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| Last Updated:08/02/2014

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Malawi: Promoting Good Sanitation in Low Income Areas

GOSPEL MWALWANDA,, 06 February 2014


Lilongwe — It is a rainy day and Junior Kaoche is sitting in the room of his house sunk in thought when he hears the sound of something falling outside, instantly jolting him out of his reverie.


Alarmed, Kaoche rushes outside to see what it is. He stands in the verandah with his arms akimbo and looks to his right and left, but sees nothing that has fallen. He thinks it must have been the rumble of thunder. Kaoche is about to go back inside the house when he decides to go and check at the backyard. There, to his chagrin, the sight of their thatched household pit latrine that has collapsed greets him.


Shortly after the collapse of the toilet, Kaoche, 42, and one of his children contract cholera and the two nearly succumb to the water-borne disease. His near-death experience instantly changes his perception of the toilet.


"I now see the toilet as the most important area in my home," says the father of six, from the village of Nkolesha in the area of Traditional Authority Kuntaja in Blantyre. "Since my brush with death, I always give it the attention it deserves."


Kaoche's perception of the toilet has been reinforced by a sanitation marketing and hygiene promotion campaign that the Hygiene Village Project (HVP) is conducting in some low income areas of Blantyre and Lilongwe.


The sanitation marketing campaign is part of the Urban Water Supply and Sanitation (UWSS) Project the Ministry of Irrigation and Water Development (MoIWD) is implementing with a $792, 701 (about K360.7 million) funding from the World Bank through its International Development Agency (IDA).


The MoIWD has engaged HVP in association with TM Associates to implement the Sanitation Marketing Strategy under the second phase of the National Water Development Programme in low income areas of Blantyre and Lilongwe.


Blantyre and Lilongwe Water Boards are implementing the project in partnership with HVP, a local non-governmental organization working in collaboration with TM Associates and FD Communication.


The sanitation and hygiene campaign aims to create demand for improved sanitation and hygiene practices in 12 low income areas of Blantyre and Lilongwe. It also aims at ensuring that 4,000 households in the targeted areas have improved latrines and the same number should wash hands with soap during five critical times.


"The need to improve sanitation and hygiene facilities and practices in the targeted low income areas comes against a backdrop of an underlying precarious sanitation situation made worse by a booming population and poverty," says Roy Khonyongwa, HVP Executive Director.


The situation, says Khonyongwa, is characterized by predominant usage of traditional pit latrines that are shared by several households comprising landlords and tenants. He says research findings show that there is a negative perception regarding sanitation at community level by tenants and landlords alike.


In many densely populated low income residential areas of the country, landlords give little attention to sanitary facilities when they are building dwelling houses for rent. In most cases, the toilets serve many people and are usually unfit for use. It is not surprising to see tenants of five families on a single plot using one latrine. This poses a danger to the tenants' health, but rarely do they complain because they think it is the norm, or for fear of being removed from the plot.


And the toilet usually is a hastily built makeshift structure sometimes without a roof, giving the user no privacy at all. It is smelly and since its pit is often not deep enough, does not take long to fill up. Such toilets are also prone to accidents.


Michael Chimaliza, a Sanitation and Hygiene Specialist at Water Development Programme in the MoIWD, says it is important for people to realize that having improved latrines and practising hygiene behaviour are crucial for a healthy life.


Chimaliza says washing one's hands with soap after using the toilet, before eating, before cooking or preparing any type of food, before feeding or breastfeeding a child and after touching a baby's nappies helps in reducing sanitation-related diseases, mostly diarrhea. He says it also brings dignity at the household.


"It is high time land lords who survive because of tenants started providing them with good sanitation facilities because access to sanitation is a right," Chimaliza says. "Tenants should now start demanding their right to dignity and health through good sanitation from their land lords." There are several types of modern latrines. The first and simplest is the traditional improved one, which is fitted with an impermeable floor, mostly cement slab or just cemented floor.


The second is Ventilated Improved Pit (VIP) latrine, which in addition to a cemented slab floor, is fitted with a vent pipe to remove bad smell. Others are the water closet toilet connected to sewer line or septic tank, ecological sanitation latrines (Sky Loo or forsa altena, or arbor loo), and poor flush. These are the common latrines in Malawi.


Chimaliza says simple modern toilets like the traditional improved pit latrine are affordable to most Malawians, except for very few who are ultra poor and vulnerable and cannot afford to cement their floor.


He says ultra poor people may sometimes be considered for targeted subsidies implemented in an approach that ensures sustainable use of the latrines.


Chimaliza says: "However, these and other types of modern toilets are affordable to people who are better off, but not necessarily rich, including land lords who own most houses in low income areas.


"There is no reason whatsoever that should prevent land lords to improve latrines for their tenants because a traditional improved one requires very little to modernize, since one improves an existing latrine."


Around 11 per cent of households in the country have no toilets and defecate in the open, according to the 2008 census. Khonyongwa says the sanitation marketing campaign is expected to increase the number of people using an improved latrine from an observed 6 per cent to 30 per cent, and those properly maintaining latrines from 5 per cent to 30 per cent.


He says the campaign also aims to increase the percentage of household members consistently washing their hands with soap in the target areas from a reported 20 per cent to 45 per cent by 2014.


He says it also attempts to increase household members who wash their hands before eating from a reported 11 per cent to 30 per cent, and after using the latrine from a reported 18 per cent to 30 per cent.


Strategic cities of Blantyre and Lilongwe, the former being Malawi's commercial hub while the latter is the seat of government, are faced with unprecedented population boom due to an increase in economic activity and rapid urbanization of the cities. According to the last population and housing census, Blantyre City has a population of 661, 444 of whom 66 per cent live in low income areas. The city of Lilongwe has 669,021 residents, of whom 61 per cent live in low income areas.


The sanitation and hygiene promotion campaign's target areas in Lilongwe are Likuni/Chigwrizano/Ntchenche, Mchenzi, Area 44, Area 38, Lumbadzi, Chiuzila and Area 23. In Blantyre, the campaign is targeting Pesulo, Mpemba/Chazunda, Bangwe/Nguludi, Chigumula/Bvumbwe and Chileka/Lunzu.


When the campaign storms an area, with it are a lorry carrying prototype latrines and hand washing latrines, and a dance and drama team to entertain the audience while giving sanitation and hygiene messages. During the open air activities, health surveillance assistants and sanitation promoters are paraded at the stage for people to know them and engage them should they want to build a modern latrine. People also get promotional materials as prizes. Khonyongwe says the campaign is yielding results judging from the number of people who are heeding the messages and starting to build modern latrines to replace traditional toilets. "As a result of the campaign, people are now building modern toilets," he told this writer at one sanitation and hygiene promotion campaign at Kachanga Primary School around Chileka in Blantyre.


"Our toilets are different from traditional ones because they do not smell and last long. The number of cholera cases in the country will go down if many Malawians build modern latrines."


So far, 122 modern pit latrines have been built in low income areas of Blantyre and Lilongwe. About 4,000 modern latrines will have been built in the target areas by the time the project winds up in 2015.


One person who has translated the sanitation campaign messages into action is Agnes Thima, 52, a resident of Lunzu in Blantyre who speaks highly of her household's modern latrine, proudly calling it "our prized possession."


Thima says since she built the Sky loo pit latrine, she has stopped digging toilets frequently. She says a modern latrine usually takes years before it can be abandoned, unlike the traditional one which she observes falls into disuse quickly.


"These modern latrines can last years and what is more pleasing is that they are free of flies," Thima says. "It cost me K18, 000 to build, but it is absolutely worth the money. I use decayed waste matter to enrich the soil in my garden in place of fertilizer."


As for Kaoche, the sanitation messages have struck home and he has vowed to build a modern latrine. He suspects he contracted cholera the time members of his household used a nearby bush to relieve themselves after their toilet collapsed.


"One would carry a hoe to the bush as if going to cultivate. He or she would then select a hidden spot, dig a hole, and quickly relieve oneself. We did this for about three weeks," Kaoche recalled in an interview with Mana.


"The bush certainly is not the right place where to relieve oneself. Besides making it a breeding ground for germs, the bush offers no privacy as there are numerous embarrassing stories of in-laws finding one another relieving oneself."