Community-led total sanitation (CLTS) does not sound such a big deal, but it is revolutionary. We have so many “revolutions” in development that only last a year or two and then fade into history. But this one is different. In all the years I have worked in development this is as thrilling and transformative as anything I have been involved in. Let me explain.
Firstly, sanitation and scale: 2.6 billion people need improved sanitation and 1.1 billion defecate in the open. The millennium development goal (MDG) for sanitation is badly off track in most countries, which affects all the other MDGs.
Secondly, sanitation and hygiene matter much more than most people realise. Where they are lacking, the effects are horrendous. Faecally related infections are many. Everyone feels outrage because more than 2 million children are killed by diarrhoea each year. We hear about cholera outbreaks. But who hears about the guts of 1.5 billion people hosting greedy, parasitic, ascaris worms, about 740 million withhookworm voraciously devouring their blood, 200 million with debilitatingschistosomiasis or up to 70 million with liver fluke? And what about dysentery, hepatitis, giardia, tapeworms, typhoid, polio, trachoma…?
On top of all these, many millions are affected by tropical enteropathy, where the gut wall is damaged and nutrient absorption is reduced – in effect, wasting food. All these can be dealt with through safe disposal of excreta and safe hygienic behaviour. We give undernourished children more, and better, food. Let that continue. But wouldn’t improved sanitation and hygiene also, in many cases, lead to more effective and longer-lasting solutions for tackling undernutrition? CONTINUE ARTICLE