Thanks Carolien. I don’t want to get into a tit-for-tat discussion, so I will approach my response slightly differently. Along with many others I want to do my best for the sanitation crisis. My particular key driver is to be an enabler of self-sustainable sanitation. So with that in mind, especially as I have just come back to the hotel from a Tamil Nadu field trip, can I say the following.

In Tamil Nadu we have supported/been supported by the state government and there are some 40,000 people who have access to UDDTs; this is family, schools and per-urban facilities. Our first school ecosan is 10 years old this year and still in use and looking great. In fact, to celebrate the 10th year anniversary, in the autumn we will be web publishing a few stories that will be largely based around some simple personal experiences. We will let the forum know when we have uploaded things to our web site. When global hand washing day took place last year we actually had 25,000 children take part.

We know from experience that those children go back to their parents and badger them to have clean, non-smelling toilets similar to the ones they have at school, generally rather than OD. Those parents come to us and request help in having their own toilet. As far as we are concerned the first stage is achieved, we have created demand.

The second stage is to satisfy the demand.

Until recently that has been much easier to do in India than most other countries. Subsidies have existed that offset the cost of a UDDT, which I acknowledge is more expensive than other toilets, especially if you want them to last for decades. That system has now changed and it is much more difficult to carry out the same work knowing the subsidy will be paid. (In this way maybe CLTS will win out anyway!)

Having built units we then follow up with the toilet’s owners and work closely with local motivators to make sure they are used often and properly. That’s stage three. As I have said elsewhere, in rural areas this has been very successful for us and have circa 90% usage after two years.

Today, a woman came up to my colleague and said that she was a school (UDDT) toilet user, with a family UDDT at home and has now got married and moved away. She doesn’t just want a pit toilet because she can see all of the advantages of an ecosan, but they cannot afford to build their own, even with the government subsidy. We don’t work in her area, so cannot help. We are only a small organisation after all. But we’ve done our job as far as her demand is concerned, and done it well.

The first time I met (the very wonderful) Jack Sim he was explaining about starting with a basic pit, moving to VIP and onwards up the sanitation ladder. I understood his argument, but disagreed. I have always aspired to give people the best from day one. I don’t see reports saying that a community that started with pit toilets has moved up the ladder to successive improved stages until they reach the pinnacle of whatever is available.

It is very much my opinion, but I truly believe that if, over the past 10 years, we had invested in sanitation units combined with the triggering and motivation of systems such as CLTS, there would now be more people with toilets around the world, and more inclination on behalf of international funders to invest further, greater, sums to solve this terrible crisis. I don't think we have been seen as successful and the 2.4 billion figure would possibly bear that out.

Best, David

Dear David,

Many thanks for taking the time to write such a detailed response to my article. You make a couple of points I agree with and a couple of points I don’t.

First I’d like to set the record straight. CLTS done well (and clearly, your example from Sierra Leone does not reflect CLTS done well and if the situation really is as you describe it, I’m sure WaterAid would agree) is much more than a training exercise. Sierra Leone was an early adopter, and CLTS in Africa has come a long way since then. It is our conviction that CLTS and its associated approaches are cornerstones to affecting a collective behavior change that is key to ensuring that large amounts of people do not only have access to, but also use safe sanitation and practice the associated hygiene behaviours. The Global Sanitation Fund was set up to seriously address the sanitation crisis in the world. Considering we’re still looking at 2.4 billion people without access to sanitation we are not going to tackle that crisis 25 villages at a time. So you are right that we are targeting the big numbers, and we do not think that’s a bad thing. You are also right in saying that we think that focusing on large scale sanitation and hygiene behavior change is value for money. Considering the size of the challenge, the limited public finances available, and the broad sector experience that providing people with hardware doesn’t automatically lead to increased use and improved health, we think the smartest decision governments can take is to strongly focus on behavior change.

However what you describe makes it sound as if those engaging in CLTS type approaches have no interest in sustainability, and do not understand that there is a technology component to sanitation or that there is a sanitation value chain. That is a misrepresentation of reality.

First, on sustainability. While engaged and inclusive triggering is an important aspect of CLTS, the follow up is as least as important. This includes repeated visits, inclusive household by household engagement (wives are important motivators when it comes to your lazy men), systems for tracking progress and for supporting those that require extra assistance, and much more. It also includes a focus on building local (community) governance mechanisms to ensure that the collective behavior change is sustained and slippage issues are dealt with, that collapsed pits are rebuilt, that innovative designs are shared and replicated among communities, etc. This generally means that more effort and resources are put into this longer term support and building of institutional structures than goes into the original triggering.

Secondly, on technology. Focusing specifically on rural sanitation and on site solutions, GSF recognizes that there are cases such as your flood prone areas where more sophisticated technology is required (although with our partners we have found that even in such cases there often are local solutions to many of these challenges that can be used to stimulate and inspire others, sometimes with a minor external support in improving the technology slightly. We call it participatory technology development in for example Togo and Nigeria) . We also recognize that there are settings, like in many Asian countries, where people do not aspire to a basic pit latrine but want higher end toilets. It may very well be that households need to access additional finances to afford such technologies, and we are gaining experience both with micro-finance and with accessing government subsidy schemes such as in India, and we are hoping to report on that experience in the coming months. One important element for us in this, is sequencing. We believe, and along with other agencies in this field are slowly gathering evidence to suggest that programmes that first and foremost succeed in changing people’s habits, have a higher chance of long term success in terms of sustained sanitation and hygiene behavior and use of improved facilities.

In addition, where the context is such (particularly in more peri-urban areas) that there is an immediate need for sanitation services further down the chain, be they pit emptying, reuse or otherwise, GSF-supported national programmes can incorporate such elements. Same with public facilities such as schools, healthcare centres, public buildings etc. where we generally form partnerships to ensure the required hardware investments are made.

Thirdly, on scale. GSF’s aim is to work with member states to achieve universal coverage. This requires reaching thousands if not millions of villages each year, and it requires using the available resources in a very smart way. It is our conviction that collective behavior change coupled with the creation of national sanitation movements and structures in which all stakeholders at all levels are empowered and enabled to act, is the only way the sanitation sector might even remotely achieve these goals. This isn’t just rhetoric. We invite you to come visit one of our African programmes to see for yourself that CLTS can be much more than a ‘training exercise’, can instead be the bedrock of a sustainable approach to collective behavior change and safe sanitation and hygiene. You can also have a look at our most recent progress report for the GSF. I especially invite you to read pages 7 and 8.

Lastly, we hope to be sharing some of our detailed case studies within the next two months and I will make sure to post them on this platform as soon as they come out, so we can continue the discussion.

Best regards,

Carolien van der Voorden

Carolien, I have just seen your article and there are a couple of points I would like to raise. Some of the text below sets the scene.

www.theguardian.com/wsscc-partner-zone/2...water-and-sanitation
The human right to water and sanitation
Water and sanitation are fundamental human rights, and providing access through CLTS is a way of empowering the most unconnected and disadvantaged

I have just come back from Sierra Leone, where we work in two chiefdoms in the South east District of Pujehun. Our core work is sanitation and water and we build community UDDTs instead of family models, largely because of the high cost of materials, and UDDTs because it is a flood risk area. To date, some 20,000 people now have access to sanitation and water (plus livelihoods and schools, but that is another story).

The local man who acts as our on the ground liaison comes from a well regarded local family and, since he started working with us, has risen to a councillor and, more recently, to being an MP for a section of the District. He openly acknowledges that his work with us helped him become an MP. He also asked a question in parliament about how many other MPs had such facilities in their constituencies and not one got anywhere close. In fact, from what I understand, not one MP even raised their hand.

I haven't been to Sierra Leone for nearly three years, Ebola played a large role in the last year and also because my colleague who looked after the projects has subsequently left. I was very surprised to see signs scattered throughout the villages we drove that stated they were ODF because of funding channelled by Water Aid through a local training organisation. I asked my colleague what this was about and he roared with laughter. He then got us to stop at a couple of different villages and we spoke to the village chief and a few people. They all had a good laugh together and basically (I paraphrase, but you will get the idea) explained that some people turned up, explained why they should not shit in the open, came back once more and then declared the village ODF. The thing that made them laugh most was the majority of people from the village were working in the fields at the time of the training. The village(s) are still largely practising OD as it did previously.

Yes, there are a few pit toilets. In fact, even in villages where we work there are self-built pit toilets because the queue for the community toilets in the morning is so long that people cannot wait and have decided to build their own. This is great, except, as I mentioned before, it is a flood risk area — and we all know what happens when floodwaters meet pits.

Last year Kamal Kar stated at WWW that he was aware that most pits constructed after CLTS training collapse within the first year. Actually, during a debate on SuSanA it was subsequently stated by the CLTS Foundation India that they often collapse within four months. This debate stopped when CLTS India refrained from answering any more questions. The pits are mainly dug by men, often reluctantly (my opinion is that in general men are pretty lazy about such things!), and the chances they will dig another so quickly after the first collapses are remote.

With the exception of Bangladesh and Cambodia, I don’t think there has been any countrywide success of CLTS. I do acknowledge there have been individual successes.

CLTS is a fantastic training method, but in my opinion IT IS a cheap, quick fix solution to a sanitation crisis that needs investment. It enables high numbers to be ticked off a list and offers a very good 'value for money' solution for people who only look at the bottom line, mainly Govts and large NGOs. Sanitation is unlike any other form of development and should be treated as such. Look at our economic figures on SuSanA with our small survey of families in Pondicherry, you may find it interesting.

We use a similar process to CLTS called Village Development Committees in India and we build UDDTs, which have a minimum life of thirty years, using Govt subsidies. Our rural survey shows that after two years pretty much 100% women, girls and boys are using toilets (men take longer but even they are an average of circa 70%). To me this is what investing in sanitation is about – long term, sustainable solutions.

As you may tell, I get very upset when I see CLTS presented as a panacea to the sanitation crisis, because it isn't. If anything it is really muddying the waters because, unless it adopts a policy of building an actual toilet, at some point we are going to have to go back and do the whole thing again. It is a waste of time and money and that is going to make a lot of institutional funders very upset.

I would like to end my rant with a story about Sierra Leone. When I first went there in May 2006 I was told, and believe me this was a throwaway line, that one child in a village of 750 people died approx. every month from some form of diarhhoeal illness. Based on checking village registers and speaking to local people, in the 25+ villages in which we have worked we cannot find evidence that one child had died from diarrhoeal illness since we installed sanitation and water facilities. (Obviously this cannot be called definitive, but is something we want to focus on in more detail later this year). This is actually obvious when you visit villages with and without toilets. There are more children in the villages with toilets! Although families appear to be having 4-5 children, rather than 6-7 – also part of out next survey. The first village now has a population of over 1,000 because people are moving there because they have better facilities and better health. Also, as my colleague noted, it being her first visit to SL, the women in villages where there are toilets are far more prepared to engage you in conversation than those without toilets.

What we do isn't perfect and I know there are people/orgs that don't like it, but at least I can show that all of our work is effective and can look my donors (who are generally hard-nosed business people) in the eye and tell them that truthfully.

Best Regards, David