Battling Ebola, It’s the Little Things That Count

New campaigns on the importance of hand washing are helping stem the spread of the disease in West Africa.

Liberian lawmaker Eugene Fallah Kpakar washes his hands before entering the Capitol Building in Monrovia on Oct. 9, 2014. (Photo: James Giahyue/Reuters)

Nov 12, 2014· 4 MIN READ
TakePart fellow Jessica Dollin studied journalism at the University of Arizona. She has written for the Phoenix New Times and HerCampus.
John R. Platt covers the environment, wildlife, and technology and for TakePart, Scientific American, Audubon, and other publications.

“Ebola is real. Wash your hands,” read signs that have been popping up around West Africa, according to residents. It’s a simple and critically important directive in the region, because while hand washing is the first line of defense against the deadly virus, it’s not a widespread practice. That’s starting to change, thanks in part to initiatives undertaken by a U.S.-based soap company, a Liberian animal welfare group, and an NGO previously focused almost exclusively on conflict resolution in Sierra Leone.

Even in the U.S., only 5 percent of people observed for a study washed their hands correctly after using the bathroom, according to researchers at Michigan State University. In Sierra Leone, effective hand washing is also not the norm, and communal-living practices exacerbate problems caused by poor sanitation.

“When we eat together, we often wash our hands before and after eating, without soap and in the same bowl,” said John Caulkner, regional director of Fambul Tok International, the group that has joined the fight against Ebola in Sierra Leone. “The same thing happens when we go to the toilet, where in the absence of a tap, water is provided in a kettle and also without soap for everyone’s use.”

Because Ebola spreads through contact with a patient’s body fluids or contaminated materials, Fambul Tok, with the help of the U.S. embassy, has launched a campaign in Sierra Leone to improve sanitation through hand washing. It includes radio programs, advertisements, community mobilization, and the distribution of soap, T-shirts, and posters.

SoapBox Soaps, a U.S. company working to spread healthful sanitation practices with a one-for-one model (think Toms shoes for soap), is donating its product through Caulkner’s group. Since 2012, SoapBox has given away a bar of soap, a month’s water supply, or a year’s supply of vitamins to someone in need every time a bar is purchased. The company has mostly donated on the domestic front to homeless shelters and soup kitchens but has recently begun providing medical supplies and aid abroad in partnership with DirectRelief, a medical relief organization based outside Santa Barbara.

“This is where access, education, and increasing supply really come into play,” said SoapBox CEO and cofounder David Simnick. “We want to empower and enable our customers through the most commoditized product.”

With 9,301 bars and 1,255 bottles of soap committed to the fight against Ebola in the next 45 days, SoapBox has its hands full.

Meanwhile, the Liberia Animal Welfare and Conservation Society has also become an unlikely partner in the fight against Ebola. For the past 10 years, LAWCS volunteers have traveled to villages throughout the country to teach people how to avoid dog bites and about the danger of rabies. In September, they added a new element to their presentations: how to stay safe from Ebola.

Pupils wash their hands at Anono school in Abidjan,
Ivory Coast, September 25, 2014. (Photo: Luc Gnago/Reuters)

Every few days, teams of two volunteers set out on motorbikes from their headquarters in Voinjama City, Liberia, carrying buckets, soap, chlorine, and educational materials about Ebola and proper hand washing. Bulor Town, a village of about 5,000 that doesn’t appear on many maps, was a recent destination. It’s in the middle of forest and far from any main roads. The motorbikes only get the volunteers so far.

“The roads leading to most of these villages are so deplorable that the teams have to walk or use locally made canoes to reach the people,” said Joseph S. Nyumah, spokesman for LAWCS and the supervisor for what has come to be known as Operation Hand Wash.

These “canoes” are more like rafts strung together from branches and small trees. Getting to another village, Wozowilie Jallah, required crossing a structure called Monkey Bridge. When Nyumah’s colleagues reached the bridge, it was little more than a few trees laid out across the river.

Like many villages in Liberia, Bulor Town lacks running water, and its residents survive on subsistence farming, earning about $1 a day. The surrounding Loma County is one of the areas hardest hit by the disease, but because cars and trucks can’t reach Bulor Town, no one from the Liberian government visited the villagers to warn them about the dangers of Ebola and how to protect themselves.

The buckets that LAWCS volunteers bring cost $10 each. The chlorine costs $3. Soap is 45 cents. But even that is beyond what most of the people in these remote villages can afford. The supplies are purchased with online donations coordinated by the U.S.-based organization Doggone Safe. To date, a little more than $2,200 has been raised.

LAWCS hopes to raise $10,000, which will help it to buy another motorbike, gasoline, food for volunteers, and enough disinfectant supplies to help it reach more people and more villages.

LAWCS volunteers are the only people who have reached out to many of these villages, though villagers had heard the disease was ravaging Liberians.

“At first, some communities were refusing groups from entering their towns,” Nyumah said. The volunteers were scared of what they might encounter. “We are always afraid of the virus, but we don’t show our fear so that the people [don’t become] too afraid,” he said.

The hygiene campaigns in Sierra Leone seem to be paying off—Caulkner said community members he’s spoken to are noticing a change.

LAWCS is also seeing results from its volunteers’ visits to more than 30 villages. In each, buckets, soap, and chlorine are left where they can be used by as many people as possible. Volunteers return as often as once a week to check on villagers’ health, conduct more awareness sessions, and check on the hand-washing facilities. Each village designates a community member to serve as a point of communication, and that person receives a mobile calling card to reach the organization if it is suspected that someone has contracted Ebola.

So far, so good, Nyumah reported: “All of the villages we are working in are yet safe. There have been no suspected cases.”

Are you washing your hands properly? Here are top tips, according to The Global Public-Private Partnership for Handwashing:

  • Wet hands with warm water, lather with soap for 20 seconds, rinse with running water, and dry.

  • The water should be disposed of when not using a sink with a working drain.

  • Hand sanitizer is most effective when a palmful is applied to the entire hand. The World Health Organization recommends rubbing the solution in for 20 to 30 seconds; hands are only fully sanitized once they are dry.