This document summarizes a presentation about Community Led Total Sanitation (CLTS). It describes how CLTS originated in Bangladesh in 1999-2000 and has since spread to over 40 countries in Asia, Africa and Latin America. CLTS is a community-led approach to achieving total sanitation that does not rely on subsidies or top-down directives. It uses participatory methods like community mapping to build awareness of open defecation issues and empower communities to develop their own solutions. The challenges of scaling up and sustaining CLTS efforts long-term are also discussed.

1. Community Led Total Sanitation (CLTS), Origin, Spread and Scaling up Dr. Kamal Kar CLTS Foundation, Calcutta, India Presented at the WASH Conference 2011 16-20 May 2011

2. Globally millions of tones of human excreta poured in the open everyday In India alone nearly 600 millions are practicing open defecation, thousands of truck loads of shit is being released in the open everyday, more than 42 children dying every hour from diarrhea, & waterborne enteric diseases OD contaminates water bodies on a daily basis and valuable human excreta not used in food security A child dies in every 15 second, millions of U5 children suffering sever bouts of diarrhea (mostly poor)

3. Traditional - professional ‘mind-set’ in tackling the problems Subsidize * Standardize *Prescribe * Top-down hygiene behaviour teaching* Health as key motivator for hygiene behaviour change Attract the poor in ways like rewards so that they use toilets

4. Fate of free toilets in a slum of a Municipality town near Calcutta, India

5. Fate of subsidized sanitation hardware- Portloko, Sierra Leone, Ibb, Yemen Who’s design for whom?

6. Fate of sanitation subsidy in Yemen

7. Abandoned Collapsed Communal Latrine –Dangme West District, Greater Accra Region, Ghana

8. The Origin Originated in Bangladesh in 1999-2000 from the process of evaluation of a traditional WATSAN project Spread rapidly in Bangladesh through NGOs mainly Water Aid, Plan International and partner NGOs DFID supported scaling it up in Bangladesh WSP (SA and EAP) was instrumental in bringing it to India, Indonesia, and other countries in South Asia and East Asia Pacific regions Through Plan International introduced in 13 countries in Eastern and Southern Africa in 2007 Since 2008 with support of UNICEF introduced in 22 countries in Africa including West and Central Africa and in Latin America (Bolivia)

10. More than 1000 facilitators and trainers in these countries have been actively engaged in implementing and training of CLTS

13. Calculation of faeces etc. Entry/ Ignition PRA How to get a latrine slab Registration daily monitoring on map Start pit latrine from tomorrow Community realization of terrible impact of faecal-oral contamination Spreading messages from the mosque We do it first and stop open defecation Each of us cover 10 families 10 H/H 10 H/H Diagrammatic presentation of the process of igniting Community- Led Total Sanitation (CLTS)

14. Land less don’t have place for defecation. Land owners often blame them for defecating in open. Landless poor (women specially) are the worst victims who want to come out of that humiliation. Will form positive pressure groups from within to convince others for having latrine X Better off X X L X X L X L X L L Medium X Spoiling environment by open defecation X X X X X X Poor X X X Very poor L L X X X X Latrine owners can’t get rid of negative impacts as many others adding faces everywhere. L X X X X X X X X Participatory Planning P. R. A. X X X Moving towards 100% sanitised village

15. More yellow powder in places where there is more shit- Sierra Leone

17. Food and shit demonstration

18. Children’s procession protesting against open defecation

19. Worried faces of mothers after their own analysis- Llala Gua, Bolivia Shit everywhere. Our children growing on shit- we can’t accept this

20. Notice who is teaching and who is learning

21. “If we defecate in the open, we eat each others shit, if you don’t wash your hands with ash or soap, you eat your own shit” - a Natural Leader of CLTS from Malawi

22. Hundreds of low-cost local community-made toilets are surfacing in the rural landscape in CLTS villages in Bangladesh.

23. Who’s idea and who's decision matters in household sanitation?South Sumatra, Indonesia

25. Great mosaic of latrine models innovated by local communities in Kampung Spu in Cambodia

26. Do we have patience to allow communities to gradually move up the Sanitation Ladder? Sanitation behaviors changes as community moves up the ladder Pour flush latrine Latrines with plastic pan and water seal Offset Pit latrines Simple Pit Latrines 10 9 8 7 6 5 4 3 2 1 Open defecation O

27. Newly constructed toilets in Kampong Svay villages, Kampong Tralach district of Kampong Chhnang province in Cambodia - great sense of ownership and pride. Mr.Hoeun invites neighbours to use his toilet to get more manure for his crops

28. Use of ash after defecation in direct pit latrine is an innovation by the community of Skun villages of Tbeng Commune of Siem Reap province in Cambodia. One gets potash rich manure at the end. Whose idea?

29. Community Innovated direct pit latrine- Skun village, Banteay Srei, Cambodia

30. Local Community Innovation in Kalyani

31. Proud Kepala Desa showing different toilet models to visitors- Lumajang,East Java, Indonesia

32. Local Community Innovation in Kalyani

33. Construction details of community innovated low-cost latrine Tin sheet, old plastic bottles and plastic sheets are used to construct such toilets

34. Locally innovated toilet model in flood prone areas and in places with high water table at Sambas, West Kalimantan

35. Repair platform of all 69 hand tube wells Stop Open Defecation All 213 H/H Clean up drain In 5 months ten slums covering more than 800 H/Hs have stopped OD by constructing toilets mobilizing more money than what KUSP could offer as subsidy Clean up garbage and Repair Road

36. Signboard declaring Open Defecation-Free, Para Vidyasagar Colony, Kalyani Municipality, West Bengal

38. Reduction in Cholera and diarrhea in the districts of Nyando, Busia, Siaya in Nyanza and Western provinces of Kenya after CLTS was introduced never returned back with that severity. All communities seriously maintain ODF status

40. Sale of medicines of diarrhea/dysentery dropped in village medicine shops

41. Sale of sanitary hardware in shops in village shops in Indonesia increased sharply

42. Everyday new villages all over the world are declaring themselves ODF

44. What are the major challenges of sustainability? In the next slide

45. Challenge of multiplying Facilitators, Trainers and Community Consultants The pace with which demand for CLTS is growing there is need to train hundreds of trainers immediately in Africa and Latin America (Franco phone Africa, Spanish speaking countries specially) Thousands of ‘Natural Leaders’ turned in to ‘Community Consultants’ with in countries Dozens of Champions with in the Government Ministries and Departments A few Ministers and MPs or elected people’s representatives in each countries

46. Institutional Challenges Attitudes and mind sets of professionals in the institutions and their belief on local community capacity Feeling of loosing control and technical and academic supremacy by engineering, health and social development professionals Institutional hierarchy and unclear understanding of the ground reality including poor functional linkages with the front line

47. Institutional Challenges Difficulty to escape from the old established mind-set of ‘donor’ and ‘recipient’ defining ‘uppers’ and ‘lowers’ Inertia in moving out of the preference of ‘things’ to ‘people’. Shiftfrom‘latrine construction’ to ‘creating Natural Leaders’ and ‘ODF villages’ Pressure of spending huge sums Variations in the focus of institutions working only on water and sanitation versus those working with wider humane objectives

48. Institutional Challenges CLTS as a fad and some have their own version of ‘community led’(subtle difference between ‘functional participation’ to ‘interactive participation’ or ‘self mobilization’) Struggle to streamline other approaches of sanitation with true empowerment encouraged in CLTS. TSSM in Indonesia, TSC in India, others in Ethiopia, individual house hold vs community CLTS is just one another approach and it might survive better if other sanitation approaches work freely without using this label. All approaches have uniqueness.

49. Institutional Challenges Challenges of intellectual institutional supremacy- who knows more and who prescribes the best solutions? Competition for attracting more donor funding by implementing agencies Struggle and compromise to fit in a new community led approach in the old existing system of government structure designed to perform in a ‘supply driven’ rather than ‘demand driven’ mode

50. Political Challenges Asia: Countries like India, China with better per capita still support subsidized, externally prescribed household sanitation where as countries like Bangladesh, Cambodia scaled up CLTS exponentially. Percentage of usage of externally funded toilets are appalling Africa: Quicker understanding and acceptance of the approach by governments of Sierra Leone, Malawi, Zambia, Ethiopia

51. Abandoned Free Latrines depicts welfare mindset of institutions in Fatenayili ODF Village

52. Existing ‘Social solidarity and community cooperation’ as insider to insider subsidy- can those be recognized? Need to document and recognize huge local resources mobilized by local communities

53. Distinct example of social solidarity- rich of village declared help for all to achieve ODF status

54. What is the potential of CLTS in countries in the East Asia and the Pacific region? CLTS has been adopted by the government of Indonesia, Cambodia and has been spreading fast WESLIC-III has been scaling up CLTS In Cambodia, Lao, PDR, Vietnam Introduced in East Timor by Water Aid Australia Still a lot need to be done Major sector players and funding agencies need to have a better understanding of the approach and its underlying principals, and support

55. Goal 7 Sanitation halving proportion without access Goal 6 Major diseases especially diarrhea Goal 4 Under 5 mortality MDG Goals MDG 5 Maternal mortality CLTS and MDG Goals

56. The Ethical Challenges The challenges are personal, professional and institutional. “We” and our normal views and reflexes are the problem. “They”, people in communities, are the solution. Serious unlearning is entailed, and then continuous learning, adapting, improvising and innovating to enable the poor to become an active partner in development and not remain as passive recipient. These changes of understanding and behaviour apply at all levels – Ministers, senior officials, staff in funding agencies, and Government and NGO staff.

58. Emergence of ODF communities - first critical step towards achieving safe sanitation that effectively prevents the fecal contamination of water

59. Initially developing few hundreds of ODF Communities as learning laboratories for CLTS

60. Natural Leaders as Community Consultants- scaling up CLTS

61. How to enhance emergence of innovative local institutions as champions on CLTS?