I enjoyed World Water Week. There were some good sessions, old friends and new people to meet, and a lot to learn. This year the theme was Water Cooperation: Building Partnerships. The bias to water was understandable but if anything stronger than usual – my rough count is that about one session in ten was on sanitation or WASH, but that was enough to keep you busy as sessions ran in parallel and much of the time there was something relevant to go to.
The prominence of CLTS. CLTS was mentioned again and again. There was no session specifically on CLTS, but much interest in it. Take, for instance, the afternoon session of UNICEF and Unilever, presenting their partnership, its challenges and successes. When it came to a panel and questions at the end, they were not on the partnership but all (as I recollect) about CLTS/CATS.
Diversification of CLTS. I was struck more than ever by how CLTS has diversified into new forms with new titles – much as PRA did. Perhaps this is a feature of the natural history of participatory methodologies that really work. So besides CLTS we have UNICEF’s CATS ( Community Approaches to Total Sanitation) which is virtually a synonym for CLTS (in over 50 countries), School-Led Total Sanitation (SLTS) (in Ethiopia, Nepal and elsewhere), the Pakistan Approach to Total Sanitation (PATS, which includes waste water and drainage management), Leader-Led Total Sanitation (an innovation of WaterAid in West Africa), ZimCLTS (Zimbabwe), Local Government-Led Total Sanitation (I suppose LGLTS), and no doubt others.
Those least able. This creative diversification allows fitting to local context, creativity, innovation, and ownership, and opportunities for others to pick up ideas. Diversification may question or modify some of the basic tenets of CLTS, bringing opportunities to learn and dangers of throwing the baby out with the bathwater. Take the issue of support for those who are weak, very poor, least able or unable to help themselves. The CLTS line is powerful if it can be held to and made to work. In triggering use the map to facilitate members of the community to identify for themselves those who need help, and then who will help them and how. This then reinforces solidarity and is likely to contribute to commitment to behaviour change and its sustainability. The help can take many forms – digging pits, building substructures, providing materials, lending money, giving access to a community fund, loans from a self-help group, or other microcredit. There are plenty of stories of generosity, but they tend to be repeated and just how common this is has not, to my knowledge, been researched. Leader-Led Total Sanitation seeks to trigger wealthy people who have left their community to contribute and assist those least able. Then there are other external solutions through local government or government. In Bangladesh, which has been so successful compared with India in achieving sanitation for the lowest income quintiles, Union chairpersons have funds they can use to help the weakest. In Pakistan, toilets are constructed for the weakest 3 per cent, and the next 7 per cent receive vouchers for materials. Communities themselves decide who are in these categories. We need to learn from these and similar cases, and whether or to what extent they undermine self-help on the part of others or could be adopted elsewhere.
Behaviour change. To be noted that this crucial dimension has been studied by UNICEF together with the University of Pennsylvania. What I picked up, from Therese Dooley and Louise Maule’s presentations, was the idea of social norms as how a person expects others to behave and thinks others expect them to behave. Open defecation is not really a social norm in this sense of an expected behaviour: others who have toilets are not expected to defecate in the open, and those who defecate in the open tend not to be under pressure or expected to do otherwise. But for a community to shift from tolerated OD to ODF behaviour does require a new social norm. And establishing that is the challenge.
FTIs (faecally-transmitted infections) and undernutrition. Unlike last year, when there was a trail-blazing session on this, there was none this year, but the penny has been dropping, not least through the work of Dean Spears which has shown so dramatically and convincingly the relationship cross-country between open defecation and low height (stunting), and how this is aggravated by population density with India, massive in numbers, at the extreme low end. The ‘shit stunts’ connection was mentioned. But we still have a long way to go before nutritionists and those committed to the right to food fully recognise its significance and implications – the right not to have food stolen by intestinal parasites, or lost through diarrhoeas, or not absorbed because of a damaged gut wall, or energy consumed making antibodies…..
Donors and governments, targets, numbers, and sustainability. Here we have the elephant below the radar. It never came out in the open, but was the subject of conversations and worry. Let me assert starkly. Donors and Governments increasingly demand results and numbers, and want them fast. Driven by accounting and disbursement imperatives, absurd targets are set for numbers of people to be reached, toilets constructed, communities ODF. This biases actions towards disbursement and construction, undermines participation, diminishes sustainability, inhibits innovation and learning, encourages unprofessional self-verification, and generates self-serving and often grossly misleading statistics. Government systems have over reporting built into their hierachical incentive structures, and international agencies accept the numbers they are given, pleading that they have to accept what governments tell them. Quite often the reported outcomes are wildly, embarrassingly, inflated. This pernicious syndrome of poor practice and misrepresentation (please show me that I am wrong) seems to prevail more and more.
Can the GSF be an exception? The Global Sanitation Fund may be able to show us how to avoid or at least minimise the bad effects of this syndrome. The GSF has a standard budget of $5 million for a country, and aims for 30 countries. We heard about experiences and achievements in Madagascar and Nepal. In the WSSCC session (the WSSCC manages the GSF) Oliver Jones told us that its programme in each country is collaboratively designed at country level, works through government-led coordinating mechanisms and systems, and is committed to an active learning agenda and setting an example by reporting successes and failures. The GSF has ambitious targets, and we know how difficult these are to achieve quickly at scale with CLTS with credible independent verification and certification. Given the diversity of countries and conditions, and diverse approaches and experiences, this presents an outstanding opportunity for learning. But the learning has to be by all stakeholders including the back-donors – those who fund the GSF – and informing and influencing them – explaining for instance that not spending budgets can be an indicator of participation and sustainability (and conversely the opposite). For policy and practice, this could be a most important contribution the GSF could make. But it would take some doing!
Can we make sanitation an inspiring challenge for young professionals? This good question was asked, and I realised that those of us who are longer in the tooth and who ourselves find it an inspiring and even enthralling challenge must try to pass that on! For myself, it has proved as multi-faceted, complex, varied, puzzling, intriguing and for those reasons as fulfilling and fun, as anything I have ever worked on, so thank you World Water Week, as part of this, for adding another stimulating experience.
Robert Chambers is Research Associate and part of the CLTS Knowledge Hub at the Institute of Development Studies.