The document discusses community-led total sanitation (CLTS) approaches to improving sanitation and achieving open defecation free communities. It outlines some of the key principles of CLTS, including community empowerment, collective decision making, and locally appropriate solutions rather than external subsidies or prescriptions. It also discusses some of the challenges to scaling up CLTS, including reliance on subsidies, prescriptive technologies, and a lack of coordination between different organizations. Examples from several countries show how CLTS has led to innovations and improved sanitation outcomes when communities lead the process.

1. At least something for many? New pathways, greater progress Scopes and Challenges of Community Led Total Sanitation Dr. Kamal Kar CLTS Foundation, Calcutta, India Presented at the STEPS Centre Water and Sanitation Symposium March 22&23 2011

2. Does some for all fits well with sanitation ? Big question is what kind of water for all? Without total sanitation ‘some for all’ could be ‘lethal for all’ or ‘poison for many’ Could basic sanitation for all ensure safety for all? ‘ Some for all’ in traditional approaches of sanitation is focused towards latrine construction, which never ensured safe environment for all of which water is most important

3. How safe is our water resources today? Freshwater lakes and rivers, ice and snow, and underground aquifers hold only 2.5% of the world's water If all of the world's water were fit into a one gallon jug, the fresh water available for us to use would equal only about one tablespoon Water use increased at double the rate of population growth; while the global population tripled, water use per capita increased by six times in 20 th century Access to basic sanitation depicts a totally different picture

4. Sanitation and MDG Over 800 million people lack access to safe drinking water, 2.4 billion to adequate sanitation. Each day almost 10,000 children under 5 in Third World countries die as a result of illnesses contracted by use of impure water. The world is on track to reach the Millennium Development Goal re water, but is woefully behind its targets for the MDG re sanitation All countries in sub-Saharan Africa are off track MDG

5. Traditional sanitation approaches misses the core of CLTS Subsidize, Standardize, Prescribe, Teach, provide, supply and reward for not shitting in the open Fragment/divide community on externally determined poverty criteria (BPL/APL) Government of India estimate says 60% IHHL coverage, meaning MDG target in sanitation achieved already JMP estimates 638 million defecates in the open (578 million in rural areas) 42 children under 5 die every hour in India GOI has been increasing hardware subsidy regularly

6. What is Community – Led Total Sanitation ? They are total & involve/affect everyone in communities e.g. total elimination of open defecation, total freedom from hunger) Collective Community decision & collective local action are the keys Social Solidarity and cooperation are in abundance They are locally decided and don't dependent on external subsidies and prescriptions or pressures Natural Leaders emerge from collective local actions who lead future collective initiatives They often don’t follow externally determined mode of development and blue print Local diversity and innovations are main elements

7. Fate of free toilets in a slum of a Municipality town near Calcutta, India

8. Fate of subsidized sanitation hardware- Portloko, Sierra Leone, Ibb, Yemen Who’s design for whom?

9. Fate of sanitation subsidy in Yemen

10. Abandoned Collapsed Communal Latrine –Dangme West District, Greater Accra Region, Ghana

11. X X X Moving towards 100% sanitised village P. R. A . L L L L L L L L X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Land less don’t have place for defecation. Land owners often blame them for defecating in open. Landless poor (women specially) are the worst victims who want to come out of that humiliation. Participatory Planning Latrine owners can’t get rid of negative impacts as many others adding faces everywhere. Spoiling environment by open defecation Will form positive pressure groups from within to convince others for having latrine Better off Medium Poor Very poor

12. More yellow powder in places where there is more shit- Sierra Leone

14. Rural community in Mardan, NWFP, in Pakistan mapping defecation areas of village

15. Food and shit demonstration

16. Children’s procession protesting against open defecation

17. Rural youth in Nepal triggering Community Led Total Sanitation. Are they not transforming the collective behavior of the society?

18. Worried faces of mothers after their own analysis- Llala Gua, Bolivia Shit everywhere. Our children growing on shit- we can’t accept this

19. Notice who is teaching and who is learning

20. “ If we defecate in the open, we eat each others shit, if you don’t wash your hands with ash or soap, you eat your own shit” - a Natural Leader of CLTS from Malawi

21. Hundreds of low-cost local community-made toilets are surfacing in the rural landscape in CLTS villages in Bangladesh.

22. Who’s idea and who's decision matters in household sanitation? South Sumatra, Indonesia

24. Great mosaic of latrine models innovated by local communities in Kampung Spu in Cambodia

25. Do we have patience to allow communities to gradually move up the Sanitation Ladder? Open defecation O 10 9 8 7 6 5 4 3 2 1 Pour flush latrine Latrines with plastic pan and water seal Offset Pit latrines Simple Pit Latrines Sanitation behaviors changes as community moves up the ladder

26. Newly constructed toilets in Kampong Svay villages, Kampong Tralach district of Kampong Chhnang province in Cambodia - great sense of ownership and pride. Mr.Hoeun invites neighbours to use his toilet to get more manure for his crops

27. Use of ash after defecation in direct pit latrine is an innovation by the community of Skun villages of Tbeng Commune of Siem Reap province in Cambodia. One gets potash rich manure at the end. Whose idea?

28. Community Innovated direct pit latrine- Skun village, Banteay Srei, Cambodia

29. Local Community Innovation in Kalyani

30. Proud Kepala Desa showing different toilet models to visitors- Lumajang,East Java, Indonesia

31. Local Community Innovation in Kalyani

32. Construction details of community innovated low-cost latrine Tin sheet, old plastic bottles and plastic sheets are used to construct such toilets

33. Locally innovated toilet model in flood prone areas and in places with high water table at Sambas, West Kalimantan

34. Stop Open Defecation All 213 H/H Repair platform of all 69 hand tube wells Clean up garbage and Repair Road Clean up drain In 5 months ten slums covering more than 800 H/Hs have stopped OD by constructing toilets mobilizing more money than what KUSP could offer as subsidy

35. Signboard declaring Open Defecation-Free, Para Vidyasagar Colony, Kalyani Municipality, West Bengal

36. BOLIVIA SIERRA LEONE NIGERIA UGANDA ZAMBIA MALAWI KENYA ETHIOPIA YEMEN TANZANIA NEPAL PAKISTAN INDIA BANGLADESH CAMBODIA INDONESIA EAST TIMOR Global Spread of CLTS Afghanistan EGYPT

37. Could Ghana, Nigeria, Mali, Sierra Leone and others achieve Millennium Development Goal in Sanitation and become an open defecation free country? The answer is yes of course! What is blocking us then? The blockages are mainly three: Old mind set of providing, prescribing and teaching Our attitude of ‘we do it for them’ and ‘they can’t do it’ Subsidy, technology prescription and teaching hygiene education VIP and communal latrines as the only solutions Serious inter-institutional in coordination Better coordination between the UN agencies and government of countries Could they incorporate new learning in to their new programmes? ADB’s “Hybrid CLTS” ???

38. Major Blockage of Scaling up in Ghana

39. Main Blockage of Scaling Up CLTS in Ghana CLTS Triggered Community Empowerment Hardware Household subsidy from donors Technology Prescription :Promotion of VIP/KVIP Promotion of Communal Latrines Attitudes of Traditional Chiefs towards free & subsidized communal latrines Institutional In coordination Poor coordination mechanism Focus on latrine and not ODF Villages Inadequate funding at district level for CLTS promotion

40. How V.I.P Latrine blocked scaling up and spread of CLTS Abandoned V.I.P latrines brought to use after 5 years- mostly dilapidated with broken doors and slabs Technical blockage Local Innovation Blockage Local resources& materials Blockage Dependence on external inputs & skills Most communities could not afford cost of construction of V.I.P latrine (Unit cost GHC 210) Prescription of only one technology prevented others Emergence of Innovative models that suit local environment is prevented Recycling/using of local materials in latrine building is blocked & misleading Dependence on masons/training and non-availability of cement slows down coverage

41. Abandoned V.I.P Latrine…

42. Dilapidated V.I.P Latrine …..

43. Expensive V.I.P Latrine…

44. Communal Vented Pit Latrine ….

45. Northern Region – 20 Districts Karaga District – 176 Communities; Estimated Population of 75, 000 – Model based on visit to Fatenayili ODF Village (24HHs) CLTS Practice in Karaga District Main Actors UNICEF World Vision District Assembly DEHO UNICEF gave materials for Slab World Vision gave materials for V.I.P Latrines No proper coordination by District Assembly DFT Triggered Communities for CLTS Communities stopped OD within 7 days of triggering Communities constructed Traditional Latrines within 7 days UNICEF gave materials for fabrication of slabs Communities abandoned Traditional Latrines World Vision provided materials for V.I.P after 1 YR Communities abandoned UNICEF Latrines New settlers sharing latrines & waiting for their free latrines Main Features Presence of knowledgeable CBVHP/NLs Abandoned latrines litter the village No room for community involvement in latrine choice Behavioural change to stop OD achieved Not sustainable, replicable and scalable Opportunities NLs willing to support neighboring communities to achieve ODF

46. Abandoned Free Latrines depicts welfare mindset of institutions in Fatenayili ODF Village

47. From Better to Best Free Latrine – Fatenayili….. Who’s scarce resources are we wasting? Can rural Africa afford this?

48. Northern Region – 20 Districts Zabzugu/Tatale District – 262 Communities Model based on the visit to Tsaondo ODF Village CLTS Practice in Zabzugu/Tatale District Main Actors UNICEF APDO District Assembly DEHO 4 ODF Villages in the District CLTS introduced by APDO in mid 2008 One week training in Tamale District level training for Area Council staff Community Triggering done by trained DEHO Presence of knowledgeable NLs Every HHs have traditional latrines Improved Environmental sanitation & Hygiene True Community Empowerment & CLTS Practice Main Features Community Led Innovative latri. No subsidy Hygiene bev. change Improved Env. Sa Empowered NLs Sustainable/ Replicable /Scalable Opportunities NLs support other communities Use the ODF Village as Learning university for CLTS. Organize exchange visits to ODF Village/ODF Celebration

49. Un-intended Positive Outcome from True CLTS in Tsaondo ODF Village High Quality CLTS triggered without hard ware subsidy & Prescription Variety of latrine models emerged Low Cost materials used for latrines Local knowledge used in abundance, e.g Use of Ash, Pit Cover Community confining free roaming pigs Stopped eating dead animals Cleaned up all the bush to avoid bush fire/No more snake bite/Reduced malaria cases Songs developed to stop OD Daily change of d/water; Hand washing b4 eating; Cleaning up for kids Right understanding of CLTS by Mr. Yahaya (DEHO) – Recipient of proper Hands-on training (Otukpo, Nigeria) contributed to the excellent outcome

50. Low Cost Traditional Latrine- Tsaondo

51. Low Cost Traditional Latrines- Tsaondo

52. How Communal Latrines block the spread and scaling up of CLTS Communal Latrines Not properly maintained Breeding factory for flies Mainly Fixed Point Open Defecation Not appropriate for emergency defecation, hence contributes to OD Blocks construction & use of HH latrines Blocks innovation and creativity to stop OD Often requires external technical support High frequency of collapse Collapse of communal latrines major reason for returning back to OD Difficult to sustain ODF with Communal latrines Communal latrines are Unimproved facilities and not regarded as Access to Improved Sanitation (WHO/UNICEF JMP Report)

53. Abandoned Collapsed Communal Latrine

55. Could we trust on our rural communities and believe that they could do it? Could we promote emergence of hundreds of Natural Leaders in each district as agents of change? Could we refrain from top-down technology prescription and allow local innovations? Could we acknowledge the contribution of children as pressure groups in getting their parents to stop open defecation and their communities to become ODF.

57. CLTS and MDG Goals Goal 6 Major diseases especially diarrhea MDG 5 Maternal mortality Goal 4 Under 5 mortality Goal 7 Sanitation halving proportion without access MDG Goals

58. Fundamental and Non Negotiable Principles of Rural CLTS No subsidy for hardware No blueprint design (only people ’ s designs, not engineers ’ ) People first: they can do it Facilitate, don ’ t provide Go slow at first for faster later

59. What do we learn? Repeatedly we learn that commitment and champions are a necessity in all situations for interventions in CLTS. For champions to make headway and achieve sustainable results, they must have a supportive policy environment to ignite the collective community understanding and response. In India the focus on NGP and toilet targets, disbursing subsidies as a measure of implementation are all a reflection of the adverse policy environment

60. Political Challenges Asia: Countries like India, China with better per capita still support subsidized, externally prescribed household sanitation where as countries like Bangladesh, Cambodia scaled up CLTS exponentially. Percentage of usage of externally funded toilets are appalling Africa: Quicker understanding and acceptance of the approach by governments of Sierra Leone, Malawi, Zambia, Ethiopia

61. Challenge of multiplying Facilitators, Trainers and Community Consultants The pace with which demand for CLTS is growing there is need to train hundreds of trainers immediately in Africa and Latin America (Franco phone Africa, Spanish speaking countries specially) Thousands of ‘Natural Leaders’ turned in to ‘Community Consultants’ with in countries Dozens of Champions with in the Government Ministries and Departments Ministers and MPs or elected people’s representatives in each countries as champions of CLTS

62. Institutional Challenges Attitudes and mind sets of professionals in the institutions and their belief on local community capacity Feeling of loosing control and technical and academic supremacy by engineering, health and social development professionals Institutional hierarchy and unclear understanding of the ground reality including poor functional linkages with the front line

63. Institutional Challenges Difficulty to escape from the old established mind-set of ‘donor’ and ‘recipient’ defining ‘uppers’ and ‘lowers’ Inertia in moving out of the preference of ‘things’ to ‘people’. Shift from ‘ latrine construction’ to ‘creating Natural Leaders’ and ‘ODF villages’ Pressure of spending huge sums Variations in the focus of institutions working only on water and sanitation versus those working with wider humane objectives

64. What are our challenges today? Sanitation to be addressed as a part of larger poverty reduction strategy given its known implications for dignity, productivity, human health and well being. Emergence of ODF communities - first critical step towards achieving safe sanitation that effectively prevents the fecal contamination of water Initially developing few hundreds of ODF Communities as learning laboratories for CLTS Natural Leaders as Community Consultants- scaling up CLTS How to enhance emergence of innovative local institutions as champions on CLTS? How to involve local communities as active partners of research in technology development and in sanitation marketing?

65. Institutional Challenges CLTS as a fad and everyone have their own version of ‘community led’ (subtle difference between ‘functional participation’ to ‘interactive participation’ or ‘self mobilization’) Struggle to streamline other approaches of sanitation with true empowerment encouraged in CLTS. TSSM in Indonesia, TSC in India, others in Ethiopia, individual house hold vs community CLTS is just one another approach and it might survive better if other sanitation approaches work freely without using this label. All approaches have uniqueness.

66. Institutional Challenges Challenges of intellectual institutional supremacy- who knows more and who prescribes the best solutions? Competition for attracting more donor funding by implementing agencies Struggle and compromise to fit in a new community led approach in the old existing system of government structure designed to perform in a ‘supply driven’ rather than ‘demand driven’ mode

67. Political Challenges Asia: Countries like India, China with better per capita still support subsidized, externally prescribed household sanitation where as countries like Bangladesh, Cambodia scaled up CLTS exponentially. Percentage of usage of externally funded toilets are appalling Africa: Quicker understanding and acceptance of the approach by governments of Sierra Leone, Malawi, Zambia, Ethiopia

68. Lessons Learned CLTS entails a shift of paradigm and change of power relations From teaching to facilitating From engineering designs to local designs From targets and counting latrines to counting ODF communities and promoting Natural Leaders From big budgets and pressures to disburse to adequate budgets From us helping the poor to communities taking responsibility From sanitised words to the crude ones – faeces are SHIT!

69. Could we trust on our rural communities and believe that they could do it? Could we promote emergence of hundreds of Natural Leaders in each district as agents of change? Could we refrain from top-down technology prescription and allow local innovations? Could we acknowledge the contribution of children as pressure groups in getting their parents to stop open defecation and their communities to become ODF.

70. Thank You