Patrick England, who recently joined the Global Sanitation Fund secretariat, travelled to Uganda to participate in a learning exchange mission. The mission turned out to be a unique opportunity to experience the true spirit of community-led total sanitation (CLTS). Read about his experiences below.
When I first entered the field of international development, I had no idea that ‘shit’ would become a standard part of my professional vocabulary. But as a Portfolio Support Analyst with the WSSCC’s Global Sanitation Fund (GSF), my mission is to discover and document everything about shit: how communities are dealing with it, and how to support our programme partners to tackle the world’s growing sanitation and hygiene crisis. So in June 2015, I received my first opportunity to become a professional toilet tourist with the GSF during a cross-programme exchange to Uganda.
Just prior to my Ugandan journey, I was working with Concern Universal, the GSF Executing Agency in Nigeria. I supported the development of case studies and lessons learned for the GSF-supported Rural Sanitation and Hygiene Promotion in Nigeria programme, which carries out Community-Led Total Sanitation (CLTS) activities in the south-east of the country. Similar to Uganda, Nigeria’s GSF-supported programme is fully owned and implemented by government agencies. However, for local officials and civil servants, the participatory, spontaneous, and dynamic ethos of CLTS often runs in direct contrast to decades of enforcing toilet construction. Not only must CLTS trigger improved sanitation and hygiene behaviour in communities themselves, but it must also trigger government authorities to create enabling environments for communities to climb the sanitation ladder.
CLTS learning journeys converge: the GSF cross-programme exchange
Dazed after two days of travel from Calabar to Kampala, I met my new Uganda colleagues in the rural district of Pallisa. Accompanying them was a delegation from Madagascar’s GSF-supported programme. While much could be written on this band of Malagasy medical doctors-cum-sanitation crusaders, let’s just say that they definitely know their ‘shit’. For them, CLTS isn’t just an approach to increase sanitation coverage and reduce under-five mortality; it’s an action-affirmative philosophy that underpins a movement to improve the health of entire countries. Most importantly, this movement must be wholly owned by communities themselves – a point continuously emphasized throughout our district visits in Uganda.
Our exchange crossed the entire country – from the shores of Lake Victoria to the jungles along the border with the Democratic Republic of the Congo – working alongside District Health Office staff to improve their CLTS approach. Led by the Malagasy doctors, each visit comprised a systematic review of existing practices, a hands-on demonstration of best-practice triggering and follow-up, and a critical self-analysis by health staff to enhance their community engagement. As was the case in Nigeria where decades of latrine enforcement and health sensitization failed to achieve any notable impact, this intensive learning process focused on ‘de-programming’ the old behaviours of local government facilitators.
Compared to Nigeria, where 25 percent of the population practices open defecation, Uganda has a relatively high level of sanitation coverage (where seven percent practice open defecation). This was made evident by the number of well-built latrines I observed during our visits to rural communities. Until then, I never entertained the notion that a toilet could be beautiful: walls carefully smoothed and polished, meticulously patterned with charcoal and red mud paint, all topped with round thatch roofs. One elderly woman in Koboko District proudly demonstrated how she used a local weed to give her latrine’s mud floor a glossy sheen. However, the presence of toilets – even those ornately designed – did not mean that these communities were open defecation free (ODF). These latrines frequently went unused, especially during planting and harvesting seasons, while a lack of adequate fly-proof covers and handwashing facilities meant that these community members were still unintentionally eating their own, and others’, shit.