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CLTSEarly Lessons from
The Western Sumatran
Islands
MULTI-USES OF RIVER BASINS:Tools to Harmonize Conflicting Interests, Davao City
November 2009
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Did you know
Just one gram of human faeces can
contain 10,000 viruses
Open defecation means that deadly
diseases are quickly spread through a
community
Water can become contaminated and a
vector for diseases
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Who suffers?
Children are often exposes to faeces in
areas that they play
Many children miss school because of
illness
But
There are thousands of communities makingtheir villages free from defecation
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How?
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CLTSCommunity Led Total Sanitation
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Summary
IHP, Water & Health, sanitation
CLTS a low cost tool
Reflection on process and
impacts from West Sumatra
Islands Conclusions & recommendations
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Water and health
IHP VII Sanitation tackled under Section 4:
Water and life support systems
this theme includes protecting water
quality from natural and anthropogenic
sources of contamination.
Here we will view if from a human health
perspective
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Sanitation: A high impact
intervention Bang for buck
Reduces humansuffering
Improvesenvironmental quality
Estimated the annual
economic loss causedby poor sanitation isP77.8 billion.
QuickTime and adecompressor
are needed to see this picture.
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West Sumatra Islands Basin
Joined the HELP UNESCO River Basin
Network thorough the third call in 2008
The Basin is at early stage in development
Stakeholder participation is ongoing at the
village and local government levels
Strives to become a leader in the globalnetwork with a focus on water and health.
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West Sumatra Islands
maps
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SurfAid International
Vision is to improve the health, well-being and
self-reliance of people living in isolated regions.
Mission is to develop and synthesize a series of
proven, high impact and cost effectiveapproaches that create lasting improvements in
the health and wellbeing of individuals and
communities at increasing scale.
CLTS is one such approach.
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CL TS
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Community Led
not SurfAid led!We only provide tools and provoke!
Individuals who volunteer their time
from the community Natural Leaders
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Total Sanitation
Is only achieved once the burned of sanitationrelated diseases are minimised.
Diarrhoea is the single biggest disease burden
from poor sanitation
[ODF, Diarrhoea, waster water, composting]
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Community Led Total Sanitation
(CLTS) is an innovative methodology where
communities are facilitated to conduct their
own appraisal and analysis of open
defecation (OD)
Decide to take their own action to become
ODF (open defecation free).
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Behavior not hardware
Traditional approaches mainly subsidydriven
Providing toilets does not guarantee their
use, Creates a culture of dependence on
subsidies.
Open defecation and the cycle of fecaloral contamination continued to spreaddisease.
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Diarrhea prevalence vs latrine
usageIndividual Sanitation Practices
Affect the Entire Community
0
20
40
60
80
100
120
=
Prevalence of diarrhe
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History
CLTS was pioneered by Kamal Kar in
Bangladesh, in 2000.
WB, Plan International, WaterAid and UNICEF
have become important disseminators andchampions of CLTS.
Today CLTS is in more than 20 countries in Asia
, Africa, Latin America and the Middle East.
No reference of CLTS being implemented in the
Philippines.
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MDGs Seriously off track
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20 million people do not have
access to improved sanitation.
Economic Impacts of Sanitation in the Philippines, WB
An approach that works:
CLTS Lessons from Sumatra
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Sumatran Islands Context
Funded by Oydimar Network with NZAID
and AusAID.
Post earthquake reconstruction
environment
Committed delivery of 64 improved water
and sanitation facilities. (21 latrines)
HELP UNESCO partner for technical
learning
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CLTS PROCESS
As refined by team SAI
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5 major steps
1. Prepare
2. Trigger3. Action Planning
4. Tracking
5. Sustaining
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Step 1. Prepare
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Outside In (Before Day 1)
Training on 5 stepsprocess.
CLTS is build on
feelings so technicalknow how is notenough!
You have to build a
cultural in your fieldteam to feel and livethe process
Outcomes
behaviours
actions
barriers
Causes
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Step 2 Triggering
Triggering is based on stimulating
a collective sense of disgust and
shame among communitymembers as they confront the
crude fact about mass open
defecation and its negativeimpacts on the entire community.
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Team Huddle
And action
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Step 2. Ice breaker
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Step 3. Discussion
Who actually has a latrine here?
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Step 4. Mapping
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Step 4. Mapping
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Step 5. Walk of Shame
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Step 6. Discussion
Amount of defeaction the village can
produce
Observe! Who is really engaged!?
Who is contributing!?
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Step 7. Clean water drink
And then not so clean
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First person to decide & act
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Village commitments
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Latrine built
5175
162
191
0
20
40
60
80
100
120
140
160
180
200
Nb of latrines
May June July August
Month
Graph 3. Total CLTS Latrines was built
Total Latrines was built
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Human impact
0 0
3
0
2
0
3
0 0 0
3
0
13
0
15
0
3
0
5
00
2
4
6
8
10
12
14
16
# Diarhea case
Hilihoya Hiligawono Sitoba'a Boyolala Hilina'a
Name of Dusun
Graph 6. Progress on Diarhea Case: Baseline Vs Current
Adult BaselineAdult Current
Underfive Baseline
Underfive Current
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Challenges
1. Maintaining healthimprovements
2. with wide scale communityconstruction of basic pitlatrines across the villages
the potential risk of groundwater contamination is high
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Pig pen
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Pig pen
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Pig pen 3
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Pig pen4
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Conclusion and
Recommendations
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Conclusion
1. CLTS is an effective low cost solution to reduceanthropogenic sources of contamination andthereby reducing pressure on water and humanhealth
2. True community empowerment approachessuffer in dole-out environments
If you are willing to tap the social entrepreneurialspirit in communities they can find solutions from
within and overcome dependences on dole out aid.
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Recommendations
1. CLTS for adoption by other HELP Basins
2. Develop a focus group on water, health and
risk reduction to refine lessons across HELP
3. to host technical cross visits to shareexperiences and engage technical reviews of
water & health community programs
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Questions?