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Early Lessons from The Western Sumatran Islands
MULTI-USES OF RIVER BASINS:Tools to Harmonize Conflicting Interests, Davao City November 2009
Did you know
• Just one gram of human faeces can contain 10,000 viruses • Open defecation means that deadly diseases are quickly spread through a community • Water can become contaminated and a vector for diseases
• Children are often exposes to faeces in areas that they play • Many children miss school because of illness But… • There are thousands of communities making
their villages free from defecation
Community Led Total Sanitation
• IHP, Water & Health, sanitation • CLTS a low cost tool • Reflection on process and impacts from West Sumatra Islands • Conclusions & recommendations
Water and health
• IHP VII Sanitation tackled under Section 4: Water and life support systems • this theme includes protecting water quality from natural and anthropogenic sources of contamination. • Here we will view if from a human health perspective
Sanitation: A high impact intervention
• Bang for buck • Reduces human suffering • Improves environmental quality • Estimated the annual economic loss caused by poor sanitation is P77.8 billion.
QuickTime™ and a decompressor are neede d to se e this picture.
West Sumatra Islands Basin
• Joined the HELP UNESCO River Basin Network thorough the third call in 2008 • The Basin is at early stage in development • Stakeholder participation is ongoing at the village and local government levels • Strives to become a leader in the global network with a focus on water and health.
West Sumatra Islands
• Vision is to improve the health, well-being and self-reliance of people living in isolated regions. • Mission is to develop and synthesize a series of proven, high impact and cost effective approaches that create lasting improvements in the health and wellbeing of individuals and communities at increasing scale. • CLTS is one such approach.
not SurfAid led! We only provide tools and provoke! Individuals who volunteer their time from the community – Natural Leaders
Is only achieved once the burned of sanitation related diseases are minimised. Diarrhoea is the single biggest disease burden from poor sanitation
[ODF, Diarrhoea, waster water, composting]
Community Led Total Sanitation (CLTS)
• is an innovative methodology where communities are facilitated to conduct their own appraisal and analysis of open defecation (OD) • Decide to take their own action to become ODF (open defecation free).
Behavior not hardware
• Traditional approaches mainly subsidy driven • Providing toilets does not guarantee their use, • Creates a culture of dependence on subsidies. • Open defecation and the cycle of fecal– oral contamination continued to spread disease.
Diarrhea prevalence v‟s latrine usage
Individual Sanitation Practices Affect the Entire Community
users of latrines
80 60 40 20 0 = Prevalence of diarrhea
• CLTS was pioneered by Kamal Kar in Bangladesh, in 2000. • WB, Plan International, WaterAid and UNICEF have become important disseminators and champions of CLTS. • Today CLTS is in more than 20 countries in Asia , Africa, Latin America and the Middle East. • No reference of CLTS being implemented in the Philippines.
MDGs Seriously off track
20 million people do not have access to improved sanitation.
Economic Impacts of Sanitation in the Philippines, WB
An approach that works: CLTS Lessons from Sumatra
Sumatran Islands Context
• Funded by Oydimar Network with NZAID and AusAID. • Post earthquake reconstruction environment • Committed delivery of 64 improved water and sanitation facilities. (21 latrines) • HELP UNESCO partner for technical learning
As refined by team SAI
5 major steps
1. 2. 3. 4. 5. Prepare Trigger Action Planning Tracking Sustaining
Step 1. Prepare
Outside In (Before Day 1)
• Training on 5 steps process. • CLTS is build on feelings so technical know how is not enough! • You have to build a cultural in your field team to „feel and live the process”
Step 2 Triggering
“Triggering is based on stimulating a collective sense of disgust and shame among community members as they confront the crude fact about mass open defecation and its negative impacts on the entire community.”
Step 2. Ice breaker
Step 3. Discussion
Who actually has a latrine here?
Step 4. Mapping
Step 4. Mapping
Step 5. Walk of Shame
Step 6. Discussion
Amount of defeaction the village can produce Observe! Who is really engaged!? Who is contributing!?
Step 7. Clean water drink
And then not so clean…
First person to decide & act…
Results to Date CLTS
• Is possibly the most powerful experience of community led development SurfAid has touched! • program had funds to build 21 latrines • 8 communities have built 191 units over a four month period • Zero subsidy!
Graph 3. Total CLTS Latrines was built 191 200 180 160 140 120 Nb of latrines 100 80 60 40 20 0 162
Total Latrines was built
Graph 6. Progress on Diarhea Case: Baseline Vs Current
16 14 12 10 # Diarhe a case 8 6 4 2 0 Hilihoya Hiligawono Sitoba'a 3 00 0 2 0 3 0 0 0 3 0 0 Boyolala 0 15 13
Adult Baseline 5 3 0 Hilina'a 0 Adult Current Underfive Baseline Underfive Current
Na m e of Dusun
Challenges 1. Maintaining health improvements 2. with wide scale community construction of basic pit latrines across the villages the potential risk of ground water contamination is high
Pig pen 3
Conclusion and Recommendations
1. CLTS is an effective low cost solution to reduce anthropogenic sources of contamination and thereby reducing pressure on water and human health 2. True community empowerment approaches suffer in dole-out environments
– If you are willing to tap the social entrepreneurial spirit in communities they can find solutions from within and – overcome dependences on dole out aid.
• 1. CLTS for adoption by other HELP Basins • 2. Develop a focus group on water, health and risk reduction to refine lessons across HELP • 3. to host technical cross visits to share experiences and engage technical reviews of water & health community programs