Building Local Knowledge is Key to Solving Sanitation Problem in Ghana

Building Local Knowledge is Key to Solving Sanitation Problem in Ghana

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Allen Clinton, CARE

The deadline for the world to meet its Millennium Development Goals is just months away, yet in Ghana, while the country is on track to meet its 77 percent safe water source goal it is coming up short for reaching 53.5 percent improved sanitation access. The impediments to reaching that goal are more social than physical. “You can’t just go in and build a few million latrines,” says Issifu Adama, WA-WASH project manager, commenting on why subsidized latrines didn’t work in the past in Ghana. “People need to first understand why latrines are necessary, or they’ll just use them to store grain. When you make the link between sanitation, health and livelihoods, people are more likely to take action and invest their own resources in building and maintaining latrines themselves.”  

That was the approach CARE took within its USAID-funded West Africa Water Supply, Sanitation & Hygiene (WA-WASH) program in Ghana’s remote Upper West region. So far, it has worked. The Community-Led Total Sanitation method involves building local knowledge rather than providing visible infrastructure gifts.

“In some 22 project communities where open defecation was done for generations – where not even one toilet existed – we now see entire villages working together, going house to house building latrines,” adds Issifu “Families now understand that open defecation has to stop and are invested in lasting change.”

According to Saabom Sebastanin, who took over as village chief in Tabier after his father passed away five years ago, “There was feces everywhere. It was around vegetables. It was in the mouths of pigs. We didn’t feel like eating. Children got diarrhea. We couldn’t even sit outside to have a meeting.”

Today, all 44 households in Tabier, and in the other 21 project communities, have latrines because of a CARE process that involved changing behaviors, improving the environment and developing skills.

Saabom recalls that before, when his father was chief, another agency approached the villagers about building latrines. “The community wasn’t involved or motivated,” he says. “The latrines were never built.” Before 2010, other agencies were subsidizing 25 percent or 50 percent or 100 percent, which led to a lot of confusion. After that, the government enacted a no-subsidies law, meaning development organizations can still help finance public latrines in schools but not for households.

“You can’t hide anything when it comes to sanitation,” says Issifu, who spent eight days in Tabier at the start of the WA-WASH project. “Out of all the communities I visited, Tabier had the worst environment I had ever seen. It was a tough place to go in and talk about no-subsidy toilets. We had to get to know the area, know the people and get households to want to pay for their own latrines. It takes a few days of talking, and then about a month later, you’ll see the first latrine go up in a village.”

CARE used a “community triggering process,” meeting with village chiefs, husbands and wives to discuss and map out where their drinking water source is, where their houses are, where they defecate and finding out the last time someone in each household had diarrhea or cholera.

“We’d tell them they’ve been defecating in the open since God knows when, flies are on it and those same flies are now in your water buckets, in your homes and on your food,” Issifu says. “We’d walk through the community together, passing through the open defecation areas and watching their faces. This was the moment of shame. This was the trigger moment when people understood why they had to stop defecating in the open and asked us, ‘What do we do?’”

CARE worked with the communities to develop action plans, with the goal of 100 percent latrine coverage in a certain number of months, detailing who needs to be involved in every step of the process. The project team, for example, trained a volunteer latrine artisan in each community to help build different low-cost models and make repairs, as well as strengthened local water and sanitation committees. With initial training from CARE, 147 village savings and loan associations (VSLAs) were formed in 22 communities, empowering 3,602 women and men to help their families invest in improving crop production and livestock rearing, thus generating extra income that, in part, has been used to pay for latrines and maintaining local water sources. CARE installed a borehole with a hand pump in six villages that didn’t have an existing clean water source. The latrines started going up one by one. Families typically built a basic unlined pit latrine with a door and roof at a cost between 280 and 395 Ghanaian cedis ($65-$95). Families shared latrines until it was time to build their own.

Within three months, every household in Tabier had a latrine.

Dery Noureru is the CARE-trained volunteer latrine artisan in Tabier. “Anyone who wants a latrine contacts me,” he says. “The basics for every latrine are a concrete slab, vent pipe and roofing sheets. I advise people how to dig based on soil structure to prevent cave-ins. We’re now able to grow vegetables around houses, because there’s no feces there. Women used to walk in the rain and squat near snakes. Now they are safe.”

His wife, Beborb, a VSLA member and mother of seven, couldn’t agree more. “Now we can go to the bathroom anytime we want.

“I was so excited the first time I used my own latrine,” she says. “If no one had knocked on the door, I would have stayed in longer!”

Beborb responds very matter-of-factly when asked what held her family back from getting a latrine for so long, “Before, we didn’t know about latrines. Now we will never go back to our old ways. Our days of shame are gone!”