Urban Community Led Total Sanitation (CLTS)

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Urban Community Led Total Sanitation (CLTS)

• Case Study
• Kalyani Municipality
• Kolkata (India)
• By
• Dr. Shibani Goswami
• Dr. Kasturi Bakshi

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Kolkata Metropolis

• 10th most populous Metropolis in the world (12.4
  million)
• Highest population density in India
• Comprises of 3 Municipal Corporations with
  population of 5.8 million 38 Municipalities
  with population of 6.6 million
• Has 55.1 of the urban population of the state of
  West Bengal
• 33 of this urban population live in slums

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KMA Slums

• Total no. of slums 9000
• Total population of slums 4.1 million
• Deplorable environmental conditions
• Poor sanitation is a major health hazard
• DFID is funding for slum improvement since
  1991-92.

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Kolkata Urban Services for the Poor (KUSP)

• KUSP is funded by DFID since 2003-04
• Total budget is Rs. 714.77 million( US 17.7
  million)
• 30.9 of total budget is for infrastructure
  improvement, with highest priority for household
  toilet construction
• Cost of each H/H toilet is Rs.9900/- (US 236)
  provided free of cost to the slum dwellers

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Urban Community Led Total Sanitation ?

• CLTS programme has been successful
• in rural areas of Maharashtra, Himachal
  Pradesh Haryana in India
• Concept of urban CLTS was conceived in late 2005
  under KUSP

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Background of CLTS Pilot

• Lack of community participation in accessing
  primary public health care services amongst the
  urban slum communities observed
• Traditionally community depends on services
  delivered by Municipal Health Care system as
  passive recipient
• CLTS was the entry point to community Led Health
  Initiatives

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Objectives Of CLTS Pilot

• Initiation of community driven health and
  sanitation improvement
• Empowerment of local communities
• Test out the model and approach of Self
  Mobilisation of urban slum community through
  facilitation (shift from the present mode of
  community participation for material incentives/
  subsidy to more interactive participation)

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Why Kalyani Municipality?

• Kalyani Municipality liked the idea of CLTS and
  offered to participate
• The Chairman of Kalyani Municipality showed
  political will to make Kalyani an Open Defecation
  Free (ODF) City
• The chief health officer of Kalyani Municipality
  showed keen interest in CLTS approach and
  coordinated and facilitated the implementation of
  the entire programme

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Background of Kalyani Municipality Slums

• One of the Municipalities out of 38 with
  population of 0.1 million
• Total 52 Slums in Kalyani Municipality having
  10947 families
• Many of the slums are existing for the last 40-50
  years
• Most of the slum residents are migrants from
  neighboring states and refugees from
• Bangladesh
• Livelihood is mostly daily wage laborer, vendors,
  hawkers, maid servants etc.

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What has been done over the past ten years, to
improve sanitation profile of slum families
before CLTS?

• MDP sector built 700 toilets costing Rs. 5,000/-
  each
• Refugee Rehabilitation Department built 3300
  toilets costing about Rs. 8,500 each
• KUSP built 365 toilets costing Rs. 9,900/- each
  during year 2006-07
• More than 35 million Rupees (about US one
  million) spent for construction of H/H toilets
  for free
• Rampant open defecation was practised even by
  those who had own toilets

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Experience with Subsidized Toilets

• Low usage
• Facilities used for other purposes than the
  purpose for which it was built
• Poor maintenance
• Lack of ownership
• Subsidy cannot cover 100 population of all slums
• Total dependence on external subsidy

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Process of CLTS Pilot in Kalyani

• Sensitised and exposed the stakeholders like
• Elected Municipal Councillors and all
  departmental heads of the municipality
• Local NGOs and CBOs
• Health Workers
• Community people including local community leaders

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Sensitisation of Councillors Dept. Heads of
Municipality

• It was made clear that
• Increasing the number of toilets only was not the
  goal
• Goal was to create ODF environment
• It was behavioral change, and not the model of
  toilet which was important to achieve this goal.
• Community Led Total Sanitation is the approach
  which totally eliminates open defecation.

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Sensitization of Local NGO, CBO Health Workers
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• Goal of CLTS was explained in seminars and
  workshops
• Hands-on training on CLTS were arranged with slum
  communities
• Post triggering follow-up ensured in CLTS t slums
• Developed field facilitators

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Methodology Used in Slum Community

• A total Participatory approach adopted where PRA
  tools were used extensively
• Facilitated community sanitation profile
  appraisal analysis through
• - Transect walk
• - Defecation area mapping
• - Fecal oral contamination analysis
• - Feces calculation
• - Calculation of H/H medical expenses
• Handing over the stick at the ignition of
  moment by facilitators
• No outsider advised to construct toilets or
  lectured on the problems of Open Defecation or
  model of appropriate toilet models
• It was made clear that there was no subsidy of
  any kind
• Participatory Planning was facilitated

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Mapping of OD areas
Community of Bidhan Pally analyzing the
sanitation profile of the Para on a social map
prepared on the ground. All houses are denoted by
cards and the names of household heads are
written on them. Each household indicates the
area used by the family for open defecation. The
amount of money spent on medical expenses per
month per family is also written on the cards.
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Community of Jhil Par Colony in Kalyani
Municipality making a social map showing houses
with open pit latrines and defecation areas
Calculation of shit and house hold medical
expenses
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How it was possible to clean up entire Kalyani
using CLTS ?

• Dr. Kasturi Bakshi
• Chief Health Officer
• Kalyani Municipality

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Policy Decision by Board of Councillors

• Unanimous decision taken
• To stop subsidy for construction of toilets
• To give full support to CLTS Pilot in 5 slums
• To give support to the communities who stop open
  defecation totally
• 5 most backward slums were selected for piloting

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What Community People didnt know?

• Community people were fully aware of the ill
  effects of open defecation but they did not know
  -
• The concept of sanitary toilet
• Sanitary toilets can be constructed at an
  affordable cost by all
• Medical expenditure will only be reduced if
  everybody uses sanitary toilet

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What is a sanitary toilet ?
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Progress of CLTS

• First Triggering was done in Bhutta Bazar and it
  failed due to high expectation for subsidy which
  was provided in the neighbouring slum
• Simultaneously triggering was done in 4 other
  slums
• CLTS clicked in all these 4 slums as there was no
  expectation for outside subsidy
• Bhuttabazar also became ODF but took longer time
  than others
• All 5 slums eliminated open defecation in 6
  months
• Good number of Natural Leaders emerged

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Example of Vidyasagar Colony

• In Vidyasagar Colony, number of toilets increased
  from initial 9 to 213 in 6 months without subsidy
• Platform of 69 hand tube wells repaired and
  plastered with cement by community themselves.
• Many years old clogged drain cleaned up by the
  community

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Paved the bases of hand pumps
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Cleaned up a clogged drain
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Community Action

• Community took collective action locally towards
  making their environment ODF
• The poorest also joined in making the slum ODF
• Established mechanism for monitoring of progress
  of CLTS
• Started non-formal / adult education on their own
  after achieving ODF status
• Empowered community banned sale of country liquor
  in the slums

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Monitoring of performance of Ward Councillors

• Coloured cards (Green, Yellow Red) for each
  Councillors with their photo were used to show
  the sanitation status of their respective wards
• Green At least one ODF slum
• Yellow No ODF slum but collective community
  action started in the slums
• Red Nothing has been done

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Monitoring
Monitoring of CLTS Programme is done at different
levels.
At the Municipality Board Room
Different coloured cards indicate the status of
different wards regarding CLTS
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Monitoring
The sanitation profile of the Para on a Social Map
At the SLUM level
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Outcome

• Gastro Intestinal disorder declined
• (as per health centre records)

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Contd.
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Outcome

• After piloting in 5 slums, CLTS spread
  simultaneously in many more
• Out of 52 slums, 44 slums are 100 ODF within 2
  years
• More than 1500 poor slum dwellers have built
  toilets on their own so far and using them
• Gastrointestinal (especially diarrhoea and worm
  infestation) disorders have gone down
  significantly

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Challenges at Policy Level

• Subsidy and associated local politics are the
  hurdles of community self mobilisation
• Political will of Municipality Leadership
  attitude of Councillors
• Mind-set of technical people philanthropic
  attitude of doing for the poor
• Non-flexibility of hardware design, project log
  frame expenditure as approved by the Donors

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Challenges at Implementation Level

• Tribal slums were more resistant initially
• Less social solidarity in some migrant
  communities with floating population
• Un-authorised slum with no legal entities
• Local political leader acting as gate-keeper
• Dependency on subsidy

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Message

• We need to shift from the Blue print approach
  to Community Led Innovative approach which is
  more flexible.
• People can do it. Just empower them

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THANK YOU