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HEALTH

IN
WATER AND
SANITATION

Student Study Booklet


1 A message to YOU the reader
We hope you are looking at this book because you would like to protect the
health of your family and especially your children.

You may already know some things about Germs.


- ……w here Germs liv e
- ……how Germs travel
- ……how they get into your stomach
- ……w hat sicknesses they cause.

Do you know how to stop them?


We hope this book will help you understand how you can protect yourself and
your family from w ater borne sic knesses like diarrhoea and cholera. The
book w ill talk about:
1. What germs are, w here they come from, why they are dangerous.
2. How germs travel into our bodies
3. How germs can be stopped by our using latrines and washing hands
4. How germs can be stopped by our taking care when we handle water
5. How we can make w ater cleaner before drinking it
6. What to do w hen someone gets sick because of germs from water

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2 What you need to know about Germs
We use the word Germs to talk about tiny animals that are too small to see.
As we have our tribes, so Germs have their tribes.

Some Germs are GOOD. They live in our bodies and help us
digest our food.

Other Germs are BAD. They live in Faeces and can make us
sic k when they get into our bodies

Even amongst the tribes of BAD Germs, there are many different types and
dif ferent sizes.

Worm Eggs :
.
These are about the size of the dot on this page 

Am oeba: These are much smaller than Worm


Eggs.
.
600 Amoeba could fit in this dot 

Bacteria : These are much smaller than Amoeba.


.
60,000 Bacteria could fit in this dot 

Viruses: These are the smallest things that cause us sickness.


.
6,000,000 viruses could fit in this dot 

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These Germ s live in ALL Faeces.

• Faeces of Men, Women, Children, Animals and Bir ds


• The faeces of Children often contain more Germs!

These Germ s are in huge numbers in Faeces. A piece of faeces the size
of your fingernail can contain:
• Ten Million Viruses 10,000,000
• One million Bacteria 1,000,000
• One Thousand Am oebas 1000
• One Hundred Worm Eggs 100

When a sm all number of these get into our bodies, they m ake us sick.
The sic knesses give us these problems from time to time

• Diarrhoea
• Stomach cramps
• Vomiting
• Blood in faeces

These sicknesses make us weak for three reasons


• Our bodies have to fight the Germs and that makes us tired
• Diarrhoea and Vomiting stop us taking energy and vitamins from food
• Diarrhoea and Vomiting remove water from our bodies. That stops it
w orking w ell.

These sicknesses can be very dangerous for Children because their


bodies are not strong to fight Germs.
• Sicknesses like Diarrhoea kill 1.5 million people in countries like ours
• The same as 3 people dying every minute of every day.
• The same as 4 full Buses crashing every hour

You m ay even know children or adults who have died from diarrhoea.

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3 Travelling Germs
Until now you have learned some things about Bacteria and Vir uses and
Amoeba.

• They live in Faeces of all kinds

• They are different siz es and shapes, but all are invis ible to the eyes

• They make me sick or w eak when they get inside my body

• These sic knesses kill Millions of children every year all over the world in
towns and villages just like the ones we live in.

But HOW do germs travel from Faeces into my body? This seems a very
strange thing!!

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3.1 A story about travelling to Dubai

There w ere once three brothers w ho liv ed in Hargeisa. Muhammad,


Mahamuud and Muxummed. They all decided to go to Dubai. They each
sat dow n to plan their trip differently. Each of them w ent a different w ay

Muhammad, the fir st brother, wanted to get there quic kly. He travelled by
bus to Jigjiga, then by bus to Addis Ababa. There he took a taxi to the
airport. From the airport he went directly by aeroplane to Dubai.

Addis
Hargaysa Dubai
Ababa

Maham uud, the second brother, was frightened of fly ing. He travelled by
bus to Berbera. From the bus station he took a taxi to the port and took a
boat to Dubai across the sea.

Hargaysa Berbere Dubay

Muxummad, the third brother w as in no hurry and did not w ant to go by


boat or by plane. He decided to travel slowly all the way by bus. He took a
different bus every day, staying in hotels along the way. He took a bus from
Hargeisa to Jigjiga, then to Djibouti, then a ferry took the bus to Yemen.
From Yemen he w ent through Oman and the United Arab Emirates by bus
until he finally arrived in Dubai

Hargeisa
. Dubay

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So how do germs travel from Faeces into our bodies? Remember the story?
Ger ms also have different ways of travelling into our bodies.

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3.2 How do Germs travel ?
Remember the story of the brothers’ journey.
• They got to where they w anted to go
• They all took different routes
• They took dif ferent forms of transport

So it is with Germ s. Let us now look at how germ s travel

Germs can travel by plane


A fly lands on faeces that are open to the air. The same fly may later land on
some of your food. The fly makes a very nice aeroplane that Germs can
travel w ith.

Faeces Flies Food

Germs can travel by Bus.

A person does not clean his hands properly after cleaning himself in the toilet.
His hands make a very nice Bus that Germs can travel with. When the
person meets another person, the Germs can change buses to reach where
they w ant to go.

Faeces Your Hands Your friend’s hands

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Germs can travel overland
An animal or person steps on faeces from a person or an animal w hich is in
the open. The germs can then travel on their feet until the person comes to a
place where there is water. The germs then get washed into the w ater.

Faeces Feet Water Sources

Germs can travel by Water

The rain can fall on faeces of a person or an animal that is in the open. It is
washed it into a place where people collect w ater.

Faeces Rain Water Sources

Germs can travel by Taxi


There are some items that are used in daily life that help Germs to transfer
from one place to another. When these items are touched w ith dirty hands,
Ger ms can take a taxi on them.
When these items are placed somewhere where Germs are waiting, they can
take a taxi on them.

Hands Water Source

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3.3 Summary
Like the story about the brothers going on a journey, Ger ms travel from faeces into our bodies in different w ays.
They in fact have a lot of choic e! Look at how many paths they have to reach our bodies!
Now test yourself . For each sentence below , point to the path on the diagram
1) People defecate in the open
2) Rainw ater or other water washes the Ger ms into a water tank or w ater
source
3) People take contaminated water for drinking
4) Flies land on faeces
5) Flies land on food
6) People eat contaminated food
7) People clean themselves or their children in the toilet
8) People touch water collectors & containers without first washing their
hands
9) People prepare food without fir st washing their hands
10) Unw ashed hands enter a w ater storage tank or source as they collect
water
11) Water containers touch dir ty ground before and after they are used for
collecting w ater.
12) Unclean water containers enter a water storage tank or w ater source

13) Dirty containers are used in the kitchen where food is prepared.
14) Dirty containers take germs to our mouths while w e are drinking

Now we understand these paths, we can understand how to stop Germs from
using them.
4 Sanitation
In the last few pages you learned how Germs can travel from Faeces to our
bodies. We learned that they have many paths to choose from.

Let us decide together today to make changes in our lives that block these

Mouth

But WHERE can we easily block the paths that Germs use to reach our
bodies? Look at the two black paths in the picture below. Faeces on open
ground can get washed aw ay into drinking water. Flies can land on it.
1) “How can we stop Faeces being open on the ground”

2) “How can we stop Faeces being open to flies”

If you w ere the head of your clan, what would you advis e everyone?
You have many options open to you and your family. The option you choose
should hide faeces where flies cannot reach, and w here water cannot wash
the faeces into water.

Look at the options you have in the pictures below .

- Which is free? Which is expensive?

- Which is easy to use? Which requires w ork to use?

- Which w ill be the best prison for Germs?

Which w ill you choose? Which can you afford?


If you cannot yet build a latrine you can still bury faeces.
Even cats can bury their faeces – surely man is cleaner than animals.
Why not dig a trench on the edge of your property for your children to use?
Educate them to defecate in the trench and cover with some of the earth.

4.1 Latrines
A latrine is best of all. When all members of a family use a latrine it greatly
reduces the number of people who become sick and die of diarrhoea.
Many people do not have enough money to build a Latrine and so they stop
trying. If you don’t have all the money, you can make the latrine cheaper if
you are wis e.

1) You can make the shelter from traditional materials to save money. Leave
the top of the Aqal open to allow some light in.

2) You can make a fence instead of a shelter. Could you afford four poles
and a tarpaulin 5 metres long? Could you use a w oven mat?

There is no shame in these designs. This latrine is far better than no


latrine! You can easily improve it after 1 year w hen you have money.
But it is not enough to have a latrine; all the family must use it.
If you have a latrine but one child still defecates in the open ground, flies w ill
still bring germs into your house.

What reasons can you think of whic h may stop children from using your
latrine?

How can you encourage them?

In this last lesson we have learned the importance of hiding faeces well.
What are the benefits of following this advic e?
Good health for you and your neighbour!

• Flies cannot touch any faeces. The germs w ill stay in the ground and die.

• The faeces cannot be easily w ashed into a place where water is collected.
Water will remain clean.

What are the costs of not follow ing this advice?


Poor health for you and your neighbour!

• Flies will bring bacteria from the faeces onto your ow n food.

• Faeces will be open w hich means that people can tread in it, or it can get
washed into a place w here water is collected.
5 Hygiene
In the last few pages you learned that by being careful how you dispose of
faeces, you can Block tw o paths that Germs can travel on. What other paths
can w e easily block?

Look at the black paths in the pic ture below . People alw ays need to wash
themselves in the toilet. Mothers alw ays have to w ash their children after
they have been to the toilet. So it is impossible to stop faeces from getting on
our hands. But, ask yourself:
3) “How can we stop Faeces going from our hands to other things”

The answ er is Hygiene. Hygiene means keeping yourself clean in a way that
benefits your own health and your neighbour’s. The habit of washing your
hands is one of the most pow erful ways you can stop Germs reaching your
mouth.
5.1 WHEN should my family wash
their hands?

Look at the pictures. For each picture,


decide:- Should w e wash our hands

• Before

• Afterwards
Can you m atch the sentences to the WITH WHAT should my
pictures? fam ily w ash their hands?
• After cleaning themselves in the toilet • Soap is best.

• After cleaning children • If you cannot find soap,

• Before eating keep a tin of ashes near


the place where you
• Before preparing food
wash hands
• Before handling containers whic h
touch water

WHAT should my fam ily use to w ash their hands?


• Something that allows both hands to wash each other
• Something that is cheap
• Something that allows you to stop the water without using your hands

HOW should my fam ily


wash their hands?
There is a Somali proverb
“One finger cannot w ash a
face”. Neither can one hand
w ash itself . It is w is er to use
both hands to wash each
other.
One simple idea for a thing to w ash the hands of your w hole fam ily.
You need Pliers, One 3 Litre jerrican, and two pieces of w ir e; 3m and 2m
long.

1)

2) 3)

4) 5)
6) 7)

How to fix
Use the other wire to fix the jerrican to a post as shown in the pictures.
.

1)

2) 3)
4) 5)

How to use
6 Summar y
Up until now w e have now talked about THREE w ays we can block the paths
of germs as they travel from Faeces into our bodies. We have made THREE
walls to block their paths
1) Using a latrine, or burying faeces.
- This stops faeces from getting w ashed into water
2) Using a latrine, or burying faeces.
- This stops flies from touching faeces
3) Washing hands.
- This stops Germs from reaching the things we touch.

Many of the paths are now blocked. But look at the paths that still remain!
These paths are now all to do w ith WATER.
In the remaining sections of the book, we w ill think about how w e can block
the remaining paths that still remain for Germs as they try to travel in water to
our bodies.
7 Water Sources

Look at the paths that remain. What does each arrow mean? Check on page
11 to remind yourself of how germs reach us as we collect water.
Now let us think about how we can w e block the path of Ger ms coming into
the water we collect.
Let us first think about the different ways we collect water.
There are many ways that we collect water.
Taps Rivers and Lakes
Birked Wells
Hand Pum ps Rain Collection
Delivered Water

Can you think of any others that are not mentioned?

Where do you yourself collect most of your water from?

Drinking unclean water is one of the common ways that people can sw allow
Ger ms. It is therefore one of the most common ways that you and your
children can become sick w ith diarrhoea.

But WHEN do Germs get into this water to make it unclean?

Do you think the Germs are already in the w ater BEFORE it is collected?

OR

Do you think that the Germs join the water some time AFTER it is
collected?
The answ er is BOTH! Why?

Water in a river or a lake


may already have touched
the Faeces of humans and
animals on the ground.
Germs are already in the
water BEFORE you
collect it.

Ger ms cannot touch water while it is in the pipe. So a tap


usually gives clean water. But Germs can join the water
AFT ER you collect it.

How can you know which w ater is clean and which w ater is not clean?
No book can tell you whether your water is clean or not. But in the
next sections in this book we will consider w ays to help you judge
your water for yourself. This know ledge w ill enable you yourself to
protect yourself and your family.
8 Judging your own Water – clean or dirty?
One w ay to judge your water is to answ er for yourself THREE questions
1) What dirty things touch the water BEFORE I collect it?

2) What dirty things touch the water WHILE it’s collected &
transported?
3) What dirty things touch the water WHILE it’s in my home?
If your water doesn’t touch anything that may contain Germs, it w ill be clean
If your water does touch things that contain Germs, it won’t be clean.

The next few pages help you decide if your w ater source is clean.

Whic h water source do you use? Turn to the pages for your water source.
8.1 Taps and Hand-pumps
Let’s start w ith the cleanest w ater. Even w ater from a Tap can become
contaminated if you are not careful.

BEFORE it is collected, tap water touches only a clean pipe.

Water is COLLECTED from the tap with Jugs, Buckets, Jerricans


and hoses

While it is TRANSPORTED the water touches Jerricans and lids

While it is STORED the water touches Jerricans, Barrels and lids

Is this water clean by the time it reaches your mouth? Look for the following
danger signs!
• Lids replaced by plastic bags. These are difficult to keep clean
• Lids placed on the ground while fill filling jerricans
• Hoses with one hundred and ten plastic bags wrapped round them.
8.2 Rain Water

BEFORE it falls rain is clean. It might have a small


amount of dust in it.

It falls on your roof


where Animals leave
faeces.

While it is STORED the water touches Jerricans, Barrels and lids

Is this water clean by the time it reaches your mouth? Look for the following
danger signs!
• Insects and bird faeces floating in the water
• No cover for the water tank
• No cloth filter covering the barrel or tank.
8.3 River & Lake & Birkets filled by the rain.

Before it reached the river or lake, the


water flowed over the ground. As it went,
it collected faeces of animals and people.

While people COLLECT the water they often stand in it. So


does the donkey!

While TRANSPORTING and STORING water in the home, it touches


lids and containers.

Is this water clean by the time it reaches your mouth? Look for the following
danger signs!
• Muddy stagnant water
• Water w hich is stepped in by people and animals
• Containers without proper lids
8.4 Wells and Birkets built above ground

The water in Wells and


Birkets is usually clean at
the begining.

If there is no lid, insects, animals and rubbish can fall in BEFORE it


is collected.

When it is COLLECTED, ropes touch the ground and return


into the water. Hands, Hoses and Funnels touch the w ater.

While it is TRANSPORTED, the water touches dirty lids &


containers.

Is this water clean by the time it reaches your mouth? Look for the following
danger signs!
• Uncovered Birkets. Rubbish & dead insects collect in the w ater.
• Ropes whic h go on the ground and return into the Birket or Well
• Containers whic h have no proper lids
8.5 Water Sellers

Water sellers get their w ater from different sources. Until now w e have
discussed the cleanliness of these sources

When it is collected, ropes touch the ground and return into the water.
Hands, Hoses and Funnels touch the w ater.

Sometimes, w ater sellers do not have very clean lids for their containers.
Some people use plastic bags or socks!

The water may touch their hands and some other equipment
when they deliver the water to you.

Is this water clean by the time it reaches your mouth?


9 How can we improve the quality of our water?
In the last lesson w e talked about the many ways that our w ater can become
dirty.

• We learned that most of our water


travels a long path to our bodies as
it is collected, transported and
stored in our houses.

• We learned that our w ater can


become dirty little by little as it
travels this path.

This lesson will talk about how we can improve the quality of our water ….
simply by being CAREFUL! Nothing more.

Why not choose 2 ideas from this next lesson and


use them in your home.
9.1 How can we improve the quality of collected rainwater?

• Do not collect the first 10


minutes of rain water, it is the
dirtiest.

• Tie a clean white sock over


the drainpipe to help filter out
bird faeces, dust and
rubbish.

• If you have no drainpipe ,


cover your rain tank with a
loose cloth while it rains.

• Always cover your water


container with a lid unless
it’s raining.
9.2 How can we improve the quality of water collected from Rivers
and Lakes ?

• Do not take water directly out of a


lake or stream that looks unclean

• Dig a sm all hole aw ay from the


lake and take w ater from this hole.
The soil w ill filter the water for you.

• Do not allow anim als or people to


tread in the w ater. Put a thorn
fence around the source if
possible.

• Be careful about drinking water


from rivers that only flow after it
has rained and then stand still or
disappear. Much faeces and
rubbish is often w ashed into these
type of new rivers.

• If at all possible River and Lake


water should be reserved in your
hom e for w ashing only, not
drinking.
9.3 Improving the way we transport water and store it in the home.

• Do not allow scoops you use to


collect water to be touched with
dirty hands. Wash your hands
before you collect w ater.

• Tie lids to jerricans & barrels so


they don’t ever get dirty or lost

• If you have a water tank in the


hom e, have one container
reserved only for scooping the
water. Keep it tied there so it
doesn’t get dirty or lost. Don’t
allow anyone to use another
scoop.

• Water containers are many;


those for the toilet, those for
washing, those for scooping
and pouring w ater, those for
drinking. Each should have
ONE purpose only, do NOT
exchange them.

• Do not use plastic bags for lids.


Even a carefully shaped block
of w ood is better!
9.4 Improving the quality of water we take from Birkas and Wells.

• Wash hands before touching


containers, rope, or anything
else that will go into the Birka
or Well.
• Ensure that neither rope nor
container go on the ground and
then return into the water dirty!
• Ensure that the scoop touc hes
NOTHING when it is outside the
Birka; When you have finished
pouring, throw it back in. Do
not place it on the ground, or
even the wall of the Birka.

• The cleanest Birkas are the


ones that are covered. They
have less rubbish, dust and
insects in them.

• Eve n better are Birkas and


Wells that have even a simple
pump. No one touches the
water with their hands and so it
is the best.
9.5 Improving the quality of water delivered by Biiyoleh.

• Wash hands before touching


containers, rope, or anything
else that will go into the Birka
or Well.

• Ensure that neither rope nor


container go on the ground and
then return into the water dirty!
• Ensure that the scoop touc hes
NOTHING when it is outside the
Birka; When you have finished
pouring, throw it back in. Do
not place it on the ground, or
even the wall of the Birka.
• Filling from covered Birkets is
safer and cleaner.
• Do not use plastic bags for
lids. Buy a proper lid.
• Replace hoses when they have
110 plastic bags wrapped round
them.
• Keep Funnel, Hose and Lids
clean and not touching the
ground.
In this lesson we talked about the many w ays that we can guard our water
against Germs.

What happens if I don’t follow this advic e?


- Nothing. The sicknesses that you and your children have
today will continue as they are.

What happens if I follow this advice?


- Slowly by slow ly you will reduce the risk of you and your
children becom ing sick.

But maybe you are thinking “What do we do if we are forced to use water
for drinking which we know is not clean from Germs?”

The next section in this book w ill help you decide for yourself whic h method
of water treatment is appropriate for you.
10 Water Treatment in the home
This book w ill not tell you to use ONE method of w ater treatment. What this
book w ill do is tell you the facts about the different water treatments so you
can choose the one you want.

What different treatment methods can you think of?

Boiling Adding Chemicals


Filtering + Settling Sunlight Treatment

But w hich of these methods is best? The answ er is that each has some
benefits and each has its costs. Let us weigh them up.
10.1 Boiling

• Water should be boiled for at least 5 minutes

• Allow the w ater to cool in a safe place away from children

Benefits Costs
Boiling w ater for 5 minutes Fuel Costs Money
kills absolutely ALL germs. Every day
Makes water safe enough Water must be cooled a
for even very small babies long time before it’s drunk

10.2 Adding a mix of Chlorine & Purification chemicals


• Small packets can sometimes be found in shops.

• Follow the instructions carefully

Benefits Costs
If used correctly, can clear Chemicals Cost Money
muddy water every day
If used correctly, kills MOST Chemicals can be difficult to
germs find
Give bad taste to the water
10.3 Filtering + Settling for one day

• Good for rainw ater because bird faeces can be mostly removed

• Filter through 4 or more folded layers of cloth.

• Allow to w ater stand in a bucket or barrel for one day

• Gently pour off the water and leave the sediment, or even better siphon it
with a hose to leave the sediment. This removes HALF the Ger ms

• Repeat for another day to remove MOST of the Germs ….OR

• Use the Sunlight treatment to remove almost ALL the Germs.

Benefits Costs
Filter ing removes large things Costs only time.
whic h float.
Leaving still for one day makes Does not remove all Ger ms
other dirt sink.
Together they can remove about
HALF the Germs.
10.4 Sunlight Treatment
Germs normally live in dark places and
are very weak against strong sunlight.

Sunlight Kills Germs w hen w ater is in


highland bottles in the sun for a day.

Germs start to die after a few hours.


They are almost all dead after 6 hours.

Benefits Costs
Kills MOST Germs Needs ‘Highland’ bottles.
Sunlight is free !! Takes one day
Not suitable for muddy w ater
Choose bottles
Without damage
Without lables
Without colour
Without dirt

Clean your hands, bottles


and tops before filling.

Choose a place which has


• No shadow in morning
• No shadow in the
afternoon
On a piece of jinkut is good
Put the bottles out early in
the morning

Leave for 1 day

• if there is no cloud
• if there is half cloud

Leave for 2 days

• If there is more than half


cloud

Take the bottles inside


early in the morning when
they are cool.
11 What to do when someone gets diarrhoea
Prevention is better than cure. This w hole book has been about prevention.
But w hat do you do if you try to block Germs but they still reach your body
and make you or your children sic k?

This section will talk about what to do when you or your family get diarrhoea.

11.1 GO TO HOSPITAL
Take the person to hospital early rather than late. Why? For tw o reasons.
1) When a person becomes so w eak from diarrhoea and vomiting that they
cannot drink, or become sleepy, they need the help of Hospital or Clinic.
2) The Hospitals and Clinics need to know early what kind of diarrhoea it is .
Why? So they can stop it spreading.

11.2 EAT
When someone becomes weak from diarrhoea and vomiting, it is important
for their life to give them the right food. God w illing, this may save their life.
YES: Bananas, well cooked Rice, well boiled grain or potatoes. Eggs
NO: Fat or grease. This may make things worse!

11.3 DRINK

When Diarrhoea and Vomiting kills people it is often because diarrhoea and
vomiting remove all the water, sugar and salt in your body. You cannot
survive without these things in your body.

So w hen diarrhoea or vomiting remove water, salt and sugar, you must
replace them again! God willing, this may save their lif e.
Mix for the sick person a bottle of special water.

1.5 Litre Highland Bottle


2 fistfulls of Sugar ½ Capful Salt
full of clean Water

Let them drink every time they vomit or have diarrhoea

Children less than 2 Children of 10 years


Adults
years or more

Give less than one Drink as much as you


Give one cup
half cup can

If God wills, this may save their life.


.
.

Waxbarashada Dadka Waa Weyn ee Jigjia


Jigjiga Adult Education Project

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