OBSERVATIONS ON HANDWASHING AND DEFECATION PRACTICES IN A SHANTY-TOWNOF LIMA, PERU

Following a two-year cohort study of diarrhoeal diseases in children a ged 0-35 months from a shanty town in Lima, 62 families were chosen fo r detailed observation of hygiene practices. All handwashing and defec ation episodes which occurred during a 10-hour observation period (8am -6pm) were recorded. The youngest child in each family was selected as the index child for observation. Handwashing was seen on 483 occasion s with 71% of the index children and 80% of mothers observed at least once. The use of clean water, soap and the thoroughness of the handwas hing varied according to the purpose, with ''better'' behaviour observ ed more frequently when the person was preparing to go out. Forty-rive index children (72%) were observed to defecate at least once. Infants defecated in their diapers or clothes; toddlers defecated more indisc riminately around the home area. Handwashing after defecation was rare (11% of occasions) and usually without soap. Faeces were often left a ccessible to children and animals (42% of occasions), especially when defecation occurred around the home/yard, and the data suggested this occurred more frequently in ''higher'' diarrhoea households. Stools de posited on the floor were usually just swept aside, covered with earth or eaten by dogs. Those deposited outside the home were frequently le ft untouched during the observation period or similarly cleared. Soile d clothes were usually left or washed separately, and stools in pottie s were thrown in latrines. These results suggest hygiene interventions might focus on clearance of stools from home surroundings, increased utilisation of potties and separate washing of soiled clothes.