Sanitation in Cambodia's rural areas is noticeable mainly by its absence - but the Cambodian government aims for one third of rural households to have access to proper sanitation in five years' time. It says it will meet the target. And it wants all Cambodians to have toilets ten years after that. A novel approach from an international NGO, that combines the profit motive with sanitation, seems to be helping.
Presenter: Robert Carmichael in Phnom Penh
Speakers: Dr Chea Samnang, Cambodian ministry of rural development; Cordell Jacks, IDE Cambodia (NGO)
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CHEA: We empower the community to think about how they can improve sanitation by themselves at the community. So, we work with them [...] .
CARMICHAEL: Dr Chea Samnang heads the department of rural health at the ministry of rural development in Phnom Penh. It is his job to ensure that 30 per cent of more than two million rural households have access to proper sanitation and hygiene by 2015. That seems a tall order. Until recently just 16 per cent of rural households had access to a latrine. Everyone else uses the 'open defecation' method, which simply means waiting until dark, then finding a suitable patch of ground near home. But that leaves large amounts of untreated human waste that contaminates water supplies and spreads disease. It is part of the reason Cambodia's under-five mortality rate is among the highest in Asia.
Dr Chea Samnang says the ministry sends teams to rural areas to meet villagers and explain the costs of poor sanitation. Villagers work out how much they spend on medicine, and how many days they lose to illness.
CHEA: And when someone in the family is sick - how much money do you pay? How about the school children, if they get sick? So, this is the situation [that is] analysed in the community.
CARMICHAEL: The hygiene campaign focuses on three key areas - encouraging people to use latrines, making sure they wash their hands, and educating them about safe drinking water practices.
The standard latrine comprises three concrete rings dropped into a six foot deep pit to provide a reservoir for waste, a concrete slab on top of that and a pan at ground level. The latrine owner then builds a small structure around that for privacy.
Part of the government's approach to solving the lack of rural sanitation relies on assistance from charities and organisations like the Asian Development Bank. But another part is based on self reliance. Once the community realises how much poor sanitation costs, villagers will improve matters themselves. However, in a country where poverty is widespread, particularly in rural areas, telling people that poor sanitation is expensive is just one part of the solution. The other is providing them with an affordable latrine.
To that end the non governmental organisation, IDE Cambodia, whose slogan is 'Fighting Rural Poverty With Profit', redesigned the standard latrine and brought its cost down to less than US$30. The NGO then trained local manufacturers of cement products in a handful of districts to make and market the toilet, branded the EZ Latrine. It launched in December.
Cordell Jacks heads IDE's water and sanitation programme.
IDE's philosophy is that subsidies for latrines create an environment in which people wait for others to fund the necessary improvements. The result is often that nothing gets done. Far better, says Jacks, to explain what poor sanitation costs, provide a cost effective solution, then use local entrepreneurs and the profit motive to solve the problem.
JACKS: In the last nine months, it's gone really well. We've sold almost 6,000 latrines and every single one of those latrines has been completely financed by the household. There's been absolutely no subsidy. Not one dollar.
CARMICHAEL: The pay off for the entrepreneur is a profit of five to ten dollars per latrine. The family benefits because they typically spend far more than US$35 annually on related health costs. In fact, a World Bank study from 2008 found that poor sanitation and hygiene costs each Cambodian family around US$150 per year.
And building the toilet is simple.
JACKS: The family will dig a hole in the ground, place the concrete rings, put the latrine together, and then put a structure - depending on what their income can afford - a superstructure - on top of that. And this can all be done in one day. It's completely revolutionised sanitation as an industry here in Cambodia. The ministry of rural development is working with IDE to help spread the message. The EZ Latrine fits the government's concept of self sufficiency for those who can afford it. Dr Chea Samnang says those who cannot, will get technical help to build the cheapest sort of latrine, a dry pit. The focus is to ensure every village is 100 per cent free from open defecation, so it is essential that the poorest are included. Ultimately, the result ought to be better health across Cambodia.
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