Ireland and UNICEF respond to Ethiopia’s drought emergency

Ireland and UNICEF respond to Ethiopia drought emergency
L-R) UNICEF Representative to Ethiopia, Ms. Gillian Mellsop and the Ambassador of Ireland to Ethiopia, H.E. Mr. Aidan O’Hara, holding jerry cans that are part of a donation consisting of water bladders and jerry cans worth over €110,000 (ETB 2.6 million) for the drought emergency response in Ethiopia. © UNICEF Ethiopia/2016/Balasundaram

13 April 2016, Addis Ababa: The drought caused by the El Niño global climatic event has driven food insecurity, malnutrition and water shortages in affected areas in Ethiopia.

In recognising the gravity of the situation, the Government of Ethiopia and its humanitarian partners have identified that 10.2 million people, 6 million of them children, are in need of food assistance, while 5.8 million people require access to clean drinking water and basic latrine facilities throughout the year.

In this latest tranche of support, Ireland has provided over €110,000 (ETB 2.6 million) worth of aid for the drought response. This includes 40 water tanks – 20 each with 10,000-litre capacity and 5,000-litre capacity respectively, 3,000 jerry cans, and shipment from the UN Humanitarian Response Depot in Accra, Ghana to the UNICEF Ethiopia warehouse in Addis Ababa. UNICEF will use these materials to scale up provision of immediate life-saving water supply across 31 worst-affected woredas (districts) nationwide through government-led water trucking campaigns. In coordination with the Ministry of Education and Ministry of Water, Irrigation and Energy, UNICEF will deploy the tanks to schools and health centres.

“Ethiopia has made impressive development gains in recent years and we must not let the drought undermine this progress. Our additional support is in response to calls from the Ethiopian Government to assist their humanitarian action; to save lives and protect livelihoods,” says H.E Mr Aidan O’Hara, Ambassador of Ireland to Ethiopia. “In recent weeks, UNICEF has been carrying out real-time water assessments in 30 worst-affected woredas. The April results show that 68 per cent of the population is using less than five litres of water per day in the worst-affected woredas. The water tanks from Ireland will be used to deliver water to the most acutely affected areas”.

“On behalf of the Government of Ethiopia and UNICEF, I would like to thank the Government of Ireland for its continued support for life-saving interventions in this drought emergency,” said UNICEF Representative to Ethiopia, Ms Gillian Mellsop. “Provision of clean and safe water is essential to prevent and contain outbreaks of water-related diseases such as Acute Watery Diarrhoea and scabies, as well as protect children from traveling long distances to collect water, keep children in school and support health and nutrition services.”

As the WASH cluster lead, UNICEF supports the Government of Ethiopia and other partners in the rehabilitation, maintenance and construction of new water supply systems, provision of water purification and treatment chemicals, scaling up of water trucking activities, and provision of sanitation and hygiene facilities in schools. In addition, UNICEF is exploring innovative ways to use satellites to detect deep groundwater for large scale, multiple-village water supply systems. As part of the overall drought emergency response, UNICEF supports programmes in child protection, education, health and nutrition.

The support to UNICEF comes on top of €9.1 million provided by Ireland to Ethiopia in response to the El Niño drought. This includes €3.8 million given in 2015 to the Humanitarian Response Fund, managed by the UN Office for Humanitarian Affairs. A further €1.8 million in humanitarian assistance was provided in 2015 through three NGO partners in Ethiopia: GOAL, Trócaire and Concern. In January 2016, €3.5 million was provided to the World Food Programme to provide highly nutritious food for children under the age of five as well as pregnant and lactating women. This year Ireland will also contribute €10.4 million to the Productive Safety Net Programme which is providing cash and or food support to some 8 million people.

Leadership matters: The case of community led total sanitation and hygiene

By Araya Mengistu


Ethiopia is a country showing strong progress in achieving global and national goals for WASH services. It has achieved the MDG target 7c for water supply. Although still behind for sanitation targets, considerable progress is made. As of 2012, 37 per cent of communities practiced open defecation, as compared to 92 per cent in 1990[1]

The progress on sanitation is mainly achieved through the national Health Extension Programme (HEP) and the community led total sanitation and hygiene (CLTSH) approach. CLTSH is an approach that helps to mainly rural communities to understand undesirable effects of poor sanitation, and through a process of “triggering” – igniting a change in behaviour – achieve sustained behaviour change leading to spontaneous and long term abandonment of Open Defecation (OD) practices. Since its introduction in 2006/7, CLTSH has remained the only instrument in Ethiopia to induce behaviour change of communities to consider construction of latrines and use them – discouraging the practice of open defecation. Although the achievements in the past decade are significant, the success of the approach varied significantly from place to place.

For example, the Oromia regional state, the largest in the country, consists 265 rural and 39 urban districts or woredas. Out of 6,531 kebeles (sub-districts each with an average population of 5,000) in rural areas, about 16 per cent are open-defecation free (ODF) – meaning no-one, including visitors and passing pedestrians, are openly defecating and all have access to basic latrines with handwashing facilities.

UNICEF supports 24 woredas in Oromia state between 2011 and 2015. Of the supported woredas, 24 per cent (116 of 477 kebeles) have achieved ODF status. Compared to regional average of 16 per cent, this is a huge achievement. Sire, one of the supported woredas, has recently been graduated in 2015 with 100 per cent performance, declaring all 18 rural kebeles ODF. Other woredas are at various stages. 11 woredas are between 20-50 per cent progresses, while the rest 12 woredas are of 0-10 per cent progress. Compared to these, Sire Woreda shows an outstanding performance.

Such exceptional achievement requires successfully overcoming a number of challenges. A key challenge is lack of thorough understanding of the steps involved in CLTSH and their importance. Usually CLTSH is about training facilitators and triggering communities. However, many practitioners agree that this is the easiest part. Rendering adequate supervision after the triggering stage and providing support that is necessary to sustain the momentum is the difficult part. Other challenges include diffusion of information to neighbouring communities that make the approach ineffective, lack of trainers with actual field experience, high staff turnover, poor coordination among stakeholders, weak commitment of staff and trained people and application of CLTSH without adequate or proper organisation and preparation.

Growing over all these challenges and as a result of four years of effort, Sire Woreda celebrated 100 per cent ODF achievement in April 2015, with all rural villages and kebeles free from open defecation.

Even though, some of these kebeles were declared ODF two or more years ago, , they continued to sustain their status despite the usual trend of falling-back to OD practice noticed as time elapses. This demonstrates an effective post-triggering activity by the Woreda that effectively complimented the planning and triggering activity.

How was this achieved? The Woreda administration leveraged existing structures to sensitize the leadership ladder down to village level on CLTSH and built it in to the regular reporting and evaluation process. This has helped to mobilize the largest possible support to the effort of Health Extension Workers (HEWs) and CLTSH facilitators, including teachers and students under the guidance and support of the Woreda Health Office. It has also avoided diversions of focus (including manpower, logistics, and resources) as CLTSH has become an official woreda priority.

Two notable practices can be praised in the woreda for this success.  (a) the technique of triggering one full kebele at a time in contrast to the usual practice of village by village, and (b) use of different post-triggering follow-up technique suited to context. The advantage of the first technique was twofold. It helped to avoid diffusion of information in to neighbouring communities. Since, focusing in one kebele at a time required more trained people, the coordinators called upon trained and experienced facilitators from adjacent woredas to support, which worked really well. On the other hand, the woreda experts consciously applied different post-triggering follow-up methods. In highland areas, they applied the ‘flag system’, where by communities themselves awarded white flags to households who have constructed basic latrines, and red flags to those who did not. In low land areas, students were organized to alert the community when they see any one defecating in the open, who will then ensure the person buries the excreta.

Currently, the Woreda continues to strengthen the community platforms for monitoring progress and pro-actively works with local leaders to provide the necessary guidance and technical support to sustain the achievement. As a result of this, they are expecting at least two kebeles to achieve secondary ODF, which includes upgrading of basic latrines to improved latrines (with washable slab, vent pipe, hole-cover) with hand washing facility by the whole community. The commitment of leaders, and subsequent effective coordination in the Woreda has benefited the wider community to keep children, women and the society at large healthy.

[1] Joint Monitoring Programme 2014.

In drought-stricken regions, children search for water and a lifeline for their hopes

In drought-stricken regions of SNNPR, children travel for hours to collect water for household needs.
In drought-stricken regions of SNNPR, children travel for hours to collect water for household needs ©UNICEF Ethiopia/2016/Ayene

HALABA SPECIAL WOREDA & MAREKO WOREDA, SNNPR, 22 March 2016 – In the northern part of the Southern Nations, Nationalities and People’s Region (SNNPR) of Ethiopia, bright yellow jerry cans are everywhere: on main roads and dirt roads, carried by hand or piled high on donkey carts being led on long journeys. Whatever the method, the goal is the same: water.

In SNNPR, 73 out of the total 136 rural woredas (districts) are grappling with water scarcity. Out of those, 45 are severely affected. In many of these woredas, water scarcity is an old problem, made much, much worse by the ongoing drought, which is the worst this country has experienced in decades. The result of a double blow of climate change and the El Niño phenomenon, the drought has led to food shortages and threats to livelihoods and survival. 

When there is no water, education takes a backseat

Wogbela, 15, travels to a neighbouring area for water, returning home the next day
Wogbela, 15, travels to a neighbouring area for water, returning home the next day. “I am late to school every day,” he says ©UNICEF Ethiopia/2016/Ayene

Lack of water affects everything: food, health, education and children’s futures. In Washe Faka Primary School, located in Washe Faka Kebele (sub-district), Mareko Woreda of SNNPR, approximately 20 students have left school in search of work to support families whose livelihoods have been turned upside down by the drought. The children who remain in school are struggling.

“Students are coming to school with empty stomachs and leaving early because they can’t focus,” says Selfa Doloko, the school principal.

Fifth-grader Wogbela, 15, is struggling too. Every day after school, he travels hours to a water point in a neighbouring area. Because of the distance from his home, he has to stay overnight at a relative’s house. There are closer water points, but the long lines often mean hours of waiting.

“I used to go every other day, but the drought has dried up the ponds here, so I have to get water for the livestock in addition to water for the family,” he says.

In the morning, Wogbela travels home with his supply of water. He is tired by the time he gets home, but has to rush to school. “I am late to school every day,” he says, worried. Education is important to him, but it takes a backseat when there is no water.

Relief in sight

HALABA WOREDA, SNNPR – 24 JANUARY 2016
Munira, 13, is a student at Asore Primary School, located 30 metres away from a new UNICEF-supported water point. “It is much easier now. We can drink and wash easily,” she says. ©UNICEF Ethiopia/2016/Ayene

This is the story of so many children here, but thankfully for some, there is finally relief in sight.

For the students of Asore Primary School in Halaba Woreda, a new UNICEF-supported water point approximately 30 metres away means a new shot at learning. Students like Munira, 13, an eighth-grader at the school, can finally breathe a sigh of relief. “I used to travel two to three hours a day to fetch water. The wait at the water point was even longer. Sometimes the taps did not work and I would have to spend the whole day there and go home the next day. It was so tiring and a waste of time,” she says, glad that clean water is now just a short walk away.

Abdusamad, 16, another eighth-grader at the school, adds, “Some students had to drop out of school because they had to spend so much time collecting water. I’m more confident now that I can finish my studies and I want to help bring the students who dropped out back to school.”

As part of the drought emergency response, UNICEF, as the WASH cluster lead, is supporting the Government of Ethiopia and other partners in the rehabilitation, maintenance and construction of new water supply systems, provision of water purification and treatment chemicals, scaling up of water trucking activities, and provision of  sanitation and hygiene facilities in schools. UNICEF is also exploring innovative ways to use satellites to detect deep groundwater for large scale, multiple-village water supply systems.

With 5.8 million people around the country in need of access to safe drinking water, UNICEF and partners are racing against the clock to provide urgent help.

For children like Wogbela, it cannot come soon enough. “I hope things change soon,” says Wogbela, “so that I can get back to learning.”

Climate change and lack of sanitation threaten water safety for millions: UNICEF

#ClimateChain Instagram campaign will highlight water and the environment

Drought in Ethiopia
Harko, 12, walks across the land with her younger brother. She is no longer going to school as is forced to go in search of water almost every day, travelling at night to avoid the heat and not returning to Haro Huba until well into the afternoon of the next day. © UNICEF Ethiopia/2016/Ayene

 New York/Addis Ababa, 21 March 2016 – On the eve of World Water Day, UNICEF said the push to bring safe water to millions around the world is going to be even more challenging due to climate change, which threatens both water supply and water safety for millions of children living in drought- or flood-prone areas.

In 2015 at the end of the Millennium Development Goal era, all but 663 million people around the world had drinking water from improved sources – which are supposed to separate water from contact with excreta. However data from newly available testing technology show that an estimated 1.8 billion people may be drinking water contaminated by e-coli – meaning there is faecal material in their water, even from some improved sources. 

“Now that we can test water more cheaply and efficiently than we were able to do when the MDGs were set, we are coming to terms with the magnitude of the challenge facing the world when it comes to clean water,” said Sanjay Wijeserkera, head of UNICEF’s global water, sanitation and hygiene programmes. “With the new Sustainable Development Goals calling for ‘safe’ water for everyone, we’re not starting from where the MDGs left off; it is a whole new ball game.” 

One of the principal contributors to faecal contamination of water is poor sanitation. Globally 2.4 billion people lack proper toilets and just under 1 billion of them defecate in the open. This means faeces can be so pervasive in many countries and communities that even some improved water sources become contaminated.

The safety concerns are rising due to climate change.

In March 2015, a year ago, Ethiopia celebrated the achievement of meeting MDG 7c by halving the number of people without access to safe water since 1990 – 57 per cent of the population now using safe drinking water. During the celebrations, it was noted that the majority of the MDG water supplies have been constructed in the densely populated highland regions. Thousands of hand dug wells, springs and small piped water schemes have been constructed to serve the highland populations using shallow and accessible surface water. 

In comparison, limited water supply development has taken place in the water scarce areas of Eastern Ethiopia. Inaccessible and deep groundwater resources make water supply to these areas costly and complex. Combined with this, the negative effects of climate change such as changing rainfall patterns and increased surface air temperatures are resulting in increased evapotranspiration of available limited water sources. 

For many years, UNICEF Ethiopia has worked to develop water sources in water scarce areas of the country. In its current Country Programme, UNICEF is assisting the Government of Ethiopia in exploring the use of satellite/remote sensing technologies to identify deep groundwater sources. These sources are then being developed through multiple village water schemes which supply water to residents (women and girls) in villages, schools and health centres. 

When water becomes scarce during droughts, populations resort to unsafe surface water. At the other end of the scale, floods damage water and sewage treatment facilities, and spread faeces around, very often leading to an increase in water-borne diseases such as cholera and diarrhoea. 

Higher temperatures brought on by climate change are also set to increase the incidence of water-linked diseases like malaria, dengue – and now Zika – as mosquito populations rise and their geographic reach expands. 

According to UNICEF, most vulnerable are the nearly 160 million children under 5 years old globally who live in areas at high risk of drought. Around half a billion live in flood zones. Most of them live in sub-Saharan Africa and in Asia.

Starting on World Water Day and ending with the signing of the Paris Agreement on 22 April, UNICEF is launching a global Instagram campaign to raise awareness of the link between water, the environment, and climate change.

Using the #ClimateChain hashtag, UNICEF Executive Director Anthony Lake, UN General Assembly President Mogens Lykketoft, UN climate chief Christiana Figueres, and other prominent figures will figuratively join hands with members of the public in a chain of photographs intended to urge action to address climate change. The images will be presented at the signing of the Paris Agreement. 

UNICEF is also responding to the challenges of climate change by focusing on disaster risk reduction for water supplies. For example:

  • Nearly 20,000 children in Bangladesh now have access to climate and disaster-resilient sources of water through an aquifer-recharge system which captures water during the monsoon season, purifies it, and stores it underground.
  • In Madagascar, UNICEF is helping local authorities make classrooms for 80,000 children cyclone- and flood-proof, and provide access to disaster-resilient sources of water.
  • In drought-prone Kiribati, new rainwater-harvesting and storage facilities are improving communities’ access to safe drinking water.

 In a recent publication, Unless We Act Now, UNICEF has set out a 10-point climate agenda for children. It sets out concrete steps for governments, the private sector and ordinary people to take in order to safeguard children’s futures and their rights.

A UNICEF rural water and sanitation programme ensures a healthy life in Ethiopia

By Araya Mengistu

Misra Redwan unloads a water jerican she just collected from a newly built water point
Misra Redwan unloads a water jerrycan she just collected from a newly built water point by UNICEF with the support of DFATD. ©UNICEF Ethiopia/2016/Sewunet

For the community in Lode Lemofo Kebele, Sire Woreda in the Arsi Zone of the Great Rift Valley of Ethiopia, access to water was an ongoing problem. During the annual dry seasons in this hot, low-land area, community members had to walk for hours under a blazing sun just to get water.

In January 2016, the communities of Lode Lemofo and neighbouring Chenge Kebeles have seen a marked improvement in their day-to-day lives, thanks to a water supply project that was commissioned and constructed with UNICEF support. About 6,500 people in two Kebeles, particularly the 3,250 women and girls who are usually charged with collecting water for household use, are reaping the benefits of improved access to clean and safe water, including increased school attendance among children.

Yesunesh lives with her husband Getachew, and 10 year old daughter Genet and 2 year old son Samuel in Lode Lemofo
Yesunesh lives with her husband Getachew, and 10 year old daughter Genet and 2 year old son Samuel in Lode Lemofo. ©UNICEF Ethiopia/2016/Sewunet

Lode Lemofo community member Yesunesh, mother of 10-year-old Genet and two-year-old Samuel, says, “Fetching water used to be the most demanding task we had to endure on a daily basis. Sometimes we had to do it twice a day. It is very tiring and takes up to three hours to and from the river. At times it is also dangerous, because sometimes hyenas try to attack us or our donkeys.”

The lack of access to water also affected health centres and schools.  Communities had to support the provision of water in these facilities themselves. Visiting patients and members of neighbouring households carried water to health centres while school girls and boys carried water to school on a daily basis.

All this has changed when the new water supply scheme became operational. The scheme draws its source from a 265-metre deep well and includes 16 kilometres of pipe network, 11 water distribution points and a 100,000-litre reservoir. One primary school and one health centre have also been connected to the water distribution system.

Yesunesh underscores the difference the scheme has made, saying, “All that suffering is now gone. My girl Genet – as you have seen – can get the water we need for cooking and other household use in less than ten minutes.”

Health centres can now provide better care to community members, particularly pregnant women, while boys and girls are better able to learn at school.

In total, 24 other Woredas in Oromia Regional State are benefitting from UNICEF’s water and sanitation programme. This is part of the overall progress in water and sanitation in Ethiopia, where 57 per cent of the population now relies on improved water supply sources such as water taps or hand pumps, rather than unprotected and risky sources such as rivers and streams. This increased access to clean and safe water has benefitted the children of Ethiopia tremendously, contributing to the reduction of under-five child mortality by two-thirds and the significant reduction of child stunting.

Ministers of Water, Sanitation and Hygiene to meet in Ethiopia

SWA Meeting of Ministers Announcement
Minister of Water, Irrigation and Electricity, H. E Motuma Mukassa, announces that Ethiopia is hosting the meeting of Ministers of Water, Sanitation and Hygiene which is organized by the Sanitation and Hygiene for All (SWA) and convened by UNICEF. ©UNICEF Ethiopia/2016/Bizuwerk

Ministers of Water, Sanitation and Hygiene from around the world will meet in Ethiopia from 15-16 March 2016 to plan and prepare for the implementation of the Sustainable Development Goals (SDGs) related to sanitation, water and hygiene.

The meeting is organized by the Sanitation and Water for All partnership (SWA), and convened by UNICEF. SWA has over 100 partners, mostly governments, and works as a platform for encouraging and coordinating political dialogue and action around water, sanitation and hygiene issues.

“This meeting will be different from all other high level meetings organized by SWA previously, mostly because of the timing: it will be the first global meeting on these topics after the UN Member States agreed on the Sustainable Development Goals last September, “says Motuma Mukassa, Minister of Water, Irrigation and Electricity of Ethiopia. Mr Motuma also underscores that the SDG targets on water and sanitation requires a higher level of coordination, alignment and communication both at global and national levels.

Ethiopia is selected to host this meeting for its commitment to implementing innovative ways towards achieving universal access to sanitation, water and hygiene by coordinating different ministries, increasing sector funding and investing in the training of health workers. The country’s One WASH National Progrmame (OWNP), launched in September 2013, is one of the most ambitious in the sector. It is based on a sector-wide approach and involves the ministries of water, health, education and finance and the government’s main development partners. Ethiopia devises this programme to modernize the way water and sanitation services are delivered to its people.  Recently, with UNICEF’s support, Ethiopia also started a South-South collaboration with Brazil in the area of urban sanitation and regulatory framework for WASH service delivery.

The Ministerial Meeting is a unique opportunity for countries to identify the major bottlenecks to achieving the SDG water, sanitation, and hygiene targets and lay groundwork for clear action plans, strategies and milestones.

High-level delegates, including the Prime Minister of Ethiopia, Hailemariam Desalegn, Kevin Rudd, Chair of SWA and the 26th Prime Minister of Australia and Anthony Lake, Executive Director of UNICEF will attend the meeting.

 

UNICEF: Without toilets, childhood is even riskier due to malnutrition

Fatuma Nuior, 16, and her cousin Audi Arab, 12, stand by her latrine next to her house in Ber'aano Woreda in Somali region of Ethiopia 12 February 2014. The village is the first village declared ODF (Open Defecation Free) and All but one household has a latrine. While flags fly over each latrine. In Somali Region water supply coverage is estimated at 59.7%, lower than the national average of 68.5%. The need for water supply normally increases in the dry season, especially at the time of drought such as in recent years. However, the technical and organizational capacity of the Somali Regional State Water Resources Development Bureau (SRWDB) the government agency responsible for water supply and facilities management in the region to satisfy the water supply need is not adequate to cope with the situation. Donor agencies and NGOs are making efforts to ameliorate the situation by constructing and repairing water supply facilities across the region, supplying water by water trucks during chronic shortages, but the supply is still significantly below the demand.
Fatuma Nuior, 16, and her cousin Audi Arab, 12, stand by her latrine next to her house in Ber’aano Woreda in Somali region of Ethiopia ©UNICEF Ethiopia/2015/Ose

NEW YORK, 19 November 2015 – Lack of access to toilets is endangering millions of the world’s poorest children, UNICEF said today, pointing to emerging evidence of links between inadequate sanitation and malnutrition.

Some 2.4 billion people globally do not have toilets and 946 million – roughly 1 in 8 of the world’s population – defecate in the open. Meanwhile, an estimated 159 million children under 5 years old are stunted (short for their age) and another 50 million are wasted (low weight for age).

A report issued today, Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene, from UNICEF, USAID and the World Health Organization, for the first time brings together years of research and case studies which demonstrate the link between sanitation and malnutrition. More importantly, it provides guidance for action.  

Lack of sanitation, and particularly open defecation, contributes to the incidence of diarrhoea and to the spread of intestinal parasites, which in turn cause malnutrition.

“We need to bring concrete and innovative solutions to the problem of where people go to the toilet, otherwise we are failing millions of our poorest and most vulnerable children,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene programmes. “The proven link with malnutrition is one more thread that reinforces how interconnected our responses to sanitation have to be if we are to succeed.” 

Diarrhoea accounts for 9 per cent of the deaths of children under 5 years old each year and is essentially a faecal-oral disease, where germs are ingested due to contact with infected faeces. Where rates of toilet use are low, rates of diarrhoea tend to be high. 

Children under 5 years old suffer 1.7 billion cases of diarrhoea per year. Those in low income countries are hit hardest, with an average of three episodes per year. The highest frequency is in children under 2 years old, who are weakest and most vulnerable. Multiple episodes of diarrhoea permanently alter their gut, and prevent the absorption of essential nutrients, putting them at risk of stunting and even death.  

Some 300,000 children under 5 years old die per year – over 800 every day – from diarrhoeal diseases linked to inadequate water, sanitation and hygiene. The poorest children in sub-Saharan Africa and South Asia are particularly at risk.

Intestinal parasites such as roundworm, whipworm and hookworm, are transmitted through contaminated soil in areas where open defecation is practiced. Hookworm is a major cause of anaemia in pregnant women, leading to malnourished, underweight babies. 

Some countries have made significant progress in addressing both access to sanitation and the nutritional status of their children. Many have successfully used UNICEF’s Community Led Total Sanitation approach, in which the affected populations themselves devise local solutions to the problem of open defecation. 

  • Pakistan met the 2015 Millennium Development Goal to halve the proportion of people who in 1990 did not have access to improved sanitation. Using CLTS, entire communities abandoned the practice of open defecation, leading to improved health and nutrition indicators among their children.
  • Ethiopia mobilized community workers and achieved the largest decrease globally in the proportion of the population who defecate in the open. Despite population growth, the practice reduced from 92 per cent (44 million people) in 1990 to 29 per cent (28 million people) in 2015.
  • In Mali the CLTS approach was also used in communities with high malnutrition rates, exacerbated by drought in the Sahel region. Improved access and use of latrines ensued, and improved health and nutrition in children.
  • During the emergency linked to conflict in the Democratic Republic of the Congo, integrated nutrition and WASH interventions were used for displaced communities. Children under 5 years old saw significantly reduced undernutrition and waterborne diseases. Around 60 per cent of the population constructed latrines and some 90 per cent of malnourished children returned to normal weight during a 12-month period.

“There are no excuses not to act on access to toilets, even in the poorest communities, or during emergencies,” said Wijesekera. “On the other hand, there are millions of reasons – each one a child who is stunted or wasted, or worse, who sickens and dies – to treat this with the urgency it deserves.”