SHEIKHUPURA, 30 April 2008 (IRIN) - Mufti Muhammad Yasin, 50, prayer leader (imam) at a mosque in the small town of Sheikhupura, some 100km north of Lahore, capital of Pakistan's Punjab Province, speaks with determination: "Helping to keep children healthy is something that we must all play a part in."

The imam is one of many who was helping to spread UN Children's Fund (UNICEF) messages during Child Health and Sanitation Week, 21-26 April. The activities staged during the week, in one district in each of Pakistan's four provinces, aim to reduce childhood sickness and death caused by poor hygiene.

According to UNICEF, 1,100 Pakistani children die every day, with a substantial proportion dying due to diseases related to poor sanitation and hygiene. Some 70,000 children in the country die every year due to diarrhoea and other diseases related to unsafe water and poor sanitation.

"We wanted to deliver a message to people that was simple and effective, but could actually work to save lives," said Naila Shahid, who coordinates the mother and child health programme for UNICEF in the Punjab. This is the second year that UNICEF has run the campaign, during which female health workers, teachers and - in a unique experiment - religious leaders, are mobilised to spread the message.

"These people are all highly respected in communities and therefore their advice is followed by people," Naila told IRIN. The campaign is being run in coordination with the authorities. The executive district officer for health, Muhammad Saeed Asghar, said planning and training programmes had begun in Sheikhupura District several weeks in advance.

About 85 teachers were trained in each of the four divisions of Sheikhpura District to maximise coverage and try and get the message across to as many households as possible. The district has 2.6 million people.

"I know I must wash my hands before meals and after visiting the toilet to avoid falling sick," said Shahzeb Naveed, a six-year-old pupil at a primary school in Sheikhpura. He added: "I make sure my younger brother also washes his hands". An older schoolmate, Fauzia Ahmed, explained how to make a jug of Oral Rehydrating Solution to give to a child suffering from diarrhoea.

The same message, emphasising hand washing, de-worming tablets for children, and home treatment for diarrhoea is brought into households by female health workers, who are part of a government programme. They also conduct sessions on the streets to raise awareness among women living there.

Role of mosques

But within communities, many people believe it is the message from the mosques that is having the biggest impact. "When I heard an announcement over the loudspeakers of my local mosque, saying that good hygiene at home was crucial and that simply washing hands with soap could prevent children falling ill, I really sat up and took notice," said Gulzar Ahmed, a father of four. He added: "I had never taken all this talk about germs very seriously."

The imam (Yasin) says that, at his mosque, he talks about hygiene in his weekly Friday sermon and also makes regular announcements about good hygiene.

According to UNICEF, most imams have responded positively to their request for help in spreading awareness of such issues.

In Sheikhupura the message goes out regularly from three mosques in the town, while several dozen others based in rural areas are also playing a part in disseminating messages or displaying UNICEF pamphlets and posters prominently within their mosques.

Schoolchildren and their teachers, at private and public schools, too, seem enthusiastic about the drive, eagerly explaining why hand washing is crucial to stopping sickness.

"Since we started boiling drinking water and washing hands, none of my children has had diarrhoea," said Fauzia Tasneem, 28, the mother of three children under eight.

"We have found children can be very effective in bringing about changes in practices within their homes," said health worker Farhat Kulsoom who, during the Child Health and Sanitation Week, had set up a centre at a local school where people could obtain medicines and get advice on health issues.

However, there are some aspects campaigns cannot change easily. Across Sheikhupura, and indeed other small towns in the Punjab and other provinces, open drains can be seen in many places. Stagnant water stands elsewhere, piles of garbage lie uncollected for days, and drinking water is often unsafe. All these factors add to the rate of disease and to the failure to control diarrhoea.

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