Total sanitation campaign gathers pace in Bangladesh

Every year 125,000 children under five die in Bangladesh from diarrheal diseases.  That is 342 children every day.  But the government has ambitious plans to change this and has committed itself to achieving universal access to sanitation by 2010.

The community based ‘total sanitation campaign’ initially began as the ‘total rural sanitation’ project, an innovative approach developed by WaterAid and its rural partner, VERC, which looked at generating demand for water and sanitation.

We worked out between us we were spending Taka 36,000 ($525) a year on medicine.  The women worked out that there were 53 tonnes of human feces on their streets every year, and realized that was fueling the disease in the village.

The idea behind the scheme is that once communities learn the link between bad hygiene and disease they will improve their hygiene practices and want to establish water and sanitation facilities themselves.

The approach showed remarkable uptake and so since 2001 WaterAid has been working with other organizations to scale up the approach in both urban and rural areas.

The ‘total sanitation campaign’ is showing great results.  By the end of December 2004 an additional 10 percent of the country's total population had gained access to sanitation.

The government has officially awarded 94 Union Parishads (rural local government institutions of around 5600 households) and four Upazila (local administrative units of around 50,400 households) for achieving 100 percent sanitation.

Each of these areas has been awarded additional funds by the government and it is hoped that this will act as an incentive for other areas to also work towards the 100 percent sanitation target.

Khotija Begum from Askarpara Uttar in Chittagong knows about the total sanitation approach first hand.  “Before the [sanitation] situation here was really bad.” she says.

“We could see no way to improve it.  Then I visited a nearby community and found out there was a way to do it.  Then I asked VERC to help us do the same here.

“First we worked out what diseases people suffered from here at different times of the year.  Then we calculated the medical cost.

“We worked out between us we were spending Taka 36,000 ($525) a year on medicine.  Then the women worked out that there were 53 tonnes of human feces on their streets every year, and realized that was what was fueling the disease in the village.

“We considered where it goes.  It enters the stomach in many different ways, through flies which transfer it to uncovered food, through our chickens, through the ponds and the canal, on our feet.

"The decision was: do we want to eat our own goo [feces], or do we find a way to overcome this problem?”

The villages overcame the problem.  There are now 63 hygienic latrines in Askarpara Uttar paid for by the villagers themselves.  And there is so much demand that a local man has set up a business selling latrine slabs.

There are tubewells providing safe, clean water and a hygiene education committee.  The dusty streets are spotless, and the air is clean.  A sign at the entrance to the village reads “Nobody is allowed to defecate in the open here.”

To help promote the importance of sanitation WaterAid was one of the main organizations involved in the national sanitation campaign and was also a co-host of the first ever South Asian Conference on Sanitation attended by participants from nine Asian countries in October 2003.

The Government of Bangladesh presented WaterAid and three of its partner organizations (DSK, VERC and PSTC) with National Sanitation Awards at a special ceremony held in Dhaka on February 9, 2005.

The awards were given in recognition of the organizations' leading role in promoting sanitation, and in particular the 'total sanitation campaign'.