Tag Archives: latrines

Ghana, Accra: Owning Latrines “Makes us Fat” – Local Community

Generally, the main perceived advantages of latrine ownership are proximity/easy access and privacy. For the people of Gozakope in the Dangme West District of the Greater Accra Region however, ownership of household latrines means all of these plus massive improvements in their health status.

Raymond Kotoka Lusu, Chairman, Water and sanitation (WATSAN) Committee of Gozakope, has said the introduction of the Community Led Total sanitation (CLTS) approach, which has led to the construction of latrines in various households in the small settlement, has improved health tremendously.

“We used to have diarrhea and stomach problems but now we are growing fat,” Lusu told members of the Ghana WATSAN Journalists Network (GWJN) who took a field trip to the area recently to know at first hand the state of water sanitation and hygiene issues (WASH), as well as, the state of interventions by the Professional Network Association (ProNet) Accra, a partner of WaterAid Ghana.

About a year ago, ProNet Accra introduced CLTS to the Gozakope community located in the Asutwuare Sub-district of the Dangme West District. Hitherto, the community engaged in “free range” defecation. Men, women and children alike defecated in the bush.

A defecation map showed that sometimes the indigenes “did their own thing” close to water bodies and on hills where it was very easy for water to run off into water bodies. Also, they had satellite refuse dumps scattered all around. Though, they experienced health hazards and its attendant problems, they appeared oblivious to the need for alternatives.

Derick Abandoh, ProNet Accra Officer in charge of Hygiene, said the organisation introduced the CLTS approach to the community because it saw evidence of open defecation. Besides, its research proved that there had not been any previous funding of any projects relating to WASH in the community.

Upon entry, ProNet officials took the community through pre-triggering (getting to know the community), triggering (mapping defecation routes), post triggering and the walk of shame (leading the community members to the defecation site and holding discussions at the scene). All of these were supposed to alert the community about the unpleasant outcome of defecating in the open.

The construction of the latrines was undertaken by the community members themselves, using locally available material and local labour. Some of them have estimated the construction cost to be between GH¢70 and GH¢100 [US$ 49-70].

According to the people, the latrines are helping to keep flies away, leading to fewer disease germs being spread from place to place and there is less fecal seepage into water bodies. The result has been that there have been fewer diseases – less diarrhea, less worms, less cholera, and less typhoid fever.

Lamisi J. Dabire, Communication and Campaigns Officer of WaterAid, Ghana, said “All these monies came from their own pockets; it shows their commitment.” She added, “We want to bring the self-help spirit in the community up.”

ProNet has also been working to improve water supply situation in the area [by] putting iron removal plants in some boreholes to make the water safe for use.

Source: Public Agenda / Peace FM Online, 23 Oct 2009

Nepal: Sanitation finally a priority

The diarrhoea that spread earlier in 2009 in 18 districts across Nepal killed nearly 300 people; nearly six months after the initial outbreak, four ministries have finally made a joint commitment to launch a massive water and sanitation campaign to meet the state’s target of providing complete sanitation to all by 2017.

“We were not able to launch all components of water and sanitation in a comprehensive manner earlier, which is why we had diarrhea-related deaths every year,” said Dr. Babu Ram Marasini, chief of health sector reform unit at the Ministry of Health.

The programme was launched on Global Handwashing Day on 15 October 2009 as a comprehensive and combined effort by the Ministries of Health, Education, Physical Planning and Works, and Local Development. The programme will see extension of the construction of latrines in all 75 districts, awareness programmes, establishment of a national sanitation fund among others, according to Kamal Adhikari, an official at the Department of Water Supply and Sewerage. Adhikari also said that the ministries have planned to review the existing policies to provide complete sanitation to all by 2017.

According to a report by WaterAid, about 14.2 million people do not have access to sanitation and 7.1 million lack access to safe drinking water and sanitation in the country; similarly, according to the Ministry of Health, 54 percent of the country does not have access to latrines. Likewise, only 37 percent wash their hands, and only 12 percent use soap. Also, 45 percent of deaths caused by avoidable diseases is because of unsafe drinking water and lack of sanitation. “Earlier, we used to implement programmes related to water and sanitation separately but we are now planning to go ahead in a joint and comprehensive manner,” said Adhikari.

Source: The Kathmandu Post; The Rising Nepal; Gorkhapatra; Naya Patrika; Annapurna Post; Kantipur; Nepal Samacharpatra / NGO Forum, 15 Oct 2009

Bangladesh: microfinance agencies enable entrepreneurs to provide more sanitation technology options

Over the last five years in Bangladesh, more than 90 million people have moved away from open defecation. While 88 percent of the population now have access to, and are using latrines, ensuring the quality and sustainability of these latrines is crucial. Without ready access to micro-credit and in the absence of well marketed technology options, many households are under pressure to move from very low cost to very high cost technology options with a significant debt burden.

In July 2009, the Association for Social Advancement: ASA (a leading Micro-Finance Institute) signed a Memorandum of Understanding with Dhaka Ahsania Mission (a national non-governmental organization) to provide loans at low interest to local small entrepreneurs for producing, marketing, and promoting appropriate sanitation technology options.

Dhaka Ahsania Mission will pilot the new financing mechanism in Jamalpur Sadar Upazilla (a sub district) with trained entrepreneurs. The Water and Sanitation Program (WSP) facilitated this process of linking local private manufacturers with micro-finance agencies to bring finance and technology together to make available a range of affordable sanitation options for households.

Source: WSP Access, Oct 2009

Nepal: opportunity to use toilet for the first time in 83 years

Silgadi: Haridatta Bhatta, 83, a resident of Nuwakot of Kalikasthan VDC-6 felt uneasy while using a toilet for the first time in his life. Bhatta, who has been practicing open air defecation, has used toilet for the first time in his life. Nepal Water for Health (NEWAH) has initiated to construct toilets in Nuwakot located 34 kilometers far from Silgadi, district headquarters of Doti district.

Bhatta shared that he felt very uneasy to use the newly constructed toilet in his house. Not only Haridatta, Ram Bahadur Bika, 49, has also similar kind of experience. Ram Bahadur, who used to defecate in the open, shared his experience, “I could not defaecate in the toilet in the first time.”

Not only Haridatta and Ram Bahadur, about 72 families in ward no. 6 of Kalikasthan VDC have constructed toilets after completion of the Nuwakot Drinking Water, Health Education and Sanitation Project launched in Mid-August 2008 with support of Nepal Water for Health. The project was completed at an investment of about Rs. 1.1 million including financial support worth Rs. 879,586 from NEWAH and local’s labour contribution worth Rs. 240,028.

Source: Gorkhapatra / NGO Forum, 25 Sep 2009

In India, New Seat of Power for Women – the success of the “No Toilet, No Bride” program

Prospective Brides Demand Sought-After Commodity: A Toilet. But by linking toilets to courtship, the “No Toilet, No Bride” program in Haryana has been the most successful sanitation promotion effort so far.

NILOKHERI, India — An ideal groom in this dusty farming village is a vegetarian, does not drink, has good prospects for a stable job and promises his bride-to-be an amenity in high demand: a toilet.

In rural India, many young women are refusing to marry unless the suitor furnishes their future home with a bathroom, freeing them from the inconvenience and embarrassment of using community toilets or squatting in fields.


Cartoon by Neelabh in Times of India, 23 Mar 2009

About 665 million people in India — about half the population — lack access to latrines. But since a “No Toilet, No Bride” campaign started about two years ago, 1.4 million toilets have been built here in the northern state of Haryana, some with government funds, according to the state’s health department.

Women’s rights activists call the program a revolution as it spreads across India’s vast and largely impoverished rural areas.

“I won’t let my daughter near a boy who doesn’t have a latrine,” said Usha Pagdi, who made sure that daughter Vimlas Sasva, 18, finished high school and took courses in electronics at a technical school. “No loo? No ‘I do,’ ” Vimlas said, laughing as she repeated a radio jingle.

“My father never even allowed me an education,” Pagdi said, stroking her daughter’s hair in their half-built shelter near a lagoon strewn with trash. “Every time I washed the floors, I thought about how I knew nothing. Now, young women have power. The men can’t refuse us.”

Indian girls are traditionally seen as a financial liability because of the wedding dowries [...] but that is slowly changing as women marry later and grow more financially self-reliant. More rural girls are enrolled in school than ever before.

A societal preference for boys here has become an unlikely source of power for Indian women. The [illegeal but widespread] abortion of female fetuses in favor of sons means there are more eligible bachelors than potential brides, allowing women and their parents to be more selective when arranging a match.

“I will have to work hard to afford a toilet. We won’t get any bride if we don’t have one now,” said Harpal Sirshwa, 22, who is hoping to marry soon. [...] “I won’t be offended when the woman I like asks for a toilet.”

Satellite television and the Internet are spreading images of rising prosperity and urban middle-class accouterments to rural areas, such as spacious apartments — with bathrooms.

[...] With economic freedom, women are increasingly expecting more, and toilets are at the top of their list, they say.

[...] “Women suffer the most since there are prying eyes everywhere,” said Ashok Gera, a doctor who works in a one-room clinic here. “It’s humiliating, harrowing and extremely unhealthy. I see so many young women who have prolonged urinary tract infections and kidney and liver problems because they don’t have a safe place to go.”

Previous attempts to bring toilets to poor Indian villages have mostly failed. A 2001 project sponsored by the World Bank never took off because many people used the latrines as storage facilities or took them apart to build lean-tos, said Ranjana Kumari, director of the Center for Social Research in New Delhi, who worked on the program.

Indra Bhatia, who is raising seven children in Panchgujran, India, said her toilet has changed her life. When I marry my daughters off, I will make sure that their home is fully equipped with a toilet and the works, she said. (By Emily Wax -- The Washington Post)

Indra Bhatia, who is raising seven children in Panchgujran, India, said her toilet has changed her life. "When I marry my daughters off, I will make sure that their home is fully equipped with a toilet and the works," she said. (By Emily Wax -- The Washington Post)

But by linking toilets to courtship, “No Toilet, No Bride” has been the most successful effort so far. Walls in many villages are painted with slogans in Hindi, such as “I won’t get my daughter married into a household which does not have a toilet.” Even popular soap operas have featured dramatic plots involving the campaign.

“The ‘No Toilet, No Bride’ program is a bloodless coup,” said Bindeshwar Pathak, founder of Sulabh International, a social organization, and winner of this year’s Stockholm Water Prize for developing inexpensive, eco-friendly toilets. “When I started, it was a cultural taboo to even talk about toilets. Now it’s changing. My mother used to wake up at 4 a.m. to find someplace to go quietly. My wife wakes up at 7 a.m., and can go safely in her home.”

Pathak runs a school and job-training center for women who once cleaned up human waste by hand. They are known as untouchables, the lowest caste in India’s social order. As more toilets come to India, the women are less likely to have to do such jobs, Pathak said.

“I want so much for them to have skills and dignity,” Pathak said. “I tell the government all the time: If India wants to be a superpower, first we need toilets. Maybe it will be our women who finally change that.”

[This article has attracted 128 reader comments so far, unfortunately many are off-topic rants about religion, abortion etc and toilet jokes]

Source: Emily Wax, Washington Post, 12 Oct 2009

South Africa, Cape Town: basic services needed to save babies

Toddler Sanele Qaqa should have been running around his home by now. Instead, his family is grieving his death, which could have been prevented. Sanele, the youngest of six children, died in March [2009], just two weeks ahead of his second birthday.

[...] A shocking 37 city children younger than five died of diarrhoea in February, March and April [2009] – deaths that could easily have been avoided. In 2005, more than 100 children, most of them from poverty-stricken areas, died, statistics show.

But health officials are making headway in the war on this disease. According to the Department of Health, the main contributors to the death rate are lack of access to potable water, and inadequate sanitation, sewerage services, and hygiene practices. The deaths earlier this year were largely concentrated in informal settlements where access to clean water was limited.

[Cape Town] has said that although it spends R10-million a year installing sanitation infrastructure, it is costing it R60m a year to repair infrastructure that has been damaged.

Broken toilets, stagnant pools of dirty water and human waste are common in informal settlements. These are the conditions in which disease thrives.

[Sanele Qaqa died on 28 March 2009, two days after falling ill]. One week earlier, on March 17, one-year-old Unabantu Mali died, tied to the back of his grandmother, as she made the two-hour walk home after allegedly being turned away from three health-care centres at which she had sought help for the boy, who had diarrhoea. A probe later cleared the facilities of wrongdoing.

Sanele was one of 3 586 children admitted to hospital for diarrhoea in the past year. Provincial health department spokeswoman Faiza Steyn said there was no accurate picture of deaths from diarrhoea that occurred outside hospitals.

[...] Of the 37 children who died, four had malnutrition and 12 were HIV-positive. Dehydration was the direct cause of the deaths of 14 of the children, said Steyn.

[...] According to Jaco Muller, of the City of Cape Town’s water and sanitation department, the capital expenditure for these services was R23m, while operating expenditure was R80m. The city has 223 informal settlements. The number of toilets needed was 27 052. In May, there were 2 078. The required number of standpipes providing potable water was 5 148, compared with the 4 402 that were in place.

“If all families were to have ready access to clean potable water, the risk of contamination would be considerably reduced,” said Steyn. “The risk would be further reduced if water was stored in clean containers that were cleaned regularly.”

While 37 deaths in three months is high, the mortality rate has improved since 2005, when more than 100 children in the metropole died. The provincial and city health departments have tried to curb the number of deaths through, among other things, awareness campaigns.

From April 1, [2010], a new vaccine is to be introduced that can reduce the incidence and severity of diarrhoea.

Source: Esther Lewis and Lavern De Vries, Cape Argus / Mercury & Independent Online, 05 Oct 2009

Uganda, Kasese: unwashed hands cause cholera

Persistent outbreaks of cholera in Kasese District have been blamed on poor hand-washing practices and bad eating habits. This was noted at a one-day advocacy meeting for district councillors on water and sanitation held in Kasese Catholic Social Hall on Thursday [01 October 2009].

Presenting a latrine coverage and hand-washing situational analysis in Kasese, the district health inspector also the disease surveillance officer, Ericana Bwambale, said washing hands among the people of Kasese ranged from 17% to 34%. He named the sub-counties where people rarely wash their hands as Muhokya with 17%, followed by Kitswamba at 18% and Rukoki at 20%.

He said Kyabarungira Sub-county has the lowest latrine coverage at 57%, followed by Rukoki at 60% and Kisinga at 65%. Kyondo Sub-county had the highest latrine coverage of 88%, followed by Maliba Sub-county at 87%.

He said the majority of the people in Kasese eat whatever food they come across without considering its cleanliness.

Since March [2009], 500 cases of cholera have been reported in Kasese with about 10 deaths. The Busongora County health inspector, Steven Bagonza, said cholera cases have been reported in all the four constituencies in the district.

The district councillors on the technical and social services committee blamed the sub-county health assistants for the deteriorating health conditions in the district. They said health workers were not sensitising the community on the need to improve sanitation and hygiene in their homes.

The head of the district technical and social services committee, Mustafa Kikusa, said all the sub-county health assistants should be summoned before the district committee and explain why they are failing to do their work. He noted that the Government was doing all it could to improve people’s standards of living but was being frustrated by civil servants who are failing to deliver as expected.

During the meeting, it was reported that people of Kasese were feeding on animal offals and fish skeletons from Kampala that have some times compromised the health of the people.

The furious councillors promised to move a motion to ban the sale of offals and skeleton fish in the district, saying they were unhygienic and partly responsible for the deteriorating health conditions.

However, some councillors on the committee, especially women said that they would block the motion if brought to council, adding that majority of the people in the district were surviving on offals and fish skeletons because they were cheap and some people cannot afford meat.

Source: Bernard Masereka, New Vision / allAfrica.com, 03 Oct 2009

Burkina Faso: Inadequate hygiene conditions put thousands at risk

International humanitarian organisation Action Against Hunger | ACF International has mounted an emergency response after the heaviest rainfall in almost a century destroyed major parts of Ouagadougou, the capital of Burkina Faso, affecting more than 150,000 people. 50,000 people have sought refuge in dozens of temporary shelter sites throughout the capital.

On 1st September [2009], more than 10 inches of rainfall dropped in a 12-hour period, flooding 50% of the capital and leaving tens of thousands of people homeless. The displaced have sought refuge at 88 temporary sites across the capital, each sheltering between 200 and 1500 people. The authorities are concerned about the inappropriate water and sanitation facilities at the temporary shelter sites and worsening hygiene conditions.

Working closely with the authorities and other humanitarian actors on the ground, Action Against Hunger is launching an emergency response to assist 6,000 people affected by the flooding by improving hygiene conditions in 12 temporary shelters with funding from the City of Paris and the French Foreign Ministry. Action Against Hunger plans to put in place sanitation systems to provide basic hygiene standards. 150 latrines as well as washing areas and showers will be constructed and hygiene kits will be distributed to the displaced. Action Against Hunger will also monitor the water and sanitation situation to ensure that a minimum of 15 litres of safe water per person per day is available in line with international minimum standards in disaster response.

The torrential rainfall in Burkina Faso was the worst since 1914. Existing systems are not adapted to deal with an emergency of this proportion. The situation also is precarious in neighbouring countries where torrential rainfall and flooding have affected 600,000 people.

Source: ACF International, 10 Sep 2009

India’s Sanitation for All: How to Make It Happen

India-Sanitation-for-All-coverBowyer, J. (2009). India’s sanitation for all : how to make it happen. (Water for all series ; 18). Manila, The Philippines, Asian Development Bank. 24 p.

Download PDF file

Providing environmentally safe sanitation to millions of people is a significant challenge. The task is doubly difficult in a country where the introduction of new technologies can challenge people’s traditions and beliefs.

This report examines the current state of sanitation services in India and offers six recommendations that can help key stakeholders work toward universal sanitation coverage in India: scaling up pro-poor sanitation programs, customizing investments, exploring cost effective options, applying proper planning and sequencing, adopting community-based solutions, and forging innovative partnerships. The recommendations were based largely on an ADB study on household sanitation and drainage in India.

ADB’s empirical study entitled “Sanitation in India: Progress, Differentials, Correlates, and Challenges” (2009) attempts to discern key policy conclusions that could assist India in meeting its set goal of “Sanitation for All” by 2012. It looks at (i) safe disposal of human excreta, as measured by household ownership of a sanitary latrine; and (ii) household access to drainage facilities. It investigates the trends, socio-economic differentials, and correlates of household sanitary latrines from 1992 to 2006, and provides rough cost estimates for universal coverage.


  1. India’s Sanitation for All: How to Make It Happen
  2. Sanitation in India: How Bad is It?
  3. Making Household Sanitation an Investment Priority
  4. Finding Optimal Solutions
  5. Moving Forward

Hygiene/sanitation photos from Ethiopia – Jay Graham/USAID

graham-tippytapJay Graham is a member of USAID’s Environmental Health Team and was recently on an assignment in Ethiopia. He has posted sanitation/hygiene photos from the assignment on a Picasa website.

If you have information to share about your organization’s work on water, sanitation and hygiene, contact Jay Graham at jgraham@usaid.gov.