“Little children in the community used to see me when I would go to defecate in the bushes,” says Sarah Nakajjoba, a mother living in Kyalulangira, a sub-county in Rakai district, south-western Uganda. “It was very embarrassing to have children young enough to be my grandchildren stumble upon me,” says, Sarah, admitting the immense shame and discomfort from such incidents.
One out of every three people in the world does not have access to a safe, clean and private toilet. The story is not different in Uganda. But the lack of a suitable latrine is not just a failure of personal hygiene and a risk to public health – it is also an affront to individual dignity.
An assessment by World Vision showed that her community traditionally had no sanitation facilities, but that did not make the problem easier. Sarah resented the fact that she was forced to urinate and defecate in the open areas around her village. Sometimes, during the rainy season, she would be forced to use bushes behind her house. Her advancing age made her more dependent making it challenging to find suitable places by herself.
The community also knew that open defecation was a health risk, but few had any idea how to install sanitation facilities. They had no choice but to do what they knew to be harmful.
A pilot launched
In 2019, World Vision through VisionFund piloted a water, sanitation and hygiene programme dubbed Loans for the Toilet. The programme involved providing small loans for toilet construction to selected families and training them in sound hygiene and sanitation practices, emphasising latrine construction and proper hand-washing. Sarah was among the five most vulnerable households identified by the community, widows, the elderly, and families with members living with disabilities. The pilot is now benefiting 35 people, of whom 23 are children.\
“Today, I feel dignified,” says Sarah, referring to her new latrine. “I use it when I need to, and I make sure to keep it clean.” Sarah also makes sure she washes her hands after visiting the toilet, understanding that her age makes her a role model. The woman who once risked daily indignity is now a champion of hygiene and sanitation in her community.
Jane Nanteza, 56, is another beneficiary of the Loan for Toilet pilot programme. Like Sarah, Jane is an enthusiastic proponent of the new teachings, seeing the programme as an answer to her deep desire for such facilities and good practices to take root in her community.
Most homes in her community are now accessing loans to construct latrines. The expense is kept low as materials are locally sourced, making it more likely that the step forward in improving sanitation and adopting appropriate hygiene behaviour will last.
“When I use the bathroom, there’s no chance anyone will see me,” says Jane. “World Vision has taught us and helped us, and they have given us back our dignity. With a toilet, life is amazing and enjoyable.”
Adraine Basiima, business development and integration supervisor at VisionFund Uganda says working with communities toward safe, appropriate sanitation and hygiene facilities is a major aspect of their WASH work. As a result, an estimated UGX25 million has been disbursed as loans since the launch of the programme to facilitate households in Rakai district construct sanitation facilities.
“There is high demand,” says Adraine. “It’s like people have been awakened from a deep slumber. From Rakai alone, we’re working on over 100 loan requests for building toilets. This is very good. We attribute the success to our approach of working with families to identify a workable solution.”
Safe water and appropriate sanitation and hygiene are foundational for life. Research reveals that 80 per cent of childhood disease is related directly or indirectly to unsafe drinking water, inadequate hygiene, and open defecation. Access to WASH also has a direct impact on other areas, including education, livelihoods, food security, and disaster resilience.
World Vision approach
In order to sustainably promote improved sanitation and appropriate hygiene behaviour, World Vision uses its proven Household Engagement and Accountability Approach to mobilise and train households to be in charge of their development agenda.
The approach brings together 10 to 20 households in densely-populated communities and 5 to 10 in sparsely populated communities. It equips and strengthens families and caregivers to be the first line of protection and care for children. It also promotes different aspects of child well-being, including health, education, livelihoods, and child protection at the household level.
Moses Kadobera Leneker, community engagement and mobilisation manager at World Vision in Uganda. is responsible for the successful scaling up of this approach across all districts where World Vision has operations. So far, a total of 12,461 household clusters have been formed and active since the launch of the approach in 2017.
“This approach has been adopted in all communities where we work and the results are just amazing. Households are in the driving seat and managing their own affairs,” says Moses noting that the approach, “allows households to tap into the power of each other” to become active agents of their own change.
The well-being of children and families is impossible without sustainable, equitable access to clean water, dignified sanitation, and appropriate hygiene behaviours. When these three factors come into play, children and their families are protected from infection, diseases and injury; living healthy lives.
That’s exactly what is happening in Sarah’s and Jane’s communities.
“I thank World Vision for helping me to reclaim my dignity. I now live like a human being, and I don’t have to worry about privacy issues anymore,” says Sarah, who is working with her neighbours to address sanitation and hygiene challenges in their community.
Jane, a mother of two does not regret taking a loan of UGX1 million to construct a toilet. “Every time you use the toilet today, think about what you would do if you didn’t have one,” she says. “A toilet is a necessity of life. Picking a loan to have a well-constructed toilet for my family is one of the best decisions I have ever made. Beyond health benefits, your dignity is kept intact.”
Written Adriane Basiima, VisionFund Uganda and Fred Ouma, World Vision Uganda