WINNING THE BATTLE AGAINST CHOLERA: IMPACT OF COMMUNITY LED TOTAL SANITATION (CLTS) IN AFRICA

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WINNING THE BATTLE AGAINST CHOLERA: IMPACT OF COMMUNITY LED TOTAL SANITATION (CLTS) IN AFRICA Dr.Kamal Kar Chairman, CLTS Foundation Kolkata, India FORUM OF SOLUTIONS 13 th March, 2012

232 million people in Africa practiced open defecation in 2008 (in millions) Eastern Africa, 90 Western Africa, 85 Southern Africa, 33 Central Africa, 16 Northern Africa, 7 Facts 171 million people in Africa gained access to an improved sanitation facility since 1990 The population that uses a shared or public sanitation facility more than doubled since 1990 to176 million in 2008 In 2008, 584 million people in Africa did not use an improved sanitation facility In 2008, 232 million people in Africa practised open defecation

How long would we see these abandoned toilets in the landscape of Asia and Africa? Port Loko district Sierra Leone Ibb province, Yemen Agona East, Central region Ghana Karaga district, Northern region Ghana

CLTS in Africa CLTS was introduced in Africa in 2008 CLTS spread in 34 African countries in just over 4 Years 15 countries in Eastern and Southern Africa 19 countries in West and Central Africa CLTS has been included in the National Sanitation policy of the Government of 15 African nations.

Co-relation between CLTS implementation and Cholera outbreak in Mali 2011 REGION Total number of communes Number of communes where CLTS is implemented Number of communes with cholera outbreak in 2011 Number of communes CLTS + Cholera SENEGAL % of CLTS communes with cholera outbreaks YOUVAROU YELIMANE NIORO DOUENTZA NARA NIONO MOPTI KAYES DIEMA TENENKOU BANDIAGARA KORO MACINA BAFOULABE KOLOKANI BANAMBA SEGOU DJENNE BANKASS KENIEBA MAURITANIE SEGOU 117 12 3 0 0% MOPTI 108 31 17 2 6% KAYES 129 12 10 0 0% GUINEE KITA KATI KANGABA KOULIKORO BARAOUELI BLA DIOILA BOUGOUNI YANFOLILA KOLONDIEBA KADIOLO KOUTIALA YOROSSO SIKASSO GOUNDAM TOMINIAN SAN TOMBOUCTOU NIAFUNKE DIRE 0 GOURMA-RHAROUS BURKINA FASO TESSALIT BOUREM GAO distances en km 200 400 ALGERIE ANSONGO KIDAL ABEIBARA 600 TIN-ESSAKO MENAKA NIGER COTE D IVOIRE

Impact of CLTS-drastic reduction in Cholera, Nyando district, Kenya(2008-2011) Under 5 Cholera cases Above five Cholera cases Total cholera cases CLTS was introduced in Nyando in 2010, Mr. Makotsi DPHO Nyando

HOUSEHOLDS AND LATRINES IN NUMBERS Direct co-relation of household latrine possession and use in ODF villages in Chad CO-RELATION BETWEEN NUMBER OF HOUSEHOLDS AND LATRINES USED IN VILLAGES OF CHAD BEFORE THE IMPLEMENTATION OF CLTS CO-RELATION BETWEEN NUMBER OF HOUSEHOLDS AND LATRINES USED IN ODF VILLAGES OF CHAD REGIONS IN CHAD REGIONS IN CHAD

Countries of Africa Kenya Eritrea Ethiopia Malawi Mozambique Madagascar Mali Sierra Leone Ghana Nigeria Mauritania SenegalChad Zambia Liberia Sudan Burundi Rwanda Djibouti Zimbabwe Angola Tanzania Gambia Guinea Bissau Guinea Conakry Cote d Ivorie Benin Cameroon Niger Togo Congo Brazzaville Democratic Republic of Congo Uganda CLTS in National sanitation strategy CLTS introduced with slow pace of scaling up

Bangladesh Rajshahi, Bangladesh East Java, Indonesia Siem Reap province, Cambodia-ash used in dry pit toilets Kampong Cham, Cambodia

Simple Pit latrines constructed in Tsaondo CLTS and MDG

Roughly more than 20 million people across Asia, Africa and Latin America have been benefiting from CLTS Fatima, a Natural Leader from Kosti, White Nile state, Sudan said that the CLTS has saved her village from cholera. This is an interesting miracle that there had been no single case reported in our health statistic records from the seven villages those adopted the CLTS approach and declared open defecation free. Thousands of people including the children in non-odf villages in that area have been affected by watery diarrhea. Md. Elsamani, Statistical Section, Ministry of Health, Government of Sudan.

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