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Project Report

Improve Health & Sanitation for Remote Indonesians

Indonesia | RUN BY: SurfAid | Status: completed

Project Background

SurfAid works in remote areas in Indonesia, where diarrhoea is common. Nias, Mentawai and Sumba are beautiful holiday and surfing destinations, however, infant and maternal mortality rates are much higher than national averages.  Behind the palms of some of the world’s most famed surfing destinations are villages so remote that basic government services don’t reach them. There is no clean water, health services, or electricity.

All of SurfAid’s programs begin with clean water. Once access to clean water is established, SurfAid focuses on health education and behaviour change to improve sanitation and hygiene practises.

The survival and healthy development of children requires sanitary environments. In areas where SurfAid works, many people don’t use toilets; this is called “open defecation”.  Defecating in fields, forests, open bodies of water, or other open spaces causes diseases like cholera, typhoid, hepatitis, polio, diarrhoea, worm infestation and undernutrition. Every day, over 800 children under five die from avoidable diarrhoea-related diseases worldwide. 

Relentless bouts of illness keep people trapped in poverty; parents unable to work, and children unable to attend school. Chronic illness significantly contributes to malnutrition, stunting physical and cognitive development.

Project Overview

Access to clean and safe toilets is imperative in order to improve the sanitation behaviours of entire communities. Even if just one person in a village continues to practice open defecation, the whole community is at risk for contamination. Consequently, a large part SurfAid’s work is educational. Once toilets are built, SurfAid works with villages to generate awareness, share information and instigate behaviour change so that toilets are used properly and consistently, with hand washing afterwards.

Project Activities

Ending open defecation is a labour intensive process, requiring significant community guidance and stimulation, so SurfAid focused on those communities that were most responsive to hygiene education sessions, and the community members that were most at risk.

We used the Community -Led Total Sanitation (CLTS) method, a well-established approach which helps rural communities understand the negative impacts of poor sanitation. It focuses on igniting a change in sanitation behaviour rather than just constructing toilets, and concentrates on the entire community rather than on individuals. As a starting point for changing sanitation behaviour, the first significant step of CLTS is to end open defecation.

The foundation for ending open defecation (open defecation free – ODF) was laid during movie sessions, discussions, and education sessions on hygiene and healthy behaviour. 

CLTS starts with triggering which enabled people to do their own sanitation profile through observation and analysis of their open defecation behaviours and the impact of them. That meant community members were asked to draw a map of their village, the water source, the location of their houses and the places where they defecate. Afterwards comes the “walk of shame”, with community members visiting those places where people use the toilet. People usually feel ashamed, and are then triggered into action. This activity is an important part of the well-established CLTS model and it encourages people to change not only because they’ve been told to, but because they understand the health risks and want to.

At the end of the walk of shame, people announce in front of the whole community when they will start building a simple latrine for their family and when the process will be completed. SurfAid and the Water and Sanitation Committees, which are groups established in water focused projects, train community members on how to build a latrine.

Then SurfAid, the local health centre and the head of the village visit families to monitor the progress of their latrines. This accountability measure ensures latrines are built and villages are progressing towards ODF.

Activities implemented:

1. Training and coaching for 8 villages on:

  • CLTS
  • Sanitation & hygiene
  • Safe toilet construction
  • Videos
  • Posters

2. Production of health promotion videos, posters and booklets.

Key Project Outcomes

  • 2,592 people (492 households) in 8 remote communities in Indonesia were reached
  • Hand-washing practices increased from 14% to 41%
  • Access to toilets increased from <10% to 64%
  • Water and sanitation committee members can now independently support toilet construction in their communities.

Community Involvement

All of SurfAid’s programs employ a philosophy of a ‘hand up, not a hand out’. To achieve this, SurfAid works to empower communities through training and behaviour change.

In this project, groups of community health volunteers (kaders) and water and sanitation committee members work together with the local health department to deliver health messages on hygiene and sanitation to their neighbours. These groups are SurfAid’s frontline, receiving ongoing training and support from SurfAid staff.

SurfAid International is a non-profit humanitarian organisation that works to improve the health, wellbeing and self-reliance of people living in isolated regions connected to us through surfing.

Case Study

For brothers Jhon and Isac of Paddi Village - living in a small and remote region in West Sumba, open defecation remains ubiquitous. Recognising the health implications of this practise, SurfAid uses Community Led Total Sanitation (CLTS) to guide communities towards healthier sanitation practises and a better understanding of the importance of these behaviours.

Jhon and Isac participated in a CLTS workshop, during which they experienced both challenges and change. Experiencing first humiliation, as Jhon and Isac were introduced to CLTS, the brothers became committed to healthier practises. During the mapping exercise, they were uncomfortable as members of the community indicated where they defecate, but as the discussion continued embarrassment and shame transpired into motivation.

SurfAid works closely with communities and fosters dialogue and respect. Respect and understanding for the local context, culture and values are at the heart of SurfAid’s interventions. Too common is the loss of young lives in remote villages, and SurfAid works with communities so they understand the root cause of this problem. A participatory process, CLTS is inclusive and open; despite being taboo, speaking about defecation and its health implications, challenges age old practises in a way that respects local culture. Community members are triggered to speak openly on topics never before discussed, to better understand the cause of preventable death and disease, as well as the solution.

As the workshop continues, a social contract forms whereby members of the community support and encourage each other to change their defecation practises and become signatories to the contract. This integrated approach prompts not only the introduction of latrines, but a deep understanding for their importance and a village-wide commitment to change. Brothers Jhon and Isac were part of the CLTS exercise in Paddi Village – they not only signed the contract, they enthusiastically embraced creating a healthier life for their families. Though they didn't stop there: ahead of the contract’s schedule and stipulations, they built latrines; and, further demonstrating their health commitment, they planted nutrition gardens.

"After joining the program, I realized that all this time I was doing something wrong. What I learned  from the program, I want to implement at home. I don't want my family members to defecate in the open anymore!" Jhon explained as he rushed to construct a latrine.

Behaviour change is a slow process, but when people understand the connection between what they do and their family’s health, they are motivated to change. If the process is fostered by culturally sensitive and contextually appropriate information the community is even more inspired. Change always comes with challenges, but they are worth it.

Original project proposal >>

 

Fundraising status

Project cost:(AUD) 20,000.00

Still
needed
Raised
Status

0

20,023.20

Thanks to the following people who have contributed to this project.

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N.agnes S.Bin Hashim L.DECALUWE A.Escoval D.Han E.HAZAMA B.Jacinto W.LAW E.Martin B.Moeu D.OCONNOR S.Preung R.SANCHEZ I.Siordia Alonso F.Steinbring F.Suzuki W.Vargas Osorio