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Malawi, 26 October 2010: Changing sanitation habits through a “Walk of Shame”

By Victor Chinyama

MCHINJI, 26 October 2010 - Fourteen year-old Maureen Mbewe is determined to bring lasting change to her village. For several years, she has observed with dismay the tendency by some in her village to relieve themselves in nearby bushes instead of using latrines that would not only improve hygiene in her village but also help to save lives.

Now, as part of more than 80 children participating in a Community-Led Total Sanitation (CLTS) exercise, Maureen sees an opportunity to bring open defecation to an end in Mkangeni village in the Malawian border town of Mchinji. The children, together with about 300 adults, have gathered to be “triggered” by a team of sanitation officials and health extension workers from the district assembly. A community is considered “triggered” when its residents are so disgusted by the practice of open defecation that they are ready to do something about it.

Thomas Mchimpa, the environmental health officer, says triggering a village involves asking the community to analyze their sanitation habits by mapping homes with pit latrines and locations where those without latrines relieve themselves.

“Quite often, they will not be forthcoming with information,” he says. “We find that many adults are appalled by the idea of disclosing their sanitation habits but it’s often the children that are forthcoming with information. They will point to a nearby bush or river after which we ask the community to lead us there. The walk is unpleasant but it is necessary for people to feel the shame.”

When they get to the site, Mchimpa says, the extension workers scoop up the excreta and place it in a plastic bag, asking the community to guess how much it weighs. Many are astonished by how much excreta is lying in the open. Mchimpa says the shame eventually gives way to disgust.

“At this point, the facilitator asks the community to trace the possible routes the excreta can travel to reach their food. Establishing the faecal-oral route is necessary to show that open defecation is a potential cause of diseases. Once a community reaches the stage where it wants every home in the village to own a pit latrine, that community has successfully been triggered.”

Mchimpa says the battle to contain diarrhoea and seasonal cholera outbreaks cannot be won unless communities were honest with themselves and their sanitation habits. As an example, he points to Mkanda traditional area in Mchinji district where the 294 villages that had been triggered in 2008 did not record a single case of cholera in 2009.

At Mkangeni village, the walk of shame has yielded some astounding results. Upon hearing advancing voices, a villager takes off in the opposite direction, leaving behind a mound of fresh excreta, proof positive that open defecation takes place in the village. The group breaks into howls of laughter when Mchimpa asks them to guess where the hovering flies will end up. As the children break into song, expressing their disgust at eating food laced with other people’s excreta and exhorting their parents to build latrines, six people step forward and offer to lead their compatriots into developing an action plan.

Maureen is jubilant. “We’ll have fewer illnesses when we all have pit latrines,” she says. “I want to see every home own one. My job from now on will be to encourage my friends who don’t have a latrine to pressure their parents to build one.”

Supported by UNICEF, CLTS was introduced to Malawi in 2008. By December 2009, about 1,000 villages in 12 districts had been triggered, with Mchinji having the highest number at 325. Of these, 346 villages were declared free of open defecation.



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