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Community Led Total Sanitation in China

Plan China decided to introduce the CLTS approach in their programme in Puchang County in Shaanxi province last year (2005) and arranged a study visit for programme staff to Bangladesh during March/April 2005. After the exposure visit to CLTS villages in Bangladesh, Plan China decided to train the front line staff of all the four PUs (Programme Units) and especially the staff from the WES (Water and Environmental Sanitation) programme in CLTS. Dr Kamal Kar conducted a visit to the Plan China programme areas in December 2005 to explore the feasibility of introducing CLTS in rural China and to train a group of Plan staff, community leaders, NGO staff and local government technicians in the approach whilst also intended triggering CLTS in a few communities.

Almost all households in the villages visited reported regular bouts of diarrhoea and dysentery in the summer seasons every year. Many families even reported to have dysentery all year round. On average, each family spends about RMB 500–700 (US$ 60–90) or more on treatment and medication for diarrhoea and other stomach ailments every year. Some communities calculated the total average annual loss of money from their respective villages and found the cumulative annual expenditure to exceed US$ 3,000.


Papers on CLTS in China
Community Led Total Sanitation in China. Feasibility study and first orientation workshop on CLTS-Puchang - DRAFT. 12-19 December, 2005, Dr. Kamal Kar. DOC (1.3MB) DOC (no photos)
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Further details on CLTS in China

Challenges:
Toilets in households – a different kind of mind-set: In the villages of Puchang County in Shaanxi province, most families have small brick walled enclosures without roof or door attached to
their dwellings. Here, people defecate on the ground, sometimes using a squatting plate or a squatting stand made of two bricks. The human excreta generally remain accumulated there for days and weeks. Except in winter, when everything is frozen solid, these toilets emit a terrible stench and are infested with flies.
Faeces used as manure: Human excreta are systematically used as manure for fertilising crops and vegetables. In many houses, the excreta of all family members are collected in buckets over the course of five to seven days, and then taken to the field and applied raw in the crops. As the practice is an age old tradition and of enormous economic value in terms of agricultural production, it presents a major challenge for introduction and sustainability of CLTS. Appropriate toilet models, allowing access to and use of faeces yet breaking the faecal-oral contamination cycle, need to be developed in consultation with communities. Plan China has developed an eco-san toilet model that
separates urine and faeces. The latter can then be collected separately for use as manure. In addition, nearly 70 per cent of the smell can be reduced if urine and stool are separated.
School sanitation: Rural schools have separate toilet blocks for boys and girls, with a row of squatting plates used for both defecation and urination.
In addition to the problems of smell and fly infestation due to accumulation of faeces and urine in a ditch behind the walls of the toilet buildings, hygiene is another problem that urgently needs addressing. Toilet paper is used for anal cleaning, but hand washing after defecation is almost non-existent. Generally, there are no water taps or water containers nearby. If water is available outside, it quickly freezes. Ensuring alternative hand washing facilities in schools months is therefore a challenge, particularly during winter. At the same time, there is great potential for scaling up CLTS through introducing it in schools and spreading it to the villages through schoolchildren.
Technology: In contrast to tropical countries or southern China, in Shaanxi province in central China latrine technology presents a challenge as temperatures often drop below zero. Frozen soil
makes it impossible to dig latrine pits. Extremely cold winds also make people reluctant to walk a distance for open defecation away from their houses. Moreover, plastic pans and pipes of different quality and standard are needed to prevent cracking and bursting in these extreme cold temperature regimes.
Five Year Plan: Government officers and Plan field staff are finding it difficult to promote CLTS without subsidy. The main reason for this, according to Plan China, is that in the Five Year Plan for 2006–2010, the Chinese Government has decided to increase rural investment, almost doubling the amount from the last Five Year Plan. A major part of the investment will be used for infrastructure as well as providing subsidy to farmers for fertilisers and seeds to improve the productivity and their livelihood. Rural sanitation is still not on the government’s main agenda. However, it is believed that stopping the subsidy for sanitation would lead to the community losing interest in building latrines as they are getting subsidy for agriculture.

Successes
• The first CLTS training workshop in Puchang in December 2005 introduced the approach to a number of interested national and international institutions in China.
• Senior officials of Plan China, including the Programme Support Manager and other sanitation specialists, seemed convinced by the approach and have decided to pilot it in non-Plan villages.
• The Programme Support Manager met with the officers of China State Council Poverty Alleviation, who showed interest in collaborating with Plan China on the natural resource management in BaiShui County of ShaanXi Province. This could be a good opportunity to trigger CLTS in non-Plan areas.

Lessons learned/recommendations
• There is great potential for CLTS in China, provided it is facilitated with the right attitude, behaviour and spirit. If it is possible to avoid the up-front, hardware subsidy for toilet construction at the individual household level, it would be possible to trigger and spread CLTS in the rural areas quite fast, similar to other countries in south and south east Asia. As in India and other countries in south Asia, rural people still feel that sanitation is something which the government should provide and thus often expect an external subsidy.
• A flexible approach may need to be adopted to initiate CLTS in some areas where subsidy on sanitation hardware cannot be avoided. The individual H/H hardware subsidy could be changed to a ‘collective community reward’. As soon as a community stops open defecation totally through local action, the amount of subsidy originally allocated for the village could be given to the community to spend on community causes like water, roads, school repair etc. This approach reduces external dependence, encourages communities to initiate local action, builds community confidence and triggers other local actions in the wake of CLTS.
• The notion that the construction of sanitary toilets costs a lot of money and that they are therefore not affordable for the poor living in villages needs to be eradicated. Raising awareness and
demonstrating construction of low cost simple toilets of different types is essential.
• It is important that an agency interested and capable of piloting CLTS in China steps forward as soon as possible, in order to pursue the introduction of CLTS in selected non-Plan programme areas.
• It is recommended that in each of the Programme Units of Plan China, special pilots are carried out, introducing the CLTS approach without subsidy. This type of pilot might provide crucial new insights on CLTS in China and show which approach is able to ensure faster total sanitation coverage.
• Because of Plan China’s hardware subsidy approach, it is recommended that CLTS is initially started in some non-Plan villages. This would make the work of the field facilitators easier. Once a few villages stop open defecation totally, they could be used as learning ground for the Plan villages. The Natural Leaders emerging from such successful CLTS villages should be used as resource persons and catalysts for triggering CLTS in other villages.
• It is important to involve senior government officers from the relevant ministries of China who might be able to influence the development of a nation wide no subsidy sanitation policy and who
could support launching CLTS in China.

(source: Kamal Kar and Petra Bongartz, 2006. Update to IDS Working Paper 257 PDF)



Introduction
Papers on CLTS
Further details
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