CLTS making an impact on sanitation in Kisumu

Over the last year or so, Practical Action and our partner organisations KUAP and Umande Trust, have been rolling out a programme of urban-adapted CLTS (community-led total sanitation) in informal settlements in Kisumu. The work is part of a five-year project supported by Comic Relief.

Last week I visited and was treated to a demonstration of some of the team’s favourite tools, as they described both what works best, and some of the challenges of taking these tools designed for rural contexts, into urban environments.

Open Defecation hotspot in Kisumu (c) Practical Action, Patrick Meinhardt

Differences in context

Two years ago, I visited similar work in Nakuru, and summarised 11 differences between urban and rural CLTS. Many of these also apply in Kisumu. The local team themselves identified these features of urban areas as the most important in making collective triggering and behaviour change more challenging:

  • Large areas with large populations, with the need to break this down into smaller chunks to reach more people
  • Large numbers of tenants, with the need to persuade landlords to invest in better sanitation
  • The opportunity to reach people through the area’s schools, with children taking messages home from ‘health clubs’
  • A diverse, shifting, population where attempting to persuade your neighbour to change their ways may be seen as disrespectful
  • Open Defecation does not only mean hotspots, but can also mean polluted latrines, leaking and ‘hanging’ toilets open to the drains, flying toilets, open dump sites with waste such as sanitary towels and nappies, burst sewer lines, and the work of pit emptiers where the contents of a pit is emptied directly onto open ground.

We have mapped all these sources of open defecation through transect walks using GIS technology and combined all the information to generate open defecation ‘heat’ maps. The aim of a CLTS approach is to help communities to eliminate all of these.

Open Defecation Hotspot Analysis for Obunga low income settlement, Kisumu

Favourite triggering tools

In CLTS, it is often the ‘triggering’ process that is the most dramatic. This is the moment when, through demonstrations and visual tools, community members realise the drastic environmental situation they find themselves in, where they are, in all likelihood, eating each other’s poo.

Public Health Officers trained by Practical Action have been supporting the process through their cadre of community health volunteers. At the same time, natural leaders have emerged from initial triggering events. These passionate and committed people have done the bulk of the triggering events so far. Many of the tools they use are familiar to CLTS practitioners such as:

  • Mapping of landmarks, houses and open defecation hotspots
  • Transect walks to open defecation hotspots and broken latrines
  • Bread and faeces side by side to watch the flies move from one to another
  • Clean water which is then polluted by faeces on a stick, and people no longer want to drink it
  • Calculations of the volume of faeces present in the community
  • Health cost calculations of the amounts spent on treating diseases caused by an environment polluted with poo

Among the most impactful of these was reported to be the health cost calculation because in urban areas, people are acutely aware of the cost of everything.

CLTS triggering in action, Nyalenda, Kisumu (c) Practical Action, Patrick Meinhardt

In the area of Nyalenda called ‘Dago’ where we met the team, there has been a dramatic improvement. A major search had to be mounted to find any faeces with which to demonstrate! It was reported that almost all the plot-owners had now built toilets. But this area was more spread-out with enough space for digging simple pit latrines and fewer tenants. The process will likely be slower and need to involve many more stakeholders and different technology choices in more densely populated areas where soils either collapse too easily, are too rocky, or where the water table is high.

We are learning from our recently completed work in Nakuru, and as the process moves forward we will share more highlights. The Public Health Department are keen to learn from others and celebrate the first communities becoming ODF. That may require some local adaptations of the verification protocol relax the requirements for hand washing facilities at the toilets, which is what has blocked settlements in Nakuru from achieving this status.

As the process moves forward, we’ll share more updates and insights via our blog.

Together with Plan International and the CLTS Knowledge Hub at IDS, Sussex University, we are compiling experiences of urban CLTS to create a new guide that will be launched later this year. This builds on the ‘Addis Agreement‘ which shares experiences of urban CLTS published in 2016.

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