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Last Updated: Saturday, 15 March 2008, 10:09 GMT
Clean break from cycle of disease
Dr Kamal Kar speaking to villagers (Image: TVE)
A combination of information and shock tactics have been successful

Bangladesh is facing an environmental crisis.

It has the highest population density of any nation on the planet; and a half of its people are without adequate sanitation.

As a result, the rivers and fields are polluted with human waste that enters the food chain.

According to figures from Water Aid, 125,000 children under the age of five die each year from diarrhoeal diseases.

"In one year, 140 people died in this village from diarrhoea; we saw it with our own eyes," a Bangladeshi man tells the Television Trust for the Environment's (TVE) Earth Report programme.

"They all died within 15 to 20 days, and people who used to dig their graves had their lunch beside the graves because they did not have time to go home."

Help yourselves

The floodplains of Bangladesh are considered to be among the most fertile soils in the world.

Gap between dwellings (Image: TVE)
Living in close proximity helped spread diseases
However, the reason behind the richness of the land is also a major threat for the rice farmers who grow their crops here.

For up to six months each year, the fields are covered by water, which increases the risk of diseases like cholera.

To stop the spread of diseases, an awareness raising scheme called Community Led Total Sanitation (CLTS) is helping local people to help themselves.

"In the CLTS approach, the solutions are not imposed from the outside and the community is not told what to do," explains CLTS founder Kamal Kar.

"The community is empowered and the solutions emerge from within."

Dr Kamal and his team of workers from the aid charity Care are taking their scheme to Jarganath Pur, a village in northern Bangladesh.

Map on the ground (Image: TVE)
A large map illustrates the extent of the sanitation problem

"Open defecation is rampant in this village and we are going to trigger CLTS," he explains.

He begins by asking the villagers to gather together for a general meeting, and the team plots a map of where everyone goes to the toilet around the village and surrounding area.

The team then show how easily people and livestock spread faeces around the village and into homes.

Dr Kamal drives home the point by asking his shocked audience if he can take a photo of any villager who is happy to eat their neighbours' faeces.

He says the aim of this is to shame the community into action. It is not too long before the first villager volunteers to build the first toilet.

"The most important thing in CLTS is that outsiders are definitely not asking the community to stop open defecation or change their hygiene behaviour practice," says Dr Kamal.

"It is just empowering people to analyse their own sanitation; everyone is a human being and no-one wants to live in a filthy and dirty condition."

Women cooking (Image: TVE)
The introduction of toilets allows more land to be farmed for food
When the team returned to the village three days later, they were told that 15 toilets were either completed or were being built.

"We didn't realise before that open defecation can cause a lot of diseases like diarrhoea and cholera," reveals one villager. "That's why we are doing this now."

As well as stopping the spread of diseases, building toilets also means that villagers can now grow food on land once used as a lavatory.

The extra crops mean that no-one suffers during "Monga", a period of seasonal hunger between the sowing and harvesting of crops.

Dr Kamal hopes the international community will look at the success of CLTS.

"Many development agencies money and resources; they spend huge amounts of money," he explains.

"But in CLTS, you empower the community, triggering all these things and you also create a conducive environment for the community to move on.

"As a matter of fact, this is a whole shift in the paradigm of development interventions."

The Television Trust for the Environment's (TVE) Earth Report - Clean Living - will be broadcast on BBC World on 14-19 March 2008. Please check schedules for further details



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