Community-led total sanitation (CLTS): the backlash

Some fascinating observations from Liz Chatterjee on the Guardian’s Poverty Matters blog after a visit to Karnataka to review local implementation of India’s national Total Sanitation Campaign:

“Best practice” turned out to be slightly alarming. The toilets had indeed been constructed, local officials had made superhuman efforts, and people of all classes and castes were using the facilities regularly. But we weren’t prepared for the degree of (often community-backed) coercion used to get the job done.

… At its mildest, this meant squads of teachers and youths, who patrolled the fields and blew whistles when they spotted people defecating. Schoolchildren whose families did not have toilets were humiliated in the classroom. Men followed women – and vice versa – all day, denying people the opportunity even to urinate.

… Equally common, though, were more questionable tactics. Squads threw stones at people defecating. Women were photographed and their pictures displayed publicly. The local government institution, the gram panchayat, threatened to cut off households’ water and electricity supplies until their owners had signed contracts promising to build latrines.

This is in response to a recent article by Robert Chambers arguing for the potential of community-led total sanitation (CLTS) to help achieve the (way off-track) MDG for sanitation.

There are excellent reader comments under both articles, including thoughtful contributions from some of those engaged in this work on the ground. The key points:

  • CLTS is not a magic bullet. In particular, it seems to have been successful so far in persuading many communities in different countries to abandon open defecation and construct latrines, but moving further up the ‘sanitation ladder’ and permanently adopting good hygiene practices such as handwashing with soap may be bigger challenges.
  • CLTS is a community-level approach; scaling-up and working out where it fits into wider public health policy is a more difficult question. Chambers and the CLTS advocates highlight some of these key obstacles, including existing vested interests in hardware-subsidy projects, and the pressure for target-driven construction programmes. Commenters on Chatterjee’s article argue that her observations illustrate exactly this point – many of the problems she saw arise from the reward-based system of targets employed by India’s rural Total Sanitation Campaign rather than the concept of CLTS itself.
  • CLTS, as any idea in development, is context-dependent. I’ve already discussed how WaterAid’s partners in Mali have started adapting the approach. A wider WaterAid report on the social-cultural barriers to total sanitation in Mali and three other West African countries highlights some of the context-specific issues to consider – this type of analysis and adaptation is crucial anywhere.

3 Comments on “Community-led total sanitation (CLTS): the backlash”

  1. David. L says:

    For as Disraeli is quoted as observing: ‘ change is not without inconvenience even from worse to better.’ Are the tactics described here a reflection of enthusiasm for improved hygiene or simply a reflection of a culture that has little regard for the individual?

    • The problem here seems to be taking the ideas of ‘community-led’ sanitation too far. The CLTS approach is based on the fact that sanitation is not just an individual challenge but a collective one, which is best tackled via a community response. This may include emotional elements such as shame, pride and disgust, but in the example quoted it seems like some of this went too far. I don’t know the Karnataka context so can’t say how much particular views on the importance and rights of individuals vs the community were important.

  2. […] the stage of government-enabled services rather than one-off programs – is key. As I have noted before, the question of where CLTS fits into wider public health policy is a tricky one. Going by this […]

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