Dakar — The UN Children's Fund (UNICEF) and NGOs operating in West Africa say the main barrier to more pit latrines in rural areas is not poverty or lack of resources, but a lack of understanding about costs and benefits.
Building and using latrines is one of the most effective ways to combat diarrhoea, which kills 1.5 million under-five children globally each year. Poor sanitation is also responsible for spreading cholera and worm infestations.
Plan International, WaterAid and UNICEF programmes all encourage communities to recognize the need for better sanitation, and to build latrines themselves. Generally this leads to the construction of basic pit latrines, which can be built for little or no cost if people work together.
Villages have advantages over urban areas when it comes to building pit latrines. Aside from access to free natural resources for building, there is more space to install latrines than in urban areas and populations are less transient so there is not the same concern people will move on after construction.
1. Shift attitudes
Building latrines starts with talking not digging, as education is the first step to sanitation. In the community-led total sanitation (CLTS) approach which aims to change social norms about sanitation, an initial community meeting encourages people to recognize the need to build latrines.
"One of the most effective tools is called 'Shit and Food'," said Jane Bevan, UNICEF water, sanitation and hygiene (WASH) specialist. This involves taking a piece of excrement from where people usually relieve themselves and placing it beside a plate of freshly prepared food. People clearly see the flies cross from one to the other and realize what this means if they defecate in the open.
Yunusa Duhuwa from Duhuwa village in Jigawa State, northern Nigeria, said an exercise he participated in calculated the amount of excrement produced by the community. "We could not explain where all the excreta had gone," Duhuwa said. "Then we realized we might have consumed a significant portion of it. At this point we decided to build latrines."
Faison Hilda Ntabe, who works with Plan International in Cameroon, said a current sanitation programme in Bafut, a village in northwestern Cameroon, to stop the spread of cholera began slightly differently as it was implemented in the context of a disaster situation. Plan staff liaised directly with health services in the area and community leaders to build demonstration latrines and deliver community education on hygiene, Ntabe said.
While this approach skipped the CLTS-style community meetings, it still relied heavily on education and prompted people to build latrines themselves.
2. Make it affordable
Another obstacle to latrines is perceived expense. Valentine Manah, a demonstration latrine coordinator with Plan, said in Bafut people initially "didn't want to construct latrines because according to them latrines are very costly... They didn't see any reason as they have bushes and a stream nearby."
But if village members do the physical labour themselves and use local materials for construction, latrines are "almost free of charge to construct", Manah said. "Now about 116 new toilets have been built."
Ada Oko-Williams of WaterAid in Nigeria said their latrine programmes aim to have "all materials locally sourced and at zero cost".
3. Develop a community plan
For toilets to effectively improve sanitation, everyone needs to use them. Villages have an advantage over urban areas here, as close ties mean social pressure can ensure all people follow suit, Bevan said.
When the decision to build latrines is made, the community is supported to develop a plan with an agreed timeframe. On occasions when communities give long timeframes, the facilitator will nudge them with questions such as "You want to wait a year? You want to continue to eat your excrement?" Oko-Williams said. "Normally they reduce the time."
Oko-Williams said in the planning stage vulnerable people who need assistance to construct a latrine are identified. "Normally the young people volunteer to construct latrines for widows and old people."
4. The community builds the latrines
Pit latrines are surprisingly straightforward to build.
Firstly a hole needs to be dug - usually the depth of a man's height, UNICEF's Bevan said. Then the slab, with a drop hole, is put at the top. This can be made of reinforced concrete if people have the means, or it can be made from wood, mud and other local materials which are usually available for free in rural areas. A cover for the drop hole is needed to prevent flies getting in. After that it is just a matter of erecting walls - from whatever materials are available - to preserve modesty.
Duhuwa said each latrine usually took a few days to build, though it was 6-7 months before everyone in his village had one.
"We used logs of wood cut from the bushes to create the platforms over the pits that we dug ourselves. Corn stalks are used to build fences around the latrine for privacy. We also use broken earthenware pots to define the drop hole and wooden planks or old enamel plate covers to cover the drop holes," Duhuwa said
Models vary depending on the country and the materials available. "In Mali they make these nice mud walls," Bevan said. "In Sierra Leone they have huts with thatched roofs."
Having people build their own toilets also circumvents issues of appropriate location and design of toilets because people make these decisions themselves. "Why should you build people's latrines for them? They know what they want," Bevan said.
5. Certify and celebrate
The CLTS approach involves certifying villages once they become open-defection-free (ODF) and continuing to monitor hygiene.
The idea of ODF certification is common in the developing world, though the rules vary slightly from country to country, Bevan said. For example, some countries include hand-washing facilities at latrines in the criteria for certification.
Across West and Central Africa about two and a half million people now live in certified ODF communities and these figures are constantly increasing, Bevan said. In Sierra Leone, two of the country's 14 districts are aiming to be completely ODF by next year, and several African countries are aiming to become fully ODF in the next few years.
Community celebrations are often used to consolidate commitment to an ODF future. "It's a bit like a marriage," Bevan said. "If you've had a celebration and someone from the government has come to witness this, you are less likely to go back on your behaviour change."
6. Monitor sanitation
Part of the CLTS process involves enlisting the aid of "natural leaders" who emerge in communities to monitor the progress. These leaders are also able to work with local governments or NGOs to begin the CLTS process in neighbouring communities," Oko-Williams said. "It becomes a ripple effect."
And when the latrine is full - which usually takes two or three years with a family of five or six people - "You plant a fruit tree and build another one," Bevan said.
[ This report does not necessarily reflect the views of the United Nations ]