Small investment, major health dividend
Mardan (NWFP), February 2007: For the women of the Kareem Shah family, one of the main advantages of building a latrine in the courtyard of their home was privacy. They did not have to wait until nightfall to relieve themselves. But they were also pleased that what was a matter of dignity for them, translated itself into better health for the family. They noticed fewer cases of diarrhoea among their children. Lack of access to basic sanitation facilities is a major cause of the high number of infant deaths and poor health of Pakistani children and women.
The same situation is being experienced by the 42 families that live in this village in the North West Frontier Province (NWFP) of Pakistan, says Zabta Khan, a paramedic and community mobiliser who encouraged all his neighbours to construct latrines in their homes. In the village of Haji Yacoub in Jalala Union Council in Mardan district, only two families out of the 42 had latrines before the project began. Men used to defecate in the fields while women and children used the courtyard. Now all households have latrines and the village has achieved open-defecation free status.
Only two families out of the 42 had latrines before the project began. Now all households have latrines and the village has achieved the open-defecation free status.
The initiative is part of Community Led Total Sanitation (CLTS), a pilot project supported by UNICEF and implemented by the local NGO Integrated Rural Support Programme in collaboration with the Takht Bhai tehsil Municipal Administration. It changes the traditional approach of providing services. Mobilisers from the community persuade men and women in their village that defecating in the open brings diseases. The change of behaviour is influenced by the collective sense of disgust and shame as they confront the facts about open defecation and its impact on the entire community. Inhabitants of 21 villages in tehsil Takhat Bhai have now constructed latrines in their houses. They are now also more aware of the benefits of hand washing with soap. The project will now be tested in 167 villages in Mardan district. According to Thowai Zai, head of UNICEF’s Pakistan Water, Environment and Sanitation section, CLTS incorporates several critical elements: household/community's ownership, a local solution to a local problem and sustainability.
It is estimated that 70 per cent of the people living in rural areas of Pakistan don’t have access to basic sanitation facilities. Improving excreta disposal can decrease diarrhea rates by a third and hand-washing with soap by almost half.
The Takt Bhai Municipal Administration has approved 200,000 Pakistani Rupees (about US$3,300) in their annual budget as a reward for the villages which get "open defecation-free status", says the elected administrator or nazim, Nawaz Tahir. In view of the success of CLTS experiences in Takht Bhai, the Government of Pakistan is considering promoting CLTS countrywide for rural sanitation acceleration. Promotion of CLTS is one of the key objectives of the National Sanitation Policy approved by the Federal Cabinet in 2006, says Jawed Ali Khan, Director General, Ministry of Environment. (CLTS has been adopted as one of the key strategies of the national Sanitation Policy for accelerating rural sanitation.)
It is estimated that 70 per cent of people living in rural areas of Pakistan don’t have access to basic sanitation facilities. Improving excreta disposal can decrease diarrhoea rates by a third and hand-washing with soap by almost half. As a paramedic, Zabta Khan has seen the benefits of this initiative in his community. He now treats fewer cases of stomach complaints.