New Delhi: Bahraich is a one the aspirational districts chosen by Niti Aayog to bring about a positive change on the socio-economic ground. With a population of nearly 35 lakh, Bahraich ranked 96 out of 117 on 6 different parameters from health, nutrition, education and water to others. Aga Khan Foundation has been working in Bahraich since 2010 with interventions in education, health, WASH as well as women empowerment. The first step towards swachh and swasth bharat was making the district of 35 lakh people Open defecation free. Challenges were immense because the scale was big. Creating a huge asset was a mammoth task, but efforts to bring about a change saw some visible results. Arvind Chauhan, IAS, Chief Development Officer, Bahraich told us, “When the survey was done by NITI Aayog initially Bahraich district was in top worst districts in the country and giving past one year we have improved a lot and there is a lot of cooperation from NITI Aayog and even logistic, financial and advisory support”.
The district received the infrastructure award as well. Added Mr. Chauhan,
The district has a sense of competition for inter-district and intradistrict, as everyone wants to fare better which is helping in improving facilities like health, nutrition, health and irrigation and now we have achieved no.1 rank in all over the country in infrastructure and now with the entire prize fund and more efforts we hope in coming one or two years bahraich should become from aspirational to exceptional district.
Supporting Swachh Bharat campaign focus was on making the district Open defecation Free. Use of toilets the very basic to a healthy population, hence behaviour change was also worked on.
Bahraich was declared ODF on 15th august 2019. Now the ground is set to take it to the next level and prove that sanitation is linked to health. Aga Khan Foundation works in 4 states supporting the Swachh Bharat Mission, working on the community Open Defecation Free campaign with the school hygiene programme.
Under the Dettol Banega Swasth India campaign, Aga Khan Foundation is partnering with Reckitt Benckiser in 3 states working together in 3000 schools. Bahraich being one district where 711 schools have been taken up.
Satviki Varma, Programme Officer, WASH & Health, Aga Khan Foundation shared with us,
We are working on community odf campaign as well as with a dedicated school hygiene program and now also at the healthcare facility level and the idea is to basically enable behaviour change at the household if people are constructing toilets if they are using it they are adopting the hand wash practices similarly in schools can we make students those change agents who could actually learn those hygiene practices, good practices such as handwashing such as personal hygiene and become those agents and ambassadors.
Children being the agents of change and take back what they learn at home back to their homes and communities, the Dettol Banega Swachh India campaign is focusing on the school curriculum. “So in both of our experience in RBF and AKF experiences we have always felt that hygiene as link was missing from the entire Swachh Bharat campaign we felt that it needed a dedicated focus now in school it needed focus in sense that you have to develop teaching materials and an age-appropriate and grade-appropriate curriculum they have also developed a very engaging games which are actually involving the students”, added Satviki.
One often hears about donating food, clothes and books.. In a unique initiative communities are coming forward to donate soaps to encourage handwashing. Handwashing is a critical element to reduce the risk of diarrhoea and other infectious diseases. “There is a lot of awareness about cleanliness in areas around the home, schools and now parents also have an interest in soap banks so instead of distributing sweets/chocolate soaps help all kids and they are regular in washing hands”, shared Shweta, teacher.
Jairam Pathak, UP State Team Leader, WASH, Aga Khan Foundation shared with us the concept of the soap bank. “The aim is not only about donating soaps but collectively inculcating the good habit of hand hygiene so we try to bring the students, teachers and community on the same level”.
Through the hygiene curriculum, peer to peer hygiene monitoring has played a very important role. After learning in school children are taking this back to their homes. For instance Suraj Kumar, a class 5 student told us,
Earlier we used to use ash and now I use soap, in fact I have even told my parents to use soap as it removes the germs.
Students are a part of child parliaments wherein they have different duties. “ Chittrajan Kumar, Cleanliness Perfect shared, “We check if their nails are cut, their clothes are clean, hair combed and also if their hygiene is maintained and we even explain to them that if one does not maintain hygiene they will fall unwell, miss school and lag behind.”
Enabling an environment with infrastructure like handwashing stations, toilets and even designated place to eat their meals has impacted the attendance of students. “Children are now aware about hygiene because they can use all the newly constructed toilets, hand washing stations and since the facilities have improved attendance has gone up as well and they don’t have to keep going home to use toilets”, said Shweta, teacher.
Midday meals in schools have had a long history in India, designed to better the nutritional standing of school-age children nationwide but the problem of management of the mid-day meal, wastage of food, lack of infrastructure for storage, cooking and serving food, lack of safety provisions, unhygienic surroundings have been a challenge. One such step taken by Aga Khan Foundation is the creation of hygienic spaces for food preparation and eating of these meals by children in a clean environment.
For many children, the mid-day meal is the first, and at times the only proper meal of the day. A designated area to cook the food as well as eat in the schools is another initiative. Sukanti has been cooking food for the midday meals for over 18 years and follows the hygienic practices to provide a wholesome meal. “We wash our hands, cover the food, clean the rice, wash vegetables properly and feed the kids with love as they are our children”, said Sukanti, Cook, Midday Meal.
It is a known fact that working on WASH is a precursor to improving the nutritional status of communities. Jairam Pathak, UP State Team Leader, WASH, Aga Khan Foundation added,
So after 2014 when government started this mission of open defecation free we are working with the government, on one hand, to create a model and demonstration of good practices while on the other hand we are supporting government in enhancing their execution capacity so this open defecation free efforts can be sustained so in order to go to next step we are also supporting government in management of solid and liquid waste providing safe water quality. So infection is the main cause of malnutrition there is the vicious cycle if the child is malnutrition then the infection will take place if infection is there then malnutrition will occur so there is a very close connection between malnutrition and sanitation. So while ensuring this open defecation free we are observing a certain amount of reduction in infectious diseases and that is surely contributing towards decreasing malnutrition.
Aaganwadi workers and Asha Didi’s play a crucial role in bringing about behavior change as well as spreading awareness on critical issues like counselling on breastfeeding, nutrition, food habits, hygiene and learning needs, combined with effective preschool education. Rina Devi, Asha worker shared with us,
We go and tell the mothers about breastfeeding the baby within one hour of birth and also eating nutritious food, fruits and vegetables so we notice that anemia and malnutrition has reduced and even diarrhea has reduced after construction of toilets so malnutrition has come down.
Shaheena from Kamali village in Bahraich delivered her twins out of which Sameer was a case of severe malnourishment. Sameer with intervention is still malnourished but on their way to becoming healthy. “We focus on overall growth but in Sameer’s case since he was only 2 kgs and severely malnourished we told the mother to take care of his health and she listened to us, today Sameer has come to the yellow category”, said Rambhavati, Kamaali Aaganwadi incharge.
A comprehensive program with adolescent’s girls on menstrual hygiene management to help them make a better decision about their health through play-way methods and informal conversations is also a unique initiative. Satviki Varma, Programme Officer, WASH & Health, Aga Khan Foundation shared with us, “when we started to work on WASH we felt that menstrual hygiene was a segment that could not be left behind and there were some issues so we went to communities to understand their practices and raised awareness on what menstruation hygiene is, what is the proper nutrients needed at that time and we are giving them basket of choices because we know with women and girls one has to give many choices so whether it is boles or re-usables they should be able to take decision about themselves we are working with them using very interactive tools like playway methods and games to basically understand how we can dispose those myths and taboos”.
Recently Bahraich has been awarded for creating good infrastructure. The next step is to work on maternal health and nutrition making the district a healthier one… And for this, it is important for all stakeholders like the govt., NGOs, corporates and most important the community to come together to bring about a significant change from only a swachh district to swasth Bahraich.