Beyond Construction USE BY ALL A collection of case studies from sanitation and hygiene promotion practitioners in South Asia Beyond Construction USE BY ALL A collection of case studies from sanitaion and hygiene promotion practitioners in South Asia Published by: WaterAid 47-49 Durham Street London SE 11 5JD T: +44 (0) 207 793 4500 F: +44 (0) 207 793 4545 E: [email protected] Registered charity numbers 288701 (England and Wales) and SC039479 (Scotland) IRC International Water and Sanitation Centre P.O. Box 2869 2601 CW Delft, the Netherlands T: +31 (0)15 219 2939 F: +31 (0)15 219 0955 E: [email protected] First published March 2008 Editorial team James Wicken, Joep Verhagen, Christine Sijbesma, Carmen Da Silva, Peter Ryan Creative inputs to design Anita Pradhan, WaterAid in Nepal Design and processed by Power Communication ISBN: 978-9937-2-0472-9 Soft copies of this publication and individual case studies are available at www.irc.nl and www.wateraid.org Copyright Copyright © 2008 IRC International Water and Sanitation Centre and WaterAid Permission is hereby granted for reproduction and adaptation of this material, in whole or in part, for educational, scientific or development-related purposes except those involving commercial sale. When reproducing these materials, please give full citation to the source. Foreword Nowhere in the world are there larger numbers of people in need of adequate sanitation and hygiene services than in Asia. In South Asia alone, almost 1 billion people do not have access to safe, improved sanitation. Political awareness of the enormity of the problem is growing, as is the recognition of the direct links between sanitation and hygiene on the one hand, and devel- opment and poverty reduction on the other. As a result of this, the amount of funds invested in the sector is slowly rising, new sanitation policies are being developed, and large-scale programmes devised and implemented. South Asia is at the forefront of this, with a number of approaches being pioneered that show great promise for replication, notably the Community Led Total Sanitation approach. But sanitation is a difficult thing to get right, and this rise in commitment, especially when coupled with a rise in delivery speed, could easily lead to more failure, more unused or unsafe latrines and unsustainable services. The practice of monitoring progress, sharing and learning, and continuously seeking to improve programmes based on lessons learnt, is crucial to ensuring success. Of special importance in this, are the practitioners who stand firmly with their feet on the ground, talk from personal experience, and have a direct stake in improving their programmes. These practitioners were the participants of this workshop. As can be read in this report, many of the issues they raised have far-reaching policy and strategy implications, and will require not only more research but also concerted advocacy efforts to raise their profile. The speed of urbanisation coupled with the scale of the urban slums accounts for an ever growing amount of faeces let loose in the urban environment. While a lot of work is ongoing to find the most effective and efficient way of collecting the faeces, not enough emphasis is placed on the rest of the sanitation chain, i.e. storage, disposal, treatment, etc. In rural areas, the current success of demand-driven approaches requires a stable supply chain and sufficient service providers, but needs a strong system of quality control. These are just some of the issues that require more research and more experience. The Water Supply and Sanitation Collaborative Council has long provided space and opportunity to practitioners and other stakeholders to come together to discuss, debate, share and learn. It actively supports the notion of networking, be it through thematic working groups, through national WASH coalitions, or through Communities of Practice. WSSCC has been proud to contrib- ute to this workshop and the ensuing book, and intends to continue its support to these and similar initiatives. I would like to thank IRC, WaterAid and BRAC for taking the lead in organizing this event, and congratulate them on organising it so well. Jon Lane Executive Director Water Supply and Sanitation Collaborative Council Contents Overview of the workshop 1. Beyond construction: Use by all - An overview of a South Asian sanitation and hygiene practitioners’ workshop 1 Urban sanitation 2. Functionality and sustainability of community latrines under the Advancing Sustainable Environmental Health urban programme 13 3. Development of community-based sanitation infrastrcutrue in Hasanpura, Faisalabad 27 4. Subsidy and sustainability in urban sanitation: The case of Quetta Katchi Abadis Environment Management Programme 1997-2003 45 5. Ecological sanitation latrines: The experience of Nepal 60 6. Sanitation, water and hygiene programme in Faridpur 78 7. Decentralised wastewater management using constructed wetlands 86 8. Mapping as a basis for sanitation implementation in Pakistan: The case of the Orangi Pilot Project 95 Rural sanitation 9. School Led Total Sanitation: A successful model to promote school and community sanitation and hygiene in Nepal 113 10. India's national sanitation and hygiene programme: From experience to policy West Bengal and Maharashtra models provide keys to success 126 11. Community Led Total Sanitation Approach: Some personal field experiences from Bangladesh 148 12. BRAC WASH programme 157 13. Sustainable Community Owned Total Sanitation 169 14. School led sanitation promotion: Helping achieve total sanitation outcomes in Azad Jammu and Kashmir 181 15. Community Led Total Sanitation in Pakistan 190 16. Promoting sanitation through decentralised governance: A case study of Rajukhedi Panchayat in India 201 17. Preventing corruption, encouraging transparency and accountability in the water and sanitation sector: A case study from Kerala, India 212 18. "Money down the pan?" Community level models for financing sanitation in rural Nepal 231 19. The reuse of human excreta in Bangladesh 247 20. Moving up the sanitation ladder: A participatory study of the drivers of sustainability and progress in Community Led Total Sanitation 263 Hygiene promotion 21. Menstrual hygiene: Breaking the silence 283 22. Journey towards changing behaviour: Evolution of hygiene education in Bangladesh 288 23. Assessment of hygiene communication plan in the aftermath of the 2005 earthquake in Pakistan 321 24. Creating user-friendly water and sanitation services for the disabled: The experience of WaterAid Nepal and its partners 343 General 25. Sanitation and hygiene in South Asia: Progress and challenges 358 Abbreviations and Acronyms CCDU Communication & Capacity Development Unit ABR Anaerobic Baffle Reactor CCL Community Cluster Latrines ADB Asian Development Bank CDD-Wat-San Control of Diarrhoeal Diseases-Water ADP Annual Development Programme Sanitation Project AFC Agriculture Finance Corporation CDG City District Government z AJK Azad Jammu and Kashmir CDGQ City District Government Quetta v ANM Auxiliary Nurse Midwife CDGK City District Government of Karachi APL Above Poverty Line CDN Community Development Network ARBAN Association for Realisation of Basic CEO Chief Executive Officer Needs CEP Community Empowerment Plan ARI Acute Respiratory Infection CFPR Challenging the Frontiers of Poverty ASA Association for Social Advancement CHP Community Hygiene Promoters ASB Anjuman Samaji Behbood CIUD Centre for Integrated Urban Development ASC Annual Stakeholders Conventions CLBSA Community Led Basic Sanitation for All ASD Assistance for Slum Dwellers CLTS Community Led Total Sanitation ASEH Advancing Sustainable Environmental CM Corner Meeting Health CMC Community Management Committee ASM Arthik Samata Mandal CPA Community Participation Agreements AWP Annual Work Plan CRSP Central Rural Sanitation Programme BAU Bangladesh Agricultural University CSA Community Situation Analysis BC Beneficiary Committee CSB Community Sanitation Block BCSIR Bangladesh Council for Science and CSO Civil Society Organisation Industrial Research CSRSP Centrally Sponsored Rural Sanitation BG Beneficiary Group Programme BHU Basic Health Unit CTC Child to Child BPL Below Poverty Line CW Constructed Wetlands BSP Basic Sanitation Package CWSAC Community Water Sanitation Action B-WASA Balochistan Water and Sanitation Agency Committee CAP Community Action Plan DACAW Decentralised Action for Children and CBN Cost of Basic Needs Women CBO Community Based Organisation DAM Dhaka Ahsania Mission CBWSSP Community-Based Water Supply and DCI Direct Calorie Intake Sanitation Programme DDC District Development Committee CCDB Christian Commission for Development in DDSC District Disabled Support Committee Bangladesh DFID Department For International Development DISHARI Decentralised Total Sanitation Project IFH International Science Federation for DNet Development Network Home Hygiene DPEP District Primary Education Project IFI International Financing Institution DPHE Department of Public Health Engineering ILE International Learning Exchange DPMU District Programme Management Unit IMC Infrastructure Management Committee DRS Demand Responsive Sanitation IMR Infant Mortality Rate z DSK Dushtha Shasthya Kendra INGO International Non Governmental vi DSSC District Sanitation Steering Committee Organisation DVUD Double Vault Urine Diversion IP Implementing Partners DWSS Department of Water Supply and IPEA Integrated Participatory Empowering Sewerage Approaches ECOSAN Ecological