In Kenya’s refugee camps, hygiene promotion aims to prevent disease by changing behaviour
By Manuel Moreno
It is early morning amidst the shelters of Hagadera refugee camp in north-eastern Kenya, and Mohamed Shorie, 22, is already at work promoting the benefits of hygiene. Surrounded by three families from Block B 0C, in what seems just a matter of seconds, at least 20 more people arrive, most of them women and children, curious to hear what he has to say.
Assisted by one boy from the community, Mohamed demonstrates the importance of good hygiene practices, in particular washing hands with soap after going to the toilet, and before eating or preparing food.
‘Bit by bit’
There are a total of 73 local health promoters like Mohamed working with UNICEF’s partner CARE International, spread out among the three camps forming Dadaab: Hagadera, Ifo and Dagahaley.
In Hagadera there are 126 blocks where more than 125,000 refugees have registered to live. Mohamed is one of them. He resides with his mother, father, three brothers and two sisters in Block A3. They were amongst the first Somali families to arrive during the 1991 Somalia civil war.
He cannot recall how many families he has reached so far in his two years as a health promoter, but he reaches an average of 12 houses a day. Despite the demand for his help, he is aware of the importance of spending time with the families and to follow up periodically to make the message more effective.
“We go bit by bit, bit by bit… You see?” he said with enthusiasm. “It is like in the school, you have primary and then secondary school, you do not learn everything at once and of course you do not change your behaviour overnight.”
Reaching the most vulnerable
One of the refugees benefiting from these activities is Ayan Abdurrahman, 26. Mother to one girl and one boy - six and five-years-old respectively - she arrived here four months ago from Mogadishu, fleeing the war in a five-car convoy.
“We have been reached (by health promoters) more than three times already and we tried to follow their advice,” explained Ayan. “It (hygiene) is a good message because it means we are developing ourselves.”After three dangerous weeks on the road, Ayan received a refugee identification card which allows her to receive food twice a month, as well as cooking items, blankets and sanitation products.
UNICEF provides support
At an average rate of 1,300 every day, Somali refugees continue to arrive in Dadaab - 100 kilometres from the border. This has pushed the total population of Dadaab to over 400,000. In the camps’ cramped, basic conditions, disease can gain a strong foothold and spread quickly throughout the population if proper sanitation and hygiene is not practised.
In order to prevent this, UNICEF has provided 5,000 bars of soap, more than 2,150 jerry cans, 4,000 buckets with lids to keep water clean, 100,000 chlorine tablets for household water disinfection, and eight drums of chlorine powder to maintain water sources.
“This is just the initial support, the first approach, but we want to improve many areas including the training of the hygiene promoters,” explained UNICEF’s John Obisa, who leads the behaviour change effort.
In addition, UNICEF is focusing on ensuring water safety in households. “The water is already treated, but because people roll the jerry cans across the ground the chances of contamination are very high,” said Obisa. “It is a practice that the teams are discouraging and on top of that they are promoting periodic disinfecting of the jerry cans”
Among other projects UNICEF has installed water points to reach refugees walking from the border along three major routes to Dadaab, in a partnership with the Danish Refugee Council. That contribution alone has ensured that to date 20,000 litres of water have been provided for some 1,670 refugees in transit, reaching the global minimum daily requirement of 15 litres per person.
UNICEF will also support the establishment of an additional eight boreholes in the Daadab refugee camps, covering some 100,000 refugees. This combination of supplies and hygiene education could provide a vital barrier to disease as more and more people are impacted by the worsening situation in Somalia and drought-affected regions of Kenya.