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8AM: Opening and Introduction (30-45 minutes)

· Welcome participants to the Clorin Home Water Chlorination Workshop
· Explain that the workshop will continue until about noon with a break for tea
· Introduce yourself and explain that we will begin with introductions. Ask participants to give their name, where they are from, and what they expect to learn from this workshop. Write responses on the flipchart about what they expect to learn so that you can come back to it at the end.
· Start with yourself. Introduce yourself and explain whom you work for.

Explain to participants what is SFH.

· SFH is a Zambian non-government organization dedicated to improving the health of Zambians by marketing essential health products to the public and by educating Zambians about important health concerns. SFH works in the areas of AIDS prevention, family planning, and child health. For AIDS prevention, we sell Maximum condoms and Lovers Plus condoms. For family planning we sell Safeplan oral contraceptive pills and Prolact vaginal foaming tablets. For child health we sell POWERCHEM mosquito nets and retreatment kits for malaria prevention, and Clorin home water chlorination solution for water borne disease prevention. If they have questions about products other than Clorin, they can ask at the end of the training.

Next explain about the Clorin Home Water Chlorination Solution project.

· The objective of the Clorin home water chlorination project is to reduce the cases of diarrhea and cholera in Zambia. Clorin is a chlorine solution that is used to disinfect home drinking water. It kills most bacteria in water that cause disease, including cholera.

· The product has been developed largely through the support of the Centers for Disease Control in the United States. The Clorin project started in Zambia in September 1998 in 5 pilot sites in Lusaka and Kitwe. It was expanded to cover Lusaka, Kitwe, and Ndola in 1999, and now in 2000 it is expanding nationwide.

· To date, more than 350,000 bottles of Clorin have been sold. There has been tremendous demand for Clorin, especially in the rainy season when cases of diarrhea increase, and when there are outbreaks of cholera. Clorin has the support of the Central Board of Health, and is often mentioned as a way to prevent cholera. In fact, because of this, Clorin has been widely associated with cholera prevention. SFH in our communications efforts would like to emphasize that Clorin should be used to disinfect your water all year round, not just in the cholera season. This is because diarrhea is a serious problem among children in Zambia, and diarrheal diseases occur throughout the year. Far more children die of diarrhea each year than cholera, which makes it even more important that people treat their water to prevent diarrhea, especially among children.

Next explain the objectives of today's Clorin training program. During the course of today's training, we will cover the following topics (write on a flipchart):

· Review the important facts about diarrhea and cholera - transmission, symptoms, and consequences.
· Understand what Clorin is and how to use Clorin.
· Learn the essential messages to discuss with people in the communities about Clorin.
· Practice communication skills/selling techniques.

Ask the class if they have any questions.


Diarrhea Transmission

Objective: Review transmission and signs and symptoms of diarrhea and cholera.

Tell the group that you are going to read a story about diarrhea, and then discuss it afterwards:

STORY: The clinic director from _________ (name a local clinic) has just admitted a seriously ill child to the clinic. Mrs. ________ has just brought her 3 year old daughter Grace to the clinic at 10pm because she had had diarrhea for the previous 4 days, and was very weak. The doctor examined Grace and found that she was very dehydrated, and had a severe case of diarrhea. He gave her some medicine, and admitted her for further observation. Two days later, Grace was feeling better and playing. Mr and Mrs. _______ were very relieved, and thanked the clinic doctor. The doctor gave Mr. And Mrs. ________ some advice on how Grace and the whole family could prevent themselves from getting diarrhea and other water borne diseases.

After reading the story, discuss these questions and write all answers on the flipchart:

1. How do you think Grace got diarrhea?

Answers to look for:
· Diarrhea can be caused by drinking contaminated water, eating contaminated food, or from contaminated hands going into the mouth, or indirectly from not washing hands before eating, after going to the toilet.
· Cholera is a bacteria that is most often transmitted by contaminated water.

2. What signs and symptoms can a person get from diarrhea and cholera?

Diarrhea - can result in weakness, dehydration
Cholera - severe diarrhea, dehydration

3. What could have happened if the parents had delayed more in taking Grace to the clinic?

She might have died

4. If the child has a mild case of diarrhea, what is the proper treatment?

Oral rehydration solution. If the child doesn't recover in 2 days, take the child to the clinic. If people say Clorin is the proper treatment, explain to them that Clorin is for treatment of water to prevent diarrhoea and not a treatment for diarrhoea.
If the child has severe diarrhea, take the child immediately to the clinic. Give lots of fluids (treated water)

5. How do you think the parents could have prevented Grace from getting diarrhea?

Make sure that the home drinking water is treated with Clorin to disinfect it.
Use a closed container with a lid to store drinking water.
Make sure that Grace washes her hands before eating and after going to the toilet.
Prevent food from getting contaminated by the cook washing her/his hands before preparing food, and by covering leftover food.

6. What is the best way to prevent Cholera?

Cholera is most commonly transmitted by contaminated water, so disinfecting your water is the best way to prevent cholera.
Disinfect your water with Clorin, or boil your water.
Use a closed container with a lid to store drinking water.
Good sanitation - use toilets/latrines, keep environment clean.
When people die of cholera, it is because of the severe dehydration from the diarrhea that is caused by the cholera bacteria. A person with severe diarrhea should be taken to the clinic immediately, and also given plenty of fluids (disinfected water).

7. If Grace got diarrhea from drinking contaminated water, what are the ways that the water could have gotten contaminated?

From the pipe, in the well (at the source)
By a dirty water container
By a person scooping water out with an unclean cup or putting an unclean hand in the water

At the end of the discussion, you should summarize what the participants have said, and add any information that was not mentioned. Ask questions of the group that will get them to say the correct answers.


The Clorin Home Water Chlorination Product

Objective: Participants understand the benefits of Clorin and how to use Clorin.

Explain to the group that this component of the training is to help them understand what is Clorin. Hold up the product. Explain that Clorin is a chlorine solution. Chlorine is a chemical that will kill most bacteria in water that cause disease and diarrhea, including cholera. Treating drinking water with Clorin is one of the best ways to prevent diarrhea and cholera.

The Clorin is sold for 500 kwacha per bottle. One bottle on average is enough for a family of 6 people for one month. The clinics and retail outlets buy Clorin for K350 kwacha. The K150 difference is for sales commission for the clinic sales agents, and trade margin for the retail outlets (use flip chart to explain if necessary). These prices are subsidized which means that SFH does not make a profit on them. The program is funded by donors, and Clorin is sold at a low price so that we can reduce the diarrhea and cholera cases in Zambia and improve people's health.

Next explain that before you demonstrate how to dose Clorin, you will tell them about how to properly store drinking water. As discussed earlier, water can be contaminated in several ways. One of the most common ways that water can be contaminated is by storing water in an open bucket where people put their hands into the bucket to scoop water out. A person's hands can easily contaminate water, even if it is already treated. So you must store your water in a closed container with a lid. Pour the water out instead of scooping it out.

Once you have filled your closed, narrow mouth container with water, you put Clorin into the container according to the directions. Only a small amount of Clorin is needed to disinfect your drinking water. Can someone tell me from the brochure, how much Clorin do I put into a 20L container?

- Fill inside ring of the lid with Clorin and pour into container.

That is correct. You fill the inside ring of the lid once with Clorin and then pour it into the container with the water. Then you close the container and shake it. Then you must wait for 30 minutes for the Clorin to kill all the germs before you can drink it.

Can anyone tell me how much Clorin do I put into a 2.5L container? A 5L container?

- Fill outside rim of lid once with Clorin.
- Fill outside rim of lid twice with Clorin.

In order for them to understand how to use the product better, let's conduct the following exercise:

Split the group in to 3 groups by having them count off 1-2-3.

Explain to the three groups that this is the situation: Someone from their neighborhood has just bought this Clorin. They need your help in figuring out what it is and how to use it. Give each group a Clorin bottle and one container (different size to each group) and ask them to read the instructions and put the correct amount of Clorin into the container.

After they have agreed how much to put into the container, switch the containers until they have tried all three.

Then ask one member of each group to come to the front and correctly dose one container each. Ask the rest of the group if they are dosing it correctly.

Ask the group if they have any questions.

Then explain what will happen if they put too much Clorin in the water.

If someone puts too much Clorin in the water, no harm will result to anybody. The only result of putting too much Clorin in the water is that you will smell the Clorin, or the water will taste like chlorine. So if anyone ever complains that the taste or the smell changes after they put Clorin in the water, what do you tell them?
That they have probably overdosed their water. Explain to them how to correctly dose it.

Some people ask if you can put Clorin in a well to disinfect the whole well
No, this does not work. Do not pour Clorin down a well.


Objective: Review of the content to this point and clarification of any content that is not clear.

Give everyone a slip of paper, or instruct them to find the blank piece of paper that is in their folder. Instruct them to write on the paper one thing they have learned and one question that they have.

Collect the papers, and read them to the class. Ask members of the class to answer the questions for the rest of the class and answer any yourself that others cannot answer.

Ask if there is anything else that is unclear, and break for tea.

TEA: 10am - 10:15am


Objective: What and how to communicate the benefits and correct use of Clorin

Divide the group into 2-3 groups of three or four by counting off 1-2-3-4 (not more than three groups if possible). Tell them they are to develop a short skit that shows what are the most important points to tell a person when they are selling Clorin to a person. (If the group is for retailers they should pretend they are going to sell Clorin to a customer. If the group is a drama, they are pretending they are educating the group about diarrhea, and trying to convince them to go to buy Clorin).

Tell them that the skit should include what they think are the most important things that they should tell the customer, such as asking them if they know how you get diarrhea or cholera, and how to properly dose water to prevent diarrhea. Tell them to come up with the other important points that they need to tell the customer. The person playing the community member or customer is skeptical. This person must think of all the reasons possible, why they would not want to use Clorin (i.e. price, never treated water, my water is clean etc)

After the groups have finished, discuss the main points that they want to talk to the customer about. Ask them to tell you the points, and you write them on the flipchart.

The main points should be as follows - if any are missing after they finish telling you what they have thought of, then you should ask them questions so that they say what is missing:

1) Did they ask (not tell): How do you get diarrhea/cholera? (Discussion of how diarrhea/cholera can be transmitted through contaminated water and get rid of any misconceptions)

2) Did they ask (not tell): Do you know how you can prevent diarrhea/cholera? (Discussion of disinfecting water with Clorin, storing water in a closed container, washing hands before eating, cooking, and after using toilet, covering food etc)

3) Explain the product - what is Clorin, what does it do, and how do you use it properly (i.e. Clorin is a solution that kills all germs in water that can cause diarrhea and cholera. Inner ring once for 20L container etc, shake and let rest for 30 minutes before drinking)

4) Explain how to store the water safely (i.e. use a closed, narrow mouth container with a lid. Pour water out instead of scooping to avoid re-contamination)

5) Explain that water treated with Clorin is safe for adults and children. The taste and smell of the water will not change if Clorin is used correctly.

6) Explain that you can find Clorin in pharmacies, clinics, drug stores, and supermarkets for only K500.

7) Address any barriers to purchase or use

· Too expensive
(it's cheaper in the long run than taking your child to the clinic for treatment. It can save your life by preventing cholera. It will save you time that you have to take off of work by taking your child to the clinic. It costs less than one glass of beer)
· My water is safe because it looks clear and comes from the tap
(Even tap water can be contaminated. The germs are too small to see, so even if the water looks clear, it can be contaminated. The city does not treat the water all the time, and it can get re-contaminated in the pipes anyway)
· I have never treated my water. Why should I start now?
(Has your child ever had diarrhea? It was probably from drinking contaminated water. Your water can have germs at any time. You should always treat your water.)
· I only need to treat my water in the rainy season.
(Your water can have germs that can cause diarrhea at any time of the year. Treat your water with Clorin all year round)

After the discussion, ask one group to perform their skit. Tell the rest of the class to watch for any of the main messages that were left out.

After the skit, ask the class to point out any messages that were left out.

11:15AM (If Neighborhood Health Committees or Clinics) GO OVER BOOK KEEPING FORMS (30 min)


Objective: Make sure the expectations and objectives of the course have been met.

Let's review the essential messages about Clorin. What are some of the essential messages that you would want to tell a customer or community member about Clorin?

· Clorin will help prevent diarrhea and cholera in your family.
· Clorin will kill bacteria (germs) in your water that causes diarrhea, including cholera.
· Clorin should be dosed according to the instructions. Inner ring for 20L container, etc.
· Store your water in a closed container with a lid to avoid re-contamination.
· Even tap water or water that looks clear can have germs. All drinking water must be treated with Clorin.
· Diarrhea can be a problem all year round. Treat your water all year round, not just in the rainy season.
· Clorin can be found in clinics, pharmacies, drug stores, and supermarkets for just K500.
· Clorin is a prevention against diarrhea, NOT a treatment for diarrhea. Diarrhea is treated with oral rehydration solution.

Refer to the original expectations and objectives.
Check them off to make sure they have been met.

Ask participants if there is anything that is unclear.

Ask the participants what they thought of the training and if they have suggestions for improvement or things they would like to know that were not covered.

Congratulate the participants and tell them that they should go out and actively try to educate people in their communities about diarrhea and cholera, and teach them to use Clorin to treat their water all year round.

Thank the participants. Give out certificates.


Centers for Disease Control and Prevention
National Center for Infectious Diseases
Division of Bacterial and Mycotic Diseases
Foodborne and Diarrheal Diseases Branch


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