WASH – UNICEF Ethiopia

MIND THE GAP – BABYWASH Launched on World Toilet Day to Improve Integrated Early Childhood Development in Ethiopia

By Samuel Godfrey

When you travel in a car through Addis Ababa, you will note that adult women and men vary greatly in height. There are tall people and short people. So which ones of these are actually stunted? And why? Scientifically stunting is defined as a reduced growth rate in human development and is a primary manifestation of malnutrition or more accurately under nutrition. The definition of stunting according to the World Health Organisation (WHO) is for the “height for age” value to be less than two standard deviations of the WHO Child Growth Standards median.

So how does under nutrition occur? Recent scientific evidence suggests that under nutrition is a result of recurrent infections such as diarrhoea or helminthiasis in early childhood and even before birth. In 2016, UNICEF Ethiopia, published a blog entitled BABY WASH – the missing piece of the puzzle[1]?, in which evidence from a paper published by UNICEF and John Hopkins University in the Journal of Tropical Medicine and International Health[2] highlighted the need to target interventions to reduce unsafe practices of disposal of baby and child faeces. To convert this evidence into action, the Government of Ethiopia, UNICEF and partners have developed a BABYWASH implementation guideline. The guideline aims at contributing to improving Integrated Early Childhood Development (IECD) through improving the baby and child environment.

World Toilet Day 2017: safe disposal of child faeces — Lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. ©UNICEF Ethiopia/2017/Mulugeta Ayene

The 2017 World Toilet Day was a perfect opportunity to launch the BABYWASH guideline. The document includes guidance on how to implement programmes with safe disposal of child faeces, providing protective environments through play mats and similar measures as well as prevention of soil transmitted helminths. The strategy was endorsed for implementation alongside regular safe sanitation and hygiene practices which are already being promoted by health extension workers. In his statement, H.E Dr Kebede Worku, State Minister of Health of Ethiopia said, “In Ethiopia, there is a common misconception that children’s faeces are not harmful while evidence shows otherwise. The current sanitation and hygiene promotion efforts, at times, overlook safe disposal of children’s faeces. In addition, most toilets are not designed keeping children’s special needs in mind. Hence, I am proud to endorse the Baby WASH manual today which was developed by the Federal Ministry of Health with the support of UNICEF and other partners in order to ensure a healthy environment for children’s growth and development especially those under three years of age.”

Ms Gillian Mellsop, UNICEF Representative to Ethiopia on her part said, “UNICEF is pleased to support the Ministry of Health in preparing these excellent guidelines on Baby WASH. We know that a contaminated environment harms infants and young children and puts them at risk of increased child mortality and stunting. Together, we have to ensure that parents and guardians, teachers and community leaders are aware of the importance of Baby WASH.”

According to the Knowledge, Attitude and Practice (KAP) baseline survey on Water, Sanitation, and Hygiene carried out in eight regions of Ethiopia, there is a general misconception about child faeces disposal. The survey showed that a lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. According to the survey, only half (49 per cent) of women knew that child faeces are dangerous to health. Misconception is higher among rural pastoralist women where only 39 per cent said child faeces are dangerous as compared with 50 per cent among rural non-pastoralist women and 54 per cent of women in urban areas. Although it may not be clear who is stunted and who is not just by looking at a child, it’s clear that safe disposal of child faeces helps improve a child’s health. Therefore, UNICEF will continue to support the Government with the implementation of the guideline throughout the country.

[1] https://unicefethiopia.org/2016/05/24/baby-wash-the-missing-piece-of-the-puzzle

[2] https://www.ncbi.nlm.nih.gov/pubmed/27546207

Children Takeover Minister Roles as Ethiopia celebrates World Children’s Day and UNICEF Ethiopia’s 65th Anniversary

20 November 2017, United Nations Conference Centre, Addis Ababa: Today, Ethiopia joined the global World Children’s Day celebrations by giving children high profile roles to become champions of their rights. In line with the event’s theme ‘For children, By children’ child parliamentarians took over the roles of the Ministers of: Women and Children’s Affairs; Health; Education; Water, Irrigation and Electricity; Labour and Social Affairs; and Urban Works and Construction. In addition, children took over the roles of the Attorney General and UNICEF Representative. In their new roles as ‘shadow Ministers’, children shared their ideas on issues that affect their lives.

World Children's Day and UNICEF Ethiopia 65th anniversary — Sara Beshir shadow Minister of Women and Children Affairs. Her message on World Children’s Day: attitudes towards violence angst children and women need to be changed. ©UNICEF Ethiopia/2017/Nahom Tesfaye

At the event, which was truly owned by children, some of the key recommendations proposed by children include:

Accelerate efforts to end harmful traditional practices, including child marriage and Female Genital Mutilation/Cutting
Provide clean water and sanitation services for all children across the country, no matter where they live
Build more hospitals that are focused on child health and ensure health professionals treat children with care and love
Involve children in child justice
Ensure quality education for all children through skilled teachers, including pre-primary education
Ensure that girls stay in school and finish their education
Provide more playgrounds and safe spaces, especially in urban and peri-urban settings
Include children’s voices when adults and local authorities discuss issues that affect children’s lives.

Child parliamentarians from different regions also had an opportunity to discuss issues relevant to children in Ethiopia with shadow Ministers and dignitaries through a Q&A session.

In her opening remarks, H.E Ms Demitu Hambisa, Minister of Women and Children’s Affairs, stated that this year’s World Children’s Day is a day of action for children by children. She highlighted that decision makers need to ensure that children’s voices are heard and reflected in decisions that affect their lives.

Ms Gillian Mellsop, UNICEF Representative to Ethiopia, emphasising the need for the participation of children said, “Meaningful participation of children is not only a fundamental right – and enshrined as such in the Convention on the Rights of the Child – but is also key to ensuring that decisions made by adults are relevant to the actual needs of children.”

In addition, UNICEF Ethiopia launched its publication ‘Hulem Lehisanat- Always for children’ depicting its 65 years history serving children and women in Ethiopia.

The event highlighted the importance of including children’s voices by providing children with an opportunity to share their own solutions on how to keep every child in Ethiopia healthy, well-nourished, in school and protected.

‘BABY WASH’ boosted at this year’s World Toilet Day in Ethiopia

Addis Ababa, 15 November 2017 – Today, Ethiopia celebrated World Toilet Day by holding a half-day workshop with the theme “Safe Disposal of Child Faeces.”

At the workshop, the national ‘Baby WASH’ strategy, which focuses on hygiene of children under three years, was endorsed by the Federal Ministry of Health. The strategy includes safe disposal of child faeces, providing protective environments through play mats and similar measures as well as prevention of soil transmitted helminths. The strategy will be implemented alongside regular safe sanitation and hygiene practices which are already being promoted by health extension workers.

In his statement, H.E Dr Kebede Worku, State Minister of Health said, “In Ethiopia, there is a common misconception that children’s faeces are not harmful while evidence shows otherwise. The current sanitation and hygiene promotion efforts, at times, overlook safe disposal of children’s faeces. In addition, most toilets are not designed keeping children’s special needs in mind. Hence, I am proud to endorse the Baby WASH manual today which was developed by the Federal Ministry of Health with the support of UNICEF and other partners in order to ensure a healthy environment for children’s growth and development especially those under three years of age.”

A strong early childhood foundation, which includes a safe and hygienic environment coupled with adequate nutrition as well as nurturing parenting and stimulation for optimal brain development, is critical to ensure toddlers can develop to their full potential. This will facilitate a smooth transition to primary school and a better chance of successfully completing basic education. Therefore, investing in early childhood development through improved hygiene practices and environments is one of the most critical and cost‑effective ways to improve a child’s future health, education and productivity.

The Ministry of Health and UNICEF urge citizens, parents, teachers, health workers, policy makers and government officials to play their role in making sure that every child receives the benefits of Water, Sanitation and Hygiene (WASH) in their homes, communities, schools and health facilities.

The Government of Sweden grants US$ 2.5 million to UNICEF for emergency response

The Government of Sweden provides another US$2.5 million to UNICEF Ethiopia to support Water Sanitation and Hygiene (WASH), health and nutrition programmes in the drought affected regions of Afar, Oromia Somali and Southern Nations Nationalities and People’s regions.

In Ethiopia, where 8.5 million people are currently in need of relief food assistance due to the recurrent drought emergency, 376,000 children are estimated to require treatment for severe acute malnutrition, 10.5 million people require access to safe drinking water and sanitation services and 1.9 million school-aged children need emergency school feeding and learning material assistance.

The contribution provided by the Government of Sweden will be used to construct and rehabilitate water supply schemes, procure Emergency Drug and Case Treatment Centre kits as well as obtain Community Management of Acute Malnutrition (CMAM) supplies including ready to use therapeutic food (RUTF), tents and Stabilization Centre materials in the four regions highly affected by the drought emergency.

UNICEF is grateful to the Government of Sweden for its continued support for providing life-saving interventions during the current humanitarian situation which continues to affect mostly women and children.

In 2017, the Government of Sweden has contributed more than US$5 million to UNICEF-assisted humanitarian programmes in Ethiopia.

UNICEF and Italian Agency for Development Cooperation made it possible for host communities and refugees in Itang Special District to access clean and reliable water supply

By Dorosella Bishanga

ITANG SPECIAL WOREDA (DISTRICT), GAMBELLA REGIONAL STATE, 6 October 2017-While it is commonly understood that water flowing in river streams is not clean and suitable for drinking nor cooking, in Itang town, Baro River was the only main source of water supply in which households depended for everyday domestic use. Consequently, as the Itang Town Water Supply Scheme was launched in October 2017, residents were delighted for the assured access to clean and reliable water supply.

The inauguration event of the Itang Town Water Supply Scheme was attended by his Excellency Senai Akwer, Vice President, Gambella Regional State, his Excellency, Thok Thoan, Head, Gambella Regional Bureau of Water and Resource Development. Ms Gillian Mellsop, UNICEF Representative to Ethiopia, Ms Ginevra Letizia, Head of the Italian Cooperation Agency Office, members of the Woreda Administration, the residents of Itang town, and delegations from UNICEF and the Italian Agency for Development Cooperation in Ethiopia.

Itang water scheme supported by Italian Agency for Development Cooperation — The Itang water supply scheme will provide water for 11,319 and 10,000 individuals in Itang and Thurpham respectively. As part of the multi donor integrated water supply project, the project will provide safe water to a total of 205,703 refugees in three camps of Kule, Tierkidi and Nguenyiel refugee camps after the system upgrade. ©UNICEF Ethiopia/2017/Mulugeta Ayene

During the inauguration of the Itang Water Supply Scheme, UNICEF Representative, Gillian Mellsop expressed her gratitude both to the Gambella Regional and the Itang Special Woreda leaders, by recognizing their commitment during the implementation of the Itang Water Supply Scheme and the remarkable collaboration towards realizing key development milestones on access to clean water as put forward in the government development agenda. Ms. Mellsop said, “With the right investment, it is possible to provide a more reliable and resilient water service to rural communities; that reduces their vulnerability and also improves the quality of their lives – in this case, also contribute to peace building efforts by avoiding potential conflict over limited available resources.”

Conveying her gratitude for the financial contributions made by the Italian Agency for Development Cooperation, which made it possible for the building of the Itang Town Water Scheme, Ms Mellsop added, “I also thank our very generous donors, including the Italian Cooperation Agency, who are also here with us, whose support has made it possible for the building of the permanent water scheme that not only provides water for the town but also the large population of refugees that is hosted in three refugee camps Tierkidi, Kule and Nguenyiel found in this Woreda.”

Likewise, Ms Ginevra Letizia, the Director of the Italian Agency for Development Cooperation (AICS) conveyed her gratefulness to the Regional and Itang Woreda administration for their cooperation as well as the management to ensure the successful completion of the project. Insisting on the need to strengthen community structures hosting refugees, Ms Letizia said, “It is a pillar for the AICS humanitarian interventions to also target hosting communities since these are the ones sustaining the burden of welcoming refugees and an equitable access for both to basic services like water is a guarantee for peace and stability.”

The Itang water supply scheme will provide water for 11,319 and 10,000 individuals in Itang and Thurpham respectively. As part of the multi donor integrated water supply project, the project will provide safe water to a total of 205,703 refugees in three camps of Kule, Tierkidi and Nguenyiel refugee camps after the system upgrade.

To curtail the development – humanitarian funding challenges, UNICEF is responding to humanitarian needs in emergency contexts, while at the same time investing in government management systems to increase the self-reliant capacity of the communities. Being one of the emerging regional states and emergency affected regions in the country hosting a proportionally large population of refugees compared to the hosting population, UNICEF has prioritized Gambella. UNICEF provides support to increase sustainable community access to safe water supply by funding the construction, rehabilitation and maintenance of water supply schemes both in refugee camps and host communities.

Besides, UNICEF is adopting new approaches to provide water to communities where water is scarce by conveying water from reliable ground water sources where it is available. Shifting from surface water sources to groundwater sources, the Itang Town Water Supply Scheme is composed of pressure main line collector pipes, storage tanks/reservoirs, a central collection tank, a booster station and an elevated water tank. In addition, the system includes the installation of electro-mechanical equipment such as pumps and generators to the host communities in Itang. 18 water kiosks including the pipe distribution system have been constructed to supply at least 20 litres of water for daily use by communities.

To ensure optimum water use, the Itang Town Water Supply System is being upgraded with the aim to meet the demand of an additional 85,000 refugees in the newly established Nguenyiel camp and surrounding communities. Through collaboration and additional financial support from the German / KfW funding, the project will supply and install pressure main pipes from Itang to the booster station, install additional storage tanks at the collection chamber and booster station, construct additional power houses, supply and install additional electro-mechanical equipment at Itang and the Thurpham pumping station, drill two additional boreholes and rehabilitate two additional boreholes.

Similarly, UNICEF has led the development of the business plan for the entire water supply project by promoting cost recovery through user fees obtained for domestic uses of water for drinking, food preparation, washing, cleaning and miscellaneous domestic purposes and institutional uses. A study was conducted with residents of Itang and Thurpham analyzing the institutional capacity and willingness to pay for water supply and sanitation services. In the context of (i) what is being paid for water at the moment; (ii) consumers’ perception about the value of the effort they make to collect water; (iii) the maximum amount that consumers would be willing to pay for a water supply service and (iv) the affordable rate to be paid by the low-income section of the society to determine the bottom level of price for water.

Additionally, UNICEF is building the capacity of the Regional Water Bureau and Itang Special Woreda Water Office to improve the overall WASH sector coordination and institutional capacity building. UNICEF has supported the establishment of Itang Town Water Utility which will manage, operate and maintain the entire water supply project. In coordination with UNHCR and the Administration for Refugee and Returnee Affairs (ARRA), the government agency with the mandate for water supply provision for refugees in the country, UNICEF is implementing the cost recovery model of public sector utility management for WASH services as a sustainable long-term solution to service provision to refugee populations. As part of this model ARRA plays a key role through membership on the water board which oversees the water utility to ensure accountability to refugee populations.

As UNICEF continues to advocate for a robust partnership with the Regional Government and donor support for different programmes in the region; it calls for a well-defined operation and maintenance system to improve efficiencies, reduce water losses, and increase the sustainability of services.

Researchers in Action for African children

Researchers from around the continent are gathered this week in Addis Ababa to Put Children First!

In Africa, two billion babies will be born between today and 2050, translating into more than 60 million new lives every year. By 2055, the continent of Africa will be home to 1 billion children, nearly 40 per cent of the number of children worldwide. Therefore, as noted in the conference by UNICEF Regional Director for Eastern and Southern Africa, Ms Leila Pakkala, nowhere in the world are children more central to a continent’s future than in Africa and “children must be put first”.

Putting Children First: Identifying Solutions and Taking Action to Tackle Child Poverty and Inequality in Africa — Policy makers, practitioners and researchers discussing better ways in identifying solutions for fighting child poverty and inequality in Africa. ©UNICEF Ethiopia/2017/Meklit Mersha

The international conference with the theme: Putting Children First-Identifying Solutions and Taking Action to Tackle Child Poverty and Inequality in Africa has been promoted by the End Child Poverty Global Coalition and organized at national level by the Ethiopian Centre for Child Research (ECCR) with UNICEF Ethiopia’s support. The Centre is currently establishing partnerships and research collaborations with potential researchers and research institutes nationally and globally.

At the conference, the Ethiopian Minister of Women and Children’s affairs stated, “Because of the Government and its development partners’ efforts, national poverty rates have seen a significant reduction over the past decade in Ethiopia, decreasing from 39 per cent in 2003 to 29 per cent in 2011. However, the decrease in poverty over the past few years has not matched the rate of economic growth, suggesting that economic growth has partly failed to benefit the most vulnerable sectors of society. Women and children are one of the least benefited and vulnerable sections in the society”.

ECCR will share an analysis on the dynamics of multi-dimensional poverty among children in Ethiopia which was also jointly presented with UNICEF Ethiopia at the Child Poverty Conference for MENA in Rabat and at the 6^th International Society for Child Indicators in Canada.

Using an adaptation of the Multiple Overlapping Deprivations Approach, it has been showed that share of children who are deprived in two or more poverty dimensions, such as lack of appropriate or access to health and education services or poor quality of housing declined from 82 per cent to 35 per cent between 2002 and 2013. In the meantime, the percentage of children non-deprived increased from 18 per cent in 2002 to 65 per cent in 2013.

For researchers and other professionals in various fields, children should be the top-most priority as we all look for pathways to unlock poverty and inequality in the continent. The ongoing conference would be a great opportunity for practitioners and policy makers from Africa to contribute to the overall debate on child poverty-towards contributing to address child poverty in all its dimensions while promoting evidence generation.

Japanese Support to make reliable water sources available in Gashamo

By Ayuko Matsuhashi

Gashamo Woreda, Somali REGION, 6 September 2017 – What if you are told that the water you would have daily for drinking, cooking and bathing is rain-dependent and dries up into a muddy puddle during eight out of the 12 months of the year?

For the lucky ones, life without water is unthinkable. Sadly enough, this still remains a daily life reality in arid and semi-arid areas in Ethiopia.

A shortage of water in Somali region has been devastating due to the ongoing multi-year drought. While climate resilient water source development is a key to mitigate negative impacts of the drought, the majority of the population in Somali region is still dependent on seasonal water harvesting ponds. Farah Abdulahi is a 34 year old single mother of four who has become an Internally Displaced Person (IDP) in Gashamo IDP site from a village which is 15km away. “I came here because I have lost all of my 150 goats and sheep since the onset of the drought,” Farah said. Several hydro-geological complications and costly investments have prevented the WASH sector from actively investing in drilling a deep borehole in the region whereas surface water sources are highly vulnerable to drought and put people at a greater risk. “I used to fetch water from birkas*. But they all dried up because there had been no rain,” Farah describes her life in the previous village before she was displaced. “Thanks to the humanitarian aid providing water at this IDP site, we are barely surviving.”

Deep borehole drilling, Gashamo woreda, Somali region — Farah Abdulahi with her children in her temporary shelter in Gashamo IDP site
© UNICEF Ethiopia/2017/ Michael Tsegaye

Ahmed Hussein Brerale, 57 years old, is one of the community elders in Haji Dereye kebele (sub-district) near Gashamo town. As a long time resident of Haji Dereye, he has witnessed the dreadful decrease of water in the area and says, “There is no borehole in this area. We heard that the nearest borehole is 78km away and is the only potable water source in this large woreda (district). What we have here is only seasonal water sources like birkas. As the last two rain seasons failed, the available volume of water in birkas has significantly decreased. We are worried.”

In order to provide access to potable water for children and women such as Farah and her children, UNICEF Ethiopia has started drilling a new borehole near Gashamo town in partnership with a private sector partner with financial support from the Government of Japan’s emergency grant aid for the Middle East and Africa region for emergencies since August 2017. The drilling site was carefully located by using hydro-geological data from satellites in close collaboration with the Somali Regional State Water Bureau. According to the satellite data, the estimated depth of finding an aquifer is at around 500-600 metres. So far one-fourth of the planned depth has been achieved. Since there is no alternative safe and reliable water source in the area, this new borehole is going to be an ‘oasis in the desert’. Although this drilling work is one of the UNICEF’s emergency projects, in a longer term the project will also bring a sustainable solution for the area which is high vulnerability to climate change. The borehole is expected to provide clean water directly to 11,000 – 25,000 people in Gashamo town with a potential to indirect beneficiaries who are passing by from surrounding areas in search of water.

“I heard about the new borehole drilling. I am looking forward to seeing clean water. That has been always my dream to have clean water nearby in my life,” says Farah with a smile on her face.

UNICEF will keep working together with the regional water bureau to ensure that people who have been living without reliable water sources get sustainable access to potable water without interruption.

*Birka – A traditional water harvesting pond which collects run-off water when it rains.

Menstrual Hygiene in Ethiopia – the Importance of Including Boys in the Discussion

By Jane Bevan and Kalkidan Gugsa

ADDIS ABABA, 30 May 2017 – Daniel Worku, a 12-year-old from Sheno Primary School in Oromia region, admits he did not know much about menstruation and thought it only an issue for girls and women to discuss. “The [menstrual hygiene management (MHM)] education in the school helped me to know more about it and how to be supportive of girls. I am a member of the MHM club, motivating my peers, particularly boys to be part of it too.”

Daniel and three courageous female students were telling their MHM experiences to a crowded room of health sector and development partners in Ethiopia. The advocacy event was held on global Menstrual Hygiene Day and organised by the Ministry of Health, in partnership with UNICEF and other MHM partners – Splash, WaterAid, SNV, Care and World Vision.

: Left to right: Daniel Worku, Hiwot Werka and Simret Hailu, students from Sheno Primary School in Oromia; and Zinebech Daniel from Bole Primary School in Addis Ababa share their experiences about menstruation during the Menstrual Hygiene Day event. ©UNICEF Ethiopia /2017/Tadesse

While menstruation is biologically a female issue, UNICEF’s recent knowledge, attitudes and practice (KAP) baseline survey of MHM in Ethiopia found that teasing from boys was a major reason that girls often skip school while menstruating, sometimes resulting in dropping out of school altogether. Thus, the involvement of boys in education about menstrual hygiene is key to improve understanding and reduce teasing, and thereby the retention of girls in school.

The KAP study found that over half of schoolgirls in Ethiopia knew nothing about menstruation prior to menarche, leaving them shocked and frightened and less than half of the girls in the county are taught about menstrual hygiene in school. The majority of adolescent girls never discuss menstruation with another person. On average, 11 per cent of girls miss school for reasons related to their periods – this is as high as 46 per cent in some regions. The main reasons for missing school were cited as pain/discomfort and teasing.

The study found there is a common misconception in Ethiopia that girls are no longer virgins because they begin menstruating and have been at times punished by parents who blame them for having sex or being raped if blood is seen on their clothes. These misunderstandings, in addition to teasing and bullying, cause girls to feel shame and isolate themselves.

“The girl who menstruates stays in a corner of the classroom or stays at desk until all classmates are gone because she does not want to be bothered by anyone,” said Hiwot Werka, grade 7.

Breaking the silence around menstruation and educating boys and men about this natural bodily function is seen as key by UNICEF to reduce harmful teasing. In schools, this includes male teachers’ awareness and sensitivity about MHM to ensure girls receive the support they need in school.

UNICEF Ethiopia’s MHM programme, funded by the Netherlands Government, began in 2016 and is piloting girl-friendly water, sanitation and hygiene (WASH) facilities in 96 schools across six regions. The facilities include more privacy, water for washing, safe spaces for girls to rest and change pads or clothes as necessary. The programme also developed and adapted educational material such as the Grow and Know booklet, a social and behavioural change tool which is being translated into local languages. The booklet targets girls, ages 10-14 years old and contains information on their changing bodies, including MHM.

A community-level component of the programme supports local women’s groups to produce reusable sanitary pads, which are sold to women and girls at an affordable price.

At the national level, UNICEF and partner agencies have worked closely with the Ministry of Health and Ministries such as Education and Women and Children’s Affairs to develop a national MHM guideline, which was also launched at the 30 May event. The guideline provides detailed guidance about the role of stakeholders in supporting women and girls with MHM. It also provides standards, for example regarding MHM kits for schools. The WASH Facilities in Schools construction manual is also being revised by the Ministry of Education to incorporate MHM facilities.

: Launching the national MHM policy and implementation guideline on Menstrual hygiene management day: “Let us break the silence about menstruation”, Capital hotel, 30 May, 2017 (Left to right: Dr. Zufan Abera, Ministry of Health, Jane Bevan, UNICEF, Bethlehem Mengistu, Water Aid, )© UNICEF Ethiopia /2017/Tadesse

Through the initiatives described above, the aim of the UNICEF MHM programme is to improve girls’ attendance and retention in schools. By promoting understanding of MHM and finding solutions to the challenges faced by girls in schools, the unnecessary silence surrounding menstruation may be lifted. Including men and boys in the discussion is a vital aspect of equalizing opportunities and improving the future for girls.

Markets and Menstruation

Women sell local products in Wukro market, Tigray region. ©UNICEF/2016/Carazo

By Blanca Carazo

WUKRO, TIGRAY, 6 December 2016 – It was Monday morning when we came across the bustling market in Wukro. Tomatoes, onions and cereals are weighed and sold by women sitting on the ground, many of them wearing traditional white shawls.

Crossing through the market stalls, we entered a small office, which operates as a factory and shop as well. Helen Hailu’s open smile welcomed us to this all-in-one space where she and two other women have launched an innovative and ecological business: they produce and sell reusable sanitary pads.

In Ethiopia, as in most countries, menstruation remains a taboo topic, often causing girls and women to be excluded from school and other activities. In Wukro town, this is changing. An integrated water, sanitation and hygiene (WASH) intervention being implemented by UNICEF, through its partner, World Vision, is raising awareness about menstrual hygiene among teachers, girls and boys in schools. The programme also promotes businesses such as Helen’s, to ensure that adequate and affordable products are available in the local market.

Helen and Meaza Gebregzabher proudly explained how they were chosen by a women’s association and trained by World Vision to produce reusable sanitary pads before receiving sewing machines and materials. They decided to call their business Raig, the Tigrigna word for ‘vision’.

Starting a business is always challenging, and this business is no exception. “It’s difficult right now to get money,” said Meaza, “some of the materials are bought in Addis Ababa and are expensive. We’re expecting you to raise awareness.” she added, kindly pressuring us, the visiting colleagues from UNICEF and World Vision. Perhaps business will pick up once the urban WASH water scheme is fully functional later this year, allowing easier access for women to clean the reusable pads. Also implemented by World Vision, the UNICEF-funded, Government of Ethiopia-designed programme will provide 100 per cent water coverage in Wukro and five satellite villages.

An agreement has been signed between Raig and seven schools to provide 600 pads, and they aim to also sell to local women. “They are for schools, but also for the people in the village,” said Helen.

Meaza Gebregzeir shows the materials and the three-unit set they sell, while Helen Hailu sews a new product. ©UNICEF/2016/Carazo

I buy a packet of three reusable sanitary pads for 30 birr (US$1.30) and I’m offered a free sachet of detergent. “It’s a promotion.” explains Meaza. They have to compete with commercial one-time-use pads that are sold at 20 to 30 birr for a packet of ten.

Helen and Meaza’s raig is that girls and women in Wukro use their ecological, effective and handmade sanitary pads while they’re menstruating; with the added benefit of ensuring business for the women.

UNICEF’s raig is that all girls and women have the knowledge, environment and materials they need to have dignity and safety when menstruating. Promoting income-generating activities like this not only contributes to that aim, but it also offers sustainable opportunities for brave women like Helen and Meaza.

Nowhere to go – School Toilets

By Hiwot Ghiday and Raymond Kennedy

EAST BADEWACHO, SOUTHERN NATIONS, NATIONALITIES AND PEOPLE’S (SNNP) REGION, 13 February 2017 – Langano Primary School is located in the southern Ethiopian countryside around 17 km east of Shone town and has been open since [2004]. Until 2016, this bustling school of over 1,300 students had only one traditional latrine – shared by boys and girls alike.

Habtamu Pawlos is 13-years-old and currently studying in grade eight – the highest level offered by Langano School. He explains, “Previously there was only one latrine at our school and since the number of students are many it was difficult to access when needed.” He thanks the donor for providing a block of four new latrines for each gender, complete with a handwashing facility and says it has solved the problem.

Habtamu is being gracious – while he knows that four boys’ toilets is an improvement on what they had before – it is still not many to share between over 700 male students at the school.

When there are not enough toilets to go around – it is not surprising that children resort to unsanitary practices. Estimates are that only 42 per cent of primary schools in the SNNP region are free from open defecation[1].

The lack of toilets in Langano Primary School caused particular problems for girls.

“Most of the time, the boys go first and we have to go back to class before we get to use the toilet,” Tsehay Moges, a 12-year-old girl who recently entered grade five explains. “Privacy was also a problem.”

Tsehay admits that the lack of toilets made it difficult for her to attend class and concentrate on her studies. She says students sometimes became sick from infections due to lack of access to proper toilets.

A recent UNICEF study found that over a quarter of girls surveyed missed school during their periods[2]. One key reason for this was the lack of private spaces to change their sanitary materials and clean properly. In many cases, girls told us that they would be teased or harassed by boys if they knew they were experiencing menses.

Private, separate toilets for girls will help Tsehay and her female classmates manage their periods with more dignity and will help reduce the number of girls absent from school.

latrine school — The previous one-stall latrine. ©UNICEF/2017/Ghiday

The contrast between the new latrine blocks and the old unimproved latrine is stark.

Shared by both boys and girls, this latrine provided little privacy and was very dirty. The uncovered latrine hole attracted swarms of flies which buzzed around the user, contributing to the spread of diseases including trachoma, which can cause blindness. Additionally, there was also no handwashing facility for the children to use. Traditional latrines may also easily collapse when it rains as they are built out of mud and sticks. This is a danger to users and also exposes the community to open defecation until they are replaced.

Through generous funding from SIDA, the Swedish International Development Cooperation Agency, UNICEF is supporting the regional government in the SNNP region to ensure that school children can use safe, improved latrines with handwashing stations. This project is supporting 10 schools in total, and new toilets have been installed in six of them thus far.

While the population of students and teachers at Langano Primary School are fortunate to have a better sanitary environment, there is still work to be done elsewhere in Ethiopia. Even though has been significant progress in reducing open defecation, far too many children are using unsafe and unsanitary latrines – particularly in rural areas. The current coverage of improved latrines is estimated to be less than per cent in rural areas of Ethiopia[3]. There is a long way to go before all children in Ethiopia have proper access to safe and clean toilets at school.

[1] One WASH (Water, Sanitation and Hygiene) National Programme Draft Report 2016

[2] Menstrual Hygiene Management, Knowledge, Attitudes and Practices Baseline Survey, 2017; Afar, Gambella, Oromia and SNNP regions of Ethiopia.

[3] Ethiopia Demographic Health Survey 2016