Klaten, 23 November 2007: In the 2007 GoI-UNICEF Central Java program, there are 50 primary schools in Klaten District which have been trained and implemented Management Based School (MBS) program which was fully supported by UNICEF Education section. MBS training focused mainly on how to use creative methods in school teaching and learning process and it also emphasized on community participation in all school activity and program. One of the main issues raised in MBS program was about aspect of water sanitation and hygiene in school environment. In September 2007, a school MBS survey particularly assessed only on water and sanitation facilities condition has been carried out by UNICEF Field Monitor, Dheny Ardhian and Muhammad Zamroni. The result was presented in MBS training and shared with all school participants. It was obviously that water sanitation and hygiene in school has become one of intervention for UNICEF program in 2008. To follow up this, UNICEF has initially planed an integrated approach of School Water Sanitation and Hygiene (WASH) and MBS in 2008 program. A follow up assessment on general situation of water, sanitation, environment and also hygiene practices is needed.

B. Purpose

a) To assess general quantity and quality problems of water, sanitation, environmental and hygiene facilities in school

b) To assess general current hygiene practices (especially hand washing, use of toilet, and waste management)

c) To see about existing health and hygiene activity or program in schools

d) To discuss and look for future strategies that can be integrated in MBS-WASH program

C. Method

The assessment was carried out in two days. There were 3 MBS schools were visited which 1 school in Prambanan and 2 schools in Gantiwarno Sub-district. Information was collected mainly from interviews, group discussion, and observation. Secondary data from previous school survey report and also IRD baseline data were also compiled.

D. Result

Morbidity among school children

Main diseases among school-age children are acute respiratory infection (ARI), fever, diarrhea, helminthes, and skin diseases. It was found that boys and girls have the same responds on regarding of ‘what diseases they usually have’, which were flu, fever, cough, headache and diarrhea.

Common knowledge of diarrhea among school children

Children knowledge about the causes of diarrhea is quite good as It was seen from their answer when asked ‘what causes diarrhea’. Both boys and girls mentioned that diarrhea caused by unclean food and drink, drink water without boiled, flies in food, and do not wash hands before eating. Even though some of children refers diarrhea caused not related to hygienic aspect of food, drink and personal, such as ‘eat too spicy food’.

Existing sanitation, hand washing, and water facilities at schools

Water, latrine and hand washing facilities in three schools are available. But insufficient facilities compared to ration of number of children are a still major problem, at least in two schools. In SD N 1 Prambanan, there is only 1 latrine for 215 students, only 1 unit of urinal facility for boy. There is 1 unit of broken bathing cubicle. And there are 2 tap stands in front of the class and functioned as hand washing facilities with no basin and proper drainage system as used-water creates muddy soil. Moreover, SD N 1 Mlese has just moved from old school to new school about 5 months ago which was donated by Deplu. There are 4 latrines but only 2 are functional. So, there were only two latrines for 156 students. Two units of hand washing basin are totally broken. There is clearly separate latrine for teachers and students. Student is usually forbidden to use teacher’s latrine. Moreover, no separate toilets for male and female teacher. In terms of water sanitation and hygiene facilities maintenance, it was found that there was special person or people to clean the toilets (Prambanan 1), teachers of ‘penjas/sport’ are given responsibilities for cleanliness of facilities (Mlese 1), establish regular student schedule for cleaning (Prambanan 3), and also sanction for children to clean latrines for those who is under un-disciplinary sanction (Prambanan 3).

Excreta disposal practice among school children

Boys and girls said that they very seldom defecated in school latrine. They prefer to using latrine at home. They usually used school latrine most for urinating. Main problems of this situation are because of lack of latrine facilities and also the cleanliness of the latrine facility. Both boys and girls complaint of queuing while there was somebody was using the latrine or they also felt uncomfortable when they have to rush and knowing that their friends were queuing outside. In some case, they usually urinated somewhere outside the latrine (boys). Moreover, girls concerned about latrine cleanliness. They felt uncomfortable if the latrine is dirty and smelly. And no separation latrine between boys and girls is the major concerned for girls. In addition, color paint of latrine is also as a consideration for girls, especially for light color such as orange (Mlese 1) which is not suitable color for the latrine and too bright.

Hand washing with soap practices among school children

It was observed during school visit, that there was a girl washed her hands in tap stand in front of the class (Mlese 1) and also couples of children washed their hand after break and before buying and eating outside the school (Prambanan 3).

Knowledge of hand washing with soap is fairly good. In terms of critical times of hand washing, most of children, boys and girls, responded that they usually washed their hands after exercising session in school, before and after eating, and after defecating. But it was also found that some barriers of hand washing with soap practice in school were because of no or inadequate hand washing facility and no soap available at school. More in terms of hand washing in critical time, the girl complaint about the location of hand washing facility that was quite far from the class (Prambanan 1).

Environmental sanitation condition at school

The environment surround school was fairly clean during observation. Each waste bin made from plastic in various sizes was observed in or outside the class. These wastes are collected and then burnt in open space. One school used concrete rings with specific design as simple incinerator to burn waste (Prambanan 3).

Existing hygiene education and other health activities

There was no regular hygiene education session carried out in the schools. Hygiene education was carried out as an addition only in some subjects, such as sport, IPA or etc. In terms of health activities or programs, Puskesmas have 3 main existing programs in school. First, immunization coverage program called BIAS (Bulan Imunisasi Anak Sekolah) which is implemented annually. During this program, new student and also student from class level 2 and 3 are immunized. Second, UKGS (Usaha Kesehatan Gigi Sekolah) program. This activity is initially carried out once a week. Third, UKS (Unit Kesehatan Sekolah) program which is including training of teachers and ‘little doctor’ (dokter kecil program). But this activity is still not active after the earthquake. Unfortunately, there is no hygiene education activities conducted so far.

Main motivators and main communication channels

Main motivators for behavior change are teachers. Sport (Penjas) teacher is considered as the entry point to spread the water sanitation and hygiene issues.

Involvement of Sanitarian staff of Puskesmas can be also as motivator. UKS as the existing system regarding health issues is considered good through regeneration of children volunteers, such as ‘little doctor’. Several methods for hygiene education can be linked to MBS program.

Roles and responsibilities school committee

School committee roles and responsible are mainly the same in all schools. But it is very different in terms of their participation and contribution in one school to another. School participation in planning, implementation and monitoring are very from school to school. But it was found that most of their participation is limited only to limited on sharing information. No or very little contribution regarding to financial support or other support. In most cases, school has to inform and involve school committee if there is project implemented in schools (Prambanan 3). Before earthquake, school committee in Mlese 1 was quite active. They involved in creating creative learning methods, participate in safety around the school, also reinforcing school extracurricular. Moreover, they used to voluntary providing materials and financial support for construction floor (Mlese 1).Reorganization of school committee is considered necessary as a lot of their members is very busy due to their carrier and also seemed that lack of number of women in school committee members. In addition, it was found that Save the Children have ever implemented of school committee capacity building. Its follow up was ’school committees association in sub-district level’ formed and established by 13 school committees.

Existing laws, rules, and school curricula

There is no specific curriculum for water, sanitation and hygiene education in school either in national, provincial and district level. There are only locally rules and laws developed by each schools related to only maintenance of water and sanitation facility, such as sanction for children to clean the water and sanitation facilities, bulletin information corner before school starting, ‘Friday Clean and Healthy’ (Prambanan 3).

Existing financial allocations for hygiene, sanitation, and water in schools

A few amount of BOS budged is allocated for buying and providing small items such as soap, bucket, waste bin, and sometimes for repairing taps or other water sanitation and hygiene facilities (Prambanan 3). It is very limited as BOS is proposed for school learning and teaching operational only.

Folow up and Recommendation

• Focused on Diarrhea and targeted hygiene practices (hand washing, use and maintain toilets, waste management)
• Itegrated construction about water, sanitation, hand washing facilities, and waste management
• To advocate and formulate of water, sanitation, and hygiene education (WASH) in school management with MoE (District Ministry of Education)
• To formulate and develop piloting of water, sanitation and hygiene education curricula for different school-age children in school which is integrated in to MoE in district level.
• To build capacity of school (Penjas teacher) to adopt School Sanitation and Hygiene Education (SSHE)
• To develop water sanitation and hygiene education IEC which is integrated with MBS and MoE
• To develop and strengthen UKS for setting up “hygiene clubs” to develop child-to-child activity which will integrate school-home-community
• To linkage health programs from Puskesmas (UKS, UKGS, and BIAS) with WASH education campaign
• To exclusively involve and strengthen school committee in operation and maintenance of WASH in school