Addressing two health crises at once

Dun Yien has been the village chief for Snay Phleung, a rural village in Cambodia’s Prey Veng province, for more than 18 years. As the highest-level of authority in his community, he’s overseen a lot of changes and dealt with many challenges. But none has been as unexpected as confronting concerns by villagers about the global COVID-19 pandemic. Yien told us, "Before the COVID-19 pandemic, people were not as concerned about hygiene and hand washing. In fear of contracting the virus, the community's attitude towards that changed significantly."

In June 2021, Yien received COVID-19 training from an iDE “village mobilizer.” Since the pandemic began in 2020, iDE field staff have been sharing information on the virus when interacting with local authorities. They also talk to people about COVID-19 when they go door-to-door talking about improved toilets as part of iDE’s sanitation program. Along with the new information Yien received from iDE, he also received printed leaflets and posters that were endorsed by Cambodia’s Ministry of Health.

Armed with these new tools, Mr. Yien created a plan to raise awareness among households in his community about COVID-19 and the importance of vaccination. He personally visited households to discuss the issues, distributed leaflets,  and encouraged community members to take vaccines when they became available. 

Yien is also one of iDE’s trained “sanitation champions,” who promotes sanitation and hygiene in rural communities. While sharing knowledge about COVID-19, Yien takes advantage of these visits to encourage households to purchase and install a latrine. Yien says he aspires for his village to claim “open defecation free” by the end of September 2021.

The big picture

Once the initial COVID-19 lockdown ended in Cambodia, iDE’s sanitation marketing team returned to visiting more than 13,000 households per month. As they restarted sales meetings, they discovered that nearly two-thirds of the households encountered were hesitant to take the vaccine due to confusion and misinformation around the topic. This prompted iDE to include information about the vaccine before each sanitation presentation. After field staff delivered the vaccination script and addressed households’ concerns, the number of households that committed to receiving the vaccine doubled (80%), proving the effectiveness of our campaign in removing objections and hesitations around vaccination. It should be noted that our intervention started four months before the vaccine effectively became available in our program target provinces as urban areas were prioritized.

The addition of COVID awareness-raising has helped iDE stay relevant with its sanitation development work by addressing the “elephant in the room" before moving to discussions on sanitation. Local authorities welcome iDE because the organization is willing to help and isn’t afraid of safely coming in contact with people as the pandemic continues. At the same time, the morale of the team has remained high as they have felt like part of the solution.

In August 2021, the Cambodia government recognized the efforts of iDE’s efforts to raise awareness and dispel myths about COVID-19 and vaccines with a “certificate of appreciation,” presented by Lun Sayteng, head of the Rural Health Care Department as delegated by His Excellency Ouk Rabun, the Minister of the Ministry of Rural Development.

Change is happening

Yien said he’s seen households starting to change their behaviors by frequently washing their hands, using alcohol spray, wearing masks, and avoiding crowds. “Before the COVID-19 pandemic, people weren’t as interested in hygiene and hand washing,” said Yien. “During the pandemic, people changed behavior by hand washing with alcohol three to four times per day, with soap from two to five times per day, and wearing masks regularly.” 

To Yien and his community, the connection between COVID-19 and sanitation is easy to understand. He was happy that, to his knowledge, nobody had transmitted COVID-19 to other villagers, and certainly nobody in his village had died from it. In his role as village chief, he wants to make sure that this doesn’t change. To prevent his community from shifting back to less sanitary habits, Yien believes that "local government should continue to promote behavior change around sanitation and hygiene practices even after the COVID-19 pandemic in order to achieve a more sustainable health impact for future generations."