CLTS Foundation Global with UNICEF Myanmar and other WASH partners

On 9^th January 2019, CLTS Foundation Global and UNICEF Myanmar initiated a discussion at the UNICEF Country Office in Bahan Yangon. The focus of the discussion was to review the progress in sanitation made by the nation so far and to look forward towards planning for scaling up of Open Defecation Free (ODF) initiatives in a meaningful partnership. The proposed agenda of the discussion was:-

1. Regional and global updates on CLTS initiatives focusing SDG 6.2 by Dr Kamal Kar
2. Brief updates on current ODF initiatives in Myanmar by WASH partners
3. Question/Answer/Discussion

The Sustainable Development Goal 6 is to ensure availability and sustainable management of water & sanitation for all. Target 6.2 within the goal specifies that by 2030, the world must achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations. This will be monitored by Indicator 6.2.1 which is the proportion of the population using safely managed sanitation services, including a hand-washing facility with soap and water.

Globally, there are 2.3 million people who still lack access to basic and safe sanitation services. According to the JMP Report, 2015, South East Asia accounts for 8.27% of people having access to basic sanitation; East and South-Eastern Asia accounts for 2.66% and Central and Southern Asia account for 33.25%. It is surprising to note that while most of the countries of South East Asia (For e.g. Cambodia, Indonesia, Philippines, Vietnam) showed an improvement in the access to basic sanitation services from the year 2000 to the year 2015, Myanmar showed a decrease from 70% to 65% despite its efforts. The percentage is stunting among infants stands at 35%. The under-five mortality rate is 50 per 1000 live births and diarrhoea incidence is 61%.

What are the reasons for the decline and lack of sustainability in Myanmar?

Myanmar has the existence of CLTS guidelines in the local language but without adaptability. While the off criterion is being established, the current standards seem quite high considering the sanitation market’s underdevelopment with either limited access to markets by the rural population, very few affordable sanitation options, or both.

There is a lack of an enabling environment including the existence of a formal well circulated proper policy/strategy. Triggering and integration with other approaches have shown good results, however low triggering quality and post off support without the access and availability of materials for scaling up does not yield good results in the long term.

Sanitation is under the Ministry of Health and since it has been integrated with other approaches, one would assume that the sanitation and health outcomes would be better. However, CLTS process continues to be led by NGOs or other implementers and is not implemented under the government’s leadership leading financial crunch in terms of funding from the government. Coordination with other ministries for CLTS is ad hoc or nonexistent without any formal mechanism.

Myanmar has only shown improvement with regards to implementation which to a large extent the victory of the communities but the support after has not been enough to ensure sustainability. The lack of government commitment and associated budget and human resources is seen as holding back the scaling up of CLTS and taking it beyond the hands of development partners and NGOs into a national approach.  The need for well-trained facilitators, including from governments, with regular refresher training, was noted in Myanmar. Construction of low-quality latrines with pits that flood in high water table areas or collapse in sandy soils resulted in a reversion to open defecation. Village leaders can generate community support for individuals in the form of labour, materials or cash, but this depends on the strength of the local leader.

What does Myanmar need to do to ascend along the sanitation ladder?

• Establish a national level WASH policy/protocol and strategy including all stages of CLTS and across all levels.
• Develop market linkages to provide access to better sanitation materials- Example Lixil (Japanese company providing to African countries in 5-10$ )
• Develop local context related proper training and triggering materials and modules along with quality control mechanisms
• Remove subsidies and mainstream CLTS into the MoH guidelines and strategy
• Establish inter-institutional working groups from all ministries
• Create flexible funding from all the ministries for implementation of innovative ideas
• Include Natural Leaders and Community Consultants along with civil society organisations for scaling up and integration
• Establish proper ODF protocol at the national level including guidelines for continuous monitoring

The post Can Myanmar be the first ODF nation in South East Asia? appeared first on CLTS Foundation Global.

Day 1 (30th November 2018): The CLTS Foundation Global team met with officials from UNICEF Eritrea including the Country Representative, the Deputy Country Representative and the WASH team members to discuss and develop a strategy for a successful mission at the Unicef office, UN Compound. The primary aim was to establish was to identify the cause for the low access to sanitation across the country and devise a plan to free up these bottlenecks in order to fast-track sanitation work in the near future. As of October 2018, only 907 amounting to 32% of the rural population have stopped practising open defecation. Therefore, there exists a mammoth size task in front of the stakeholders to accelerate the access to sanitation for all to achieve the SDG target.

However, the focus of this mission would be to draw from the good practices and successful outcomes the CLTS approach has demonstrated across the country to convince the stakeholders at the zoba(zonal) and national level to prioritise sanitation.

The meeting was to fine-tune the strategy for the first Eritrean Sanitation Conference to be held on the 11th and 12th of December this year. This will witness participation of a number of ministers, ambassadors from different countries, partners and departmental/ ministerial officials from the different levels to seek commitments from them to support and coordinate for faster, smoother and better quality implementation of CLTS across the country making Eritrea ODF soon.

Left to Right: David Tsetse (WASH Chief, UNICEF Eritrea), Dr. Kamal Kar (Chairman, CLTS Foundation Global), Dr. Pierre Ngom (Country Representative, UNICEF Eritrea),  Megha Sen (Programme Officer, CLTS Foundation Global), Shaya Asindua (Deputy Country Representative, UNICEF Eritrea), Geoffrey Acaye (CSD Chief, UNICEF Eritrea), Yirgalem Solomon (WASH Specialist, UNICEF Eritrea)

Day 3 (3rd of December): The CLTS Foundation Global team along with members from the UNICEF WASH team had a meeting with Her Excellency Amina Nurhussein, Minister of Health and Dr. Andat Tefatsion, Director General of  Public Health of The State of Eritrea. The discussion revolved around the current access to sanitation which stands at 32% and how the country could achieve better results in the coming years. The Minister was convinced of the power of collective local action and stated that the political willingness and enthusiasm from the community could make the country ODF by 2022. On a highly encouraging note, she also agreed with Dr. Kamal Kar, the Chairman of CLTS Foundation Global that the date of achievement for an ODF Nation could be advanced to 2020, given the right kind of enabling environment and motivation. She believes that the focus of all the ministries and stakeholders should move beyond the sub-national level to free up the blockages and the aim to become the first African country to achieve ODF National status.

Left to right: Megha Sen (Programme Officer, CLTS Foundation Global), Yirgalem Solomon (WASH Specialist, UNICEF Eritrea), H.E. Amina Nurhussein (Minister of Health), Dr. Kamal Kar (Chairman, CLTS Foundation Global), Mr. David Tsetse (WASH Chief, UNICEF Eritrea), Dr Andat Tefatsion (Director General of Public Health)

Day 4 (4th of December): Dr. Kamal Kar and Ms. Megha Sen of the CLTS Foundation Global Team along with Yirgalem Solomon, Wash Specialist  (UNICEF) met with Berhane Habtemariam, the Minister of Finance to seek his presence at the First National Sanitation Conference in Eritrea (Eri-San I) which is to be held on 11th and 12th of December. After an intense discussion on the urgent need for a common platform with the involvement of all institutional actors across all departments and levels to fast track access to sanitation in the country, the Minister agreed that it is crucial to hav e a healthy population to build capacity. He graciously accepted the invitation to the conference and agreed to show his support towards the national movement against open defecation.

Badaraoh village in Maekel Zoba

Day 5 (5th of December): Dr. Kamal Kar and Ms. Megha Sen met with Dr. Zemui and Mr. Abraham Milash Head of Sanitation and Health Unit under the Ministry of Health in order to prepare for the upcoming Field visit to the different Zobas as well as the Sanitation Conference. The CLTS Foundation Global team also visited Badaraoh village in the Maekel Zoba (89 out of 94 villages are ODF) to see the villages which have embraced and consistently maintained the ODF status for a long time. It was also interesting to note that these community members had not just refrained from open defecation but had also invested their resources to move along the sanitation ladder to better sanitation facilities including hand-washing systems. The women of this community spoke out about the need for better sanitation and how their health, dignity, privacy, security and environment had significantly improved since they stopped the practice of open defecation. a

Day 6 (6th of December): Dr. Kamal Kar and Ms. Megha Sen along with Mr. Abraham Milash Head of Sanitation and Health Unit under the Ministry of Health and other members visited Anseba Zoba to understand the status and quality of CLTS implementation in these areas. Anseba Zoba has comparatively performed better and 199 out of the total 295 villages have been declared ODF. The team visited Fanna village in Haggaz sub-zoba, Anseba Zoba. This village had successfully maintained its ODF status for almost a decade and showcased massive strength through collective action and social solidarity mechanisms. The women community members of the village said, ‘We do not have to go very far in this heat anymore and we can use the toilet next to our house which gives us more privacy and security and we have witnessed its health benefits, as well.’ The community members also showed the visiting team a toilet they had constructed for an 84-year-old man who was unable to do it himself due to physical, financial and familial constraints. When asked about the inspiration to keep their village ODF, the community members said that they have seen the health gains and want to continue them through clean and healthy practices and surroundings. The community members were requested to join the upcoming National Sanitation Conference and present their sanitation story to the high officials and ministers.

Picture above: Interactive session with community members from Fanna Village, Haggaz sub-zoba, Anseba Zoba

Day 7 (7th of December): The visiting team continued their travel to Gash Barka Zoba to understand the reasons for the inefficient implementation and monitoring in this particular area. The Environmental Health Officers and the Medical Officers of the Zoba explained that one of the reasons for heavy slippage to OD rate was the presence of nomadic communities and the unavailability of material. Following this, the team met with General Tekhle, an Army official who has become a crusader against the practice of OD in the area and mobilized his army officers to make the Zoba ODF. He proudly said that the Zoba communities are capable of changing and sustaining their sanitation practices even before the official date of declaration. He also said that Gash Barka will set an example for other Zoba Army Generals to mobilize their troops in the fight against OD. The team proceeded to meet the Zoba Governor who said that though it is an ambitious task to make the Zoba ODF in a short span, keeping in mind the huge number of villages (937 Total and 211 ODF), all the efforts will be undertaken to make this a reality.

Picture above: National Sanitation Conference Day 1, Eritrea

Community Members presenting their sanitation story

Speech by Mr. Ian Richards, the British Ambassador to Eritrea

The post CLTS Foundation Global in National Sanitation Conference 2018, Eritrea appeared first on CLTS Foundation Global.