Latrines, lifelines and links: the view from Ethiopia

‘I was persistently sick. One time, the sickness lasted three months and I came near to death.  Our lives are very greatly changed because we have a toilet.  We still struggle to grow enough to eat and life is hard, but the toilet has made such a difference.’  

These are the words of Ethiopian Tirame Ayago (55 years old), and they illustrate the enormous benefits of gaining access to a latrine.   

Tirame outside her latrine [photo: Richard Hanson/Toilet Twinning]

Toilet Twinning wanted to take a peep behind the scenes to find out about the thinking that goes into bringing about changes like these.  So we asked Tadesse Dadi, Tearfund’s programme support advisor based in Ethiopia, to write this blog:

Tadesse Dadi [photo: Louise Thomas/Tearfund]

My daughter has just completed her high school in Addis Ababa with very good exam results. This was a great joy for the whole family and we praised God for it.  

I still remember the first day my wife and I took her to nursery school. She was very happy and was looking forward to playing with the other children and finding new toys. A week or so later, though, we had to keep her at home for a few days until she recovered from a bout of diarrhoea. It was clear that poor hygiene and sanitation at the school were the cause of this.

Those of us who have had the privilege of bringing up babies and infants know how vulnerable they are to infection in their early years. Poor nutrition and unhealthy environments associated with poverty take a huge toll on young lives. The statistics are alarming: pneumonia and diarrhoea are leading killers of the world’s youngest children, accounting for 18 and 11 per cent of deaths respectively. This equates to more than two million lives lost each year.  

Unsafe water, inadequate sanitation and poor hygiene are all contributory factors. Together they account for nearly 90 per cent of deaths due to diarrhoea worldwide.  

I recently learnt about the ‘F’ diagram, which shows the route taken by disease-causing pathogens, from faeces to our food and water. These pathogens are helped along their way by fingers, fluids, flies, fields and floors. The first line of defence is to block the path of the pathogens through safe disposal of faeces - in other words, using latrines.  

This is not a new idea!  In the Bible, God instructed the Israelites: “Designate a place outside the camp where you can go to relieve yourself. As part of your equipment have something to dig with, and when you relieve yourself, dig a hole and cover up your excrement.” (Deuteronomy 23:12-14, NIV). This is clear instruction to us to erect ‘primary’ barriers to prevent disease transmission.  

We also know that handwashing with soap, particularly after using the toilet or changing nappies, is an essential habit for all of us.  

So creating an understanding of the link between the way we dispose of faeces on the one hand, and killer diseases such as diarrhoea on the other, is the first step in tackling the problem. Once that understanding is created, then sustainable solutions to problems - such as taboos surrounding the use of pit latrines - usually come from within the communities we are working with.

On a recent visit to the Turkana area of Northern Kenya, I found awareness of the problems among the villagers, but a lack of action. Most of the 50 or so households in the village did not have pit latrines. So while the risk of open defecation was well understood, the cost of constructing a pit latrine was prohibitive.

As development practitioners we need to bring people to the point where they understand that investing in pit latrines saves lives, so that the solution is owned by the community, not imposed from outside.

In Turkana a lady in the group I was talking to proposed a local way to reduce the latrine cost. She drew a diagram on the sandy ground to show us that the top of the pit could be covered by locally available poles, with twigs and earth on top of them.  

I left the area on a positive note, knowing that it is possible to save lives – by looking for local solutions. Enabling people to solve their own problems truly empowers them to be creative.  

Thank you Tadesse!

References:

Water Supply and Sanitation Collaborative Council and World Health Organisation. 2005. Sanitation and Hygiene: programming guidance.  WHO Press, Geneva.

UNICEF. 2012.  Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children. New York.  www.childinfo.org/publications

Water Supply and Sanitation Collaborative Council. 2010 . Hygiene and sanitation software: an overview of approaches.   Geneva

Reasons to be cheerful

Jolly Rwomushana, a Ugandan mother of three, has reasons to celebrate. Her family life has been transformed thanks to Toilet Twinning.  

Jolly outside her latrine.  Photo: Vernon Kingsley

For years her children, aged six, 14 and 19, suffered frequent bouts of sickness thanks to diarrhoea and worms.  And in the dry period, March to October, lack of clean water meant conjunctivitis spread like wildfire. Her family was part of an uncomfortable statistic: more than 30% of rural Ugandans have no access to decent drinking water.

And although they had a latrine, its lack of roof afforded no privacy. Instead it offered up swarms of flies, which flitted back and forth to their kitchen area.

Sickness frequently ruled out regular school attendance for the children. The  family found themselves in a time-consuming round of hospital trips,  expensive medical fees and equally expensive medicines. And time spent away from their fields brought risk of reduced yields, which they could ill afford.

But then Toilet Twinning was able to help through its Ugandan development partner Diocese of Kigezi. It showed the family how to construct a proper latrine and taught them the importance of hygiene and handwashing. Simple measures such as covering a latrine with a cap and a stick handle, to guard against flies, can make a huge difference to health.

What’s more, the Diocese have helped villagers construct a giant rainwater harvesting tank at the school, so the children can have clean water there.

Life is no picnic for Jolly, even now. Recent scant rainfall has caused the rainwater tanks to run low, so the children have to bring in their own water to school - water which takes time to collect.

But among the life-saving lessons learnt, her children now know water needs to be boiled before it can be used for hand-washing and drinking. And that simple process alone makes all the difference in the world, not just to the children’s health but also to their future.

School Support Report

Most of us probably have some toilet-related memories from our schooldays. And they may not necessarily be happy ones!  

But for many school pupils round the UK today, toilets are becoming synonymous with twinning thanks to their enthusiastic adoption of Toilet Twinning as a focus for fundraising.

It’s a natural partnership - toilet humour ranks pretty high on the junior school joke list.  And older students don’t forget the serious nature of the problem: for example, in Africa, half of young girls who drop out of school do so because they need to collect water, often from many miles away.  

So while many schools have been fundraising hard, and having fun into the bargain, it’s also great to hear news of some help they’ve had along the way from others.  

Etone College students show off their Toilet Twinning certificates .  They are joined by Seddon Construction staff in  the new school block.

Nuneaton’s Etone College are shortly going to be enjoying a new ten-classroom block and library, with office and toilets. Their construction company Seddon seized the chance, while on site, to twin three of the school’s toilets. Pupils have taken delivery of the certificates showing their twinned latrines in DRC, Nepal and Sierra Leone.  

Meanwhile, on the Somerset coast, two Clevedon schools have benefited from some fabulous fundraising at their local churches. Christchurch and St Andrew’s Church beat a baker’s dozen: they raised enough money to twin not only their own 13 toilets, but also to donate twinnings to St Nicholas Chantry School and Mary Elton School. Miniature toilet-shaped collecting boxes were given to church members, who were asked to 'spend a penny' or, better still, 'spend a pound' to fill them up. The total raised - £1,359 - was way beyond expectations: a testament to the generosity of the churchgoers and their enthusiastic support of Toilet Twinning.  

Young people from Clevedon fundraised enthusiastically for Toilet Twinning, and a golden  loo brush was awarded as a quiz prize

Further east, Sussex Coast College students have also been hard at work, and have raised enough to twin six toilets so far, with another two likely before the end of term. Lay chaplain Barbara Powell-Jones helped the cause by making and selling almost 200 lavender bags.  As the name ‘lavender’ derives from the Latin lavare: to wash, the connection with a sanitation charity (not to mention language lessons) was entirely appropriate!  Proceeds from the bags were enough to achieve the first three twinnings for the college.  

Younger children don't get forgotten either. Bevan Lodge pre-school in Farnborough recently refurbished their toilets - and a generous parent twinned the new loos. Kate Jamieson, chair of the school’s management committee, said, ‘It seemed like the perfect opportunity to broaden the children’s knowledge while supporting a worthy cause.’

Thanks to everyone who has encouraged their local schools and colleges to help flush away poverty through Toilet Twinning. And don’t forget, there are lots of useful resources for schools on our website at www.toilettwinning.org/resources/

 

Water wars or water peace?

Have you ever considered that twinning your toilet could make you an instrument of peace in our troubled world?

In the 21st century, water is being dubbed ‘blue gold’ and the prediction is that wars will be fought over it, just as they have been over oil and other resources. Certainly there are regions of the world, principally in the Middle East, where water is in critically short supply. Yemen has the dubious honour of being tipped as a country about to run dry.

Benjamin Franklin, one of the founding fathers of the USA, is reputed to have said

‘When the well’s dry, we know the worth of water’. How much more true that would be if you had had to walk for several hours to reach the well in the first place. And how tempting to stop off on the way at a polluted source, leading to illnesses such as diarrhoea and cholera.

Tapping in: the journey to reach this water source may have been a long one
Photo: Layton Thompson/Tearfund

At a local level, tensions often rise where shortages are found: human nature makes sharing a challenge, and queuing for water can be one burden too many in an already difficult day.

Add into this mix the fact that one in four people in the world live in countries which are officially termed ‘fragile and conflict-affected states’. And they are the very same people who are most likely to be without access to safe water or improved sanitation. For shortages are not necessarily absolute as in Yemen: often they are down to poor infrastructure, and are entirely fixable.

In the DRC, the government is known to be an unreliable provider of services. As one man commented ‘Who is the government? Who are they? I have never seen them. They have not brought schools or clinics to the village.

Toilet Twinning uses a ‘community-led total sanitation’ approach to development - you could call it a ‘bottom up’ strategy. The local community identifies their own needs and resources, and are trained, helped and encouraged to achieve their goals. And it’s called ‘total sanitation’ because Toilet Twinning works to enable water supply, hygiene education and sanitation, not just latrines.

In Afghanistan, for example, locally-trained manufacturers have developed and installed water purification systems in a school, giving children access to clean and safe drinking water. The school has now seen a significant improvement in the health of the students and hygiene education has been integrated into their regular activities.

Educating and empowering people to come up with their own solutions brings dignity and sustainability. And that has to make for a more peaceful world.

Having your cake and eating it

Boris Johnson once said, ‘My policy on cake is pro having it and pro eating it.’ Whatever your politics, it’s hard to dislike this statement: cake is, after all, one of the pleasures of life. And when it comes to fundraising for Toilet Twinning, it seems to occupy a pretty central role. Or should that be ‘roll’... and Swiss, naturally!

Here's a snapshot of some recent events that have raised plenty of dough, to help people living in poverty build loos and learn about hygiene:

Lenzie Union Parish Church in Scotland, along with three local schools and several associated youth organisations have all been baking furiously for Toilet Twinning funds. Parish youth worker Edgar de Blieck reported that one young girl baked all day Saturday and into the evening for a cake sale and raised enough for no fewer than nine twinnings. Another boy made shortbread and sold it on a friend's market stall.

A pupil at Kent’s Roseacre School acknowledged the serious message that underlies the humour of Toilet Twinning. She told her fellow students, “I know you are going to laugh but you can stop it right now, because this is serious.” They were certainly serious about fundraising: they held cake, toy and book sales and raised enough to twin all 12 of their toilets.

Craig Bishop, a vicar in the South Cotswolds Team Ministry, tweeted to tell us that his Lent lunch and cake and brownie sales had enabled him to twin two of his vicarage loos. His daughters were looking forward to taking the certificates to their school show & tell.

In Frome, Somerset, the launch of a community toilet scheme has been a good chance for Councillor Peter Macfadyen to encourage twinning as well. Several local businesses including The Old Bath Arms, have taken the plunge(r). Could this be the start of many town-wide twinnings? 

Girl Guides, Brownies and Rainbows from Slough celebrated World Thinking Day by hosting activities with an international flavour, such as African drumming and line dancing. They donated the entry fees to Toilet Twinning. 

Pupils and staff at Kemnay Academy, Aberdeen, sold fairtrade products in their tuckshop and are using the profits to twin with a school toilet block.

Visitors to Boscastle Rectory in Cornwall lobbed their donations into an old bed pan when they enjoyed a coffee morning and raffle at Rev Robert Thewsey’s home.

Malcolm and Lubala, a couple getting married in Sussex in July, have requested donations to Toilet Twinning in place of presents. They are also planning to have ‘spend a penny’ collection tins at the reception.

64th Glasgow Girls' Brigade raised £830 for Toilet Twinning, by cleverly using their 60th anniversary as a link to the £60 cost of a twinning.

Vale of Glamorgan environmental health officer, Rowan Hughes, took the direct approach by asking his local mayor to twin the town hall toilet - and was flushed with success, naturally.

Royal Holloway College student, Lucy Milne, made headlines in Surrey newspapers after she secretly twinned her mum’s loo as a surprise gift - only to find her mum had secretly done exactly the same for her. What’s more, they found their twinned Ugandan loos were only 300 metres apart.

Our supporters display a wealth of ingenious ways to raise their pounds so that others can spend their pennies in privacy, and they clearly have fun too. Thank you so much.

Maybe you feel your personal time is sliced up too thinly, or perhaps you sometimes find yourself at a bit of a loose end. But there’s one thing certain: enjoying the company of others while raising money for Toilet Twinning is a piece of cake!

Books and Bogs

It goes without saying that your first action on visiting your loo will be to gaze lovingly at your Toilet Twinning certificate and think about the people who are using their latrine in a faraway place.

But for many of us, the few minutes we spend behind the closed door of the smallest room might be the only chances we get to pause in a busy day. Indeed there’s a poem (or prayer, depending on your viewpoint) called ‘Slow me down Lord’ which speaks of the importance of these little rests in our routines:

Teach me the art of taking MINUTE vacations,

Of slowing down to look at a flower,

to chat with a friend,

to pat a dog,

to read a few lines of a good book. 

So maybe your only chance to read a good book happens on your ‘minute vacation’ in your toilet. But what to read? Well, the Times Educational Supplement has recently published a ‘Teachers’ Top 100 Books’ list - a goldmine for readers gleaned from the top 10 favourites of 500 teachers.

How many have you read? How many do you want to read? Do you even agree with their choices? The Times Ed seems to be expecting dissent, because they commented, ‘Very little, beyond politics and religion, divides people quite like a list.’

And remembering all those junior school jokes about book titles like ‘The Highwayman’ by Ann Dover, what could you suggest as great titles to read while enthroned in your private space? Let’s get the obvious ‘Winnie The Pooh’ by A A Milne out on the pedestal mat right away and open up this serious debate!

Pain in the neck?

Feeling the weight of water in South Sudan.  Photo: Layton Thompson/Tearfund

‘They’re so graceful!’ ‘ They make it look so easy!’  ‘Of course they’ve been doing it all their lives.’

These might be common reactions to seeing women and children in developing countries carrying heavy loads on their heads.There’s a sort of residual feeling that it must be good for the posture: none of that weighed-down, lop-sided lugging of our weekly shop in a plastic bag that’s cutting into our fingers.

But the reality is distressingly different. It’s one of the reasons why Toilet Twinning is concerned with the holistic improvement of water supply as well as sanitation, latrine provision and hygiene education.

We know that women in communities without access to running water spend hours of their lives fetching and carrying - and the carrying is almost always done on their heads.They are frequently transporting the equivalent of 20 litre-bottles of water and often walking barefoot along paths that may be steep and stony, unstable, or fraught with potential dangers from both humans and animals. And perhaps they are doing all this on an empty stomach or during periods of sickness.

Professor Ray Lloyd, a sports scientist at the University of Abertay Dundee, was concerned about this. He conducted research on a group of 24 South African women from the Xhosa people and compared them with nine British Territorial Army Women.

His tests found that life-long experience of carrying loads on the head did not make it physically easier to do so, nor did it protect against pain and discomfort.

‘All the experienced head-loaders reported that neck pain was a big problem for them,’ he said, adding: ‘They reported having to give neck massages to their mothers and grandmothers whenever they returned from fetching water.

‘All the women agreed that they would prefer an alternative method of transporting essential items such as water and firewood.’

And the pain factor is just one part of this scandal - imagine having to commit a major part of your day to collecting water, and perhaps missing out on schooling to do so.

This World Water Day (22 March), feel free to express some righteous anger about this! Could you encourage your community group, workplace, school, church etc to twin their toilets? Or use social media inform others about Toilet Twinning? Or maybe write something for a publication you have an interest in? Let’s keep at it until water and sanitation are a universal right, not a privilege.