When COVID-19 began to spread in Kenya, Uganda, and Malawi, 50,000 volunteers stepped up to protect their communities from the virus. Beginning in May of 2020, these volunteers – known as promoters – became the backbone of our COVID-19 Prevention Hygiene Project, which provided soap, disinfectants, and hygiene education to over 16,500 rural communities in Sub-Saharan Africa.
Prior to the outbreak of COVID-19, promoters were part of our Dispensers for Safe Water program, which installs chlorine dispensers next to commonly-used water sources, enabling people in rural communities to treat their water and make it safe to drink. Promoters are in charge of educating community members on how to properly use the dispensers, as well as communicating with our team of “circuit riders”, who are responsible for ensuring dispensers are functioning and regularly stocked with chlorine. The promoters are selected by their peers in every village serviced by a dispenser. They are typically well-established members of their community who have spent most of their lives in the surrounding area, know their neighbors well, and are in good standing with the community at-large.
In March of 2020, when it became clear that COVID-19 was going to impact countries across the globe, we began working on an emergency response that could leverage our existing distribution network in rural Kenya, Uganda, and Malawi. Called the COVID-19 Prevention Hygiene Project, the objective of the initiative was to provide vital supplies to the communities we serve, allowing them to follow crucial preventive measures recommended by the World Health Organization: regular handwashing and the disinfecting of commonly touched surfaces. By leveraging our pre-existing network of volunteers, we were able to rapidly respond to the virus and successfully deliver essential supplies to even the most isolated communities.
Between March and July of 2020, we delivered over 924,000 liters of chlorine for treating drinking water; over 3 million kilograms of soap for handwashing; over 99,000 liters of disinfectant; and nearly 44,000 informational stickers to promote good hygiene practices. Promoters were an essential part of this last-mile supply network, taking on new roles to further support their communities. They began regularly disinfecting dispensers and other community infrastructure with chlorine to reduce the risk of spreading the virus, and also delivered multiple bars of soap to each household served by Dispensers for Safe Water.
Our deliveries were met with an outpouring of gratitude, as there was awareness that hygiene is key to preventing COVID-19, but many community members were unable to afford soap or disinfectant. However, providing soap and safe water wasn’t sufficient – individuals also needed knowledge of proper handwashing techniques, social distancing practices, and symptom identification. This is where the promoters’ experience in educating communities came into play, and they rose to the occasion, teaching community members how to properly wash their hands, and offering basic knowledge about virus symptoms and preventative measures.
In an effort to both improve and learn from the project, we wanted to understand what motivated our promoters to voluntarily take on their new roles, despite the increased risk, and how they viewed the project as a whole. So in collaboration with the Busara Center for Behavioral Economics, 21 remote in-depth interviews were carried out with promoters in Kenya, Malawi, and Uganda in May. Through these interviews we found that promoters were largely motivated by altruism and their desire to protect their community from disease. By providing the community with soap and improving hygiene, the promoters felt that they were not only safeguarding the community as a whole, but also helping to ensure the safety of their own family.
“We know that we are protecting our village. We are protecting the people in our own community,” explained a promoter from Malawi. This recognition that communities are linked, and if one person falls ill the entire population is at risk of infection, was a key motivator for volunteering. The majority of promoters were happy to be chosen to represent their community. Many felt that the trust that was placed in them by their peers was meaningful, and they wanted to serve their community dutifully. “When my people are free of germs and keep their hygiene well, I find myself happy,” attested a promoter from Uganda.
Thanks to the dutiful work of our promoters, communities began reporting substantial behavioral changes in regards to preventative hygiene practices. Some of the most encouraging changes included; frequent handwashing with soap, increased hygiene in the home, the wearing of masks, the use of chlorine to treat water, and a decrease in gatherings. “The changes I have seen are that people are maintaining high levels of cleanliness in their homesteads, they are walking around with their masks on, nowadays they wash their hands all the time, also, there are not too many gatherings like before,” explained a Kenyan promoter.
Promoters attributed these changes to their dissemination of hygiene education. After each round of deliveries, our team interviewed promoters and households to get a sense of behavioral change. After the fourth and final round, nearly 100 promoters and well over 350 households were interviewed from each of the three countries, and 100% of respondents reported regular handwashing within the last two weeks, 99% could identify at least one symptom of COVID-19, and over 95% understood that 20 seconds of handwashing was an effective preventative strategy. “I have been visiting some of the communities and their behavior in washing hands has changed completely,” explained David Matabwa, Area Coordinator for Dispensers for Safe Water in Malawi. “They want everyone who is coming there to wash hands.”
We are now focused on repairing and replacing dispensers and replenishing chlorine stocks after the initial COVID-19 disruptions. We are extremely grateful to The END Fund, The Waterloo Foundation, The Clorox Company, The Life You Can Save, Latter-day Saint Charities, and our other generous donors for their support of this work.