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KABUL, Afghanistan, August 26, 2004 — Household surveys in Aqali Shams, one of the most disadvantaged sections of this city, have shown that door-to-door female educators have been successful in promoting hygiene and use of PSI's safe water system Clorin. In July 2003, PSI sent a team of trained female health educators door-to-door visiting 1,500 of the 2,000 families currently living in Aqali Shams once a month for six months. Approaching households in the early mornings and chatting freely with Afghan mothers as they prepared the day's meals, PSI's health educators shared hygiene information and emphasized the role that Clorin could play in preventing diarrhea. Funding for PSI's diarrhea prevention interventions is provided by the U.S. Agency for International Development. Picture cards developed by PSI were used to illustrate health messages and educators measured knowledge and practices surrounding water, storage and precautions taken with water. These surveys were analyzed on a monthly basis and data collected showed vast improvements in behavior during the six-month duration of health educator interventions. The number of respondents reporting their water container was uncovered or incompletely covered fell from 834 the first month to 12 the last month. In the first month, 722 respondents reported their water storage container was unclean and by the sixth month there were only seven. The number of respondents admitting their water container was on the ground fell from 1,107 in the first month to only seven by the sixth month. The number of people using Clorin in the home increased from 12 to 1,025. Dr. Shukria, a PSI health educator who was involved in the campaign, returned to Aqali Shams to the home of Neigar, a 35-year-old mother of seven living in a two-bedroom apartment in Aqali Shams with 11 family members, to explore the impact of Clorin use on her family. Families in Aqali Shams like Niegar's obtain their drinking water from a community hand pump. Her children help her carry water from the pump to their home in open, often rusty, buckets. Once at home, the water is poured again into an old vegetable oil jerry can that, according to Niegar, has not been washed since it graduated from holding vegetable oil nearly a year ago. Upon this visit with Niegar, Dr. Shukria is very pleased with the changes she can visibly see within the home: a bowl of dinner vegetables soaks in water treated with Clorin and a jerry can, recently cleaned, is stored on a short stool awaiting the next trip to the well. Niegar explains, "We no longer use the dirty buckets for carrying water, only covered containers. And when I went to the market to buy vegetable oil, I bought this new jerry can. We use this to store our water and to mix Clorin for making the water safe." The bottle of Clorin on the kitchen counter corroborates Niegar's story. "The information you gave me is very important for our health," Niegar says. "Last year my young daughter became very ill with diarrhea and vomiting and I had no idea what to do. There were no doctors here, and nobody to help me take her all the way to the hospital. All of the children were regularly sick." "Now they are rarely sick," Niegar adds. "I have told them to stay away from the mud and dust, and to wash their hands after touching dirty things. I'm using Clorin in all of their water." For Niegar and countless women like her, Clorin and the safe water system, provide an opportunity to take control of their family's health. By killing diarrhea-causing bacteria in the home and avoiding transmission of these germs through dirty hands and food, the Clorin program is preventing countless cases of diarrhea and saving lives. — Lorri Anne Carrozza, PSI/Afghanistan
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