CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights?
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TOPIC: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights?

CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 21 Jan 2013 23:03 #3186

  • muench
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I recently came across this very interesting article which was published by Jamie Bartram et al., in the Journal of Water and Health.
It is such an important and well written article on an important topic that I approached IWA Publishing if they could make an exception and allow me to place the pdf file in the SuSanA library. I am happy to announce that they agreed so now I can share this article with you in the SuSanA library! See library link below.

Bartram, J., Charles, K., Evans, B., O'Hanlon, L., Pedley, S. (2012). Commentary on community-led total sanitation and human rights: Should the right to community-wide health be won at the cost of individual rights?. Journal of Water and Health, Vol 10 No 4 pp 499–503 © IWA Publishing 2012, doi: 10.2166/wh.2012.205.

www.susana.org/lang-en/library?view=ccbk...p;type=2&id=1695

Jamie pointed out in an e-mail to me:
I think what we all found shocking was not so much that these things [human rights violations in connection to CLTS] happen on the ground but that they were reported uncritically by major international agencies. And we take great care to say that we are not at all anti-CLTS. Rather that some things done in the name of CLTS should not be done (at all, by anyone, anywhere …)


Summary:

The Millennium Development Goals (MDGs) set out to halve the proportion of the population without access to basic sanitation between 1990 and 2015. The slow pace of progress has lead to a search for innovative responses, including social motivation approaches. One example of this type of approach is ‘Community-led Total Sanitation’ (CLTS). CLTS represents a major shift for sanitation projects and programmes in recognising the value of stopping open-defecation across the whole community, even when the individual toilets built are not necessarily wholly hygienic. However, recent publications on CLTS document a number of examples of practices which fail to meet basic ethical criteria and infringe human rights. There is a general theme in the CLTS literature encouraging the use of ‘shame’ or ‘social stigma’ as a tool for promoting behaviours. There are reported cases where monetary benefits to which individuals are otherwise entitled or the means to practice a livelihood are withheld to create pressures to conform. At the very extreme end of the scale, the investigation and punishment of violence has reportedly been denied if the crime occurred while defecating in the open, violating rights to a remedy and related access to justice. While social mobilisation in general, and CLTS in particular, have drastically and positively changed the way we think about sanitation, they neither need nor benefit from an association with any infringements of human rights.


After having gone through the trouble of obtaining this pdf file, obtaining permission for copyright waver and uploading it in the library, I hope that it will be useful for some of you and that those people who are interested in CLTS, or who have experiences with it, will comment here.

Regards,
Elisabeth
Dr. Elisabeth von Muench
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Frankfurt, Germany
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Last Edit: 21 Jan 2013 23:10 by muench.
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 23 Jan 2013 06:12 #3207

  • F H Mughal
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Dear Ms. Elisabeth,

It was great on your part to have obtained the IWA permission and, placing the article in the library. It is very useful and interesting paper. Dr.Jamie was kind to send me the paper, few days back. I wish, Kamal Kar, whom I met at the 6th World Water Forum in Marseille, could comment on the Dr. Jamie's paper and; on the growing criticism on CLTS vis-a-vis human rights violations.

F H Mughal
F H Mughal (Mr.)
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 28 Jan 2013 13:13 #3280

  • Petra
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Thanks, Elisabeth for inviting us to comment.

Of course, I and indeed, I think, most CLTS practitioners, condemn practices that entail human rights abuses. However, as the article itself states, these are isolated examples. And, since CLTS is an approach not owned or controlled by anyone, and relies on humans to facilitate, train, implement,... and as such , like any other approach is always open to abuse, that's just the nature of an approach that depends on human beings...So apart from speaking out against bad practice, and constantly encouraging good practice and sharing examples of it, I wonder what there is to do? Seen in context, these examples of bad practice are far and few between the mostly inspiring, well done cases of CLTS which support the basic human right to a life lived in dignity.

The assumption that CLTS encourages ‘shaming’ that is behind this and some similar publications puzzles me since a) none of the key materials on CLTS support this and b) we and others have repeatedly written to emphasize that CLTS is not about shaming and that there are also different understandings of shame – in many cultures and languages, shame is the same as embarrassment, and the shame that some practitioners talk about is not so much about outsiders shaming community members, but about people feeling shame within themselves when they realise what the implications of their own behaviour are (so it’s more about dignity and self-respect for me!) - see for example

Emotional triggers: Shame? Or shock, disgust and dignity
Is shame a bad thing?
The shame question in CLTS

I also think that perhaps rather than blaming the approach for human rights infringements, it would be good to look at the specific contexts in which CLTS is being used in that way and ask what (traditions, norms, hierarchies) leads to the approach being used in this way? Eg in India where the caste system may very much encourage extreme social sanctions...

Apart from repeatedly emphasising what CLTS is and is not about, it's impossible to police the approach, especially at community level- and, if it's really about handing over the stick to communities, it raises the question about who really leads the process if outsiders decide how it can and cannot be used? Who is it that makes a judgement about what is (in)appropriate in a community context, what qualifies as an infringement of human rights and what is really the local community policing what is important to them? I suspect that this is not just the case with CLTS but a broader question with all sorts of participatory interventions and approaches? Does this concern over what the community does with the approach mean that 'we' outsiders once again decide what the community should or should not do?

I do not feel like I want to write a defensive response because I do not feel there is a need to defend CLTS, with all the evidence out there to support that in the majority of settings it is creating very positive changes. Nor do I feel that I or we here at IDS should be the people to do it. I will ask some of our colleagues who are involved at field level to add to the discussion if they like. And it would be good to hear from Kamal, as I am sure he has some strong points to make in response.

Best wishes,
Petra

Petra Bongartz
Coordination, Communication and Networking Officer for
Community-led Total Sanitation (CLTS)
CLTS Knowledge Hub @ the Institute of Development Studies (IDS)
www.communityledtotalsanitation.org

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Institute of Development Studies at the University of Sussex
Brighton BN1 9RE
www.ids.ac.uk
Petra Bongartz
CLTS Knowledge Hub at the
Institute of Development Studies
Brighton
UK
Last Edit: 28 Jan 2013 15:34 by Petra. Reason: to add contact details
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 30 Jan 2013 12:51 #3312

  • dietvorst
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One of the key resources on the IDS CLTS web site, the 2008 "Handbook on Community-Led Total Sanitation", lists many do's and do'nts for CLTS implementers. In the light of ongoing discussions, it would be advisable for future CLTS handbooks to provide examples of unacceptable bad practices, such as those listed by Bartram et al.

Also in the same light, I wonder whether the (Ethiopian) excerpt below, taken from the above mentioned Handbook, really is an example of "good practice" that the CLTS promoters think should be shared:

"I found four men at different times defecating in open fields in our village. I ordered
them to shovel it with their hands and take it into the nearby toilet. As I caught them with their trousers down, they didn’t resist; they only begged me to allow them to handle their shit with leaves. I allowed them and they shoveled it with leaves into the toilet.”

Cor Dietvorst, Programme Officer, Global Team
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 01 Feb 2013 08:10 #3336

  • pfeldman
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Dear Elisabeth and all-

Thanks for this opportunity to comment. The JWH article raises important issues for WASH practitioners. The allegation that significant human rights violations may have taken place under CLTS or other sanitation campaigns is a concern that should not be dismissed or ignored. However, there is not a lot of evidence presented in the article for these violations; most were sourced from blog posts or workshops, at least one of which (Chatterjee’s blog post), generated widespread disagreement at the time.

What is the context in which “social coercion” rights violations allegedly occur? Does anyone understand the range and magnitude of human rights violations experienced in poor communities? Or how incidents supposedly related to CLTS fit into this context? How do local government officials, village police, or other authority figures normally treat people in these communities? I ask because I wonder if strong-arm tactics are originating from within (poorly supervised) sanitation campaigns, or if they are creeping into sanitation campaigns from social and governance systems which may have low respect for human rights in general? Even Chatterjee admits that social coercion used under the TSC was “often community-backed”. This does not justify such techniques, but it may signal that we poorly understand day-to-day (human rights) realities in such communities.

I’m also not clear on the point being made about involving children. The article references examples from Bangladesh where children whistled at open defecators, or ‘flagged’ piles of shit. I’m unclear how this constitutes a serious violation of human rights. I personally visited Bangladesh recently, and virtually all adults I interviewed spoke memorably and highly of the roles that children had played in sanitation campaigns, whether it was ‘flagging’, whistling, or otherwise. If children are violating the rights of adults in the community, what are the adults doing about it? Who’s minding the children?

The article expresses concerns with ‘social sanctions’, ‘fines’, and ‘taunting’ (cited as “effective” by the JWH article’s source). Other approaches used under the TSC allegedly included stone-throwing, women’s photographs displayed, threats to cut off water and electricity, and a ‘handful’ of toilets constructed without owner consent. These practices should not be ignored or condoned (though others working in India commented they did not believe such practices were common). This goes back to the question of how much do we really know about social sanctions in the TSC, or in CLTS campaigns? As Petra from IDS pointed out in her posting, development agencies have encouraged decentralized programs, and are generally thrilled when efforts like CLTS spread (replicate) on their own, or through government-led initiatives. Supervising or policing a rapidly expanding effort that is largely carried out beyond the view of development practitioners is going to be difficult, if not impossible. However, we do have an obligation to know more about these issues, and the JWH article is fair to point this out.

The JWH article cites an incident in Bangladesh where a local official reportedly told fathers that if their wives or daughters were raped because they had to leave the family compound to defecate, the official would not convene an ‘arbitration’ to confront the perpetrator. The JWH article cites this threat as evidence of “the extreme end of the scale” of CLTS rights violations. If such a denial of justice has ever occurred, it would indeed be cause for concern and action. However, the reader also is left wondering if this threat was ever really carried out, or if local residents even considered the ‘threat’ to be credible. The assertion in the article that ‘the right to justice has… been withheld’ therefore seems to be an overstatement.

On the other hand, accounts of women being abused because they have to defecate in the open are continuing to come in, and what is being done about it? The IPS news service reported that in Bangladesh, of 109,621 complaints of various forms of violence against women (VAW) lodged during 2010-2012, only 6,875 cases were deemed ‘genuine’ and fit for further proceedings. The Inspector-General responsible for VAW crimes told IPS, “On many occasions our investigations showed that the law was used to harass the accused. It does seem that not all complaints are genuine.” The IPS article goes on to quote the executive director of Nari Unnayan Shakti, a women’s rights NGO, who said “Due to better awareness female victims have learnt to raise their voices, but stop short of seeking police help. During our 20 years of experience on VAW we have found that police often do not cooperate with victims and favour the accused.”

Based on information and comments like this, one has to wonder how frequently a victim of rape or abuse would actually report such an incident, whether the incident took place on the way to defecate, or under other circumstances. And if reported, would it result in any legal action? The point being – does a ‘threat’ by a local official that he would not convene a rape case arbitration have any real credibility? One has to wonder how significant these alleged CLTS ‘rights violations’ are, in comparison to what appears to be a massive problem of sexual violence against women and children in South Asia and elsewhere. Given the recent and horrifying case in New Delhi, we have to ask ourselves how to ensure the rights of women and girls everywhere. Given the scale and scope of the gender violence problem, what should we be most outraged by, and taking action against?

In many communities where CLTS has been carried out, the social norms that had once freely allowed the practice of open defecation (which in and of itself has human rights implications) appear to have irreversibly changed. Were all of the techniques used to achieve this outcome perfect? Possibly not, as the JWH article points out. Were they sanctioned by the community members themselves? Possibly yes, as Chatterjee might assert. Ultimately, was the greater good (and the human right to survival, and to live a healthy life in a clean environment) served? Perhaps these and related questions should be the focus of the more “systematic analysis that the JWH article calls for.

When women and girls are still being abused and raped because their households have no toilets, or because their status in society is still so unequal to that of men, or because the criminal justice system is essentially deaf and blind to the problem of gender-based violence – what are the most pressing human rights issues that call for our attention?

In spite of my many questions and concerns about the article, I believe the authors have done the sanitation and hygiene community a good service by writing the thought-provoking piece, and I hope it leads to greater attention to human rights issues in WASH (and other development) programming. And though the issues raised by the JWH article deserve attention, I also hope that the development community does not lose sight of the many well-documented human rights issues faced due to the lack of access to WASH services, and also to the basic human rights of equality, justice, and freedom from gender-based violence.

Peter Feldman
Seattle, Washington, USA
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 01 Feb 2013 14:16 #3337

  • ben
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Hi everyone,

I just wanted to point out the similarities between the cycle of world fame followed by hard critics that CLTS is facing just like microcredit a year ago.

After his nobel prize in 2006, Muhamad yunnus and all the microcredit institutions have been hardly critizized from 2010 till nowdays, including accusation of "sucking blood from the poor" and "pushing poors to commit suicide" from high rank world officials.

So what's next, sanitation marketing ? Public Private Partnership ?
All these concepts, when they get global, will always have dark sides, bad implementation, sad stories ... you can be sure there will be always a journalist to point it out.

Every implementation concept in Water and Sanitation has to be analysed and adapted to the local context. Let's bring back responsabilities to the implementers, wherever they're from, NGOs as much as local leaders. No-one should be just a parrot applying to the coma what Kamal Kar is preaching, I think his concept is very interesting and that everyone has to pick in what ever he finds usefull. No one can deny that the shame approach is very powerfull, obviously it will never be the only catalyst for behavior change.

Thanks for bringing up the discussion,

Ben
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 04 Feb 2013 12:17 #3361

  • Petra
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I asked others to contribute their opinions and experiences to this forum and received a few interesting responses from Asia which I am sharing here on the writers' behalf:

Wahyu, WASH Advisor, Plan Indonesia

Wahyu shared his opinion that any approach implemented at the community level, where people are brought together both among villagers as well as between villagers and “outsiders” may always run into the risk of human rights abuse. This is because the boundary of human relationship under such a situation is too thin and can easily be transgressed. CLTS, which relies on intensive people interaction, has similar risks to violate human right. And it DID happen.

I’m referring to the undesirable triggering sessions where some sort of “pressure” was applied by external facilitators, community (internal) facilitators, and perhaps the natural leaders. At the point when the so-called triggered people write down their action plan, in few cases I found that some people were pushed to do so, or participated based on “being followers” spirit rather than voluntarily commit themselves to stopping open defecation. It happened due to the pressure nuances during the session. It is proven by our research that such a pressure won’t result in a sustainable ODF status. They slipped back to OD. In this instance I think we need to recognize that CLTS might have violated human rights.

What about shame?

I have never come across a case where shame was put upon the communities by external facilitators or outsiders. The shame came to the surface as the communities realized that open defecation was something bad, and it is something that came to their mind as they are engaged during the triggering process. This is surely debatable, especially for those who have never had a hands-on experience of CLTS triggering. But my point is we’re outsiders who come to the village with the objective of discussing with the community if open defecation is bad practice. If they say it is, then people will feel the shame. But when the people say nothing is wrong with open defecation, please do remember that, as recommended in the Handbook, we’re free to leave them. No shaming as part of our intention, definitely not in the good triggering process.

Nilusha, WASH Adviser, Plan Srilanka

The application of the CLTS approach in different cultures brings diverse interpretations, impacts and experiences. Having a latrine definitely contributes to the dignity and social status of a person and it has been proved in several social research works in our country. Dignity and avoiding shame are like two sides of the same coin. Implementing the CLTS approach by giving/promoting dignity among the people and communities especially those who continue the OD is a good strategy rather stressing on shame. It’s about the interpreting the same thing in different ways to reach same target.

Jorge Álvarez-Sala Torreano, Senior Advisor/ Programme Leader WASH, SNV in Vietnam

CLTS has been successfully introduced in many countries and contexts. Millions of people globally have changed their behaviour and are stopping open defecation. Of course there could be exceptional cases where CLTS has not been applied properly and has created problems, but again, I think that those cases are really exceptional.

Nitish Jha, Staff Consultant, ADB Vietnam

Open defecation occurs because it has long received public sanction, and CLTS tries to eradicate it by altering the public mood against supporting such a practice. However, any "shame" experienced is watered down because the embarrassment is shared by all members of the community and does not single out an individual or household. From what I have observed, it does not (or should not) try to insult or demean -- intentionally or otherwise -- either the target community or individuals within it.

But, as with everything, this answer depends on the context. [...] In one case of "autonomous" CLTS in India (although I hesitate to call it CLTS because no external trigger or agency was involved), a community's leaders carried the message to all members and, with the help of cross-subsidies from richer to poorer households, managed to achieve total sanitation in the village. The community also agreed and instituted its own rules for "shaming" and fines for those who continued to defecate in the open rather than use their newly built toilets. But in practice, the few caught doing this were always spoken to privately rather than in a public meeting or forum, and fines were rarely levied. If they continued to offend perhaps a public meeting would have been called to address the issue but this had not yet happened at the time I came across the village, which was probably 6-8 months after total sanitation had been achieved. Public shaming was held out as a last resort sanction or punishment, and it appears that the mere threat of it was enough.

But if a community shames its own members in public interest, can we argue that it is a breach of individual rights? Consider that in many urban settings, people are encouraged not to litter, urinate or even spit in public areas. I think it hardly constitutes an infringement of their individual rights if they are shamed into not doing these things, or if a fine is levied on them if they do. Open defecation is comparable. By its very definition, it almost always occurs in public areas or negatively affects a public good (e.g., a water source, or community health).
[...]
The practice of "shaming", in and of itself, is not the culprit. Instead one should ask questions like WHO is doing the shaming, and HOW is it being done?
Petra Bongartz
CLTS Knowledge Hub at the
Institute of Development Studies
Brighton
UK
Last Edit: 04 Feb 2013 12:18 by Petra. Reason: correction
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 20 Feb 2013 07:11 #3526

  • Marijn Zandee
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Dear all,

First of all, thank you Elizabeth for making this article available to those of us who do not have regular access to journal articles. Also thank you to Petra and others for providing some counter arguments.

I will start by saying that I would probably be put in the CLTS critical group by most people, but I also realize that there have been significant impacts. One thought that struck me reading the article and the responses was the wider question of "being relativist about human rights". This is a difficult discussion, mainly focusing on the issue of how universal human rights really are and should be? I think we see a sort of pragmatism/realism versus a more "principled" approach in the discussion here.

Another thing that happened to me reading the article was that I found a word for something that has made me feel uneasy about CLTS for a longer time: "conflict sensitive development" also know as the "Do no harm" framework. As usual I write this post from a perspective of working in Nepal, which is a post conflict country. In Nepal,unfortunately, one of the legacies of the conflict is that in some communities and regions using violence and other forms of coercion have become acceptable to an unhealthy degree as ways of "forcing decisions". Also in many of the larger population centers (district head quarters, etc.) there tend to be groups of young man that can be used by local "strong man" (either from political parties or outside them)to show strength and use violence. These groups tend to be mobilized when existing power balances are disturbed and or challenged. Obviously I am not writing this post to defend these practices .

My question to Petra (or other CLTS community members) is the following:
"Has there been a critical self examination of the CLTS framework through the lens of conflict sensitive development/Do no harm? And if that has been done, is there also a set of guidelines/recommendations resulting from this process?"

A second, only partly related, question that I emailed to the CLTS website once but was not answered:
"Are there any case studies following-up CLTS triggered communities (5 years on), which do show that the impacts are sustainable, the communities still ODF and that communities have moved up the "sanitation ladder?"

Kind regards

Marijn Zandee
Marijn Zandee
Technical Advisor
Nepal Biogas Promotion Association (NBPA)

Deutsche Gesellschaft für
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 20 Feb 2013 11:44 #3529

  • joeturner
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I'd like to add to Marijn questions:

1. Is there any evidence of progression of communities up a sanitation ladder?

2. Is there any evidence of measurable improvements in Open Defecation Free villages (such as cleaner water or health improvements)?

3. Are villages which have taken the initiative to build their own facilities discriminated against when agencies look for communities to work with (given that they may be said to have some sanitation)?

The shame question is an interesting philosophical point. On the one hand it does appear to involve some level of embarrassment and lowering of human dignity. But then I don't know that you can truly say that other WASH interventions are not also based on the same idea. To suggest to a community that a new latrine or water system might be appropriate is also to imply that the options they have are inferior. Given that communities are unlikely to understand the reasons behind sanitation and hygiene messages, there is ends-justify-means thinking in operation. In western countries with full sanitation, there is definitely a level of compulsion (involving fines, taxes and legal action) that encourages users to engage with the system rather than living without it. The vast majority of Western users co-operate with sewers because it is far easier than the alternatives/penalties, rather than because they have full knowledge of the benefits and have made a rational choice.

Shame, as far as most people in most INGOs are concerned, is a valuable emotion - otherwise they would not use advertising that appealed to shame, disgust and anger to attract donations.

That being the case, why should those involved in CLTS not use shame? What is so special about users of the interventions which means that they are protected from the same methods that are used routinely on the donors of the same project - both for their own sanitation and for the donations?

I think the answers to those questions come back to the ones I pointed to at the beginning. If there is little obvious progression on a sanitation ladder, if the interventions triggered are poor, if there are no obvious benefits, then I think that changes the nature of the shaming act. And it becomes extremely problematic to read of community members in triggered communities who rejected the process because their 'aspirations are too high' or because they have (possibily legitimate) reasons to believe that doing something themselves will mean they are bypassed when better interventions are distributed in the area in the future.

I don't believe that anyone in a community that prior to triggering was unaware of the importance of sanitation is able to build themselves anything that can be considered useful sanitation. The knowledge level is too low. Hence the systems are almost bound to fail.

Another very problematic issue is what users are supposed to think of interventions they are offered when they know that other, better, interventions exist. Rationally individuals should accept anything as being better than what they have. However in practice communities may reject these interventions (as happened recently in South Africa) and claim that they are being treated as second class citizens and second class humans.

As far as I am concerned, that feeling is not only understandable, it is right.
I don't work for anyone, I am a philosopher interested to think about how we think about WASH and sanitation. All thoughts are mine alone, I am responsible for any errors.

Previously trained and worked as a Soil Scientist and worked on projects composting sewage sludge.
Last Edit: 20 Feb 2013 11:47 by joeturner. Reason: grammar
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 20 Feb 2013 14:52 #3532

  • JKMakowka
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joeturner wrote:

I don't believe that anyone in a community that prior to triggering was unaware of the importance of sanitation is able to build themselves anything that can be considered useful sanitation. The knowledge level is too low. Hence the systems are almost bound to fail.


Most people are not aware of the importance of sanitation and rather evaluate available sanitation solutions according to their convenience and cost factor (case in point: open defecation is more convenient that other options when individual costs are taken into account for most people that practice it).
Obviously it requires knowledge and skill to construct a worthwhile sanitation system out of "sticks & stones", but if there is a market available for affordable and appropriate (and hopefully convenient) sanitation components, people can easily construct useful sanitation systems themselves.

joeturner wrote:

Another very problematic issue is what users are supposed to think of interventions they are offered when they know that other, better, interventions exist. Rationally individuals should accept anything as being better than what they have. However in practice communities may reject these interventions (as happened recently in South Africa) and claim that they are being treated as second class citizens and second class humans.

As far as I am concerned, that feeling is not only understandable, it is right.


I disagree.
This basically comes back to the long discussion of water (&sanitation) as a human right. While it sounds logical at first, it really is a completely different thing than other human rights which (except in special cases) need to be actively violated instead of just neglected.
However, I can understand that people complain (in special cases) to their elected leaders that promised certain level of sanitation interventions to "keep their promises" (and efficiently use the tax-generated funds), but often people that are doing so are just spoiled by donor handouts or cross-subsidies.
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Last Edit: 20 Feb 2013 15:01 by JKMakowka.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 20 Feb 2013 16:36 #3534

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JKMakowka wrote:

I disagree.
This basically comes back to the long discussion of water (&sanitation) as a human right. While it sounds logical at first, it really is a completely different thing than other human rights which (except in special cases) need to be actively violated instead of just neglected.
However, I can understand that people complain (in special cases) to their elected leaders that promised certain level of sanitation interventions to "keep their promises" (and efficiently use the tax-generated funds), but often people that are doing so are just spoiled by donor handouts or cross-subsidies.


Thanks for this. I disagree that this is a 'rights' discussion, my final phrase was to suggest that those who feel that they're being offered something (which they perceive to be) inferior are correct to feel that they are being treated as second class citizens - what else can they feel if they live in a place where 80% of other people have flush toilets? That to me is a perfectly logical conclusion when offered a bucket toilet.

I don't think that is quite the same as a 'human rights' discussion. And I reject the idea that someone who aspires to more than a bucket toilet has been spoiled by anything.

To me this underlines a problem with the way we talk about sanitation - as if some intervention that is objectively totally inadequate should be welcomed because it is 'better' than some really horrible alternative. People don't think like that. If you offer them something that sounds like a cut-price and poorer alternative, why should they not be upset?

And moreover, why should everyone else not be upset on their behalf that they only thing they're being offered is something which we all know is totally inadequate?
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Previously trained and worked as a Soil Scientist and worked on projects composting sewage sludge.
Last Edit: 20 Feb 2013 16:39 by joeturner.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 21 Feb 2013 10:32 #3537

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The article you linked was not very specific in details. However was there some specific thing actively preventing them from building an flush toilet themselves? If not I don't quite understand your issue.
From a regulators point of view it is correct to force people to have *some* sort of sanitation solution for public health reasons, so either they build themselves what they consider adequate, or they have to accept what is being offered.
Of course a smart offer would include a cash subsidy equal to what the offered solution would cost, but not in every case that is really feasible or anywhere near of what people would need to pay for the flush toilet.

Now a different case would be if they were offered an expensive but inadequate solution, like done in a case with a badly designed vacuum toilet system in South Africa etc. (edit: well designed vacuum sewers are a good idea in many cases though).

Besides (but I guess you know that) a properly designed and operated waterless toilet is not inferior to a flush toilet (I wouldn't mind switching myself, and have used one for longer periods in the past).
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Last Edit: 21 Feb 2013 10:41 by JKMakowka.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 21 Feb 2013 10:46 #3538

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JKMakowka wrote:
The article you linked was not very specific in details. However was there some specific thing actively preventing them from building an flush toilet themselves? If not I don't quite understand your issue.


I'm sorry, I was blogging about the concept rather than the specifics. In brief they are that the SA government has a responsibility to ensure that everyone has basic sanitation. In Durban/eThekwini, over 80% of residents have flush toilets. Of the rest, there has been a massive programme of building VIP-style latrines, which are emptied periodically by the municipality. This particular group has been offered UDDT which are basically buckets for reasons of cost. More details here

That they could build their own flush toilets is irrelevant. The government has decided that it cannot afford to offer them more than bucket toilets.


From a regulators point of view it is correct to force people to have *some* sort of sanitation solution for public health reasons, so either they build themselves what they consider adequate, or they have to accept what is being offered.


Which ignores the objective fact that bucket toilets are totally inadequate. And also does not engage with my point - in that human psychology means that people are inclined to reject things when they feel they are being short-changed. In this case they are right, they are being short-changed.


Of course a smart offer would include a cash subsidy equal to what the offered solution would cost, but not in every case that is really feasible or anywhere near of what people would need to pay for the flush toilet.


A smart solution would be to offer people a sanitation offering which is adequate. Clearly by any measure a bucket toilet is not as good as a VIP toilet which is not as good as a flush toilet.

Now a different case would be if they were offered an expensive but inadequate solution, like done in a case with a badly designed vacuum toilet system in South Africa etc.
I don't know anything about that.

Besides (but I guess you know that) a properly designed and operated waterless toilet is not inferior to a flush toilet (I wouldn't mind switching myself, and have used one for longer periods in the past).


Based on what, exactly, do you make that statement? Dry toilets do not kill pathogens sufficiently to be safe. So no, they are definitely inferior and are unsafe. I accept there are different types of flush toilet and that there are problems where they flush into septic tanks. But a drain-and-sewer flush toilet is absolutely and undoubtedly safer than any kind of dry urine diversion toilet or VIP system.

It is not about the design and engineering, it is about the science. Small scale cold composting does not kill the pathogens. Therefore it doesn't work. Therefore it is not safe.
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Previously trained and worked as a Soil Scientist and worked on projects composting sewage sludge.
Last Edit: 21 Feb 2013 10:47 by joeturner.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 21 Feb 2013 11:07 #3539

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I agree that if the SA's government has a law that they have to offer basic sanitation, and that if they build VIPs in the past in the same area (I assume the flush toilets where self financed?) the solution for the remaining inhabitants should be equally convenient (to avoid wasting money on something that isn't used). However if there isn't any money for that, what exactly is the respective agency supposed to do?

But as mentioned above, a properly designed and operated dry toilet, with a feces collection system and professionally run composting sites is vastly superior in any sense to a VIP toilet that is emptied from time to time (and the sludge dumped somewhere).
And a case could be made that it is also better than the typical "leaky sewer, no properly running waste-water treatment plant and discharge into a water body that is used for drinking water abstraction, fishing, irrigation etc." classical solutions, besides being much more cost efficient and less prone to technical breakdown.
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Last Edit: 21 Feb 2013 11:16 by JKMakowka.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 21 Feb 2013 11:22 #3540

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JKMakowka wrote:
I agree that if the SA's government has a law that they have to offer basic sanitation, and that if they build VIPs in the past in the same area (I assume the flush toilets where self financed?) the solution for the remaining inhabitants should be equally convenient (to avoid wasting money on something that isn't used). However if there isn't any money for that, what exactly is the respective agency supposed to do?


I'm not offering solutions as much as illustrating that it is a rational belief to reject CLTS and poor sanitation offerings, even if they can be said to be better than no sanitation.

But as mentioned above, a properly designed and operated dry toilet, with a feces collection system and professionally run composting sites is vastly superior in any sense to a VIP toilet that is emptied from time to time (and the sludge dumped somewhere).


Totally agree on this point. Mesoscale composting is the only ecosan composting toilet system that works. All other types of composting toilet are bunk.

Of course, there are very high health risks associated with the collection and operation of a co-composting site, especially for the workers.

And a case could be made that it is also better than the typical "leaky sewer, no properly running waste-water treatment plant and discharge into a water body that is used for drinking water abstraction, fishing, irrigation etc." classical solutions, besides being much more cost efficient.


I think we agree more than we disagree. Properly run mesoscale composting and vermiculture systems are the answer. VIP latrines and pit latrines are not. But even that is a minority view, as far as I can tell.

I am no fan of flush toilet systems, mesoscale composting sites work well. But it is definitely true to say that a person who has a bucket or a VIP latrine is aspiring to something better by looking for a flush system. The challenge is therefore to persuade him that a composting system is as good as a flush system, rather than to try to persuade him to use poor quality bucket or VIP systems.

With regard to CLTS, I cannot see anyone having enough knowledge of mesoscale co-composting to safely construct their own system, can you?
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Last Edit: 21 Feb 2013 11:24 by joeturner.
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 21 Feb 2013 12:57 #3542

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joeturner wrote:

With regard to CLTS, I cannot see anyone having enough knowledge of mesoscale co-composting to safely construct their own system, can you?


Yes, good idea to get back on topic

In my opinion CLTS alone only really works (and was originally intended and tested) in remote rural areas. This is both because of social factors (which partly plays into the problems that were discussed previously in this topic) and because in low population density areas low-tech solutions like the Arborloo that don't require emptying are usually acceptable from a public health point of view. Besides that, you will rarely find an rural area with a high percentage of flush toilet systems, the remaining users could aspire too
However, some components of CLTS can be used in an (peri-)urban setting for demand creation of a service model that incorporates meso-scale composting for example.
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Last Edit: 21 Feb 2013 13:00 by JKMakowka.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 05 Jul 2013 12:29 #4945

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The project under scrutiny is suppored by an organisation piloting UDDT in Ethkwini municipality in SA.

When I visited the locating in 2008, the facilities were poorly maintained due to several reasons, and not due to technical competence of the facilities. Also, some toilets were water logged while some were well maintained and I am pf the opinion that there were several lessons to be learnt as a result of the pilot programme.

In Nigeria, type of excreta disposal facilities at household level is the prerogative of the household since the policy says its the household responsibility, with locations advice and support from the EHOs. Government only supports the software component of training and advice and pilot with donor assisted funds and not direct construction of toilet in households, while through CLTS, so many communities have been triggered and are ODF as a result of better understanding of various detrimental issues related to open defecation.

There has also been a comparative study, being rounded up in Osun State, Nigeria in 3 communities (subsidy driven, pure ODF triggering and ODF prior to CLTS), with various degrees of lessons and outcome results.

However, there have also been several reports of FORCED COMPLIANCE as part of CLTS, aimed at recording success at all cost by programme drivers and this is a source of concern, from human rights perspective.
Femi Aluko

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 05 Jul 2013 14:56 #4947

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ooaluko wrote:
However, there have also been several reports of FORCED COMPLIANCE as part of CLTS, aimed at recording success at all cost by programme drivers and this is a source of concern, from human rights perspective.


While I agree with the general concern, shitting on the road or in a nearby bush will get you arrested and you will have to pay a penalty fee in basically every developed country (if a police officer sees you). And while that is of course not completely comparable, I don't think anyone would cry out that that is a violation of human rights.

The violation of human rights is that the person does not have access to an adequate sanitation facility, not that he or she is forced to use it.

Edit: Having the human right to an adequate sanitation facility does however not mean that the individual can keep idle and wait for the government or some other actor to build it. It does however mean that government has the responsibility to enable everyone to build one, be that through technical support, enabling supply chains, building main sewerage lines (and subsequent treatment) or even providing subsidies to the poorest.
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Last Edit: 05 Jul 2013 15:05 by JKMakowka.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 05 Jul 2013 15:19 #4948

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Dear Makowka,

your submission is great and understandable but social inequity ramifies the people domiciling in many rural communities where bush abounds and that is why about 22 million people was estimated to be indulged in open defecation in my country. If a police man is pressed, will go into the bush and practice open defecation.

There is minimal number of commercial defecation sites, operated through PSP while efforts is channeled towards household angle, mostly, through CLTS.

supply chain (through sanitation centres) failed previously and hardly work since you still expect the people to patronise vendors for sani wares.

its a complicated situation in terms of enforcement and management of meeting the sanitation MDGs from the human right perspective.
Femi Aluko

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 05 Jul 2013 21:35 #4951

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I am not really a fan of CLTS due to various other reasons, but if you really look at it closely you realize that it works (most of the time) because it makes people enforce compliance from others.

And that is not necessarily a bad thing as written above and also because we (you in this case) are all too quick in excusing OD behavior and blaming it on some more or less external factor like poverty etc.
The reality is however that for people who practice OD it is often simply more convenient or at least building a toilet ranks very low on their list of priorities.
Now the last part is somewhat understandable, given the stark realities many people face, but it is also true that even the most simple HH pit-latrine is an improvement over OD from a community health point of view, and that is something anyone can build for free. However unless forced to build & use one, many people simply can't be bothered.

Add to that, that a cheap and simple to build Arborloo type of latrine can actually be seen as an "adequate" sanitation solution in really rural areas, I don't see how we should continue to excuse OD behavior on the epidemic extent it is still practiced around the world.
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Last Edit: 05 Jul 2013 22:06 by muench.
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 15 Jul 2013 12:03 #5048

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Dear Julius,

I think in your before last post, you do make a very important point, but I am not sure you realized this;-). In any case, I had not thought about this before, but I think it is important.

While I agree with the general concern, shitting on the road or in a nearby bush will get you arrested and you will have to pay a penalty fee in basically every developed country (if a police officer sees you). And while that is of course not completely comparable, I don't think anyone would cry out that that is a violation of human rights.


I think there is a subtle thing here that is very key to the human rights angle of this thread. The word "police officer", in "the North" a police officer is a person authorized by the society to "police", in other words: to make sure people stick to the law. It is very core to the way our society is structured. And more importantly, a core function of having a police force is to make sure people do not take the law into their own hands, which leads to a situation where the strongest person gets his or her way.

If looked at it in this way, i think I can word some of my hesitation towards CLTS as: "CLTS encourages people to police (and discipline) each other,rather then leaving this to the (theoretically) impartial state. I do think there is a serious problem with this, and even though I am not a specialist I am quite sure this does go against the spirit and possibly against the letter of the human rights conventions.

Thanks, for getting me on this track,

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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 15 Jul 2013 17:03 #5049

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Marijn Zandee wrote:

If looked at it in this way, i think I can word some of my hesitation towards CLTS as: "CLTS encourages people to police (and discipline) each other,rather then leaving this to the (theoretically) impartial state. I do think there is a serious problem with this, and even though I am not a specialist I am quite sure this does go against the spirit and possibly against the letter of the human rights conventions.


Hmm, you are right I did not really think of this, even though I was subconsciously slightly hesitant to make that comparison.

I have to say that I agree with your insight theoretically, but such self-policing would and does happen in "western" countries too, where OD behavior is highly frowned upon and would result in expression of disgust, ridicule or worse.
And pragmatically speaking I don't see how that is not justified to some extend too, as after all OD behavior is directly detrimental to the health of all community members (and the police can't and should not be everywhere).

I guess it becomes problematic if really serious actions are taken, as in some of the examples described in the beginning and/or when power is abused by outsiders with an ODF agenda (government officials etc.).

On a quick thought, maybe it would make sense to create some sort or elected community committee to deal with conflicts arising from the CLTS process, as a sort of self-governing solution? But I guess in praxis it wouldn't make much difference as the majority could still "terrorize" a minority.

Ultimately I am however of the opinion that such extreme measures of self-policing do not happen normally, but are rather results of outside interference. An example for this would be the modified CLTS approach that includes handing out some reward after the community reaches ODF status.

P.S.: The reason I personally dislike the CLTS approach is a different one: I think in really rural areas where it admittedly works well, stopping OD is simply of relatively little concern due to low population density and largely useless in the presence of much livestock living directly amongst the people.
In more densely populated areas, CLTS becomes less and less effective due to different social dynamics, while on the other hand the public health concern becomes more stressing which ultimately should prohibit a "no-subsidy" approach like CLTS. And as explained above, including subsidies in CLTS leads to all sorts of unintended and negative consequences (which I think the original creators of CLTS realized very well).
Krischan Makowka
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Last Edit: 15 Jul 2013 17:31 by JKMakowka.

Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 24 Dec 2013 12:29 #6792

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Shaming people, especially women, to stop open defecation, has again drawn criticism. This time in the Indian state of Madhya Pradesh, where a local government guideline promotes "tricks" to change behaviour "from catcalls to publishing names to photographing the people caught". Read "India, Madhya Pradesh: sanitation campaign humiliates women, say critics" at http://wp.me/aGBZ


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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 24 Dec 2013 13:26 #6794

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Dear Colleagues,

Take it easy...
Don't we have all our own "human rights" on our own stupidity and ignorance?

CLTS and any of best sustainable WATSAN approaches will not change a bit on ongoing larger global developments regarding "stupidity and ignorance". I do not want to list down all the higher level odds, you know them all too.

Practicing real equal "human rights" on this higher level will abolish by it self over the time any CLTS's and others too...

All the Best
Detlef SCHWAGER

E.g.: Just one for X-mas, try to imagine by your self, what would be happen to African, Latin-American aid-workers, who maybe campaigning with TOTAL "Blame and Shame" about the many thousands of death Africans, Latin-Americans and Others in the Meditation Sea and on the US south-border throughout US and Europe... Will the Communities join them?
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 11 Jan 2014 21:42 #6948

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Recently came across this interesting document:

www.ids.ac.uk/publication/the-dynamics-a...llenges-and-pathways

As we have been discussing the more "philosophical" challenges of CTLS, it seemed to fit rather well here.
Krischan Makowka
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 29 Jan 2014 06:37 #7151

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Also relevant:
onlinelibrary.wiley.com/doi/10.1111/dech.12075/abstract

"In Indonesia as elsewhere, CLTS involves more than just education and encouragement; it uses social shaming and punishments. The authors argue that this is not only an inadequate approach but one which echoes coercive, race-based colonial public health practices."
Krischan Makowka
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 29 Jan 2014 11:31 #7155

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This open access article is well worth reading. It contains harsh criticisms of how the WSP/World Bank implemented the CLTS approach in Indonesia. Interested to hear their response. See the post in Sanitation Updates, wp.me/paGBZ-2wM
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 30 Jan 2014 10:33 #7162

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I can only repeat:
forum.susana.org/forum/categories/5-clts...12&start=12#6794

I would be very interested in the views on CLTS of colleagues from Africa, Asia and America!

Regards,
Detlef
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Re: CLTS and human rights: Should the right to community-wide health be won at the cost of individual rights? 07 Feb 2014 09:01 #7279

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Hi all,

My first posting - I'm one of the authors of the article about CLTS in Indonesia. I do agree Detlef that human rights issues are global, as an Australian our treatment of refugees arriving by boat at the moment appals me but equally nothing will change at any level if we don't speak out against it!
I'm also hoping for some response from the World Bank, we sent it to the Jakarta office, so we'll see. But in the meantime the response from others interested in sanitation has been great. The question is how do we keep the debate and scrutiny of CLTS going? Any suggestions?

Best,
Susan
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