ranges from 75 to 1400. The introduc-tion of the noon-meal programme inTamil Nadu, combined with the growthin population, has resulted in a rapidrise in the numbers attending primaryschool in the state.

The building of schools, classrooms,and water-supply and sanitation facili-ties has not kept pace with the increasein numbers. As many as 70 childrenoften sit together in one classroom, andone latrine can serve up to 700. In afew schools, the lack of adequate class-room space means that the childrenhave to sit in the compound. The ruralschools - which are open all day -are more crowded than their urbanneighbours. The schools are often inneed of repair, with cracked walls andunstable roofs.

The schools studied are governedeither by the Municipality of Madras,or the panchayat (village council).Most authorities do not have any con-tact with the schools and have not vis-ited them for a considerable time, andonly a few civil servants have met withstaff to discuss each school's activitiesand conditions, and to plan for thefuture. The teachers maintain that they

influenced the attitudes and approachesof the teachers. The International Waterand Sanitation Centre hopes that thesefindings will be tested in a number ofschools, and thus confirm their useful-ness both as general lessons for othersto learn from, and as starting points forprogramme improvement.

The schoolsTen of the 22 schools lie in the poorerareas of the city, while 12 are in neigh-bouring villages. They are all co-edu-cational, and there are almost as manyfemale as male teachers. The staff usu-ally includes a dean, teachers, a cook, acleaner, and a watchman. The usualteacher/children ratio is ] :70, and thetotal number of children in the schools

A 1992 STUDY of 22 public primaryschools in the city of Madras, and invillages nearby, indicated that schoolstaff and children have a useful roleto play in the promotion of improvedwater-supply and sanitary conditionsin schools. The findings suggest thatattending school poses a significanthealth risk for children; they alsohighlight just how important it is forfor teachers to be highly motivated,with positive attitudes towards estab-lishing adequate water-supply andsanitation conditions and hygienebehaviour in the schoolenvironment.

This article highlights both the issueswhich have an impact on water supplyand sanitation conditions in the 22schools, and those key issues which

Teaching by example - promoting hygieneand sanitation in primary schoolsby Maria SorenssonAccording to a recent study, school can makeyou sick. But the poor water-supply andsanitation conditions in many Indian primaryschools have spurred on some determined staffto work with the children to find innovativesolutions, and educate the community.

In most parts of Madras, the water is contaminated and unsafe to drink - in schools, it is rarely boiled or filtered.

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You 're never too young to learn - pre-school lessons in hygiene in 1amil Nadu.

receive very limited financial supportfrom the authorities. It was not clearwhether the schools' funding is basedon the number of pupils, or if eachschool receives a fixed amount.

Water supply andsanitationThe quality and quantity of the water inthe schools is a great problem, as it isfor all the people of Madras. In mostparts of the city, the water is contami-nated and unsafe to drink. Unless thereis enough water for people to washtheir hands, and drinking-water isboiled or filtered, the shortage andimpurities of the water can lead to ahigh incidence of infectious diseases.These range from diarrhoea, which isparticularly dangerous when transmit-ted to younger siblings, to diseasessuch as cholera and hepatitis A and B,which pose a serious public-health riskto all age-groups.

The study found that, in mostschools, drinking-water is neither

boiled nor filtered. It is usually kept ina special vessel, which is covered witha wooden plank or an aluminium lid.The children take water out with amug, which they all share. Usually,there is no special ladle to fill the mug.Children who dip the communal muginto the vessel have to put their fingersinto the water which, in the absence ofgood handwashing facilities for useafter visiting the latrine will, in manycases, cause bacteriological contamina-tion. If there are no water vessels, thepupils take water directly from a tap ora pump, using either their hands or acommunal mug. In a few schools, thequality of the water supply is so poor

that the children have been asked tcbring in their own drinking-water.

Teachers, children, andcommunityAll the teachers in the Madras are2have had training in hygiene and envi-ronmental sanitation; and more thanhalf have received supplementarytraining at the Institute for PublicHealth.

The children interviewed for thestudy are aware of the relationshipbetween poor water and sanitation con-ditions, and poor health. They can citevarious reasons why one gets diar-rhoea, and are aware of how to prevenlit. They all succeeded in drawing a pic-ture depicting one correct, and onepoor, sanitary situation. In a fewschools, the children are responsiblefor cleaning their classroom and theschool compound. Some children alsoparticipate in outreach activities, suchas promoting hygiene and sanitation intheir neighbourhood.

There are very few public and pri-vate latrines in the communities sur-rounding both the rural and the urbanschools. Some adults use the school'slatrines, while others enter the schoolcompound to defecate; both optionsoffer some degree of privacy. In certainareas, there is often an acute lack ofwater, and the women attempt to usethe school's water-supply facilities.

'Promising' schoolsOf the 22 schools investigated, threecan be described as 'promising' in thecontext of their water and sanitationconditions. They have functioningwater-supply facilities and latrines, all

of which are used and well-maintainedby staff and children. The staff alsotake care of garbage disposal anddrainage. One school has turned itscompound into a garden, looked afterjointly by the watchman and thechildren.

In the ] 9 remaining schools, some orall of the children defecate in the open,and the water supply is limited (in oneschool, water is only available for twohours in the morning). The children inthese schools cannot practise what theylearn from their books - a sad irony,as hygiene education is compulsory inall Madras primary schools, and theteachers agree on its importance as acurriculum subject. So, why are thewater-supply, sanitation, and hygieneconditions markedly better in thosethree schools? What makes them spe-cial?

Teachers' attitudesThe study found that the teachers in thethree 'promising' schools share a com-mon belief in the crucial importance ofteaching children about water, sanita-tion, and hygiene. They are dedicatedto incorporating these issues intoeveryday school activities, and they trydifferent ways of improving conditionsand practices. This positive attitudestrongly influences the other staff andthe children. Although teachers fromthe other 19 schools received similartraining, and work under the samebasic conditions - such as a tiny bud-get and inadequate staffing levels -they do not actively promote bettersanitation conditions in their schools.Finding out what influenced the atti-tude of the more enthusiastic teacherswould be interesting in order to stimu-late similar thinking among otherteachers.

Initiating activities andfinding solutionsIn each 'promising school' , one teacher- or the dean - has been responsiblefor taking the initiative to improve con-ditions by ensuring that operation andmaintenance is taken care of, and thatadults in the local community cannotmisuse the water and sanitation facili-ties; a few individuals have encouragedthe rest of the staff both to play anactive part, and to take the initiativeboth in improving conditions, and inhygiene education. The staff worked asteams; the teachers co-ordinated theiractivities with the cleaners; and allteam members advised each other. Theresult of this team approach was thatthe teachers felt that they were being

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Where one latrine serves up to 700 schoolchildren, trespassers are unwelcome!

supported in trying to promote goodhygiene and sanitation practices.

A major characteristic of the teach-ers' approach in these schools is theircontinual search for alternative ways ofimproving the sanitary conditions with-out spending a lot of money.

Education in its broadestsenseThe children who attend the threeschools that came out best in the studyclean up, and do repairs. In this waythey learn to respect the work of thecleaners and the cooks. This positiveattitude is strengthened by the way inwhich the teachers relate to their non-teaching colleagues. In India, there isoften a strong, religion-based resis-tance to dealing with anything that isconsidered dirty, and those who handledirt are looked down on. Breakingdown these traditional attitudes is avery positive lesson for the children,and it encourages them both to respectcleaners, and to modify their ownwashing and toiletary habits.

The communities to which thesethree schools belong lack proper water-supply and sanitation facilities. To pre-vent the people from using the schoolfacilities - which were not designedfor a multitude of users - and to pro-mote good practices, the teachers invitelocal families to join in special eventssuch as a Water Day, and other occa-sions where the children take part inteaching them about hygiene. Theschools also have a more directmethod: they have put up fences with agate and lock, and/or employ a watch-man, who stops anyone entering theschool compound.

Lessons for allThe teachers who have succeeded inimproving their school's environmentalhygiene conditions and practices arestrongly motivated, and possess a pio-neering attitude to improving water-supply and sanitation conditions andhygiene education. They take advicefrom other staff members, such asthose responsible for cleaning thelatrines, on how to improve cleaningand maintenance. Through this practi-cal team working, the teachers alsoreceive the support and encouragementthey need to carry out their own initia-tives for improving water-supply andsanitation conditions, and can motivatetheir pupils to put their hygiene knowl-edge into practice.

In contrast, many of the teachingstaff at the other schools talked of thelack of support they received both

within the school, from the authorities,the Institute of Public Health - andthe parents - as a major constraint intheir efforts to improve conditions.

Adequate, if basic, water-supply andsanitation facilities (that work) inschool are a precondition for anyteacher who wants both to developlessons in practical hygiene, and toensure that his or her pupils learn howto use and appreciate the facilities. Asdescribed earlier, in each of the threemost promising schools the teachershave found ways to manage operationand maintenance and to involve thechildren in hygiene activities, althoughthe problems in all 22 schools arelargely the same. The main differenceis that the teachers in the three innova-tive schools have looked for simplesolutions using the existing capacitiesand resources within the school.

What can motivate teachers to initi-ate this type of action deserves furtherinvestigation; the findings couldencourage teachers in many moreschools to actively involve children,their colleagues, and local people inwater-supply and sanitation improve-

ment and hygiene education initiatives.It may give a crucial entry point: teach-ers' attitudes and actions - rather thantextbook lessons - may well be thekey to improving school conditions.

Also, it would be worthwhile enlarg-ing the review to see if the lessonslearned in Madras are more widelyapplicable, and could be used to pro-mote practical improvements withinschools. This, in turn, may bring abouta change in teachers' training pro-grammes to include motivationalfactors and attitude building.

Maria S6rensson is a social scientist andresearch associate who. IIntil recently, was basedat the International Water and Sanitation Centre(IRC), Postbox 93190, 2509 AD The Haglle, TheNetherlands. Tel: +31 70 33 141 33. Fax: +31703814034.

Th issu rai oed in thi. ani Iwill be I ked al again - and in awider variety of 111 t. - in theJanuary 1996 i sue f Waterlines.

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