A girl carries cans of water. Image by Alex Stonehill. Ethiopia, 2008.
A girl carries jerry cans of water in Ethiopia. Image by Alex Stonehill. Ethiopia, 2008.

Experts and advocates from humanitarian organizations stressed the need to provide adequate water, sanitation and hygiene (WASH) facilities and instruction for school children in the developing world at a congressional briefing yesterday.

Two out of three schools in the developing world lack decent toilets, according to UNICEF. The World Health Organization estimates that 272 million school days are lost each year due to diarrhea and some 400 million school-aged children worldwide have worms.

The panel discussion featured presentations by Pamela Young, Ph.D., of Plan International USA and Dennis Warner, Ph.D., of Catholic Relief Services (CRS). Save the Children's Senior Director of School Health and Nutrition Seung Lee moderated the event, which was co-sponsored by U.S. Representative Earl Blumenauer and non-profit groups Water Advocates and the Basic Education Coalition.

Young, a senior basic education advisor for Plan, explained how water, sanitation and hygiene facilities (such as latrines and hand washing stations) are vital in schools for increasing classroom attendance and learning.

"Those children who are able to stay in school and are able to be healthy when they are in school, they are able to pay attention more in their classrooms," she said. "We know it's also vital for their parents and their families and for their caregivers because these children, from what they learn, they take these messages to others in their communities and share those messages and help them to develop good practices."

Young cited Plan's recent work in the Dompu District of Indonesia's island of Sumbawa, where primary schools partook in a life-size version of the board game Snakes and Ladders that incorporated messages on hygienic behavior. As a result, the district saw an increase in student hand washing with soap from 24 percent before the implementation of the program to 96 percent. Latrine use also significantly rose, from 28 percent to 88 percent.

In the Jaldhaka Province of Bangladesh, literal whistle-blowing resulted in an up to 90 percent decrease of open defecation in community areas. Children would blow whistles every time they caught a classmate defecating in a field. "This was actually very, very effective. It really stopped the practice among children," Young explained. Moreover, it inspired families to build more toilets for the community.

Young said the success of the program underscores the importance of involving children in the decision-making process: "With all of our programs, we work with the communities and with the children to determine what is the best way. It's a way of the kids saying what is actually going to stop us from doing this, what's going to make us pay attention to others. So that is something that the children come up with themselves."

Senior Technical Advisor for Water and Sanitation Warner also shared anecdotes of schools that had benefited from WASH programs. One school teacher in Honduras who received CRS assistance reported a decrease in diarrhea incidents amongst his students; he claimed that the children were more motivated and more active during the day as a result.

But Warner also described the challenges facing relief organizations in building and maintaining adequate facilities and therefore effective learning environments for school children.

"It would be nice if every project had a well-designed facility and system," he said, explaining that children are often afraid to use dirty and dilapidated toilets at schools. "Even when a system is improved in a community, it may not be a very good system." For instance, some community latrines and wells are unable to meet the demands of the village or are built too far away from schools. Hand pumps can be tainted by mud, and NGO workers have found latrines built close to or on top of rivers, thereby contaminating an entire village's water supply.

"One doesn't need flush toilets to have a healthy, safe facility that supports dignity," Warner continued. He recommended involving the community in the construction of school latrines, which children could decorate with paintings and etchings. In order to avoid jealousy and rivalry between schools and the communities they serve, Warner urged that priority should be given to districts or villages where there is already a water sanitation project in place and the school has had only minimal support or improvement. "That way you can work with the school without making the community feel as if they are being ignored," he explained.

Young advised that all facilities should be built using inexpensive and easily replaceable parts, since parents and community leaders will need to sustain them long after relief workers have left; students should learn how to wash and care for the hygiene stations as well.

Both Warner and Young stressed that separate toilets should be built for boys and girls to avoid incidents of sexual harassment.

"In many countries if you have sanitation facilities for both boys and girls that are very close to each other, girls may not use them," Young said." They're afraid of violence, they are afraid of being raped and so they tend not to use them. Sometimes they'll even go home rather than use these facilities or they'll use a field." The construction of wells and ceramic water filters near schools also promotes gender equality, as girls are no longer sent from school to fetch water from distant and often polluted lakes.

Students from HB Woodlawn Secondary Program also spoke at the event. They became involved in water and sanitation activism after their French teacher initiated a partnership with H2O for Life, an advocacy organization that connects schools in the United States with schools in developing countries to complete WASH projects.

"As students in Arlington, Virginia, we know that we lead very privileged lives and that there's no way to compare our lives to those of children in much of the developing world," said high school junior Mary Shields, who described how she first realized the importance of WASH while working in a remote hospital in Rwanda. "I personally witnessed the birth of a child in 2010 in Rwanda who went home from the hospital to face the challenges that come from living in an area without access to clean water."

"I find it appalling that girls my age have to stop going to school when they reach puberty because they lack access to adequate sanitation," she added. "It is unacceptable that children arrive into the world in this day and age without access to clean water." Through various fundraisers, Shields and her class raised money for WASH programs for school children in Cameroon.