The workshop itself served as a vibrant platform for moving from tools to transformation. Day 1 focused into the practical participatory tools being used across states under the Jal Jeevan Mission programme. Participants actively mapped the tools using chart paper and cards that showcased diverse field-level innovations. Each tool was linked to the specific challenges it addresses, ensuring that solutions remain rooted in local realities. This was followed by group discussions which enabled the participants to analyse the tools in depth, examining their context and methodology, the resources required and results achieved, the changes brought about in community dynamics, and opportunities to further strengthen outcomes in the future. Day 2 culminated in an energetic plenary session where participants presented their learnings to peers and experts, fostering learning and collective reflection cross the states. All the participants were invited for a networking dinner which was held on 22^nd December.

By documenting and sharing Jan Bhagidari tools through this collaborative process, the workshop laid the foundation for developing a National Compendium that will guide participatory and sustainable water management in the years ahead. CLTS Foundation contributed in the national effort and  continues advocating for people-centred, participatory approaches that place communities at the heart of water security and development.

The post National Workshop on Participatory / Jan Bhagidari tools under Jal Jeevan Mission appeared first on CLTS Foundation Global.

Somalia, which is part of the Horn of Africa and an actor within the confluence of the Mediterranean belt, should be seriously considered as part of the Mediterranean pavilion debate of issues concerning better strategies for supporting Agri-food systems in Arid and Semi-Arid lands (ASAL) and riverine systems with and through proper analysis and understanding of the coping mechanisms that negatively impact climate change. Adaptation and mitigation strategies for sustainable food and energy systems should be community led and focus on reinforcing the green circular economy by restoring / preventing further biodiversity loss in Somalia.”

– By Dipankar Datta, Ph.D.

The post Agri food systems in Somalia appeared first on CLTS Foundation Global.

Over the last one-year Norwegian Church Aid / Kirkens Nødhjelp (NCA) and its partners namely KAALO and SADO mobilized 32 youth football teams in two districts of Belet Hawo in Jubaland and Garowe in Puntland states of Somalia and hosted 30 matches by bringing more than 5,000 youth in the playgrounds. These football matches provided avenues to all the clans to come together towards peaceful co-existence and dialogue for conflict resolution. Like many youths in Somalia, we can also say that “when the youth play and are positively engaged, the world wins”.

Traditionally sports activities are organized and managed by individual clans. Every clan at the local level has its own sports team and clan members only support their clan sports team. Inter-clan football matches often triggered conflicts as when one team wins the other team would not accept defeat. The peace building initiative of NCA in Somalia has successfully resolved these conflicts by facilitating the participation of youth from various clans in dialogue forums, civic education, and community conversations to prevent violence followed by bringing them together to participate in inter-clan sports.

The impact of extensive sensitization activities towards social cohesion can be experienced in many fronts. For example, the winning team is now recognized and congratulated by members from all the clans. The other example would be the participation of local authorities in the peace building process who not only come to the playground to cheer up the teams but also amplify the voices of the youth towards social cohesion and strengthen the social ties between and within districts and to pass key messages on prevention of gender-based violence (GBV) and other harmful practices against women and girls. Through social mobilization, 50 male youth have been trained as role models acting as change agents on prevention of GBV and promoting human rights. The experience also establishes the fact that youth could be the ambassadors of peace.”

– By Dipankar Datta, Ph.D.

The post Football for peace appeared first on CLTS Foundation Global.

It’s 1st December 1997, my first day at Concern Worldwide Bangladesh as a deputy team leader of a newly formed department – Organizational Development Unit. This department was given a big room where I was the first to set foot on. There was a bookshelf in the room, which was not cleaned for some time, so upon entering, I started clearing out the bookshelf. When doing so I came across a bookmark where a few lines of a poem were printed as you can see in the picture. The last five lines of the poem resonated with me in a way that I could always see a ray of light in any crisis and work towards translating the crisis to an opportunity. To me, the photo by Shahidul Alam at Drik not only captures the rays of sunlight falling on a vast paddy field, but it also reflects on the key leadership quality where a leader looks at the organization from the vantage point and sets vision and mission for the team.

Noel Molony, the Country Director, was one of the persons who welcomed me at Concern on my first day. Concern was the first INGO for me to work with, and it is Noel Molony who from the very first day took every possible step to support me in adopting with the culture of the organization, creating avenues to take up new challenging initiatives, establishing space to participate, encouraging to take up leadership role, etc. I have experienced him as a great mentor and observed his passion towards capacity building of both individuals and institutions. I have witnessed his leadership to strategic and operational decision-making with an aim to serve people more efficiently by staying in their proximity. He has always remained as an enabler of my growth as a development and humanitarian aid professional.

Many of us witnessed Noel Molony as a charismatic leader who nurtured us as second line youth leadership and pushed the organization to move out from its comfort zone. Once he left Bangladesh, we were even afflicted with the “Molony disease” where many staff members feel that all leaders should be like Noel Molony. I had a hard time explaining to my colleagues that it’s very important to realize that no person is the same and it’s not fair to weigh every leader using the same balance. We can only learn from the values inculcated by our role leaders and pave our own way towards leadership.”

– By Dipankar Datta, Ph.D.

The post The story of a bookmaker and Molony Disease appeared first on CLTS Foundation Global.

The COVID-19 pandemic spread to India when its first case, in Kerala, was confirmed on 30 January 2020. As of 5 October 2020, there have been 6.62 million positive cases, with 5.59 million recoveries, and 103,000 deaths across the country. On 24 March 2020, Prime Minister Narendra Modi announced a 21-day national lockdown to contain the pandemic which was further extended until the end of May, generating a massive urban to rural exodus with millions of migrants desperately trying to return home; thousands were seen walking or bicycling hundreds of kilometers to go back to their native villages. UNICEF has supported various states in reaching an estimated 40 million beneficiaries with hygiene messages, WASH services, and supplies in partnership with government, NGOs, and the private sector (via corporate social responsibility initiatives) as of November 2020. UNICEF has, at the central-level and in states, provided technical support to the government in planning, capacity building, implementation of COVID-19 activities, behavior-change communications as well as the development/dissemination of protocols on safety practices.

Strategies /approach:

Delhi and 27 state office teams have led and contributed to multiple rapid assessments, especially during the beginning of the response period when information was required to identify urgent needs. UNICEF staff members in Bihar, Gujarat, Uttar Pradesh (UP), and Chhattisgarh conducted WASHES assessments in health care facilities (HCFs) and quarantine centers. The findings have informed the development of state WASH protocols. Other states, such as Assam, Rajasthan, and Odisha, conducted assessments at households, as well as intermediary and temporary medical camps, which helped inform state planning. UNICEF supported Rapid Needs Assessments on migrants and shelter camps in Maharashtra, Odisha, UP and Gujarat. The findings were used to support the state to develop a real-time shelter management protocol. Odisha and West Bengal led a detailed study to understand the disruption of basic WASH services in urban slum settlements, supporting the COVID response        Around 15,805 hand washing stations in rural communities and shelter camps, which inspired local governments to scale up this initiative with their own resources. UNICEF provided technical support to state-level PHED water quality laboratories on the production of hand sanitizers in multiple states, and trained Self-Help Groups (SHGs) on local soap production. Compendium of hand washing designs, including foot-operated hand washing station designs, has been particularly successful and translated into local languages, inspiring local producers to start producing and installing these designs. In Maharashtra UNICEF WASH colleagues coordinated the humanitarian response to migrants and launched a collaborative platform (named Jeevan Rath) of 75 partners and over 1,000 volunteers that distributed food, hand hygiene materials, sanitary napkins, footwear, water, basic medical support, etc. in Mumbai. WASH colleagues in Andhra Pradesh, Karnataka, Telangana, Chhattisgarh, Odisha, MP, and UP also supported addressing migrant populations’ needs, including setting up protocols for temporary camp management; developing mobile applications aiming to map migrant skills to ongoing needs in home states; and providing necessary hygiene kits and food rations to people on the move.

Government of India (via the Department of Drinking Water and Sanitation, Ministry of Jal Shakti) for the issuance of guidance for the ‘continuity of work for sanitation and hygiene activities during lockdown in rural areas under Swachh Bharat Mission (SBM) Open Defecation Free (ODF) ’ as well as for the safety of sanitation workers. Importantly, these advisories granted the authorization to state governments to use part of the programme budgets for COVID-sensitive and COVID-specific interventions.

Accessing government data on the WASH situation (including WASH in health care facilities) was a challenge, partly due to the sensitivity of the data as well as challenges in collecting the data given COVID-related restrictions. UNICEF conduced baselines in April and May to collect data for evidence-based decision making. However, there needs to be follow up surveys to reassess the situation. In settings such as health facilities, teams used assessment tools approved by the government rather than the detailed WASH assessment tools that they would otherwise have used.

Gaps in the WASH-related response included reaching people with disabilities and supporting supply chains for affordable sanitary products to manage menstrual hygiene (including making them available at distribution points given that schools and Anganwadis were closed). Newspaper reports of people drinking alcohol-based hand sanitizer meant distributing such supplies to slums and schools had to stop, and hand soap had to be promoted more rigorously.

– By Sourik Das (Intern)

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CLTS was first introduced to Cambodia by CONCERN Worldwide in 2004, but without immediate follow up. UNICEF and Plan Cambodia started to implement at a larger scale in 2006.  CLTS is now an approach to rural sanitation improvement as shown in the National Action Plan (NAP) for Rural Water Supply, Sanitation and Hygiene (RWSSH) 2019-2023. The number of communes that attain ODF status has become one of the Joint Monitoring Indicators (JMIs) of the RWSSH sector. JMIs represent the highest priority work to be implemented by the Royal Government of Cambodia with the support of its development partners.

Ms Khaim Sophorrn is one of the few national female professionals in the RWSSH Sector.  She has been working intensively and extensively for rural sanitation improvement since 1996.  As a national consultant she has worked for the Ministry of Rural Development (MRD) and almost half of the country’s 25 Provincial Departments of Rural Development (PDRDs) to improve sanitation and hygiene practices. Back in 2006, although she was working for a project that did not promote CLTS, she immediately adopted the CLTS ways of working with communities in her duties as a program coordinator.  She triggered communities that she visited and long before the institutional triggering concept was introduced, she triggered PDRD officials through capacity development activities and local authorities particularly at the commune and district levels through various advocacy efforts.

Ms. Sophornn joined SNV for the partnership between SNV and Plan International Cambodia in the Cambodia Rural Sanitation and Hygiene Improvement Program (CR-SHIP) funded by the Global Sanitation Fund (GSF). SNV was implementing the Sustainable Sanitation and Hygiene for All (SSH4A) Programme.  The Programme responded directly to issues in the sector described in the MRD RWSSH Strategy of 2010. It was implemented in the rural areas of the country where in 2008 only 23% had access to sanitation facilities. The Programme targeted areas where there was potential to increase sanitation coverage and to reach open-defecation free (ODF) status at district and provincial levels.     Specifically, it targeted 5,600 villages in all districts in target provinces.

She contributed to the achievement of ODF status of the Banteay Meas District in Kampot Province. Banteay Meas District used to be one of the districts with the lowest levels of sanitation coverage in Cambodia – only 16% of households had access to sanitation.  She subsequently joined Save the Children for the implementation of a USAID-funded NOURISH Project, a nutrition improvement project with a strong rural sanitation and hygiene component that provided opportunities for Sophornn to maintain her support to CLTS in Cambodia.

She is a “natural leader” when she worked with Village Focal Points, Commune Council, Commune Council for Women and Children, District Officers of Rural Development, PDRD and District Governors to support them to develop, implement and monitoring ODF action plans Sophornn’s passion in working for the rural sanitation improvement remains strong throughout all these years.  She was well-known among the communities as well as Government staff and local leaders.  She found working with poor households with scarce materials and labour and people with disabilities with no access to improved sanitation facilities as the most challenging and sometimes frustrating aspects of her work.  However, these are also the main reasons for her continuing interests and passion in helping rural communities to reach ODF status.  Among these is meeting some very poor families who managed to join the village collective efforts to reach ODF and some people with disabilities who proved to be strong advocates within their communities. One of these is Mr Seak Phen, pictured here in his wheelchair, who has responded to Sophornn’s encouragement and actively participated as a CLTS village facilitator and eventually recognized as a sanitation role model for his village. He has been helping his village chief who is an old man.

He understands that CLTS is the way towards the quality of living, shown through clean homes, clean neighbourhood and clean community. He rides a bicycle with his hands to visit his neighbours (door to door visit) every day. He has known the local sanitation suppliers in his commune and established contact with them. When he knew a villager who wants to construct a latrine he helped to coordinate with suppliers via phone. He wants every household in his village to access sanitation and living in healthy life. He continues to motivate and encourage households to build a simple dry pit latrine first if they cannot yet afford more expensive latrines.

Cambodia is continuing its long journey towards ODF Cambodia.  Encouraging results have been documented.  In the latest Progress on Drinking Water, Sanitation and Hygiene 2000-2020, WHO/UNICEF Joint Monitoring Report, Cambodia is shown as the best performing country in reducing open defecation practice ie by 16 percentage point from 2015-2020.  CLTS has contributed to this achievement. CLTS requires highly committed natural leaders who can contribute at their specific community only or natural leaders like Ms Sophornn who can work across many communities in different provinces as well as with national and sub-national level officials responsible for sanitation improvement.

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CLTS is an approach which helps rural communities to understand the ill effects of open defecation and empower them collectively to come up with solutions to eradicate unsanitary conditions. Dr. Kamal Kar, the founder of CLTS Foundation Global, is the pioneer of this approach.

Norwegian Church Aid / Kirkens Nødhjelp is implementing a project supported by UNICEF where eight communities have been triggered on CLTS. It’s essential to educate these communities about the serious health implications like cholera and diarrhea which are often associated with open defecation. CLTS is cognizant of the fact that until the communities do not change their behaviors towards open fecal discharge, mere toilet construction will not be enough to tackle poor sanitation. This approach has zero subsidy as no external source of motivation will help if the people are not self aware to address this problem.

Ceeblo Abdullahi Arab, a resident from one the communities shared her experience when due to lack of a toilet she had to wait till night to relieve herself. Those times were traumatic not only physically but psychologically too. CLTS helped bring about a change in her lifestyle and now along with her son in law, she constructed 2 latrines. She is one of the many success stories that we are proud to share and as the project continues we look forward to change many more lives and get all the eight identified communities Open Defecation Free (ODF).

By Dipankar Datta, Ph.D  |  Country Director, Somalia at Norwegian Church Aid / Kirkens Nødhjelp  |  9th September 2022 .

The post Community Led Total Sanitation (CLTS) in Somalia appeared first on CLTS Foundation Global.

One can easily enumerate the many milestones Community-Led Total Sanitation (CLTS) has contributed toward the goal of achieving a world free from open defecation (OD). The CLTS approach to sanitation has come far from its humble beginnings in Bangladesh in 2003. Since then, 50 million people now live in OD free (ODF) environments in 66 countries across Africa, Asia, Latin America, the Middle East, the Pacific Islands, and the Caribbean due to the adoption of CLTS by various governments and international agencies, bringing with it many positive outcomes for health and human dignity.

While it has enjoyed widespread success over a range of geographical and social contexts, a number of challenges and concerns have arisen concerning the efficacy of CLTS not only to galvanize communities into ending OD but also to remain ODF. Unfortunately, it is not uncommon for people who had built and used latrines to abandon them and resume the practice of OD. While poorly implemented CLTS has resulted in communities that have not become ODF, many factors play into a community’s failure to become ODF. However, it is chiefly the recidivism back to OD that is the most prevalent obstacle to sustained behaviour change. Why do communities recede back into the practice of OD? And what is responsible for this ‘backsliding’ of sanitation practices after communities? Further, how can these gaps be addressed and reflected in future CLTS planning and implementation exercises?

While a comprehensive analysis of sanitation recidivism is beyond the scope of this article, a combination of factors influences a society’s decision to collectively end the practice of OD and remain ODF. In 2013, a case study studying 4960 households in 116 African villages that had been declared ODF for two or more years found that 92% of the households had receded back to the practice of OD.¹ Physical factors include sandy soil, heavy floods or rains, and termite attacks, and can lead to the destruction or collapse of latrines that have been built. A host of cultural and socioeconomic factors include age, sex, education, income, household size, local leadership, and religious beliefs often act concomitantly to undermine sustained behaviour change concerning OD and determine whether communities will strive to remain ODF.

CLTS cannot change fixed physical factors that contribute to the decline in post-CLTS latrine usage. As mentioned previously, difficult soil conditions, excessively wet or dry climatic conditions, and pestilence all play an important part in determining whether individuals or communities rebuild their sanitation hardware or not. In this case, community living in an area with consistently heavy rain or floods might become discouraged and abandon their broken, full or overflowing latrines.² For instance, many ODF communities in the northern district of Nampula, Mozambique fell victim to heavy flooding in 2015 which destroyed 10,860 homes.³ A follow-up survey indicated that many latrines had collapsed, and so their sanitation status could not be defined.

A community’s morale (or lack thereof), as well as its perception concerning its abilities to rebuild latrines, the longevity of the latrines, and the material resources, required clearly influences the decision to remain ODF or slide back into the practice of defecating in the open. In many cases, poorly designed latrines that were used for a short period were eventually abandoned due to issues with poorly constructed doors, roofs, pans, and pits.⁴

Cultural and economic barriers to sustained behaviour change are, however, more readily addressed by the CLTS approach. In many communities, beliefs about ritual purity and pollution concerning latrines, education about sanitation and health issues, the size and income of a household, plays an important part in their use even after they have been constructed. In Northern Mozambique for example, a study shows that more years spent in school is associated with a higher likelihood of rebuilding a latrine.⁵ Some community members like farmers find it burdensome to use a latrine in the middle of a working day, while others such as the elderly are less likely to use a latrine due to the sanitation habits they have adopted for many decades.⁶ One notices that many of these are indeed the same factors that discourage latrine construction and use, to begin with.

Arguably, however, it is primarily a community’s social dynamic and environment that plays the largest role in its decision to become or remain ODF or continue the practice of OD. Changing the way community members interact with and relate to each other in the context of health and sanitation is central to the CLTS approach. Therefore, the concepts of social capital, social dilemma, and social identity need to be considered in order to delineate and relate the overarching social challenges with sanitation backsliding. While social dilemmas describe situations in which individuals are better off  not doing something which benefits the whole group, social capital encapsulates factors as trust, cooperation, communication, and social cohesion within a community.⁷ Lastly, social identity illustrates how well individuals are connected within a group and how strong intra-group ties are.⁸

It is here that CLTS can make the biggest difference in the behaviours and attitude of community members towards each other with respect to health, sanitation, and general social cohesion. Communities with higher collective ambitions to reduce or eliminate OD, as well as higher levels of solidarity, trust and cohesion between residents are more likely to make the required efforts to galvanize the community into shaping solutions to their specific sanitation situation. When conducting pre-triggering and triggering exercises, CLTS facilitators must accurately investigate the social capital of a community and emphasize its importance in the process of eliminating OD, capitalizing on it if it is strong, and seeking to augment it if it weak. In this context, issues such as feelings of vulnerability to disease, latrine ownership, cooperation in building sanitation hardware, and confidence in the ability of others should be emphasized to all community members to give a sense of a shared risk as well as a goal. Ultimately, it must be effectively demonstrated that building, owning, and maintaining a latrine poses little risk or cost to a household.

Health concerns are also big drivers for communities to strive towards eliminating OD. In Benin, a study demonstrated that latrine users felt safe from contact with harmful bacteria or viruses by using a latrine. They are also more likely to rebuild or repair a damaged latrine than to recede back into the practice of OD.⁹

The pre-triggering and triggering exercises could also extend to teaching communities how to evaluate their physical environment and advising them on how best to optimize resources towards the design and development of sanitation hardware, especially in areas where soil conditions are poor and communities are not likely to rebuild damaged latrines.¹⁰ Moreover, it would also be highly beneficial if organizations implementing CLTS provided communities with comprehensive guidance on how to maintain and empty existing latrines so they may be used again. This is especially important as several studies have demonstrated that latrines are often abandoned when they are full.¹¹

CLTS interventions must, therefore, be adjusted and customized to fit the needs and tackle the challenges unique to a community, and must also attempt to successfully change some of the conditions that facilitate the decision to reconstruct or continue using a latrine. If it is possible to ascertain how the success of CLTS in influencing sanitation behaviour is related to structural, social, and individual conditions, then CLTS can be improved and amended so that it encourages collective behaviour change within the community that not only supports the goal of becoming or remaining ODF but also equips community members to better assess the obstacles to that goal. The addition of data-based behaviour change strategies within the CLTS framework could improve its effectiveness even more. As such, such strategies could target and augment factors like education, social cohesion and trust, vulnerability to disease and community health concerns, perceptions towards latrine ownership, and confidence in latrine construction, rebuilding and repair.

While the responsibility of not sliding back to OD does lie upon the community, it would be beneficial for various implementers of CLTS around the globe to incorporate the above factors into all their triggering exercises. CLTS has indeed succeeded in transforming the mindsets of myriad communities to recognize the dangers of OD. However, an improved framework of behaviour change that not only empowers a community to accurately assess its sanitation goals, but also allows for the establishment of stronger social capital, would only hasten the achievement of Sustainable Development Goal 6.2.

Featured image source: https://www.hindustantimes.com/mumbai-news/here-s-proof-mumbai-isn-t-free-of-open-defecation/story-3qSgOZdv3rspFgpXQPe0JM.html

1,2 Tyndale-Biscoe P, Bond M, Kidd R. ODF Sustainability Study. FH Designs Australia: PLAN International. 2013:1±181.

3 Mozambique: Floods Emergency Appeal MDRMZ011 Final Report: International Federation of Red Cross and Red Crescent Societies, 2015

4,5, 10,11 Mosler, Hans-Joachim, et al. “Is Community-Led Total Sanitation Connected to the Rebuilding of Latrines? Quantitative Evidence from Mozambique.” Plos One, vol. 13, no. 5, 2018, doi:10.1371/journal.pone.0197483.

6 Routray, Parimita, et al. “Socio-Cultural and Behavioural Factors Constraining Latrine Adoption in Rural Coastal Odisha: an Exploratory Qualitative Study.” BMC Public Health, vol. 15, no. 1, 2015, doi:10.1186/s12889-015-2206-3.

7 Grootaert C. Measuring social capital: an integrated questionnaire: World Bank Publications; 2004.8 Cameron JE. A three-factor model of social identity. Self and identity. 2004; 3(3):239±62.
9 Jenkins MW, Curtis V. Achieving the ‘good life’: why some people want latrines in rural Benin. Soc SciMed. 2005; 61(11):2446±59.

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It is estimated that 0.12 million tonnes of faecal sludge is generated in India per day.³ With poor sewage networks in Indian cities, a large proportion of the urban poor still depend on public toilets. Public toilets often have no water supply while others are not connected to the public sewage system. The lack of public sanitation infrastructure also propagates crude septage handling practices like manual scavenging which require scavengers to collect human excreta from one household to the next. In contrast with the large proportion of on-site installations, limited attention has been accorded to proper construction, maintenance management and safe disposal of septage from septic tanks and pit latrines in Indian cities. Most of the latrines built under the Swachh Bharat Abhiyan will depend on on-site containment systems, augmenting the urgency of the rapid and widespread development of Fecal Sludge Management (FSM) solutions in the face of increased latrine access and generation of faecal sludge.

While large-scale networked sewage systems have their own financial, legal, administrative, and infrastructural barriers, there exist shorter-term solutions that are effective, efficient and environmentally sustainable precursors to the increasingly urgent problem of faecal sludge and wastewater management. In the face of massive deficits in urban sanitation and considerable investments required for the design and installation of sewage systems, small-scale on-site treatment systems offer a potential way to further close the sanitation deficit in India.

Among other things, FSM entails developing tools to assess the generation of faecal sludge, its pathways from containment to treatment, the constraints to establishing an effective chain of services to manage it. Developing new waste handling and treatment technologies is also essential.⁴

In the effort towards establishing an effective FSM network throughout India, the Consortium for DEWATS Dissemination (CDD) Society has been leading the charge and exploring novel ways in which to design and implement smaller-scale FSM systems in smaller Indian cities. The sanitation not-for-profit introduced its first dedicated faecal sludge treatment plant in Devanahalli, a town in Karnataka of 28,000 people. Since the beginning of its operation in 2015, it prevented about half a million litres of faecal sludge from polluting the environment in its first two years.⁵ It was eventually recognized by The Federation of Indian Chambers of Commerce and Industry and the India Sanitation Coalition and awarded the Best Innovation in Sanitation Award in 2017. The plant, no larger in area than a medium-sized bungalow, collects the faecal sludge of Devanahalli from desludging vehicles, which is then treated through anaerobic respiration. The treated sludge is then dried and distributed to local farmers as an organic soil conditioner.

The CDD society developed a multistage research and development process prior to the establishment of the plant. Firstly, it assessed the volume of faecal sludge generated in Devanahalli, the total number of toilets, pits and septic tanks, and the frequency and mode of desludging by residents. This led to the development of an operations model in which desludging operators do not have to travel large distances before emptying their truck, the location of the plant was close to the city.

Particularly beneficial in the development of such small-scale FSM projects is the collaboration and partnerships that form between the private/non-profit and public sector. In the case of Devanahalli, the town passed a series of resolutions pertaining to the regulation of new containment systems, licensing and regulation of private desludging operators, outsourcing the operations of the treatment plant to private operators, and property taxes to support the cost of the plant. It is worth noting that the cost of the Devanahalli treatment plant is also well within the budget of most towns of similar size, as it is operated by just one operator and runs on gravity, not electricity. Sales from faecal sludge compost, as well as desludging fees and property taxes also help to finance the operation.⁶ It is thus cheap, sustainable, and effective.

CDD is now working with governments and authorities in various towns in Rajasthan, Tamil Nadu, Orissa, Leh, and Bhutan to expand and scale up their affordable FSM operations throughout India.

A similar example of the private-public partnership model in FSM involves a faecal sludge treatment plant commissioned by the Jhansi Municipal Corporation in Jhansi, Uttar Pradesh, and built by Purna-Pro Enviro Engineers. As the town sits on the rocky terrain of India’s central plateau, it has been difficult to plan and build underground sewage. Consequently, about 80% of the population is dependent on on-site sanitation systems. The remaining 20% dispose of their untreated excreta openly into the environment. In Jhansi, additional desludging vehicles were commissioned in order to provide desludging services within the entire city, while a request-for-services and payment system was also established.

No more than an acre in size, the plant was built in 2018 with a capital investment of INR 2 crores. Its daily treatment capacity is 6000 liters and carries an annual maintenance and operation cost of INR 27.6 lakhs.⁷ Here, the treatment process entails many similar features as that of the Devanahalli plant: gravity-powered anaerobic filtration, gravel filters, and drying beds. The treated water is subsequently used for irrigation, and the treated sludge is used as organic manure.

The above FSM solutions are a much-needed innovation in a sector of development which does not receive adequate attention in India. To begin the heavy lifting of urban sanitation, authorities in India must further incentivize the design and innovation of cost-effective and reliable engineering solutions that are able to treat large volumes of waste, at least in smaller and medium-sized cities such as Devanahalli and Jhansi. Their establishment also sets up a precedent for and provides an understanding of the necessary aspects of construction, regulation, logistics, and financing of such sanitation projects. This will also allow for the effective and smooth scaling up of FSM in bigger cities such as Mumbai, Delhi, Bangalore, or Kolkata.

While the above FSM solutions are worthy and desirable investments in urban sanitation, they are not long-term solutions to India’s massive deficits in urban and peri-urban sanitation, as their treatment capacities over time will have to increase drastically. In the coming years, the Government of India will have to grapple with this fact. The consistent disposal of millions of litres of untreated septage continues to wreak havoc on India’s ecosystems and natural habitats, massively polluting its various water bodies and water supplies. This subsequently carries dire implications for public health, disease prevention, and quality of life in general. It is important then for India to begin to deploy a slew of strategies and projects that develop an effective regulatory and licensing framework, engage citizens and garner public support, use competition to improve the quality of planning and encourage innovative funding mechanisms, rapidly develop “quick-win” projects, and rapidly invest in public-private partnerships,  among other things. In this sense, the treatment plants of Jhansi and Devanahalli serve as effective pilot projects to developing sustainable and effective FSM solutions.

Featured image source: https://www.borda-sa.org/strengthening-the-operation-maintenance-sector-for-servicing-decentralised-urban-sanitation-infrastructure-in-karnataka-india/

1,2 Dobbs, Richard, and Shirish Sankhe. “India’s Urban Transformation.” McKinsey & Company, www.mckinsey.com/~/media/McKinsey/Featured Insights/Urbanization/Indias urbanization A closer look/Indias urbanization A closer look.ashx.

3,4 Luthra, Bhitush. “Faecal Sludge Management Gets World Attention.” Down To Earth, www.downtoearth.org.in/news/faecal-sludge-management-gets-world-attention-48293.

5 “Faecal Sludge Management.” CDD Society I Water and Waste Management Solutions I Faecal Sludge Management I Wastewater Treatment Systems I City Sanitation P, 18 Apr. 2018, cddindia.org/faecal-sludge-management.

6 India, Dasra. YouTube, CDD India, 18 May 2017, www.youtube.com/watch?v=WZgT2Vwfvwc.

7 Faecal Sludge Treatment Plant at Bijoli, Jhansi. Center for Science and Environment, www.cseindia.org/feacal-sludge-treatment-plant-at-bijoli-jhansi-9070.

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A wealth of reports and studies have described open defecation as one of the biggest public health concerns in developing nations. They elaborate upon the various health problems that arise from children’s chronic exposure to open defecation while emerging evidence has linked open defecation to a number of poor health outcomes the most prevalent of which is child stunting, particularly in South Asia. It is estimated that 159 million children worldwide under the age of five are stunted.¹ Inadequate access to latrines also has its consequences. In 2015, a joint report by UNICEF, USAID and the WHO compiled a list of case studies and scientific studies that demonstrated a link between poor sanitation and chronic malnutrition in children through the spread of diarrhoea and other intestinal parasites.

Child Stunting

Child stunting and wasting is observed to be one of the most widespread consequences of open defecation and poor sanitation around the world. A study published by Dean Spears and Arabinda Ghosh studies 112 districts in India demonstrated that child stunting statistics were significantly higher in areas where the practice of open defecation was more frequent.² In these districts, it was noted that “Over half of the children are stunted, and almost a third of children are severely stunted.” In another paper, Spears has stated that living with or near neighbours that continue to practice open defecation the negative health effects of open defecation are significantly more pronounced  owing to densely populated regions.³

This is especially common in many areas in India. He mentions “the difference in average height between Indian and African children can be explained entirely by differing concentrations of open defecation. There are far more people defecating outside in India more closely to one another’s children and homes than there are in Africa or anywhere else in the world.”⁴

Diarrhoea and Child Mortality

Diarrhoea accounts for 9% (800,000) of deaths of children under five years of age worldwide due to constant exposure and ingestion of germs from faecal matter.⁵ In Ethiopia for instance, diarrhoea is the leading cause of mortality for children under five, causing 23% of deaths. A study conducted in Ethiopia from the Journal of Environmental and Public Health demonstrated that “the overall prevalence of under-five diarrhoea among the individuals living in the ODF kebeles [neighbourhoods] was lower as compared with the OD kebeles.” ⁶ A similar result was observed in Kenya, where the only two sub-districts in the country that were ODF had significantly lower prevalence of diarrhoea than other areas.⁷

Similarly, it was reported in 2015 that 100,000 children in India died due to diarrhoea, with a combined 499,000 from India and Nigeria alone.⁸ While the study cited above also states that “71 out of every 1,000 babies born alive die before they are one year old”⁹, another report from the Lancet journal, however, has noted some encouraging news. While overall diarrhoea deaths in children under the age of five dropped by 34.3% globally between 2005 and 2015, in India the rate of reduction was at 43.2%. The number of under-five deaths in India declined from 3.33 million in 1990 to 1.34 million in 2013.¹⁰

Malnutrition

The WHO estimates that 50 percent of malnutrition is associated with repeated diarrhoea or intestinal worm infections from unsafe water or poor sanitation.¹¹ This is because children with diarrhoea eat significantly less food and are able to absorb fewer nutrients from their food, which perpetuates the cycle of catching bacteria-related illnesses. Diarrhoea is also caused by lack of clean water for handwashing. It is also exacerbated by the lack of functional toilets which adequately dispose of faecal matter, as faeces on the ground contribute to contaminated drinking water and water resources.

This means that millions of children are unable to attain a healthy body no matter how well they are fed, a classic sign of malnutrition. Jean Humphrey, a professor of human nutrition at Johns Hopkins Bloomberg School of Public Health mentions that the “children’s bodies divert energy and nutrients away from growth and brain development to prioritize infection-fighting survival.”¹² This eventually leads to stunting and inadequate childhood development. This phenomenon is, again, much more prevalent in India due to its dense population concentration in many areas of the country.

Gender-based violence

There are also strong and disproportionate gender-based impacts of open defecation and the lack of adequate sanitation hardware. For girls and young women, the lack of access to private latrines and toilets renders them vulnerable to sexual violence, which frustrates efforts for them to lead a healthy and productive life. This is a major public health concern as well as one of human rights.

This means that many girls and young women live in constant fear, as has been noted by the Sanitation and Hygiene Applied Research for Hygiene (SHARE) organization.¹³ As there are no private lavatory facilities for women, they are often forced to relieve themselves in public places during the early hours of the morning or late at night, when the likelihood of sexual assault or violence is higher. In India for example, the SHARE report notes various instances of rape as boys were observed to wander around women’s toilets at night. The report also mentions “boys shamelessly staring at them, making threats, throwing bricks and stabbing them.”

Moreover, the report also outlines that many women fear the water and public toilets that they can use to clean themselves is far from clean, which contributes to the fear of infection or sickness, further exacerbating the health problems that result from open defecation.

Featured image source: https://www.yashodafoundation.org/sanitation-for-children-in-rural-india/

1 “Without Toilets, Childhood Is Even Riskier Due to Malnutrition.” UNICEF, 19 Nov. 2015, www.unicef.org/media/media_86283.html.

2,9 Spears, Dean, and Arabinda Ghosh. “Open Defecation and Childhood Stunting in India: An Ecological Analysis of New Data from 112 Districts.” PLoS ONE, 2013.

3 “Open Defecation Linked to Stunting in Indian Children.” Down To Earth, www.downtoearth.org.in/news/open-defecation-linked-to-stunting-in-indian-children-42252.

4,12 Harris, Gardiner. “Poor Sanitation in India May Afflict Well-Fed Children With Malnutrition.” The New York Times, 13 July 2014, www.nytimes.com/2014/07/15/world/asia/poor-sanitation-in-india-may-afflict-well-fed-children-with-malnutrition.html?_r=0.

5,6 Ayalew, Abireham Misganaw, et al. “Assessment of Diarrhea and Its Associated Factors in Under-Five Children among Open Defecation and Open Defecation-Free Rural Settings of Dangla District, Northwest Ethiopia.” Journal of Environmental and Public Health, vol. 2018, 2018, pp. 1–8., doi:10.1155/2018/4271915.

7 Njuguna, John. “Effect of Eliminating Open Defecation on Diarrhoeal Morbidity: an Ecological Study of Nyando and Nambale Sub-Counties, Kenya.” BMC Public Health, vol. 16, no. 1, 2016, doi:10.1186/s12889-016-3421-2.

8,10 Livemint. “India Continues to Record High Child Mortality Rate Due to Diarrhoea: Study.” Https://Www.livemint.com, Livemint, 2 June 2017, www.livemint.com/Science/oWS5VjPoILlK0HG3TK3QSM/India-continues-to-record-high-child-mortality-rate-due-to-d.html.

11 “Water, Sanitation, Hygiene, and Malnutrition in India.” Population Reference Bureau, www.prb.org/india-sanitation-malnutrition/.

13 Lennon, Shirley. Fear and Anger: Perceptions of Risks Related to Sexual Violence against Women Linked to Water and Sanitation in Delhi, India. Sanitation and Hygiene Applied Research for Hygiene, Nov. 2011, www.susana.org/_resources/documents/default/2-1758-vawindia.pdf.

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