Saturday, January 22, 2011

For Ourselves

The deadline for the world to meet its millennium development goals is now only four years away, yet in sub-Saharan Africa, there are still 570 million people without adequate sanitation, and it will be another 200 years before just half of the population of this region have access to a safe, private toilet. In Nigeria sanitation coverage stands at just 32%. Children die at the rate of 4,000 a day. That's the equivalent of one child dying in the time it takes to read this paragraph. Building a latrine is only half the battle.

In many rural areas in west Africa, the practice of open-air defecation is ritualised and bound in tradition. Beyond individual differences, the members of a group or society are united by similar ways of thinking and behaving, and will react to situations in similar ways. Our research showed that reasons for resistance to using a latrine included beliefs that one might be possessed by demons, lose magical powers or live a shorter life. Some believe a toilet is meant only for wealthy people or that, if somebody feeds you, you should in turn defecate in their field. For many in so-called modern cultures who take the use of a safe, private toilet for granted, these reasons may sound funny, even ridiculous. However, it soon becomes sobering to think that each of these beliefs may be directly linked to disease, debilitation and death.

An approach known as community-led total sanitation (CLTS) was first conceived in Bangladesh and the concept has been sweeping across south Asia with impressive results, and many are hoping that it can bring similar results to Africa. It is based on an understanding that the people themselves have the solutions and are best able to determine which interventions will enable them to attain a self-defined, collective destiny.

Instead of focusing on the supply and installation of sanitation hardware to communities, CLTS focuses on changing attitudes and behaviour through community mobilisation to stop open defecation, and to build and use latrines. Participants have reported that they find the approach engaging, participatory and, most notably, empowering – putting them in control of their own destiny, in a context in which, more often than not, death by disease is accepted with fatalistic submission to the 'will of God' or the hex of an enemy or the local witch. Empowering local communities – especially women – with information that allows them to make decisions pertaining to their health and well-being ensures that they "own" the desired change. It is they who can be credited for the health benefits of safe sanitation and hygiene practices. It is they who commit to the necessary behaviour change, they who hold themselves and their peers accountable.

Help is not coming from outside, but from within - and people are in charge of their own destiny.


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