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Students lead behavior change

How school health clubs in Haiti are saving lives

By IMA World Health

August 8^th, 2016

Alexandra Ryisitaelle is a 9-year-old student at École Nationale de Trou-Mahot. She wishes her school had trash cans in their classrooms so that her classmates wouldn‘t throw trash in the school yard. She also wishes her school had flowers. Alexandra understands why behavior change is important to being healthier. At home, she has to boil the water before she can drink it but at school, there is no water to drink and there is no running water.

In Haiti, children who do not have access to clean water are more likely to be exposed to infections such as intestinal worms, diarrhea, typhoid, cholera and other water-borne illnesses. Poor water, sanitation and hygiene - or WASH - can also negatively affect school performance, school attendance, particularly for girls, and hygiene practices in their homes and communities.

In 2010, UNEP reported that contaminated water is the leading cause of infant mortality and childhood illness in Haiti. This statistic reflects the poor services and practices in communities where the lack of clean water, sanitation and hygiene negatively affect the health, economic status and livelihoods of their people, especially children.

Alexandra Vierna Ryisitaelle is student at one of our target schools in Haiti.

Old construction of latrines at Alexandra's school that was never completed.

One of the few functioning latrines at Alexandra's school.

Healthy Schools, Successful Children

With funding from Episcopal Relief & Development, IMA World Health is implementing the Healthy Schools, Successful Children or Santé nan lekol, se Sikse Timoun yo project in Haiti to improve WASH in schools like École Nationale de Trou-Mahot. The purpose of this project is to improve students’ health, school participation and academic success through water, sanitation and hygiene interventions. We identified 60 target schools in the South, Southeast and Grand Anse departments of Haiti and the plan is to ensure that they all have sustainable access to water, functional and user-friendly latrines, behavioral reinforcements and related supplies to ensure proper hand-washing.
Infrastructure is an important part of this change. However one of our primary focuses is on improving WASH practices through behavior change. If we can reach kids like Alexandra early when they are still learning and impressionable, then we can begin this behavior change where it matters most, with youth.

Students lead their peers in a song about good WASH practices.

ART Demonstrates A HEALTHY Life

It is not a foreign concept. From the alphabet song to jingles in TV and radio commercials; creative learning, especially for children, is an effective to way to memorize information and convert it into behavior change. One of the most important pieces of our WASH behavior change programming in Haiti is the creation of school health clubs at each target school. These student-led health clubs are effective because peers have a powerful and unique influence on a child’s behavior. In addition, learning through the use of innovative songs, poems, skits and other activities that are filled with important lessons, creates a fun and positive environment where children can thrive.

“Singing and dancing is deep-rooted in our culture, and is in our soul,” says Dr. Paul-Emile Dalexis, WASH Program Manager with IMA World Health in Haiti. “So in the education field, these approaches play a crucial role in fostering young children’s healthy social and psycho-social development. These approaches get children engaged, closely interacting with their peers and helps nurture imagination, independence and creativity. One of the most important differences is the environment. It is less stressful and children can express their feelings easily, and share their joy and happiness, which is not always the case in a formal teaching setting. It is quite different.”

One student leads her part of a song about washing hands.

Young students intently watch a skit on the dangers of Cholera.

Students perform a skit about the dangers of Cholera.

A group of second-graders thanks IMA staff for their work. They say it is changing their lives.

First-grader performs a poem and song about how to wash hands correctly.

Three students recite a poem about the dangers of poor hygiene.

join the club

IMA works with regional education staff and teachers to set up a health club at each target school. These clubs provide students with leadership opportunities to develop WASH skills, spearhead student improvement in hygiene, maintenance and cleaning of school infrastructure. At a recent WASH Fun Day celebration at the National School of Lavanneau in Jacmel, Haiti, these activities came to life and the engagement and participation of students was incredible. From a poem and song about hand-washing from a first-grader to a comedic, yet serious, skit about cholera and a contagious rap from a student and his sidekick, the messages on the importance of WASH were clear and kids of all ages embraced it.

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“With these activities, children learn how to educate their peers in creative and fun ways,” says Dalexis. “They learn how to examine a problem and demonstrate how to solve it. For the WASH fun day, they learned about the risks and consequences of poor sanitation and the right attitudes and behaviors to adopt to keep healthy.”

The ultimate goal? To allow the students to become agents of change in hygiene and sanitation in their families and communities.

“What kids learn at school they practice and share at home with their parents, younger siblings and friends. We are educating the next generation of youth and equipping them with healthy habits that will serve them for a lifetime” says Lior Miller, Senior Program Officer at IMA World Health.

Ensuring success through support and infrastructure

School health clubs are considered to be an international best practice and are guided by the Ministry of Education’s école amie de l’hygiene model that was developed with technical support and funding from UNICEF, the Inter-American Development Bank, Ministry of Health and National Bureau of Water and Sanitation. The health clubs are back stopped by teachers and school directors who are also partaking in trainings that allow them to teach and mentor the students. In addition to these clubs, schools receive new sources for clean water and hand-washing, improved latrine facilities, and a cleaner, more secure school environment.

Latrine availability and use are one of the challenging issues for WASH in Haiti, both in rural and urban settings. Open defecation in Haitian communities is common and latrine facilities are often in disrepair, with students and teachers alike venturing to the edge of a field or woods to answer nature’s call. The project’s interventions are critical to accessing clean water and improving sanitation in schools and communities, but it is the health clubs that have the best chance of making long-term change that might ultimately mean the difference between life and death.
At age 9, Alexandra wrapped up a school year where she and her friends were encouraged to wash their hands whenever possible - which is only when rainwater is available from a bucket. But next year, when she returns to school she’ll be able to turn on the tap. Wash her hands. Use a latrine. She knows these behaviors are important to her health, at school, at home and in her community.

Students wait in line to wash their hands after participating in the WASH fun day activities.

Student demonstrates how to wash hands correctly as part of a pop quiz.

© 2026 IMA World Health

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