John Anner, president of East Meets West Foundation, talks about how his organization is helping to transform sanitation and hygiene practices of some of the world’s poorest people.
As leaders gathered in Stockholm last week for World Water Week to discuss the future of our most precious natural resource, we are soberly reminded that for millions of people around the world, water safety is compromised because of poor sanitation and hygiene, which are the cause of numerous infections and waterborne illnesses.
This is certainly the case in Vietnam and Cambodia, where open defecation and poor hygiene are part of everyday life — borne from necessity, long-held cultural norms and poverty. In fact, 50 percent of Vietnamese and approximately 80 percent of Cambodians do not have proper sanitation or hygiene at home. The threat of disease is constant and these conditions result in an estimated 17,000 deaths and $1.2 billion in economic losses each year in these two countries alone.
With the support of a new grant from the Bill & Melinda Gates Foundation, East Meets West is pioneering a new approach to behavior change -– one that we believe can help transform the sanitation and hygiene practices of those living in the most disadvantaged communities in Vietnam and Cambodia. It’s an innovative yet straightforward approach that will impact the lives of 1.7 million of the people most in need by:
- Starting with locally-led meetings and events designed to educate communities about hygiene and sanitation and build community support for installing systems;
- Connecting families with credible sources of financing to have home latrines built and installed;
- Training local masons to build and maintain latrines, and ensure the installation progress and completion are independently verified;
- Rewarding households confirmed to be using the latrines with a rebate to offset the cost of their latrines;
- Rewarding community volunteers with a bonus for their successful outreach work, and
- Rewarding communes with conditional cash transfers when their sanitation rates reach 30 percent, and again when rates reach 95 percent.
Simply put, this is a business model that is about ensuring buy-in and rewarding success. Communities are engaged and invested at the outset, and the promise of a financial reward serves as an accelerant to encouraging immediate, widespread participation in the program –- a necessary condition for achieving the maximum public health impact.
World Water Week reminds us not only of the critical role sanitation and hygiene play in ensuring water safety, but also the urgent need for it throughout the developing world. Communities across sub-Saharan Africa are facing a similar crisis, with UNICEF estimating that 70 percent of its population lack access to proper sanitation coverage, particularly those living in rural areas.
Single pit latrine. Photo credit: East Meets West
This is what makes our results-based community approach so exciting and rewarding –- its portability and scalability. Our results-based approach is locally-led, drawing on existing networks and communities that can most effectively inform and persuade their residents about implementing new, safe and healthy norms. In addition, working with community organizations and government agencies ensures that policies, human resources, financing and technology are in place, extending the sustainability of the program over the long term.
The key elements of our approach –- local networks and a rewards-based program -– are not only effective in Southeast Asia; they can be applied, with a large degree of success, to regions and communities throughout the world, including in sub-Saharan Africa, where we know we can make a meaningful impact. Community networks and locally-driven aid organizations can be identified in every part of the world. And a system that draws on local manufacturers and funding mechanisms and provides results-based incentives to spur action can be put into place effectively, wherever there’s an urgent need.
Recognize the need. Identify a practical, achievable, low-cost solution. Form local partnerships to reach and educate communities. And reward results rather than intention to ensure commitment and buy-in. This is our formula, and we feel confident it is one that can be replicated and applied to other sectors of health and global development -– in every part of the world.
John Anner is president of East Meets West Foundation, an international development agency working to transform health, education and sanitation systems for disadvantaged communities in Asia. The organization has invested more than US $105 million in development solutions in Asia, and currently operates programs in Vietnam, Cambodia, India, Laos, Myanmar, Philippines and Timor Leste.