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About the editors

  • Ruth Spencer (EJC)
    Ruth Spencer is a journalist, Editor, producer and hails from Montreal, Canada. She has worked for the European Journalism Centre since September 2008 and has edited all three rounds of TH!NK ABOUT IT. She has production experience in print media, theatre and broadcast television. She tweets via @thinkteam and is currently based in Toronto.
  • Guy Degen
    Guy Degen is an Australian freelance journalist and is based in Germany. He travels widely contributing stories to international broadcasters and is regularly commissioned by UN agencies as a multimedia producer. Guy writes for the Frontline Club blog and tweets via @fieldreports. Guy also trains journalists in multimedia skills and mobile journalism.


Sanitation - a S-word we should talk more about

Published 17th May 2010 - 10 comments - 6462 views -

I've spent the past week on the road north of Bamako around Kita, Segou and Mopti. It's been an interesting trip so far. Filming emergency or humanitarian and development projects has its moments. You could find yourself observing clearance of landmines; flying low over vast tracts of spectacular jungle; meeting people with incredible stories to tell; or, as I'm faced with on this assignment in Mali, trying to figure out how to best film projects involving clean water but also... shit, poo, faeces, caca, excrement... Whatever you want to call it, something that no one likes talking about.

In development circles you'll often hear the acronym WASH which refers to water, sanitation and hygiene. And water projects usually shine in the media spotlight. Everyone understands the need for clean water. People feel good about clean water. But sanitation is another matter. And I must admit I've seen more than my fair share of open sewers or filthy toilets and latrines around the world. Some unspeakable places come to mind (and sadly too many in schools I might add) that have required mustering all of my rather feeble courage to simply poke my head around the corner long enough to verify what people tell me is well... just plain wrong and needs fixing.

So it was somewhat with raised eyebrows that I read about a programme here in Mali that introduced a new development acronym to me - CLTS, or in development parlance, "community led total sanitation". This also involves another acronym - OD, standing for open defecation. Are you still with me? According to figures from WHO and UNICEF, 2.6 billion people, or 39 per cent of the world’s population, live without access to improved sanitation. Something to think about next time you go to the toilet, and wash your hands. Guardian Global Health blogger, Sarah Boseley, has a good post on progress towards achieving water and sanitation MDG's too.

Over the past week I've been talking with people from small rural communities who are participating in a CLTS program led by Plan and UNICEF Mali. You can read more about this approach to sanitation in Mali here, but in a nutshell, people are gathered together to talk about sanitation in their village. Sometimes a griot, a traditional Malian storyteller, will be involved - someone who can help to get people talking. Out comes a plate of food to share. Everyone takes a little bit to eat and the plate is placed on the ground. Meanwhile, there's been an open defecation hunt, and lo, a poo is found and placed near the plate of food.

It's deliberately confronting but a little experiment takes place. Flies that were feasting on the food move over to the poo, and as flies are want to do, fly from the poo back to the food. Program trainers say at that point someone usually yells out: "we're eating our own caca". There's often a reaction of shame or disgust and as you can imagine a lot of debate follows. People talk about what's actually happening in their village, their cultural practices or traditions and the potential health benefits of stopping open defecation, particularly diarrhea related illness, building covered latrines, having access to clean water, and importantly, having the means to wash their hands properly with soap or ash. This is part of what trainers call the triggering process.

Balla Moussa Sidybe, the mayor of a commune near Kita, told me the reaction in his home village Dafela was instant. In his eyes, people were jolted into doing something immediately about building better latrines, as pictured above, and improving village sanitation. And here's where the programme attempts to be "community led". Through the whole CLTS process, the communities themselves determine the number of latrines they need, the locations and work out how they will build them with locally available materials. It's very much a grassroots approach.

In several villages I visited, I spoke with people who were busy digging new latrines. The father and son team below were hard at work in the blazing sun building a new family latrine the day after a CLTS workshop. A lot of people said they saw the need for change in their village.


The test of course comes later if villages can be declared "open defecation free" and if it's sustainable. That's the CLTS goal. The achievment of being open defecation free is recognised with a local ceremony and as one village elder near Mopti put to me: "We didn't do it for anyone else, we did it for ourselves."

In 2009, 48 communities in Mali were declared open defecation free, benefiting around 95,000 people. The target for 2010 is bring 200 communities to open defecation free status, benefiting 280,000 people.



  • Johan Knols on 17th May 2010:

    The S-word is always great to talk about. I can’t remember a trip in Africa without it. Here is another one that shows that even when toilets are present, you still want to OD.

    1989, Lake Malawi, on a ship.

    We had a sleeping place on the deck, but the toilets where below decks. Before tucking in I went down where it was easy to find the loos, I only had to follow my nose. The main door looked a bit rough, but was very clean in comparison what I would encounter in a few seconds. As I opened the door to the Men’s, I realized I wasn’t on a cruise ship. The stench made me breathe through my mouth instead of my nose. Of the seven toilets the first four were blocked. The following two were out of order, so I carefully opened the last one’s door handle with my boot. Wow, I never sat in, let alone on a toilet which had the lightbulb and ceiling covered in shit. I decided to skip this one as well.
    Needless to say I had to OD by hanging over the rail on the deck after the ship was covered in darkness. The starry night sky and the fresh air from the lake made the wait worthwhile.

    Sanitation is great, but only when it gets cleaned.

  • Bart Knols on 17th May 2010:

    Thanks Guy. Toilet stories, an all-time favourite. Interestingly I recently heard that a strong relationship exists between mobile telephony and latrine construction. Here’s why. In Ghana, where funerals would normally have 30-50 people present, they now have hundreds. Simply because mobile phones can mobilise people faster to take part in the ceremony. These ceremonies sometimes last for days, with lots of food and drinks. Because of the large number of people now gathering at funerals, families construct new latrines for the upcoming funeral. Obviously these remain afterwards and contribute to overall sanitation. Who would ever have connected mobile phones to better latrines?

  • Guy Degen on 17th May 2010:

    @Bart fascinating connection between mobiles, funerals and improved sanitation. A wake and legacy latrine.

    @Johan OD drama on Lake Malawi! You’re absolutely correct about keeping toilets/latrines clean. And, you don’t have to go to sub-Sahara Africa to see problems either. One of the most appalling sanitation situations for school children that I’ve seen was in Albania, just on the outskirts of Tirana. The shed that served as a toilet block was barely standing, the latrines were in such a state that few children would attempt to use them. And really, we’re just talking about holes in concrete to squat. Kids would OD behind the shed or crawl through a fence to a vacant plot to relieve themselves. A broken tap was the only place for them to wash their hands. For girls it’s of course all the more difficult. In contrast, you’ll find a lavash - car wash stand - literally on every street corner. Clean cars over clean toilets?

  • Hanna Clarys on 18th May 2010:

    I love the CLTS initiative! And apparently, it is working. Looking forward to hear more about Mali.

  • Guy Degen on 18th May 2010:

    @Hanna thanks for your comment. BTW I’ve fixed the link in the text to CLTS Mali. It also has more info on Kamal Kar who pioneered CLTS.

  • Iris Cecilia Gonzales on 19th May 2010:

    Hi Guy,

    Interesting post as always! You’re very privileged to be able to go around and around so many places that really need attention. The sanitation problem is always interesting and quite a very relevant issue.

    I was just in Mindanao in the southern Philippines and I saw the same problem of sanitation (among other problems) in a refugee camp of internally displaced persons. Here’s my story on it:

  • Hieke van der Vaart on 19th May 2010:

    Hey Guy,

    Have you seen this article? It is quite pessimistic about achieving MDG 7, target 3 (Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation)

    What do you think?

  • Guy Degen on 27th May 2010:

    @Iris - vivid writing and photos on displaced people in Mindanao, great feature. Thanks for posting it.

    @Hieke - I have read comments of Biswas and he’s a straight talker. I think in general more of that is needed, not only for UN agencies, but for the whole development sector. Because let’s face it - development is a big business. It’s interesting to read what he says about the definitions of improved water sources such as building a concrete apron around a well. He’s right of course that concrete around a well won’t make the water cleaner. No arguments there. But from what I’ve seen, it certainly helps people to access the water point (especially in a rainy season) and helps tp keep water containers people are filling up cleaner. To film around a well with an apron, even a traditional well, means following everyone else and removing shoes to try and keep the area a little more clean.

    I asked water and sanitation specialists what progress Mali was making towards MDGs. There was a lot of frowns and a bit of frustration on people’s faces. On water, they were optimistic, but sanitation is much further behind and unlikely to reach the goal.  Though they hope regional pockets in Mali may produce some better results in sanitation before 2015. They are pleased that programs like CLTS are beginning to gain a little bit of traction and building momentum.

  • Iwona Frydryszak on 23rd July 2010:

    Thanks for post and hope for more links as always. In the mid of NOvember there is the World Toilet Day - we want to introduce the topic to Polish society a little bit - It’s what you said - my organisation has a mission in Sudan and it’s quite easy to collect money for water and building wells, but we have also mission in oPt where we mostly built toilets and it’s not so easy to sell to the public. So if you know more about successful campaign about toilets in North societies, please let me know. smile

  • Helena Goldon on 20th January 2011:

    Dear Guy, I remembered about this article while recently researching on behavioural change strategies for improving sanitation in Tanzania.

    Just like in Mali, the sanitation specialists I talked to seem helpless.
    One latrine is shared here by a community of 15-20 people. When it comes to buying a concrete lid (a cost of $1 - 5-8 cents per person) for a common cause and a member of a community comes out with such suggestion the other members say: ‘It’s OK, YOU can buy it, if you want - I don’t need it’.

    Unbreakable wall of convictions?? Mentality?

    Do you mind if I ask you about any other strategies you observed
    (other than the demonstration of feaces: that you considered effective in terms of motivation and behavioural change?

    I know you are a busy person so thank you in advance smile

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