Urban Community Led Total Sanitation (CLTS)

Case StudyCase Study

Kalyani MunicipalityKalyani Municipality

Kolkata (India)Kolkata (India)

By By

Dr. Shibani GoswamiDr. Shibani Goswami

&&

Dr. Kasturi BakshiDr. Kasturi Bakshi

Kolkata Metropolis

1010thth most populous Metropolis in most populous Metropolis in the world (12.4 million)the world (12.4 million)

Highest population density in IndiaHighest population density in India Comprises of 3 Municipal Comprises of 3 Municipal

Corporations with population of Corporations with population of 5.8 million & 38 Municipalities 5.8 million & 38 Municipalities with population of 6.6 million with population of 6.6 million

Has 55.1% of the urban population Has 55.1% of the urban population of the state of West Bengal of the state of West Bengal

33% of this urban population live 33% of this urban population live in slumsin slums

KMA SlumsKMA Slums

Total no. of slums 9000Total no. of slums 9000

Total population of slums 4.1 millionTotal population of slums 4.1 million

Deplorable environmental conditions Deplorable environmental conditions

Poor sanitation is a major health Poor sanitation is a major health

hazardhazard

DFID is funding for slum DFID is funding for slum

improvement since 1991-92.improvement since 1991-92.

Kolkata Urban Services Kolkata Urban Services

for the Poor (KUSP)for the Poor (KUSP) KUSP is funded by DFID since 2003-04KUSP is funded by DFID since 2003-04 Total budget is Rs. 714.77 Total budget is Rs. 714.77

million( US$ 17.7 million)million( US$ 17.7 million) 30.9% of total budget is for 30.9% of total budget is for

infrastructure improvement, with infrastructure improvement, with

highest priority for household toilet highest priority for household toilet

constructionconstruction Cost of each H/H toilet is Rs.9900/- Cost of each H/H toilet is Rs.9900/-

(US$ 236) provided free of cost to the (US$ 236) provided free of cost to the

slum dwellersslum dwellers

Urban Community Led Urban Community Led Total Sanitation ?Total Sanitation ?

CLTS programme has been CLTS programme has been successfulsuccessful

in rural areas of Maharashtra, in rural areas of Maharashtra, Himachal Pradesh & Haryana in Himachal Pradesh & Haryana in IndiaIndia

Concept of urban CLTS was Concept of urban CLTS was conceived in late 2005 under conceived in late 2005 under KUSP KUSP

Background of CLTS PilotBackground of CLTS Pilot

Lack of community participation in Lack of community participation in accessing primary & public health accessing primary & public health care services amongst the urban care services amongst the urban slum communities observed slum communities observed

Traditionally community depends on Traditionally community depends on services delivered by Municipal services delivered by Municipal Health Care system as passive Health Care system as passive recipient recipient

CLTS was the entry point to CLTS was the entry point to community Led Health Initiativescommunity Led Health Initiatives

Objectives Of CLTS Objectives Of CLTS PilotPilot

Initiation of community driven health Initiation of community driven health and sanitation improvementand sanitation improvement

Empowerment of local communitiesEmpowerment of local communities Test out the model and approach of Test out the model and approach of

“Self Mobilisation” of urban slum “Self Mobilisation” of urban slum community through facilitation (shift community through facilitation (shift from the present mode of community from the present mode of community “participation for material “participation for material incentives/ subsidy” to more incentives/ subsidy” to more “interactive participation”) “interactive participation”)

Why Kalyani Why Kalyani Municipality?Municipality?

Kalyani Municipality liked the idea of Kalyani Municipality liked the idea of CLTS and offered to participateCLTS and offered to participate

The Chairman of Kalyani Municipality The Chairman of Kalyani Municipality showed political will to make Kalyani showed political will to make Kalyani an Open Defecation Free (ODF) Cityan Open Defecation Free (ODF) City

The chief health officer of Kalyani The chief health officer of Kalyani Municipality showed keen interest in Municipality showed keen interest in CLTS approach and coordinated and CLTS approach and coordinated and facilitated the implementation of the facilitated the implementation of the entire programmeentire programme

Background of Kalyani Background of Kalyani Municipality & Slums Municipality & Slums

One of the Municipalities out of 38 with One of the Municipalities out of 38 with population of 0.1 millionpopulation of 0.1 million

Total 52 Slums in Kalyani Municipality Total 52 Slums in Kalyani Municipality having 10947 familieshaving 10947 families

Many of the slums are existing for the Many of the slums are existing for the last 40-50 years last 40-50 years

Most of the slum residents are migrants Most of the slum residents are migrants from neighboring states and refugees from neighboring states and refugees fromfrom

Bangladesh Bangladesh Livelihood is mostly daily wage laborer, Livelihood is mostly daily wage laborer,

vendors, hawkers, maid servants etc. vendors, hawkers, maid servants etc.

What has been done over the What has been done over the past ten years, to improve past ten years, to improve

sanitation profile of slum families sanitation profile of slum families before CLTS? before CLTS?

MDP sector built 700 toilets costing Rs. MDP sector built 700 toilets costing Rs. 5,000/- each 5,000/- each

Refugee Rehabilitation Department built Refugee Rehabilitation Department built 3300 toilets costing about Rs. 8,500 each 3300 toilets costing about Rs. 8,500 each

KUSP built 365 toilets costing Rs. 9,900/- KUSP built 365 toilets costing Rs. 9,900/- each during year 2006-07each during year 2006-07

More than 35 million Rupees (about US$ More than 35 million Rupees (about US$ one million) spent for construction of H/H one million) spent for construction of H/H toilets for freetoilets for free

Rampant open defecation was practised Rampant open defecation was practised even by those who had own toiletseven by those who had own toilets

Experience with Experience with Subsidized ToiletsSubsidized Toilets

Low usageLow usage Facilities used for other purposes Facilities used for other purposes

than the purpose for which it was than the purpose for which it was

builtbuilt Poor maintenancePoor maintenance Lack of ownershipLack of ownership Subsidy cannot cover 100% Subsidy cannot cover 100%

population of all slumspopulation of all slums Total dependence on external subsidyTotal dependence on external subsidy

Process of CLTS Pilot in Process of CLTS Pilot in KalyaniKalyani

Sensitised and exposed the Sensitised and exposed the stakeholders like:stakeholders like:

Elected Municipal Councillors Elected Municipal Councillors and all departmental heads of and all departmental heads of the municipalitythe municipality

Local NGOs and CBOsLocal NGOs and CBOs Health WorkersHealth Workers Community people including Community people including

local community leaderslocal community leaders

Sensitisation of Sensitisation of Councillors & Dept. Heads Councillors & Dept. Heads

ofof Municipality Municipality It was made clear thatIt was made clear that

Increasing the number of toilets Increasing the number of toilets only was not the goal only was not the goal

Goal was to create ODF Goal was to create ODF environment environment

It was behavioral change, and not It was behavioral change, and not the model of toilet which was the model of toilet which was important to achieve this goal. important to achieve this goal.

Community Led Total Sanitation is Community Led Total Sanitation is the approach which totally the approach which totally eliminates open defecation. eliminates open defecation.

Goal of CLTS was explained in Goal of CLTS was explained in

seminars and workshopsseminars and workshops

Hands-on training on CLTS were Hands-on training on CLTS were

arranged with slum communities arranged with slum communities

Post triggering follow-up ensured in Post triggering follow-up ensured in

CLTS t slumsCLTS t slums

Developed field facilitatorsDeveloped field facilitators

Sensitization of Local Sensitization of Local NGO, CBO & Health NGO, CBO & Health

Workers on Workers on

Methodology Used in Methodology Used in Slum CommunitySlum Community

A total Participatory approach adopted where PRA tools A total Participatory approach adopted where PRA tools

were used extensivelywere used extensively Facilitated community sanitation profile appraisal & Facilitated community sanitation profile appraisal &

analysis through: analysis through:

- Transect walk- Transect walk

- Defecation area mapping- Defecation area mapping

- Fecal oral contamination analysis- Fecal oral contamination analysis

- Feces calculation- Feces calculation

- Calculation of H/H medical expenses- Calculation of H/H medical expenses ‘‘Handing over the stick’ at the ignition of moment by Handing over the stick’ at the ignition of moment by

facilitators facilitators No outsider advised to construct toilets or lectured on the No outsider advised to construct toilets or lectured on the

problems of Open Defecation or model of appropriate problems of Open Defecation or model of appropriate

toilet modelstoilet models It was made clear that there was no subsidy of any kindIt was made clear that there was no subsidy of any kind Participatory Planning was facilitatedParticipatory Planning was facilitated

Mapping of OD areasMapping 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.

Community of Community of Jhil Par Colony Jhil Par Colony

in Kalyani in Kalyani Municipality Municipality

making a making a social map social map showing showing

houses with houses with open pit open pit

latrines and latrines and defecation defecation

areas areas

Calculation of shit and house hold medical expenses

How it was possible to How it was possible to clean up entire Kalyani clean up entire Kalyani

using CLTS ?using CLTS ?

Dr. Kasturi BakshiDr. Kasturi Bakshi

Chief Health OfficerChief Health Officer

Kalyani MunicipalityKalyani Municipality

Policy Decision by Policy Decision by Board of CouncillorsBoard of Councillors

Unanimous decision taken Unanimous decision taken

To stop subsidy for construction of To stop subsidy for construction of toiletstoilets

To give full support to CLTS Pilot in To give full support to CLTS Pilot in 5 slums5 slums

To give support to the communities To give support to the communities who stop open defecation totallywho stop open defecation totally

5 most backward slums were 5 most backward slums were selected for pilotingselected for piloting

What Community People What Community People didn’t know?didn’t know?

Community people were fully aware of Community people were fully aware of

the ill effects of open defecation but the ill effects of open defecation but

they did not know - they did not know - The concept of The concept of sanitary toiletsanitary toilet Sanitary toilets can be constructed at Sanitary toilets can be constructed at

an an affordable cost by allaffordable cost by all Medical Medical expenditure will only be expenditure will only be

reducedreduced if if everybodyeverybody uses sanitary uses sanitary

toilettoilet

Breaking the fecal oral contamination cycle

Water seal prevents

•Visibility of excreta

•Foul Smell

•Access to insects and animals

•Fecal oral contamination

Pit

What is a sanitary toilet ?

Progress of CLTSProgress of CLTS

First Triggering was done in Bhutta Bazar and First Triggering was done in Bhutta Bazar and it failed due to high expectation for subsidy it failed due to high expectation for subsidy which was provided in the neighbouring slumwhich was provided in the neighbouring slum

Simultaneously triggering was done in 4 Simultaneously triggering was done in 4 other slumsother slums

CLTS clicked in all these 4 slums as there CLTS clicked in all these 4 slums as there was no expectation for outside subsidywas no expectation for outside subsidy

Bhuttabazar also became ODF but took Bhuttabazar also became ODF but took longer time than others longer time than others

All 5 slums eliminated open defecation in 6 All 5 slums eliminated open defecation in 6 monthsmonths

Good number of Natural Leaders emerged Good number of Natural Leaders emerged

Example of Vidyasagar Example of Vidyasagar ColonyColony

In Vidyasagar Colony, number of In Vidyasagar Colony, number of

toilets increased from initial 9 to toilets increased from initial 9 to

213 in 6 months without subsidy213 in 6 months without subsidy Platform of 69 hand tube wells Platform of 69 hand tube wells

repaired and plastered with cement repaired and plastered with cement

by community themselves.by community themselves. Many years old clogged drain Many years old clogged drain

cleaned up by the communitycleaned up by the community

Paved the bases of hand pumps

Cleaned up a clogged drain

Community took collective action locally Community took collective action locally

towards making their environment ODFtowards making their environment ODF The poorest also joined in making the The poorest also joined in making the

slum ODFslum ODF Established mechanism for monitoring of Established mechanism for monitoring of

progress of CLTSprogress of CLTS Started non-formal / adult education on Started non-formal / adult education on

their own after achieving ODF statustheir own after achieving ODF status Empowered community banned sale of Empowered community banned sale of

country liquor in the slums country liquor in the slums

Community Action

Monitoring of performance of Ward Councillors

Coloured cards (Green, Yellow & Red) Coloured cards (Green, Yellow & Red)

for each Councillors with their photo for each Councillors with their photo

were used to show the sanitation status were used to show the sanitation status

of their respective wardsof their respective wards

Green – At least one ODF slumGreen – At least one ODF slum

Yellow – No ODF slum but collective Yellow – No ODF slum but collective

community action started in the slumscommunity action started in the slums

Red – Nothing has been doneRed – Nothing has been done

MonitoringMonitoring

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

The sanitation profile of the Para on a Social Map

At the SLUM level

MonitoringMonitoring

OutcomeOutcome

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

347

225

124

0

100

200

300

400

05-06 06-07 07-08

GI Disorder Cases

GI Disorder Cases

Contd.

OutcomeOutcome

After piloting in 5 slums, CLTS spread After piloting in 5 slums, CLTS spread

simultaneously in many moresimultaneously in many more

Out of 52 slums, 44 slums are 100% ODF Out of 52 slums, 44 slums are 100% ODF

within 2 yearswithin 2 years

More than 1500 poor slum dwellers have built More than 1500 poor slum dwellers have built

toilets on their own so far and using themtoilets on their own so far and using them

Gastrointestinal (especially diarrhoea and Gastrointestinal (especially diarrhoea and

worm infestation) disorders have gone down worm infestation) disorders have gone down

significantlysignificantly

Challenges at Policy Challenges at Policy Level Level

Subsidy and associated local Subsidy and associated local politics are the hurdles of politics are the hurdles of community self mobilisationcommunity self mobilisation

Political will of Municipality Political will of Municipality Leadership & attitude of Councillors Leadership & attitude of Councillors

Mind-set of technical people & Mind-set of technical people & philanthropic attitude of “doing for philanthropic attitude of “doing for the poor” the poor”

Non-flexibility of hardware design, Non-flexibility of hardware design, project log frame & expenditure as project log frame & expenditure as approved by the Donors approved by the Donors

Challenges at Challenges at Implementation LevelImplementation Level

Tribal slums were more Tribal slums were more resistant initiallyresistant initially

Less social solidarity in some Less social solidarity in some migrant communities with migrant communities with floating populationfloating population

Un-authorised slum with no Un-authorised slum with no legal entitieslegal entities

Local political leader acting as Local political leader acting as gate-keepergate-keeper

Dependency on subsidy Dependency on subsidy

MessageMessage

We need to shift from the “Blue We need to shift from the “Blue print” approach to “Community print” approach to “Community Led Innovative” approach which is Led Innovative” approach which is more flexible.more flexible.

People can do it. Just People can do it. Just empower themempower them

THANK YOUTHANK YOU