Delivered by Pamela Crane-Hoover, this presentation introduces Lifewater's "Missional WASH" (mWASH) curriculum, which the organization will be using in its international water, sanitation, and hygiene programs.

1. mWASH Curriculum:
Hygiene Tools
ACCORD WASH Summit
Pamela Crane-Hoover
November 2014

2. 3
• Foundation of our programs
• Foundation of lasting change
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Behavior Change

3. 4
• Understand new tools for hygiene behavior
change available for integration into your
programs.
• mWASH
• WASH in Schools
• Facilitation Guide
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Goal

4. 5
• Enabling self-discovery
• Building knowledge – attitude – practice
• Facilitation not teaching
• Time
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Principles

5. 6Lifewater.org
mWASH

6. 7
• PHAST
• ToT models
• CLTS(H)
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Common Methods

7. 8
• missional WASH: bringing transformational
development concepts and the church to WASH
behavior change
• Curriculum: tool for program use – to teach your
staff & to use in the field
• Region: All
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mWASH

8. 9
• Community triggering
• Foundations in CLTS
• Total sustained change
• ToT / PHAST
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mWASH: Program goals

9. 10
• Foundations of mWASH
• WASH 101
• Framework for Change
• Program Application
• Appendix
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mWASH: 4 main sections

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• Transformational development
• Key community development principles
• Inclusion
• Intro mWASH
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mWASH:
Foundations of mWASH

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• WASH-related disease transmission
• Dehydration
• Sanitation ladder
• Types of sanitation
• Cleaning latrines
• Handwashing at critical times
• Safe & unsafe water sources
• Making water safe
• Keeping water safe
• Keeping food & utensils clean
• Environmental hygiene
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mWASH:
WASH 101

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• WASH-related disease transmission
• Dehydration
• Sanitation ladder
• Types of sanitation
• Cleaning latrines
• Handwashing at critical times
• Safe & unsafe water sources
• Making water safe
• Keeping water safe
• Keeping food & utensils clean
• Environmental hygiene
Lifewater.org
mWASH:
WASH 101

13. Lesson 2.1 WASH-Related Disease Transmission
Lesson 2.1: WASH-Related Disease Transmission
Notes:
Purpose of Lesson:
· To learn that handwashing with soap reduces rates of diarrhea
Objectives:
· Discuss how washing your hands can stop the spread of diarrhea between people
Materials:
· Poster Set: “Disease Transmission”
· Poster Set: “Transmission Stories”
· Poster Set: “ Disease Blocking”
· String or branches for showing the transmission pathways
· Cloth for covering up diarrhea pathways diagram
· Optional: Flip Chart and markers
Preparation:
1. Determine what the local terms for “diarrhea”, “feces” and “microbes” are
2. Get statistics for the country you are in on the number of children under 5 that die every year from
diarrhea. Also get statistics on the number of lives that can be saved through handwashing. You will
use this in lesson 5
3. Determine which optional activity to use in the lesson
4. If doing the Drama Activity: Choose two women to demonstrate how diarrhea can be passed from
one person to another in a community
5. Collect needed poster sets and materials
Time: 60 minutes

14. mWASH Manual
WASH 101
Lesson 2.1 WASH-Related Disease Transmission
Background
· Diarrhea kills around 1.8 million people worldwide every year.
· Microbes are tiny germs found inside feces that can cause diarrhea and sickness if they get into
someone’s mouth.
· All feces, even animal feces, contain microbes that will cause sickness.
· Microbes that cause diarrhea can enter someone’s mouth by traveling on our hands, on flies, on
food, on animals, or in water.
· You can stop the spread of diarrhea sickness by washing your hands with soap and boiling water.
· Handwashing with soap is one of the easiest and most effective ways to block the spread of
diarrhea.
1. How Diarrhea is Spread: 20 minutes
Introduction Learning Questions:
· What do people in the community believe about what causes disease?
Use the “Disease Transmission” poster set to show how the sickness of diarrhea is spread. Lay the feces
and the mouth posters about two meters apart on the ground. Arrange the rest of the posters in the order
that is shown in the reference picture. Use strings or sticks to show the pathways from the feces poster to

15. Background
· Diarrhea kills around 1.8 million people worldwide every year.
· Microbes are tiny germs found inside feces that can cause diarrhea and sickness if they get into
someone’s mouth.
· All feces, even animal feces, contain microbes that will cause sickness.
· Microbes that cause diarrhea can enter someone’s mouth by traveling on our hands, on flies, on
food, on animals, or in water.
· You can stop the spread of diarrhea sickness by washing your hands with soap and boiling water.
· Handwashing with soap is one of the easiest and most effective ways to block the spread of
diarrhea.
1. How Diarrhea is Spread: 20 minutes
Introduction Learning Questions:
· What do people in the community believe about what causes disease?
Use the “Disease Transmission” poster set to show how the sickness of diarrhea is spread. Lay the feces
and the mouth posters about two meters apart on the ground. Arrange the rest of the posters in the order
that is shown in the reference picture. Use strings or sticks to show the pathways from the feces poster to
the mouth poster that microbes could travel to make someone sick. Show the participants one pathway that
microbes can travel. Let the participants complete the rest of the pathways.
Activity Questions:
· What are ways microbes can move from place to place?
· Does where you defecate matter in spreading microbes?
· Are there any places where people openly defecate in your community?
· How might the feces in this area be spread to people?
Discussion Questions:
· What are some ways that diarrhea affects you and your community?

19. food, on animals, or in water.
· You can stop the spread of diarrhea sickness by washing your hands with soap and boiling water.
· Handwashing with soap is one of the easiest and most effective ways to block the spread of
diarrhea.
1. How Diarrhea is Spread: 20 minutes
Introduction Learning Questions:
· What do people in the community believe about what causes disease?
Use the “Disease Transmission” poster set to show how the sickness of diarrhea is spread. Lay the feces
and the mouth posters about two meters apart on the ground. Arrange the rest of the posters in the order
that is shown in the reference picture. Use strings or sticks to show the pathways from the feces poster to
the mouth poster that microbes could travel to make someone sick. Show the participants one pathway that
microbes can travel. Let the participants complete the rest of the pathways.
Activity Questions:
· What are ways microbes can move from place to place?
· Does where you defecate matter in spreading microbes?
· Are there any places where people openly defecate in your community?
· How might the feces in this area be spread to people?
Discussion Questions:
· What are some ways that diarrhea affects you and your community?
· Where are the microbes that cause diarrhea found?
· What are some pathways that microbes can take to make you sick?
2. Optional Activity: Drama about the spread of Diarrhea: 5 minutes
Actors perform a drama about how the sickness of diarrhea can be passed along in the community.

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5
· What are some ways that diarrhea affects you and your community?
· Where are the microbes that cause diarrhea found?
· What are some pathways that microbes can take to make you sick?
2. Optional Activity: Drama about the spread of Diarrhea: 5 minutes
Actors perform a drama about how the sickness of diarrhea can be passed along in the community.
Activity Questions:
· What was happening in the drama?
· What were some of the ways the sickness got passed along?
· Does this happen in your community?
· In what ways does this happen here?
3. Optional Activity: Create a Story About How Diarrhea is Spread: 20 minutes
In this activity, participants will create a story about how microbes in feces can spread from one person to
another. Break participants up into groups of 4-5. Give each group a different story (A, B and C) from the
“Transmission Stories” poster set. Give groups a few minutes to create their stories and then ask them to
share their stories with the group.
mWASH Manual
WASH 101
Lesson 2.1 WASH-Related Disease Transmission
Activity Questions:
· Out of the stories that were shared, which ways does diarrhea spread in your home most
often?
· How does this affect your family?
4. Ways to Stop the Spread of Diarrhea: 20 minutes
Use the “Disease Blocking” poster set and the “Disease Transmission” poster set used in lesson one to
show how the sickness of diarrhea can be stopped from spreading. Make sure that the “Disease

21. Latrine Use Drama…

22. Activity Questions:
· Out of the stories that were shared, which ways does diarrhea spread in your home most
often?
· How does this affect your family?
4. Ways to Stop the Spread of Diarrhea: 20 minutes
Use the “Disease Blocking” poster set and the “Disease Transmission” poster set used in lesson one to
show how the sickness of diarrhea can be stopped from spreading. Make sure that the “Disease
Transmission” poster set is arranged correctly on the ground and connected by sticks or strings to show
how microbes are spread. By placing the posters from the “Disease Blocking” poster set on the pathways,
you can show how the spread of sickness can be stopped. Use the picture of a girl boiling water to
demonstrate. Place this picture between the river and the mouth to show that boiling water can prevent
microbes in the water from entering someone’s mouth. Hand out the rest of the posters to the participants
and let them complete blocking the pathways.
Activity Questions:
· Can someone describe how each picture blocks the spread of sickness?
· What ways can you help to block the spread of sickness in your home?
Discussion Questions:
· How can picking one place to defecate, like in a latrine, help to block the spread of
microbes?
· How can you stop animals from spreading microbes?
· How can you make sure no microbes get on your food?
5. How Handwashing Can Prevent the Spread of Disease: 15 minutes
Still using the “Disease Transmission” poster set this is arranged on the ground, show how handwashing can
prevent the spread of disease. Share the statistic that you prepared about the number of lives that can be

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6
Have 10-20 of the participants stand in the middle of the circle to represent the number of deaths from
diarrhea. Have half of the participants remain standing. Direct the other half to pretend to wash their hands
with soap while they go to sit down. The people still standing are those that die each year from diarrhea.
Discussion Questions:
· Why is handwashing with soap important?
· Were you surprised by any of the things you learned?
· How can you stop the spread of diarrhea in your community?
6. How Handwashing Effects Others: 5 minutes
Use the Bible verse below to explain how handwashing can affect others in your community. Either read the
Bible verse out loud or write it on a large poster or flipchart.
“Love your neighbor as yourself. Love does no harm to its neighbor.”
Romans 13:0-10 (NIV-1984)
mWASH Man
WASH 1
Lesson 2.1 WASH-Related Disease Transmiss
Discussion Questions:
· What do you hear in this verse?
· What have you seen that can bring harm to us or to others?
· How can you protect yourself and your neighbors from diarrhea?

24. 25
• WASH-related disease transmission
• Dehydration
• Sanitation ladder
• Types of sanitation
• Cleaning latrines
• Handwashing at critical times
• Safe & unsafe water sources
• Making water safe
• Keeping water safe
• Keeping food & utensils clean
• Environmental hygiene
Lifewater.org
mWASH:
WASH 101

25. 26Lifewater.org
Tippy Taps

26. 6 Steps to Handwashing…

27. Wash Your Hands…

28. 29
• Foundations of mWASH
• WASH 101
• Framework for Change
• Program Application
• Appendix
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mWASH: 4 main sections

29. 30
• Understanding
transformation:
• K – A – P
• Introduction to
community triggering &
total sustained change
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mWASH:
Framework for Change

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• Community triggering:
• Pre-triggering stage
• Triggering stage
• Ignition moment
• Post-triggering stage
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mWASH:
Framework for Change

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• Total sustained change
• Contextualization:
• Communication methods
• Learning tools
• Attitudes
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mWASH:
Framework for Change

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• Strengthening discussion questions to improve
the quality of WASH program using information
and strategies learned in the mWASH course.
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mWASH:
Program Application

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WASH in Schools

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• Primary school teachers and students
• Classrooms, WASH in Schools
• Theme: Steps to better health
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WASH in Schools

35. · Microbes are tiny germs found inside feces that can cause diarrhea and sickness if they get into
someone’s mouth.
· All feces, even animal feces, contain microbes that will cause sickness.
· Microbes that cause diarrhea can enter someone’s mouth by traveling on our hands, on flies, on
food, on animals, or in water.
· You can stop the spread of diarrhea sickness by washing your hands with soap and boiling water.
· Handwashing with soap is one of the easiest and most effective ways to block the spread of
diarrhea.
1. How Diarrhea is Spread: 20 minutes
Introduction Learning Questions:
· What do people in the community believe about what causes disease?
Use the “Disease Transmission” poster set to show how the sickness of diarrhea is spread. Lay the feces
and the mouth posters about two meters apart on the ground. Arrange the rest of the posters in the order
that is shown in the reference picture. Use strings or sticks to show the pathways from the feces poster to
the mouth poster that microbes could travel to make someone sick. Show the participants one pathway that
microbes can travel. Let the participants complete the rest of the pathways.
Activity Questions:
· What are ways microbes can move from place to place?
· Does where you defecate matter in spreading microbes?
· Are there any places where people openly defecate in your community?
· How might the feces in this area be spread to people?
Discussion Questions:
· What are some ways that diarrhea affects you and your community?
· Where are the microbes that cause diarrhea found?
water and other places but often live in other organisms. They can only be seen with a microscope.
· Viruses are even smaller than bacteria and cannot be seen with normal microscopes. Although they
can survive many places, they can only reproduce and grow inside another organism. HIV is an
example of a virus.
· Protozoa are one-celled organisms that are larger than bacteria. They act like little animals and may
seek out other microbes as food, so they are considered more complex than bacteria or viruses.
They live in other organisms but may also be found in other places such as soil, water, and insects.
Malaria is caused by a kind of protozoa that is carried by mosquitoes.
· Worms/ Helminths that cause disease can be very small or large. The worms or their eggs can enter
the body many different ways, including drinking water or through the skin. Examples include
tapeworms or hookworms.
· Parasites also cause disease. A parasite is an organism that lives on or in another organism. The
parasite gets its food from the other organism. Bacteria and viruses may sometimes be called para-
sites, but usually they are not included in this category. Protozoa and worms are often called
parasites.
· Not all microbes and parasites cause disease. However, the main focus for this curriculum will be
organisms that cause water-related diseases and are often found in feces.
1. Introduce
Say the first 2 Steps together with hand motions.
Share Step 3 with students: Stop the spread of disease! Create an action to go with the Step.
Lead a short discussion about how it feels to be sick.
Introduction Learning Questions:
· What are some ways we become sick?
· How do we feel when we are sick?
· What happens when we are sick?
· What are some of the consequences of being sick?
2. Add Information
mWASH vs. WASH in Schools

36. food, on animals, or in water.
· You can stop the spread of diarrhea sickness by washing your hands with soap and boiling water.
· Handwashing with soap is one of the easiest and most effective ways to block the spread of
diarrhea.
1. How Diarrhea is Spread: 20 minutes
Introduction Learning Questions:
· What do people in the community believe about what causes disease?
Use the “Disease Transmission” poster set to show how the sickness of diarrhea is spread. Lay the feces
and the mouth posters about two meters apart on the ground. Arrange the rest of the posters in the order
that is shown in the reference picture. Use strings or sticks to show the pathways from the feces poster to
the mouth poster that microbes could travel to make someone sick. Show the participants one pathway that
microbes can travel. Let the participants complete the rest of the pathways.
Activity Questions:
· What are ways microbes can move from place to place?
· Does where you defecate matter in spreading microbes?
· Are there any places where people openly defecate in your community?
· How might the feces in this area be spread to people?
Discussion Questions:
· What are some ways that diarrhea affects you and your community?
· Where are the microbes that cause diarrhea found?
· What are some pathways that microbes can take to make you sick?
2. Optional Activity: Drama about the spread of Diarrhea: 5 minutes
Actors perform a drama about how the sickness of diarrhea can be passed along in the community.
mWASH vs. WASH in Schools
Step 3a
Stop the Spread of Disease!!
Draw pictures of microbes where they can be seen by the class. Students can copy these in exercise books
if available.
Discussion Question:
· How do you think these little tiny microbes can get in our stomachs to make us sick?
3. Apply
Use posters for lesson 3 to tell a story of one way microbes can make people sick. When finished, ask a
student to retell the story to the class.
One by one, show the other posters from this lesson to the class. Ask the following question for each:
· How can poop travel from (poster) to our mouths?!
4. Optional Activity: Younger Students
Let students work together to tell a story for each picture group.

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Facilitator Guide

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Lecturing Facilitation
Starts with his / her own knowledge Starts with the group’s knowledge
Presents new information Addresses issues & ideas identified by the
group
Presents to / in front of Sits in circle or to a side, uses
participatory methods
Concerned with right answers Draws out and builds on group
knowledge, values different points of view
Formal relationship with students Considered an equal, relationships based
on trust and desire to serve
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Facilitation – Counter Cultural

39. 40Lifewater.org