Handwashing in Honduras
Marissa Brown & Riley Murphy
INTRODUCTION
Honduras is a developing country located
in Central America bordering countries such
as Guatemala, El Salvador, and Nicaragua.
Residents of this country face many hardships
such as poverty, crime, and lack of resources.
Honduras also has the highest rate of crime in http://www.apparelsearch.com/world_clothing_industry/
honduras/honduras_map.htm
the world with approximately 59 murders per 100 000 residents (World
Bank, 2017). As of 2016, approximately 66% of the Honduran population
live in poverty with some making only $1.90 USD per day (World Bank,
2017). This has potential impacts on the access to basic necessities for
those in very impoverished areas. For example, more than 1 million people
living in Honduras lack access to proper water sanitation and about 638
000 lack access to safe water (Water.org, 2018). Government funded
education in the country is offered up to the 6th grade and further education
is available only to those who can afford it. According to the Central
American Refugee Health Profile published by the Center for Disease
Control (CDC), there are approximately 0.37 physicians per 1 000
population which is “likely insufficient to achieve adequate coverage for
primary healthcare needs” (Center for Disease Control, 2017).
Due to the minimal access to clean water and health care services, the
need for further education focusing specifically on when to and why
handwashing is important was evident. This deficit in knowledge led to the
development of a short presentation as well as implementation of
handwashing stations (Veronica buckets) in two communities. After
extensive research and discussion, a short 40 minute presentation was
produced ensuring that those with a 6th grade education would be able to
understand. The presentation included a brief overview of the proper
handwashing process, background information about where germs come
from, as well as discussion about when to hand wash as well as the
importance of doing so. Overall, the purpose of the project is to bring new
knowledge that can potentially improve the health of the population and
well as implement a sustainable solution to increase the incidence of hand
washing for the populations of several small Honduran communities.
SITE OF IMPLEMENTATION
• Presentations were given at
Programa de Rehabilitación de
Parálisis Cerebral (PREPACE)
located in El Hatillo, a community
part of Tegucigalpa, the capital of
Honduras, as well as two rural
schools in the district of Yoro
• Veronica bucket handwashing
stations were implemented at
http://www.emapsworld.com/honduras.html
PREPACE as well and one rural
school in Yoro.
TARGET POPULATIONS
The target populations of the projects were the children and caregivers
at PREPACE as well as the teachers and students at the rural schools in
Yoro. Information was also given to a nurse who runs a clinic in rural
community of El Siriano (part of the Yoro district). A challenge with
developing a project for this target population was that their level of
education was at maximum, at a 6th grade level.
RESEARCH POSTER PRESENTATION DESIGN © 2015
www.PosterPresentations.com
Trent/Fleming School of Nursing
https://www.crwflags.com/fotw/flags/hn.html
GOALS AND OBJECTIVES FUTURE DEVELOPMENTS
Project Goal 1: • As the hand washing stations at PREPACE were to be installed by the
To educate the caregivers at PREPACE in regard to when, how and why to effectively hand wash during our time spent at the orphanage. This can be construction company at a later date, the effectiveness was unable to be
measured through the glo-germ activity as well as a short verbal quiz testing comprehension of material. assessed. Students attending future brigades, specifically those who take
Objectives over this project, are encouraged to evaluate the implementation. This
would include assessing, frequency of use, accessibility of locations, as
• Facilitate a glo-germ activity to assess how well the caregivers can effectively remove the glo-germ through handwashing. well as how the individuals are using the stations and if they are being
• Educate the caregivers on when to hand wash in order to prevent the spread of germs and infection. used properly.
• Educate the caregivers regarding the importance of handwashing in order to prevent the spread of disease and infection, as well as ensure they know why their • As the implementation of the hand washing stations were a pilot project,
hands need to be washed. future students are encouraged to build more stations to be implemented
in many other communities across the country.
Project Goal 2: • Future students are also encouraged to evaluate the effectiveness of the
To educate about and implement 4 “Veronica Buckets” in various accessible locations around the orphanage in order to increase the access to and incidence of current design of the buckets as well a receive feedback from the
handwashing. The buckets will be implemented during our time at the orphanage and can be potentially evaluated by gathering data in future years about how often communities. If needed, a new design of the stations could be created to
the stations are being used as well as incidence of diarrheal disease related to improper handwashing. ensure effectiveness of the implementation and related education.
Objectives: • Future development of this project could include teaching community
members and leaders how to build and maintain the hand washing
• Implement the bucket stations in locations that are convenient and accessible.
stations to create a sustainable project.
• Education of the caregivers about how to use the stations while maintaining infection control measures.
• Students of future brigades are encouraged to investigate whether or not
• Education of the security guard about how to make and repair the stations. the knowledge from the presentations have been retained by the
populations who were presented to. Students are also encouraged to
identify other populations within the country that could benefit in the
METHODS future from the knowledge presented in this project.
• Conducted research regarding the effect of proper handwashing and the reduction of certain diseases in preparation for presentation development
• Created a presentation regarding when and how to hand wash at a grade six education level
ACKNOWLEDGEMENTS
• Conducted research on various types of portable handwashing stations in order to choose the best option for the target population. Out of the four options (Tippy • The project would not be made possible without the assistance from
Tap, Andy Handy, SpaTap, and Veronica buckets), Veronica buckets were chosen as they are grounded, unlike the other three stations that hang from a Horizon’s of Friendship in Cobourg in regards to funding for our
stand. Implementing a station that is hung was foreseen as an issue especially since one of the target populations were children with disabilities and their implementations, such as supplies.
caregivers.
• The project would not have been successful without the cooperation of
• Veronica buckets were invented by Veronica Bekoe, a Ghanaian Biological Scientist in her efforts to improve sanitation in Ghana between 1972 and the members of PREPACE, as well as the students, teachers, and health
2008 (Ghana Together, 2012). care staff in the rural communities of Yoro.
• Conducted a walking survey in country to assess current state of infrastructure, economy, public services, etc. • This project would not have possible without the assistance from David
• Presented handwashing presentation to the caregivers at PREPACE, the nurse at a rural clinic in Yoro, and to the children of a rural school in Yoro. “Glo-germ” Venegas the logistic coordinator for the brigade in Honduras.
was used as a visual learning tool. • This project would not have been successful without the guidance and
• The “glo-germ” simulated germs on hands and objects and were able to be seen when placed under assistance of Dr. Patti Tracey and Barbara Couper.
ultraviolet light. The product was used to demonstrate how germs can be transferred from hands to
other hands and objects. This was an essential component of the presentation as it helped to
explain that handwashing is important not only for personal health but also the health of others. http://wikieducator.org/Glo_Germ
• Built Veronica buckets with assistance from a construction company and created posters regarding when and how to hand wash that would be hung next to the
handwashing station.
• A prototype station was built prior to departure, a spigot was placed into the side of a 24L garbage can with a lid. The bucket was placed on a stand
and a smaller bucket was placed underneath to catch the run-off.
• In country, buckets were purchased with spigots already installed. With assistance from the construction company, large stands were built to hold the
https://www.northumberlandnews.com/northumberlandcounty-
topics/4360390-horizons-of-friendship-educational-tour-to-el-salvador/
https://hondurasgapyear.wordpress.com/2012/02/08/328/
bucket as well as the catching bucket at a reasonable height to be used by both children and adults.
• Implemented Veronica bucket hand washing stations in two different sites: PREPACE (3) and a rural school in Yoro (1). Upon arrival, we assessed the sites and
determined the best possible location/locations for the placement of the handwashing station to ensure accessibility and convenience. These locations were
REFERENCES
determined in collaboration with the administrators.
Centers for Disease Control and Prevention. (2017, January 25). Healthcare
Access and Conditions in Guatemala, Honduras, and El Salvador.
RESULTS Retrieved March 18, 2018, from
• Overall, the presentations went as planned and the audiences seemed engaged. It was important while https://www.cdc.gov/immigrantrefugeehealth/profiles/central-
presenting to ensure knowledge was being retained by asking recall questions and by watching body american/healthcare-diet/index.html
language.
• After presenting at PREPACE, one of the caregivers responded that she “did not know that one should Ghana Together. (2012). Health & Sanitation Projects. Retrieved March 18,
hand wash before putting on gloves and that she only hand washed after taking them off”. This was a 2018, from http://ghanatogether.org/HTML/Projects/Sanitation.html
good indication that the project was successful because one of the audience members admitted to
learning something new.
The World Bank. (2017, October 10). Honduras Overview. Retrieved March
• At PREPACE, the hand washing stations were to be installed at a later date after the group had moved
18, 2018, from
on to another community. This made it difficult to evaluate the implemented handwashing stations on
http://www.worldbank.org/en/country/honduras/overview
their effectiveness.
• At the rural school in Yoro, the use of the hand washing stations were explained to the students by a
translator who seemed to understand the not only how to use the stations but why there are important Water.org. (2018). Honduras Water Crisis - Clean Water in Honduras.
to be used. The figure (right) shows a little girl - who is even too young to attend the school – using Retrieved March 18, 2018, from https://water.org/our-
the handwashing station. This is a great representation of the success of the project as a young girl can impact/honduras/
use it without much instruction.