Handwashing Module

FOR PUBLIC DAY CARE CENTERS

Department of Health (DOH) Department of Social Welfare Clean Hands, Healthy Lives
and Development (DSWD)
Handwashing Module

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 Handwashing Module

INTRODUCTION

Have you ever watched a carpenter built a concrete stairwell? He starts from
the foundation and pile blocks of cement and stone to create steps that lead to the
second floor. Children, when building castles with their Lego blocks also do the
same thing. They start at the foundation until they progress at the turrets that
need smaller blocks but complete the whole structure of the castle. It is the same
thing with learning. We build blocks piece by piece and we start at the foundation
until we fashioned the structure that we wanted to achieve. Handwashing is gov-
erned by this principle of learning. Every learner targeted to adopt hand hygiene
practices must learn the importance of the behavior and how to do it.

This module is designed just that—teach our young children to wash their
hands properly after each activity that exposes them to harmful bacteria block by
block using fun and engaging strategies so that at the end of the module, children
are expected to have internalized the rationale and the skill required for handwash-
ing.

The module, which is a part of the Clean Hands, Healthy Lives Program for
kindergartners, covers three main sessions: (1) Storytelling, (2) Getting Cleaner
Hands through Music, (3) The Importance of Handwashing. The third session in-
cludes four activities: (1) How Germs Are Spread, (2) What Can Germs Do To You,
(3) When to Wash Hands, (4) Handwashing Day. Each activity contains important
sections like Rationale of the activity, list of Materials needed, Things to do for
Teachers, Lessons/Lecture Guides, Reflection Questions and Reminders to guide
the teacher every day. It also includes a Hand Hygiene Inspection Chart which you
could use in the weekly inspection. The module can be applied for the duration of
two to three weeks, depending upon the pace of our young learners.

At the end of the sessions, as your student starts incorporating into their
daily routines the newly learned behavior, it would not be difficult to see the blocks
that you and your student built together to create a structure of a healthy child in
a healthy community. Clean hands beget healthy lives!

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Handwashing Module

LESSONS AND ACTIVITIES

SESSION 1 STORYTELLING

Rationale

Storytelling is a creative technique employed to set our young learners’ minds

to the idea of what it means to be healthy and the big role that handwashing plays
in it. The next two weeks in class would be spent on lessons in handwashing that
would culminate in its performance. The storytelling part is employed to serve as a
curtain opener, a mental and emotional marker that would cue children to the type
of health lessons that they are about to learn and set an atmosphere receptive to
these ideas. Stories, with their comfortingly familiar plots, language and characters
present non-threatening opportunities for children to learn. They act as motivators
and offer possibilities for spin-off activities that demand a higher level of cognitive,
visual, emotional and tactile involvement.

Things to do for the Teacher

To make storytelling an effective teaching tool, set the children in a story

frame of mind. Before you start telling the story, there are a number of important
things that you have to observe:

• Change the seating arrangement into a semi-circle in front of you

• Encourage the younger children to sit on the floor around your feet
• It is very important for the children to see you and the book that you are using
• Do not begin until you have everyone’s attention
• Begin with an introduction to the story
• Prepare a brown paper bag, draw a smiley face on one side and label it “Mr/
Ms Story Bag.” Make statements like “Today, I am going to introduce you to
someone special: Mr/Ms Story Bag. S/He is here to tell us a very special story
about a little girl named Lydia. Listen carefully for at the end of the story, Mr/
Ms Story Bag has a number of questions for you. And if you get them right, you
will have something that s/he has in store for you inside this big pocket (HOLD
THE BAG BY THE OPENING AND SHAKE IT)”
• Stop to look at the children’s expressions, to listen to questions, and to show
some pictures
• Have your finger ready to turn the next page
• Do not tell story longer than ten minutes
• Stamp 3 stars at the back of the child’s hand if s/he is able to give right answers
during Mr/Ms Story Bag’s Reflection Questions. Do not discourage children
who did not get the right answers, give follow up questions to motivate deeper
thinking and analysis and praise the child for working hard.
• At the end of the session, remind the children of another fun activity the next
day related to Lydia’s story

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 Handwashing Module

“When the Moon Shone Down Upon Lydia”

In a small village outside of town, there lived a family with a six year
old girl named Lydia. Like the kids in the neighborhood, Lydia attends
kindergarten at the village centro. She also loves to play. There is a
hill near their house where she and her brothers go tobogganing every
sunny Saturdays. Behind them is a ricefield where she played rough-
and-tumble with her dog Brownie as soon as the farmers gathered the
last grains from the panicles and the mud dried up in the golden summer
sun. But what she loves most is playing hide-and-seek with her friends
Annie and Julia every afternoon until their mothers summon them at a
quarter before six to pray the Angelus.

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One day, when the classes draw into a halt, Lydia suggested a
different game to her friends. They would gather lumps of mud from
the rice paddy then knead and pat them into small plastic molders
to make little mud cakes. When the two girls agreed, they set out to
gather as many lumps as they could.

“This is fun,” Annie cried in delight as she patted a lump of mud on the
molder.

“We could do this often if you like,” Lydia replied.

“Look!” Julia shrieked. Her eyes were wide in amazement as she removed
one cake from the molder. “Mine looks like the burger patty that I saw
in the neighbor’s TV!”

“Let me see,” the two girls jumped in chorus.

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Just then, Lydia’s mother called from the house. “Girls, I prepared
a snack for you—ripe bananas in sugar syrup! Go wash your hands at
the faucet. Use the detergent bar in the jabonera.”

Annie and Julia ran to the faucet to wash their hands but Lydia
went straight to the kitchen, propped herself on the wooden bench, and
started eating.

“Ops, you did not wash your hands. They are dirty from playing with
the mud.” Lydia’s mother admonished as she took the spoon from her.

“But mother! I am hungry!” Lydia protested eyeing the food on the

lamesa.

“Yes, you are, Lydia but you must wash your hands first.”

“It’s all dry. I wiped it up with the hem of my dress. I just want to eat!”

“No, Lydia! It does not take a long time to go wash your hands.” Her
mother wagged a finger at her.

“Mother, I am too hungry to go wash my hands. Besides, the faucet is

outside. There’s not enough water in the sink as well.”

Annie and Julia came into the kitchen, their hands dripping with
water. “See, Annie and Julia are such good girls they don’t want to get
germs on their food.”

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Lydia did not like being compared to her two friends. She could
not understand why her mother would not let her eat her snack without
washing her hands even just this once. Just this once! Suddenly,
Lydia stood up, stomped out of the house, ran towards the trees and
hid behind a thick bush crying. It was dark when she came back and
her father was already home from the farm.

“Lydia, dinner is ready. This time you should wash your hands.”
Her mother called from the kitchen. But Lydia did not want to eat with
her parents and her Mano Junjun. She could not face her mother.
Much more, Mother might have already told her father what happened
that afternoon. So, she went straight to her room and buried herself
under the blankets.

A few seconds later, Junjun tiptoed into her room. “Lydia, Mama
and Papa are waiting for you at the table.”

“No, I am not hungry. I am not feeling well, besides. Save my share for
breakfast, please.”

“Mother, she’s not eating!” Her brother shouted as he was heading out
of the room.

“Let her be” her father interjected. “I know she will come down soon.”
A few minutes later, except for the sound of spoon and fork and the
banter of her parents and brother, there was silence.

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Lydia squeezed her eyes tight forcing herself to sleep but opened
them just in time to see the moon climbed out from behind the mountains
and peeked at her window. There was something different about the
moon tonight, Lydia wondered. It is unusually bright. Then, from the
corner of the room came a soft clicking that grows louder and louder as
it draw near her. Lydia strained her neck to see where the sound came
from and there, before her eyes, she saw Nail Cutter with hands and
feet coming towards her wrapped in a thin layer of mist!

“Lydia, I notice how your nails are dirty these days. Since you did not
want your mother to clip it last Monday, I will do it for you,” boomed
Nail Cutter’s hoarse voice.

Lydia was scared and started shouting but no sound came out
of her throat. She could not get up. Blanket who suddenly had eyes,
nose and mouth held her down.

“Lydia, you are not going away until we have you cleaned,” sounded
Pillow under her head.

Then, Soap and Hand Brush stood beside her, looked at the moon
and raised their hands imploringly, “Oh, Moon, shine down upon Lydia.”

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Thereupon Moon climbed even higher from the mountains, looked

and smiled at Lydia through the window and bathed the room with its
silver light. Tumbler proceeded to wet her hands. Soap rubbed himself
all over her palm, in between her fingers up to her elbows. Bubbles
were singing “Dirt go away, dirt go away, dirt go away,” as they slid
off her fingers and floated in the air. Then, Brush scrubbed her nails.
After Tumbler rinsed the suds off her hands and Towel dried them up,
Nail Cutter proceeded to clip her nails until they were clean.

Then, everything stood still. The mist vanished. Blanket’s eyes,

nose and mouth faded into the checkered cloth and all the others were
gone except the Moon. Finally, Lydia found her voice and managed to
cry out “Help!”

At once, three pairs of feet came rushing towards the room where
little Lydia was lying in her bed gasping for breath.

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“What happened?” There was alarm in her mother’s voice.

“I-I had a bad dream, Mama. But it seemed so real.” Her throat was
dry and her heart was beating so fast but Lydia faced her mother and
with remorse in her eyes said, “Mama, I am so sorry for this afternoon.
I won’t do it again. Help me up please I want to wash my hands.”

Her mother’s face shone with so much love as she held out her
hand and said, “Oh, Lydia, dear. Here.”

“Look! Did I just see the moon wink?” Lydia’s brother, who was looking
at the window, wondered aloud. She turned to him and smiled. They
would not know the secret that she and Moon had shared tonight.

Reflection Questions from Mr/Ms Story Bag

• What were Lydia and her friends doing before her mother called them up from
the house?
• Why did Lydia’s mother ask them to wash their hands at the faucet?
• Why didn’t Lydia washed her hands as her mother told her? What can you say
about Lydia’s behavior? If your mother asked you to wash your hands before
eating, what would you do? Why would/would not wash your hands as your
Mother bid you do?
• What happened to Lydia as she was lying in her bed that night?
• Who were there with her in the room? What were they doing?
• Why did they clean her hands?
• What happened to Lydia when she woke up?
• What did you learn from the story?

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Handwashing Module

SESSION 2 GETTING CLEANER HANDS THROUGH MUSIC

Rationale

Like stories, songs attempt to teach values and meanings with codes (language
and melody) which are easy to acquire. “I Have Two Hands” is a song popular
among Filipino children. They are learned on the first day of class in first grade
along with the Alphabet Song. It is the purpose of this activity to teach this song
among kindergarten students to reinforce the idea of cleaner hands and healthy
lives in a fun way.

Things to do for the Teacher

• Before you teach the song to the children give a short recap of the story that you
read last session, “When the Moon Shone Down Upon Lydia”
• Connect the present activity with the story by telling children this was a song
Lydia’s mother taught her to sing after she woke up from her dream and washed
her hands clean that night
• Read the song aloud to the students
• Translate it into the vernacular
• Ask the students what lesson(s) the song wants to impart to children
• Sing the song line by line allowing the children to repeat after you
• Once the children mastered the tune, ask them to sing with you
• During rest period, you and your assistant can write the song on the assignment
notebook of each student with instruction for the parents to teach their child
the song every night until they memorized it

“I Have Two Hands”

I have two hands/

The left and the right/
Hold them up high/
So clean and bright/
Clap them softly, one, two, three/
Clean little hands are good to see.

Reminder

Inform the children that the class is going to have a simple experiment related
to the song the following session—to discover what gets into the hands when you
touch different objects and surfaces. Explain to the children that the experiment
is safe. For the experiment, you need to choose two volunteer students. You can
choose volunteers in advance or during the experiment itself.

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 Handwashing Module

SESSION 3 THE IMPORTANCE OF HANDWASHING

Rationale

This series of activities is designed to teach kindergarten students such

important concepts as Spread of Germs, what the Germs Do to the Body, When to
Wash Hands and How to Properly Wash Hands. The activities are organized from
concept learning to skill acquisition in a progression appropriate for young learner’s
capacity to absorb information, to reason and reproduce behavior. At the end of
Session 3, kindergarten students are expected to have basic understanding on the
spread of germs, the threats they pose to health, the importance of handwashing,
when and how to do it.

Activity 1 How Are Germs Spread?

Materials

• Hand lotion
• Glitter
• Wash basin or water bucket
• Paper towel
• Soap
• Water
• Two students

Procedure

• Put all the implements on a low table in front of the class and ask the students
to gather around
• Squeeze about a quarter size of hand lotion on the palm of the volunteer student
and ask him/her to rub it evenly all over his/her hands
• Put a pinch of glitter in one of his/her palms
• Ask the student to close the hand with the glitter and open it up to see what
happens
• Ask the children what happens
• Ask the student to press his/her palm together
• Let the children relate what they notice
• Let the other volunteer student touch the first student’s hands. Ask the children
what they see in the second student’s hands
• Get a paper towel and ask both students to wipe the glitters off their hands
• Ask the class what happened. Did it work?
• This time ask the volunteer students to apply soap on their hands and rinse
them with water
• Ask the students to note of any changes--if the glitter came off

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Lesson

Explain how the experience of having glitters spread from one student’s hand
to the other and from person to person. When the student tried to remove the
glitters with paper towel, some of it came off but most remained in the hands. But
when soap and water was applied the glitter came off easily. Relate this to the
spread of germs. Germs are microscopic that you cannot see them when they get
into your hands from another person or from touching objects or surfaces which
harbored germs. It is also difficult to get germs off your hands.

When the child with glitter in his/her hands accidentally touched his/her
mouth, nose or eyes during the experiment, glitters were left behind these areas.
It is the same thing with germs. They could get into your mouth, nose or eyes and
found their way inside your body through these portals of entry if you touch your
face with dirty hands. Then, once they are inside your body, you could get sick.
This is the reason why it is very important that one should always wash his/her
hands after touching something that might have germs. If the child does not wash
his/her hands, s/he can spread the germs to another person even his/her sisters
and brothers at home and they could get sick too.

Reminder

Inform the children in advance that you will continue this lesson on
handwashing the next day and you have a different set of activity for them. Remind
your children to tell their parents that an activity occurring two sessions from this
day will need either of them to assist their kid. At rest time, you and your assistant
should write this reminder in each of the child’s assignment notebook which one of
the parents has to sign in order to signify their attendance. Check the notebooks
the following day for parent’s signatures. You can also inform the parents who
accompany their children to school about this activity.

Activity 2 What Can Germs Do To You?

Materials

• Students would need to have a piece of white paper

• A set of crayons
• Pencil
• Pictures of bacteria (E. coli, Shigella, Staphylococcus, etc.)
• Prepare representative cutouts of E. coli, Staph, shigella, Diarrhea, Child and
Doctor beforehand (at the back of each cutout, attach one end of a coconut mid-
rib with a masking tape)
• A piece of cloth, or a sheet of Manila paper with crayon drawings of a landscape

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Things to do for the Teacher

• At the start of the activity, ask the children to copy one of the bacteria drawings
using their paper and crayons
• Hang the cloth in front of the class as background
• Get Mr/Ms Story Bag and use it emphasizing that this time, s/he has a different
story to tell
• Introduce the characters of the puppet play
• With your assistant, stand behind the cloth background and hold the other tip
of the midribs to move the cutouts according to the short puppet play below

“Attack of the Germs”

STAPH: Look E. coli! Can you see what I am seeing?

E COLI: Yes, Staph! Two pairs of little hands touching the bathroom
knob, the tiles and toilet bowl!

SHIGELLA: Do you know what I am thinking?

E COLI: What do you have in that small head of yours, Shigella?

SHIGELLA: Let’s get ourselves into the kid’s hands so that we can mul-
tiply fast and get into another kid’s hands

STAPH: (GIGGLING) Oh, Shigella, that would be fun!

E COLI: Come on then!

STAPH, E. COLI & SHIGELLA: (CRYING IN CHORUS AS THEY JUMP

ON THE KID) Wooh!

STAPH: (GIGGLING ONCE MORE) Thank goodness, he didn’t wash his

hands. This means we could reproduce ourselves fast enough. I am sure he
has other siblings at home. Once he plays and touches with them, we can
get ourselves into their skin and inside their bodies too!

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E COLI: Or we could get ourselves into objects—the spoons, the plates, the
table…

SHIGELLA: Or the food!

(MOVE THE KID TOWARDS THEIR HOME)

(ENTER DIARRHEA)

DIARRHEA: (CALLING OUT TO THE THREE BACTERIA) Hey, guys! It seems

you are having a lot of fun out there! Let me join you to complete the company!

THE THREE BACTERIA: (IN CHORUS) Come on!

(TWO DAYS AFTER, THE BOY WAS ADMITTED TO THE HOSPITAL FOR
DIARRHEA)

DOCTOR: This boy is having diarrhea brought about by bacteria which he

may have contacted from the toilet, from other surfaces with germs or from
contaminated food and drink. It is very fortunate his parents brought him
to the hospital earlier. Had he came later, he would have suffered more
from loss of fluid. Children should really learn when and how to wash their
hands.

END

Things to do for Teachers 2

• After the play, ask students what they think the boy should have done to avoid
getting sick. If possible, ask volunteer students to act out the advisable health
practice using the puppets
• After the puppet play, post the germ drawings on the activity board within the
children’s eye level and above it tack in the cardboard with the message “Germs
could get into our hands and bodies and make us sick.”

Reflection Questions

After the puppet play, ask the children to explain what they understand
about the play; the lessons they learned.

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Activity 3 When to Wash Hands

Materials

• Two flannel boards or two sheets of Manila paper (One labeled Wash Hands
Before the other Wash Hands After)
• Cut outs/drawings of the following: Eating/snacking, drinking, preparing food,
touching mouth, using the toilet, coughing and sneezing on hands, playing,
handling pets, gardening, doing other activities that dirty hands
• Masking or scotch tape
• Scissors

Things to do for the teacher 1

• Before the activity check the assignment notebooks for parent’s signature
• Praise the children for reminding their parents about it
• On the board, prepare two flannel boards for the next activity
• Give a recap about yesterdays lesson—the spread of germs
• Deliver a brief lecture on when to wash hands
• Test understanding on when to wash hands with the picture matching activity

Lesson

In the last two days the class learned about how germs can spread throughout
the body and from one person to person and makes one sick. That is the reason
why each child should not forget to wash his/her hands. Also, they need to know
when one needs to wash his/her hands. Any idea when does one needs to wash
his/her hands? (ASK THIS QUESTION IN CLASS TO GIVE THOSE WHO HAD
BASIC UNDERSTANDING ON HANDWASHING A CHANCE TO EXPRESS WHAT
THEY KNOW. ASK THE CHILD WHO TAUGHT HIM/HER THIS. ASK THE CHILD
IF S/HE DOES THIS EVERYTIME, MOST OF THE TIME, SOMETIMES, RARELY.
ENCOURAGE THE CHILD TO TALK ABOUT HIS/HER EXPERIENCE WITH
HANDWASHING. IN SO DOING, YOU ALLOW OTHER KIDS WHO MAY NOT HAVE
KNOWN ABOUT THE RIGHT TIME FOR HANDWASHING TO HEAR IT FROM THEIR
CLASSMATES WHO KNEW ABOUT IT. HEARING THIS FROM KIDS THEIR AGE
HELPS REDUCE PERCEIVED BARRIERS TO HANDWASHING AMONG THE REST
OF THE STUDENTS IN CLASS.)

As what your classmates (SUPPLY THE NAMES OF THE STUDENTS WHO

GAVE ANSWERS) explained you should never forget to wash your hands before:

1. Eating and snacking

2. Drinking
3. Preparing foods
4. Touching your mouth

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Wash your hands after:

1. Using the toilet

2. Coughing or sneezing on your hands
3. Playing
4. Handling pets
5. Gardening
6. Doing other activities that dirty your hands

Things to do for the Teacher 2

• Hang the two sheets of Manila paper on the board side by side
• Group the students into 10
• Give one drawing to each group
• Ask each group to tape the drawing to where it belongs (BEFORE or AFTER)
• Check the students’ work
• If a drawing is misplaced, ask the class where it is supposed to be
• Stamp one star at the back of their hands after the activity
• Post the two sheets on the activity board beside the germ drawings under the
cardboard with the message “But we could avoid getting sick by washing our
hands after each activity that exposes us to germs.”

Reminder

Do not forget to remind the children to ask one of their parents for the next
day’s activity and to bring the materials they would need.

Activity 4 Handwashing Day

This activity which aims at providng the students the procedural knowledge
and skill on handwashing is the focal point of the school-based campaign. This
day marks the role of the school in promoting health among children and reducing
the burden of infectious diseasess in the community by targetting one of the known
factors of disease transmission--spread of infection in daycare centers. Thus,
the conduct of Handwashing Day shall be done in collaboration with the other
stakeholders of the campaign.

Materials

• Soap
• Water
• Wash basins
• Handwashing chart
• Paper star pins/brooches

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Things to do for the teacher

• This is an activity that is best done with community involvement

• Ask the parent to sit beside their child
• In front of everyone, explain the handwashing process shown in the Handwashing
Chart
• Then, along with your assistant, wash your hands using the process in the chart
• Request the parents to take note of the process too
• Start the return demonstration in the schoolyard
• Ask each parent to stand beside their child and watch the child perform
handwashing
• Parents are only expected to assist when a child forgets or has difficulty following
a certain step
• Monitor the children during return demonstration
• After the activity, congratulate the children for doing a good job
• Emphasized the need for them to always remember when they need to wash
their hands and how to do it
• Request parents to assist and apply their children of their newly acquired skill
at home
• Distribute the star brooches/pins and ask the parents to pin them on their child
• Place the Handwashing Chart on the wall beside the activity board at children’s
eye level for their reference

Reminder

Positive health habits are not developed instantly. A newly acquired knowledge
and skill take a steady dose of reminders, encouragements, and performance to
become a permanent part of a person’s repertoire of behavior. This is especially
true for kids. Thus, even when the lesson progresses to other health concerns,
children’s handwashing behavior must be periodically monitored and assessed
using the Evaluation part of this module.

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Handwashing Chart

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HANDWASHING EVALUATION

As part of the Clean Hands, Healthy Lives Program, there should be a weekly
monitoring of the hand hygiene practices of kindergarten students. Every Monday
morning of the week, before class activity starts, the teacher must conduct hand
inspection and assess the status of hand hygiene using the items spelled out in the
Monthly Hand Hygience Inspection Checklist. Each observation must be entered
on the form so that possible explanations for students’ inability to observe hand-
washing practices can be drawn and possible solutions can be explored to address
these barriers.

Week 1 Week 2 Week 3 Week 4

Criteria No. of Rating No. of Rating No. of Rating No. of Rating Remarks
cases cases cases cases
Number of
children with
well-scrubbed
hands
Number of
children
with clipped
fingernails
Number of
children with
dirt under
fingernails
Approximate
number of
children who
wash their
hands after
using the
Classroom CR
Approximate
number of
children who
wash their
hands after
outdoor play
Approximate
number of
children who
washed their
hands before
snack time?
Amount of
soap left on
the dispenser
each week (in
grams)

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