NOMSA NKANA, Mpongwe
AFTER initiatives from Ministry of Local Government and Housing (MLGH) and its cooperating partners UNICEF, DFID and others to roll out Community Led Total Sanitation (CLTS) in Machiya and Chitanda villages in Mpongwe and Chibombo districts, the two chiefdoms have now recorded significant reduction in diarrhoea-related diseases and deaths.
CLTS is an approach to achieve sustained behavioural change in mainly rural people by a process of â€œtriggeringâ€ leading to spontaneous and long-term abandonment of open defecation (OD) practices for improved sanitation intended to transform a communityâ€™s health.
Public health officer Emmanuel Banda said CLTS programme in Chitanda chiefdom was introduced in 2012 when the MLGH realised the importance of each household having a toilet.
Mr Banda said through CLTS education, traditional leaders, and other stakeholders were engaged to sensitise the community on the repercussions of open defecation on their health.
â€œBefore CLTS, our incidences were 114 cases per population of 1,000. Sanitation coverage was between 31-33 percent when the programme started, to that effect, we worked hard to increase coverage to reduce incidences,â€ he said.
At the end of 2014, there was a reduction in diarrhoea cases ranging from 40-45 percent to date.
In 2010, Mr Banda said, the chiefdom was recording a lot of cholera cases but from 2012 to date, there are no more cholera cases recorded.
He attributes this to implementation of CLTS where people have stopped OD and now have toilets.
During recent Open Defecation Free (ODF) commemorations in Machiya chiefdom, sanitation champion Emmies Matafwali who has lived in the village for 20 years said there were a lot of diarrhoeal cases in his community, respiratory problems, and people also had body rash due to use of contaminated water.
â€œSince the trend was OD, our drinking water was contaminated. We drew water from shallow wells and our children died,â€ he said.
But in 2014, Mr Matafwali was among seven sanitation champions who were trained for one week to spearhead CLTS programme in his community.
During the training, champions were taught to dig latrines three meters deep, construct a super structure, cover the squat hole with a lid and also have hand washing facilities with soap after using the toilet or changing baby nappies. The hand washing facilities usually include a tippy tap.
The champions were also taught to tell the people to pour ash down the latrine to stop the foul odour and flies which transfer germs from the toilet to food and water.
However, changing the mind-set of people who have been born into a life of defecating in the bush is not always easy, says Mr Matafwali.
â€œSome would get upset, saying they have used the bush all their lives and have not died so why should [they] change,â€ he said.
According to Mr Matafwali, some villagers would say it would be embarrassing to be seen washing hands by children as they would know that their parents came from the toilet.
But a change of mind would come after some of the villagers started falling sick.
â€œWhen taking one of them to the hospital we explained that the cause of diarrhoea is poor sanitation,â€ Mr Matafwali said.
And Chief Machiya said the disease burden in his chiefdom has now reduced due to implementation of CLTS.
Chief Machiya said before CLTS, some villagers would wash their hands and clothes in the stream where they drew their water for cooking and washing, resulting in high disease and death rates.
As a traditional leader, Chief Machiya has had to work hard to change the mind-set of his subjects by telling them that there is no dignity in going to the bush as they risk bumping into their in-laws.
For those that resisted construction of toilets, Chief Machiya punished them with community service or legal action.
The chief has however appealed to Government to give his chiefdom more boreholes as sanitation requires clean water.
And in Chibombo, Chief Chitanda has also prioritised the health of his people by ensuring 100 percent of houses have toilets and hand washing facilities.
During the celebrations of his chiefdom which became the third in Central Province to be ODF, Chief Chitanda coined the motto, â€˜One Zambia, More Toilets.â€™
He urged his chiefdom to maintain ODF status and pass it on to the next generations.
And Edgar Nsofwa of Chitanda chiefdom is happy with introduction of CLTS, saying it has come to save their lives.
â€œWe used to have toilets but they were not adequate. For instance we had no lid covers on squat holes and hand washing facilities, so flies were spreading disease. But with CLTS we now know how to do it right,â€ he said with glee.
Mpongwe District Council public health inspector Onicious Munkombwe said people have been taught the importance of having an adequate pit latrine (APL).
Mr Munkombwe said an APL should have a superstructure with roof, door, smooth floor, the squat hole should have a lid cover, and hand washing facilities with soap or ash.
â€œWhen a chiefdom has 95 percent or above of the requirements, then it is declared ODF,â€ he said.
CLTS, spearheaded by MLGH with support from UNICEF and DFID, has a great potential for contributing towards meeting the MDGs, both directly on water and sanitation (goal 7) and indirectly through the knock-on impacts of improved sanitation on combating major diseases, particularly diarrhoea (goal 6), improving maternal health (goal 5) and reducing child mortalityÂ Â (goal 4).
NOMSA NKANA, Mpongwe