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Ho West District Environmental Health Officer, Mrs Stella Kumedzro, in an interview with Mary Anane-Amponsah
Ho West District Environmental Health Officer, Mrs Stella Kumedzro, in an interview with Mary Anane-Amponsah

No more open defecation at Dodome Teleafenu - Community embraces Community-Led Total Sanitation (CLTS)

Simple and basic as it may appear, regular handwashing is considered one of the most important aspects of personal hygiene that helps fight diseases.

That routine has again been touted as one of the keys to combat the novel coronavirus disease (COVID-19) which continues to claim thousands of lives daily around the world.

Though a mundane activity, handwashing with soap under running water has the ability to get rid of pathogens (bacteria, viruses, or other microorganisms that can cause disease).

Since past education on handwashing had emphasised the routine for some activities such as after visiting the toilet, when about to eat or when the hands were visibly dirty, many people found making the hygiene activity an integral part of their lives daunting, given the challenges in accessing potable water in many rural communities.

However, there are successful stories to be told from 12 communities in the Ho West District of people adapting to this routine activity to serve as a motivation for others to follow.

Indeed, in those 12 communities, handwashing and proper waste management practices have become a way of life for the residents who have been living this way for the past eight years, following the introduction of the Community-Led Total Sanitation (CLTS) programme

An initiative of the government and the United Nations Children’s Fund (UNICEF), the programme was introduced in 2012 and triggered in 98 communities in the district.

Today, the CLTS initiative, implemented in collaboration with district assemblies, has been scaled up in beneficiary communities due to the coronavirus pandemic.

Residents of areas such as Kpale Xorse, Luvudo Kassadjan, Abalakpoe, Saviefe Gbedome, Gbedekorpe, all in the Ho West District, practise good hygiene such as washing their hands very frequently.

A Natural Leader showing how clean the community is
 
Situation before CLTS

Prior to the introduction of the CLTS, the communities lacked proper handwashing facilities and lavatories, leading to open defecation (OD) and high insanitary conditions.

One of the communities, Dodome Teleafenu, with population of about 610, had only 17 household latrines out of 84 households, with the rest of the population heavily dependent on the community’s sole public latrine; a situation which led to OD and numerous other health challenges, including typhoid, cholera and diarrhoea.

A visit to the community last month, revealed that the CLTS had turned the community into becoming the pride among the cleanest communities in the Volta Region. It has now qualified to become one of the 12 communities declared open defecation free (ODF) in the district.  The household latrines in the community increased from 17 to 82 enabling it to achieve that status in 2016.

Not only that, from struggling to provide water readily for handwashing, the Daily Graphic’s visit to the community again revealed that all households had been fitted with tippy taps or Veronica buckets to encourage handwashing.

One of the key persons who spearheaded the project as a natural leader, Mr Courage Nuku Kodzi, told the Daily Graphic that OPD attendance at the Community Health Centre before the CLTS initiative was high.

He said numerous cases of diarrhea and malaria were the most reported due to the poor sanitation situation.

However, he said, hospital attendance had reduced drastically, due to improved sanitation.  

Statistics provided by the Volta Regional Health Directorate indicates that no case of cholera and typhoid had been recorded in the community since 2012.

Cases of diarrhea have also declined from 256 in 2014 to 63 in 2019.

It was also observed that the community remained spotless with no rubbish littered indiscriminately.

Togbe Akpabe I demonstrating how the tippy tap functions


Fighting COVID-19

The importance members of the community attach to personal hygiene, particularly handwashing, has kept COVID-19 at bay in the community as it has not recorded any positive case of the viral disease as of yesterday.

A food vendor, Ms Stella Koffie, scoffed when she was asked about challenges in adhering to the COVID-19 safety protocols and quickly pointed to a fixed tippy tap she described as a way of life for the people in the community.

She proceeded to demonstrate how to effectively wash one's hands by applying soap and stepping on the wooden latch to her five-litre water container to drip some water to rinse her hands.

The tippy tap is a simple device that facilitates handwashing with soap under running water. It comes with a containers of different sizes with a small hole near the cap. The container is filled with water and hung on a rope suspended on two clubs of about two metres.

Another rope is tied between the neck of the container and a stick on the ground, which serves as a pedal. A block of soap or liquid is also hung near the container of water.

When it is time to wash the hand, the person only has to press the stick, which suspends between 45 and 90 degrees on the ground, to tip water from the container to clean the hands.

Since only the soap is touched with the hands, the device is considered very hygienic.    

Ms Koffie said she made the facility available to her customers after encouraging them to wash their hands with soap under running water.

Since most households have the tippy taps, the community has abandoned the use of the only public toilet in the town, which is now available mainly for visitors.

Madam Stella Koffie in a handwashing demonstration
 

Challenging beginnings

A former Environmental Health Officer, Mr Edward Agbeka, who led the CLTS programme implementation in the district, said the process was not a walk in the park.

He explained that initially some community members resisted the programme on the assumption that they might suffer revolte from the individual household latrines.

However, Mr Agbeka said “through education and the usage of the vent pipe which would carry the odour away, most of them started warming up to the idea and eventually accepted the construction of the new and innovative sanitation facilities in their homes.”

Several volunteers who emerged from the CLTS triggering sessions, referred to as Natural Leaders, also came on board to assist in setting up the facilities, which were cost effective.

For instance, affordable alternatives of bamboos for vent pipes were utilised for the projects instead of the costly PVC pipes, Mr Agbeka added.

He explained that as residents became accustomed to the usage of their private facilities, it significantly reduced pressure on the public toilet and eliminated the unpleasant stench normally associated with public latrines.

Education on hygiene practices, he said, was carried to schools in the area, with vigorous sensitisation for children, who had now become formidable catalysts for change in the community. They constantly reminded members of their households to wash their hands regularly.

Mr Agbeka, who was filled with blissful pride on the feat, said the children in Teleafenu exhibited strong assertiveness on the importance of regular handwashing in their homes.

The children have also hugely participated in clean-ups both at school and in the community.

He expressed the hope that the community would soon reach the sanitised status, when all households have their own latrines.
 
Strategies for sustenance


Natural leaders, Messrs Courage Nuku Kodzi and Sewornu Agbo in an interaction with the Daily Graphic

The Ho West District Environmental Health Officer, Mrs Stella Kumedzro, lauded efforts of the natural leaders for their great show of leadership, and that of the residents for their commitment towards the success of the programme.

She described as a great achievement, the community’s ODF status, and encouraged residents to strive and achieve the sanitised status, with a 100 per cent of households with latrines.

The concept was triggered in 98 communities in the district, with 12 achieving the ODF status.

Mrs Kumedzro added that her outfit was preparing some other 10 communities for entry into the programme, but was sidetracked as it had to shift focus to take COVID-19 education to the communities.

She urged other communities and individuals to get on board the CLTS programme, which she described as “eye opening” and could guarantee health safety for all.
 
Other communities inspired


An empty health centre in the Dodome Teleafenu community


The Sub Divisional Chief of Dodome Teleafenu, Togbe Akpabe I, said the programme had been fully accepted in the community, with his office ensuring strict adherence to sanitation laws drafted by the traditional authority, making insanitary practices such as open defecation and littering offences which attracted a fine of GH¢50.

Togbe Akpabe said he was impressed with the communal spirit, especially youth, who have played critical roles on National Sanitation Days and the community’s solely instituted sanitation days on the first Thursdays of every month and Sunday mornings, which were dedicated to cleaning lanes, open spaces and the roadside.

He identified the need for chiefs to play effective leadership roles in order to get their people committed to such programmes.

Togbe Akpabe said the community’s accomplishment had already inspired other communities to enrol in the programme.

“The programme is good, so every community in Ghana should embrace and adapt it as they stand to reap huge benefits from it,” he emphasised.

The critical role of chiefs and other traditional leaders cannot be overemphasised in the CLTS programme.  
Their effective leadership paves the way for community management and sustainability of results.

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