Safe sanitation protects health and builds futures
Inadequate WASH can keep poor families trapped in cycles of poverty. In remote communities, UNICEF-supported latrines are improving health, keeping children in school, and reducing financial stress
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7 March 2024, Ratanakiri – “Before we got the latrine, I would get sick easily,” says 13-year-old Koun Chanthom, a Grade 4 student from Ratanakiri. She was often absent from school because of illness.
Although she knew how important good hygiene is for her health, because her family didn’t have a proper toilet at home, she found it hard to keep clean and wash her hands regularly. Until recently, her family practised open defecation in a makeshift pit a short distance from their house, which spreads disease as faecal matter contaminates the surrounding environment.
“I felt upset when I couldn't come to school and play with my friends,” she says. And when she did come to school, she wasn’t learning much. “I couldn’t keep up with the lesson.”
It’s been around five months now since she’s been able to use a UNICEF-supported latrine next to her house, and it’s made a big difference.
“After I started using the latrine, I felt less sick and then I started coming to school more regularly,” she says. “And now I can understand my lessons well.”
Across Cambodia’s northeastern provinces, where around half of the population still practise open defecation, inadequate hygiene and sanitation impacts every aspect of life and prevents children from reaching their full potential.
Diseases spread through poor sanitation can cause stunting, which has significant and long-lasting effects on early childhood development. In Cambodia, 22 per cent of children under five are stunted. Diarrheal diseases are also a leading cause of child mortality. Regular illness also means children miss crucial time in the classroom, risking falling behind their classmates. Health-related expenses – from hospital bills to transport and food – are an additional source of stress, especially when breadwinners are kept from earning income because they need to care for unwell family members.
Through the UNICEF East Asia and Pacific Regional Office (EAPRO) regional pooled fund, UNICEF Cambodia has been working with the Provincial Departments of Rural Development (PDRD) in under-served and flood-risk areas to help IDPoor families, especially those with children affected by malnutrition, access safely-managed and climate-resilient sanitation.
Chanthom’s family are using what’s called an alternating twin pit, which is considered safer than the most common type of latrine found across the Cambodian countryside. It converts waste into usable fertiliser without needing treatment, reducing the risk of environmental contamination. It’s also cheaper in the long-run as families do not need to pay for costly treatment services.
The household shares the facility with relatives next door, an indigenous Tompuon family who pick cashew nuts for income. Thirty-year-old Romom Ngoum says she was informed by the village chief that using a proper latrine is important for health, but she was worried about being able to afford the costs of construction.
“The village chief encouraged me to build a latrine but I told him that I didn’t have any money,” says Ngoum. “Then he said that there’s support available for me, so I decided, okay.”
Her son’s health was a deciding factor. Like his next-door neighbour, six-year-old Yoeun Chiva was often sick, overwhelming his mother both with concern for well-being as well as financial stress. One trip to a private clinic revealed that Chiva was malnourished.
“A nurse said he wasn’t growing. He was too thin,” she says.
“I was so worried at that time. Whenever he showed little signs of not feeling well, I would bring him to a clinic. If I didn’t have any money I would borrow from my relatives because I was scared that he would get seriously sick. Then I would need to earn money to give back what I borrowed.”
Desperate to make her son well, she also went to a local traditional healer to get some answers, a common practice among indigenous communities in the area. She ended up paying for pigs and chickens as offerings to the spirits after she was promised it would cure her son’s regular bouts of sickness.
They ended up saving up over three months to be able to build the latrine, including hiring labour for the construction, the rest covered by UNICEF. Chiva’s health is now improving, which she attributes to the cleaner environment around her house.
Awareness raising efforts from local community leaders like village chiefs play a huge role in the drive to improve hygiene and sanitation in rural areas, reaching vulnerable households through group sessions and door-to-door visits with messages about handwashing, nutrition, and keeping home environments clean.
Wanting to make the village clean and safe for everyone, Rocham Lea, village chief in Trom Village, was not afraid to push people to really drive the message home.
“When I did the awareness raising, some villagers understood the message and tried to change their behaviour or install the toilet,” says Lea. “But others, we needed to talk with them again and again, and sometimes they felt annoyed and sometimes even a little bit angry. And then they built the toilet.”
Lea’s advocacy efforts and the support from UNICEF has helped Trom Village become open defecation free (ODF), with 22 IDPoor families finally agreeing to build twin pits.
“I’m happy and proud because the people can practice better hygiene and better sanitation,” he says. “When the community is safe, it means less people in the community will get sick and then they can save time and money to buy clothes and food.”
UNICEF also supports awareness raising through tuktuk mobile loudspeakers and radio broadcasts, including in indigenous languages.
With cultural differences among ethnic minority communities presenting additional challenges, financial incentives – including being able save money on costly traditional healing ceremonies – have proven some of the most effective in terms of changing behaviours, says Ou Dararith, Deputy District Governor for WASH in Bar Kaev district.
“Their ancestors lived in a very simple way,” he says. “The community here were not really worried about not having a toilet until we provided a lot of awareness raising. I tried to communicate with the commune regularly to make sure they shared the message every day and to make sure that the people understood. Now most people understand the benefits and all of them are using a toilet.”
Chanthom understands this message all too well. Now back in school, she’s not afraid to look towards the future with hope.
“I want to be a teacher so I can help young people in the future,” she says.
