A remote community shows how a simple story of
fecal-oral transmission can change people’s behaviors.
September 2017, North Cotabato — “Shoot-Boom!”
This was how residents of Camasi described the practice of open defecation.
Camasi is a remote village in the municipality of President Roxas in the province of North Cotabato. In June 2016, Camasi was selected as one of few communities with outstanding sanitation practices. Camasi is now a far cry from the old “Shoot-Boom” Camasi.
“Maghuhukay sila, tapos, uupo. Itatama nila sa hukay [ang dumi nila], kaya, shoot, boom [They would dig a hole, sit over it and aim their waste into that hole. Such is why they’d call it shoot, boom,” says Melly Castrello, village health worker for 25 years, and a longtime resident there.
Residents could not relieve themselves at the hills close by. A fruit company used to occupy the knolls to plant bananas. Hence, they had no choice but to relieve right in their own backyards. Even when they covered the defecated holes, the stench of feces would still reach the main streets.
Some households fared a little better. Families who serve as farm workers in the fruit company would get black plastic bags from the plantation to seal off the pits they dug. Still, it followed the shoot-boom practice of their neighbors.
Some other households, usually children of natives who themselves have families of their own, would share a communal toilet. Between three and five families would have to use a single toilet.
Aileen Cumla, a visually impaired mother, used to rely on her mother’s toilet. Despite her condition, Cumla never had a problem finding her way. The challenge was getting there fast. “Kailangan pa naming tumakbo nang malayo pag nadudumi [Sometimes it would be a hassle to run toward her place when nature calls], ” she says.
“Wala namang nagtuturo nang tama noon [no one was teaching us the right way back then,” Castrello tells.
In her childhood, Castrello recalls, defecation practices were worse. “Wala kaming banyo (No one owned a toilet then).” Back in the day, they also dug holes, but some neighbors did not bother covering the diggings with soil. “Tapos hindi na gumagamit ng tubig (And they did not even wash their rear ends with water afterward).”
More than half of Camasi’s residents did not own their own toilets. In 2013, shared Jenny Rose Fare, who used to head the village’s rural health program, only 37 percent had sanitary toilets. The situation is more or less the same in the nearby villages.
It was not until 2014 when development agencies like UNICEF and ACF International, in partnership with the local government, began making rounds around President Roxas and taught residents the proper way of heeding the call of nature.
Under the Community Led Total Sanitation (CLTS), said Castrello, “lahat ng nanay na bakante, papupuntahin namin [sa multi-purpose hall]. Pagdating doon, tinuturuan namin sila kung ano ba ang tama nilang gawin, kung ano ang kaibahan ng merong kasilyas sa wala, at ng naghuhugas at hindi. (We would fetch mothers who were in their homes and take them to the multi-purpose hall. There we would teach them how to practice proper sanitation, share them the difference having their own toilets makes, and the difference of washing their hands and bottoms after defecating). “
But convincing people was never easy for three reasons.
First, the residents’ behaviors toward sanitation were already ingrained, says Fare. “Marami kaming nakaka-away (Often, we would find an enemy or two).” She recalls what they would tell her: “Nabuhay naman kami ng ilang taon na walang ganung facility. Bakit ngayon kailangan na siyang gawin (We survived without such facility. Why are we now forced to build one)?”
A bigger reason than behavior is poverty. Husbands and wives both have to do farm labor to make both ends meet. “Araw-araw nandun sila sa plantation (every day they had to show up to work at the plantation)”, Fare says. Before daybreak, farmworkers would walk up the hills so they can clock in at 7:00 am. They would stay there until just before the day closes. Their main goal every day would always be putting food on the table. Keeping the house clean was not a priority.
Worse still, the barangay had limited funds for sanitation. “Wala po talaga kaming hawak na budget,” says Fare. “Mas maliit ang importansyang binibigay dati sa sanitation habang mas malaki ang budget nila for infrastructure. Pero sabi namin, aanhin naman nila ang infrastructure kung hindi naman healthy ang community? (They were giving a greater premium on infrastructure at the expense of sanitation. But we argued: how could you maximize infrastructure when the community isn’t healthy?),” she says.
Camasi’s road to the National Search for Barangays with Best Sanitation Practices of the Department of Health (DOH) started with a two-pronged strategy.
First, they sparked behavioral change by explaining the advantages of having a toilet. “We established the link of bad sanitation practices to illnesses like diarrhea,” Fare says.
Castrello used a simple story to get the desired reaction of disgust. “Ginawa naming halimbawa ang tae ng aso. Pag ang pagdumi, ginawa niya sa ilog, maaring makain ng isda ang dumi niya. Pag kinain natin yung isdang galing sa kontaminadong ilog, nakakain din natin yung dumi.” Castrello would get the residents’ buy-in as they cringed with the idea of fecal-oral transmission of unseen germs in the environment.
Second, they sought assistance not only from the barangay, but also the municipal government and development organizations. As a result, they were able to provide households with toilet bowls.
“Pero hindi naman namin ibinigay lang sa household lahat,” says Fare. By asking the households to provide the cement and the piping, “we were inculcating in them some sense of ownership, to make them feel na, ‘Sa akin ‘to. Pinaghirapan ko ito. (This is mine. I worked hard for it.)'”
The closure of the banana plantation earlier this year was also a blessing in disguise for the village—not only because the plantation left a rich soil for farmers to plant rice, rubber, and other crops, but also because the former farm workers got to have time to construct their own toilets, with the help of construction workers paid through the Department of Social Welfare and Development’s cash-for-work program.
Residents like Cumla were able to feel the benefits of having their own toilets almost immediately. To her, it was a big sigh of relief. Despite her condition, Cumla, who has memorized her abode in every nook and cranny, would always make sure the toilet is always clean and stocked with water.
How about sustainability?
The challenge, however, lies in sustainability.
Currently, among the barangays, only Camasi has reached the Grade 2 status in terms of sustainable sanitation: “Lahat ng mga tao (sa ibang barangay), pagkain ang priority. (At the end of the day, residents will still prioritize putting food on the table), Fare says.
A Grade 2 status means all households and government buildings, including day care centers and schools have improved sanitation facilities.
To help households keep their practices in check, the municipal government of President Roxas will soon assign one sanitary inspector for each barangay. The municipal health office also planned to conduct a two-day workshop to ensure the inspectors are well informed of their roles and functions.
More importantly, scaling up sanitation will only be possible with sufficient access to clean water. Achieving zero open defecation in other villages where there are no reliable water systems is still a problem.
If the water problem is addressed, more villages in Roxas could be the next Camasi, according to Fare.
Castrello could never be any less proud of their achievement: “Kahit maliit na bahay, merong CR. Nakita ninyo naman, ay ka-guapo, ka-limpio! (Even the smallest house has its toilet. And as anyone will see, they’re all very beautiful and clean!) she says, joking that the only “Shoot-and-Boom” happening now in Camasi is the shooting of pictures for posterity sake.
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