Community Sanitation
Small communities suffer from a lack of health and sanitation measures which can have a negative affect on all of the community's members. Health and sanitation programs can be complex and expensive or they can be relatively simple projects. Health committees can be formed in communities in an effort to improve sanitation measures, and also to improve access to health services.

Schools can also have a role in promoting health and sanitation within their communities; they can be agents of change by introducing health and sanitation measures that they learn at school to their families. For example a newly formed health committee can use schools to launch new programs. They could launch hand washing program at a school very inexpensively, they could launch a deworming program at a school very inexpensively, they could launch a gardening program at a school inexpensively, and with the investment of a relatively small amount of money they could launch a latrine program at a school. Each one of these could be good starter projects for new health committee.

Sanitation is very complex subject, and can also imply a variety of things. It can imply setting up a program to eliminate open defecation in communities or it can imply the safe and proper disposal of rubbish. Similar to community water projects, a sanitation project may not be the first thing that an NGO wants to do when there are health problems within the community. Scientific studies bring a mixed review over the efficacy of latrine programs for example. I'm hoping that some of you in this group will be able to provide studies that will show us some positive results and help us better understand under what circumstances were these projects successful.

For people living on the edge of poverty a communitywide latrine program can be a very expensive investment. Plus there are many cultural and health aspects involved in designing, siting and constructing latrines. Similar to water programs, some latrine programs fail because they were designed and installed by enthusiastic amateurs.

The microbes behind intestinal ill health caused by poor sanitation can come from many different directions. Sometimes it's more cost-effective and will produce a more immediate effect if you promote hand washing and kitchen hygiene before you promote a latrine program. Microbes creating ill health may be coming from five different sources.  A latrine programs will only restrict one of those five. The hand washing program will remove the microbes from one's hands from all five of the sources. The point is that a professional analysis needs to be made of a specific community situation in order to put together a planned approach to sanitation. I'm hoping that those of you in this group will help us to discover field guides for analyzing community situations and for properly designing and implementing projects.

A health committee can also work on a community health program that might include a clinic. There have been some very successful programs utilizing community members trained in basic health care who are able to treat the majority of everyday problems. But they also provide the function of determining when a health problem is more serious and when a community member needs to see a physician.

These programs have been successful for several reasons, one is that maintaining a community health worker is much less expensive than maintaining a physician. Secondly a community health worker is from the same community and culture as their incoming patients and so will be prepared to quickly understand the local causes of an ailment and also which treatments will be culturally appropriate.

Be sure to visit our Community Health and Sanitation Working Group.