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Improving Youth Hygiene, with Comic Books for Students, by Students

For Jennifer and Matthew, sixth-year students at Opah Municipal Assembly Primary School in Ghana’s Greater Accra Region, learning lessons on hygiene and sanitation is now as easy as reading a comic book. In May their school received the comic book, Who Will Go For The Ball?, a full-color comic book on sanitation and hygiene education. Across five regions, the USAID-supported Ghana WASH Project is using a new approach – comic books – to share sanitation and hygiene messaging with youth. Importantly, the book’s storyline is informed by students’ own daily experiences and stories.

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Students read WASH education comic books at Opa Primary School, Ga West, Accra, Ghana.

Students read WASH education comic books at Opa Primary School, Ga West, Accra, Ghana.

The concept for the comic book emerged out of a series of WASH education workshops held at a cluster of schools on the other side of the Greater Accra Region, in an area known as Ledzukuku Krowor Municipal Assembly (LEKMA). For many of the schoolchildren at LEKMA, lack of access to improved water and sanitation facilities at home, school and in their community is a challenging daily experience. According to the Municipal Assembly, households and communities are regularly confronted by water problems, while a small proportion of households have domestic toilets and public toilets are insufficient in number and poorly maintained. As well, misunderstandings about sanitation and hygiene are common.

In 2011, the Ghana WASH Project targeted LEKMA’s schools for educational workshops on water, sanitation and hygiene issues. In focusing first on with these young people, the project aimed to jumpstart a ripple effect of behavior change; the change would begin with these students, who could in turn educate those around them.


Learning Proper Hygiene through WASH Education Workshops

Over several months, the Ghana WASH Project worked with a group of local organizations to carry out WASH education workshops at LEKMA schools. Each workshop included three main elements: a session on proper toilet usage and hand washing, an explanation of the sanitation and water facilities the school would be receiving through the Ghana WASH Project, and a creative writing session for the students.

In the first session, Hugh Sydney Kobla Quist, a sanitation advocate who with a local Saturday morning radio program on sanitation and hygiene, lead students in a session on proper toilet usage and hand washing, focused on proper sanitation techniques. Sherrie Thompson of Solutions Africa led the second session on the benefits of the institutional latrines, rainwater harvesting and MamaLoo biogas facility and how it would benefit the students, as well as explaining how the technologies were integrated.

Each workshop began with an introductory discussion of the young LEKMA students’ current practices, in order to encourage the young people to become comfortable talking about their own behaviors and perceptions about open defecation.

“Our approach was to help them to understand that hygienic evacuation is a natural process – they don’t need to feel ashamed or fearful of it when they have a proper place in which to do it,” Ms. Thompson said. The students discussed the locations where they would go to relieve themselves, highlighting the few appropriate places in which to do so. Many said that because they lacked toilets in their own houses or only had access to poorly maintained public toilets in their communities, they relieved themselves in gutters and at the beach.

The workshop facilitators guided the students in thinking through the consequences of their actions for their environment and their communities. At the outset of one workshop, a young male student was proud about his regular practice of relieving himself at the beach, because he thought that the sea would wash everything away when the waves washed along the shore. However, he learned about the community impact – that fish would eat that waste and then he and others in the community would in turn consume those fish – he immediately became disgusted by the idea of consuming fish that had eaten human feces or urine, and he quickly changed his attitude.

“When we explained to them the chain of events and results and consequences [of their behavior], they better understood their role,” Ms. Thompson said.

In the final session, the facilitators and teachers guided the students as they wrote their own sanitation stories in small groups, describing their experiences relieving themselves in the bush, and incorporating the lessons they learned from the workshop session. The facilitators used the stories as a basis for the creation of the comic book, titled Who Will Go for the Ball?, with the aim of passing on the positive messaging that these students had received.

Creating Comics as a Tool for Youth Education

The opening scene of the comic book opens in the final minutes of a competitive football game between two schools: Kokro School and Nyansa School. A Nyansa player blasts a kick of the ball, launching it so far it lands in the D-zone (defecation zone), the “dirty and smelly place” where pupils of the home school go to toilet.

“Who will go for the ball?” a player asks. Ato, a Nyansa player ignorant about the area and focused on the goal, chases the ball in the D-zone, where he slips and falls.

The incident shames the Kokro student and prompts them to action: The school sets up a new school toilet and forms a watchdog group to stop open defecation in the D-zone; soon, the zone has been transformed from a no-go area into a green zone. When the two teams meet again a few months later, Ato and his teammates are impressed to see the clean area, complete with a new toilet and hand washing facilities: “This time he was not picking his steps and not being told to watch out. He used a proper toilet facility,” the book describes.

Ato’s story is based on the personal experiences of the LEKMA students, who told stories about the negative impacts and results from open defecation and the impropriety of lack of hand washing. Their stories not only serve as evidence of the challenges they face, but also cautionary tales that can persuade and encourage their peers to adopt positive practices.

The book also features Patu’s Tips for Proper Pooping, a colorful, step-by-step guide where Patu, a white bird sporting a cap and shirt made of Ghanaian kente cloth, shows how to properly relieve oneself, wipe one’s bottom and wash one’s hands after using the bathroom. The instructions, which stress washing one’s hands with soap under running water, are in line with the project’s WASH objectives to encourage behavior and techniques for proper hygiene. PATU, which stands for “Pay Attention To Us,” has been used in a number of other educational campaigns in Ghana over the past few years.


Passing On the Lessons

LEKMA South students benefitted through the educational workshops. They were armed with knowledge to enable them to be change makers in their own communities.  Ama, a female student at LEKMA, described how she has informed her siblings, friends and neighbors about what she has learned, especially hand washing and proper hygiene. She and her classmates demonstrated the step-by-step techniques of hand washing that they learned in the workshop, and she said that they are putting their new knowledge to use.

“I’m teaching others,” she said. “It is important to wash your hands before eating and after going to the toilet, so you don’t become sick.”

Across Ghana, more students are benefitting from this knowledge, by reading the comic books that the young LEKMA students helped devise.

For Jennifer and Matthew, sixth-year students at Opah Municipal Assembly Primary School, young Ato and colorful Patu are lively characters who have made proper hygiene educational and entertaining. Through Ato’s experience, the youngsters say they see and identify the connections between poor hygiene, poor sanitation and the everyday consequences.

“When Ato fell down, they learned a lesson,” said Matthew, “and he made them to clean the dirty place. They learned from Ato’s experience, Matthew continued. “They shouldn’t put rubbish where it’s not supposed to go.”

Their teacher, Ms. Ellen Kumi Asante, who also leads the School Health Education Program (SHEP) activities at the school, said the students have been receptive to the new materials. The children relate to the story, and its events have prompted discussions on open defecation and how the students can address it in their own communities, she commented.


For Jennifer, a shy student who dreams of becoming a doctor, PATU is a personal favorite. She learned new things, she said, which she tries to pass on to those around her.

Passing on these lessons is not always easy. When they see their classmates and peers defecating in open areas, Matthew and Jennifer said they counsel them not to. “We tell them they shouldn’t do that,” Matthew said.

“But If you tell them not to, they insult you,” Jennifer added in. “They say, ‘our grandfathers used to defecate there and it didn’t harm them, so if we do it, it wouldn’t bring harm to us.” But it does, Jennifer continues, highlighting her lessons from SHEP activities and the comic book: “Houseflies can settle there, and when they settle on your food, you can become sick.”

Matthew, who intends to become a banker when he gets older, explained the lessons he’s taking away from the comic books.


Working Together to Influence Youth

These activities—the WASH education workshops and comic book development—would not have been possible without the wide-ranging collaboration between the various NGO and private-sector partners, including Zingaro Productions, Solutions Africa and Curious Minds, who lead the workshops, and The Coca-Cola Foundation, a funding partner.

Ate Ofosu-Amaah, Public-Private Partnership Coordinator for the Ghana WASH Project, highlighted the key role of collaboration to foster this intervention at the LEKMA schools: “For me, it is a unique experience seeing two donors in USAID and Coca Cola, whose corporate objectives and categories of implementation may not be similar, but work to achieve a common goal.”

Through these partnerships, and through the stories of students, the Ghana WASH Project is able to have an education, and sustainable impact in the lives of countless youth.

Read the comic book Who Will Go for the Ball? [PDF Document]


Updated July 2012