Sit Rep 2 From Haiti. In search of the Happy Crapper….or a lesson in Safer Shitting? Read on…..

Girl from La Piste.

Hi Finn, here's a young girl I met in the camp in La Piste, she's there with some of her family, but others have gone missing, uncles, aunts all of whose whereabouts are unknown, disappeared, like so many thousands, probably buried, unidentified, vanished.

Alright Dad, I hear you saying…what the hell are you doing out there, far away from Peppa Pig, Charlie and Lola and Spider Man…Grrrrrrrr..go on, spill the beans!

Alright son, here’s my best shot…what am I up to?

As I said before I’m out here in Port Au Prince, Haiti with the The British Red Cross and we are currently working in two large camps in Port au Prince as a response to the earthquake on the 12th jan, in two camps, La Piste camp, with 35 – 40,000 and Auto Mecca with15,000 inhabitants.

I’m with a specialised unit, the Mass sanitation Module, who’s role is to go out at an initial phase of an emergency to target sanitation and hygiene promotion for a maximum population size of 20,000, for the initial 3 month phase of an emergency.

This is an image from Auto Mecca.

It's a pretty small camp and well organised. There are nothing like the tensions that exist in La Piste, here. Our work in these camps includes latrine, handwashing and shower facility construction and hygiene promotion in the form of community health education, the promotion of community ownership through linking with local sanitation committees and volunteers.

As part of this, we are continually assessing not only the quantity, but also quality of the services we provide. It is obviously important that there is sufficient number of latrines for population sizes and we aim, tho rarely, if ever achieve, the target of 1 toilet for 20 people. In La Piste it’s currently 1 per 400, and this is at best…but more of that in a much later blog entry.

In addition to the numbers of latrines provided, we try to assess and meet locally acceptable quality standards. For the hygiene promoter this is a crucial part of our role. All health promotion work strives to limit the barriers that prevent good health and hygiene behaviours.

A classic example of a poorly designed latrine, with loads to make you want to crap elsewhere, poorly placed, you've got to walk over shit to have a shit, and when you get there and are squatting down, with your trousers round your ankles, it only takes a gust of wind, and it's for all the world to see...umm, maybe this isn't what the happy crapper is looking for!

With regards to hygiene promotion, we need to ensure that toilet design, location and maintenance act to support, rather than obstruct successful toilet use. In short, we need to make sure that our latrines are the prefered location for any plopportunity

As hygiene promoters, we have several tools at our disposal to ensure or verify this. These include site visits and observational walks to see how well latrines are used and maintained, as well as whether the local populations are using other sites as latrines, defecating in the open (an issue that any festival goer may have experienced), returning to their ruined houses to defecate in existing latrines or defecating in plastic bags. Although this last option does not sound ideal, the use of defecation in plastic bags can be a realistic option in the short term to prevent faecal contamination of the environment….technically we’d call this a case of safer shitting…but let’s not get too technical!

Another useful to tool find out what people really want are Focus Group Discussions. In the urban camps of Port Au Prince, community members complained they did not like the design of the latrines, so I met with the sanitation committee of the camp (who represent the community) to discuss exactly that, latrine design….it’s amazing what people pay you to talk about!

People showering in the open, gets them clean but creates large pools of standing water, a perfect place for mosquitoes to breed and thus spread Malaria and Denge Fever….this really needs working on!

La Piste in particular, is made up of people from a number of populations who come from diverse communities affected by the earthquake. This means we are potentially working with population groups who may have very different original experiences and behaviours in regard to hygiene practices and latrine design, management and maintenance. We need to understand this more fully if we are to have an effective hygiene promotion response, both in terms of “hardware” (toilets, washing stations and malaria nets) as well as the “software” (hygiene behaviour maintenance or alteration).

An image of highly littered area. Without the development of local ownership and management of sites, litter takes over and acts as a breading ground for flies and mosquitoes, with the ensuing epidemics of diahorrhea, malaria, denge fever, typhoid or scabies. The challenge is to meet this together as partners.

We also need to take in to account that the effects of a major disaster and change of normal environment, with vastly reduced resources and support systems, frequently leads, at least at initial stages of an emergency, to highly compromised health behaviours. In effect people don’t necessarily behave as they would…again, something that festival goers may appreciate.

Dramatic increases in the population of these camps means we need to work with them in smaller groups or zones in order to be able to respond effectively. To identify the layout and demographic mix within the camp, we completed a community mapping exercise, in which people developed their own over view of the camp, adding various water and sanitation details, where there are toilets, where they access water, wild shitting sites, dangers like areas of large/fly or mosquito population.

What it also showed us was where there were populations with no latrine or water sources, providing an overview that is difficult to gain otherwise, and all from a community perspective.

Our current aim is to have the sanitation committee identify managers for these zones who will organise latrine attendants and garbage cleaners to improve environmental hygiene and latrine cleaning.

A Community Mapping Exercise at La Piste.

There are multiple challenges, especially in La Piste, where employment opportunities have been hijaked by local gang members, making community participation very difficult, in the face of gang control of resources…but more of that later.

Following the mapping, we began our focus group discussions. We did this with both adults and children, to see if there were specific needs for children, that could lead us to build latrines specific to their needs.

Children brainstorming “good toilets”, as they didn’t write we used a scribe…this is our driver!

Firstly we brainstormed, “what makes a good toilet”? The factors they came back with were many, but included: a seat with a lid, a solid structure made from wood, that it can be locked, enough space, cleanliness, availability of toilet paper and handwashing facilities. Interestingly in looking at reasons why latrines were dirty, adults blambed childrens mal practice and children blambed adults for being irresponsible…..we’ll have to build separate toilets to find out who’s telling the truth.

The La Piste Focus Group visit to wooden latrines. They liked these, but there was still room for improvement. There are currently four different types of latrines in the camp. To get feedback on each of them we visited them individually….and the both children and adults explained their likes and dislikes for each design. This then led to discussions about what they really wanted.

Kids visiting plastic sheeting toilets…..they weren’t impressed!

Women designing their toilets. This told us what we should have known already...learning, we're not the fastest! Following visits to the latrines, brainstorming and the Focus Group discussion, the steering group divided in to groups of men and women and designed their perfect toilet. The designs were then presented and discussed by the whole group. A final design was agreed by all.

Girls designing their latrines.

Pic 10. Scanned Toilet designes. As a result, of this exercise in asking communities what they wanted, the Red Cross has designed a prototype which will be presented to the Sanitation Committee as soon as possible. We hope that through this work we are now able to provide secure, safe and desirable latrines which will not only improve the living conditions in the camp but perhaps restore some dignity for the earthquake affected people in Haiti.

Childrens' Toilet Designs.

Building new latrines. It's difficult to explain how hard it is to gain a consensus re latrine design. One of the challenges we face is that in urban camps, there is a huge shortage of space. Initial pit latrines fill up and can only be emptied once or twice before they collapse.

New Latrine design in progress.

In Haiti there is a tribe called the Baiyaku who are specialists in emptying latrines, which they do in the middle of the night and are highly paid for their troubles. Everyone knows them as specialists in this area and we'll be employing them in camps to do just that.

However in the long term, we needed to include space saving in to our new latrine designs, and as such we planned blocks of four around a central submersable tank that cound be "desludged", making them more user friendly, ergonomic and sustainable, now all we need is to ensure maintainance...now there's a story!

New latrines for happy crappers.