Thursday, June 27, 2013

One Family, One Toilet: Changing Old Habits to Save Lives in Northern Viet Nam

Quai Nua commune, Tuan Giao district – Until not so long ago, Lo, Thi Trang, did exactly like other children in her village when the call of nature came. 

“I used to poop in the river”, the 12 year-old giggles. “We had had no toilet and did not even know what it was. Really, I didn’t mind. We used to go down the hill to the river. Everyone in the village was doing the same: no shame! During the rainy season, it was a bit scary as it became slippery and we had to watch our steps.”

Trang is proud to introduce the new hygienic latrine that her parents built next to her house seven months ago, in Quai Nua commune, Tuan Giao district, Dien Bien province.
© UNICEF Viet Nam/2013/Matthew Dakin
Trang lives in the mountainous Tuan Giao district, in Dien Bien province, northern Viet Nam. Just a few months ago, Trang’s Quai Nua commune had the lowest number of toilets in the whole province and its inhabitants simply didn’t understand the value of sanitation facilities. In the commune, only 4 per cent of the families had hygienic latrines meeting the standards of the Ministry of Health (MOH), and open defecation was widely practiced. 

Although modern toilets are an ordinary sight across urban parts of Viet Nam, basic latrines are less common in rural areas where about 70 per cent of the country’s 86 million inhabitants live. It is estimated that close to 9 per cent of rural families in Viet Nam practice open defecation.

This in turn hinders the country’s efforts to reach UN Millennium Development Goal 7 of reducing by half the proportion of people without access to basic sanitation by 2015.

Changing old habits

“It’s all about changing old habits”, explains UNICEF Viet Nam Water and Sanitation Specialist Ms. Nguyen Thanh Hien. “We focus our efforts on getting communities themselves to understand how open defecation links up with common diseases like diarrhea and worm infection, so they see for themselves the latrines’ true importance.”

Aiming to change people’s behaviour as well as improve the quality of their lives, UNICEF is collaborating with the Viet Nam Ministry of Health to introduce ‘Community Approaches to Total Sanitation’ (CATS) in selected areas of Viet Nam. CATS is an innovative programme helping families build their own hygienic latrines with little budget. The approach has been implemented in nine communes of Tuan Giao district since end of 2012.

Trang’s mother, Lo Thi Dinh teaches her how to clean the latrine in the proper way. in Quai Nua commune, Tuan Giao district, Dien Bien province.
© UNICEF Viet Nam/2013/Matthew Dakin

A wake-up call for communities

To ensure local residents understand the health impacts of their current toilet practices, UNICEF supports the organisation of “triggering sessions” by social mobilisers from the community, that have received preliminary training. As part of the exercise, residents visit those areas commonly used for defecation in their village. 

Once there, they are then asked to calculate approximately how much human feaces they might produce on a daily, then monthly basis.

“During our first triggering session, villagers we really ashamed to find out how human excrement left in the open was leading to unhealthy conditions for their children, and the related healthcare expenses”, remembers Lo Thi Thanh, Head of the Quai Nua commune health centre. “That was a wake-up call for the whole community. They immediately agreed to join to  stop open defecation and build latrines. The number of latrines built in each home started increasing significantly from that moment.”

Health benefits

Trang is proud to introduce her family’s brand-new latrine, built seven months ago. “Before, children in the village were too often down with diarrhoea, or eye infection,” says Trang’s mother, Lo Thi Dinh, 44 years old. “Our family comprises six members, including my parents-in-law, and two children. We used to spend a lot to get proper medical treatment. Since we have the new toilet in our house, Trang has never been sick, neither have my parents-in-law.” 

“My mother showed me how to properly use the latrine,” expresses Trang. “She remembered very well all the information she got during the triggering meeting. She also taught me to wash my hands after pooping. In the same way, when I came to class, I taught my classmates how to do the same. I feel proud I am sharing knowledge, so that people around me can have a better life.”

Ninety-eight per cent of families in Quai Nua commune now have a toilet. From 2012 UNICEF started expand the CLTS approach to two additional provinces in Viet Nam: Lao Cai and Gia Lai. 

Trang practices hand washing with soap. in Quai Nua commune, Tuan Giao district, Dien Bien province.
© UNICEF Viet Nam/2013/Matthew Dakin

By Ngo Thu Tra

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