The city of Tiruchirappalli in Tamil Nadu, India shows a way out of the sanitation crisis. The Tiruchirappalli model of community-managed toilets with bathing and washing facilities is an example of a partnership between sensitive city authorities, communities and NGOs, working together to address these problems. The work undertaken by these partners over the last six years has demonstrated how this can be taken to scale at the city-level. Within the next two years, it is expected that all slum communities in the city will be covered by community-managed toilets (CMTs).
There are 339 community toilets in the Tiruchirappalli (pop. 7752,000, of which 23 per cent live in slums), around half of which are now managed by communities. Since 2001, most community toilets are Integrated Sanitary Complexes (ISCs) built under the Tamil Nadu Urban Development Programme.
A study  undertaken by Gramalaya and WaterAid, with the support of Tiruchirappalli City Corporation (TCC) in July 2006, sought to understand the benefits of CMTs and the challenges facing this model after six years of experimentation. The study reveals that communities can manage their own toilet units, and when they do this, the toilets are much cleaner than when managed by TCC, and entire communities can be declared open defecation free. Achieving clean and healthy slums does not require huge financial investment; it requires a city authority sensitive to the problems faced by slum communities and supportive of community action, and dedication of communities and their support-NGOs. Managing their toilets leads to empowerment of women with many positive impacts in terms of personal and community development.
After initial reluctance, communities do pay for using toilets and services can be provided at affordable costs, even for the poorest. Financial management skills, systems for transparency and a focus on hygiene education are key elements for the success of CMTs, and NGOs should build capacity of Self-help Groups (SHGs) in these areas. Financial sustainability of community toilets is dependent upon the number of users and smaller toilets require support to be viable, for example waiving of electricity charges. City authorities should provide this support because community management of toilets saves them money. Ensuring sufficient and affordable water supply in all CMTs is a concrete step, which city authorities need to take to maintain hygiene standards and financial viability. Toilets are only a part of the sanitation solution. Sewage, wastewater and solid waste management must also be tackled and city authorities must play a lead role. Where land is available, community-managed solutions such as DEWATS are effective.
Tiruchirappalli shows the way by demonstrating effective, basic, community infrastructure and pro-poor solutions that work at the city-level when supported by city authorities, a social development organisation, or an NGO and empowered groups instead of leaving it to contractors to manage these complexes. The question is why is community management better than other forms of management? The answer lies in a process of management that goes beyond finance to hygiene education, a sense of ownership of community assets and provides a much needed social space for poor women to come together and discuss issues other than sanitation.
 Gramalaya and WaterAid India (2008). Tiruchirappalli shows the way : community-municipal corporation-NGO partnership for city-wide pro-poor slums’ infrastructure improvement : policy recommendations for community-managed toilets, bathing and washing complexes in urban slums. New Delhi, India, WaterAid India. xi, 24 p.
The above text is taken from the report’s exective summary.