COMMUNITY LED TOTAL SANITATION – CLTS IN SOUTH TURKANA

(CLTS TRAINING REPORT)

Submitted To: WORLD- RENEW

Submitted By: PLAN KENYA

December, 2012.

INTRODUCTION Plan Kenya has been providing consultancy services in Community Led Total Sanitation (CLTS) training to a number of partners who are implementing WASH activities both at national and international levels. As part of this consultancy, a five day CLTS training workshop was organized targeting the frontline staff (Public Health Officers and Community Health Workers - CHWs) who works at level one in Katilu Division, Turkana South District. The training was conducted from 10th -14th December, 2012.

BACKGROUND CLTS was introduced in the wider Turkana County by GOK/UNICEF WASH program which also targeted other 20 Counties in the whole country. However, scaling up CLTS in Turkana South never took off. WCRS which has been implementing WASH activities in the district has adopted CLTS as an integral component of WASH. WORLD- RENEW is targeting 6 villages where they have drilled and installed water point facilities in the division.

ParticipationA total of 14 participants attended the training workshop. They were Ministry of Public Health and Sanitation staff and the local CHWs. These are the frontline officers that will be charged with CLTS implementation in Katilu Division, Turkana South District. List of participants attached, check annex I.

DAY ONE

Welcome & inaugural addressThe workshop was officially opened by Engineer James Origa by giving a welcome speech and history of the WORLD- RENEW. He said that this was a great opportunity for participants to train on CLTS approach, a unique approach which gives strength and self-respect to community members to eliminate open defecation. He noted that the training was necessary for the district and especially the division since sanitation coverage was only 14%. He requested participants to the training sessions serious.

IntroductionsAfter welcome address, participants and facilitators introduced themselves, this being a basic tool to build relationships and understanding each other. The introduction was by:

Name Area of origin/work Marital status and Position in the community.

ExpectationsExpectations of participants were drawn by the help of an exercise whereby the participants listed out their individual expectations from the workshop on vipp cards. The following were a summary of expectations raised by participants.

Learn more about CLTS Sharing ideas on CLTS Acquire certificate of participation To be paid allowance

Group normsParticipants formulated the following ground rules to guide them throughout the training period

Phones to be kept on silent mode Listen and respect other people’s opinions Raising of hands before asking questions No disrupting sessions with unnecessary movements Time keeping/punctuality Start and end sessions with prayers

LeadershipParticipants chose their leaders as follows;Chairperson- Fred SimiyuEnergizer – Alice EkalTime keeper – Joyce AsimitiSpiritual leader – Pastor Lokorio

Pre - assessmentThe exercise was done to gauge the level of knowledge and understanding of participants before the workshop. This form of assessment gave a quick overview of the knowledge and experience levels of participants and helped the trainers re-confirm the training content. The overall knowledge assessment stood at 49.4%. On the last day of the workshop the same questionnaire will be administered.

Workshop objectivesBy the end of training, all participants will be expected to have:

Understood the meaning of CLTS, its background, genesis and concept of CLTS. Acquired the requisite knowledge, skills and attitudes for triggering villages/

communities to attain ODF status. Understood the monitoring and reporting framework and responsibilities at the level

of CHW/PHT/PHO. Develop action plans for introduction, and scaling up CLTS in the respective areas of

work/ communities.

Group formationParticipants were asked to form working groups. Three (3) groups were formed by counting 1,2, and 3. All 1s formed group 1, 2s formed group 2 and 3s group 3. Then members gave their group a name as follows: Group 1------------------Kazi bureGroup 2------------------WisdomGroup 3----------------- Ng’kunonoi Ang’acin

Sanitation and its components

Participants in their groups were tasked to define or explain what they understood by the word sanitation, giving its components. This was followed by presentations by groups.

Group 1. Kazi bureDefinition: Sanitation is general cleanliness both individual and the environment free from contamination

Components: Proper faecal disposal Proper hand washing Proper food preparation Safe clean water Cleaning bushes Compost pit

Group 2. WisdomDefination: A way of having safe and clean environment that can affect human life. It focuses on personal hygiene, cleanliness of environment and safe water.

Components: Hand washing Personal hygiene Proper disposal of children’s feaces to latrine Burning rubbish and availability of where to dispose rubbish Cutting nails short Safe and clean water

Group 3. Ng’kunonoi Ang’acinDefinition: A process people claim, effect and sustain hygiene and healthy environment for themselves as the whole community.

Components: Solid waste disposal Excreta Hygiene

Sanitation ladderParticipants were introduced to this concept and the challenges rural communities face in constructing sanitation facilities. Participants raised the following as the challenges:

Life style (pastoralism) Taboo (In Laws not using same pit latrine) Ignorance Poverty Shortage of building materials Insecurity Political interference Shit smell

Inadequate cooperation between the locals and lead organizations/agencies Government laws prohibiting cutting of trees Weak soil formation Rocky grounds Termites

Participants in their groups were then assigned to arrange these sanitation challenges on a ladder, starting with easier to resolve at the bottom of the ladder and placing the most difficult challenges higher on the leader.

Group 1.Ignorance, taboos, life style, inadequate cooperation between locals and NGOs, political interference, termites, Gov’t policies/laws, shit smell, shortage of local building materials, weak soil formation, poverty, insecurity.

Group 2.Poverty, lack of local building materials, taboos, ignorance, shit smell, termites, weak soil formation, rocky grounds, political interference, lack of cooperation between locals and NGOs, Gov’t laws, insecurity, life style.

Group 3.Life style, Taboos, ignorance, shit smell, shortage of local building materials, termites, weak soil formation, political interference, inadequate cooperation between the locals and the NGOs, rocky grounds, poverty, Gov’t laws, insecurity.

DAY TWORecapCommenced at 9.30 am with a recap session. After the recap, participants were asked to get into their working groups for the next session.

Sharing experiences and assessment of sanitation projects of the past giving the main reasons of failure and recommendations of improvement.In groups, participants made discussions and prepared their presentations as follows:

Group 1Reasons for project failure

Lack of proper follow up (monitoring) Lack of community participation and involvement Lack of proper funding mechanism Lack of proper accountability and transparency

Recommendations Proper needs assessment Involvement of local community Proper accountability and transparency Involve all- men, women, youth and old

Group 2Reasons for project failure

Poor social mobilization Project identification wasn’t a priority for community (“Top-down” approach) Minimal community participation Low women participation Subsidies to communities

Recommendations Community participation and involvement Problem identification/ let people identify the problem Proper social mobilization

Group 3Reasons for project failure

Inadequate sensitization Poor community involvement Prescribed design models Poor follow up Corruption No political will

Recommendations Projects should be community led not top-down approach Right people right job Proper accountability Community participation

Introduction to CLTSParticipants were taken through the meaning, the background and the concept of Community Led Total Sanitation. The concept has now spread in many parts of the world including Asia, Latin America and Africa. In East Africa Kenya and Uganda have seriously embarked on the approach.

CLTS toolsThe CLTS tools were introduced to participants. CLTS borrowed its tools from PRA. The various CLTS trigger tools and the rationale behind each tool was explained. Participants asked to pay great attention to these tools/steps as they were very critical in the triggering process.Tools/steps

Introduction and rapport building Social Mapping/defecation mapping Transect walk/walk of shame Shit calculation Faecal – oral route Water shit demonstration Food shit calculation Medical bill calculation Action planning

Introduction and rapport buildingThe process of triggering shame, disgust and fear among participants was introduced. Community entry process begins with Introduction and rapport building. Introduce yourself and organization you work with as well as purpose of the visit. You have come to learn sanitation status of the community.

Social MappingThis is a participatory exercise undertaken by the community members themselves indicating community households, landmarks and areas of open defecation with different coloured powders. Usually done separately for adults and children.

Transect walk After social mapping, the immediate tool of practice is Transect walk or walk of shame. The facilitator asks participants to take them for a walk in their village. During the walk be curious, walk slowly and observe carefully. The facilitator should make the whole process interactive by asking to be taken to open defecation sites. Pick some of the shit from the walk of shame for another demonstration.

Shit calculationThis session highlighted the importance of shit calculation as an illustration of the magnitude of sanitation problem. Ask how much human excreta is being generated by each individual or house hold per day, week, month, year. This is then multiplied by the total number of households in the village. The facilitator emphasized that it was the “big picture” that was important in the exercise.

Faecal –oral routeParticipants were introduced to this tool using the information from the Walk of shame and Shit calculation. In groups, participants were to state where all the shit goes by developing the faecal – oral route.After making presentations in plenary, there was an interactive session to address the gaps.

F- Diagrami). Water/shit demonstration Facilitator demonstrated water/shit exercise by opening and giving a bottle of mineral water to a participant to drink. A stick is then used to touch shit brought from field and dip in bottle water and shake. Participants were asked to drink but all refused saying it was contaminated. ii). Food/shit demonstrationLike the first demonstration, some food on a plate was given to community members to eat. Thereafter the plate was put next to shit and flies flew from shit to food. The same plate was given out for eating but the community members refused saying they had seen flies fly from shit to food and therefore it was contaminated.

Medical bill expenseParticipants were asked to mention the common diseases related to with OD and imagine how much each household spends on an individual treatment and medicine. As with shit

calculation, participants asked to calculate how much they spend as a family per week, month and year. The facilitator encouraged participants to have a discussion around the amount of money spent on treatment.

Action planningParticipants guided on how to lead community members on the aspect of developing an action plan for stopping open defecation. The plan was to include a particular activity, timeline, where the activity will take place, the responsible person and resources (if any) required.

DAY THREE

RecapThe first session of Day was recap, reviewing the activities of the previous day.

How to trigger behaviour changeParticipants brainstormed on some general incidents that promoted positive behaviour change. This was followed by events in the community that promoted behaviour change to stop open defecation. Lastly, the facilitator helped participants understand the difference between individual and community triggers and how applied.

Challenging field situationsParticipants were taken through this tool and tasked to work in their groups. This was followed by presentations and plenary discussions which participants admitted were practical scenarios.

Mock triggering In preparation for real life triggering, participants were exposed to mock triggering exercise where two groups were formed. One group representing the community and the other acting as the visitors (triggering team). The later conducted a triggering process. The session that followed this was a discussion on how to improve on tool application.

Preparations for triggering villageTwo (2) groups were formed for village triggering. The villages identified were IDP1 (KambiBaraka) and IDP 2 (Nangaita). The group members shared the roles and responsibilities among the teams/groups such as lead facilitator, co-facilitator, crowd controller (environment setter), note taker (process recorder), and logistician (material manager).

Group 1. Village: IDP 1. Members: Joyce Asimet, Mary akai, Linet Nekesa, Susan Lumala, Levis Wasiki, Welly Muhamed, Kelengwe Pili, Sylivia Eseton, and Charles Ngira.

Group 2. Village IDP 2.Members: Timothy Elot, Francis Kourion, Millicent Ngimat, Fred Simuyu, Philip Esekon, Alice Ekal, Jame Oregi, Wilfred Ireri.

DAY FOUR

Field visits for hands-on learningExercise on sharing of experience of field visitsThe participants groups were given a format for preparing their presentations on the field visit experience as follow:i). What did you enjoy most about the field work?ii). What did you find difficult?iii). Which trigger tools did you find most effective? Why?iv). Which tools did you find least effective? Why?v). What would you do differently when you go to the field again?

Group 1 analysis report.What they enjoyed most:

Good participation from both team members and the community. Good reception from the community. Village elders fully participated and active. Organized community as a whole.

What they found difficult: There was message distortion To change the notion that the community was living temporary life. Some community members giving false information Division of members of the community during transect walk.

Tools found most effective: Transect walk. This caused a sense of shame, disgust and fear. Social mapping. People were afraid of showing open defecation areas.

Tool found to be least effective: Introduction and rapport building. Not done well and it was total confusion.

What they would do differently next time: Ensure that introduction and rapport building is done well, short and brief to the

point not to bore the community. Ensure social mobilization is done properly to avoid confusion as it was observed.

Group 2 analysis reportWhat they enjoyed most:

Transect walk because they walked together and when they found shit, it was shame and nobody admitted responsibility of open defecation.

What they found difficult: According to the group, nothing was difficult because the process was smooth.

Tool found to be most effective: Shit calculation: The amount of shit produced by the community and consumed was

huge that they couldn’t believe it. Medical bill: The medical bill was very high and could help the community do other

things like starting a business or pay school fees.Tool found least effective:

Nothing, all tools were effective to this particular exercise.What they would do differently next time:

They would improve on time for field visit so that they are not late. They would conduct social mobilization properly so that people come in big

numbers. They would include some songs in the introduction and rapport building section so

that it becomes more entertaining.

Triggering outcomeThe facilitator discussed the triggering outcomes. Basing on the four types, the facilitator said the triggering process could lead to either Matchbox in Petrol station, promising flames, scattered sparks or damp matchbox. Each outcome was explained in details. Participants were asked to rate the triggering exercise they conducted in the day based on the above outcomes. Both groups responded to promising flames.

DAY FIVEShearing community experiences after triggering A total of eight (8) community members attended the workshop on the last day of the training. They shared their experiences, commitment and action plan to make their villages ODF. After presentations, there was an interactive session where the community made specific commitment like achieving ODF was a must within the shortest time possible. Some of the statements of community leaders were captured as follows: “we have feared shit in the past, but what we saw yesterday was very strange to our lives”, now we are no longer scared of shit any more. Another said “talking about shit has been a taboo up yesterday, today it is not”. Yet another elderly lady said “ Tumepotezaa pesa zetu mingi kwa hawa madaktari, sasa nujua nini yakufanya” (“We have lost a lot of our money to these medical people, now we know what to do”). Finally, a short film of triggering session at IDP 2 village was shown (Nyangaita village).

Community monitoringParticipants to lead community monitoring process where they will track the progress of their own development and decide on:

What is working well What is not working well How to proceed next

Monitoring tools by CHWs and CHEWs were shared during the session.

Action planning by participants.Participants were divided into their working groups and asked to develop their action plan and thereafter present the same. The presenters committed to making some villages in their respective areas ODF in next 1- 3 months as per the following details:

Group 1.Activity Time/when who where Resource1st committee meeting

2nd week Dec

Chairperson CLTS committee

Asst Chief’s office

Writing materials

Visiting households

3rd week Dec

CLTS committee village Transport

Digging latrines

31st Jan, 2013

Household owners Individual household

-

Follow up 31st Jan, 2013

CLTS committee village Transport

Latrine completion

31st Jan, 2013

Individual households

village -

Group 2Date Activity where who Resources Remarks18/12/2012 Social

mobilisationvillage committee -

19/12/2012 Committee meeting

village committee venue -

20/12/2012 Digging pits households Household heads

JembePangas

29/12/2012 Follow up households committee

KITILU CLTS PROGRAM: CRWR/MOPHS ACTION PLANNING/MONITORINGDECEMBER 2012 – 31ST MAY 2013.

Target village

CHW CHEW PHO Pre-triggering

Triggering

Community follow - up

Team meetings

IDP 1 Slyvia/susan Alice Patrick 10/12/2012

12/12/2012

CHW/CHEWOnce/ week

Once every month

IDP 2 Millicent ,, 10/12/2012

12/12/2012

PHO/MusaEvery 2 wks

Line moja Simiyu ,, 29/12/2012

Ngabakan Emekwi ,, 28/12/2012

Kale IDP camp

Francis 12/01/2013

Nakwacilla Joyce 9/01/2013

Lopur Mary/Alice 20/12/2012

Post – training assessmentSelf-assessment questionnaires that were distributed to the workshop participants at the beginning of the workshop were again distributed to workshop participants. It was noticed that there was an increase in the understanding of participants. The knowledge was rated at 60%, an increase by 11% from 49.4%.

PHOTO GALLERY

CLTS training session in progress at Katilu RCEA church. Typical Turkana households targeted for ODF status.

Community members gathering at a site under a tree where triggering Community participation during social mapping exercise.will take place.

Children participation during triggering. Transect walk through IDP 1 village.

“Ng’acin”- the local name for shit. Amount of Ng’acin produced in IDP 2 village. ANNEX I.

LIST OF PARTICIPANTSKATILU CLTS TRAINING WORKSHOP 10th to 14th December 2012, Katilu RCEA Church.

Lead Trainers.

1.Charles Ngira-Plan international CLTS Unit.

2.Wilfred Ireri-Plan International, CLTS Unit.

Date; ....10th – 14th December, 2012............

S/No Participant Name Sex ROLE LOCATION1 Fred Simiyu M Community health worker Katilu line moja village

2 Phillip Esekon M Community health worker Lopur village3 Susan Lomaala F Community health worker Ang’arapt village

4 Alice Ekal F Community health Extension worker

Lokichar health centre.

5 Francis Emekwi M Community health worker Katilu village6 Millicent Ngimat F Community health worker Nyang’aita village

7 Sylvia Esekon F Community health worker Baraka IDP camp

8 Linet Mabunde F KEWI attachee Katilu

9 Welly Mohamed M Clinical officer Katilu health centre

10 Timothy Elot M Nurse Katilu health centre

11 Francis Kourion M Nurse assistant Kalemngorok health centre

12 Mary Akai F Nurse Lopur health centre

13 Joyce Asimit F Community health Extension worker

Kalemngorok

14 Lewis Losike M Community health Extension worker

Kainuk health centre

15 TEAM LEADER.Kilengwe

M Divisional Public health officer Katilu division

ANNEX II.

WORKSHOP SCHEDULE Training Program

5 Days CLTS Training of PHOs/CHEWs/CHWs

Session No Session Title From To ResponsibilityDAY 1Session 1 Registration and Opening 0800 0830Session 2 Introduction/Opening Remarks 0830 0900Session 3 Setting Training Workshop Norms 0900 0915Session 4 Group Formation 0915 0930

Session 5 Participants Expectation and Planned Workshop Objectives

0930 1000

Pre Workshop Assessment 1000 1030Tea Break 1030 1100

Session 6 What is Sanitation? Components of sanitation etc

1100 1115

Session 7 Sanitation Ladder 1115 1130Session 8 How to Prevent the Spread of Diseases 1130 1200Session 9 Current Sanitation & Hygiene Situation in

Kenya1200 1230

Session 10 Experiences and Assessment of Sanitation Programs in Kenya and Nyanza region.

1230 1330

Lunch Break 1330 1430Session 11 Community Led Total Sanitation 1430 1630

Group Reading of Trainers Notes and quiz preparations.

1630 1730

DAY 2Session 1 Recap of Day 1 0830 0900Session 2 How to trigger the behaviour change? 0900 0930Session 3 Learning to Trigger: Required Attitudes

and Tools0930 1000

Tea Break 1000 1030Session 4 Mock Triggering Session 1030 1200Session 5 Challenging Field Situations 1200 1330

Lunch Break 1330 1430Quiz Competition amongst Group (based on Trainers Notes)

1430 1530

Session 6 Planning for Field Demo of Triggering CLTS in a typical village and collection of supplies by each group

1530 1730

Day 3Session 1 Field-level Training I 0830 1400

Lunch Break 1400 1500Session 2 Analyzing Feedback from Field Work 1500 1630Session 3 Classification of triggers 1630 1700Session 4 Sustaining behavior change and moving

up the sanitation ladder1700 1730

Session 5 Planning Field Visit II 1730 1800Day 4Session 1 Field-level Training II 0830 1400

Lunch Break 1400 1500Session 2 Analysis of Field Work II 1500 1700Session 3 Identifying Elements to Support Sustained

Behaviour Change1700 1730

Day 5Session 1 Recap of Day 4 0830 0900Session 2 Community Monitoring 0900 0930Session 3 Briefing on Preparation of Action Plans 0930 1000

Tea Break 1000 1030

Session 4 Activities to Achieve the Goal 1030 1100Session 5 Allocating Responsibilities and

Presentation of Action Plans1100 1130

Session 6 Presentation of Action Plans by ODF Committees /Facilitators and revisions

1130 1330

Session 7 Lunch Break 1330 1430Session 8 Feedback from Last group of Trainee

PHTs, discussions and way forward1430 1530

Session 9 Certificates awarding ceremony, concluding remarks and departure

1530 onward