Impact of Open Defecation Free (ODF) Campaign - a case study of Ranipani VDC, Parbat/Nepal By Ganga Datta Nepal WASH Technical Officer WHO-DWSS WASH Program/Nepal (Email: [email protected]) About 62 per cent people in Nepal have access to toilet. So we are moving ahead to improve this situation to meet the national target of sanitation for all by 2017. Towards the achieving this goal; Community Led Total Sanitation (CLTS) is an innovative way to achieve communities free from open defecation. It changes people’s behaviour by shifting mindsets – to focus their desire for, and triggering them to build a sanitation system themselves. It is a community-driven approach to improve sanitation behavior among the community peoples in developing countries; CLTS represents a strategic shift in focus from creating awareness to community people for the toilet construction for individual households to one that seeks to create ODF communities/ villages through behavioral changes in the entire community. The change happens as communities learn that everyone in the village is negatively affected by the unsanitary practices of some. “CLTS is a simple but effective strategy to empower communities in taking a decisive step towards achieving something on their own to be proud of. It motivates communities to take collective action in partnership with local governments, development organizations, and civil society organizations. This approach promotes 100% open defecation free communities to minimize the risk of contamination for all, breaking the cycle of faecal-oral contamination. Contrary to most conventional sanitation approaches which aim simply at providing toilets, CLTS aims to promote collective behavior change as the key to sustainable and improved sanitation. The process of CLTS is starting through a Lead Total Behavior Change Facilitators (L-TBCF) and Total Behavior Change (TBC) Triggerer; communities conduct their own appraisal and analysis of their sanitation situation and take action to become open defecation free. During the process, the facilitators brings attention to sanitation related topics, provides facts (e.g. faecal-oral hazards can only be reduced if open defecation is completely banned from the community as a whole), and provokes a discussion about open defecation and the feelings of disgust and shame associated with it. CLTS has proven effective in various settings and contexts, enabling communities to set their own goals and fulfill them with minimal (external) financial inputs. In some settings, communities have extended CLTS beyond latrine construction to that of hand washing stations. Of course, coverage is not always total: certain members of the community never reach the target or fall back into practicing open defecation. Other issues presenting challenges are scaling up the approach and the issue of exclusion or punishment of community members who do not (or cannot) comply with self imposed restrictions. Ranipani VDC lies in the southern part of Parbat district of western Nepal, this VDC is being selected for the program VDC of Rural Water Supply and Sanitation Project Western Nepal (RWSSPWN) funded by Government of Nepal & Finland, VDC is one of the water supply hardship area. It has not excess of water sources; so people are facing numerous problems for the fetching of drinking water. RWSSPWN is come with the modality of total sanitation and quality water supply for the community people. In the aspect, the total behavioral change process in hygiene and sanitation started from the very beginning from the VDC level Triggerer's Training. All party orientation and advocacy meeting were held for the orientation on WASH at district level than after VDC level. This meeting serves as a start for district level ignition process in the behavioral change. As a result of the meeting, decision makers were fully aware on the importance of WASH in general and total behavioral change in hygiene and sanitation in particular. 1|P a g e In addition, another important step of the ignition to district and VDC level was the Multi-Stakeholder Forum (MSF) with all WASH stakeholders. As a result of MSF, there is district and VDC wise commitment and coordination agreed upon, and common goals have been established for the implementation of WASH. This orientation to the district and VDC level stakeholders motivated them to implement Community Led Total Behaviors Change in Hygiene and Sanitation (CLTS); where VDC should be part of the MSF. This approach is an innovative methodology for mobilizing communities to completely eliminate open defecation (OD). Communities are facilitated to conduct their own appraisal and analysis of open defecation (OD) and take their own action to become ODF (open defecation free). It focuses on the behavioral change needed to ensure real and sustainable improvements – investing in community mobilization instead of hardware, and shifting the focus from toilet construction for individual households to the creation of “open defecation-free” villages. By raising awareness that as long as even a minority continues to defecate in the open everyone is at risk of disease, CLTS triggers the community’s desire for change, propels them into action and encourages innovation, mutual support and appropriate local solutions, thus leading to greater ownership and sustainability. Picture: ODF Declaration Ceremony at Ranipani VDC, Parbat Source: Nepal (June 2010) In addition to creating a culture of good sanitation, CLTS can also be an effective point for other livelihoods activities. It mobilizes community members towards collective action and empowers them to take further action in the future. Actual process of total behavioral change starts from rapport building. It is the first step for ODF declaration. In rapport building the actual ownership to Community Led process is created. Immersion with community, understanding the situation and community values before actual intervention help in building trust and mutual understanding between the community and facilitators (trained TBC triggers). During the rapport building, different local words for "shit" and "shitting" should be sought out for using during the triggering process. Rapport building aims in accessing actual situation and perspective of community as well as different aspects associated with hygiene and sanitation making the facilitation process easier. Picture: Clean activities being started at VDC level 2|P a g e Informal discussion with the community people at the tea stall, community gathering, random HH visits carried out during the rapport building process. At the end of the rapport building the date for the next meeting will be agreed. Make sure the date and time is fixed so that whole community can participate. Make sure that none is left outside. For Source: Nepal (June 20110) It is fact that there is direct relationship exists between water, sanitation and health. Consumption of unsafe drinking water, improper disposal of human excreta and lack of personal and food hygiene have been the major causes of many diseases in the community. High infant mortality rate are also attribute largely to poor sanitation. It is the context in rural community; so CLTS come to action with objective of improving the quality of life of the rural people and to provide privacy and dignity to women. After the long social awareness building and triggering process; Ranipani VDC was ready for ODF; declared on 8th of June 2010 with a huge program organized by VDC as first ODF-VDC in Parbat district. Now Parbat district has been declared ODF district. No. of Patients in Helath post Patients in Health Post 450 400 350 300 250 200 150 100 50 0 2010 2011 2012 2013 2014 Dirrahea 249 330 265 188 151 Dysentry 362 228 192 165 134 Typhoid 356 418 385 236 121 Source: Ranipani VDC Health Post, Ranipani-Parbat (Dec.2014) 3|P a g e After the ODF declaration, major Behavior Change activities were started within community; VDC is cleaned and people are conscious on household wastes and point of use of use of water. As the information from local Health Post Office, patients of Diarrhea, Dysentery and Typhoid has been significantly reduced from this year. Above shows the comparison of no. of patients in different years; it also shows the reducing trends of Diarrhea, Dysentery and Typhoid patients in Ranipani VDC after the declaration of ODF and heading towards Total Behaviors Change (TBC) VDC.