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Health Education            

Health education has been quite a success at the local high school. The Senior 3 class was very interested in and had many questions about the previous HIV/AIDS education. I based the next class on their questions. The following week I chose malaria as the topic because of its prevalence in the area. The students were misinformed about transmission of malaria. They thought that it was transmitted through unsafe drinking water, as so many of the other common diseases. I think that this may have been a communication error in previous education about removing stagnant water which breeds mosquitoes.  I continued health education in the general paper (essay) classes which I mentioned in my last update.   Students have turned in the required information on their selected health topics. The topics they could choose from were as follows: malaria, food contamination, safe water, community safety, and HIV/AIDS .  The students’ personal experience stories are educational for me and very eye-opening to the severity of these community health problems. The quality of their work varies widely. Ensuring that each student learns has involved individual study sessions after school hours. The students know where I am staying and come to visit me for help, sometimes voluntarily, sometimes by my request. I am in the process of grading the papers and discussing the topics with them. It has been helpful to the students to spend so much time discussing major health concerns in their community. This education has served a total of 112 students. Teachers also learn and ask questions.

Hand Washing and Water Treatment

My hand washing campaign has transitioned from group audiences at the school and church to individual homes in the village.  Each home visit has involved education through a translator and giving of written instructions in the local language and providing soap. I have also been providing each home I visit with a water treatment liquid produced by U.S. Aid. This treatment kills many of the biological contaminants in the local water. Some people are familiar with the product and its use, but are unable to afford it; others have not seen the product before.  I have provided an amount which should treat drinking water for an average family for one month.  This is only an estimate, because the bottle does not say how much water it will treat.  The instructions only say how much to use one cap-full for twenty liters of water.  Also, family sizes vary largely.   The education at each home includes information about boiling water as a method of killing contaminants.   They do not have a word for boiling, so I have explained that they must cook it until bubbles cover the surface for several minutes. This outreach into the community required the permission of the village elder, Anastasie Mukabashanana. We met and discussed my plan, after which she gave her blessing for the home visits. I then began the campaign with the village leader, giving her the items and education. She or one of her aids has been accompanying me on the home visits. The people in the village have been very receptive and thankful and this has been a rewarding experience.  A day of visits involve several hours of hiking at a time in significant heat; the terrain is hilly and the footpaths are rough.  The living conditions and lack of education are staggering and these visits have been incredibly educational for me.  We have visited 72 homes, which housed 332 people.   The local church congregation was also given this water treatment product.  There were 115 participants at the church, many of whom will share the liquid with families at home. This is a total of 554 participants in the safe water education. There have been a total of 706 participants in hand washing education to date. The difference in the two numbers is 112 high school students.  They are benefiting from bio-sand filters, and therefore were not given the water treatment liquid.

Bio-sand Water Filtration

Following up on the bio-sand filter installation project, I have overseen the “feeding “ of the bio-layers daily.  The Rwandese Health and Environment Project Initiative (RHEPI) that originally installed the filters has been helpful in continued maintenance. On Tuesday June 8, a RHEPI representative returned at my request to investigate slow flow rates of four of the filters. Other minor maintenance has been required, which I have performed with guidance from RHEPI.   Four of the filters are currently working well, with flow rates of about 0.7 liters per minute.  RHEPI will be returning soon to replace the sand in the one that is still flowing poorly.  After I leave, the school secretary has promised to maintain the two located at the school. The administrator at the children’s home will maintain the three there. The major maintenance is required during the initial setup, and further maintenance should be as simple as using the filters daily. Should there be problems, the school and children’s home have my contact information and the contact information of RHEPI.  On Friday, June 18, I travelled to Kigali to visit the RHEPI office to investigate options for future projects through partnership with them.

Malaria Prevention

I continue to work toward protecting the children and caretakers of the Faith and Hope Children’s Home from the hazards associated with mosquitoes and other insects.  I again sprayed the homes again with insecticide one month following the initial treatment as recommended by the manufacturer.  Also, I paid for and arranged the replacement of two broken windows to avoid insect entry into the homes. Communicating with a technician for such a project to specify exactly what needs to be done and how much it will cost can take several hours. I will spray the homes again in one month and have instructed the home administrator about using the insecticide after I leave. Also, to make the screening over the windows more permanent, I have hired a local technician to put wooden frames around the screening. Spiders have become more prominent with the change of seasons, so the efforts to avoid mosquitoes have also been useful in avoiding the spiders.


In doing all this, I have educated myself as well. The interventions and education that I have done in the last two weeks have been predominantly beyond what I have learned in classes at the College of Public Health at East Tennessee State University. I have used my skills on how to find information, which I learned in various classes while doing papers and projects. The World Health Organization and Centers for Disease Control and Prevention websites have been excellent resources for lesson plans at the school. I just happened to notice the water treatment liquid at a store one day and then looked into it. Communication has continued to be a necessary and difficult skill to use. This includes communication with the people I am educating with community gatekeepers and people all helping me.  I have learned that attitude and creativity is very important in accomplishing a task.  Many times, it has been up to me to come up with ideas and find a way to make them happen.  Motivational skills and a positive attitude have been necessary to do this.

My field experience has been very busy and successful so far. I look forward to seeing the results of some of the interventions that will produce tangible results soon. For example, the bio-sand filters will be producing drinkable water beginning July 4. I also look forward to continuing health education at the school. Despite challenges, this experience has been very educational and rewarding. I am excited to see what the rest of the internship holds in store for me and for the village of Cyegera