Many people in the world lack clean water which is extremely important to life. When some families have access to water, they are constantly exposed to waterborne diseases. It is reported that 670 millions people live in countries facing chronic and widespread water shortages and more than a billion people lack access to safe drinking water(World bank, 2007). Even if some people can have access to safe drinking water, their condition of poverty and the fact that they don’t insist on the principles of hygiene contribute to worsen their health condition.

Our project in Iquitos, Peru have two major components. The first one is the construction of wells to give access to clean water to the people of the poor remote village of Llanchama and the second one is the Hand Washing With Soap and Hygiene(HWWSH) intervention in order to emphasize on the benefits of hand washing at three critical moments: before eating, after using the bathroom and after cleaning a child who has been to the bathroom.

There is no pipeline system in Llanchama. The people generally use the water from the river for their consumption. Sometimes they use the water from the springs but many animals use to be around those springs contaminating them. Thus a well’s construction project was extremely needed.

Most of the people in the village do not have latrines. They use the bush. And most of the times, according to their revelations, they forget to wash their hands with soap. Some of them did not understand the importance of the soap in hand washing. Therefore, the hand washing project was a must.

We started the Well and HWWSH project on May 24 with the students and professors of the School of Engineering controlling the Well part and the students of the School of Public Health controlling the Hand Washing part.

We met the local workers in order to explain to them what kind of well we want to build in the village. It is a motor pump well type which should be able to provide the village, of about 60 families, with clean water. The local workers started the perforation of the well on May 25. They chose a place surrounded with trees where they said that they should find water. They worked hardly almost every day using drills, wheelbarrow, picks to do their job for the benefits of their community. We had some difficulties in finding water at the first place where the workers started digging. We decided to move to another place and finally with insistance the workers found the water for the people of Llanchama. The water from the well is kept in a 1,500 liters tank which is connected to a filter. Before the water gets to the tank, it is purificated by the filter. From the tank there is a pipe with a faucet that the population can use to pour water in their containers. Actually the people of Llanchama are enjoying the water of the well. They are very grateful for the project.

Regarding the HWWSH project, it was conceived in three parts: a pre-intervention questionnaire whose aim was to assess the knowledge , attitude and behavior of the population of Llanchama toward hand washing with soap, some education sessions whose aim was to improve the practice of hand washing and hygiene and the post-intervention questionnaire whose aim was to determine the impact of the intervention on the attitude and behavior of the population. We had to stay in close contact with some responsible in the Ministry of health in Lima and some responsibles in the regional health district in Iquitos in order that we could obtain the approval to start the project.

The first day we went to the village, we were introduced to the people by the municipal agent and the director of the primary school. We presented the project to a group of parents and ask them for their collaboration

The participants were selected randomly from the list of the members of the Parents’ association of Llanchama under a voluntary base. Since many teenagers are parents in Peru, our target group was people aged from 15 to 70 years old. The participants were informed of their selection and invited to come to a meeting with us. Some of them were given the consent form to read but for most of them we read the consent form loudly and ask them to sign it if they agree to participate in the project.

In the first week we administrated the pre-questionnaires, during the two following weeks we made the education and practice sessions, and in the last week we administrated the post-intervention questionnaire. Through the questionnaires we could see that many of the participants had a blurred perception about clean hands and dirty hand.

Many of them were asking for a latrine’s project also since, as we said earlier, they use to go the bush to defecate. In the education sessions we had 90% of  the participants to who the questionnaires were administrated. We talked about what we learned from them through the questionnaires, the contamination way, the benefits of hand washing in preventing disease, mainly for the children. We also talked about the three critical moments where everyone should wash his hands. At the end of every sessions we talked about water purification with chlorine, or by boiling the water. We also had practice sessions of hand washing at the end.

To make sure that the message would be understood and kept, I wrote a song in Spanish about Hand Washing. At the beginning and at the end of every session all the participants sang the song with us.

Here is the lyrics of the song in Spanish and English:

Spanish                                                                          English

En este pueblo                                                   In this village

Nos lavamos las manos                                   We wash our hands

Para proteger a los niños                                To protect the children

En este pueblo                                                  In this village

Nos lavamos las manos                                   We wash our hands

Con jabón así siempre                                     Always with soap

Manos limpias                                                 Clean hands

Niños sanos                                                      Sane children

Debemos lavarnos las manos                       We must wash our hands

Después de usar el baño                                After using the bathroom

Debemos lavarnos las manos                        We must wash our hands

Después de limpiar un niño                           After cleaning a child

Y antes de comer                                            And before eating

Así debe ser.                                                   That’s the way it should be.

All right reserved

Copyright: Junior Bazile, MD.

June 2008.

A video of the song can be found on youtube at the following link:

http://www.youtube.com/watch?v=DcuKAfVfbao 

All the participants were eager to sing the song that they really liked. They attended the sessions with their children, and those were always happy to sing . At the end of the project all of them could sing the song without watching the lyrics.

After the education sessions, we had the post-intervention questionnaires. We could see the significant change in the response of the participants compared to the pre-intervention questionnaires. For some questions, they just remembered the lyrics of the song to provide the answers.