Nangarhar Province, June 20, 2018

Kama is declared defecation free. Villagers now use safe water and promote good personal and hygiene behaviour. A ceremony was held to celebrate the very positive developments in the district.

Dunghills are covered. The old places, where villagers used to defecate in the open, cleaned. Waste is properly managed, perpetual and external waste water eliminated.

A staggering 6815 traditional latrines are improved and 1193 latrines are newly built. All people, including children, use them properly and they know the critical importance of washing their hands.

The result is impressive! Kama District is declared the fifth Open Defecation Free District in Afghanistan.

 The people now use the safe water and they see positive changes and maintain good personal and environmental hygiene behaviour. Therefore, the ratio of diseases has significantly decreased.

All due to committees, groups and individuals in Kama District working together in a Community Led Total Sanitation (CLTS) programme, managed by DACAAR.

Participation is key

Participation of the villagers has been vital achieving the goal.

As in a Bazid Khail village, where a widow lost a son to diarrhea, wanted to save her other 14-year-old son. She, therefore, built a latrine immediately after knowing the root cause of the death.

In Naw Abad Naqshi Qallah, one disabled family consisting of an old father, mother and five members’ being mentally ill constructed their own latrine when they got to know the harm of open defecation. And the family members are now using it!

Life-threatening health issues

Kama District has gone far since April 2016 when DACAAR started the Community Led Total Sanitation (CLTS) programme.

Despite the fact that a lot of NGOs worked in the health sector, the deep-rooted health issues remained the biggest life threats in the district where most residents are farmers.

A significant part of the household income was spent on hospital bills due to diseases particularly diarrhea, dysentery, malaria, typhoid, hepatitis and malnutrition.

A very limited number of households had basic sanitation facilities.

Residents used their traditional latrines which were not safe. Many males did not use them at all. Instead, they went to defecate in open areas such as gardens and ruins and believed that the only females have to use latrines. Over ¾ of the population did not have latrines at all and the women had to wait until dark to go outside for the Open Defecation.

The children were misguided and due to bad design of a few existing sanitation facilities they feared using the latrines; hand washing habit was not seen among elders, youth and children, and generally, residents used unsafe water.

Ultimately, diseases increased day by day but no one knew the reason until DACAAR started CLTS interventions in Kama District in April 2016.

Winning the villagers’ heart

 The CLTS team were mobilized to visit each village and thought that this program would be faced with hurdles and difficulties due to no financial aid, but reality proved different.

The team members had been trained well and were enthusiastic about the experimental approach. They managed to win the villagers’ heart and the people accepted and welcomed the program.

Like a chain, they lend a helping hand to each other and solved their own problems as they constructed or renovated their sanitation facilities.

DACAAR’s CLTS-teams visited each village and held meetings separately and collectively. Three-day workshops for male and female Committees were conductedand a great deal of other measures were taken to lay the foundation for stopping the open defecation. Each house built latrines, maintained their houses and surroundings, all according to the CLTS criteria.

Celebrating success

To celebrate the remarkable achievements, a ceremony was held on 26th of March 2018 with the participation of different governmental and non-governmental organisations, jointly with the Provincial Governor, District Governor, DACAAR’S top management, community leaders, religious scholars, and other influential figures in the area.

John Morse, the DACAAR Country Director, praised the communities’ efforts: “I’m pleased to join the ceremony and want to thank the communities, their leaders and others who have helped making Kama District open defecation free.”

The director similarly appreciated the hard work of DACAAR CLTS-staff and other partners for their technical support.

 Mr. Mohmmad Ashraf Hotaki, CLTS Coordinator, proudly stated: “In Kama District, as many as 8008 newly built or improved latrines wereconstructedby the villagers without any subsidy or outsiders’ financial support. During the implementation, 2018 community leaders and at least 1881 Female Health Action Groups have been trained in hygiene and sanitation in order to make the district Open Defecation Free.”

Now the task of keeping communities clean, the sustainability and enhancement of hygiene in those villages is the responsibility of the Shura (assembly of elders) and the villagers, he stressed.

Bringing communities together

The DOOR representative, M. Karim, praised DACAAR for the community approach in the rural setting and felt that the program was carried out admirably across Kama District according to the CLTS criteria and policy.

The CDC’S Elder, Hedayatullah, indicated that the DACAAR team had done well in implementing the programme. He clearly sees a huge difference as compared to before when it comes to diseases. He also saw the programme eliminating the conflicts between tribes and families bringing the communities together once again. This was crucial in accelerating the program.

“I want to say thanks from the core of my heart on the behalf of the communities and very thankful to DACAAR’s strive.”

Challenges, measures taken and lessons learnt

Kama has been declared open defecation free and the DACAAR CLTS-team has been phased out in the district.

Future insecurity will challenge the stability in the district because new returnees and internally displaced people will settle in Kama resulting in increasing pressure on the meagre existing WASH facilities and structures accordingly.

Of the lessons learnt is clearly the participation of religious scholars, village elders and other influential people in all phases of the programme and primarily giving them time is important in reaching the goal: eradicating solid waste, fluid waste, and human excreta from the public sphere.

Inviting community members, for instance, women and elders, to a clean sample house in the village has yielded positive results.

Flexibility is required. CLTS staff had to change their plans and location from one community to another. Activities were carried out when the situation allowed for the assigned tasks to be completed.

Nangarhar Province, the fourth Province of East Region, has 22 districts, one of them Kama.

The district has a total population of 171199 in 52 Village Community Development Councils and 25457 families, 99% of the district residents speak Pashto.

Momhmand, Gushta wall, Gujar, Arab, Shinwari, Safai and Ibrahim Khailare major tribes living in the district.

According to the Afghanistan Living Conditions Survey from 2014 presented by UNICEF, open defecation is very common in Nangarhar province and Kama district was no exception to this before DACAAR intervention.

What is Community Led Total Sanitation?
Community Led Total Sanitation (CLTS) is a new concept developed by Kamal Ker in Bangladesh in 2000. This innovative approach results in positive changes in people’s lives and a reductionof transmitted diseases like diarrhea, cholera, malaria, typhoid, hepatitis etc. The concept is now successfully implemented in 60 countries including India, Pakistan and Afghanistan.
In CLTS, a subsidy is prohibited.
The focus is on behavioral change of the community members who participate actively to eradicate fluid waste, solid waste, human excreta from the community.
Knowledge about hygiene and sanitation is passed on to each segment of society.
The program to end open defecation in Afghanistan aims to scale up the CLTS implementation rate following proven approaches.