This was the first ever Global Forum on Sanitation and Hygiene. There have been the regional meetings – Sacosans, Africasans and so on, but never one for the whole developing world. Water Supply & Sanitation Collaborative Council (WSSCC) (and most notably Archana Patkar, who got a standing ovation at the end) did a great job in imaginative and thorough planning. The facilitation by Archana, Barbara Evans and others was outstanding. WSSCC had brought together some 450 of us. There was fuller representation of Africa than usual, and fewer Indians than one might have expected. There was a family feel about it for those of us who pitch up for the regional ‘Sans’, and a sense of common purpose and commitment which was stronger than before. That augurs well. I didn’t pick up any sense of institutional rivalries.
What stands out now the four main days are over?
- Passion And it is a common passion. Jon Lane set the tone with an eloquent unscripted introduction in which he drew on Gandhi and Mandela. He mentioned that worldwide about half of the toilets constructed for people were either not used or used for other purposes. Demand-led, not supply led…
- Behaviour change This was a good idea, a plenary in which people from different fields gave their insights into what leads to behaviour change. All of their contributions fitted, supported and helped to explain Community-Led Total Sanitation (CLTS), more or less like these soundbites distilling what they said:
‘No health education, please!’ (Yes, that really was said)
Telling people to send girls to school does not work (Yes that really was said)
Focus on want, need, desire
For behaviour to change, experiences have to be ‘radical, real, immediate and dramatic’
Let choice be compelling so that there is no choice
When frames of mind change, behaviour change is easy
For behaviour change, social norms must change
- Equity and inclusion. These were big, big themes throughout. We had previously excluded people who here came to talk to us in small groups – rehabilitated manual cleaners, slum dwellers, disabled, minorities. We spent part of a whole morning on this, set up by Louisa Gosling of WaterAid who has written authoritatively on this. Everyone will go away with this firmly imprinted. A lot was said on the shift from the Millennium Development Goals approach (and how well it is filling the glass) – to right-holders and duty bearers, and the concept that as long as the glass is not full, and people are excluded, are we as duty-bearers not guilty of discrimination? This from Archana. And this orientation came across powerfully from my nomination for the wittiest speaker award – she had us in stitches – Nomathemba Neseni, Commissioner, Human Rights Commission, Zimbabwe.
- CLTS Bushfire in Africa was Kamal Kar’s title for his rousing presentation, and that imagery seems increasingly justified. Jane Bevan said she thought those in credibly Open Defecation Free (ODF) communities in Africa might now number not four but five million, sustaining the sense that much spread there is exponential (though of course not everywhere). Sammy Musyoki impressed with his presentations on urban CLTS in Mathare, and on the use of mobiles in monitoring. Kamal and I (mainly Kamal) did a four hour CLTS ‘training’ in which we re-christened a familiarisation. Though in competition with field visits in Mumbai, we still got about 25 people, and had fun taking over and messing up some of the paved area outside the hotel with a role play of triggering and lots of (yuk!) yellow rangoli powder which stayed on your hands. The joint IDS- CLTS Foundation stall was well set up by Andii Paul, and attracted a great deal of attention – much material was picked up, many signed up for the bi-monthly e-newsletter. There were country meetings around CLTS – Nigeria, Uganda, Tanzania,Madagascar. And lots of energy.
- CLTS ‘debate’ or moving forward? A debate had been planned but the atmosphere was different. There isn’t much debate about CLTS – yes or no – now. The sceptics are fewer. It is an extraordinary change, and has happened fast. I noticed the same at the Water Engineering and Development Centre (WEDC) conference a couple of months ago in Loughborough. Instead of a debate we split into topic groups and brainstormed. Old ground had to be covered in the groups to bring people up to date, but that was all right. The PHAST issue seems to have subsided – there doesn’t seem to be much argument there any more – it is so painfully obvious why the PHAST approach is incompatible with and undermines, inhibits, slows, stops CLTS. All the same, we still need practitioners to record their experiences. The concerns now (except still in much of India – the elephant in the room) are how to do better with and through CLTS, and how to go to scale with quality and sustainability. Louis Boorstin of the Gates Foundation called for going straight to scale, without pilots (there is a debate to be had there, but perhaps it’s a question of semantics) and realism ‘call it like it is’ and convened a breakout meeting on going to scale with CLTS and total sanitation – experiences of how to do it.
- Handwashing surprise Steve Luby from the International Centre for Diarrhoeal Disease Research (ICDDR) astonished with his finding from rigorous research in Bangladesh that of the five times when you are meant to wash your hands – after shitting, after handling children’s shit, before eating, before preparing food, and before feeding a child, only two had a significant effect on the incidence of diarrhoea. Which two do you think? The answer is at the end of the blog.
- Nepal number 15 The first 14 countries can welcome a new member to the club. In the week before the Forum, Nepal adopted CLTS as national policy for rural sanitation, making it the 15th country to do so, and the second outside Africa, the other being Indonesia.
- India Still underplayed. The gross enormity of open defacation in India, and its impacts on undernutrition of children, on livelihoods, on poverty, is still not really recognised as it should be. If India still has 56-58 per cent of the open defactation in the world, we need to get our minds around this, and so does the Indian Government. The Hindustan Times carried an article about undernutrition in Mumbai, and quoted IDS Director Lawrence Haddad that India was an economic powerhouse but a nutritional weakling. A third of the children in Mumbai are undernourished.
- Shit transect Visits were organised to slums, one of which didn’t seem from the video to be a slum at all, but it wasn’t necessary to go far. Sammy, Naomi and I walked just ten minutes from our five star hotel to an area I had found when jogging. In the early morning we saw children crapping in the middle of a tarmac road, six men in a small plot of vegetation where they must surely have been stepping on the stuff, and shit on raised flat concrete surfaces. All gross, disgusting and smelly. And oh a disused toilet block, and another quite dirty one actually in use, all of these apparently draining into a stream that feeds into the (beautiful?) lake of which we had such a good view from our lap of luxury. Back in the hotel, I washed my trainers.
- ‘Shit’ is OK The word was widely used, even in the concluding plenary. This is a watershed passed, a mini but meaningful tipping point from which there is no return. We collected more words for the international glossary.
So, well done and thank you WSSCC, and let’s look forward to a summary from this Forum. May the ripples spread wide. Some may be through the Communities of Practice that were launched (see WSSCC website). And don’t let this be the last Forum but the first, so that we can look forward to the next!
PS: The answer is after shitting, and before preparing food
Robert Chambers is a Research Associate in the Participation, Power and Social Change research team at IDS.