Safe
Water System Manual
ANNEX
I:
EXAMPLE TRAINING CURRICULUM
FROM ZAMBIA
CLORIN HOME
WATER CHLORINATION GUIDELINES FOR TRAINING CURRICULUM
FOR CLINIC STAFF, NEIGHBORHOOD
SALES AGENTS, RETAILERS, DRAMA GROUPS
HALF
DAY TRAINING
8AM:
Opening and Introduction (30-45 minutes)
·
Welcome participants to the Clorin Home Water Chlorination Workshop
·
Explain that the workshop will continue until about noon with a break for tea
·
Introduce yourself and explain that we will begin with introductions. Ask participants
to give their name, where they are from, and what they expect to learn from this
workshop. Write responses on the flipchart about what they expect to learn so
that you can come back to it at the end.
· Start with yourself. Introduce
yourself and explain whom you work for.
Explain
to participants what is SFH.
·
SFH is a Zambian non-government organization dedicated to improving the health
of Zambians by marketing essential health products to the public and by educating
Zambians about important health concerns. SFH works in the areas of AIDS prevention,
family planning, and child health. For AIDS prevention, we sell Maximum condoms
and Lovers Plus condoms. For family planning we sell Safeplan oral contraceptive
pills and Prolact vaginal foaming tablets. For child health we sell POWERCHEM
mosquito nets and retreatment kits for malaria prevention, and Clorin home water
chlorination solution for water borne disease prevention. If they have questions
about products other than Clorin, they can ask at the end of the training.
Next
explain about the Clorin Home Water Chlorination Solution project.
·
The objective of the Clorin home water chlorination project is to reduce the cases
of diarrhea and cholera in Zambia. Clorin is a chlorine solution that is used
to disinfect home drinking water. It kills most bacteria in water that cause disease,
including cholera.
·
The product has been developed largely through the support of the Centers for
Disease Control in the United States. The Clorin project started in Zambia in
September 1998 in 5 pilot sites in Lusaka and Kitwe. It was expanded to cover
Lusaka, Kitwe, and Ndola in 1999, and now in 2000 it is expanding nationwide.
·
To date, more than 350,000 bottles of Clorin have been sold. There has been tremendous
demand for Clorin, especially in the rainy season when cases of diarrhea increase,
and when there are outbreaks of cholera. Clorin has the support of the Central
Board of Health, and is often mentioned as a way to prevent cholera. In fact,
because of this, Clorin has been widely associated with cholera prevention. SFH
in our communications efforts would like to emphasize that Clorin should be used
to disinfect your water all year round, not just in the cholera season. This is
because diarrhea is a serious problem among children in Zambia, and diarrheal
diseases occur throughout the year. Far more children die of diarrhea each year
than cholera, which makes it even more important that people treat their water
to prevent diarrhea, especially among children.
Next
explain the objectives of today's Clorin training program. During the course of
today's training, we will cover the following topics (write on a flipchart):
·
Review the important facts about diarrhea and cholera - transmission, symptoms,
and consequences.
· Understand what Clorin is and how to use Clorin.
·
Learn the essential messages to discuss with people in the communities about Clorin.
·
Practice communication skills/selling techniques.
Ask
the class if they have any questions.
8:30AM:
DIARRHEA AND CHOLERA - THE PROBLEM (30 MIN)
Diarrhea
Transmission
Objective:
Review transmission and signs and symptoms of diarrhea and cholera.
Tell
the group that you are going to read a story about diarrhea, and then discuss
it afterwards:
STORY:
The clinic director from _________ (name a local clinic) has just admitted a seriously
ill child to the clinic. Mrs. ________ has just brought her 3 year old daughter
Grace to the clinic at 10pm because she had had diarrhea for the previous 4 days,
and was very weak. The doctor examined Grace and found that she was very dehydrated,
and had a severe case of diarrhea. He gave her some medicine, and admitted her
for further observation. Two days later, Grace was feeling better and playing.
Mr and Mrs. _______ were very relieved, and thanked the clinic doctor. The doctor
gave Mr. And Mrs. ________ some advice on how Grace and the whole family could
prevent themselves from getting diarrhea and other water borne diseases.
After
reading the story, discuss these questions and write all answers on the flipchart:
1.
How do you think Grace got diarrhea?
Answers
to look for:
· Diarrhea can be caused by drinking contaminated water,
eating contaminated food, or from contaminated hands going into the mouth, or
indirectly from not washing hands before eating, after going to the toilet.
·
Cholera is a bacteria that is most often transmitted by contaminated water.
2.
What signs and symptoms can a person get from diarrhea and cholera?
Diarrhea
- can result in weakness, dehydration
Cholera - severe diarrhea, dehydration
3.
What could have happened if the parents had delayed more in taking Grace to the
clinic?
She
might have died
4.
If the child has a mild case of diarrhea, what is the proper treatment?
Oral
rehydration solution. If the child doesn't recover in 2 days, take the child to
the clinic. If people say Clorin is the proper treatment, explain to them that
Clorin is for treatment of water to prevent diarrhoea and not a treatment for
diarrhoea.
If the child has severe diarrhea, take the child immediately to
the clinic. Give lots of fluids (treated water)
5.
How do you think the parents could have prevented Grace from getting diarrhea?
Make
sure that the home drinking water is treated with Clorin to disinfect it.
Use a closed container with a lid to store drinking water.
Make sure that
Grace washes her hands before eating and after going to the toilet.
Prevent
food from getting contaminated by the cook washing her/his hands before preparing
food, and by covering leftover food.
6.
What is the best way to prevent Cholera?
Cholera
is most commonly transmitted by contaminated water, so disinfecting your water
is the best way to prevent cholera.
Disinfect your water with Clorin, or boil
your water.
Use a closed container with a lid to store drinking water.
Good sanitation - use toilets/latrines, keep environment clean.
When people
die of cholera, it is because of the severe dehydration from the diarrhea that
is caused by the cholera bacteria. A person with severe diarrhea should be taken
to the clinic immediately, and also given plenty of fluids (disinfected water).
7.
If Grace got diarrhea from drinking contaminated water, what are the ways that
the water could have gotten contaminated?
From
the pipe, in the well (at the source)
By a dirty water container
By a
person scooping water out with an unclean cup or putting an unclean hand in the
water
At
the end of the discussion, you should summarize what the participants have said,
and add any information that was not mentioned. Ask questions of the group that
will get them to say the correct answers.
9AM
CLORIN - THE SOLUTION (1 HR)
The
Clorin Home Water Chlorination Product
Objective:
Participants understand the benefits of Clorin and how to use Clorin.
Explain
to the group that this component of the training is to help them understand what
is Clorin. Hold up the product. Explain that Clorin is a chlorine solution. Chlorine
is a chemical that will kill most bacteria in water that cause disease and diarrhea,
including cholera. Treating drinking water with Clorin is one of the best ways
to prevent diarrhea and cholera.
The
Clorin is sold for 500 kwacha per bottle. One bottle on average is enough for
a family of 6 people for one month. The clinics and retail outlets buy Clorin
for K350 kwacha. The K150 difference is for sales commission for the clinic sales
agents, and trade margin for the retail outlets (use flip chart to explain if
necessary). These prices are subsidized which means that SFH does not make a profit
on them. The program is funded by donors, and Clorin is sold at a low price so
that we can reduce the diarrhea and cholera cases in Zambia and improve people's
health.
Next
explain that before you demonstrate how to dose Clorin, you will tell them about
how to properly store drinking water. As discussed earlier, water can be contaminated
in several ways. One of the most common ways that water can be contaminated is
by storing water in an open bucket where people put their hands into the bucket
to scoop water out. A person's hands can easily contaminate water, even if it
is already treated. So you must store your water in a closed container with a
lid. Pour the water out instead of scooping it out.
Once
you have filled your closed, narrow mouth container with water, you put Clorin
into the container according to the directions. Only a small amount of Clorin
is needed to disinfect your drinking water. Can someone tell me from the brochure,
how much Clorin do I put into a 20L container?
-
Fill inside ring of the lid with Clorin and pour into container.
That
is correct. You fill the inside ring of the lid once with Clorin and then pour
it into the container with the water. Then you close the container and shake it.
Then you must wait for 30 minutes for the Clorin to kill all the germs before
you can drink it.
Can
anyone tell me how much Clorin do I put into a 2.5L container? A 5L container?
-
Fill outside rim of lid once with Clorin.
- Fill outside rim of lid twice with
Clorin.
In
order for them to understand how to use the product better, let's conduct the
following exercise:
Split
the group in to 3 groups by having them count off 1-2-3.
Explain
to the three groups that this is the situation: Someone from their neighborhood
has just bought this Clorin. They need your help in figuring out what it is and
how to use it. Give each group a Clorin bottle and one container (different size
to each group) and ask them to read the instructions and put the correct amount
of Clorin into the container.
After
they have agreed how much to put into the container, switch the containers until
they have tried all three.
Then
ask one member of each group to come to the front and correctly dose one container
each. Ask the rest of the group if they are dosing it correctly.
Ask
the group if they have any questions.
Then
explain what will happen if they put too much Clorin in the water.
If
someone puts too much Clorin in the water, no harm will result to anybody. The
only result of putting too much Clorin in the water is that you will smell the
Clorin, or the water will taste like chlorine. So if anyone ever complains that
the taste or the smell changes after they put Clorin in the water, what do you
tell them?
That they have probably overdosed their water. Explain to them
how to correctly dose it.
Some
people ask if you can put Clorin in a well to disinfect the whole well
No,
this does not work. Do not pour Clorin down a well.
10
AM REVIEW OF CONTENT (30 min)
Objective:
Review of the content to this point and clarification of any content that is not
clear.
Give
everyone a slip of paper, or instruct them to find the blank piece of paper that
is in their folder. Instruct them to write on the paper one thing they have learned
and one question that they have.
Collect
the papers, and read them to the class. Ask members of the class to answer the
questions for the rest of the class and answer any yourself that others cannot
answer.
Ask
if there is anything else that is unclear, and break for tea.
TEA:
10am - 10:15am
10:15AM
- COMMUNICATION - SELLING Clorin (1 Hr)
Objective:
What and how to communicate the benefits and correct use of Clorin
Divide
the group into 2-3 groups of three or four by counting off 1-2-3-4 (not more than
three groups if possible). Tell them they are to develop a short skit that shows
what are the most important points to tell a person when they are selling Clorin
to a person. (If the group is for retailers they should pretend they are going
to sell Clorin to a customer. If the group is a drama, they are pretending they
are educating the group about diarrhea, and trying to convince them to go to buy
Clorin).
Tell
them that the skit should include what they think are the most important things
that they should tell the customer, such as asking them if they know how you get
diarrhea or cholera, and how to properly dose water to prevent diarrhea. Tell
them to come up with the other important points that they need to tell the customer.
The person playing the community member or customer is skeptical. This person
must think of all the reasons possible, why they would not want to use Clorin
(i.e. price, never treated water, my water is clean etc)
After
the groups have finished, discuss the main points that they want to talk to the
customer about. Ask them to tell you the points, and you write them on the flipchart.
The
main points should be as follows - if any are missing after they finish telling
you what they have thought of, then you should ask them questions so that they
say what is missing:
1)
Did they ask (not tell): How do you get diarrhea/cholera? (Discussion of how diarrhea/cholera
can be transmitted through contaminated water and get rid of any misconceptions)
2)
Did they ask (not tell): Do you know how you can prevent diarrhea/cholera? (Discussion
of disinfecting water with Clorin, storing water in a closed container, washing
hands before eating, cooking, and after using toilet, covering food etc)
3)
Explain the product - what is Clorin, what does it do, and how do you use it properly
(i.e. Clorin is a solution that kills all germs in water that can cause diarrhea
and cholera. Inner ring once for 20L container etc, shake and let rest for 30
minutes before drinking)
4)
Explain how to store the water safely (i.e. use a closed, narrow mouth container
with a lid. Pour water out instead of scooping to avoid re-contamination)
5)
Explain that water treated with Clorin is safe for adults and children. The taste
and smell of the water will not change if Clorin is used correctly.
6)
Explain that you can find Clorin in pharmacies, clinics, drug stores, and supermarkets
for only K500.
7)
Address any barriers to purchase or use
·
Too expensive
(it's cheaper in the long run than taking your child to the
clinic for treatment. It can save your life by preventing cholera. It will save
you time that you have to take off of work by taking your child to the clinic.
It costs less than one glass of beer)
· My water is safe because it
looks clear and comes from the tap
(Even tap water can be contaminated. The
germs are too small to see, so even if the water looks clear, it can be contaminated.
The city does not treat the water all the time, and it can get re-contaminated
in the pipes anyway)
· I have never treated my water. Why should I start
now?
(Has your child ever had diarrhea? It was probably from drinking contaminated
water. Your water can have germs at any time. You should always treat your water.)
·
I only need to treat my water in the rainy season.
(Your water can have germs
that can cause diarrhea at any time of the year. Treat your water with Clorin
all year round)
After
the discussion, ask one group to perform their skit. Tell the rest of the class
to watch for any of the main messages that were left out.
After
the skit, ask the class to point out any messages that were left out.
11:15AM
(If Neighborhood Health Committees or Clinics) GO OVER BOOK KEEPING FORMS (30
min)
11:45AM
REVIEW OF EXPECTATIONS AND CONCLUSIONS (30 min)
Objective:
Make sure the expectations and objectives of the course have been met.
Let's
review the essential messages about Clorin. What are some of the essential messages
that you would want to tell a customer or community member about Clorin?
·
Clorin will help prevent diarrhea and cholera in your family.
· Clorin
will kill bacteria (germs) in your water that causes diarrhea, including cholera.
· Clorin should be dosed according to the instructions. Inner ring
for 20L container, etc.
· Store your water in a closed container with
a lid to avoid re-contamination.
· Even tap water or water that looks
clear can have germs. All drinking water must be treated with Clorin.
·
Diarrhea can be a problem all year round. Treat your water all year round, not
just in the rainy season.
· Clorin can be found in clinics, pharmacies,
drug stores, and supermarkets for just K500.
· Clorin is a prevention
against diarrhea, NOT a treatment for diarrhea. Diarrhea is treated with oral
rehydration solution.
Refer
to the original expectations and objectives.
Check them off to make sure they
have been met.
Ask
participants if there is anything that is unclear.
Ask
the participants what they thought of the training and if they have suggestions
for improvement or things they would like to know that were not covered.
Congratulate
the participants and tell them that they should go out and actively try to educate
people in their communities about diarrhea and cholera, and teach them to use
Clorin to treat their water all year round.
Thank
the participants. Give out certificates.
