Community Health handbook for Action Learning

The Trainee’s Handbook
for Action Learning

©2010 MKFC COMMUNITY

TRAINEE’S HANDBOOK 2

Content

Your Handbook for Action Learning.......................................... 3
Niliyungdo Village Shares with You.......................................... 3
Face the Challenges – Grasp our Future, The Key Goals........... 3
Action Learning For Good.......................................................... 4
To keep up on with new practices............................................... 4
Action Learning for Good – TEMPLATE................................ 4
1. Choose the area
2. Make Learning Goals
3. Imagine: Good, Better, Best
4. Inform You
5. Inspire Change – Make local Assignments
6. Innovate
7. Bounce the idea – Whom and How to Share
8. Put your ideas to work – Use Microfinance
People in Our Dream Community and
Dream Community Festival........................................................ 8
Clean Water................................................................................. 11
Clean Hands................................................................................ 12
Sanitaion and Hygiene................................................................ 18
Clean Environment..................................................................... 21
Diseases...................................................................................... 25
Reducing Food and Nutrition Problems..................................... 31
Business and Microfinance......................................................... 35
Your Opinion is important - Share it with us – TEMPLATE.... 39
Action Learning - MKFC Training Cource – TEMPLATE..... 41
MKFC Community, Contact Information................................... 43

©2010 MKFC COMMUNITY info@mkfc.se www.stockholmcollege.se


Your Handbook for Action Learning
Grasping our Future Community

This Handbook is a summary on the Community Health Management Reference
Book made for the MKFC Learning Community Programs. The purpose of this
Handbook is to guide to learning through action and practical work, observation
and sharing to grasp our Future Community.

Curiosity and an expectation of new possibilities and new goals is the path to
create solutions that make our future community better.

Niliyungdo Village Shares with You

The Chief of Niliyungdo Bimbila District, Northern Ghana comments on local
changes for better health and living conditions, brought out by the village people
together with the local MKFC CAP Team.

“In a community where hope seemed lost, our children were constantly ill,
our mothers and wives were always tired. The community was polluted; we
could not sit outside, for mosquitoes plagued the environment.
We had given up hope. But we never thought that through the simple steps of
Sharing Awareness, we could change our community!
Our children are healthier, our mothers and wives now sit outside and laugh
with each other. Our community has changed! We now know we can and if
we can, you can too!”

Face the Challenges – Grasp our Future
The Key Goals

Improve Community Health Management for lifelong wellbeing Improve
family and community health practices as a component of WHO’s Integrated
Management of Childhood Illnesses programme. Community members:  Leaders,
teachers, health workers, chiefs, local councillors, parents  and children can
participate to create change in their livelihoods. They can be part of improving
their health through practical action and increasing knowledge.



Bring change at national level beginning from the grassroots level as has been
advocated by many social development icons like Wangari Maathai, Amartya Sen
and Mohamed Yunus.

Recognise and advocate  children and students as effective agents of change in
community development.

Bounce new ideas to others – make Sharing Awareness festivals and
demonstrations.

Inspire Contributors to keep going. Name Winners with Innovator Award, Inspire
Award or Share Awareness Award.

Support new ideas to be sustainable small businesses through Microfinance.

Action Learning For Good

Action learning is an educational process, whereby the participant study their own
actions and experiences in order to improve practize. Participants make actions
too in order to make changes. Learning is doing by asking questions and then
make actions for the  shared vision or dream for good, better, best.

Action learning tackles problems through a process of first asking questions to
clarify the exact nature of the problem and create solutions making actions.

Questions often begin with why, how, or what do you think about etc. They help
people discover answers, and develops how to reach the changes. Children can
do this well and even often learn adults new ways to think by reflecting and
identifying possible solutions.

The practice of shared vision involves the skills of unearthing shared ‘pictures of
the future’ . That foster genuine commitment. Bouncing new ideas to others with
Festivals is a nice way to get new supporters.

To keep up on with new practices

Understanding
Much more important than memorising, when study is concerned, is
understanding. This is the kind of learning which requires a willingness by the
learner to work with ideas and a willingness to explore whether an idea has really
been mastered. Making mistakes can be a helpful stage in this kind of learning



because the mistakes can reveal what it is that is not understood.

This kind of learning require the learner to work actively with new information
and ideas. To achieve this inspire learners to apply, to elaborate, to evaluate what
they have been given. Ask them to create their own ideas and frameworks. The
most telling activity of the changes is to show others the new practice. It can be
demonstrated by songs, drama, paintings, story telling and texts of all kind.

Doing – Bouncing ideas to other people
No amount of explanation of how to compose a clear technical solution for solar
energy is good for others to grasp but demonstrating a practical example can be.
We can fully appreciate the changes only if we watch the skill in action. Similarly,
our skill as a team player could be best appreciated through observation of at least
some elements making a show for your community.

Talking about what something means with other people is bouncing ideas to other
people. Microcredit supports sustainability for new ideas and gives work.



The Template to practize Action Learning for Good

1. Choose Working area, Clean Environment
2. Pay attention on Learning Goals

At the end of this section, everyone should be conscious on the importance of
keeping their environment clean, understand the connection between a dirty
environment and diseases.

All individuals make their own personal dream. Then the group  make one united
dream to work with. Dreams can be visualized by paintings after telling the
dreams .  Then the group sets up  practical measurable  goals to reach the united
dream. When the goal is measurable then the group can measure  how far they
realized the dream.  Think that  the dream you want to reach makes you follow the
lead.
Dream of clean environment  with goals for the group: My village with 0
polythene bags, 0 rubbish heaps around your home and on the roads, 0 deaths and
diseases caused by dirty environment.

4. Get Informed About Today
Under this title you find  common information :

“According to the World Health Organisation, approximately one-quarter
of the global disease burden, and more than one-third of the burden among
children, is due to modifiable environmental factors.“



5. Inspire Change – Make Assignments
To become Change Maker the  members of the group needs to inform itself how it
looks like locally. Group must go out and  make questions. Finding answers -  and
making reports (make assignements) their work makes it possible to start changes
for good. The process is on.

6. Innovate
Make practical work. Use Sodis to clean the water.

Making the practical changes you realize your dream as planting a fruit tree in the
school yard is to get more food vitamin and forest.

Now you and the members of the group can Share your dreams and new practice
with your community Bounce the ideas!

How: The global hand-washing day of the world is October 15th.

Have the Global Hand washing Day in your community.

Present the soap making technique to others in your community. Do it
together on the market.

Demonstrate how to wash hands to others.

Sell Sodis to rural areas, villages.

Summary for Change Making for Good:

1. Choose  the problem to solve
2.  Make Learning Goals
4.  Inform You
5. Inspire Change – Make local Assignments
6. Innovate



PEOPLE IN OUR DREAM COMMUNITY
AND DREAM COMMUNITY FESTIVAL

Learning Goals
The purpose of this section is to show the important roles of all community
members in developing their livelihood regardless of gender or age. At the end
of the lesson, everyone should be able to come up with methods of how they can
create change  for good to ensure that everyone in their community is involved in
making decisions and development of their community.

Imagine: Good, Better, Best
An equal community for all with 0% violence on women and children, equal
rights for all, equal access to resources and 0% tolerance on breaking the law on
human rights.

Get Informed About Today
Children and Women in the community are important tools for change..Children’
need support to get the right to proper sanitation, food, good education, care,
love, health care and the right to live.  Women are  needed in order to be with our
community  development. Basicly all humans need access to  basic needs, to
have food and clean water, health, care. Everyone wants to be respected as good
persons with capability to support our common wellbeing. Some 2.5 billion
human beings live in severe poverty, deprived of adequate nutrition, safe drinking
water, basic sanitation, adequate shelter, literacy, and basic health care. Every
third of all human deaths are from poverty-related causes, including over 10
million children under five. The welfare of all humans is a reflection of how we
live up to Human Rights, Children’s and Women Rights.



Inspire Change – Make Assignments

School
–  Do you see at school that you are respected as you are?
–   What does your school say about respect ?
–   Discuss with your teacher and some of the older students.

Home
–   What do your relatives, parents think about their identity?
–   Do they feel respected?
–   Do they feel that they can affect their lives and make them better?

Community
–   Is there  an organisation monitoring the wellbeing of children, women and all
inhabitants?
–   Can citizens leave their suggestions to this authority?

Innovate – Be a Change maker for good
Form a children’s right board in your school or community that monitors the
welfare of the children. Involve the children in the board.

Form a community watch committee or group that ensures community members
exercise their rights.

Bounce – the Dream Village
Through out this material, you will learn how you and your community can
improve your livelihood.

Map out your dream village, you can do this together as groups or as individuals
on pieces of paper, verbally  by singing, using drama.



Each of you think ‘How can I make our /my dream village come true?’

–  Make a chart and divide roles, everyone has a place in the community.

–  Write down your community Goals and how you will measure them to see
if you are making progress. This is how you will Create Change on the annual
festival!

Share the awareness, use the local radio station to bring change to your
community.

Make it to an annual Festival to remind everybody how they can contribute and
share.



CLEAN WATER

Learning Goals
At the end of this section, everyone should be able to know; what dirty water is,
the effects of drinking dirty water, know and be able to show at least one way of
making water clean and be able to do it independently.

Imagine : Good , Better, Best
Think about availability of clean water in your home, your village and your
country. What do you wish would be different? Set some Goalss about availability
of clean water in your home or village – example, reduce the percentage of people
drinking dirty water.



The lack of clean water is a huge obstacle of development in many areas in
the world. It makes the reality even worse, as almost 25% of non-salty water
resources in the world has been spoilt and is dangerous for human health. For
instance, in Ethiopia, it has been estimated that approximately 75 % of children
illnesses, infections and deaths are caused by dirty water, combined with low
level of hygiene. The most common sicknesses by dirty water are diarrhoea,
cholera, and infections by parasites, rashes and river blindness.
Drinking or coming into contact with dirty water causes diseases like Diarrhoea,
cholera, typhoid, amoebic and bacillary dysentery, river blindness and
schistosomiasis bilharzi .


School
–   Do you have clean water at school?
–   If yes, where do you get it and how is cleaned?
–   If not, why is it not available?
–   Talk to your head teacher, teachers and other students – what are their thoughts
on drinking water? Does dirty water cause diseases? Which ones? How can it
be made clean?

Home
–   Do you have clean water at home?
–   Where do you get it?
–   How do you clean it?
–   What do your parents say about drinking water – Is it important to make it
clean? If yes or no, why? Do they know any cleaning methods?

Community
–   Go around your community. Observe the drinking water sources available.
–   How does the water look, is it brown? Does it have waste?
–   Is it clear? Clear water DOES NOT ALWAYS mean CLEAN water.
–   Talk to different people in your community, how do they clean their water and
who cleans it?



Innovate - Be a Change Maker for Good

1. Learn how to make water clean using these methods:

• The Solar Water Disinfection (SODIS) method.
Filter the water – if you have no sieve use a clean cloth.
Put your dirty drinking water in transparent bottles (e.g. 3 litre bottles, only
transparent bottles can be use   that can be glass or plastic.
Put the bottles on a flat surface in direct sunlight for 6 hours.
Turn the bottle every half-hour
If weather is cloudy, put the bottles outside for two days.

• The following 3 steps:
Filtering – can be done with a clean piece of cloth, or sieve.
Boiling
Storing – all stored water MUST be covered and MUST be in clean
containers.

2. You have learnt how to make the change, Now Do IT!
Clean your water using these methods in your classroom.
Does it work? – Invite science students to test the water in the laboratory.

3. Make the change in your school, community and home – Share Awareness
–   To increase awareness, present what you have learnt to the whole school, par
ents, and other community members by play acting or singing the songs.
–   Have a Clean Water Day Festival in your school annually. The whole school
can learn how to do the SODIS method, filtering and covering.
–   Teach your parents at home, do it with them.

Bounce – Whom and How to Share
What have we learnt in this section of clean water? Everybody mention/write
something they have learnt.

Put your Ideas to Work – How to use Microfinance
Sodis or other products.



CLEAN HANDS

Learning Goals
At the end of this section, everyone should know: why it is important to wash
their hands, when they should wash their hands, how they should wash their hands
and how they can make changes in their society to reduce diseases.

What do you wish would be good, better, best wellbeing
Set some goals together on how you will reduce problems related to hand washing
– example, increase awareness on hand washing by a certain percentage in your
community.

Get informed About Today
Hand washing is by far the best way to prevent germs from spreading and to
keep everybody from getting sick. Good hand washing is the first line of defence
against the spread of many illnesses, from the common cold to more serious
illnesses such as meningitis, bronchiolitis, influenza, hepatitis A, and most types
of infectious diarrhoea. The spread of germs mostly occurs through:

• Touching dirty hands
• Changing dirty diapers
• Contaminated water and food
• Droplets released during a cough or a sneeze
• Contaminated surfaces
• Contact with a sick person’s body fluids

Washing hands often after coming into contact with these carriers and before
handling food highly reduces the risk of contracting diseases.

Today, diarrheal disease and respiratory tract infections are the two biggest
killers of children in the developing world. The simple act of washing hands with
soap can significantly cut the risk of diarrhoea (from 30% to 50%) and that of
respiratory tract infection (from 21% to 24%).

UNICEF estimates that diarrhoea kills one child every 30 seconds. Scientific
research shows that hand washing with soap prevents disease in a more
straightforward and cost-effective way than any single vaccine.




School
–   How do you wash hands in your school?
–   Have you learnt which methods to use to wash hands in any of your lessons?

Home
–   Do you wash hands at home? How often?
–   What do you use and how do you do it?
–   Observe your family members, how and when do they wash their hands?

Community
–   Go around your community and observe. How often to people wash hands?
–   Discuss with some of the members about hand washing. What do they think
about it? Is it important? Do they know about the relationship between hand
washing and different diseases?

Innovate – be a Change Maker for Good
1. Learn how to wash your hands and make soap

Simple instructions how to wash your hands:

Make soap easily to wash your hands:



Instructions:

Step 1
Strip the husks off the coconuts and press the husks to force out the palm
oil. You should use heavy weights, as hand power will not provide enough
strength. Leave the weights on for at least 15 minutes to make sure you get
all of the oil out. If you take the weights off too soon, all the oil may not
have been extracted. Pour the oil in a bowl, and set it aside.

Step 2
Take the cocoa beans from their pods and ignite them until they turn into
ash. You will also burn the shea bark to ash.

Step 3
Place the ashes in a small container and add about a tablespoon of water to
the ashes. Stir until no solid pieces of bark or beans remain.

Step 4
Put the palm oil in a pot over a low heat on top of the stove. Add to it the
ash mixture and leave on a low heat until melted and creamy. This process
usually takes about 15 minutes.



Step 5
Pour small amounts of the mixture in shallow containers depending on the
size you would like your soap to be. You could also pour into a pan and cut
the soap into squares after it cools. Allow at least two hours for the soap to
harden correctly.

Step 6
Remove the soap from the container. It is ready to be used.

You have learnt how to make the change, Now Do IT!
–   Make soap together.
–   Using the soap, wash your hands using the method you learnt.

Bounce the idea – Whom and How to Share
What have we learnt in this section of people in our community? Everybody
mention/write something they have learnt.
How and with whom to Share your new ideas. Decide that, too.

–   The global hand-washing day in the world is October 15th. Have the Global
Hand washing Day in your community.
–   Present the soap making technique to others in your community.
Do it together!
–   Demonstrate how to wash hands to others. Do it together!

Put your Ideas to Work – Use Microcredit
Sell the soap on the market?



SANITATION AND HYGIENE

Learning Goals
Huge percentages of populations in developing countries do not have access
to proper sanitation facilities. In this section the Goals is for everyone to
understand the connection between poor sanitation to diseases, the meaning of
poor sanitation, why it is important to use toilets, keep toilets clean and different
sanitation technologies and how the community can build them.

It is estimated that more than half of the world’s population lacks access to basic
sanitation. Think about your community (school, neighbourhood) – is the situation
the same?

Do you have access to a clean, properly constructed toilet? What sanitation
changes would you like to see in your community? Write down the Goals that you
would like to achieve in order to improve sanitation and health issues related to it.



Around 2.6 billion people lack access to adequate sanitation globally. The regions
with the lowest coverage are sub-Saharan Africa (37%), southern Asia (38%) and
eastern Asia (45%).

Lack of sanitation facilities forces people to defecate in the open, in rivers or
near areas where children play or food is prepared. This increases the risk of
transmitting disease. The Ganges river in India has 1.1 million litres of raw
sewage dumped into it every minute, a startling figure considering that one gram
of faeces in untreated water may contain 10 million viruses, one million bacteria,
1000 parasite cysts and 100 worm eggs. In Africa, 115 people die every hour from
diseases linked to poor sanitation, poor hygiene and contaminated water.

Studies show that improved sanitation reduces diarrhoea death rates by a third.
Diarrhoea is a major killer and largely preventable: it is responsible for 1.5
million deaths every year, mostly among under-five children living in developing
countries.

It is estimated that more than half of the world’s population lacks access to basic
sanitation.


School
–   Are there toilets in your school?
–   Are the toilets for boys and girls separated?
–   Are they clean, do they smell?
–   Who cleans them? How?

Home
–   Where do you go to the toilet at home i.e. latrine, bush, and plastic bag?
–   Do all members of your family use the same toilet?
–   Is it clean? Does it smell?
–   Who cleans it and how?

Community
–   Go around your community. Observe the sanitation facilities, for instance in
local public places like restaurants. How do they look?
–   Discuss with other locals about sanitation, what do they think about it? Is it
expensive to build? What affects their choice of sanitation?




Learn about different sanitation technologies and how to use them.

• Building a Dry Toilet:
Most people are unaware on how to make cheap simple toilets that are
beneficial to them and to the environment. Dry toilet is a good toilet
technology that can be built by households and also is a source of manure
for small-scale farming.

• Using a toilet:
Simple steps to remember how to use a toilet, you can make it into a song
1. Pull down your pants
2. Squat on the toilet (if it is a pit latrine; if it is elevated, sit down on the
basin)
3. Go to the toilet
4. Wipe yourself  - with paper or soft leaves
5. If it is a dry toilet, pour some ash, saw dust or soil
6.  Wash your hands, using soap/roots/ash or whatever is available in your
community.

You have learnt how to make the change, Now Do It!
–   Observe your toilet, if it smells and is dirty, clean it with a brush and some
water. An eco-toilet normally doesn’t require washing with water.
–   If you do not have a toilet at home or school, you can build an
eco-toilet together.

–   Have a public presentation on sanitation. Show to community members and
your school the importance of using toilets.
–   Build an eco-toilet as an example in your community, preferably where the
need for one is high. Show everyone how it is built.
–   Make a Good Sanitation Festival and share together your knowledge on good
sanitation practices. Invite different speakers and experts.

Make your own sanitation center including cleankeeping with small fees.



CLEAN ENVIRONMENT

Learning Goals
At the end of this section, everyone should be conscious on the importance
of keeping their environment clean, understand the connection between a
dirty environment and diseases, be aware of the importance of community
responsibility in promoting well-being.

Your village with:

0 polythene bags lying around,
0 rubbish heaps around your home and on the roads,
0 deaths and diseases caused by dirty environment.

This can be your village! Set Goals to make this into a reality.



According to the World Health Organisation, approximately one-quarter of the
global disease burden, and more than one-third of the burden among children, is
due to modifiable environmental factors.

Diseases with the largest absolute burden attributable to modifiable environmental
factors according to WHO are: diarrhoea; lower respiratory infections; ‘other’
unintentional injuries; and malaria.

• Diarrhoea. An estimated 94% of the diarrhoeal burden of disease is
attributable to environment, and associated with risk factors such as unsafe
drinking water and poor sanitation and hygiene.
• Lower respiratory infections. These are associated with indoor air pollution
related largely to household solid fuel use and possibly to second-hand
tobacco smoke, as well as to outdoor air pollution. In developed countries,
an estimated 20% of such infections are attributable to environmental
causes, rising to 42% in developing countries.
• ‘Other’ unintentional injuries. These include injuries arising from
workplace hazards, radiation and industrial accidents; 44% of such injuries
are attributable to environmental factors.
• Malaria. The proportion of malaria attributable to modifiable
environmental factors (42%) is associated with policies and practices
regarding land use, deforestation, water resource management, settlement
siting and modified house design, e.g. improved drainage. For the purposes
of this study, the use of insecticide-treated nets was not considered an
environmental management measure.This ‘environmentally-mediated’
disease burden is much higher in the developing world than in the
developed.
Children bear the highest death toll with more than 4 million
environmentally caused deaths yearly. The infant death rate from
environmental causes is 12 times higher in developing than in developed
countries, reflecting the human health gain that could be achieved by
supporting healthy environments.




School
– Look around your school, what kind of rubbish is lying around?
– Who is responsible for cleaning your school compound?
– Are there rubbish bins in your classrooms, around the school?
– How does the school dispose it’s waste when it’s collected?
– Discuss with your schoolmates about keeping your school compound clean.
What do they think about it?

Home
– Look around your home, what kind of rubbish is lying around?
– Who is responsible for cleaning your home compound?
–How do you dispose your waste when you have collected it at home?

Community
– Go around your community and observe. Is there rubbish on the streets and
roads?
– Are people throwing things on the ground as they walk around?
– Are there any rubbish bins on the paths for disposing waste?
– What are community members saying about their environment?

Learn how manage waste

1. Waste separation. In order for waste to be disposed properly and to keep our
environment clean, it is important to separate it before disposal. Waste is normally
separated in 3 main ways:

• Biodegradable – is used to create compost. This could include food from
kitchens; package material that is made of degradable material, human waste from
toilets (has to be treated).
• Non-degradable – is best recycled, re-used to create new products, or buried
deep in the soil. Examples are plastic bags, bottles, tin cans.
• Toxic waste – should never be mixed with other waste. This kind of waste is
difficult to dispose. In many developing countries, governments do not offer
solutions for toxic waste disposal. Some ways you can deal with the problem:

– Consider reduction as a disposal tactic – can you buy rechargeable
batteries instead of one use batteries?
– Reuse and recycle potentially hazardous materials.



Many items that can turn in to hazardous materials can be recycled
or in some cases reclaimed, which is a process that recovers what is
left of the useable product. Can you take your waste oil, batteries, and
lamps to an industrial company near your area?
– Look into land disposal. Land disposal of hazardous waste permanently
contains the waste in a landfill, waste pile, injection well or other land based
disposal area. Can your community together with the government create a
landfill that can be used for waste disposal?
– Find out what collection facilities are available in your community or area.

2. Setting up waste bins
One of the reasons why most people throw rubbish on the roadsides and the
community is because they lack waste bins. Waste bins can be made out of old
metal, plastic or wood containers. Paint the containers and label each clearly
emphasise waste separation.

3. Cleaning up the environment
Constant collection of waste around the community public and personal space is
important. Community members can use brooms to sweep public spaces, rakes to
gather litter or collect by hand (while wearing gloves).

Bounce the idea – Whom and How toShare
Have a public presentation on clean environment. Make others aware on the
importance of keeping the environment clean and how to deal with waste.
Use social and visual media like radio, posters, plays and demonstration from
your school to show others how to keep the environment clean.

Set up a Community Clean Up Day. It can be once a month. Everyone in the
community participates in the clean up of the environment. Make up a motivation
song to encourage everyone.

Set up rubbish bins by the roadsides, especially on the walking paths. Put up 3
different bins for the different types of waste. This can also be considered as a job
opportunity – recruit the local handwork people or youth to make the bins for a
small fee.

Put your Ideas to Work – Use Microfinance
Maybe a waste station with fees for provider, what else



DISEASES
Diarrhoea, Malaria, HIV-Aids

Learning Goals
This section on diseases is closely connected with studied above as clean hands,
clean water and clean environment.

You know what different diseases are most common in our communities, how
they are spread and how we can prevent them.

You have a vision on how health can be improved in your community.

Imagine 0 deaths from diarrhoea, malaria and HIV-Aids. This can be your
community. Think about some of the things you could do to make this a reality.
What Goals and milestones can you set up to help you achieve this vision?



Many countries in the South continue to face high death percentages caused by
Malaria, Diarrhoea and HIV/AIDS.

Malaria is the most common disease in tropical areas. Although being preventable
and curable, each year approximately 300 – 400 million people are infected and
1.5– 2.5 million of them die. It is estimated that every 30 second, one child dies of
malaria. Malaria is caused by parasites that are transmitted to people through the
bites of infected mosquitoes.

Diarrhoea, loose, watery stools occurring more than three times in one day--is a
common problem that usually lasts a day or two and goes away on its own without
any special treatment. However, prolonged diarrhoea can be a sign of other
problems. Diarrhoea can cause dehydration, which means the body lacks enough
fluid to function properly. Dehydration is particularly dangerous in children and
the elderly, and it must be treated promptly to avoid serious health problems.
People of all ages can get diarrhoea. The average adult has a bout of diarrhoea
about four times a year. Diarrhoea kills over 1 million children every year through
dehydration and malnutrition. Children are more likely than adults to die from
diarrhoea because they become dehydrated more quickly. About one in every 200
children who contract diarrhoea will die from it.

HIV-Aids (Human Immunodeficiency Virus), another disease that is prevalent
in many poor nations destroys white blood cells in a human body. As a result,
the normal ability to resist different kind of diseases weakens. HIV is able to get
in through blood,  dirty needles and  unprotected sex. Already a baby can get
infected in a womb or at the time of birth. HIV leads to the disease that is called
AIDS (Acquired Immune Deficiency Syndrom    that is fatal when not treated
well. Over 20 million people have died, 5 million new infections exist yearly and
about 50 million people carry the disease overall.


School
–   What do teachers and other students say about Malaria?
–   What do teachers and other students say about Diarrhoea?
–   What do teachers and other students say about HIV / AIDS?

Home
–   Talk with your parents and relatives how many people do they know who have
passed away from  Malaria  Diarrhoea and  HIV / AIDS.
–   What do they think is the cause for Malaria



–   What do they think is the cause for Diarrhoea
–   What about prevention of Malaria
–   Do they know how they can reduce and eradicate Malaria
–   What do they think is the cause for Diarrhoea
–   Do they know how they can reduce Diarrhoea
–   What cultural beliefs do they have about these diseases?

Community
–   Observe your community, visit your local health centre or clinic – what are the
statistics on  Malaria and Diarrhoea HIV / AIDS in your community?
–   Look at your environment – does it look like a good breeding place for diseases
or is it clean, have good sanitation and drainage?
–   Think about all the above questions, ask the community, why is the situation
the way it is?


Learn the symptoms of diarrhoea and malaria

Diarrhoea is normally accompanied by:
–   Cramping abdominal pain
–   Bloating, nausea, or an urgent need to use the bathroom,
–   Fever or bloody stools.

See a doctor when you have bloody stools and this signs of dehydration

General signs of dehydration:
Thirst
Less frequent urination
Dry skin
Fatigue
Light-headedness
Dark colored urine

Signs of dehydration in children:
Dry mouth and tongue
No tears when crying
No wet diapers for 3 hours or more
Sunken abdomen, eyes, or cheeks
High fever
Listlessness or irritability
Skin that does not flatten when pinched and released



Malaria
People with malaria normally have cycles of chills, fever, and sweating that recur
in periods. Other symptoms, like vomiting, and diarrhoea often go along with the
fever.

Learn how to avoid contracting Malaria, Diarrhoea and HIV-Aids

Malaria

Cleaning your environment
Reduce the amount of time you spend outdoors especially around dusk and
dawn. Remember that mosquito bites all hours. After dusk, wearing light
colours will make you less attractive in their senses. Long sleeve shirts and
pants, will for their sake make biting you not that easy.
Cover water ponds . They feed mosquitos
Separate animals from humans
Mosquito nets
If possible, cover all the open windows
Planting mosquito anti-repellant grass like the lemon grass

Diarrhoea

Hand washing with soap
Clean water supply including treatment and safe storage of school and
household water;
Community-wide sanitation promotion
Fluid replacement to prevent dehydration
Zinc treatment
Rotavirus and measles vaccinations
Promotion of early and exclusive breastfeeding, because the water is not
safe everywhere

HIV-Aids
Choose carefully and limit the number of sexual partners.
Get tested and treated for sexually transmitted diseases and ask partners to get
tested and treated too.
Have safe sex
Use condoms during sex, all the time



Now make the change

Make your own Mosquito net:

4-inch metal “O” ring
Cup hook
2-feet diameter embroidery hoop
20 yards of tight weave chiffon fabric
4 feet of satin cord or ribbon
Hot melt glue gun
Clear hot melt glue sticks

Step 1
Using a stud finder, locate a ceiling joist over the bed, crib or other piece of
furniture that the mosquito net will cover. Screw a cup hook into the joist.

Step 2
Attach 2-feet lengths of satin ribbon or cord to the 4-inch “O” ring using lark’s
head knots. The 4 lengths of ribbon should be opposite one another on 4 sides of
the ring. Attach the other end of each piece of ribbon or cord to the embroidery
hoop. The hoop will then hang below the ring, creating a frame for the mosquito
net when it is hung from the cup hook.

Step 3
Cut chiffon fabric into 12 feet lengths. Bunch fabric so that it can be threaded
through the 4-inch metal “O” ring. Drape fabric over the 2-feet diameter
embroidery hoop and tack in place with a hot melt glue gun.

Step 4
Hang net from ceiling hook. Drape fabric over bed, crib or other piece of furniture
so that it is completely covered. Make sure all layers of fabric are overlapped,
with no gaps. Fabric should brush the floor when the net is in place.

Know your HIV-status – find out what is the closest counselling centre in your
area. Get tested, it is better to know your status early so as to get proper treatment
in time. Discuss together (community members, health workers, doctors) the most
common misunderstandings and beliefs about diarrhoea, malaria and HIV-Aids.
These misunderstandings could be the biggest barrier to reaching your Goals.




– Through mass media (radio, plays, posters, sms) share the knowledge on how
to treat diarrhoea at home in cases of emergency, HIV testing, how the diseases
spread and how to avoid them.
– Have a Community Action for Health Day to spread information and discuss
your Goals.

Put your Ideas to Work – Use Microfinance
Clean up the environment to reduce malaria. Community can gie small fees



REDUCING FOOD & NUTRITION PROBLEMS

Learning Goals
At the end of this section, everyone should be able to understand how important a
balanced diet is.

You know what foods they can eat which are available in their communities in
order to get all nutrients they need.

You know about other foods that are not in your community but have good
nutritional value and can be grown your homes.

Zero deaths caused by malnutrition and lack of food



Good food for newborn babies and pregnant mothers is crucial for the wellbeing
of communities. Brain development of children occurs mostly when they are
under 5 years. Malnutrition for children under 5 causes severe damage to the
brains capacity to function as adult.

Iodine and brain development
Good nutrition is a major determinant of educational performance for children.
Iodine, for example, is essential for the development of the brain during foetal
life. Pregnant women living in iodine-deficient areas are likely to give birth
to mentally retarded children. The mental impairment on children resulting
from iodine deficiency is permanent, having considerable impact on children’s
educability and school dropout rates.

Anaemia Iron deficiency
Iron deficiency anaemia reduces the learning ability, cognitive development and
educability of children. In Ghana, iron deficiency, is most common in young
children and in women. In Ghana, national surveys indicate that about 81% of
children less than five years, 69% pregnant women and 17% of non-pregnant
women are anaemic. The Volta region also shows 56% of school age children
anaemic.

Stunting due to protein-energy malnutrition
Stunting occurs when children do not get enough food to eat during the first, two
years of life. Currently about 39% of all Ghanaian two year olds are moderately or
severely stunted. Stunted children grow up to become stunted adult.



Comparison table between Ghana and Kenya:

Ghana Kenya
The number of undernourished people Some 11 million people in Kenya are
in Ghana has decreased from 34 per- malnourished
cent to 8 percent over approximately
15 years
Total population (millions): 22.5 Approximately 70 percent of the popu-
lation depend on agricultural liveli-
hoods, the majority unable to meet
their daily food requirements. Total
population (millions): 34.7
Life expectancy at birth: 54 Life expectancy at birth: 45
Urban population: 47% Urban population: 21%
Agricultural labour force (thousands): Agricultural population, including for-
11 801 estry and fisheries (1000s): 23 837
Number of people undernourished Number of people undernourished
(millions): 1.7 (millions): 11
Proportion of undernourished in total Proportion of undernourished in total
population: 8 % population: 32%
Child malnutrition, underweight: 18 % Child malnutrition, underweight: 20%
Child malnutrition, stunting: 22% Child malnutrition, stunting: 30%
Child mortality rate (per 1000 live Child mortality rate (per 1000 live
births): 95 births): 123


School
–  What can we do in our school to enhance food and nutrition?

Home
–   What foods do you eat at home and when?
–   Why are these foods the ones that are mostly eaten in your family?
–   Ask your parents, what does each of this food add to your body?

Community
–   Discuss with your local chief, elder or leader about the food situation in your
community.
–   What is the plan for improving the food situation in your community?



Innovate – be Change Maker for Good
Learn the many different ways you can improve food and nutrition
ENO (http://www.joensuu.fi/eno/basics/briefly.htm) has an annual tree-planting
day for schools in 140 countries in the world. Most people think of trees as
forests, but did you know that fruits like mango, banana and orange are also types
of trees that can be planted?

Most people are not aware of what the foods they eat contain. It is important
that every meal should have carbohydrates, vitamins, protein and minerals. A
food circle with foods in each of these categories can guide you on which food
combinations are best for good health.

There are many other foods that may not be grown in your community but have
very high nutritional value and can grow in your soils.

What have we learnt in this section of people in our community. Everybody
How and with whom you wmnat to share your new ideas. Decide that, too.

–   Have a Tree Planting Day like ENO. Instead of planting one type of tree, plant
fruit trees also.

–   Make a food circle in your class, with health workers or at home. In the
food circle, put all the different foods you eat and their nutritional value. Use
this food circle to guide you to eat a balanced diet.

–   Have an Information Day in your community. Invite the agricultural officer
to come and tell you about the different food crops that can grow in your
area and which are good for your health and how to grow them. Plant these
crops in your farms.

–   Have a public presentation on nutrition. Make others aware on the importance
of eating a balanced diet and which foods in your community can ensure this.

–   Use social and visual media like radio, posters, plays and demonstration from
your school to show others how to keep the environment clean.

Start a plant school, what else can you do?



BUSINESS AND MICROFINANCE

Lessons Learnt Goals
You should be able to know what micro-finance is and be able to come up with
their own business idea/plan, be able to obtain microcredit.

Imagine living in a community where everybody can afford food, health care,
shelter and clothing.



In Africa, women account for more than 60 per cent of the rural labour force and
contribute up to 80 per cent of food production, yet receive less than 10 per cent
of credit provided to farmers.

Micro-finance emerged as a solution to problems of this kind. Originating
from Grameen Bank through Prof. Mohamed Yunus, it has become one of the
fastest growing and adapted solutions to eradicating poverty. Grameen Bank in
Bangladesh aims to provide credit to those in extreme poverty. Some 94 per cent
of those who meet the bank’s criteria and take up loans are women. Grameen
borrowers keep up repayments at a rate of around 98 per cent. The Bank lends
US$30 million a month to 1.8 million needy borrowers.

The World Bank estimates that there are now over 7000 microfinance institutions,
serving some 16 million poor people in developing countries. The total cash
turnover of MFIs worldwide is estimated at US$2.5 billion and the potential for
new growth is outstanding.

Fewer than 2 per cent of poor people have access to financial services (credit
or savings) from sources other than money lenders and under 10 million of the
500 million people who run micro and small enterprises have access to financial
support for their businesses. Micro-finance is a stepping stone for many poor
people who are struggling to get our poverty.

–   Have you ever heard of micro-finance?
–   Do you know of any micro-finance institutions in your community or near your
village?
–   Have you ever thought of starting a business to help you earn income or to
expand your business?
–   What challenges have you faced in trying to achieve your dream?
Discuss with other people in the community, what are they saying about micro-
finance? Do they know about it?
Visit some microfinance.

Innovate – be Change Maker for Good

1. Learn how Microfinance works
Microfinance typically refers to microcredit, savings, insurance, money transfers,
and other financial products targeted at poor and low-income people. Microfinance
aims to fulfill these needs:



•   ifecycle Needs: such as weddings, funerals, childbirth, education,
L
homebuilding, widowhood, old age.

• Personal Emergencies: such as sickness, injury, unemployment.

• Disasters: such as fires, floods, cyclones and man-made events like

war or bulldozing of dwellings.

• Investment Opportunities: expanding a business, buying land or
equipment, improving housing, securing a job.

• Microfinance institutions give loans to people who are not able to ac
cess commercial banks. They can borrow money without any
collateral and they can also obtain loans through group security –
members of a local women’s group can act as guarantors for one
of their members to borrow a loan.

2. How to Use Microfinance for your Dreams
Visit/ Invite staff from a local microfinance  or visit them.

Example of Kenya
There are various microfinance institutions in many developing countries. For
instance, in Kenya, the Association of Microfinance Institutions lists many MFI’s
that are working in Kenya - http://www.amfikenya.com/pages.php?p=1

One such MFI is Jamii Bora (http://www.jamiibora.org/finance.htm). By 30
September 2007, Jamii Bora had over 170,000 members. Many of the members
are street beggars or ex-street beggars. Some of the members are on their way out
of poverty, a few would even say they are not poor any more. In Jamii Bora, the
existing members who have risen out of poverty act as mentors of those who are
still very poor. They act as examples proof that however poor you are, you can get
out of poverty if you are determined enough.

To obtain contact information on Micro-Finance Institutions in other countries,
access: http://www.microfinancegateway.org/p/site/m/

Bounce the idea – Whom and How toShare
mention/write something they have learnt. Share your new Ideas.  When you share
you learn more.



Decide how to share
– Make this information available. Through the local radio, posters, word of
mouth.
– Arrange for a Community Information Day on microfinance and have someone
from your closest microfinance can tell the community about starting a business
and borrowing money.

Your own women group or school class can start. Maybe you start to make
information about microcredit.



Your Opinion is important - Share it with us

Workshop Bounce template
Please, circle the alternative to describe your opinion best.

1 = I totally disagree
2 = I partly disagree
3 = I am not sure
4 = I partly agree
5 = I totally agree

1.   I got new information during this workshop   1   2   3   4   5

2.    I am satisfied with the quality of the Workshop Handbook 1   2   3   4   5

3.    I will use the Workshop Handbook in my work with children   1   2   3   4   5

4.    I will use the Handbook in other purposes in my community 1   2   3   4   5

5.    This workshop was useful for my work with children 1   2   3   4   5

6.    This workshop was useful for my work within my community 1   2   3   4   5

7.    The timetable of the workshop was functional 1   2   3   4   5

8.    It was easy to understand what we discussed at the workshop 1   2   3   4   5

9.    It was easy to be an active participator at the workshop 1   2   3   4   5

10.  People were interested in my opinions at the workshop 1   2   3   4   5

11.   I got good answers for my questions at the workshop 1   2   3   4   5

12.  There was a positive atmosphere at the workshop 1   2   3  4   5

13.  The aims made for the period between workshops were    1   2  3   4   5
clear enough

14.  I was happy with the snacks and beverages at the workshop 1   2  3  4   5

15.  I am now more motivated in the work about health education 1   2  3  4   5



For the following questions you can use the empty space on the other side of the
paper.

Please, describe:

16.  Which things succeeded well at the Sharing Awareness workshop?

17.  Which things could be worth of doing another way at the Sharing  Awareness
workshop?

18.  Which content area was not that important to handle?

19.  Which content area was completely missing at the workshop?

20.  All other Bounce and comments – to make this work better.



Action Learning – MKFC Training Course

Goals for the method

Keeping an open-ended, learner-centered and cooperative approach, which is at
the heart of this educational practice.

Make e-Learning a common tool to reduce costs and offer better accessibility for
Teacher Training in Service programs.

Become Compass to develop innovative methodologies and approaches for
training.

To Share Awareness through Social Media.

Training Trainers
The advanced course is based on the proven methodologies of the Long- term
training courses, as this type of course allows for an optimal balance between
theory and practice, between learning and practical implementation, between Face
to Face and eLearning and understands training as a process that is necessarily
longer than the duration of Training Work Shops.

Objects: Phase 1 eLearning, Phase 2 Workshop, Phase 3 Training project,
Phase 4 Evaluate training project, Phase 5 Follow up, Phase 6 Evaluation
Lessons Learnt.

Phase 1 eLearning
This phase will serve to create a common ground for communication and
developing a learning culture for the course. Based on an e-learning
Platform, this phase will include:

– Getting to know each other
– Building up a learning community
– Learning how to work with the e-learning technology
– Researching assignments for learning area
– An introduction to education theory
– Self-perception and self-assessment of competences and
– Preparation for the workshop

Phase 2 Workshops
The participants will develop a training project with an explicit training.
Programmed to implement during the next phase.



Phase 3 Training project
During this phase the participants will work on the implementation of their
training project. They will benefit from the support and mentoring of
the trainers and from e-learning opportunities. This phase will also
serve to identify specific training needs and any questions to be addressed
during the next seminar.

Phase 4 Evaluate training project
This workshop will serve to consolidate the learning process developed in
the practical phase. The projects will be evaluated with regard to their
educational function. Workshops (some of them run by participants) and
study groups will be organized so as to adjust and tailor the programme
for health betterment.

Phase 5 Follow Up
In this phase, the participants will work on the basis of individual personal and
professional development plans.

The learning community will remain active with the discussion forum, and regular
assignments proposed by the trainers and the facilitators of the e-learning process,
with open access and facilitation by the participants themselves. Mentoring and
consultations will remain a feature. The participants are expected to put into
practice a programme for the advancement of health betterment within the context
of their own work.

Phase 6 Evaluation Lessons Learnt
The work shop will evaluate the overall relevance and achievements of the course,
and review the context for education.

This should be complemented by exchanges of best practice and the consolidation
of the network of expertise generated by the course.

The e-learning tools will remain available after this final phase (depending on the
needs and commitments of the participants).

Have a Happy Changing Days !



MKFC Community
End-to-End eLearning Education for All™

Phone +46-8-21 64 26

Adress Sweden
Mäster Samuelsgatan 42, 111 57 Stockholm, Sweden

Adress Finland
Piritanaukio 3B19,fi-00150 Helsinki

MKFC Community
http://www.stockholmcollege.se
http://www.mkfc.se
http://www.netvibes.com/mkfc#Welcome_to_MKFC
http://www.netvibes.com/mkfc#community_media
http://www.netvibes.com/mkfc#Sharing_Awareness
http://www.netvibes.com/mkfc#College_Courses
http://www.netvibes.com/mkfc#MKFC_Folkhögskola

Office: Stockholm, Helsinki, Asmara, Accra, Nairobi

For further information or questions, please contact
the course secretariat: info@mkfc.se


Community Health handbook for Action Learning

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