Breaking Taboos

Afou is a smart, yet shy 15-year-old girl who lives with her parents and siblings in a rural Mali village. Her favorite subjects at school are biology, physics, chemistry and English. She enjoys spending time with her friends and she is determined to complete her studies to become a doctor.

Yet adolescent girls like Afou encounter many obstacles as they approach young adulthood. Historically, cultural customs have prevented adequate education in the areas of female hygiene, sexuality and reproductive health during these crucial years. Such basic knowledge is often not passed from mothers to daughters because such subjects are considered taboo. The consequences of this lack of communication are unwanted pregnancies, and sexually transmitted diseases.

Afou in her school yard

In addition, many young girls face the hardship of early or forced marriage — a dire situation that robs them of their childhood. In fact, teenage girls under the age of 16 are often forced by their parents to get married, which means they must leave school and any hopes of achieving a meaningful education are thwarted.

At age 13, Afou’s father wanted her to marry a man that she did not know. She disliked the idea of leaving school and not being able to play with her friends. Afou’s dreams of becoming a doctor were dashed and her future looked bleak.

However, in 2016, Save the Children implemented an Adolescent Development program in Afou’s village to combat these problems, raise awareness and enable adolescents to develop and grow to their full potential. The program provided courses in sexual and reproductive health while at the same time informs the community on the effects of early child marriage.

In addition, the program’s Peer Educators guide teens on how best to manage relationships with peers and parents through various activities and presentations. By 2018, the program reached 13,283 adolescents including 6,875 girls. As a result, the rates of teen pregnancy went down substantially. “Now the program is on track, and the awareness has paid off,” explains a peer educator.

Afou and her Peer Educators

Afou’s outlook brightened, too. She invited her parents to participate with her in various sketches and awareness skits held in the public square of the village and at school. This training gave her confidence to continue the discussions at home, and she soon persuaded her father to give up on the idea of an early marriage.

“No girl from our family will leave school. The mistakes we did in the past, will no longer be repeated; I am proud of the strong girl she has become today,” proclaims Afou’s Uncle Issa.

Afou and her Uncle Issa

Afou now collaborates with peer educators to help and advise other adolescents in her village. She is also preparing for her high school entrance exam. “The Adolescent Development [Program] has positively impacted my life and changed my parents mind. I love this program that helped me to reach grade 9. May God bless the work of Save the Children.”

COVID-19 Pandemic Reinforces the Need for Healthcare Facilities’ Preparedness

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

Written by the BASICS Team

In declaring the COVID-19 coronavirus a pandemic, World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus urged nations to “ready your hospitals” and “protect and train your health workers.”

Those two actions are at the core of what BASICS (Bold Action to Stop Infections in Clinical Settings) proposes: helping health systems to adopt simple, inexpensive measures to reduce infections at the point where care is delivered; measures supported by training platforms, upgraded water, sanitation and hygiene infrastructure, reliable supply chains and monitoring and accountability processes.

As the COVID-19 crisis has deepened worldwide, BASICS can play another role beyond reducing healthcare-associated infections and combatting antimicrobial resistance. Establishing a healthcare workforce equipped with the knowledge, training, resources and incentives needed to maintain a clean healthcare environment and the supplies is critical. Without adequate infrastructure, functional supply chains, modern training, monitoring progress and rewarding high performance, staff cannot protect themselves and their patients during routine care, let alone during high-risk events like a global pandemic.

Largely overlooked is the toll that COVID-19 is exacting on frontline healthcare workers, who are themselves becoming infected or spreading the disease because of a shortage of personal protective equipment like facemasks and gloves. A stable supply chain would help ensure that staff and facilities have vital materials. 

“Without secure supply chains, the risk to healthcare workers around the world is real … We can’t stop COVID-19 without protecting health workers first,” Ghebreyesus warned on March 3.

While frequent handwashing is one of the most effective ways of reducing tranmission of infections and a pillar of the BASICS solution, handwashing is more effective when coupled with the cleaning of high-touch surfaces. BASICS addresses handwashing alongside cleaning practices that create “safe to touch” surfaces like bedside tables, doorknobs and faucets.

BASICS Partners Responding to the Pandemic

Save the Children, the London School of Hygiene and Tropical Medicine, WaterAid and Kinnos have all mobilized responses to the pandemic.

Save the Children was among the very first international aid organizations to deliver critical supplies to health workers on the front lines of the crisis, as well as provide families with supplies and trusted information to reduce transmission and keep children safe. Its regional and country offices will be responding directly to vulnerable children and families to support their needs, with an emphasis on those in places with weakened health systems, fragile contexts or a limited capacity to respond due to other ongoing crises. 

Its global and national health teams are participating in daily conversations with the World Health Organization, the UN and other COVID-19 coordination bodies and advising the global READY consortium, which seeks to strengthen preparations among nongovernmental organizations for major disease outbreaks or pandemics.

The London School of Hygiene and Tropical Medicine’s experts are involved in many aspects of research and are providing guidance to those responding around the globe to the pandemic. Since January, teams from the School have mobilized to help slow the spread and mitigate COVID-19’s impact. Its global public health experts are working around the clock to provide accurate, measured and objective information and advice to governments, industry and the public.

The School’s mathematical modellers have been mapping the virus since the earliest days of the outbreak. Their insights into patterns of transmission, behavioural response and control measures are also informing the global response, including helping assess how many hospital beds will be needed, the stress on healthcare systems and how communities can prepare.

WaterAid is supporting the sharing of hygiene messaging and activities through social media and other media channels based on global and national recommendations, including developing materials in local language and with visuals to showcase good hygiene practices. In some countries, building off existing hygiene programs, it is working with government on promoting hygiene, predominantly handwashing, through government-supported behaviour change campaigns in response to COVID-19. This may expand beyond government to others, such as private-sector employers, and expand to include improving infrastructure where needed in line with government action.

WaterAid is committed to tackling inequalities in all aspects of WASH. This extends to COVID-19, as we know the most marginalized and discriminated against will be impacted the most. WaterAid is committed to supporting responses that are gender and socially-inclusive.

Kinnos, the social venture whose colorized decontamination technology Highlight®  will be used in BASICS to help cleaners and other healthcare workers achieve full disinfection of surfaces, has sent shipments of Highlight® to China to help with that country’s outbreak.

Letter Delivery Party

Did you know there is a World Letter Writing Day? It is celebrated every September 1, and the idea behind this initiative is to encourage the practice of picking up a pen and paper to write a letter to someone special. This might sound archaic in these modern days of texting and social media, but you wouldn’t believe how meaningful receiving a hand-written letter can be for a child.

Save the Children has an initiative called Letter Writing Parties – events organized at local companies in the U.S. to provide employees with the opportunity to learn about Save the Children programs. The occasion also provides a chance to write a letter to a child who doesn’t receive letters regularly from his or her sponsor.

Recently, we received dozens of these letters in our community near the impact area of Sonsonate in El Salvador, and I had the opportunity to witness a delivery “event.” We gathered two groups of around 20 boys and girls, and we told them we would be hosting a Letter Delivery Party! The children were surprised with all the colorful letters that came to us, and although some of them didn’t understand at first what was happening, they soon learned the letters contained messages of love and care for them. They were happy that someone from far away had taken a bit of his or her time to write a special letter just for them.

Katerine and a friend show off their letters

“I felt very happy today with the letter I received,” explains nine-year-old Katerine who has never received a letter from her sponsor. “I think if people want to say something important sometimes they write a letter, and when you get the letter they tell you that important thing. On the letters we read today, people wrote about their dogs, daughters, or that they are from Texas.”

In El Salvador, we have more than 12,000 sponsors, but only 1,500 of them write letters. That is more than 10,000 children who don’t get the chance to establish a friendship with his or her sponsor. That’s why the Letter Writing Parties initiative is so important – it gives children who do not regularly correspond with their sponsor an opportunity to enjoy the benefits of sponsorship. “To the person who wrote this letter for me today (his name is Shawn), I want to thank him and tell him that I have a dog named ‘Doggie,’ and a little sister who is three years old,” says Katerine.

Katerine reading a letter from her new friend Shawn

We know it can be difficult to find the time, but we encourage you to pick up a pen and a piece of paper, and send an inspiring message to the little girl or boy you sponsor – we assure you it is worth the extra effort!

The Meeting of Two Worlds

By: Memory Mwathengere

When the news broke that an international visitor was coming to her village school, it sent shock waves through Dorothy’s small community in Malawi – they had never had a visit from a child sponsor before and they were all eagerly awaiting the big day.  You see, it’s a very special event when a sponsor is able to meet their sponsored child in person, and for Dorothy, the impending visit was no exception.  “I was very happy when I was told that my friend was coming,” she explained shyly.

Dorothy outside her school

Yet, at the same time, she was nervous that the visit would not actually happen. Sponsored children rely on their imaginations as to what their sponsor is like and the reality of a face-to-face meeting is sometimes hard to fathom, she explained.

Luckily, the big day arrived and Dorothy finally met her sponsor, Sabrina, who had come all the way from Italy with her partner. The community welcomed the pair in typical Malawi fashion — with joyful dancing and ululation.

Dorothy was surprised to see a young looking woman, “I imagined her to be light in complexion and older, and I was very happy to see her.” Sabrina went to Dorothy’s classroom to observe a lesson, and later she had the opportunity to observe program activities. “She asked me the type of sport and subjects I like; she also asked me to read a passage in an English textbook,” Dorothy recalls fondly. “Sabrina is very nice.”

Dorothy receiving gifts from her sponsor Sabrina

Dorothy was also happy with the gifts Sabrina bought her, particularly the school bag, notebooks and pencils. She indicated that her school items used to go missing, but with her new gifts, now she has somewhere safe to keep her things.  And in appreciation for her visit, Dorothy’s family presented Sabrina with some locally weaved baskets.

Encouraged by Sabrina’s visit, Dorothy’s parents now ensure that she does not miss school and Dorothy is inspired to work hard to become the doctor she is aspiring to become. “I would like for her to continue sponsoring me until I complete my education,” says Dorothy.

As for Sabrina, she was so inspired by her visit she has become a Save the Children Ambassador and plans on returning to Malawi to visit Dorothy as soon as possible!

Creativity and Passion Brought to Teaching

By: Carlin Trevin Lenggu, Data Quality and Communication Officer

Every day, Tika’s father takes her to school near their home in a small village in Indonesia. Even heavy rain does not discourage her from making the trip — she is too excited to be learning how to read and write! Her excitement in gaining new skills through fun lessons and activities is thanks to the support and encouragement of her parents, teachers and Save the Children’s early childhood education program.

Tika and her literacy teacher Katarina

Tika also benefits from the special training her teacher, Katarina, has received through the program’s Literacy Boost for early grade teachers.  This specific training provides teachers with new strategies and tools to help bolster their classroom instruction.  For example, Katarina had trouble preparing material that was both engaging and easy to follow for her first-grade students.  The literacy training showed her new, fun ways to approach lessons that focused on the needs of her students. “Now my class is alive with attractive and colorful material and I am excited to see that there is a lot of improvement from the children,” she proudly explains.

For example, Tika is now a model student and enjoys helping her classmates with their reading and writing. She can also attest to the difference she felt in the classroom.  “My teacher taught us in a different way and now it’s fun,” she says. “She provided us with new games and songs of the alphabet, and decorated our classroom with colorful alphabetic drawings.” Laughing, she adds, “my favorite game is guessing letters written on our back by a friend using their finger.” 

Tika (middle) with her friends checking out books in their school library

Katerina understands that motivation, hard work and commitment are key to providing proper education to young children.  Through her creativity and passion, Katerina is able to foster a love of learning in her students and see the positive results of her efforts.  The smile on Tika’s face says it all!

A New Friend for Sofindja

By: Kervens Fils-Aime, Community Engagement Assistant

Sofindja is a very smart and cheerful little girl who lives in a small community in Haiti. She is the eldest of two children and has participated in sponsorship programs for three years. For the first two years, she regularly exchanged correspondence with her sponsor.  However, the sponsor was no longer able to continue the sponsorship, causing the friendship to come to an end.  Although Sofindja was disappointed, she looked forward to starting up again with someone new.

While she waited to be connected to a new sponsor, she enjoyed reading the letters her friends received from their sponsors, an activity that allowed her some connection to her old routine that she missed so much.

One day, at the end of 2018, a field agent came bearing good news. Sofindja was finally getting a new sponsor!  Even her good grades from the quarter did not make her happier than this news! The long awaited exchange was finally going to start again, and Sofindja was getting a new friend.

 I was so happy to finally be able to talk to my new friend, she exclaimed. “I sent him some information about meI told him that I have a little brother, and I made him a nice drawing of a flower. I hope we will get along well, because he is a boy and I love soccer like many boys. 

Sofindja chatting with a Save the Children field agent

Every day, sponsors make a tremendous difference in children’s lives, and exchanging letters is just one part of the program.  For example, Sofindja and her schoolmates also enjoy important life-changing benefits – from the construction and restorations of schools and play areas, to the implementation of important health and hygiene programs. Thanks to our partnership with Save the Children, this school has been totally renovated and we now have a playground that all the children can use during recess,” explains Sofindja’s school principal. The children love playing outdoors and this allows them to take a break, every day! They now also have access to a handwashing station that they can use to help them stay healthy.”

Sofindja using the new hand washing station at her school

Sponsorship offers a window to life in a different country, and can be a rewarding experience for both parties. Thank you for committing to making Sofindja — and many children around the world — smile daily!

The Dignity of a Photograph

By: Zewge, Internal Communications Manager

Over 40 children lined up in their school compound in the Central Tigray impact area, Ethiopia, for the annual photo day, where children have their photos taken to send to their sponsors. Some children look nervous and are unsure of what to make of this process, while others are very excited. These photographs are the only way for these children to let sponsors know how they look, so they have dressed as nicely as they could on this important day. It is also an exciting and busy day for Gebrerufael Gebrehiwot, Save the Children’s Sponsorship Operations Officer, who has organized this event.

According to Gebrerufael, the ‘photo shoot’ is an important part of sponsorship operations. He loves the children’s excitement because “their smiles follow when they are excited,” he explains. Yet, surprisingly,nearly 90% of the children have no experience with the photo shoot before they enrolled for sponsorship. “Many [children]are nervous and shy away from the camera,” says Gebrerufael. “It takes teachers’ and sometimes parents’ explanations to make them understand how important these photos are.”

The children also dance, sing songs and play fun games to get more comfortable before sitting for their photographs. “That is to help them to face the camera in a relaxed mood,” he explains.  “It’s also helpful to show the children the end result to keep them motivated.”

Sponsorship Operations Officer Gebrerufael Gebrehiwot showing a group of children some of their photographs during the photo shoot

It is also common that many children wear the same clothes for recurrent photo shoot sessions. “What mainly explains this is poverty,” Gebrerufael affirmed. Most children come from poor families with subsistence farming or daily labor as the main source of livelihood. “They are unable to afford to buy new clothes for their children every year,” he explains.

Million’s sponsorship portrait

For example, ten-year-old Million wears the same outfit she had for last year’s photo shoot. She said, “My parents don’t have money to buy me new clothes. I am shy, but I like seeing my pictures. I am happy my sponsor receives them, too.” 

Gebrerufael explains that although it is important the photo-taking process is fun for the children, it is just as critical that the activity fosters self-respect. “Not only do we want to achieve a quality photo to share with sponsors, we also want the children to preserve their dignity in the process.”

Gaining Self Confidence

By: Samah Sabry, Program Coordinator

In a small community near Abnoub, Egypt,  Amany lives with her father, mother, four sisters and two brothers. She is 14 years-old, and likes drawing, coloring and knitting. She also likes learning and going to school – she wishes to become a doctor one day so she can save lives and help people in need.

Yet, due to being a stunted child, Amany encountered many obstacles in her early years. This means that Amany faced impaired development due to poor nutrition.  Although she attended an inclusive school, her schoolmates did not understand her challenges. They started to annoy and make fun of her, and did not usually involve her in school activities. Amany found herself increasingly isolated, and did not participate in class and preferred to be silent even if she had questions related to her lessons. As a result, she failed her first year at school.

“She is very kind and smart, and she did not deserve this bad treatment because of her condition,” explains Amany’s father who was very worried about her.

Amany’s teachers did not have any previous experience or knowledge on how to deal with her situation, but fortunately, her school was one of 11 others in Egypt that received specific teacher training as part of the Child Protection Program.

The program objective is to improve the school environment to help children receive a better education, and aims to enhance children’s skills and cope with and report cases of abuse and bullying. In addition, all students are encouraged to accept differences, and adapt to their surroundings inside school and society.

Eventually Amany had the courage to ask for help from School Psychologist Ms. Safiya and the Social Support Officer Ms. Sanaa. “I went to them because I understood that they are here to teach and protect us students,” said Amany.

Amany with one of her teachers

Both teachers intervened by holding several group sessions with Amany and the students, connecting them together through activities that focused on acceptance, and understanding of differences. After a few sessions, teachers started to notice that the children were reacting positively and participating with Amany, especially in the games of relationship building.

Now in her second year of preparatory school, Amany has restored her self-confidence, and is making friends. She is a member of the girl’s football team and participates in school clubs like the Broadcast Group. She is also active in class and getting better grades.

Amany working in the science lab at school

Amany’s father was relieved when he learned that she was doing better at school. “I was very happy when the students started to treat her well,” he explains. “Amany wants to be a doctor and I will do everything I can to help her achieve her dream.” With her newfound confidence, Amany is well on the path to doing just that.

Water, Sanitation and Hygiene Improvements Are Key to Sustaining Healthcare’s Ascendency in Cambodia

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

 

 Written by Channa Sam Ol, Manager, Water, Sanitation and Hygiene (WASH)
and Health Programs, WaterAid Cambodia

Over the past 20 years, Cambodia has made remarkable progress in improving health care, as evidenced by declines in maternal mortality from 900 to 170 per 100,000 live births and infant mortality from 115 to 35 per 1,000 live births.

Ongoing health system reforms have addressed the quality of care, access and affordability. The government has supported these reforms by introducing schemes that make care free for families with limited incomes and subsidize health facilities and the women who use them to give birth. This latter scheme has helped to dramatically increase the number of women delivering their babies in facilities, from 22% in 2004 to 83% in 2014[1].

But challenges still cast a shadow on the very positive trajectory that has been established. This manifests in the limited progress in newborn health when compared to the improvements in maternal health. It is much safer for a woman to deliver her baby in a Cambodian health center or hospital today than it was 20 years ago, but it is not as safe as it should be for a newborn baby. The United Nations estimates 1 in 6 newborn deaths are associated with blood infections during delivery and an unhygienic environment after birth[2].

While previous Cambodian health policies and standards rarely mentioned water, sanitation and hygiene (WASH)[3], the current National Health Strategy is the first to set targets for improving WASH. Despite this, many health facilities still do not have sufficient WASH infrastructure and lack good hygiene practices.

Most facilities have a water supply, but only half have enough water for use year-round. Fewer than half of facilities have three adequate latrines. Only 15% have handwashing stations at points of care and only 10% perform basic waste management.

According to a 2016 assessment of WASH in public healthcare facilities in five provinces conducted by the country’s National Institute of Public Health in collaboration with the Department of Hospital Services and health partners, the lack of knowledge and commitment to WASH and infection prevention control were a challenge among healthcare workers and cleaners.  

Neglecting these essentials and improving rural health services is hampering progress towards safe, clean healthcare for all. Without improving the basics, Cambodia will not achieve the objectives set in its health strategy, nor will it see improvements in health as it has in the past.

Clean healthcare is something every patient expects – and it is achievable, as these examples demonstrate.

WaterAid first visited the Peus Pi health centre in Tbong Khmom Province in late 2017. The facility didn’t meet basic hygiene or sanitation requirements. What did that mean? Handwashing stations or alcohol hand sanitizers weren’t available at points of care such as outpatient consulation rooms, near toilets or in the waiting area. Toilets weren’t accessible for all, didn’t have separate facilities for men and women, and there were no facilities supporting menstrual hygiene management or postpartum bleeding.

Waste was not being separated and waste bins were not color-coded according to the national standard for health care waste management. Moreover, most staff were reluctant to share about hand hygiene practices and their knowledge of infection prevention and control.

In collaboration with the Ministry of Health and the provincial health department, we have  been working to upgrade the centre’s facilities and build staff knowledge to improve infection prevention control.

Rodiya, a mother who uses the Peus Pi centre, told us about the significant change compared to how it was several years ago. To Rodiya, the “health centre looks cleaner, has more equipment and materials and staff pays more attention to patients.” And now she can use the latrine and handwashing station inside the postnatal room. These improvements gave her the  confidence to choose the centre when it came time to deliver her third child.

 

 

[1] Cambodia Health Demographic Survey 2004 and 2014

[2] UN Inter-Agency Group for Child Mortality Estimation. Levels and Trend in Child Mortality; UN Inter-agency Group for Child Mortality Estimation: New York, NY, USA, 2017

[3] Por, Ir (2015). Towards Safer and Better Quality Health Care Services in Cambodia: A Situation Analysis of Water, Sanitation and Hygiene in Health Care Facilities. Phnom Penh, Cambodia: WaterAid.

 

Small Words, Big Impact

By: Romy Carol Lima Nina, Sponsorship Assistant

I wish you could see Roberto’s big contagious smile and wide eyes every time he receives a letter from Manisha, his sponsor.  It brings him such joy!

Roberto, who lives in Bolivia, had sponsors previously, but unfortunately, he never received any letters.  When I informed him that he now had a new sponsor, he hoped that this time things would be different.  Luckily they were. Roberto and Manisha began exchanging letters and soon developed a very special friendship.

Most people do not recognize the huge impression a sponsor’s letter can have on a child’s life. In the case of Roberto, the friendship he has with his sponsor is very important to him.  In one letter, Manisha asked Roberto what he wanted to be when he grew up. This simple question really got him thinking and he decided then to work hard and fight for his dream of becoming an architect. Manisha’s response in her next letter encouraged him to move forward and wished him success.

Roberto sharing his dreams with his sponsor Manisha

In a recent letter, Manisha asked Roberto what he wanted to build once he became an architect.  Roberto felt so motivated, because for him this was not such a simple question. He felt that even though Manisha is thousands of miles away — and he has never seen her face-to-face– she cared about his interests, hopes and dreams. Smiling, he replied: “I would like to build a 30-story building.”

Every time I arrive in Roberto’s community, he runs to ask me if I have a letter for him and he tells me he is already learning things about building houses. He started helping his dad and brother who are construction workers. He proudly says: “One day I will build a house for my mom” and makes sure to share all of these experiences with Manisha so she can be proud of him.   

Sponsorship Assistant Romy Carol Lima Nina and Roberto reading a letter to his sponsor

I have known Roberto for the past three years and his smile brightens my day. As a Sponsorship Assistant, I have the opportunity to work with many children in the letter-writing process with their sponsors. I have witnessed many letters that range from very descriptive, to touching and funny. It is motivating to see how even a few small words and phrases like “Hello,” “How are you?” or “What do you want to be when you grow up?” have such a meaningful impact on the lives and in the hearts of these children.