HEALTHY HOMES PROJECT: Ed Session #1: Diarrhea Illnesses

Diarrhea is a fact of life in Peru.  It happens so frequently that many adults accept it as normal and they fail to recognize the danger it poses to children.  There were numerous routes of potential contamination, most notably through lack of proper hand washing after going to the toilet, after handling animals and before preparing or eating food.  And although the water provided by the municipal government was filtered and chlorinated, it still was not 100% safe and needed to be treated. 

For the first educational session, I sought to drive home the idea that mothers are self-contaminating with bacteria, parasites and amoebas – which are normally found in feces.  Essentially, when a person has diarrhea, it is often the result of getting poop in the mouth.  To demonstrate this point, I utilized a activity appropriately called “Caca en la Boca (Poop in the Mouth).”  First, I pasted a drawing of a pile of poop and a drawing of a mouth on opposite sides of the blackboard. Next, I showed the mothers a set of other drawings, which included a fly, a bucket of water, a plate of food, a hand, a person defecating, animals roaming free, a shoe, etc.  I asked the participants to tell me how each drawing lead us through the route of transmission from the pile of poop to the mouth.  It inspired a lot of giggling and disgusted faces, which I hoped were vivid enough to inspire actual changes in behavior.

It seemed important to define diarrhea and explain what types of stools are considered diarrhea, because loose stools are such a regular occurrence and considered normal.

Below is the English version of the visual tool that I utilized in the educational session to describe diarrhea, which is typically defined as passing three or more loose stools in one day:

Bristol stool chart

Then I showed images of bacteria, parasites and amoebas that cause diarrhea and also happen to flourish in feces.  The mothers were horrified by the photos, which are ugly enough to turn stomachs and make a strong enough impression to take steps to avoid contracting them.

Photo of parasites

The health promoters explained how to prepare water to drink (boiled for 3-5 minutes or treat with drops of bleach), and how to store water properly to avoid contamination by flies or mosquitos.  We reviewed other ways to prevent diarrheal infections, including using a bathroom or latrine, cutting short fingernails, and not allowing animals to run freely in the home.

It is always expected that the organizer of an event will provide snacks for participants.  But before handing out refreshments, we requested that everyone wash their hands first using a Tipi Tapa, which is an easy to make tool that provides running water.  It is made from a plastic soda bottle that is turned upside down.  The base of the bottle is cut off to allow the user to fill it with water, and the cap can be opened and closed to drip water onto hands as needed.  It is an easy tool to make at home using readily available materials and it solves the issue of lack of running water.

Photo of Tipi Tapa

At the end of the session, we explained the changes that need to be made in the home and provided mothers with a handout that listed the key points of learning.  Participants were reminded that they will be visited by a health promoter to verify their compliance with requested improvements.  Finally, we provided materials to the participants, including a Tipi Tapa, soap, and a bucket with lid to store treated drinking water.

With respect to the barriers to change, participants have been provided with resources for hand washing (Tipi Tapas) and safe water storage (bucket with lid and spigot), memorable handouts on the transmission of microbes that cause diarrhea, opportunities to practice new behaviors, and support for making changes from program participants and from health promoters.

Please click here to read about Educational Session #2: Respiratory Infections and Tracking Development Milestones.