea sent in by Andrew Maclean, WaterAid, Rukungiri, Uganda.  

by Richard Franceys. We all know that water is a wonderful gift. It falls as rain and collects in streams and rivers or under the ground. From there we can take it for drinking, for cooking, for bathing and for washing pots and pans and clothes.

 by Elena Hurtado. Shortage of water is the main reason why people fail to wash their hands regularly. Here is an idea which only uses about a tenth of the amount of water usually used to wash hands. The Tippy Tap is made from an old plastic container with a hollow handle. It is based on the mukombe (Footsteps 14). It also uses less soap as the soap is hung up and protected from rain so it does not become soggy.

The Saradidi Rural Health Project is found in Western Kenya, near the shores of Lake Victoria. It was begun almost ten years ago. It has strong links with the 61 villages within the project area, nearly all of which now have their own health worker and an agricultural worker. From the beginning, the community has been fully involved in deciding the priorities of the project.

When Anita Narre left her in-laws’ home because it had no toilet, the residents of the village of Zitudhana were shocked. Defecation in the open was usual even among the few graduates in the village, so the new bride’s decision made news in the community.

Clean water and safe sanitation improve everyone’s health and opportunities in life. When people have clean water and safe sanitation, many diseases are less easily spread. But why is good sanitation so difficult to achieve?

Good health is a great blessing. None of us enjoy feeling unwell. We have all had times of feeling unwell. Sometimes this is because we catch an…

During the first six months of a child’s life, breast milk alone is the ideal food. It contains all the nutrients and water needed for healthy…

Menstruation is a natural event for all women of reproductive age. For most women it occurs once a month. Each month the womb develops a special…

The microbes that cause diarrhoea and other diseases can be spread through food as well as water. Most people already have good ways of handling…

Good hygiene in handling food is very important. However, it is also important to make sure that the dishes and utensils used for serving food are…

If people do not have access to latrines, then burying faeces in the ground is a simple step that will improve hygiene. It will reduce people’s risk…

Latrines need to be built near the house but at least 20 metres from any water source. The walls can be built of mud, brick, matting or corrugated…

Young children are often afraid to use a latrine. They may be unable to open the door, afraid of the dark or the pit. However, even young children…

Latrines take a long time to plan and build well. Sometimes there may be situations when there is no time to build proper latrines, such as after…

People are more likely to respond to positive messages that respect their reasons for doing things, rather than to warnings about dirt. Share…

After a time of sharing the messages learned from this Guide with people in the community, it is good to assess their impact. We need to know whether…

In this Guide we will learn many useful messages that we can share with people to help them to live healthier lives. It is very helpful to first find…

Most of the time when we look at our hands, they seem clean. However, they can look clean but still be covered by many thousands of tiny microbes.…

It is helpful to make washing hands regularly as quick and easy as possible. If water is limited, there are ways of washing hands that use very…

It can be hard to encourage people to wash their hands if they don’t see the need. If we know what people believe about washing hands, we can share…

We have already learned about the importance of keeping our hands clean. The rest of our body also needs to stay clean. Every day we should wash our…

When people get diarrhoea, they can lose a lot of water and salts from their body very quickly. Babies and young children suffer most. In many…

The World Health Organisation has estimated that 80% of all sickness and disease in the world is caused through lack of clean water and poor sanitation.

As with many things, when it comes to approaches to changing hygiene behaviour, one size does not fit all. A method that works in one context is unlikely to have the same results in another.

Explanations of some of the words and phrases used in this edition.

by Felina Albornoz, Paulina Rivas and Hermógenes Lizarazu Part of the Mosoj Yan programme in Cochabamba, Bolivia, is a ‘Motivation Centre’ which works with young female street dwellers. These people have acute health needs as they live in unhealthy and unhygienic conditions and suffer from frequent infections and an unbalanced diet.

Many of the ideas which Richard Franceys has suggested for involving children in improving water supplies and sanitation, could also be adapted to be used with agricultural work.

By Richard Franceys.   The provision of clean water for drinking, and the safe disposal of human waste, are vital for human health. The Director-General of the World Health Organisation has said that the number of water taps per 1,000 persons is a better indication of health in a country than the number of hospital beds.