Institute of Development Studies

'Shit' Matters: Community-Led Total Sanitation and the MDGs

Robert Chambers - 19 November 2008

Wednesday 19 November is World Toilet Day – but this is no time for toilet humour. Almost 6,000 people, mainly children under five, die every day because of poor sanitation, hygiene and lack of access to clean water, making sanitation one of the most important challenges for developing countries.

A revolutionary approach to sanitation

IDS and partners in Bangladesh, India and Indonesia are currently engaged in research, action learning and networking on Community-Led Total Sanitation (CLTS). This is a revolutionary approach to rural sanitation.

In the past, subsidies have been given to households to build standard latrines. The approach has been top down and driven by the need to disburse funds. This has not been effective – structures have been used for other purposes, and many people provided with latrines have continued to defecate in the open. The poorest who are meant to benefit have often been left out. And open defecation has persisted to the detriment of all in the community, creating a vicious cycle of illness, high expenditure on health care, lost work hours and poverty.

How it works

CLTS takes place without hardware being provided or even financed from the outside. The key is facilitation. Facilitators ask simple and direct questions, encouraging community members to do their own analysis. ‘What words do you use for shit?’ (The crude word is always used), ‘Where do you shit?’, ‘What happens to it?’.

Community members make coloured maps on the ground that show where they live and where they shit. They walk and stand in the area where they do it. They calculate the amount generated in a day, a month and a year by a household and by the whole community. They analyse the pathways between the shit and their mouths. There is embarrassed laughter and powerful emotions of shame and disgust, as they realise that they are literally eating one another’s shit. When their own analysis confronts them with this truth, the seeds for behaviour change are planted and collective decisions to take action are made. The community installs its own sanitation and works to achieve ODF (open defecation free) status.

Celebrations of newly attained 100 per cent ODF status are often celebrated on World Toilet Day. So on 19 November, around the world – in Asia, Africa and elsewhere, there will be celebrations and local publicity for communities that have achieved ODF status.

CLTS and the MDGs

The change brought about by CLTS can have dramatic effects on human health, wellbeing and local empowerment. CLTS, as with sanitation generally, supports all other MDGs (Millenium Devlopment Goals) as shown in the diagram on this page. (Download the diagram as a pdf document).

Where sanitation is total, with all members of the community confining their waste safely, it is a public good from which everyone benefits. When sanitation is only partial, all in a community are still exposed. So going total should sharply raise the benefits.

A development success story

CLTS has the potential to be a real development success story. It has been spread from Bangladesh where it originated, to India, Cambodia, Indonesia, Nepal, Pakistan, Bolivia, Yemen, Ethiopia, Kenya, Uganda, Zambia, Sierra Leone, Nigeria and other countries. More and more organisations are supporting its introduction and spread. The Water and Sanitation Programme of the World Bank was active in early dissemination. Now Plan International, WaterAid, UNICEF and the Gates Foundation are among others leading the way.

For World Toilet Day, we asked CLTS practitioners from different countries to talk about their experiences

• Where better to celebrate World Toilet Day than in a toilet?
by Heino Guellemann, Project Coordinator, Swiss Red Cross, Cambodia
• Indonesia: Indigenous strategies for scaling up CLTS
by Nilanjana Mukherjee, Sr. TSSM Project Adviser and Djoko Wartono, TSSM National Coordinator, WSP–East Asia and Pacific
• CLTS steadily becoming a movement in Kenya
by Sammy Musyoki, Plan Kenya

Going to scale

CLTS faces many challenges of how to go to scale while maintaining high quality. CLTS facilitators have to behave in a special way in order to be effective; not everyone can do that. Budget and disbursement driven subsidy programmes implemented by NGOs (non-governmental organisations) and by Governments, and supported by donors, remain a major obstacle - for when there are subsidies, self-help is weakened and it is much harder for CLTS to take off.

The hope is that the collaborative research programme being led by IDS will shed light on realities on the ground, the effects on different groups, especially women, children and the poorer and weaker people, and help to identify ways forward. The stakes are high. CLTS could deteriorate and become less effective as it is spread; or it could realise much of its transformative potential and make life better for millions of rural people.

Robert Chambers is a Professorial Fellow at IDS.

Photo: ‘CLTS mapping exercise to trigger behaviour change’, IDS.