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

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

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

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

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

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

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

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

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

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

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

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

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

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
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