The year 2015 is the deadline for the world to meet its Millennium Development Goals, yet Ghana has not achieved the improved sanitation access of 53.5%. The impediments to reaching this goal are more social than physical. Some countries across the West Africa region are continuing to subsidize latrine construction to quickly to expand their sanitation coverage. However, this strategy did not work in Ghana as mentionned by Issifu Adama, the CARE project manager for the USAID WA-WASH Program: “You cannot just go in and build a few million latrines. People need to first understand why latrines are necessary, or the will just use them to store grain. When you make the link between sanitation, health and livelihoods, people are more likely to take action and invest their own resources in building and maintaining latrines themselves.” Per the national regulations, development organizations can still help finance public latrines in schools but not for households. This approach was adopted by the country as a national strategy and the USAID WA-WASH Program implemented it in Ghana’s remote Upper West region.
The community-led total sanitation (CLTS) method involves building local knowledge rather than providing visible infrastructure gifts. In the village of Tabier, as in most of the 29 CLTS targeted villages, open defecation was done for generations and not even one toilet existed. According to Saabom Sebastanin, the village chief in Tabier, “There were feces everywhere, around vegetables, in the mouths of pigs and we did not feel like eating. Children got diarrhea. We could not even sit outside to have a meeting.” Today, all 44 households in Tabier have latrines as a result of CLTS implmenetation that involved changing behaviors, improving the environment (see Photo 1). The USAID WA-WASH Program used a community triggering process, meeting with village chiefs, men and women to discuss and map out the location of their drinking water sources, houses, and defecation places. Each household was also surveyed on the last occurrence of diarrhea or cholera. The Program worked with the communities to develop action plans, with the goal of 100 percent latrine coverage in a certain number of months, detailing who needs to be involved in every step of the process. The Program team strengthened local water and sanitation committees and trained a volunteer latrine artisan in each community to help build different low-cost models and make repairs, as well as. From the initial training, 147 village savings and loan associations (VSLAs) were formed in the 29 communities, empowering 3,602 women and men to help their families invest in improving crop production and raising livestock, thus generating extra income that, in part, has been used to pay for latrines and maintaining local water sources. USAID WA-WASH installed a borehole with a hand pump in six villages that did not have an existing clean water source. The presence water sources facilitate latrines constructions over time. Families typically built a basic unlined pit latrine with a door and roof at a cost of 280 to 395 Ghanaian cedis ($65-$95). Families shared latrines until it was time to build their own. Within three months, every household in Tabier had a latrine.
Dery Noureru, the Program-trained volunteer latrine artisan in Tabier (see Photo 2), stated that “Anyone who wants a latrine contacts me. The basics for every latrine are a concrete slab, vent pipe and roofing sheets. I advise people how to dig based on soil structure to prevent cave-ins. We are now able to grow vegetables around houses, because there’s no feces there. Women used to walk in the rain and squat in the open. Now they are safe.” His wife, Beborb, a VSLA member and mother of seven, could not agree more. “Now we can go to the bathroom anytime we want. I was so excited the first time I used my own latrine,” she says. “If no one had knocked on the door, I would have stayed in longer!”. Beborb responds very matter-of-factly when asked what held her family back from getting a latrine for so long “Before, we did not know about latrines. Now we will never go back to our old ways. Our days of shame are gone!”.
The implementation of CLTS in the Upper West region of Ghana resulted in the building of 1040 household latrines entirely funded by the beneficiaries. The success of these activities led to 24 communities, including Tabier, declared opend defecation free (ODF) by the Regional Inter-Agency Coordinating Committee on Sanitation (RICCS) in Ghana.