SEED Madagascar

With a lack of an immediate vaccination, COVID-19 has changed the world in a number of different ways, most noticeably in human behaviour. Whether physically distancing, self-isolating or working from home, our most basic daily interactions have become altered and changed. Arguably the most critical of these changes is our attitude towards handwashing. If COVID-19 has shown us anything it is the prevalence of hand washing as a personal responsibility that prevents the spread of disease and can have the potential to save lives. Yet in Madagascar, like many places in the world, handwashing, despite its simplicity, is not accessible to everyone. The reality of being the third lowest in the world for the use of unimproved sources of water and having only 10 per cent of the population using basic sanitation facilities makes COVID-19 a far more dangerous threat to everyday life¹. With the onset of this danger and in light of World Handwashing Day 2020, SEED examines the progress being made to promote the active use of handwashing throughout Madagascar.

Earlier this year SEED conducted knowledge, attitudes and practice surveys in over 3,000 households in Anosy to gain a better understanding of the challenges people in rural areas faced in gaining access to water, sanitation and hygiene facilities. The findings in regard to behavioural patterns surrounding handwashing are certainly very worrying. Data shows that only 0.2% of households wash their hands at critical moments such as before preparing food or after defecation. Whilst 55.2% of households wash their hands most commonly before eating, only 1.9% of households wash their hands after changing a diaper and some 12.7% of households do not wash hands at all.

However, this low prevalence of handwashing does not necessarily correlate to a negative attitude or a lack of motivation among communities, but rather to limited access to basic hygiene resources.  Only 3.3% of households have some form of handwashing station and whilst 87.5% of these do have access to water, only 31.7% have access to soap. Under such circumstances, it is easy to see why engaging in good WASH practice is no small challenge for the communities of Anosy.

The findings of the KAP surveys regarding handwashing may be alarming in the context of COVID-19, but they marked the beginning of SEED’s multi-faceted response to the threat facing Madagascar. Since April, SEED has been working alongside UNICEF on a region-wide Rural WASH Project, set up to provide access and support to WASH knowledge, resources, and services to over 190,000 people across the region of Anosy. Changing routine behaviours is vital to this process, so SEED is employing a Community-Led Total Sanitation (CLTS) method to share information that will ‘trigger’ individual and collective changes in attitude and practice. This project is working towards Malagasy government’s nation-wide Madagasikara Madio (Clean Madagascar in Malagasy) target of having 90% of the population routinely washing hands with soap by 2023.

In addition, SEED’s COVID-19 response project has been delivering widespread messages about the measures that can be taken to minimise COVID-19 transmission through posters, radio broadcasts and multi-platformed social media campaigns. In rapid response to the crisis, SEED has also distributed essential equipment such as masks, handwashing stations, and soap as well as capacity building training sessions for health-care professionals, schools and local authorities. The focus on handwashing in Madagascar, such as it is around the world, has never been so relevant.

The scale of what SEED has been able to achieve to support communities since the beginning of the COVID-19 crises is quite astounding. Since April, SEED has trained 14,241 community members in effective handwashing methods and 8,401 in construction of handwashing stations. We have also erected 90 handwashing stations in strategic sites, distributed 57 boxes of soap and trained 23 healthcare centres on COVID-19 prevention. To further raise awareness and promote handwashing, over 250 radio broadcasts have been transmitted and over 1,000 villages have received sensitisation sessions to shift attitudes in the context of COVID.

Tsina Endor, SEEDs Deputy Director, explains "COVID has changed my view on the importance of handwashing and how often I wash my hands.  Before I used to wash my hands before eating and after using the toilet, but now I do it whenever I don’t feel comfortable, so for example whenever I go from one building to another and whenever I have touched money. My Mum is also vulnerable, so I now wash my hands all the time whenever I see my Mum to limit the risk of infection. I now see handwashing as more of a protection to myself and others and it has been COVID that has changed this”

This Thursday 15^th October marks Global Handwashing Day, and SEED will be busy as ever sharing the message and celebrating this day in Madagascar. Working alongside the British Embassy and UNICEF, SEED will be organising a number of activities to promote the importance of washing hands at all times, but particularly during this period of COVID-19.

In Fort Dauphin and in the rural communities that surround it, handwashing stations have been erected at strategic points in the town where handwashing demonstrations and interactive contests will take place. We will be partnering with Tatirano Social Enterprise, who will be providing clean rainwater for handwashing sessions en masse, and soap will be distributed to the contest winners. A speech will also be given by local officials on the importance of the day and of good WASH practices. Through collaboration with the Anosy WASH Cluster and our other partners in Madagascar, SEED is working to achieve a unified response to the challenges surrounding handwashing in the shadow of COVID-19.

The challenges to be faced in the coming months are unpredictable but through a collective effort there is hope for change. SEED will continue to support communities in the face of its COVID-19 and to aims to support communities to practice good WASH behaviours lasting long into the future.

1. Unicef.org. 2020. Water, Sanitation And Hygiene. [online] Available at: <https://www.unicef.org/madagascar/en/programme/wash> [Accessed 13 October 2020]