iPhone app iPad app Android phone app Android tablet app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors

How to Save the World With Sanitation

Posted: 10/27/09 02:17 PM ET

There is a feisty old woman in every village. In Maparanhanga, a remote village in Mozambique, reached by a several-hour-trip through potholes held together by scraps of road, the feisty old woman didn't stand out at first. She sat alongside her female neighbors in a circle divided by age and gender -- men standing on one side, women sitting in another group, children closing the circle -- watching with some horror as a young man, unknown to her before today, asked her to eat some nice meat and rice.

It was considered high-class food in this rural area where meat stew is a luxury and two months of the year around harvesting are known as "the hunger period." And still she said, no way, her face showing nothing but disgust. Why not? Because the nice meat and rice had been placed next to some human feces, carefully arranged on a piece of paper, and she had watched, along with the rest of the village, as flies happily flew from shit to food and back again.

This cannot have been a new event: as is the case in 80 percent of villages in Mozambique, and countless others worldwide, the only latrine available to villagers was bushland. Left in the open, the shit would surely have come back into the village on flip-flops and feet and fingers; on chicken claws and dog paws. That was how it had always been. Nothing wrong with it. But seeing the shit and food together was a revelation. There were gasps, screams, embarrassed laughter. The children covered their mouths; the old woman looked outraged. She was seeing her living environment with fresh eyes, and with those fresh eyes had come disgust.

And with disgust comes change -- or so goes the theory of Community-Led Total Sanitation (CLTS). CLTS, a methodology aimed at improving the parlous state of global sanitation, was developed ten years ago by the Indian agricultural scientist Kamal Kar. Community-Led, because it's not supposed to be about instruction but revelation. Total Sanitation, because that's the goal: there's little point in 90 percent of villagers having a latrine when the other ten percent are still tramping shit back into the living environment.

The need for this theory, and the change that comes with it, are more significant than one would assume. The idea of defecating in the open air to a toilet may seem unthinkable (though it's the reality of four in ten people on the planet, or 2.6 billion), but it is a curious fact that even if someone has a latrine, they may not choose to use it despite the obvious and less obvious risks. Human excrement can carry up to fifty communicable diseases. Diarrhea, 90 percent of which is caused by food and water contaminated by excrement, kills a child every fifteen seconds. That's more than AIDS, malaria, or measles, combined. Human feces are an impressive weapon of mass destruction.

Decades of efforts, global and local, have aimed at eradicating the practice of open defecation. In the late 1970s, the revered Mozambican independence leader Samora Machel decreed that every family had to build a latrine, and, says Manuel Freitas, head of UNICEF's water and sanitation section, every family did. "I was working in the provinces at the time and it was my job to see that the latrines were built. And they were. But when the rains came they all collapsed." After the rains, Mozambique's twenty-year civil war destroyed huge quantities of infrastructure. Villagers fled to the cities, where the war was waged less, and moved into slums with no sanitation. The Samora Machel-inspired latrines were no more.

2009-10-27-BM105531.jpg
One of the first latrines in Venceremos ("We will overcome") village in Mozambique, built by the village leader as an example to follow. Venceremos is now Open-Defecation-Free (ODF). (Benoit Marquet)


In villages across the developing world, governments have provided reasonable enough latrines that have again and again been turned into storage spaces or simply abandoned. In India alone, millions of government-funded latrines have become goat-sheds. Some had been built near kitchens, a taboo in Indian households. Some people preferred the bush to a smelly, stuffy box with a dark hole in it. Children were scared of falling down the pit. And then there was human perversity: The World Bank's Water and Sanitation Program, in its annual cartoon calendar, provided an image of a rich farmer in India, at home with his well-dressed family, expensive television and hi-fi, a fine Maruti car parked outside. In the next frame, the well-dressed family was getting out of the Maruti and trooping off to the open defecation grounds.

Open defecation is what many Mozambicans do. The songs schoolchildren sang to me when I visited were about cholera, because cholera comes as regular as the rains. The children described the symptoms clearly and with authority: You defecate a lot. You vomit. And then you might die. Diarrhea kills 16 percent of Mozambican toddlers every year, more than AIDS. Only pneumonia and malaria kill more. Villagers know this. After years of being bombarded with health messages, they know about contamination and hand washing and flies. And still they were shitting in the bush.

But in Maparanhanga, over 100 people followed Americo Muianga, a UNICEF CLTS specialist, down the earth paths to some bush-land. The villagers laughed as Muianga stood there, asking someone to show him some fresh shit. They didn't seem ashamed. That was before the flies, merrily landing on the rice and meat.

2009-10-27-BM105579.jpg
UNICEF's Americo Muianga helps the villagers of Maparanhanga calculate how much excrement their practice of open defecation is leaving around the village, in daily, monthly and yearly amounts. (Benoit Marquet)


"Are those different flies?" Muianga asked the crowd. "No," said one man. "They are the same." He looked appalled. This is known as the "triggering moment" in CLTS. It is when villagers realize -- but aren't instructed -- that if they defecate in the open, they must be eating their own and their neighbor's shit, because it's on their feet and hands; on the claws of their chickens and the paws of their dogs. It's elsewhere too, as Muianga demonstrated with a bottle of water. He opened it and offered it around. Then he dipped a stick into the excrement, stirred it into the water and offered it around again. People recoiled. They looked nauseous and horrified. And the penny had dropped. "The basic assumption," says the CLTS handbook, "is that no human being can stay unmoved once they have learned that they are ingesting other people's shit."

"When are you going to build latrines?" Muianga asks. "Tomorrow," the men reply. They look determined. A few draw latrine designs on paper: a two-metre pit, some planks in a criss-cross to form the hole. You can come back in a month, they say. You will see how we have changed. There will be no more shitting in the bush. It's easy to be sceptical. The whole meeting had taken only two hours. Two hours to change the stubbornness of forever? Except that CLTS is the biggest success story in sanitation for decades.

2009-10-27-BM105595.jpg
In Mozambique, villagers attend a "triggering" aimed at getting them to build latrines. Food and shit, and the flies that land on both, make for a powerful message about contamination. (Benoit Marquet)


CLTS turned some development tools on their heads. It is not about hardware, but software. The beauty of it is its manipulation of human emotions, not plumbing. Disgust, then pride. In triggered villages in Mozambique, the village leaders showed me their new latrines, beaming, along with signboards declaring their village ODF. Most CLTS programs provide no subsidy, relying on people to help themselves. In India, it's common for villagers to turn themselves into "toilet spies," reporting on people who continue to openly defecate, because they are shaming the village. The toilet spy gets half of the village fine the transgressor must pay.

In Mozambique, CLTS is instead combined with an awards system. There's no social punishment, because in Mozambique the village leader rules. In villages that remain ODF (Open Defecation Free), the village leader is awarded a bicycle. "In our culture," one district administrator told me, "the leader is a mirror." So far it's working. In 2007, when Mozambique first tried out CLTS, 105 villages applied to the award scheme. Thirty five were judged to be properly ODF. Two were disqualified when an inspector peered into a latrine pit and found it empty. "The village leader was furious!" says Freitas of UNICEF. "He said, you lost us our prize!" in another, a toddler was seen defecating in the open, and the village was disqualified.

It may seem harsh, says Freitas, but something's working. This year already there are over 400 applications for the ODF awards. "I didn't believe in CLTS in the beginning," says Freitas. "I was totally against it. I thought, you can't just go into a village and start insulting people! But there I was, counting how many latrines had been built. In 2007, it was 2000. In 2008, 30,000. And now, look, this year we are expecting 270,000 people to be ODF. It's amazing." Nor is it just in Mozambique. CLTS is now being used in over 20 countries.

Peter Hawkins, the country representative for the World Bank's Water and Sanitation Programme, wasn't convinced either. He's still not sure about the awards scheme and notes a few problems with the new latrines: villagers were leaving toilet paper in an open container because they were scared the pit would fill up, and some of the lids weren't tight enough to keep out flies. "But moving from open defecation to latrines is a huge step," Hawkins tells me now. "And not having shit all over the place has to be a good thing."

I ask the village leader of Venceremos ("We will overcome") village how the place has improved. "It smells better," he says. "And the cholera has gone." On his latrine, he has painted slogans in English. Why English, when his everyday languages are Ndau (a local dialect) and Portuguese? Because he aspires to speak English, he says. And the slogans make their point better. "When you want to defecate, run to here on the toilet to avoid sickness. Do not be deceitful. All the village have toilet." And it only took a month to persuade them.

2009-10-27-BM105550.jpg
A mother and child outside their new latrine. In Venceremos village, a powerful sanitation campaign has seen 100% of families build latrines in a matter of months. (Benoit Marquet)


I ask Freitas and Hawkins how convinced they are by CLTS? Hawkins says 95 percent. Freitas, the man who thought it would never work, has no doubt. 120 percent, he says. Definitely. "I have no doubt. In thirty years in this sector, I've never seen anything like this. It's a social explosion."

 
There is a feisty old woman in every village. In Maparanhanga, a remote village in Mozambique, reached by a several-hour-trip through potholes held together by scraps of road, the feisty old woman did...
There is a feisty old woman in every village. In Maparanhanga, a remote village in Mozambique, reached by a several-hour-trip through potholes held together by scraps of road, the feisty old woman did...
 
 
  • Comments
  • 47
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Recency  | 
Popularity
Page: 1 2  Next ›  Last »  (2 total)
photo
Levonsky
a fan of enlightened self interest
02:08 PM on 10/30/2009
The reason we don't have similar conditions here is because we have government paid public health workers who go around and see to it that the sh*t is taken care of.
I should know. I was one of those people and every county in the country has them.
They are the same people that make sure that restaurants are not pig sties.
12:01 AM on 10/29/2009
Thank you for your enlightening well written post.

As is with many of the worlds challenges, a viable physical solution is not enough, if effort is not put into education to change the relative norms of small and large social groups. (sadly, this theme repeats itself over and over again, knowing no physical nor political boarders)

With several a hundred if not more relief agencies pouring huge sums of money and equal hours of labor into addressing sanitation in the next 10 years we are in desperate need of follow up to understand what works were when and how.
I do question the (extrinsic) rewards model, while it has it place I worry the means displace the ends. It diminishes the need for conversation and understanding. Rewards is a conversation in itself and should not detract from the importance for the common sense approach of CLTS. ( books like Three Cups of Tea show the value of intrinsic rewards and the importance of education being a two way street when helping).

For those new to this there is an alphabet soup of acronyms to use in your searches to learn more: WATSAN (water & sanitation) WASH (water sanitation and hygiene) HSES: (Hygiene Sanitation Environment and Sewerage) and CLTS. Also search on ecosan.
05:07 PM on 10/28/2009
When I was a child, my grandmother had a 'pee-pot'...
at night...
when we were little...and were visiting my grandmothers old home...
upstairs...far from the toilet..
my mother permitted us to use 'it'
as she had done when she was a young girl...
and had not wished to go alone, in the cold and the dark
to the outhouse...

if each home were given a pop-up curtain tent (they make them for camping showers)
and a pot
families could deficate in the home, in privacy....
and empty the waste into some sort of sealed compost bin...
(many municipalities pass out food compost bins...work with who you are working with)

when someone finds a useful mineral in human excrement,
we won't even have to pay for the truck that will come to empty these bins...
until then...
it is a good united nations initiative.
09:25 AM on 10/29/2009
there's no need to find a mineral in human excrement: we know what's in it already. I'm hoping that as phosphate reserves become harder and more expensive to extract, enlightened authorities will notice how much phosphorus is being thrown away in sewage, and proper change will happen. Those pee-pots used to be worth money: where I grew up in the north of England, urine was widely used in the textile and tanning industries. And now we just throw it away. Puzzling, to say the least.
This user has chosen to opt out of the Badges program
04:58 AM on 10/28/2009
Teaching hygiene and sanitation is well and good, but the root cause of most of our problems remains the human population of almost 7 billion people.

We have not figured out how to live sustainably on this planet with the number of people we have now, and we are doing nothing to stop the population explosion. Efforts to bring sanitary practices to primitive societies, like the efforts to increase food production or to reduce poverty, cannot alleviate suffering for more than a short time unless we start implementing ways to humanely halt the population explosion.
photo
HUFFPOST SUPER USER
Changeizgood
10:35 AM on 10/28/2009
If the pro-lifers would stop the BS, birth control could have changed the population explosion long ago.

They want to force you to get pregnant by not giving pill, spermacide creams, shots that last two to five years ad other items that would help the people to control it themselves.

I say this because people love to screw, and if the mood hits them in the proper place, wouldn't it be better to cover it up with a condom or add some cream or foam.

Keep it up and there won't be enough room here. I think because the galaxy has now come almost full circle and the discovery of 32 newer planets have been discovered, WE will find another life sustaining planet and then the over population problem won't be a problem.

All other historical civilizations have left, or passed on. Where are they. I know God wouldn't want all this hate brought there that I see daily over color. Suppose the new planet has majority black or green people. Would they be hated and conquered as well for their color.

No these hatemongers will have to remain here in the hell of their choice.
11:29 AM on 10/28/2009
Are you going to hop in your Hummer and drive to that new planet?
03:09 AM on 10/28/2009
Help spread the word about sanitation this November 19th - World Toilet Day. Visit us here:
http://worldtoiletday.com/
photo
mlaiuppa
Pres. Sarcasm Society. Like we need your approval.
11:37 PM on 10/27/2009
Kamel Kar needs to be recognized with a Nobel Prize.

Clean food. Clean water.

We can stomp out 90% of diseases that kill people with just clean food and water.
08:56 PM on 10/27/2009
To all you America Haters, would you rather be in USA or in Africa right now? Not a hard decision. Love the capitalist system that has propelled the USA to the highest living standard in the world. I love this country.
photo
CigarGod
What is your process?
10:03 AM on 10/28/2009
You mean, on the backs of third world countries?

You are confusing local mom and pop capitaism, with global capitalism.
Try reading "Confessions of an Economic Hitman".
05:06 PM on 10/28/2009
Are you serious? USA has lifted more people out of poverty than any other country on the planet. Mr. Lib, how many other countries have lifted more people out of poverty? Russia? France? Cuba? Venezuela? The answer is none. USA, USA, USA. Love it or leave it.
08:53 PM on 10/27/2009
Wow, there are a lot of people commenting forgetting that their own grandparents probably grew up using latrines - and knew how going out in the open might have been more pleasant.

Here's a really good video about the musical group Massukos, they sing songs about sanitation:
http://heatherleilamoz.blogspot.com/2009/05/massukos-estamos-e-niassa.html
07:54 PM on 10/27/2009
The hell with "climate change" and bogus "sustainable energy" today, THIS is where $$ billions ought to go! The other stuff will evolve over time.
06:56 PM on 10/27/2009
after how long these people are still in mud huts? come on. what is wrong i mean different people from different times were waaaaay more advanced.

maybe that is the problem, after becoming advanced we destroy ourselves and always revert back to mud huts and start over again. maybe these people are smart by not advancing?
07:38 PM on 10/27/2009
Ignorance is bliss?
photo
HUFFPOST COMMUNITY MODERATOR
GabeSmall
06:46 PM on 10/27/2009
Ms. George, I just read your book a couple of weeks ago. It was one of the most eye-opening experiences of my life! I had no idea how many modern humans do not have access to even the crudest, most basic sanitation. I had thought that accounts of the streets of London in its pre-sewer days were exaggerated. To think that they were not only accurate of old London but of countless modern day communities was a staggering revelation.

Thank you for bravely wading into the muck.
02:50 PM on 10/28/2009
Thanks! Very pleased you got something from the book. It was a steep learning curve for me too. I highly recommend the world of muck: it's fascinating.
photo
HUFFPOST SUPER USER
angelinarosa
06:40 PM on 10/27/2009
We are so fortunate! We take so much for granted.
wired
unconditional basic income
03:49 PM on 10/27/2009
"That's more than AIDS, malaria, or measles, combined. Human feces are an impressive weapon of mass destruction." Will the UN have to reduce their projections for AIDS deaths again?
03:28 PM on 10/27/2009
Great Work!

That sewage can be converted into energy fuels and carbon negative fertilize, via BioChar:

http://terrapreta.bioenergylists.org/taxonomy/term/487

I suggest you find a waterless toilet design and add the biochar unit to it.

Then get the entire units factory build and just deposit them where needed.

See my profile for more info and links.

A solar panel on the top would also make sens for the fans, and controls.
03:49 PM on 10/27/2009
I have previously read about Biochar, and I think it is a wonderful idea.
03:19 PM on 10/27/2009
The Romans and Greeks had sewers 2,000 years ago! What's up with these people? Take charge,take responsibility!
photo
HUFFPOST COMMUNITY MODERATOR
GabeSmall
06:48 PM on 10/27/2009
Sewers are an appropriate solution for cities. Not necessarily for rural areas.
09:09 PM on 10/27/2009
We had latrines in 5th century Spain.
02:52 PM on 10/28/2009
Sewers aren't much use in slums either. The crucial truth of sanitation is that it pays to be flexible, adaptable and innovative. A pit latrine here; an ecological toilet there; a flush toilet with sewer network somewhere else.