Going the last mile in ending open defecation in Nepal

Sunaina Devi standing outside her home in Devi Village.

Nepal’s sanitation campaign making a difference in Majhi

By: Charles Dickson

Sunaina Devi standing outside her home in Devi Village.

MAJHI, Nepal - Recently, the national campaign to end open defecation across Nepal arrived in Sunaina Devi’s village, and it promises to be transformational.

Sunaina lives in Majhi, a village of 104 impoverished people in Nepal’s Terai region. Majhi’s huts of mud, thatch and straw stand in a row along the shoulder of a dirt road that carves through endless rice fields. Working these fields is how Sunaina, and the majority of her neighbours earn their living.

Among their hardships has been the absence of sanitation. “Previously, the people did not have toilets, they did not see the necessity of having a proper place to defecate,” says Raju Prajad Sah, the Chief Administrative Officer of the rural municipality of Kalikamai, where the village of Majhi is located.

He describes how open defecation has been the age-old and accepted practice. The pond across the road where the villagers raised fish and watered animals became often contaminated.

Mr Sah recalls that episodes of diarrhea were normal in Majhi with open defecation and a lack of handwashing compromising health and well-being. “Especially vulnerable are the young, the old, and anyone compromised by factors from disability to mental illness, or even just the misfortune of living alone,” he said.

Young and old are more vulnerable to the impact of water contamination.

Children are the hardest hit. According to the Ministry of Water Supply, over recent decades, from seven to ten thousand Nepalese children were lost each year, mostly to diarrhea.

This was the familiar reality of Sunaina, her family and their neighbours, until a few months ago. That’s when a nation-wide effort to motivate every Nepalese household to stop open defection and use a toilet came to Majhi. Spearheaded by the Government of Nepal, the campaign appears to be changing everything, not least behaviours.

“In the beginning, the majority of the people were against this project, they were saying no, it’s against our longstanding culture and we will defecate outside of our houses,” says Nathuni Prasad Kushwaha, the elected chairperson of Kalikamai.

Mr Kushwaha says that a group formed in each community would go house-to-house to talk about the connection between open defecation and illness. They motivated villagers with inspirational videos and large posters, constantly promoting the health gains of using toilets and of good hygiene practices such as handwashing.

“When the awareness campaign got started, and taught them about the benefits of sanitation, and its effect on their lives, slowly and gradually they understood that,” says Mr Kushwaha.

Mr Sah, in his role as Chief Administrative Officer, is responsible for the implementation of development projects across the municipality. He says that after three intense months of persuading for open defecation free (ODF) benefits, every household in Majhi decided to construct its own toilet.

L-R: Raju Prajad Sah  Chief Administrative Officer In Kalikamai Rural Municipality,   and Nathuni Prasad Kushwaha is Chairperson.

“Now they all are using the toilets and obviously the difference is that there will be the reduction of diseases and the living standard will be, I think, uplifted,” says Mr Sah.

On 30 September, Prime Minister KP Sharma Oli declared that all 77 Nepali districts are free from open defecation. Alongside many other stakeholders, the UN family in Nepal has expanded its multi-faceted support for the government to achieve this milestone.

Large posters were mounted on the walls of Majhi’s WASH resource center promoting the health benefits of using toilets and hand-washing.

Building on this momentum, the government announced to lead a new national campaign on total sanitation to sustain the ODF achievements, addressing long-term behavioural changes and transformation of social norms.

Sunaina leads the way through her house and out the back to show her new latrine. “I built it myself by taking a loan. I have not paid it back but I will within one year by cutting rice paddies,” she says.

The campaign to end open defecation also raised awareness about the benefits of hand-washing.

Since 2011, the UNOPS hosted Water Supply and Sanitation Collaborative Council (WSSCC) has contributed to the implementation of the behaviour-change-based push to transform the country’s sanitation and hygiene status. Its efforts have been concentrated on the southern Terai plains, the challenging ‘last mile’ of Nepal’s sanitation campaign for the past five years. Despite the region’s daunting socio-economic challenges, the programme, supported by WSSCC and implemented by UN-Habitat, NGOs and government partners, successfully helped accelerate sanitation coverage in eight Terai districts from around 13% to 98% in just over four years, according to government data.

“The progress we are seeing in Nepal is very encouraging, and it is testimony to what can be achieved when national governments, development partners, NGOs and local communities work together,” says Sue Coates, WSSCC’s Executive Director ad interim.

“This is really a key message of World Toilet Day (November 19), an opportunity each year to celebrate such achievements and, at the same time, rededicate ourselves to ensuring that such gains are sustained and that we continue to support countries to move upward on the sanitation ladder, which is crucial in the achievement of all the Sustainable Development Goals,” says Coates.