The equity day at the WSSCC Global Forum in Mumbai (October 2011) made a deep impact on me. I am ashamed to admit this. I should not have needed this. I have been banging on about ‘putting the last first’ for years, but the fuller implications of this with sanitation only came home to me on this day. Thank you those who came and shared their experiences with us –rehabilitated manual cleaners, slum dwellers, disabled, minorities… and Louisa Gosling, Archana Patkar and Nomathemba Neseni and who pulled scales from my eyes.
I am not proud that when sanitation as a human right first came up, my enthusiasm was muted. I was so imbued with the CLTS (Community-Led total Sanitation) philosophy of no hardware subsidy and of people digging their own pits and making their own toilets that I feared that a rights focus would encourage dependent attitudes and undermine CLTS. People might demand that government provide them with everything. Well, how wrong can you be? It depends how you see rights. Frame them differently and you can see that poor rural people have a right not to be marginalised by top down standardised hardware subsidy programmes like the Total Sanitation Programme in India, in its usual and classic form. Instead they have a right to be facilitated, to be enabled to do their own appraisal and analysis and collectively come to recognise the gruesome reality that they are ‘eating one another’s shit’ and decide to do something to stop it. Before the equity day, that was about as far as I had got.
What hit me on this day went further. The pieces were shaken up and settled to fit in a new pattern. We have rights-holders, to be sure. But we also have duty-bearers. And we are duty-bearers. But how are our duties determined? They have been defined in terms of the MDGs, of building up from the base, of filling the empty glass fuller, of achieving targets. But even achieving the MDG targets would leave hundreds of millions of people still without even the most basic sanitation, still without hygienic behaviour, still suffering the multiple deprivations of OD and the horrendous and often cumulative debilitations and sufferings of multiple faecally-related infections. Not only that, but what does striving for the MDGs in sanitation imply? It implies going for the easy ones, picking the low-hanging fruit. That’s how you achieve targets (or minimise shortfalls). And that implies neglecting, leaving out, not serving, the more difficult, more challenging, and more deprived ‘last’ whose need is so often greater. For achieving targets, those who are last are not cost-effective.
And who are these last? Well, the UNICEF quintile bar charts show how the poor and rich compare: and among these, the charts for India are a stark and shocking indictment of a decade of programme failure on a mega scale: the last who were meant to be served –like the bottom two quintiles – have been barely touched. Then consider who these last are. Someone said that half of humankind are in some way disabled or specially vulnerable. I found that difficult to believe until I began to think it through. Consider who they include: the very poor and destitute; those with the many forms of physical or mental disabilities; people living with HIV/AIDS; those who suffer discrimination – sex workers, LGBTs, low status minorities…; those exposed to and living in insanitary slums and other ‘places of the poor’; migrant workers, refugees, internally displaced people, and other distress migrants; the chronically sick; and more and more, the infirm aged (unable to walk or walk far, unable to squat…) who are a growing proportion of humankind. And then, what about vulnerable children? And all this before considering discrimination against females, or menstrual hygiene. There are shocking answers to questions too, questions I had not asked myself. How do blind people manage with OD? Or people who have to crawl? Do they have to go where others go? Do they get the stuff on their hands? How do they clean up?
As long as any of these ‘last’ are exposed or deprived in such ways, and lack proper access, are we as duty-bearers discriminating by default? That was the question Archana threw out at the end. And it will not go away.
So I am in a new space. With renewed anger. And asking what the implications are for CLTS. Two stand out straight away. First, with rural CLTS, triggering and/or early follow up must be facilitated so that people identify the ‘last’ in their communities and what needs to be done that they cannot do or be expected to do for themselves. For the poorer and less able this is already standard good practice but it must go further, and identify those who face physical and other disabilities, encouraging local actions and innovations to provide what is needed.
Second, with urban Citizen-Led Total Sanitation, when full or even partial self-provision is not an option, rights-based demands, mobilising to secure support and services from the authorities, has to be a major part of the way forward.
So thank you WSSCC for the equity day and for the whole Forum, and roll on the next; and by then let’s hope we will have seen big shifts with many actors and champions – in communities, in governments, in NGOs …- turning the MDGs on their heads to put equity first by starting with the last.
(This piece will feature in a forthcoming publication by WSSCC, entitled WSSCC Global Forum on Sanitation and Hygiene: Insights on leadership, action and change)
Robert Chambers is a Research Associate at the Institute of Development Studies, Brighton, UK and part of the CLTS Knowledge Hub that is based there.