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Focusing Sanitation Programmes on Mothers and Older Siblings of Small Children

Sanitation programmes in rural areas of developing countries frequently overlook segments of the population that are most vulnerable to the ill effects of inadequate sanitation and at the same time in the best position to serve as agents of change. These segments comprise infants, small children and their mothers and older siblings. This paper examines the rationale, methods and expected results of such focusing. Although usually considered to be innocuous, the stools of infants and small children are more infectious than those of older children and adults, because children have a higher incidence of gastrointestinal infections and as a result a higher prevalence of carrying the organisms concerned. It may be in fact that they contain greater numbers of pathogenic organisms per unit of weight (Feachem et al. 1983). Even considering environmental factors such as heat and drying that slow down bacterial growth, it stands to reason that if the source of pathogens (an infant's or child's stool) has an initially high concentration, this natural attrition will have less impact on the ultimate dose delivered to the mouth of a susceptible individual. For this reason alone small children deserve special consideration in the planning and execution of sanitation programmes. Means must be found to protect the environment against this highly infectious source of contamination. From the stools of infants and small children, via the contaminated fingers of the child or his mother, microorganisms are transmitted to household objects (especially cups, spoons, and other utensils