Prey Khmeng village, in Khnat commune, Puok district, of Cambodia’s Siem Reap province, is a small, rural village around 15 km from the provincial town. Until quite recently, Among Prey Khmeng’s population of 517, only 68 households had access to a toilet, which was equivalent to about 63% sanitation coverage. Because of this, Prey Khmeng had a high rate of sanitation related illnesses like diarrhoea, with many households spending a considerable portion of their monthly income on medical treatments. And, parents worried about the safety of the elderly and their daughters, especially at night, who had to wander away from houses to use the bathroom.
But with the support of USAID’s Integrated Nutrition, Hygiene, and Sanitation (NOURISH) project, Prey Khmeng succeeded in building 140 new toilets in less than two years, increasing their sanitation coverage to 100%. All 108 of Prey Khmeng’s households are now using their own hygienic toilets, and on June 15, 2017 the village was declared open defecation free (ODF) by Cambodia’s Ministry of Rural Development (MRD).
Prey Khmeng’s success was not achieved as a collection of individual households, but as a village coming to together to achieve a common goal.
NOURISH, which guided and supported Prey Khmeng to achieve an ODF status, takes a unique, multi-sectorial approach to reducing malnutrition in low-income, rural districts of Cambodia’s Battambang, Siem Reap, and Pursat provinces. The project integrates innovative approaches to improve water, sanitation and hygiene (WASH) with strengthened nutrition services within the health sector in order to address key causal factors of chronic malnutrition. NOURISH is funded by USAID led by Save the Children in partnership with SNV.
During baseline surveys that NOURISH conducted prior to the start of project’s activities, it was revealed that most people in the targeted villages, like Prey Khmeng, had little understanding of disease transmission and the importance of sanitation and hygiene. Most caregivers of young children did not know about the importance of properly disposing of infants’ faeces, which was often just dumped on the ground near the home. And hand washing with soap before meals and after defecation was not commonly practiced. Although many families aspired to own a latrine, it was not high on their priority list.
SNV set out to help the households of Prey Khmeng understand the importance of proper sanitation and hygiene, and the dangers that could result from a lack of sanitary infrastructure (like toilets and handwashing stations) and habits. In April 2016, SNV, in partnership with Cambodia’s Provincial Department of Rural Development (PDRD) and local government authorities, conducted Community Led Total Sanitation (CLTS) triggering activities in Prey Khmeng.
CLTS is an innovative methodology that mobilises communities to improve their sanitation and achieve an ODF status. CLTS begins with a triggering event that shows communities how open defecation and poor sanitation can cause diseases, negatively impact health and nutrition, and contribute to childhood stunting. After the triggering, SNV works with communities to create and sustain demand for improved sanitation and to self-monitor instances of open defecation to encourage change from within their own villages.
Through CLTS, SNV worked to educate Prey Khmeng’s residents on three key messages: 1) the importance of using a toilet; 2) the need for hand washing with soap; and 3) how it is essential to drink safe water. After the CLTS events, PDRD staff have conducted regular follow-up activities with the village’s households, including door-to-door visits in the village, to make sure that the community was mobilising to improve its sanitation. As a result of the CLTS events and PDRD’s follow up activities, many of Prey Khmeng’s households decided to buy the necessary materials and build toilets.
However, some of the households on the lowest end of the income scale were still unable to build toilets due to lack of funds. These households were forced to continue open defecation. And as a result the entire village was unable to reach their goal of achieving an ODF status.
Prey Khmeng’s Village Chief, Mr. Phal Chit, led efforts to support these households to acquire their own toilets. Both households with and without toilets were invited to the CLTS events to share their experiences and learn from each other. He also negotiated with toilet suppliers to accept payments for building materials in instalments, so that toilets became available to low-income families. Ever present at all village events and ceremonies, Mr. Phal Chit never missed the opportunity to spread the key messages of the importance of sanitation and the benefits of having a toilet.
By early 2017, only 12 households in Prey Khmeng were still without a toilet. With the Village’s support, Mr. Phal Chit rallied the community together to volunteer labour assistance to help these last remaining households construct toilets.
By coming together as a community, and with SNV's and NOURISH’s support, Prey Khmeng was able to achieve 100% sanitation coverage and an ODF status without leaving a single household behind.