Time to acknowledge the dirty truth behind community-led sanitation

In rural India, extremes of coercion are being used to encourage toilet use writes Liz Chatterjee in the Guardian’s Poverty Matters blog. Her provocative post has drawn comments from the likes of Robert Chambers, Rose George, Ned Breslin and Erik Harvey.

Wall art on the local council headquarters in Karnataka, where a two-year sanitation education campaign still has a long way to go. Photo: Liz Chatterjee

A spectacular rise in toilets usage from 20% to nearly 100% in a semi-rural district in Karnataka, realised by India’s national Total Sanitation Campaign (TSC), Ms Chatterjee discovered, was founded on community-led coercion.

Previous efforts to build toilets in the area failed to ensure actual use. They were often used to store firewood or chickens while families continued to defecate outdoors.

But some of the techniques used to persuade reluctant community members to construct toilets were unorthodox to say the least.

At its mildest, this meant squads of teachers and youths, who patrolled the fields and blew whistles when they spotted people defecating. Schoolchildren whose families did not have toilets were humiliated in the classroom. Men followed women – and vice versa – all day, denying people the opportunity even to urinate. These strategies are the norm, not the exception, and have also been deployed in Nepal andBangladesh.

Equally common, though, were more questionable tactics. Squads threw stones at people defecating. Women were photographed and their pictures displayed publicly. The local government institution, the gram panchayat, threatened to cut off households’ water and electricity supplies until their owners had signed contracts promising to build latrines. A handful of very poor people reported that a toilet had been hastily constructed in their yards without their consent.

A local official proudly testified to the extremes of the coercion. He had personally locked up houses when people were out defecating, forcing them to come to his office and sign a contract to build a toilet before he would give them the keys. Another time, he had collected a woman’s faeces and dumped them on her kitchen table.

Chatterjee was equally shocked by some of the “sensationalist scare tactics” used in TSC educational campaigns.

These included graphic media stories on the rape-murders of women, and dramas about the dangers of child-snatching, robbery and snakebites while openly defecating (all rare in the area). In one village, a Unicef-sponsored NGO had even been showing people grotesque pictures of vast tumours and conjoined twins, suggesting they were the result of poor sanitation.

Chatterjee’s article has sparked a lively discussion, with 25 comments posted so far. In a reaction to several comments stressing that the TSC is not the same as community-led total sanitation (CLTS), the author counters that

TSC can offer insights into what scaled-up, state-sponsored CLTS-influenced programmes might look like as they’re rolled out across developing countries [and that] the TSC is undoubtedly an evolution that follows the logic of CLTS.

The incentive to use extreme coercion to force a minority of non-ODF adopters to comply seems to have been fuelled by the TSC’s financial reward scheme (Nirmal Gram Puraskar).

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Source: Liz Chatterjee, Time to acknowledge the dirty truth behind community-led sanitation, Poverty Matters Blog / The Guardian, 08 Jun 2011

10 responses to “Time to acknowledge the dirty truth behind community-led sanitation

  1. Development in sanitation will not come by fear and force. It has not worked anywhere. Positive results come from a change in mindset, an understanding of issues at stake. Resources are being wasted on CLTS. Why not PHHE through Community Health Clubs. We have evidence that this works.

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  3. I recently challenged Kamal Kar, the originator of the approach, with this information at the Africa San conference in Kigali 2011. His response: “Dont you worry about that, its not our programme. This is done by the government…. ”

    Whoever does it, is not the point… this methodology encourages abuse, and is unethical. CLTS may achieve its objectives of limiting open defecation but at what cost? Does the means justify the end? Just as medical doctors have to be responsible, where are the checks on unethical development practice?
    There are alternatives: The Community Health Club approach achieves the same with positive rather than negative peer pressure. see the website http://www.africaahead.com for another way of doing things!
    Juliet Waterkeyn

    • It is with considerable perplexity that I have been reading the criticisms of the CLTS appraoch. As an anthropologist, I went to Nepal to undertake a study to explore Health Promotion Efforts to prevent the practice of OD. I went out there somewhat sceptical and concerned as alarm bells had been triggered when reading of the CLTS techniques such as ‘walks of shame’ ‘whistle blowing’ ‘faecal calculation’ ‘faecal mapping’ not to mention the ‘glass of water technique’ ! So with my anthropological and western lenses on I went out thinking I would indeed uncover situations of abuse and unethical practices. To my complete surprise, however, at least in the Western Region of Nepal, this was not the case at all, and the primary reasons were:
      The approach is by definition “community led”
      Most of the triggerers I met had previously been ‘OD practitioners” themselves, and as a result related well and had empathy with the communities they were working with
      Drawing on the theoretical framework of Actor Network Theory, one explanation of the success appeared indeed to draw a variety of ‘actors’ and ‘actants’ coming together and ‘consequences’ and ‘impacts’ of the the OD behaviour became clearly evident when engaging in some of these techniques.
      The approach is not ‘prescriptive’ or supply oriented but promotes demand

      Some of the personal stories gathered also testified to the sensitivity of this approach:
      One of the most vivid recollections I have was going to the home of an ‘out caste’ woman. I was accompanied by a project staff member, a Brahman, who explained in quite some detail that this woman’s life had been turned around, since she had finished building her own toilet. A toilet had not been constructed for her, she had not received any subsidy, but of her own volition constructed her own toilet, and as a result she was no longer treated as an outcaste. Her status in the community had raised considerably as a result of constructing her own toilet.
      Another memorable time was being taken to a home and shown a latrine that had been constructed by the 12 year old son of a widow. This followed his being targeted at school, a technique that horrified me at first, but seeing the pride and changed lifestyle of this por family, convinced me otherwise.
      In one of the community meetings, when I asked specifically the question, “but why do you want to change your behaviour when these people come in and use ‘rough’ techniques and make you embarrassed, if it was me, I would want to chase such people away”. The response was “because we know they favour us and care”
      Every village we visited bestowed on us the most amazing hosptiality and warm reception, and some visits were unannounced.These visits were initiated by members of a project implementing CLTS. If abuse and unethical behaviour had been happening it would hardly elicit such a response from these communities.

      I am not sure what is happening in other places, but I can certainly testify to the dramatic success that was evident in the very short time I was in Nepal.

      Abuse? Unethical? i don’t think so. As an outsider I thought so at first, but after holding several FGDs, interviews and community meetings, my anthropological and western lenses were penetrated with another, unexpected image.

      I have read of the successes of the Community Health Club approach as well, and believe indeed these are sometimes working and considering the historical legacy of colonial practices with them I found this surprising.

      My caution would be, Community Health Clubs sit much more comfortably with us as Westerners, and indeed the confrontational and crude appraoch of CLTS doesn’t sit so comfortably, but personal stories from the communities I visited, did not reflect this degree of discomfort.

      I think it would be an enormous set back in health promotion efforts to prevent OD if CLTS does not continue to receive the acclaim that it deserves. Having engaged in all the reading I have done on CLTS, I am in awe of the work of Dr Kamal Kar and his insightful, innovative approach that is, in my limited experience, being carried out with sensitivity and concern. Lets not forget the foundation for this approach is based on the principles of Particpatory Rural Appraisal of Dr.Robert Chambers and Kamal Kar. The ‘participatory’ approach of CLTS has inbuilt mechanisms that, I believe, safe guard it from abuse and unethical practices.


  4. Juliet, I recognize this, saw pretty awful CLTS video’s last year in Northern Uganda. But… how was it in Western Europe when we tried to eradicate Cholera in cities (London), or get rid of the stench in the Amsterdam canals. Was the approach more subtle then? Peter

  5. HI Peter,
    We cant compare today’s standards of practice with the way cholera was handled in London, over 100 years ago, as we now have a whole disicipline of community development , which should recognise certain ethics. For example, we wouldnt tolerate work houses for the poor as they did in Dickens time… it would not be acceptable today. We have to have respect communities and practice development in a professional way. Its amazing how much quiet chuntering is going on in Africa about the method of ‘naming and shaming’ in CLTS as it is against African culture to insult and belittle seniors in public. However because CLTS seems to be the flavour of the month, many local practitioners are hesitant to speak out, but these cultural issues need airing. What is good for Asia is not necessarily appropriate in Africa. As Nyerere famously said, “In Africa we sit under a tree, til we agree!” Direct confrontation is considered barbaric. The achievements of ODF using CLTS method of coersion through shame, need to be compared in the light of what can be achieved with positive rather than the negative peer pressure that is used in ‘triggering’. For example in Northern Uganda in 2005, a CARE programme in IDP camps succeeded in constructing 11,800 latrines in 8 months, though a benign process through Community Health Clubs of empowering through knowledge, leading to informed decision making and concensus to build latrines. There was no agressive pointing of fingers, dividing community against themselves as people are shamed into behaving. There is already enough inter communal friction in sensitive communities such as those in IDP camps or post conflict.. and it is inappropriate to use CLTS which creates more agro. Lets hear from others on this point…

    All the best, Juliet

  6. Nripendra Kumar Sarma, Guwahati, Assam (India )

    I would like to thank Peter Rayon for expressing one important point in connection with CLTS …. “that getting to sanitation for all, forever, requires consideration of a huge range of factors, from politics, to finance, to culture, to technology, to behavioural change etc. It also necessitates consideration of who should be doing what… Concentrating on any one of these, to the exclusion or minimisation of any other, will be bound to result in failure to reach the goal.” ….. So an area specific comprehensive approach with due consideration of all relevant factors will be more effective.
    This is quite relevant to my state (Assam) in India, wherein open defecation is rare in rural areas. The age-old practice, that prevails in Assam, is the use of individual household toilet in their traditional manner. But irony is that such toilets are not SANITARY one. So when, the CLTS approach takes up the issue of use of toilet vs open defecation, the community comes up as loud as they can … “ We use Toilets”…. . So the question of safe sanitation ( rather than open defecation ) alongwith the wide range of technological options need more attention.
    The actual need in rural Assam is the large scale conversion of their traditional toilets into SANITARY TOILETS. In this regard, the issue of finance, appropriate technological option and change of mindset etc. become more relevant and these issues are not really addressed well under CLTS approach.
    In this connection, I would like to thank K. N. Bajpai also for expressing another important point …. “CLTS is just a facilitation approach as we have many, and we will find many such approaches successful in facilitating communities. But, CLTS, should have been a complete package of approach, which is not now. When we talk about triggering a community and as they are ready to construct their toilet or sanitation facility, or don’t practice OD, we must tell them various technical options available / way forward and also about maintaining it in long run. “…..
    Moreover, there are lots of subsidy ( or incentives ) oriented schemes being implemented by Government in the Rural Development Sector. So the community is much more inclined to the Government package in the sanitation sector also. In this regard, the issue of Political Will with the much needed social touch becomes more important.
    On the other hand the issue of sustainability in the sanitation sector should be dealt with greater concern unlike under CLTS approach.
    Thanking you.
    With Regards
    Nripendra Kumar Sarma
    Assam, India

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  8. I would thank Mr. Sharma for making it more clear through an example and agreeing with my earlier view point. I have a few additional points to share with:
    1. When we are measuring sanitation at the cost of ‘Shit’, we are closing the loop for the future use of excreta for composting and energy usage and that is futuristic solution and a visionary principal in many ways, e.g. energy, bio-mass, carbon financing, among others. So, when our approach is not comprehensive, it’s not going to succeed in long run. So, will be CLTS. We need to include technology options and post construction aspects with it, which is the necessity of time with development/glocalization.
    2. The other thing we should also consider that CLTS is best received where there has been no provision of hygiene and sanitation (at all), and in this case people have reservation about CLTS, which has been recorded from various studies. So, in countries like India we might not have a place where no approach was applied earlier.
    3. Another point is that, this approach will mostly work in countries where communities have reservation for going out to their female family members and they generally don’t have many choices so, may go for this. But, there are ‘n’ number of approach when applied will work in similar manner.
    4.Let’s be clear that CLTS is not a comprehensive and universally applicable approach, as many of its advocates claim it to be. And it’s appropriate that the facilitators of this approach also think in various dimensions of development discourse which is comprehensive, forward looking and futuristic. Business will come automatically..!

  9. Ajay Ciciliya

    Using coercive methods for arresting OD, is a sensitive issue. First, it is a right of citizen to make a choice as per the prevailing law of the land. I have worked for 5 years promoting toilet construction and subsequent usage. Some of my learning are…
    • Force methods are not sustainable for usage. May be construction of toilet takes place, but usage is not sure of..
    • Usage requires understanding of open defecation issue and inner realization of need for toilet defecation.
    More importantly….
    • Victims of coercive methods are largely (almost) belong to lower strata of the society / communities. They do not have either power to bargain with dominant communities / authorities, or they do not have means for toilet construction. Their immediate needs are different.
    • Sometime authorities are also using such techniques / methods to settle score with political enemies or social revolutionaries.
    The reasons for non-compliance or non-construction of toilet are as under
    • Toilet do not fit to their immediate planning house construction.
    • They do not have adequate space for construction.
    • They do not have economic means for construction.
    • They have other issues with panchayat / authority and they want to settle the same through toilet construction.
    Such methods and techniques should not be employed in any civil society. Democratic rights need to respect. Lastly, there is no need to hurry for NGP awards. Adequate time should be given to each HH to understand the issue and construct the toilet as per their requirements. Such toilets will be used for generation to come with any force methods.
    Ajay Ciciliya – Public Sanitation Expert.

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