Dr. Kamal Kar

Chairman, CLTS Foundation

Tampere, Finland ~ August 22, 2012

Globally millions of tones of human excreta poured in to the open everyday

2.6 billions have no access to safe sanitation

More than a billion practice open defecation, thousands of

truck loads of shit is being released in the open everyday,

more than 42 children dying every hour from diarrhea, &

waterborne enteric diseases in India alone.

OD contaminates water bodies on a daily basis and valuable

human excreta not used in food security

A child is dying in every 15 second and millions of U5

children suffering sever bouts of diarrhea (mostly poor)

Global annual loss from death, treatment, disability, labour,

exceeds trillions of dollars

Dry Toilets: Solution for environmentally challenged water scarce areas

Population lacking access to basic sanitation in Sub Saharan Africa is more than 450 million

In India more than 630 million practice OD.

More than 40% of world’s area is considered to be dry land, In various regions it ranges from 20 to 90%.

Dry lands are inhabited by more than 2000 million people, nearly 40 percent of world’s population.

Traditional - professional ‘mind-set’ in tackling the problems

Subsidize * Standardize *Prescribe * Top-down

hygiene behaviour teaching* Health as key

motivator for hygiene behaviour change

Major shits are in assumptions, who’s ideas

and who leads?

From top-down prescription of technology for

possessing latrines to collective behaviour change

Fate of free toilets in a slum of a Municipality town near Calcutta, India

Fate of sanitation subsidy in Yemen

Abandoned Collapsed Communal Latrine –Dangme

West District, Greater Accra Region, Ghana

Abandoned Free Latrines depicts welfare mindset

of institutions in Fatenayili ODF Village

Fate of subsidized sanitation hardware- Portloko, Sierra Leone

Who’s

design for

whom?

Quic kTime™ and a decompress or

are needed to see th is p ic ture.

Why CLTS could pave the way for wide

spread adoption of Dry Toilets?

Why CLTS could pave the way for wide spread adoption of Dry Toilets? It triggers spontaneous and immediate collective local

action to stop OD, which no other approach could initiate so fast

Instant reaction is to cover or burry shit rather than wash it out; it is easier to handle, simpler, cheaper and low external input and technology dependent

Starting point for the ODF communities to climb along the sanitation ladder

Other factors that influence adoption and spread include:

Cultural practices and social norms

Availability of low cost local materials

Mobility of the people (Nomadic, semi-nomadic and population living in riverine delta regions affected by severe erosion of embankment and other climatic/environmental factors e.g. very cold areas -Mongolia)

Ownership/Access to land, Makeshift/Temporary settlement etc.

Urban or Rural Settlement

What is Community – Led Total Sanitation ?

They are total & involve/affect everyone in communities e.g. total elimination of open defecation, total freedom from hunger)

Collective Community decision & collective local action are the keys

Social Solidarity and cooperation are in abundance

They are locally decided and don't dependent on external subsidies and prescriptions or pressures

Natural Leaders emerge from collective local actions who lead future collective initiatives

They often don’t follow externally determined mode of development and blue print

Local diversity and innovations are main elements

Entry/ Ignition

Defecation area transect Defecation Mapping Flow diagram Calculation of faeces etc.

Community

realization of

terrible impact

of faecal-oral

contamination

Self Empowered Committee

formed

Identification

of right

person in the

community

How to get a

latrine slab Registration

daily monitoring

on map Start pit

latrine

from

tomorrow

We do it

first and

stop open

defecatio

n

10 H/H 10 H/H

Spreading

messages

from the

mosque

Each of us

cover 10

families

Diagrammatic presentation of the process of igniting Community- Led Total Sanitation (CLTS)

X

X

X

L

L L

L

L L

L

L

X

X

X X

X

X

X

X

X X

X

X

X SHG

X

X

X

X GP

X

SHG

X

X

X

X

X

X

X

X

Land less don’t have place for defecation.

Land owners often blame them for defecating

in open. Landless poor (women specially) are

the worst victims who want to come out of

that humiliation.

Participatory

Planning

Latrine

owners can’t

get rid of

negative

impacts as

many others

adding faces

everywhere.

Spoiling

environment

by open

defecation

Will form positive

pressure groups

from within to

convince others for

having latrine

Better

off

Med

ium

Poor

Very poor

Moving towards 100% sanitized village

Mosque

GKS

ANM

ASHA

Anganwadi

School

More yellow powder in places where there is more shit-

Sierra Leone

Quic kTime™ and a decompress or

are needed to see th is p ic ture.

Quic kTime™ and a decompress or

are needed to see th is p ic ture.

Rural community in Mardan, NWFP, in Pakistan mapping defecation areas of village

Rural youth in Nepal triggering Community Led Total Sanitation. Are they not transforming the collective behavior of the society?

Look at the faces of worried mothers after their own analysis- Llala Gua, Bolivia

Shit

everywhere.

Our children

growing on

shit- we can’t

accept this

Quic kTime™ and a decompress or

are needed to see th is p ic ture.

Food and shit demonstration

QuickTime™ and a decompressor

are needed to see this picture.

More than 150

toilet pits were dug

within 24 hours of

triggering in seven

villages in rural

Djibouti.

Djiboutian rural

community have

proved that they

can achieve ODF

status if

empowered. Are we

ready to create a

conducive

environment for

ATPC?

Notice who is teaching and who is learning

Djiboutian

rural

community

taught us the

way forward

for an ODF

Djibouti

A child in Sera Leon sharing ODF

plans of community with outside

professionals

Hundreds of low-cost local community-made toilets are surfacing in the rural landscape in CLTS villages in Bangladesh.

Newly constructed toilets in villages of BangladeshNewly constructed toilets in villages of Bangladesh-- great great

sense of ownership and pride sense of ownership and pride

Who’s idea and who's decision matters in household sanitation? South Sumatra, Indonesia

Great mosaic of latrine models innovated by local communities in Kampung Spu in Cambodia

Do we have patience to allow communities to

gradually move up the Sanitation Ladder?

Open

defecation O

10

9

8

7

6

5

4

3

2

1

Pour flush latrine

Latrines with plastic

pan and water seal

Offset Pit latrines

Simple Pit Latrines

Sa

nita

tion

beh

avio

rs chan

ges a

s com

mu

nity

mov

es up

the la

dd

er

Use of ash after defecation in direct pit latrine is an innovation by the community of Skun villages of Tbeng Commune of Siem Reap province in Cambodia. One gets potash rich

manure at the end. Whose idea?

Community Innovated direct pit latrine- Skun village,

Banteay Srei, Cambodia

Watch the striking difference; mud walls & thatched roofs of houses versus brick & cemented walls & roofs for toilets. Whose designs and decisions?

Local Adaptation and community innovations are the key for scaling up and spread of any approach- Dry Toilet has an edge over other approaches

Collecting shit for use in agriculture, Shanxi province in China

Cemented lid cover of dry pit latrine, Madagascar.

Toilet built

using locally

available low

cost materials

in Chibelle

village in

Djibouti–

Whose

innovation?

Dry toilet constructed by the communities in

different parts of the world in highly diverse

environment signifies community’s preference

Dry pit latrine with retractable wooden lid-cover

constructed within a few days of triggering in

villages in Zuunkharaa Sum in Mongolia

Local Community Innovation in Kalyani

Construction details of community innovated low-cost latrine

Tin sheet, old

plastic bottles

and plastic

sheets are used

to construct

such toilets

Local Community Innovation in Kalyani, India

Utilisation du calcaire au Tchad

Community latrine constructed over a defunct ring well –no subsidy- all local innovation. Whose idea?

We have constructed this and we all use it. Whose ideas are appropriate? Who can scale-up faster?

Stop

Open

Defecation

All 213 H/H

Repair

platform

of all 69

hand tube wells

Clean up

garbage and

Repair Road

Clean up

drain

In 5 months

ten slums covering

more than 800 H/Hs

have stopped OD by

constructing toilets mobilizing

more money than what KUSP

could offer as subsidy

West & Central

Africa Mauritania

Mali

Senegal

Burkina Faso

Gambia

Guinea Bissau

Guinea Conakry

Sierra Leone

Liberia

Cote d’ Ivorie

Ghana

Benin

Nigeria

Cameroon

Chad

Niger

Togo

Congo Brazzaville

Democratic

Republic of Congo

CLTS in

National

sanitation

strategy

On-going

donor

funded

projects

hinder

scaling up

CLTS

introduced

with slow

pace of

scaling up

East & South

Africa Kenya

Tanzania

Sudan

Burundi

Uganda

Rwanda

Djibouti

Eritrea

Ethiopia

Malawi

Mozambiq

ue

Zambia

Zimbabwe

Angola

Madagasca

r

CLTS in

National

sanitation

strategy

On-going

donor

funded

projects

hinder

scaling up

CLTS

introduced

with slow

pace of

scaling up

Signboard declaring Open Defecation-Free, Para Vidyasagar Colony, Kalyani Municipality, West Bengal

Emergence of Latrine

Models

Temporary

andseasonal

use

Models

focussingonuse

offaecesin

agriculture

Modelsoflocally

availablelow

costmaterials

Adhocandextra-

temporary(threat

andeviction)

BOLIVIA

SIERRA LEONE NIGERIA

UGANDA

ZAMBIA

MALAWI

KENYA

ETHIOPIA

YEMEN

TANZANIA

NEPAL

PAKISTAN

INDIA

BANGLADESH

CAMBODIA

INDONESIA

EAST TIMOR

Global Spread of CLTS

Afghanistan

EGYPT

0

5

10

15

20

25

30

35

40

45

JAN

FE

B

MA

R

AP

R

MA

Y

JUN

JUL

AU

G

SE

P

OC

T

NO

V

DE

C

2008

2009

2010

2011

Under 5 Cholera cases

0

5

10

15

20

25

30

35

40

45

50

JAN

FE

B

MA

R

AP

R

MA

Y

JUN

JUL

AU

G

SE

P

OC

T

NO

V

DE

C

2008

2009

2010

2011

Above five Cholera cases

Impact of CLTS-drastic reduction in Cholera, Nyando district,

Kenya(2008 -2011)

0

10

20

30

40

50

60

70

80

1 2 3 4 5 6 7 8 9 10 11 12

2008

2009

2010

2011

Total cholera cases

CLTS was introduced in Nyando in 2010 , Mr. Makotsi DPHO Nyando

Niando Hospital record shows how incidence of diarrhea and cholera dropped

dramatically in Niando districts in

Kenya – Impact of simple pit latrines on health

IMPACT ON HEALTH

KADIOLO

BAFOULABE

BOUGOUNI YANFOLILA

KITA

KENIEBA

KANGABA

KATI KOUTIALA

KOLONDIEBA

DIOILA

SIKASSO

BARAOUELI KOULIKORO BLA

KOLOKANI

DIEMA KAYES

NARA YELIMANE NIORO

BANAMBA SEGOU

NIONO

TOMBOUCTOU TOMBOUCTOU

GOUNDAM

DOUENTZA

YOROSSO

SAN

MACINA

TENENKOU

BANKASS

TOMINIAN

MOPTI

DJENNE

KORO BANDIAGARA

BOUREM

NIAFUNKE

YOUVAROU

GOURMA-RHAROUS DIRE

TESSALIT

GAO

ANSONGO

MENAKA

KIDAL TIN-ESSAKO

ABEIBARA

distances en

km 600 400 200 0

ALGERIE

SENEGAL

GUINEE

BURKINA FASO

NIGER

MAURITANIE

COTE D’IVOIRE

Co-relation between CLTS implementation and Cholera outbreak in Mali

2011

REGION

Total

number of

communes

Number of

communes

where CLTS is

implemented

Number of

communes with

cholera

outbreak in

2011

Number of

communes

CLTS +

Cholera

% of CLTS

communes

with cholera

outbreaks

SEGOU 117 12 3 0 0%

MOPTI 108 31 17 2 6%

KAYES 129 12 10 0 0%

Source: DNACPM , National Directorate of Sanitation; Government of Mali

CLTS triggering in a

village in Mali and it’s

positive outcome-

construction of toilets by

the people for their own

good.

Goal 6

Major diseases especially diarrhea

MDG 5

Maternal mortality

Goal 4

Under 5 mortality

Goal 7

Sanitation halving proportion without access

MDG Goals

CLTS and MDG Goals

Fundamental and Non Negotiable Principles of Rural CLTS

No subsidy for hardware

No blueprint design (only people’s

designs, not engineers’)

People first: they can do it

Facilitate, don’t provide

Go slow at first for faster later

THANK YOU