How do you protect your family in CAR: the "worst country in the world"?

Ericaine’s story is about a mother’s love, a wife’s resilience and a woman’s determination to make life better – not just for her family, but for everyone in the displacement camp they call home, writes Toilet Twinning CEO Lorraine Kingsley.

I met Ericaine in the middle of a displacement camp in Central African Republic. It’s considered one of the worst countries in the world to live – and Ericaine is one of CAR’s most vulnerable people.

Ericaine (left) is now keeping her community safe and healthy

It was stifling inside the large, wooden-framed tent that housed Ericaine’s family – and seven other families besides. Her tarpaulin-walled compartment housed a bed of sticks held together with string, with a flimsy rattan mat on top. It didn’t look comfortable enough to sleep on for one night – let alone three years and counting.

Above the bed, clothes hung from lines of string hung between nails in the wooden struts: a woman’s skirt, a top and a shirt, and a few items of children’s clothing so dishevelled they looked more like cleaning rags.

Next to the bed sat a tiny cabin-sized suitcase, and a few pots and pans. On the bed lay a small pile of dog-eared textbooks and exercise books.

Before Ericaine came to this camp, she told me, she had a market stall selling groundnuts, cassava and palm oil. She had her own home, enough money to feed her children and money for clothes. Her husband works away on a diamond quarry.

Life in a displacement camp in CAR is tough

Ericaine, now 39, was at home when she heard gunfire. She went outside, to find people running in all directions, terrified, desperately looking for their children and relatives.

Ericaine called to her four children, and started running. She carried her two-year-old daughter on her back: her teenage daughter Sandra carried her younger brother and Ericaine’s other son ran alongside them.

A man was gunned down in the street ahead of them. A woman told them she’d seen armed militia nearby and she pointed to where it was safe for them to go. 

Ericaine and her children ran to the bush and sheltered for two nights. She stayed awake, guarding her children. On the third day, she felt brave enough to make her way to a nearby church, where she took refuge with about 100 other families. A large tarpaulin shelter was set up for them in the church compound – and that was their home for the next eight months until a UN camp was established next-door. 

Ericaine was four weeks’ pregnant when she arrived at the church. Over the next eight months, they often heard gunfire and often hid in the bush for days at a time.

It was while they were cowering in the bush one day that Ericaine went into labour. She sent Sandra on ahead, with her siblings. She had her baby there in the bush, before help came.

A couple of women carried Ericaine back to the church, where staff looked after her, gave her sheets and clothes and medicine.

Soon after Ericaine’s baby girl, Pricille, was born, the UN camp was set up. Conditions had been terrible in the church compound: they were just as bad in the camp.

A teenager doggedly continues her education, despite everything

Sickness and diarrhoea were rife. Ericaine’s daughter Benicia, who was two at the time, spent a month in hospital with extreme fever and sickness – probably typhoid.

Without proper latrines, children went to the toilet anywhere and everywhere. The smell was awful: so were the rats and flies. Women would go to toilet in the bush – where they feared being attacked.

Ericaine and her cleaning kit

Enter the organisation we raise funds for, Tearfund. Water and Sanitation staff capped a nearby spring to provide clean water for residents in the camp, and built them ten toilet blocks and bathing blocks, along with handwashing stations. They trained a small team of residents who were charged with looking after the toilets and making sure people used them properly.

Ericaine volunteered immediately. ‘I wanted to make the camp a healthier place – not just for my family – but for the whole community,’ she says.

Ericaine and the cleaning team asked for padlocks, so they could stop children making a mess of the toilets and damaging the temporary wooden-framed structures. Mothers took responsibility for holding the keys, so the toilets would stay as clean as possible.

Gradually, conditions have improved and people are healthier. Ericaine and her team are proud they’ve been able to play a part in protecting their community.

‘We saw a big reduction in sickness and diarrhoea,’ says Ericaine. ‘Here, we live on top of each other, so everyone can hear you when you’re sick. We’d often look after children if a mother was ill.

‘Things are so much better now. I can’t thank you enough for giving us back our health.’

Ericaine’s nation is still volatile: intense violence flares up without warning. But, here at least, in Ericaine’s corner of ‘the unhappiest country in the world’*, she’s able to keep her family safe, from disease at least.

*UN poll, March 2017 

How do we become a Toilet Twinned Town?

We bet you’ve visited 20 different toilets in the past year. Imagine how amazing it would be if they were all twinned… That’s all it takes to twin your community. It’s easier than you think!

‘Toilet Twinned Town’ (or village or city or island) is an accolade we give to communities who have come together to twin lots of loos.

Skelmersdale in Lancashire became the UK’s first Toilet Twinned Town in January 2015 when a local vicar got his congregation to donate twins to public venues across the town. 

Since then, 14 other communities have received the award – from the city of Chester to the Isle of Man – and many more are in the pipeline.

Skelmersdale becomes the first Toilet Twinned Town. Photo: Martyn Snape

If you’ve twinned your own toilet, and perhaps given a Toilet Twin as a gift, the next step might be to twin your town. Without belittling the efforts of those who’ve already won the award, we reckon it’s not as hard as you think.

We ask you to reach a certain number of twins by achieving five different goals (eg involve the local council or MP; twin a school, church or businesses; and get some media coverage). The number of twins varies, depending on the size of your community. For a Toilet Twinned Town, for example, that can be as few as 20 and for a Toilet Twinned Village it can be just five.

Ask us today for the goals you’ll need to achieve in order for your village, town, city or island to get in on the action! Remember: every toilet built is used by an average of six people – so twinning 20 toilets could provide proper sanitation for 120 people… or more.

Here are some thoughts about how you might get started…

1: Make it a team effort

Gather some like-minded people who are passionate about privies.

Dorothy Mansfield was part of a group at St Andrew’s Church in Stewton who spread the word about twinning across their Lincolnshire village. The group held ‘Community Coffee’ events each month and gradually built up a ‘wall’ of toilet twins. The church had just invested in their own toilets so wanted to help others abroad.

Our friends in the aptly named Scottish town of Bathgate took a similar approach. Their Fairtrade coffee mornings proved a great way to raise funds and inspired several local townsfolk to twin their loos too.

2: Order a Make-a-Stand kit

Set up a Toilet Twinning stall at a local event and tot up more twinnings for your town.

Burnham’s Inner Wheel group led the way in making their Buckinghamshire community a Toilet Twinned Village. They held a stall at their local donkey derby, as well as other fundraisers which have included an Indian-themed evening and a quiz night. As a result, they’ve twinned several local loos including the newly refurbished public toilets. As Inner Wheel President Beryl Senior says, ‘We have learnt a great deal about toilets!’

Burnham Inner Wheel's stall at the local Donkey Derby

3: Spread the word by stealth

Don’t wait for people to donate: give them the Toilet Twin you want them to have!

St Paul’s Church in Skelmersdale drew up what they called a ‘hit list’ of local toilets they wanted to twin – from the staff loos at their local Asda to the local soft play area. Rev Chris Spittle says, ‘It’s been great to see churches, schools, care homes, businesses, shops, pubs, community centres, our mayor and MP all agreeing to receive a toilet twin.’

4: Think big if you dare…

The world’s your oyster: twinning your town is not the end of the road.

A Churches Together team in Eastbourne have set themselves the ambitious target of twinning 1,000 local loos in 2017. Eastbourne twinners are really going for it – contracting schools to plumbers merchants to hotels – and they’re backing up these efforts with a digital strategy which includes a website and an online giving page.

Group member Stephen Brown told BBC Radio Sussex that he though Eastbourne ‘probably has more toilets per head than any other town in the UK’, not least because of all its hotels and B&Bs. ‘We have 100,000 people in Eastbourne so we think 1,000 toilets is a do-able aim,’ he says.

Twinning your town is a sure-fire way to help local people bond around a great cause and change lives forever in poor communities.

Get in touch today so we can start you off on your journey towards becoming a Toilet Twinned community.

The twelve days of Christmas twinning

To get you in the festive mood, here’s our countdown to Christmas, with 12 days of Toilet Twinning (and some terrible puns)… Join us as we take an affectionate look back over some of the highlights of 2016.

On the first day of Christmas…

‘Dundee’ (which rhymes with ‘pear tree’, ish) becomes our first Scottish Toilet Twinned City and host to our first-ever Malawi twin (in the ‘cuddies’ on board RSS Discovery, no less).

On the second day of Christmas…

We absolutely ‘turtle dove’ (cockney slang for ‘love’) all our two-legged heroes who have taken on sporty challenges for us, from cycle rides to treks, runs to rowing.

On the third day of Christmas…

ROQ holds three weeks’ worth of toilet-themed craziness in their office to twin toilets, complete with a school uniform day, loo-roll dodge ball contest, bingo and maths quiz.

On the fourth day of Christmas…

Toilet-tastic Petra Crofton twins 20 loos to mark her four-tieth birthday, by setting herself fundraising challenges throughout the year, including a triathlon.

On the fifth day of Christmas…

The Guardian crossword marks World Toilet Day with a fiendishly tricky cryptic one in aid of us. Can you guess the answer to Five down? Reduce or eliminate wrinkles (8). (Answer below.)

On the sixth day of Christmas…

Christine McGibbon in Northern Ireland allays (geese a-laying… it’s close!) all fears she’s slowing down, by setting herself a target to twin six-ty toilets to mark her 60^th,

On the seventh day of Christmas…

1^st Maxwell Mearns Rainbows, Brownies and Guides raises more than seven hundred pounds (£750) by collecting money in specially painted ceramic ducks (distant relatives of ‘seven swans’).

On the eighth day of Christmas…

For eight weeks, the Sunday School children at Llanishen Evangelical Church collect money in uber-cute coin collectors ‘maid’ (as in a-milking) out of toilet rolls, with specially knitted hats.

On the ninth day of Christmas…

Nine-year-olds make a big splash with their twinning this year, including Emily Greenway from Nottingham who organised a ‘toilet fair’ (which included a game of ‘splat the poo’) and Ronan McGowan who ran the junior Great North Run for us.

On the tenth day of Christmas…

Lordsalummy! Ten out of ten for bravery for a little girl with encopresis who overcame her own toilet battles to raise money in her penny pot and provide a loo for a family who didn’t have one.

On the eleventh day of Christmas…

Thomas Lloyd, who’s eleven slept outside in a bivvi bag for at least one day a month, in temperatures which were not exactly piping hot. Brrrr…illiant.

On the twelfth day of Christmas…

Many, many more than twelve people at St Brendan’s Sixth Form College in Bristol join in with the pre-Christmas fun run – drumming up support for toilets!

There are many, many more twinners we could and should have mentioned here: huge thanks to you all and a very Merry Christmas!

Answer to Day 5 puzzle: Decrease

Why World Toilet Day matters for the Dorteas of this world

Every toilet twinned to celebrate World Toilet Day brings safety and dignity to a family like Dortea’s. No wonder she’s happy…

It wasn’t so very long ago that Dortea’s smile was a rare event. Every time she and her daughters needed the toilet, they had to venture out into the bush.

‘My husband would stand at the edge of the compound and wait, worrying that something bad might happen to us,’ she recalls. ‘As a mother, I was afraid every time my daughters went. They had to go in groups or be escorted by me.’

Dortea's life has changed, thanks to her loo

The dangers in this remote part of eastern Democratic Republic of Congo are many. Snakes and scorpions lurk in the scrub. Dortea’s husband was bitten by a snake a few years and was in hospital for three weeks.

But it wasn’t the wildlife that posed the greatest threat to Dortea and her girls…

‘I came back from the fields one evening with my husband,’ recalls Dortea. ‘A man was waiting in the bush. He came from behind and tried to push me forwards. He used a lot of force… said he had a machete. Then my husband appeared and the man ran off.’

Mwandiga village is in South Kivu province, close to the border with Rwanda and Burundi. At the height of the civil war, armed insurgents from these countries flooded across the frontier, to join what became known as ‘Africa’s World War’. Sexual violence against women was rife across Congo – but South Kivu was a flashpoint.

‘At that time, many people were being attacked as they worked in their fields or came home in the evening,’ says Dortea. ‘Women and girls were also attacked as they went to the bush to go to the toilet, or when they walked to get water. Things were really bad.’

Mwandiga village began as a clearing hacked out of the forest that still surrounds it. Most people came here with nothing in 2008 and found nothing here. They had fled to Tanzania at the height of the civil war, and then been forcibly repatriated.

Gradually, people started building homes and cultivating land. But there was no clean water, and no sanitation. Dortea and her daughters used to have to walk to the shore of Lake Tanganyika to wash or collect water for cooking. It was a long trek, fraught with risks.

Now, despite DRC’s volatile political situation and rumours of conflict, Dortea and her neighbours in Mwandiga feel much safer. Their first line of defence is the new latrines being dug at homes across the village.

Ekyoci watches her son use their tippy tap

Tearfund, whose water and sanitation work Toilet Twinning funds, began to set up Community Health Clubs in the area in 2013. The aim was to help villagers learn and share skills in hygiene and health matters, and to encourage everyone to dig pit latrines next to their houses, for their own families and for one another.

Now Dortea and family have a toilet: they dug the pit, Tearfund provided the slab. And there’s now a borehole nearby, ending their long treks to the lake.

Residents of Mwandiga are now proudly showing off the new tippy taps they use to clean their hands and the bathing areas that they've constructed so they can have privacy when they wash themselves and their children. They now have a drying rack for their pots and pans, to keep them off the ground, and a rubbish pit to contain their waste.

‘Personal hygiene for us and our children was all new to us,’ says Ekyoci, Dortea's neighbour. ‘There used to be a lot of flies buzzing around but they have decreased. We have a lot less disease now.’

Their friend, Zaina, laughs as she talks of Health Club members’ hard sell as they encourage everyone to have a toilet.

‘There is always someone in this village talking about toilets!’ says Zaina. ‘”You must have a toilet, you must have a toilet…” That's how I knew that it was really important for my family’s health and security.

‘The best thing about having our own toilet is the privacy. We know now that we can’t be seen as we go to the toilet.’

Zaina is proud she can protect her sons' health

Dortea, Zaina and Ekyoci are all immensely proud of their toilets. Because, although they have no control over what happens at national level, they can at least be sure that they’re doing what they can to keep their families safe.

As Dortea puts it, ‘People do not need to go far from their houses any more. The instances of women being attacked are much reduced. Things are different now…’

World Toilet Day, which is on November 19 every year, exists to help more people like Dortea, Zaina and Ekyoci access proper sanitation. Their lives have been transformed by a simple pit latrine and some basic training.

Isn’t it time the same thing happened for the one-in-three people who still don’t have a toilet? Twin your toilet today and rewrite someone’s future.

How toilets are restoring dignity and hope in the DRC

Simple latrines mean safety and dignity for women like Bawili and Ebinda in the Democratic Republic of Congo, as Toilet Twinning's CEO Lorraine Kingsley discovered.

Ebinda was 14 when she was attacked. It was early evening – about 6pm – and she had gone into the bush to relieve herself. It was not yet dark so her mum, Bawili, allowed her to go out alone.

But as Ebinda crouched down, someone grabbed her neck. She doesn’t know how many of them there were: she couldn’t see them. They pushed her to the ground.

Bawili saw the bruises and scratching around Ebinda’s neck as soon as she ran in, crying. She knew instantly what had happened.

The Médecins Sans Frontières doctors who treated Ebinda observed that, if she’d had a proper toilet at home, the attack would never have happened.

Ebinda, with her mother, Bawili

Meet Bawili and Ebinda for yourself: watch our Big Relief film

But Bawili couldn’t afford to build a toilet. Her husband was shot dead during the civil war insurgency in the 1990s, and the remaining family fled as refugees to Tanzania. When the Tanzanian refugee camp was closed down in 2008, they were sent to South Kivu province, eastern Congo, to start again.

They had nothing and there was nothing for them in Mwandiga village. No water, no sanitation, no home.

They could only afford one jerry can, so Ebinda would make three journeys a day to the lake for water. It was a 90-minute round trip. Each journey put her at risk of being attacked. Each jerry can of dirty lake water put the family’s health at risk. 

A few months after they settled in Mwandiga, Ebinda was bitten by a snake as she crouched in the bush – and the hospital didn’t have any antivenom serum. She says she has felt weak ever since.

A few months after that, the brutal attack happened. Ebinda fell pregnant and left school as a result: her son is now six. She told us that she hasn’t felt truly happy since the attack. 

Bawili believes that if her husband had still been alive, he would have had the strength to build them a toilet. 

Widow Bawili provides for her family alone

And yet, this family – despite their deep poverty – spent three days with us, opened up their home to us, laughed with us and shared their story with grace and poise. 

Toilet Twinning helps fund the water and sanitation programme of Tearfund, and when Tearfund first set up Community Health Clubs in the Mwandiga area in 2012, Bawili was among the first to join. She never missed a meeting; she always arrived first.

When the group voted in their first president, Bawili was the obvious choice. She encouraged villagers to build their own toilet, one by one – even though she wasn’t able to build one herself. ‘Don’t look at me,’ she’d say. ‘I can’t afford a toilet but you must do this for your family’s health and safety.’

So the group voted unanimously to build Bawili a toilet. A year ago, members gathered materials and dug it together. Bawili brought the water each day and helped make the bricks. 

Now her toilet is her pride and joy. ‘My toilet brings us freedom, privacy and dignity as a family. We used to feel shame when we had people visit us and we didn’t have a toilet for them to use. People would shout abuse at us as we walked to the bush. I am so thankful and so happy to have a toilet. It is a big relief.’

Bawili (centre), with her family and their toilet

Now, when the Community Health Club meets under the trees each Sunday, the members open with a song they have written themselves:

‘Community, we must build a toilet 

Community, we must have a bathroom 

Community, we must wash our hands with soap or ash 

Community, we must have a rubbish pit 

To protect our health.’

Listen to Mwandiga’s Community Health Club’s toilet song

During our time in Mwandiga, we would get many impromptu renditions of the song as the children crowding around us would start to sing.

DRC remains one of the poorest countries in Africa. There is no infrastructure, no rule of law. There are fears that President Joseph Kabila may call off the elections scheduled for November. If he does, civil war may follow. 

And yet, there is hope. You can see it and touch it in Mwandiga.

The community have come together, learnt together and discovered that they have the power to improve life for their families. They don’t need to wait for the government to act. They don’t sit around, hoping that another NGO might turn up to build a school, or hand out food.

As members of a Community Health Club, they can all see what happens when they take charge of their families’ futures. They all talk about feeling safer, and having less disease now. 

And they all talk about the day they built their toilet – and restored dignity to their household. 

They may not know what the future holds. But they believe it will be better than their past. Their toilets are an important first step in the right direction.

Meet Bawili and Ebinda for yourself: watch our Big Relief film 

And why not plan your do for a loo for World Toilet Day on November 19?

The Isle of Man’s alternative TT

What possesses someone to drive around the Isle of Man for hours, with a toilet perched on their car roof? Toilet Twinning champion Rosemary Clarke and our CEO Lorraine Kingsley come clean…

Manx residents were caught unawares by the scene that greeted them that sunny spring morning.

A van topped with a toilet and decorated with loo brushes, balloons and bunting wound its merry way through towns and villages across the island for a full seven hours, before coming to a halt outside the Tynwald.

Twenty-eight times over the course of the day, the Toilet Tour-ists parked up, dived out and rushed to the loo.

It was not a case of overactive bladders. Rather they were marking a world first: the Isle of Man becoming our first-ever Toilet Twinned Island.

The Toilet Tour reaches Douglas. Photo: Isle of Man Today

'It’s not often you get invited into people’s homes to look at their loos or drive around in a toilet-topped van!’ says Rosemary (pictured front right, above). ‘But it was marvellous to see the enthusiasm of all the twinners and to be able to celebrate our new status as the world’s first Toilet Twinned Island.’

Over the past five years, more than 130 toilets have been twinned across the Island, in schools, businesses, churches and offices. Our Toilet Twinned awards are given to special communities which go above and beyond to twin toilets and work together to make a difference.

The earliest recorded toilet twins on the Island go right back to January 2011. Then, Manx twinning was given fresh impetus by Rosemary Clarke and colleagues at the One World Centre in St Johns when they launched a ‘Twin your toilet’ campaign with Churches Alive in Man during One World Week in 2014.

Knockaloe Beg Farm in Peel - and guests

One World Centre itself has held various memorable events including entering a Christmas ‘lav-a-tree’ made of loo brushes in the Festival of Trees at Ronaldsway Airport in 2014.

‘Twinning a toilet is such an easy thing to do and can have such a positive impact on the health, education and economic prospects of others. We’re delighted so many people have taken up the challenge and hope the tour might inspire even more people to do so.'

Lorraine (pictured second from right, front row, above) says, ‘It was truly heart-warming to tour the island, and see so many individuals, schools, churches and business people who were genuinely thrilled to be part of the day – and part of Toilet Twinning’s mission. We received a warm welcome wherever we went – even with people who let us run into their home and take a photo of them sitting on the loo with their certificate!’ 

The Toilet Tour ended with a reception at the Legislative Buildings in Douglas hosted by Ray Harmer MHK and David Anderson MLC. Toilet twinners were invited for a celebratory cuppa and a slice of toilet-themed cake, as Lorraine presented the award to Ray Harmer.

The TT reaches Henry Bloom Noble Primary School in Douglas

Of course, becoming a Toilet Twinned Village, Town, City or Island is just the start of the next leg of the journey: several Islanders have been inspired to twin their toilets as a result of the Toilet Tour.

Manx twinners are on a roll and don’t look like stopping any time soon, if Gladys Corlett of Onchan Methodist Church is anything to go by.

‘Both my grandmothers on the Island had outside loos and I'm so thankful we don't have that today,’ says Gladys. ‘We think that everybody deserves a decent toilet. Millions of people don't have access to one – and that's totally unacceptable. If you can help in any way at all, you feel you must.’

·         Find out more about how your community can become Toilet Twinned

A toilet is for life – or why sustainability matters

For toilet aficionados like us, there’s nothing more tragic than the sight of a tapstand in disrepair or a toilet in disuse. We’re determined not to let this happen…

Picture the scene. A line of abandoned loos, busy only with flies. Close by, a cluster of children relieve themselves in the open air.

Sadly, it happens… but only when toilet-building statistics take priority over sustainability.

It happens when a team in a 4 x 4 sweeps in, builds loos, drills a borehole perhaps, and speeds off again straight after the obligatory handover photos. A month later, the new latrines are filthy, and people go back to relieving themselves outside.

We want to ensure that every toilet or tapstand we install is still being used and properly maintained a year later… and into perpetuity.

As our water and sanitation adviser, Frank Greaves, says, ‘No one refuses a new latrine for their household.’ But, unless people really grasp the life-transforming impact of proper sanitation, clean water and simple things like handwashing with soap, projects are money down the drain. Not on our watch…

Watch our short film about sustainability

Sustainability has two key ingredients: buy-in and behaviour change. In other words, if people realise the importance of proper sanitation for themselves in the first place and are willing to invest in it, good hygiene habits are likely to stick.

One key tool our partners use to help ‘trigger’ a desire for toilets is the gloriously named ‘defecation walk’.

Essentially, they invite villagers to walk with them around the community and point out the places where they relieve themselves. Through gentle questioning, they help people see the health risks for themselves, as Frank Greaves explains.

‘It’s not about blaming or embarrassing people or telling them what to do: it’s simply about facilitating a process through which people are encouraged to reflect on their own (and their communal) sanitation behaviour: disgust, revulsion, even shock, all play a part.

‘If the process is facilitated well, a real desire for change takes root. Sometimes, pointing out the simple fact that their children play very near a place where people defecate is enough to trigger the change.’

Susan has learnt about handwashing at school

The importance of sustainability is all too clear for our Ugandan partner, North Kigezi and Kinkiizi Dioceses (NKKD), which works in some of the poorest villages in the impoverished south-west of the country.

Previous state-led sanitation projects in Uganda have failed: latrines quickly fell into disuse because there was no local ownership. Child mortality linked to poor sanitation remains high.

So NKKD has refocused its work to make sustainability a priority – by placing a strong emphasis on local buy-in.

Its approach is to identify families who are particularly receptive to their sanitation and hygiene messages, and to equip them to lead by example. So their houses become ‘demonstration homes’ with a proper latrine, clothes lines, dish-drying rack, handwashing tippy tap and bins – so that these families can model good hygiene to their neighbours.

In one village, Kabirago, the number of toilets has almost doubled since NKKD began work there. Now three-quarters of households have their own toilet.

It also harnesses ‘pester power’: installing toilets and tippy-taps in school and teaching children about handwashing with soap so they will nag their parents to have the same facilities at home. 

Marius (right) with the headteacher of a school
where NKKD has built toilets

Creating a sense of ownership is vital if the community goes on to install shared facilities since these too must be properly maintained. So in any community project -– whether it’s a gravity flow pipeline or a school toilet block – NKKD insists that even the poorest of local communities contribute 15 per cent of the cost, either in cash or labour.

As NKKD Sustainability Mobiliser Marius Katanguka says: ‘Before, there would be breakages and nobody would be able to take care of them or nobody would be concerned.’

NKKD also works hard to ensure behaviour change is long term. In some communities it has encouraged people to draw up local by-laws relating to sanitation and it makes regular return visits to families to help embed good habits.

And all this matters of course because, as Marius says, it’s the cumulative benefits of long-term use of proper sanitation and clean water that give families the best chance of breaking out of poverty.

‘In the long term, [people’s] economic status [will improve] because the money that used to be spent in hospital is going to be saved to improve on their livelihoods,’ says Marius.