On March 22, to commemorate World Water Day 2006, New Delhi-based NGO WaterAid India, which works to enable poor communities to access adequate, safe water, formally launched a Handwashing Campaign. The campaign is an initiative to spread awareness about sanitation by convincing people of the importance of washing their hands with soap or ash as and when necessary.

Drawing from several health and sanitation studies conducted by the London School of Tropical Medicine, WaterAid has found that there is both the need and space for such an initiative. This research found that one of the biggest causes of child (under-five) mortality is diarrhoea, which is closely linked to clean water and sanitation. (According to UNICEF, the under-5 mortality rate for India in 2003 was 87 per 1,000 live births.) It has also found that frequent washing of drastically increases sanitation. Other, more informal research, conducted by WaterAid India has found that compared to other methods, washing hands is a cost-effective way of promoting sanitation.

The Handwashing Campaign will focus on both rural and urban India, and is based on the use of mass media and those channels that reach a wide section of the public.

WaterAid estimates that this will be a three-year campaign. Its primary targets are school-aged children both in school and in other settings, teachers, mothers of children who are less than five, other caretakers of children, and health workers. Ten intervention states (in which WaterAid already has a presence) have been chosen, and the campaign is expected to reach 1,000 schools, 100,000 children and 500,000 community members. Its impact will be evaluated on an annual basis.

The handwashing campaign is unique in its three-pronged approach. First, it views and uses children as agents of change. Second, it hopes to affect people's behavior by addressing their desires rather than simply by providing them with information. Third, it works on a partnership framework - the community will be treated as a partner in mobilizing frequent handwashing. These three issues are the nodal points of how the campaign will be carried out.

How are children agents of change? According to Asha Ramesh, Director for Policy and Partnership at WaterAid India, "Children often affect adult behavior. What they learn at school, they talk about at home, and in this way generate interest and discussion amongst adults." Yet, even if they do not talk about what they learn, their very activities create interest among adults. Children also affect each other. They discuss what new issues they encounter, and collectively play and experiment with ideas that strike them as unusual. When a child has become strongly convinced of an idea - especially an idea such as the frequent washing of hands - the idea becomes translated into a life-long habit. All of the above produce long-term changes in society.

Children develop interest in an issue through gaining knowledge, through play, and through activities such as painting and drama. They also develop interest through knowing about or interacting with those they are likely to consider role models. Initiatives in other areas - such as Bal Panchayats in the area of governance - have been successful in using the above methods. The handwashing campaign hopes to reach children through all of these means.

The second prong of the campaign's approach - changing behavior through addressing desire - is inventive. The campaign creates local interest, especially among adults, through the intensive use of different communication techniques. It suggests that the best way to address problems of sanitation is not by dictating reason, but by working with people's existing motives and practices. Anand Shekar, Regional Manager for WaterAid India, says, "We believe that building on people's desires, rather than rational argument, is the best way to effect change in people's behavior." 

Affecting behavior through desire rather than through rational argument leads to  interesting methods of advocacy. For example, such an approach must necessarily be multifaceted. More than just disseminating information, it must also use techniques that will make information attractive. Almost like an ad-campaign, it must generate desire and ideas of what is indispensable.

The Handwashing Campaign incorporates this multifaceted approach. It uses mass media as well as direct contact as means of promoting its message. It creates art, in the form of wall paintings. Its written and activity-oriented support material engages with children, teaching them to assess problems, identify causes and effects, and make informed choices in the use of water. Other support material helps teachers and health workers demystify current practices related to sanitation and come up with creative solutions to promote sanitation.

A partnerships framework is the third prong in the campaign's approach. This framework believes that for change to be long lasting, communities themselves must be involved and enmeshed in promoting that change. It is only when communities have a stake in the success of an idea that they will work towards it. According to Chandra Ganapati, Human Resources Manager for WaterAid India, WaterAid works directly with community groups, often using the framework of partnership. In this project too, if the initiative is to be successful, communities must themselves feel responsible for its success. WaterAid hopes to create such  a sense in the communities, and to ensure the participation of the government and industries in the initiative.

Whatever the approach, the Handwashing Campaign is important. It will contribute significantly to the Millennium Development Goals, the Swajaldhara campaign (rural drinking water supply program based on community participation) and the Total Sanitation Campaign. Most importantly, it will improve standards of living, and reduce incidence of disease and child mortality. This campaign is a simple, yet essential, step in achieving clean and safe living environments.