Knowledge, Attitudes, and HIV/AIDS Risk Behaviors of Myanmar Migrant Workers in Thailand GHMJ (Global Health Management Journal) 2022, Vol. 5, No. 2 Indonesian Scholars’ Alliance Open Access Photo Essay POLITEKNIK KESEHATAN KEMENKES PALANGKA RAYA: HEALTH FORUM AND INTERNATIONAL SEMINAR THE NEW NORMAL: Creating a Pleasant Virtual Communication Hand-washing promotion during Covid-19 outbreak in Riverbank of Kahayan River, Central Kalimantan, Indonesia Missesa 1,* , Trissa Viranti 1 , Shasa Dini Martha Ewa Kaswana 1 , Carolin Firsta Athena 1 , Hendrowanto Nibel 2 1 Department of Nursing, Poltekkes Kemenkes Palangka Raya, Indonesia 2 Fakultas Keguruan dan Ilmu Pendidikan, Universitas Palangka Raya, Indonesia *Corresponding author’s e-mail: missesa@polkesraya.ac.id DOI: 10.35898/ghmj-52944 Selection and peer-review under responsibility of the scientific committee and the editorial board of the Annual Health Forum and International Seminar of the Politeknik Kesehatan Kemenkes Palangka Raya © Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars’ Alliance). This is an open-access following Creative Commons License Deed - Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) COVID-19 is a new type of disease caused by infection with the Virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCOV-2) Virus (Singhal, 2020). Since the emergence of COVID-19 in end of 2019 up to end of October 2020, the virus has infected 44,002,003 people and caused death to 1,167,988 people worldwide (WHO, 2020). According to Child Protection for Population Control and Family Planning (DP3, AP2KB) data, hundred and eleven (111) children were infected with Covid-19 in 2020. In mid-2020, COVID-19 cases in Central Kalimantan showed relatively high at 1,055 cases. In other words, approximately 10.5% of children suffered from COVID -19. Source: Kasriadi dan Hidayat, 2021 (https://www.antaranews.com) Figure 1. Children with Covid 19 in Central Kalimantan, July 2021 3% 26% 71% < 1 years old 1 - 5 years old 6 - 15 years old mailto:missesa@polkesraya.ac.id https://doi.org/10.35898/ghmj-52944 Missesa et. al. GHMJ (Global Health Management Journal) 2022, Vol. 5, No. 2 154 In 2021, COVID-19 cases showed an increase in a number of cases in children compared to the previous year. In July 2021, a total of 3.241 cases were reported, including those aged 6-15 years old (2,302 cases), 1-5 years old (844 children), and < 1 year old (95 children) (Figure 1). The increasing number calls all parties to protect, sustain, and accelerate progress in fighting childhood COVID-19 by maintaining healthy standard behaviour. Many institutions have been implementing health education on the positive healthy behaviour standard for COVID-19 prevention, including regular hand washing, mask-wearing (Figure 2), and social distancing. The purpose of this article is to give clear and actionable guidance for children living in river-basin residences. Figure 2. Masks to protect healthy children during the Covid Pandemic living in Central Kalimantan This photo essay records health promotion given during Covid-19 outbreak in Riverbank of Kahayan River, Central Kalimantan, Indonesia (Figure 3). Central Kalimantan geographically has a number of rivers known as a watershed area (DAS). Figure 4 shows the children use small boat made by wood to mobile or visit their friends to play. Figure 3. View of the Kahayan riverbank in Central Kalimantan Figure 4. Children playing together by the river in Central Kalimantan before Pandemic 155 GHMJ (Global Health Management Journal) 2022, Vol. 5, No. 2 Missesa et. al. Before the Covid-19 Outbreak, using face mask in not compulsory and parents will just freely give permission to their children to play outside. It is shown that it is challenging to encourage children to protect themselves from the COVID-19 infection in the area of DAS. Moreover, the existence of this abundant water source is a potential natural asset for positive hygiene behaviour. Thus, it is worth noting that hand washing with soap and water is recommended (Przekwas and Chen, 2020). Research by Widodo and Alexandra (2018) reported that levels of knowledge about clean behaviour living habits in residents living in the riverbank of Kahayan River were not optimal (56.8%) and behaviors of hand washing with soap were only 14%. The Corona virus outbreaks impacted education across the word. Our local Government took action to prevent the spread of the virus by disclosing schools throughout all levels of education, including Early Childhood Education (PAUD) level to higher education institutions. We have been learning about the COVID-19. Although basic information has been informed, parents are required to encourage their children, maintaining the healthy behaviour during the Covid-19 pandemic. Instead of continuously closing schools indefinitely for preventing the spreadable virus, teaching children good hand and respiratory hygiene practices for schools and outdoor activities are crucial. Some educational health learning on these includes frequent hand washing, covering a cough or sneeze with a tissue or tugged elbow, followed by throwing the tissue into a closed waste bin, preventing their eyes, mouth, and noses from their dirty hands. Moreover, it is also good to have a look at their mental health. Some mental health which can be suffered by children during the pandemic involves sleeping disorders, bedwetting, pain in the stomach as well as stress. Teaching them how to cope with stress can be encouraging. Some efforts to address the spread of COVID-19 and mental health problems during the pandemic should be made. Those are as follows. Firstly, regular surveillance of children’s health and asking them to stay at home in case of illness are encouraging. Other efforts are teaching and demonstrating good hygiene practices for children (Figure 5). As per Government policy on COVID-19 health protocol, hand washing with soap is recommended. The handwashing action can be conducted in schools Figure 6. Doing a focus group discussion activity is also helpful for children to understand better about COVID-19 pandemic. Furthermore, it can explore their feelings during the pandemic. Hence, children feel secure when they face issues on COVID-19. Since the COVID-19 virus is able to survive on various types of objects in a few hours, some even up to several days, it is suggestive to ask children to avoid touching their face, eyes, mouth, and nose. Likewise, consideration for other people around children should be taught to children. Therefore, asking them to cover their mouths with their elbows or a tissue once coughing and sneezing is a key message for parents and caregivers. Figure 5. Teaching children to wash their hands Figure 6. Children make a habit of washing hands in school activities Missesa et. al. GHMJ (Global Health Management Journal) 2022, Vol. 5, No. 2 156 Proper hand washing activities need to be taught as early as aged 2-10 years (WHO, 2020). At this age, children like to discover new things. Hand washing was also suggested by Anhusadar and Islamiyah. (2020) that it is important to implement clean and healthy behavior for early childhood in the midst of the Covid-19 pandemic. Healthy living behavior in children must be taught from an early age stage because ofthe rapid development of the brain in early childhood. At early age, the memory capacity of the brain reaches its maximum level. Therefore, it is useful to develop healthy behaviors at the early age that children will have a healthy lifestyle in adulthood. source : https://promkes.kemkes.go.id/ Figure 7. Educational poster on how to wash hands School environments are effective in disseminating health promotion strategies. A program which engages children in schools to support healthy lifestyles provides a medium for creating creative environments through posters. Posters offer a great impact visually on audiences and give messages a lot of exposure, allowing posters to reach a number of different types of people. In the following are steps on how to wash hands. How to wash your hands in 20 seconds are (Figure 7) 1) Wet hands thoroughly with running water 2) Rub soap into palms, backs of hands and between fingers. 3) Clean under the nails 4) Rinse hands with running water 5) Dry your hands with a towel / tissue or dry with air / air dry 157 GHMJ (Global Health Management Journal) 2022, Vol. 5, No. 2 Missesa et. al. Posters delivered messages in the form of the comic along with words and pictures will have powerful message to tell stories which might be preferable to children. Comics can convey key persuasive messages of COVID-19 attractively to children to influence their behaviors. COVID-19 campaign through poster is also known as an effort to prevent disease transmission which can be conducted to change children’s habits. Hands are agents which carry germs and cause pathogens to move from one person to another, either by indirect or direct contact. Campaigns on COVID-19 to children can be conveyed through visual and auditory information. Audio- visual campaigns encourage children to keep healthy lifestyles. Research conducted by Listiadestiet al. (2020) reported the effectiveness of audio-visual media as health promotion which significantly helped children's understanding on hand washing with soap. Figure 8 shows our effort to support healthy lifestyles by storytelling which engages children with COVID-19 information. It incorporates narrative texts and stories with a fun way which, attracts children's interest. It does not seem to be patronizing and can develop children's imagination in which storytelling contains a story of experiences and an incident or invention which actually happened in the real world. Perdani's research results (2018) show an effective campaign, promoting the handwashing program to children. A cultural approach can also be an alternative for health campaigns. Figure 9 shows how we use one of traditional musical instruments of Central Kalimantan, called Japen, and the lute is used as an instrument for making audio-visuals. This instrument is made from a sack. It includes education and has a key message of moral wisdom with the social value of the Dayak people in Borneo. Figure 8. Educational activities by telling stories Figure 9. Children are taught to use a typical Central Kalimantan musical instrument "Kecapi" Maintaining children's health during the Covid 19 pandemic with creative educational campaigns, using various modes such as posters, multimedia, and storytelling is beneficial for positive health behaviours. Responsibility and health disciplines which are developed from an early age in the new normal era will enable them to build intrinsic motivation for stopping the spread of COVID-19. .Consent The informants (identifiable) photographed have given their consent for their pictures to be used in the publication of this photo essay. Conflict of Interests: None Acknowledgments: The authors wish to thank Politeknik Kesehatan Kemenkes Palangka Raya, Central Kalimantan. Missesa et. al. GHMJ (Global Health Management Journal) 2022, Vol. 5, No. 2 158 References Anhusadar, L. O. Islamiyah.(2021). Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini Penerapan Perilaku Hidup Bersih dan Sehat Anak Usia Dini di Tengah Pandemi Covid, 19, 463-475. doi: 10.31004/obsesi.v5i1.555. KaltengPos (2020) Memilukan ! Tercatat, 111 Anak di Kalteng Terpapar Covid-19. Available at: https://kaltengpos.co/berita/-50022-memilukan_!_tercatat,_111_anak_di_kalteng_terpapar_covid-19_.html (Accessed: 30 October 2020). Kasriadi dan Hidayat, M.A. 2021. Kasus covid 19 pada anak-anak di kalteng cukup tinggi https://www.antaranews.com/berita/2269882/kasus-covid-19-pada-anak-anak-di-kalteng-cukup-tinggi. (Accessed: 30 October 2021). Przekwas, A. & Chen, Z. 2020. Washing hands and the face may reduce COVID-19 infection. Med Hypotheses, 144, 110261. 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Cite this article as: Missesa, Viranti T, Kaswana SDME, Athena CF, Nibel H. Hand-washing promotion during Covid-19 outbreak in Riverbank of Kahayan River, Central Kalimantan, Indonesia. GHMJ (Global Health Management Journal). 2022; 5(2):153-158. doi:10.35898/GHMJ-52944 https://doi.org/10.31869/mm.v3i1.2198 https://doi.org/10.35898/ghmj-52944