The partial or total non-use of toilets, with some or all in a household defecating in the open, is a growing concern. Although all households may have a toilet, communities cannot remain open defecation free unless they are always used by everyone. This is not just an issue of maintenance and accessibility but also of social norms, mind-sets, and cultural preferences. The problem is widespread but most evident in India. This issue of Frontiers of CLTS asks how serious the problem is, why it occurs, what can be done about it, and what more needs to be known.
Menstruation is a natural and healthy part of the life of women and girls, but is often a taboo subject, not easily talked about, which can lead to feelings of embarrassment and shame. It can also lead to girls losing attention at school or missing days from school. Menstruation is a core element of sanitation and hygiene which affects half of the world’s population for a large proportion of their lives.
In this IDS Working Paper, Robert Chambers (CLTS Knowledge Hub, IDS) and Gregor von Medeazza (UNICEF) argue for a more inclusive framework for thinking about and dealing with undernutrition. One concept is FTIs (faecally-transmitted infections). This is designed to avoid the reductionisms of faecal-oral infections, waterborne diseases, and the focus on the diarrhoeas to the neglect of less dramatic and less measurable FTIs especially environmental enteropathy. A second concept is the 5 As – availability and access which both have oral associations, and absorption, antibodies and allopath
CLTS aims at total sanitation. For that it has to be inclusive. There are ethical reasons for this, but the bottom line is that while any open defecation continues, all are affected.
Although the lack of access to appropriate sanitation, hygiene and water services is not the root cause of violence, it can lead to increased vulnerabilities to violence of varying forms, with incidences reported from a wide range of contexts.
Handwashing is a vital part of good sanitation and hygiene. When Community-Led Total Sanitation (CLTS) and its aim of ODF (open defecation free) communities are fully understood and put into practice it is clear that handwashing is implicit in the approach. Without addressing handwashing and other hygiene practices, communities can never become fully ODF since CLTS aims to cut all faecal-oral contamination routes. However, in practice, the degree to which handwashing is integrated into triggering and follow up, depends on the quality of facilitation.
Sanitation and Hygiene in Africa: Where do We Stand? (IWA Publishing 2013, eds Piers Cross and Yolande Coombes) takes stock of progress made by African countries through the AfricaSan process since 2008 and the progress needed to meet the MDG on sanitation by 2015 and beyond. This book addresses priorities which have been identified by African countries as the key elements which need to be addressed in order to accelerate progress.