Fast-forward to 2019, and 370,000 children – not only in Kenya, but also in Zambia and Ethiopia – now know how to prevent trachoma, the most common infectious cause of blindness in the world.
Thanks to the Super School of Five programme, they are able to protect themselves, their families and others from the devastating experience of losing their eyesight.
Yet despite all that has been achieved, in some ways we are just at the beginning. In the next month we will begin expanding the programme in Ethiopia, the country with the highest trachoma prevalence in the world, creating a scalable model that can be incorporated into Ethiopia’s national education programme. The impact of this could be huge.
This project, in Ethiopia, Kenya and Zambia, introduces five superhero characters to encourage school children to wash their hands and face.About the programme
Trachoma is a neglected tropical disease most commonly found in poor, rural communities that have limited access to clean water and sanitation. The disease is easily spread from person to person, yet it’s entirely preventable.
The simple act of hand and face washing with soap can help reduce the risk of trachoma in children by 60 per cent. That’s why, in 2014 Unilever and Sightsavers created Super School of Five, inspired by Lifebuoy soap’s ‘School of Five’ handwashing campaign.
This innovative programme features five cartoon superheroes designed by Craig Yoe, the creative director who worked alongside Jim Henson on The Muppets, and his wife Clizia Gussoni. The engaging characters help children remember the five key times that hands and faces should be washed every day.
Trachoma is the world’s leading infectious cause of blindness. Repeated infections cause the eyelashes to turn inwards.About the disease
Around 340 schools and 3,700 teachers in Kenya, Zambia and Ethiopia have taken part in the programme since it began. The impact has been huge — an evaluation of participating schools in Turkana in Kenya in 2018 found face and hand washing increased by 40 per cent after the programme, a level of change that had been sustained 20 months after it ended.
Supported by other activities, the prevalence of trachoma in communities where the programme has run has fallen by an average of 30 per cent.
The programme aims to form, then reinforce, good hygiene habits. It works because it’s fun, memorable and rewarding, and is based on what current evidence tells us are the factors that motivate children to change their behaviour.
At the heart of the programme are the five superheroes: Hairyback (my personal favourite), who encourages kids to wash their hands after using the toilet; Biff, Bam and Pow, triplets who encourage hand washing before breakfast, lunch and dinner, and Sparkle, the leader of the gang, who reminds you to wash your hands, face and whole body during bath or shower time. The gang has adventures fighting their arch enemy Nogood, a baddie who loves germs.
Each child in the programme is given a diary, which they are expected to write in every day for three weeks. Under each day, you will find the five superheroes, each with five bubbles next to it. Every time a child washes their hands and their face they can tick off one of the bubbles.
At the end of each day, then each week, teachers and parents sign off to show they’ve seen how many ticks have been entered. Sometimes teachers will encourage participants by giving little prizes to those with the most ticks or by celebrating them in some other way.
The characters are five of the ’coolest, cleanest’ superheroes, which each represent one of the five key points in the day when children need to wash their hands.
The superheroes must fight their arch enemy Nogood, a baddie who loves germs.
Everyone in the programme also takes a pledge, committing to washing their hands and faces at the five critical times every day. They are encouraged to perform this, and a few simple songs, in front of families and others to help spread knowledge about how to stay trachoma-free.
Over the years I’ve seen kids come up with their own version of the pledge and teachers give out awards for the most creative. Others have held inter-school competitions, encouraging pupils to devise songs about hand and face washing as a way to reinforce and spread the messages of the programme.
In 2016, I was part of the team that helped evaluate the Super School of Five programme at the two-year point. It was during this project that its power and potential really struck me. We had returned to a number of places where the programme had long since ended, yet the superheroes and their songs had become embedded in the fabric of the schools.
Not only that, each school had added its own creative stamp on the programme, adapting the music and the pledge or creating plays about the characters. And in the communities surrounding the schools, families and others had taken on the messages of the programme, greatly reducing their vulnerability to trachoma.
Now we are on the cusp of expanding Super School of Five in Ethiopia, where 70 million people are currently at risk of trachoma. The expansion is interesting and ambitious. It has been born from a partnership between Sightsavers, Unilever and Big Win Philanthropy, an organisation mainly involved with child nutrition through Ethiopia’s Seqota Declaration to end stunted growth in children.
This means Super School of Five will be part of a larger nutrition programme. It will be delivered in Tigray and Amhara, two of the most malnourished areas of Ethiopia, which are also highly endemic for trachoma.
The first round of implementation will begin in the next few weeks and will involve 40 schools, 20 in each area. By 2020, this will grow to 287 schools, reaching 173,000 pupils. By this point we aim to have a fully scalable model that the ministry of education can then integrate into the national curriculum.
We’ve spent the past few months making some changes to the programme to make it more effective, and will be making further adaptations as we roll out. For instance, the idea of breakfast, lunch and dinner doesn’t always translate; sometimes one meal a day is the best that can be hoped for.
So we’ve changed the triplets to represent washing hands after eating, after play and after touching animals. We’ve also changed the superheroes’ names to make them more relatable.
Having been there from the start of Super School of Five, what excites me most about where we are now is the possibility of devising a leaner, more efficient model that could really work at a national level. This is my biggest aspiration for the next two years — and if we reach this goal, the possibility of doing something similar in other countries becomes very real. In the next five years, the power of these superheroes could become very mighty indeed.
Geordie is technical director for WASH and behaviour change for neglected tropical diseases at Sightsavers.
A version of this blog was first published on Medium.com.