19 November is World Toilet Day, a day to raise awareness of the global sanitation situation and to celebrate something many of us take for granted: a toilet.

The Sanitation Challenge

Imagine what it would be like without a toilet - the inconvenience, the embarrassment, and the effects on our health of not disposing of our ‘shit' safely. More than a third of the global population are faced with exactly this situation. An estimated 2.5 billion people do not currently have access to a safe, private and hygienic toilet and the wide-spread practice of open defecation results in a lot of disease and death in the developing world. According to the World Toilet Organisations, 1.8 million people, 90 per cent of whom are children under the age of five, die from fecally-transmitted diseases every year. Moreover, diarrhoea in children under the age of two can have irreversible debilitating effects such as stunted growth.

This is why IDS co-organised a workshop for almost 60 participants from eight countries in the South East Asia and Pacific region last week in Phnom Penh, Cambodia, to talk about Community-led Total Sanitation.

About Community-led Total Sanitation

Community-led Total Sanitation (CLTS) is an unsubsidised approach to rural sanitation that facilitates communities to recognise the problem of open defecation and take collective action to clean up and become ‘open defecation free'. Since CLTS was introduced in Bangladesh by Dr Kamal Kar in 1999, it has spread to almost 30 countries in Asia, Africa, the Middle East, the Pacific and Latin America.

At the heart of CLTS is ‘triggering', where facilitators convene communities and through participatory mapping of households and defecation areas, the problems of open defecation are quickly made visible. Facilitators run exercises that shock and disgust, for example, calculating the amounts of ‘shit' produced and analysing pathways between ‘shit' and mouth, This leads to a moment of ‘ignition' when the community collectively decides to take action and become ‘ODF'- open defecation free - and starts to construct and use latrines.

CLTS Workshop in the South East Asia and Pacific Region

The workshop aimed to take stock of CLTS in the region and to strengthen both practice and policy efforts. Sharing and learning from each other's experiences was at the heart of the five days of activities. Participants from Cambodia, Indonesia, Laos, Myanmar, Papua New Guinea, the Philippines, Timor Leste, Vietnam, and India were joined by a number of international experts. There was also an opportunity to learn from the Cambodian experience, with field visits to CLTS and other sanitation projects in Takeo and Kampong Speu provinces where the Swiss Red Cross, the Cambodian Ministry of Rural Development and Lien Aid are implementing CLTS.

By bringing together a broad range of organisations and players in the region, international and national non-governmental organisations, government staff and bilateral agencies, the event provided an excellent opportunity for networking and helped to strengthen the dialogue between countries and organisations in the region.

The workshop was hosted by the Ministry of Rural Development (MRD) of Cambodia and organised by a committee of organisations including IDS, Plan International, UNICEF, the World Bank's Water and Sanitation Program (WSP), WaterAid Australia, the Swiss Red Cross, Lien Aid and SNV (Netherlands Development Organisation).

Click on the audio links below to hear participants reflect on the workshop, their learning and the key challenges for CLTS.

Common challenges faced by CLTS

While the presentations and discussions showed the diversity of CLTS in different contexts and the innovative adaptations that are taking place, participants also agreed on a number of common issues and challenges faced by CLTS:

Engaging government - While the quality of facilitation and training of trainers is crucial to the success of the triggering phase of CLTS, institutional support is crucial for good post-triggering follow up and sustainability. Participants agreed that taking key government staff on exposure visits to countries with successful CLTS and allowing them to experience the triggering process can turn hardened sceptics into champions of the approach and change their mindsets from subsidy-based approaches to CLTS. Countries with more CLTS experience urged those who are still new to CLTS to find ways of getting government involved in order to achieve better success and strengthen the sustainability of CLTS programmes.

Ensuring good post-triggering follow up and strategies for monitoring and evaluation - Related to the issue of sustainability, participants recognised that keeping local natural leaders and champions inspired and committed is key for long term sustainability and success of CLTS.

Linking demand for sanitation to supply of necessary provisions - CLTS is very good at rapidly creating demand for sanitation but in some contexts the supply side has not been able to keep up. When appropriate and affordable materials for construction of latrines are not available, this can stall community enthusiasm and action towards achieving ODF status. Finding better ways to harmonise linkages between demand and supply is vital for solving the rural sanitation problem. Sanitation marketing is one approach that can fill the gap.

More low- and medium-cost latrine options need to be available - There is an urgent need for more sustainable low and medium cost latrine options. Affordable technologies for difficult environments, e.g. for communities living in areas that flood in the rainy season, also need more attention. Bangladesh was given as a good example where many different low cost options have been designed and cheap durable parts are widely available..

Knowledge Gaps - Participants identified several areas where more knowledge is needed, for example: What happens post ODF and why do some people revert to open defecation? How can you identify and support good facilitators and trainers to meet the emerging demand of CLTS training and capacity building? And how, from the start of the CLTS process, can you facilitate involvement of the very poor and less able in communities?

Ways forward

Based on the exchange of knowledge, challenges and ideas, participants engaged in strategic thinking and planning on how to take CLTS further forward in their respective countries and organisations, drawing up country action plans for follow up. The idea of a regional secretariat or working group on CLTS, cutting across countries and organisations, was also put forward.

Closing remarks from several participants recognised that the workshop represents a milestone both for rural sanitation and for CLTS in particular and expressed the hope that it would serve as a launching pad for a number of CLTS-related activities in the region.

Read the full version of this article on the Community-led Total Sanitation website.

Find out why many communities in Kenya have reason to celebrate World Toilet Day in a short update from Plan Kenya

To learn more about CLTS, visit the Community-led Total Sanitation website.  

Petra Bongartz is Coordination, Communication and Networking Officer at IDS.

Photo: Mark Henderson.