Can rural sanitation work without subsidies?

Sumber:The Jakarta Post - 28 Februari 2006
The gamelan gong reverberated through Kenongo village, East Java.

Colorful streamers waved in the wind. Children in ceremonial costumes danced as they welcomed visitors to the village square.

The date was June 15, 2005, and the villagers had gathered in their festive finery for an event never before celebrated in Indonesia -- the village had just attained liberation from the hazardous and disgusting practice of defecating in the open air!

Kenongo is the first village in Indonesia to have undergone this transformation and declare itself free of open defecation -- in a matter of 10 weeks.

Nine other communities had followed suit by December 2005. At the time of writing this, 20 more are on their way to reaching the same goal soon. These are findings reported from a new approach fielded during 2005 in six districts of Indonesia, called the Community-Led Total Sanitation (CLTS) approach.

To be able to appreciate the full import of what CLTS is doing, one has to know that rural sanitation coverage in Indonesia has stagnated at 38 percent of the population since 1985, according to the UNICEF-World Health Organization Joint Monitoring Program.

The greatest majority of the rural population even today continues to deposit thousands of tons of human waste daily into rivers, ponds, streams and lakes, in forests or on beaches.

This includes many people who even have toilets at home. The resulting environmental health disaster shows up in the high rates of diarrhea and intestinal disease in the population, which are entirely inconsistent with the country's per capita Gross National Income of over US$700 per annum.

Rural sanitation programs have to date had little success in changing population sanitation behavior. Program strategies have included building free latrines for villagers, or distributing subsidized latrine construction materials or loans.

As in many other developing countries -- free or subsidized latrines and the loans were mostly captured by a few powerful and well-off people in each village, since project funds could never stretch to serving all households.

The poor majority inevitably failed to gain access to sanitation. More tragically, even the free or subsidized latrines have all too often remained unused and allowed to fall into disrepair.

After several decades of rural development programs, less than half the rural population presently uses some kind of sanitation facility; that, too, inconsistently. Among poor households, less than 5 per cent generally do so.

Against this perspective, the Community-Led Total Sanitation (CLTS) approach was launched in 17 villages of six Indonesian provinces in mid-2005. It involves a community sensitization and mobilization process developed by international and national non-governmental organizations (NGOs) in Bangladesh in 2000-01, and thereafter also adopted in India, Nepal, Cambodia and Pakistan.

Typically, a one-day participatory analysis exercise was used in each Indonesian village to "trigger" community action.

Within the following week whole communities were seen digging toilet pits in their backyards, building their own low-cost household toilets and influencing their neighbors to do the same.

Children's groups roamed the lanes singing slogans and identifying homes without toilets. Informal neighborhood committees drew up community maps and marked houses for monitoring the progress of toilet building.

Change had been ignited: "Open defecation" had to be stopped immediately and completely in their village.

This happened in village after village. Within weeks of "triggering", Dusun Mergodadi in Kenongo became the first community in Indonesia to declare itself free of open defecation. 100 percent of households had acquired toilets, up from a mere 20 percent ten weeks previously.

To the amazement of the local government officials concerned, other villages followed the same pattern, reaching "open-defecation-free" status within one to four months each, in Lumajang, Sambas, Muara Enim, Sumbawa, and Muaro Jambi districts.

A variety of locally devised toilet designs emerged, reflecting both the limited range of sanitation supplies available in local markets and peoples' unlimited creativity.

Technical quality of the toilets built varied widely, but they did meet the basic criteria of a "hygienic toilet", i.e. they effectively prevented contact between human excreta and people and flies. People managed to build functional toilets at Rp 130,000 to 250,000 (US$14 - $28). As the months pass, many of the first toilets are being gradually upgraded and made more durable.

The process has been an eye opener for sanitation program planners and implementers in Indonesia. CLTS has been a departure from their conventional knowledge in every way possible. From the start, it focused only on the behavior that needs changing, instead of toilet building.

It prescribed no toilet designs to build. Nor did it offer a single rupiah as assistance. It simply helped villagers collectively to realize the revolting consequences of the practice of open defecation for the whole community -- and then left the decision to them about doing or not doing anything about it.

How was this done?

Trained local facilitators used graphic simulations to illustrate how open defecation in one's living environment leads to fecal contamination ultimately finding its way into people's mouths, and that as long as even one community member still continues with the practice, all the rest are at risk.

The idea assaulted peoples' sensibilities and self-respect. How could they bear to continue to live like this? Indonesian villagers responded with an immediate resolve to stop the abhorrent practice.

Ways were rapidly found within communities to convince every family and even help the poorest households to make the change so that the behavioral transformation could be total. Whether or not sanitation behavior was changing began to be monitored by the communities themselves.

They set up local monitoring mechanisms and social sanctions against violators of the collective code of conduct i.e., NO open defecation, and excreta disposal only in toilets.

In villages where the approach has spread, one can no longer see toilets suspended over rivers and ponds -- otherwise a common sight in rural Indonesia. People have dismantled them to prevent their continued use.

Once "open-defecation-free" status is reached, people proudly put up a board at the village entrance proclaiming that no one in this village defecates in the open. This has begun to automatically trigger change in neighboring villages -- collective disgust and shame are powerful tools for social transformation.

CLTS is bringing about a change of hearts and minds among communities as well as government personnel in Indonesia.

Health Department officials are vocal in their support. Dr.Irfan of the Senduro Puskesmas in Lumajang, East Java had refused to believe that a subsidy-free sanitation approach could work.

He admits to being amazed that in spite of communities being long-exposed to subsidized sanitation programs, the CLTS approach showed that even the poorest households were able to change their sanitation practices without external assistance, if they wanted to.

Achmad Basyir of the Jambi Health Department adds: "After seeing what the Mendalo Laut villagers have achieved all by themselves, I have realized how wrong we have all been till now -- for example, in our belief that the poor communities on riverbanks will never change their sanitation practices; in our instructional mode of hygiene education and directions to villagers about the toilet types to build."

Natural leaders have emerged in each "triggered" community. They are igniting and stoking the fire of communitywide behavior change. They all say that subsidized sanitation programs of the past have created community dependencies on external aid.

To break such dependencies, they are devising innovative home-grown strategies. Masduki of Ploso village in East Java asks people "have you ever imagined that your feces go back to you via flies and the chicken running around your house?" and then "Do you want to keep eating your s***t until you get aid money from outside?"

Mujiono of Sidomakmur appeals to people's sense of self-respect: "You work to earn a living. You don't expect to be fed by charity. Why do you want to be subsidized for defecation?"

Ny. Suparti, the Kenongo village chief's wife, used the economic carrot: "Being sick is very expensive. You can save a lot of money by building and using toilets. The cheapest one costs only Rp. 120,000 to build!"

Sanapiyah Hasyim, Chief of village Mamak in Sumbawa emphasizes that top-down, didactic approaches create expectations for aid. Instead of using his Kepala Desa's authority to instruct, he appealed to his community members' sense of solidarity for common benefits.

In Mamak, households with sanitation facilities have increased from less than 5 percent to 100 percent in just two months, with no external assistance.

Local government functionaries now only need to provide follow-up support to correct minor flaws in locally devised toilet designs, and release the agreed government share of funds for the water supply system that the Mamak residents are co-investing in building.

Government personnel as well as community members involved agree that CLTS has the potential to rapidly scale up desired behavior change in Indonesia. However, they point out that this is only possible in an environment free of external aid for household toilet construction.

At a recent national workshop to review progress of total sanitation approaches in Indonesia, more than 60 stakeholders from the six participating provinces asked the national government to immediately establish a clear policy eliminating the use of subsidies for household latrine construction.

Field trials with the CLTS approach have produced evidence that even the rumor of possible subsidy quickly kills community initiative for change.

People keep waiting for the subsidy, and when it does come -- it reaches only a few. The rest then continue to wait for the next project instead of taking action to help themselves. This is particularly tragic in Indonesia's current socioeconomic setting where villagers are proving that they can afford to improve their access to basic sanitation without external aid.

The field trials have demonstrated that dole-outs are not what villagers in Indonesia need to improve their access to sanitation. What they need and want are locally available low-cost options for sanitation improvement, and full information about them so they can make more informed choices.

AND they need the freedom to choose the improvements that they want to make, rather than being handed a sack of sanitation supplies which limits their options.

The development behemoth now has to realign itself in response. As summarized by Basah Hernowo, Director Housing & Settlements, BAPPENAS: "We need a paradigm change to be able to promote 100 percent open-defecation-free communities ... It must be understood by us all that CLTS is very different from `latrinization' and counting toilets. CLTS is a community's understanding of the relationships between cleanliness and health -- translated by them into concrete action".

Nilanjana Mukherjee,
The writer is a senior community development specialist and country team leader of the World Bank-funded Water and Sanitation Program - East Asia & Pacific.

Post Date : 28 Februari 2006