In Mali, Communities Take Health and Well-Being into their Own Hands. Global Waters, July 18, 2017.
In the center of Simaye village in Mali’s Mopti Region, men, women, and children gather under a large tree to listen. Two USAID-trained facilitators discuss the health challenges facing the village.
Tackling open defecation in communities is a starting point for improved health. Ensuring the drinking water sources are clean is another. USAID works with local artisans in communities like Anga to repair or rehabilitate artesian drilling, such as this one, as an incentive to become ODF-certified. Photo Credit: CARE Mali
Only three latrines serve many families, so more than half of the people are practicing open defecation; the water point no longer functions, so most families are pulling dirty water from the river; many of the infants and young children are not benefitting from exclusive breastfeeding or a diversified diet, so they are malnourished.
Holding a glass of clear water and pointing to feces on the ground, the facilitators paint a clear picture of the health risks associated with leaving feces in the open — contaminated drinking sources, diarrheal disease, and poor outcomes for children and their families.
Their objective: to trigger a sense of disgust, a determination in the community to control their own health and well-being, and to set in motion plans and solutions to create open defecation free (ODF) communities through a process known as community-led total sanitation (CLTS).
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Discovering sanitation realities through rural immersions. by Jamie Myers, CLTS, March 2017.
At the end of last year the CLTS Knowledge Hub heard that the Indian Institute of Management (IIM), Indore, in collaboration with UNICEF and the Government of Madhya Pradesh, were sending 630 of their first year management students to spend a week living in 157 open defecation free (ODF) villages.
The villages cut across 13 districts in the central Indian State of Madhya Pradesh. Students were asked to verify ODF status of villages through a household survey and early morning and evening inspections of open defecation sites. They were also tasked with collecting data on school and Anganwadi (child and mother care) centres sanitation and handwashing facilities.
The sheer number of people involved was impressive in itself as was the level of detail that could be collected in the length of time they were able to spend there. Furthermore, the fact that they would be staying overnight meant that they would be in the villages at the times when open defecation was most common, early in the morning and later in the evening. Needless to say we were excited to hear not only about their findings but also the process and methodology.
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Exploring “The Remote” and “The Rural”: Open Defecation and Latrine Use in Uttarakhand, India. World Development, January 2017. Authors: Kathleen O’Reilly, Richa Dhanju, Abhineety Goel.
- Remote places are different than rural places due to physical and social distance.
- Remoteness significantly contributes to practices of open defecation.
- Structural inequalities produce conditions that impede sanitation uptake.
- Addressing infrastructural causes of remoteness is key to reducing open defecation.
- Reducing multi-scalar, socio-spatial inequalities can lead to latrine adoption.
Open defecation is a major global health problem. The number of open defecators in India dwarfs that of other states, and most live in rural places. Open defecation is often approached as a problem scaled at the site of the individual, who makes a choice not to build and/or use a toilet.
Attempts to end rural open defecation by targeting individuals, like social marketing or behavior change approaches, often ignore the structural inequalities that shape rural residents’ everyday lives. Our study explores the question, “What is the role of remoteness in sustaining open defecation in rural India?” We deploy the concept of remoteness as an analytical tool that can capture everyday practices of open defecation as a function of physical and social distance.
Using ethnographic methods, we interviewed and observed 70 participants in four villages in Uttarakhand, India over a three-month period in 2013. We find that remoteness in general, and its lived nuances, form a context for prevalent open defecation. Structural inequalities across space will need to be addressed to make latrine building and usage viable in remote places.