Human Waste Disposal Impact on Health

During the primary survey conducted last October 2011, data showed that only 47% households have access to sanitary toilet facilities. The following reasons have been revealed during the initial assessment of households:

1.      Lack of awareness on effects of unsanitary toilet facilities 

2.      Inadequate communication strategies to promote use of sanitary toilet facilities

3.      Lack of programs targeting toilet sanitation

4.      Lack of political will to address issues on sanitation

5.      Cultural barriers continue to exist in 35% of the households in the community

In collaboration with identified key persons from the community, the team was able to formulate a comprehensive health plan with the objective of increasing the number of households with access to sanitary toilet facilities from 47% to 75% by the year 2015 consistent with Millenium Development Goal which targets to halve the proportion of people without sustainable access to sanitation by 2015.

Sanitation is defined as the safe disposal of human excreta and associate hygiene promotion. A safe toilet accompanied by handwashing with soap provides an effective barrier to transmission of diseases.

Each of the following sanitation facility type is considered basic sanitation for monitoring progress toward household sanitation targets.

·         If the facility is shared among no more than 5 families or 30 persons, whichever is fewer and if the users know each other

·         A pit latrine with a superstructure and a platform or squatting slab constructed of durable material including pour-flush latrines, ventilation improved pit latrines (VIP), pit latrine with slab

·         A flush toilet connected to a septic tank, other depository or a sewer

PROPOSED SOLUTIONS

           

Toilet adoption comes from providing the appropriate toilet design, nurturing community involvement and ownership of the problem, encouraging collaborations with the local leaders and stakeholders from the community and more importantly, understanding people’s ideas and values around sanitation. (Devine, 2009)

With this in mind, conceptualization of strategies for sustainable sanitation was created, which were the guiding principles of this project.

Breaking the Cycle of Cultural Barriers:

·         Identifying cultural practices: assessment of cultural influences on toilet adoption

·         Bridging leadership training with local leaders through self-awareness leadership training (SALT)

Mrs. Rubinos, then a 4Ps Parent Leader and Mrs. Ganob, Barangay Health Worker, taking notes during the leadership training

Orientation of Identified Key Persons from the community during a Communication Exercise

Team Mauswagong Mirangan attempting to reach the remote area of the barangay for primary health survey, October 2011

Primary Health Survey with Mrs. Silao, Barangay Nutrition Scholar, and members of the barangay council and health team

BNS accompanies Medical Student during the survey activities

Child Education: (children as promoters of good hygiene practices at home)

·         Launching of Global Hand Washing Day: Health education on hand washing

·         Stage Play: “Diarrhea Monster”

A shot taken during the play entitled Diarrhea Monster

Diarrhea takes the life of thousands of children annually. Increasing awareness of its prevention can make a difference in the lives of these children.

Global Handwashing Day celebration, October 2014

Handwashing Promotion during Global Handwashing Day Celebration, October 2014

Global Handwashing Day celebration, October 2012

Toilet Construction

·         Engaged social contract (Goal: One Toilet, One Household)

·         Solicit Sanitary Inspector advice on toilet construction

·         Construction design - culturally appropriate

·         Construction Phase –Bayanihan approach: A Filipino value

Head of Household signing a written agreement to support sanitation campaign by agreeing to construct toilet facility for a safer, healthier community.

Mr. Albano, Sanitary Inspector talks about the importance of sanitary toilet facilities during a Family Development Seminar

Locally Available Materials used for construction of toilet facilities

Newly constructed toilet facility for sustainable sanitation

Pour-Flush Toilets or water-seal type of toilets with less water required for flushing help increase toilet adoption in communities with problematic water supply

Toilet Construction at Purok 3

Monitoring

·         Establish Guidelines for Assessing Toilet Sanitation

Sustainable Sanitation

·         Establish a sanitation surveillance team

·         Creation of Local Ordinances to promote use of sanitary toilet facilities

Fostering political will through creation of written policies

Involvement of the stakeholders from the community proved to be an essential step towards achieving the goal of increasing percentage of households with access to basic sanitation

Monitoring of household's access to basic sanitation using a Sustainable Sanitation Criteria

Sanitation Surveillance Team in action, March 2013

SUSTAINABILITY

            Local leadership training of key persons identified provided an avenue for potentials to be realized and fresh ideas to be explored. Core group members were given the opportunity to exercise their leadership skills when the medical students gave them full responsibility in organizing events in the community. Action plans discussed during the previous years included plans for health education activities and monitoring of target households, these were implemented according to the pace set by the core group members. Their decision-making skills have been honed by years of experience in the community and their local influence has been beneficial in a multitude of sanitation campaigns and health promotion activities, proving that this unit can help mobilize the community even after the completion of the community immersion.

Construction of toilet facilities by target households in the beginning was difficult to promote, however, a steady increase in toilet adoption was observed during the years that followed. Nurturing community ownership of the problem coupled with behavior change communication proved to be effective in this community. As households began constructing their sanitary toilet facilities, they have assumed ownership of the program itself, placing value on hard work by peers and neighbors willing to help construct such a structure and encouraging other neighbors to do the same.

Written policies and regulations mandated by the legislative body of the community was the final step in the programs for toilet sanitation in hopes of reinforcing a sustainable sanitation program implemented in the community.

From 2011 – 2015 there have been changes in the behavior of the residents at Barangay Mirangan when it comes to sanitation. As shown in the figure above, the number of households with access to sanitary toilet facilities has steadily increased in the past three years, from 47 percent to 80 percent exceeding the hoped for target of 75 percent.

Nurturing community involvement and ownership of the problem, collaborations with the local leaders and stakeholders from the community and more importantly, understanding people’s ideas and values around sanitation helped in increasing toilet demand and therefore toilet adoption in the community.