i IDS Working Paper 257 Subsidy or self-respect? Community led total sanitation. An update on recent developments (Including reprint of IDS Working Paper 184) Kamal Kar and Katherine Pasteur November 2005 INSTITUTE OF DEVELOPMENT STUDIES Brighton, Sussex BN1 9RE ENGLANDiiNote: this reprint incorporates the original IDS Working Paper 184, preceeded by an update on recent developments. It may be appropriate to read the original first, which begins on page 15, before the update. Subsidy or self-respect? Community led total sanitation. An update on recent developments Kamal Kar and Kath Pasteur IDS Working Paper 257 First published by the Institute of Development Studies in November 2005 © Institute of Development Studies 2005 ISBN 1 85864 888 2 A catalogue record for this publication is available from the British Library. All rights reserved. Reproduction, copy, transmission, or translation of any part of this publication may be made only under the following conditions: • with the prior permission of the publisher; or • with a licence from the Copyright Licensing Agency Ltd., 90 Tottenham Court Road, London W1P 9HE, UK, or from another national licensing agency; or • under the terms set out below. This publication is copyright, but may be reproduced by any method without fee for teaching or non-profit purposes, but not for resale. Formal permission is required for all such uses, but normally will be granted immediately. For copying in any other circumstances, or for re-use in other publications, or for translation or adaptation, prior written permission must be obtained from the publisher and a fee may be payable. Available from: Communications Unit Institute of Development Studies at the University of Sussex Brighton BN1 9RE, UK. Tel: +44 (0)1273 678269 Fax: +44 (0)1273 621202 Email: [email protected] www.ids.ac.uk/ids/bookshop Printed by XPS Limited, Brighton UK IDS is a charitable company limited by guarantee and registered in England (No. 877338).iiiSummary Community Led Total Sanitation, or CLTS, is an approach which facilitates a process of empowering local communities to stop open defecation and to build and use latrines without the support of any external hardware subsidy. Since the approach was first pioneered in Bangladesh in 1999 CLTS has continued to spread within that country and many interesting innovations, as well as some important sustainability issues, have emerged. The approach has been introduced in a number of other countries in Asia and in Africa with much success. Interest amongst different institutions is growing, particularly as it is realised that CLTS has a great potential for contributing towards meeting the Millennium Development Goals, both directly on water and sanitation (goal 7) and indirectly through the knock-on impacts of improved sanitation on combating major diseases, particularly diarrhoea (goal 6), improving maternal health (goal 5) and reducing child mortality (goal 4). However, rapid institutional take-up of CLTS has raised some dilemmas and challenges, not least of which is the need for changes in attitudes and mindsets of donors who wish to support and promote CLTS. Reflection on new experiences and lessons is proving important to ensure that the quality and spirit of the approach is maintained and therefore this short update documents recent developments, highlighting emerging innovations, lessons and challenges which enrich the original 2003 Working Paper, which is reprinted after the update. Keywords: sanitation, participation, Bangladesh, update, community, entry-point.ivvContents Summary iii Acknowledgements vi List of acronyms vi 1 Introduction 1 2 What has happened in Bangladesh 1 2.1 Community consultants 2 3 Sustainability and innovation 3 3.1 Sustainability of impact 3 3.2 Maintenance of methodological quality 3 3.3 Second-generation problems and innovations 4 3.4 Sanitation ladder 4 3.5 Markets and livelihoods 5 3.6 Entry point 5 3.7 Urban 5 3.8 Impact 6 4 Spread to other countries 6 4.1 India 6 4.2 CLTS spread via WSP in South and South East Asia 7 4.3 Further spread in Asia 8 4.4 CLTS in Africa 8 5 Institutional dilemmas 9 5.1 CLTS needs less not more money 9 5.2 CLTS needs wholesale not partial commitment 10 5.3 CLTS needs institutional commitment to learning and sharing 10 6 Challenges and opportunities 11 6.1 Continuing research, feedback and learning 11 6.2 More documentation and sharing 11 6.3 Scaling up at the grassroots 12 6.4 Concluding: mindsets, learning and change 12 Original edition Wp184 15viAcknowledgements Many thanks to the editorial team, including Caroline Knowles, Alison Norwood, Robert Chambers, Jane Stevens and Jethro Pettit for their hard work and advice in making this update happen. Acronyms CLTS Community-led total sanitation DFID UK Department for International Development IDS Institute of Development Studies NGO Non-governmental organisation PRA Participatory rural appraisal SACOSAN South Asia Conference on Sanitation UNDP United Nations Development Programme VERC Village Education Resource Centre WATSAN Water and sanitation WSP Water and sanitation programme1 1 Introduction Poor access to adequate sanitation, resulting in the practice of widespread open defecation, has negative health and social impacts on communities, particularly in terms of diseases such as diarrhoea and cholera. Community-led total sanitation (CLTS) involves facilitating a process to inspire and empower rural communities to stop open defecation and to build and use latrines, without offering external subsidies to purchase hardware such as pans and pipes. Through the use of PRA methods community members analyse their own sanitation profile including the extent of open defecation and the spread of faecal-oral contamination that detrimentally affects every one of them. The CLTS approach ignites a sense of disgust and shame amongst the community. They collectively realise the terrible impact of open defecation: that they quite literally will be ingesting one another’s “shit” so long open defecation continues. This realisation mobilises them into initiating collective local action to improve the sanitation situation in the community. The CLTS approach was first pioneered in 1999 by Kamal Kar working with the Village Education Resource Centre (VERC) and
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