UNDSG Jan Eliasson washes hands with ashes in Ethiopia

By Sacha Westerbeek

DSG Jan Eliasson wash his hands with ash with the help of Lemma Buchule
Jan Eliasson, UN Deputy Secretary-General, washes his hands with ash with the help of Lemma Buchule at her home in Sebeta District in Oromia Region of Ethiopia,. ©UNICEF Ethioia/2014/Ose

HAROJILA FULASO, OROMIA REGION, 1 February 2014 – “The health extension worker told us to wash our hands with soap and if we don’t have soap, we can use ashes. So, when I have not been able to buy soap, this is what we use to disinfect our hands”.

Ms Shure Gore takes the can of ashes and hands it to United Nations Deputy Secretary-General Mr Jan Eliasson. He gently takes out some of the greyish substance and rubs it before rinsing it off with the water from the jerry can attached to the tree, next to the family’s’ latrine. “My hands are clean,” he exclaims while the family is observing his actions closely.

In Ethiopia’s Oromia region, the hygiene and environmental sanitation activities are the main focus for household and community level interventions. The woreda (district) latrine coverage is about 70 per cent. In Harojila Fulaso, however, 80 per cent of the households have reached the status of becoming a “model household.”

The model family is the approach adapted by the Health Extension Programme to improve household practices. After 96 hours of training and adopting 12 of the 16 packages, a family graduates to become a so-called model family. The health extension package is categorised under three major areas and one cross cutting area: namely Hygiene and environmental sanitation; family health services; disease prevention and control; and health education and communication.

The Lemma-Buchule family, in which Ms Shure Gore is the driving force, has a latrine with hand washing facilities and dry and liquid waste disposal pits. In addition, the household has adequate aeration and light and the animals are kept separate from the living area – to name a few requirements of becoming a model household.

The family lives a couple of minutes walk away from the health post. Ms Abebech Desalegn is one of the two health extension workers running the facility. The health post provides services to 736 households and 3,532 inhabitants – ensuring that health care is delivered at the doorstep. “I know Shure and her family very well,” says Ababech. “The family consists of 10 members, including eight children between the ages of 3 and 22 years old. They come here when they need vaccine, a new mosquito net or when they are ill.” She has assisted the household in reaching the status of “model household”. “They now inspire others to do just like them, they are an example to the community,” Ababech explains.

DSG visit to Ethiopia
Jan Eliasson, Deputy Secretary General of the United Nations, discusses the importance of hygiene to Lemma Buchule, right, and Abebech Desalegn, Health Extension Worker, at Buchule’s home in Sebeta District in Oromia Region of Ethiopia, 1 February, 2014. © UNICEF Ethiopia/2014/Ose

Health extension workers deliver health care at the doorstep

Ababech is a government salaried and trained health worker, under the Health Extension Programme, an innovative community based programme which started in 2003. To date, 38,000[1] health extension workers have been deployed in nearly all rural villages. The programme aims to create a healthy environment and healthy living by delivering essential health services to communities.

UNICEF supports the Health Extension Programme in different dimensions. Training of HEWs to improve their technical competencies in delivering health and nutrition services, procuring and distributing of vaccines, medicines and supplies, ensuring availability of job aids at health posts, have all led to increased coverage of health and nutrition services at community level.

In addition to prevention and health promotion services, health extension workers are also now involved in case management of pneumonia, diarrhoea and severe acute malnutrition in more than 90 percent of health posts.

The Deputy Secretary-General, Mr Jan Eliasson studies the charts on the wall of the small health post. “You are doing an excellent job here,” he says while impressed with the statistics and service delivery provided by this health extension post.

Abebech Desalegn, Health Extension Worker explaining her role in the community to  DSG Jan Eliasson
Abebech Desalegn, Health Extension Worker, explains her role in the community to Jan Eliasson, UN Deputy Secretary-General at Haro Jila Folaso Health Post in Sebeta District in Oromia Region of Ethiopia, ©UNICEF Ethioia/2014/Ose

Abebech explains that she is required to split her time between the health post and the community. Community outreach activities include working with model families, community groups or households. “Every day I’m very busy she continues. When I’m at the health post I provide basic services such as: immunisation; health education; antenatal care; family planning; delivery and postnatal care; growth monitoring and community treatment of severe acute malnutrition; diagnosis and treatment of malaria, pneumonia and diarrhoea; treatment of eye infections; treatment of selected skin problems; Vitamin A supplementation; first aid and referral of difficult cases… just to name a few of my daily activities.”

In addition, this young health worker, who has worked at this health post for the last seven years, has done thirty deliveries and many more postnatal checks. “I’m happy UNICEF provided delivery beds, but I also need clean water. Every single day I walk to the nearest water point, because I need clean water for the latrine and health interventions.”

WASH interventions at Health Post level

To date, UNICEF has provided a total of 160 health posts with a complete WASH package.  This includes: providing capacity in the design of WASH facilities, construction of water supply and sanitation facilities and hygiene promotion to health institutions through construction and disseminating information on hygiene and environmental sanitation. In addition, WASH interventions at the health post level include: the provision of a hand-washing stand; a septic tank; incinerator; placenta pits; general solid waste and sharp pits.

“I’m lucky having clean water nearby,” says Ababech. “But too many of my colleagues really struggle, especially those who work in remote and dry areas.”

Ethiopia has been an active participant in the Sanitation and Water for All Partnership. In 2013, the Ethiopian Government, with support from UNICEF, was able to establish a Sector-wide Approach termed the ONE WASH National Programme with a dedicated budget line for sanitation in the Government of Ethiopia’s treasury.

Although good progress is underway in the area of water, sanitation and hygiene, still some challenges remain. In 2010, out of a population of over 80 million, about 46 million were without access to improved water supply and sanitation and Ethiopia had the highest number of people (38 million) practicing open defecation among African countries[2]. The lack of access to adequate clean drinking water and sanitation services has a dramatic impact on the lives of people, especially women and girls, and undermines efforts to improve health, nutrition and education outcomes.

Mr Jan Eliasson underlines the need for clean water and sanitation. “We really must act now. We have to talk about sanitation and improving access to toilets and clean water. We also must change attitudes and behaviours,” he emphasises with passion.

Ms Gore fully agrees. “Since I have a latrine and we wash our hands at critical times, I see less disease in my family. The children go to school and we work on the land – for this, we need to be healthy.”

‘Toilets’ shouldn’t be a dirty word

This article originally appeared on Trust.org

In this 2011 file photo, a toilet is seen in a house destroyed by the January 2010 earthquake in Port-au-Prince REUTERS/Eduardo Munoz

WaterAid’s Director of International Programmes Girish Menon opened today’s debate on Water, Sanitation and Sustainable Energy in the Post-2015 Development Agenda at the UN General Assembly in New York.

Here are his reflections on why sanitation and water are so critical in the post-2015 process:

I spent this morning talking toilets at the UN.

Of all the potential topics of conversation with global decision-makers, needing the toilet might not be high on your list. We all do it on a daily basis but in polite conversation, it appears we’d prefer not to talk about it.

Whether we like it or not, the silence surrounding how we dispose of our bodily waste has to be broken. The health, prosperity and wellbeing of 2.5 billion people rests on it – 2.5 billion people who right now have nowhere to go to the toilet.

This lack of basic sanitation facilities causes diseases that kill 2,000 children under the age of five every single day. As well as gross indignity, women and girls in particular face sexual harassment and even violence when defecating in the open.

It’s a sign of how far we’ve come that today’s debate happened at all – that sanitation is now recognised as worthy of discussion at the highest level.

But there’s much further to go…

Put toilets at the centre of new goals

When the Millennium Development Goals were first agreed in 2000, sanitation wasn’t included. It was added later, as an afterthought. And now, progress towards the sanitation MDG target is massively off-track – in fact, it is one of the most off-track targets of all.

When the MDGs expire in 2015, a new set of ‘sustainable’ development goals and targets will replace them. It is vital that sanitation, along with safe water and hygiene, is at the forefront of this new framework.

So it’s been encouraging to hear key decision-makers in the UN acknowledging this today.  Sitting next to me this morning was the President of the General Assembly His Excellency John Ashe who said that sanitation is one of “the pre-eminent development challenges of our world”. Minutes later, Secretary-General Ban Ki-moon added, “Access to water, sanitation and hygiene must feature prominently in the post-2015 agenda.”

For the last three years, the water and sanitation sector has been discussing possible targets for the post-2015 framework. 200 organisations from around the world, including WaterAid, have come together in a process facilitated by the World Health Organisation and Unicef’s Joint Monitoring Programme. This consultation has led to a Furthermore, it includes a target on water and sanitation so that by 2030:

  • No one practises open defecation.
  • Every household, every school and every health centre has drinking water, sanitation and hygiene.
  • The proportion of the population without access at home to safely managed drinking water and sanitation is halved.
  • Inequalities in access are progressively eliminated.

I’d recommend that anyone interested in this process read more about the targets and the consultation in this document.

This crisis can be tackled

But of course, none of this will be easy.

It needs member states to hold true to the ambition of creating a post-2015 framework that can both eradicate extreme poverty and achieve sustainable development.

It requires convincing donor and developing country governments to increase their financing for water, sanitation and hygiene.

It requires us to get better at making projects sustainable, so that the taps and toilets built today are still working in a decade’s time.

It requires us to move beyond serving just the easy-to-reach, to include all those who live in rural and remote areas, or who find their access limited by disability, gender, or ethnicity.

But it is possible.

I quoted Nelson Mandela this morning and his words seem entirely appropriate: “It always seems impossible until it is done.”

This crisis can be tackled if national governments, donors, NGOs, civil society coalitions and the private sector work together to transform the lives of the world’s poorest people.

Time to act

All over the world, people now recognise the importance of safe sanitation not just to the world’s poorest people but to all of us. Two million people have called for governments to commit to reaching everyone, everywhere with safe water and sanitation.

Today I heard leaders at the UN talk toilets.

Now it is time to act.

International Children’s Day celebrated big and colourful in Ethiopia

All sectors will come hand in hand to help children in need
International Children’s Day was big and colourful in Assosa, the capital of the Benishangul-Gumuz Region of Ethiopia. The event was graced by the Regional president, HE Ato Ahmed Nasir, Minister of Women, Children and Youth Affairs, HE Zenebu Tadesse, the chair and vice chair of the parliamentary standing committee on women and children, line sector bureau heads, development and humanitarian agencies, and of course children from various backgrounds.

HE Zenebu Tadesse, Minister of Women, Children and Youth Affairs, makes an opening speech International Children's Day celebration in Assosa

HE Zenebu Tadesse’s message highlighted the need to strengthen cooperation and coordination of the all partners to increase efforts for the effective delivery of services to Orphans and Vulnerable Children (OVCs). She stressed on the importance of participating children in all our endeavours.

Ibrahim Sesay, UNICEF Ethiopia’s Child Protection Specialist, key note speech during the day urges partners to strengthen the effort to deliver on promises for children.

“This year’s global theme for the celebration is to “Stop Violence against Children”, with a special emphasis on birth registration, child marriage, positive parenting and non-violent discipline. However, in Ethiopia, this event has been tailored to mark the need to strengthen various initiatives that will improve the situation of vulnerable children.

The name of the vulnerable child that requires our urgent attention and support is called TODAY. This child can no longer wait for all the promises we usually make. The child TODAY is calling for appropriate actions that will improve his/her situation. Our children in Ethiopia are asking from duty bearers – ‘give us what you promised’!

From his conversation and listening to children’s voices, Ibrahim Sesay enlisted five key promises which children are eager to receive from all partners:
1. Making laws/policies and programmes very relevant through effective implementation. Government’s efforts should be tailored in creating an enabling environment for the enforcement of legislative frameworks and policies that have been developed, and improving co-ordination across government departments and partnership with service providers.
2. Building on existing community strengths and resilience
3. Improving public information on the situation of vulnerable children.
4. Empowering children. The need to further promote the active participation and organization of girls and boys in all our programmes.
5. Accelerating the current child care reforms to better protect vulnerable children.

Ibrahim Sesay, Child Protection Specialist, makes a key note statement during International Children's Day celebration in AssosaMr. Sesay affirmed that UNICEF continues to support the government to implement the five point agenda and call for action, leveraging with other development actors to support the core programmes that promote children’s rights in Ethiopia.”

UNICEF launched the #ENDViolence Against Children campaign earlier this year. It urges public acknowledgement of the problem of violence against children and encourages support and engagement with local movements to address a compelling global issue.