The provision of potable water alone does not significantly reduce the incidence of diarrhea. Yet if potable water is part of an integrated system with commitment by national and local officials and includes improved sanitation and hygiene education, substantial reductions in diarrhea do occur. Hygiene education should be based in existing community ideology, values, religion, and myth to change behavior and involve traditional leaders. Another benefit of projects is that women have more time to spend on other important activities, such as income generation. Since decisions revolving around water use are the responsibility of women in developing countries, their involvement in water supply and sanitation projects is crucial. They should take part in disseminating information and in managing water systems. They should also attend workshops on water and sanitation. For example, a study in Togo showed that the children of women who had participated in water projects were more likely to have complete immunization coverage and the women knew more about oral rehydration than those not involved. Nevertheless the health benefits of a water and sanitation project do not last if sustainability is not built into the project. For instance, water and sanitation specialists need to train community members to be responsible and manage improved water systems. In Yenmen, specialists introduced a water and sanitation project to the government as a project serving the entire community since anything focusing on women invites the evil eye. Most health workers, sanitarians, and engineers who had the experience and knowledge to teach women were men, so the project enlisted the women of the women's extension service of the Ministry of Agriculture to teach the women. These Arab women were excellent role models for behavioral change.
In a Literacy, Population, and Family Planning Education workshop held in New Delhi in 1970, Asian development and communication planners acknowledged the potential of puppetry as a method of education and social development. In 1975, the National Media Center (NMPC) created its Nutrition Communication Office (NCO) to disperse information for the Philippine Nutrition Programme. The medium of puppetry was employed because of its low cost and popularity. The NCO understood its goals of promoting good nutritional habits and beliefs among children and met these goals by testing the feasibility of puppet theater, running training workshops for interested individuals and groups, and by continuing to evaluate and review programs and reactions. In the past 11 years, the National Media Production Center has grown to develop programs on population, agriculture, values, the role of rural women and good health habits. Evaluation and review of the success of puppet theater programs has shown that a very high percentage of children understand the messages of the shows and approve of this method of instruction and entertainment.
The Board of Science and Technology for International Development's Rapid Epidemiologic Assessment (BOSTID REA) program began in 1982. Prompted by a recommendation by the Advisory Committee on Health Biomedical Research and Development, the plan was to establish an organization devoted to better health care in developing countries. One of the prime objectives of the REA program is to provide a fast, inexpensive yet reliable method of data assimilation that would lead to improved health care. 3 of the broad tasks of the program are to perform small sample surveys and experiment with sampling methods, and to control methods and assess risks. The survey and sampling method task is designed to develop better ways to cut health care costs and avoid delays in information analysis; whereas the case control task of the REA program seeks to determine the risk of disease by expedient and inexpensive means. The 3d task of the program identifies the specifics of risks relating to a sub-group or region and surveys the health status of an identified community by either reissuing surveys on a periodic basis or by monitoring changes in the general health of the area. The REA program illustrates the idea that organizations are ready to seek innovative approaches to costly and inefficient health care situations.
A method of understanding the problems and situations of the illiterate and encouraging their expression of thought is through the medium of art. In a group setting individual artwork allows everyone the opportunity to communicate his thoughts; no single personality dominates or retreats as often happens in group discussions. The finished artwork allows each participant the chance to portray his feelings and thoughts with no interruptions or judgement. Another alternative method of learning is popular theater. The subject matter of popular theater is often political and can provide new perspectives on controversial issues such as a strike. It is defined as a medium for the communication of the people a means of rebuffing the propaganda of powerful controlling groups a method of identifying reality on a smaller scale and identifying personal hopes and aspirations and as a method of recounting ones history and culture. Popular theater also provides a way for acting out possible actions and changes and analyzing results. The authors experience with these methods in Bangladesh and Canada has met with success; however women have played a minor role in this alternative form of communication and need to be encouraged to become directly involved.
