Today we are posting a discussion about ‘building children’s handwashing habits’ with one of the Children for Health founding Trustees, Anise Waljee (AW) and our director, Clare Hanbury (CH). Anise has known Clare for 22 years! They have worked together many times and as a creative partnership linked to developing materials that strengthen and deepen adults participatory work with children. Anise works in children’s participation in health and education, curriculum development, institutional change etc. Her work takes her all over the world to Africa, Asia, and Central Asia and more!
CH: Anise, as we develop our messages and resources for Hand Washing, Sanitation, other Hygiene issues and clean water. We have to think about about how parents and educators can engage children’s interest in this. The message ‘wash your hands with soap after latrine use and before you eat’ is so dull isn’t it? I’m not sure it actually is the message we want children to learn anyway (more later!). It doesn’t lead to behaviour change even when the children sing it! “This is the way we WASH our hands, wash our hands, wash our hands”!
AW: Oh lord, that song is so dated! Children can make up their own songs about hands. Well, perhaps we need to contextualize the topic, what do we do with hands first of all so children learn to love their hands?
CH: Is it that the children become so amazed by hands that they cherish them more? Is that the point?
AW: Yes, absolutely.
CH: So, how to trigger their interest?
AW: Perhaps we could get the children to pretend they are aliens doing research on human hand.
CH: Would that work in all cultures?
AW: Well, yes if we let the teachers call them whatever they use to describe ‘other world’ people. I think, but am not sure, that every culture will have some fairy tales of other creatures who could be looking at hands.
CH: What kinds of things might they be looking at? What guidance could we give teachers?
AW: OK so what do hands do? Hands create things artistically: finger painting, art, sculpture, origami, building things with mud and so on. There’s that lovely story about the praying hands painted by Dura.
CH: I don’t know that one.
AW: Dura and his brother were both good painters. But they were poor so Dura’s brother chose to support Dura’s education as a painter by doing physical labour. The idea was that when Dura finished his brother would go on to study painting. So when the time came he showed his hands to Dura and told him they could no longer be painter’s hands. Dura painted his brother’s hands in prayer in memory of what his brother sacrificed for him for love.
CH: That’s a lovely story.
AW: Then there’s the one about the boy who held the sea back with his finger to prevent the dykes breaching. Different cultures will have their own stories about the power of hands.
CH: What else do hands do?
AW: Hands communicate: e.g. happiness by clapping, cuddling a baby. Love by holding someone else’s hand or putting a hand on a shoulder. And, also, crucially, sign language – right? Hands are functional: they build and cook and hold pencils to write. And then there’s the uniqueness of hands? Teachers could talk about fingerprints, textures, sizes, healing hands even. And the importance of the thumb for gripping. Get children to tie up their thumb so they can’t use it and see how hard that is to do. Also, let’s not forget that hands are spiritual.
CH: Oh yes, of course. You are a Muslim and washing is an important part of the prayer ritual isn’t it?
AW: Yes, in mosques and in other faiths it’s part of the preparation ritual. Which is why you will almost always find water near mosques even in places with scarce water. In Islam you must wash your hands, your feet and your face before prayer.
CH: But not with soap?
AW: Not always with soap as far as I know. Because you come from home sort of clean, but you wash off the dirt at the mosque again.
CH: In a way then this could be a potential difficulty with the message ‘wash your hands with soap’ if at a deep level children learn that ‘rinsing’ purifies when it will not remove actual germs that could be harmful.
AW: I think we can get around that, it’s not that water alone purifies, but at least water, if you see what I mean… this is why we need anthropology. We really need to understand or draw from those who do understand the local cultures in these very sensitive issues. So then we move from all of this to preserving and taking care of our hands and also being ‘good friends’ to others by making sure our hands don’t carry bad things to others. We do so many wonderful things with our hands we don’t want to do not so good things with them… so not pass on the germs etc, and those come onto our hands from what and how?
CH: Something that really bothers me is that people/children are told/taught to wash their hands after the toilet or before they eat, but isn’t the point that the hands must be clean before the hands touch the eyes or the mouth (whether or not this is after toilet and before they eat). For example, if a child washes their hands REALLY well with soap after toilet and then in the next couple of hours touches many things that may be infected and then wipes his mouth or rubs his eyes – the child has adhered exactly to the health message and yet it has not promoted their health.
I think what we should build on after this triggering an awareness of the hands (that only hands washed with soap [for 20 seconds by the way] can touch the mouth and hands to avoid germs going into the body and causing illness) is, YES, a more complex message but isn’t it the only message that is accurate?
AW: Yes, exactly. Should we look at germs that ‘sit’ on hands and ‘travel’ and so get the children to think about this? It’s crucial what you are suggesting there.
CH: And I don’t think it’s that complex either – I discussed it with my 11-year-old son and he gets it and, in fact, thinks it is more sensible than the before you eat and after toilet message! I love the sit and travel thing, like the hand is a kid of ‘bus way’ for germs.
AW: The central message of germs: they are crafty, small and invisible and they LIKE TO TRAVEL! We can then say, “The hands look clean but the naughty germs are still hiding.” And they can only be removed with soap. And build in a sense of responsibility. Dirty hands hurt us, but if we eat from a communal dish (as so many cultures do), then it could hurt the others, could hurt the baby etc.
CH: These are all great ideas and it’s not for us to get too worked up figuring out all the answers. If we use a participatory process then the children can identify the issues re: hand washing with soap, which might be A, B and C in one family and X, Y and Z in another. So if there is a PROCESS where children are able to bring the complexity to the fore then there is also a chance that behaviour can be developed at a family level with the children being the change makers.
I think we need to find out a bit more about local soap making too. It’s BOUND to be something children can do or help with.
Let’s leave it here for today. Thank you Anise for your great insights.