World Toilet Day – is an opportunity to reflect on one of the most basic common needs of man (and woman!) – when you need to go, you need to go! Readers of the British Medical Journal voted sanitation the single greatest medical advance of the last 150 years, and yet more than 2.5 billion people globally still do not have access to a safe, clean toilet. Of these, 1.1 billion people (15% of the global population) have no sanitation facilities at all and practise open defecation, the riskiest sanitation practice in terms of human development outcomes.
Over the past years, the elimination of open defecation has been recognised as a key contributor to improved outcomes in the health and nutritional status of children and has emerged as an area where UNICEF programmes are achieving results at scale. This is being done through Community Approaches to Total Sanitation (CATS) - an approach that is rooted in community demand and leadership, focused on behaviour and social change, and committed to local innovation. As a result of our programming and evidence-based advocacy, this has become an area of focus internationally. Earlier this year, at the Sanitation and Water for All High-Level Meeting (April 2012), our Executive Director called for the elimination of open defecation and described it as an “affront to human dignity”. Since then, the WASH Section in New York has developed a strategy to support the elimination of open defecation in priority countries, where numbers of open defecators are highest.
At the global level, UNICEF will use World Toilet Day to raise public awareness on the sanitation crisis through a massive social media campaign that follows-on from Global Handwashing Day in October. For UNICEF offices around the world, World Toilet Day provides an opportunity to advocate with Governments and partners to prioritise the elimination of open defecation and to highlight some of the great work that is already being done. Over 50 UNICEF Country Offices are now supporting Community Approaches to Total Sanitation: through our direct support, more than 24 million people are now living in over 39,000 open defecation free communities; while an additional 88 million people now live in open defecation free communities thanks to indirect support, such as policy development and capacity building, to Government and partners.
Eliminating Open Defecation in the world’s newest nation
In East and Southern Africa, CATS programming has proven extremely effective at changing behaviour and creating social norms across a range of different countries and contexts. Recently emerging from decades of civil war, South Sudan is one of the latest countries to adopt CATS. With extremely low access to adequate sanitation - a mere 12.7% of the population regularly use improved latrines - many factors inhibit the adoption of improved sanitary and hygiene practices, including the high degree of instability wrought by war, on-going intra-tribal conflicts, and returnee movements, as well as harmful and often contrary customary beliefs and practices that deepen resistance to behaviour change. In 2012, to start to address these challenges, UNICEF spearheaded the introduction of CATS in South Sudan. To date, five villages have been declared ‘open defecation free’ (ODF), and a further 8 villages have reached over 90% latrine coverage and are soon expected to achieve open defecation free status.
On 1st November, the village of Adiem held the first ever ‘open defecation free’ celebration in South Sudan. The occasion was well attended by the local community, State government officials and international WASH partners, and was covered by South Sudan Television. After a transect walk across the village to see the improved sanitation situation, congratulatory speeches were interspersed by song and dance by the community, and a group of youth led the community in several “laps of honour” to celebrate their achievement.
This early success shows that CATS is a viable option even in the context of fragile states and in post-emergency situations. It also demonstrates the latent demand for sanitation that exists even in the most remote and conflict-afflicted communities and that the ability to affect change for sanitation is entirely within reach.