More basic than cell phones

Nearly nine in every 10 Filipino families (87 percent) own a cellular phone, and yet only three in every four (74 percent) have their own sanitary toilet, Philippine Statistics Authority (PSA) data tell us. Among the poorest 30 percent of families alone, barely over half have their own sanitary toilet, even as nearly eight in every 10 own a cell phone. At this time when a public health emergency seriously threatens lives and livelihoods, we ought to be going back to the basics and worry about our people’s access to basic sanitation.

PSA’s latest Annual Poverty Indicators Survey tells us that around 6 million Filipinos, mostly in rural areas, still practice open defecation. “Maluwang ang padumihan namin dati, ekta-ektarya (we had a very large toilet spanning hectares),” joked Jimboy Tanglao, a resident in an Aeta community in Sitio Monicayo in Mabalacat City, Pampanga. The problem with having neighbors defecating in open fields and waterways is that it makes people, especially children, more prone to diarrhea and worm infections. This in turn impairs nutrition and health status in poor communities, contributing to higher incidence of severe malnutrition and stunting in children. Loretta Queddeng, a barangay nutrition scholar residing in the same sitio, knows the importance of families having their own toilet: “Kapag sa tabi-tabi lang po dumumi, maaaring mapunta po ‘yung dumi na iyon sa iniinom naming tubig (if people defecate in our open surroundings, it could contaminate the water we drink).”

This is what motivates the Department of Health to pursue its Zero Open Defecation (ZOD) Program. Aimed to have all barangays in the country attain ZOD status by 2022, the campaign uses a “Community-Led Total Sanitation” approach and strategy aimed to influence a range of behaviors: stopping open defecation, ensuring access to sanitary toilets for all, frequent and proper handwashing (now so important in the midst of the COVID-19 epidemic), hygienic handling of food and water, safe disposal of animal and domestic waste, and general maintenance of a clean and safe environment.

But getting to ZOD is not as simple as giving away toilets to toilet-less households. I was once involved in the field monitoring of a local government-led poverty alleviation initiative that included giving away toilet bowls to households without toilets in a depressed barangay in Palawan. In one household we visited, we were greeted by the amusing sight of a toilet bowl on the wall hanging like a vase, adorned with flowers. Our LGU host explained that the toilet bowl recipients were supposed to provide the “sweat equity” of digging their own septic tank—but they obviously failed to ensure that the recipients actually did. We later found that the hanging toilet bowl flower vase we saw was not the only one used as such.

The “sweat equity” concept is a sound one, but one cannot assume that recipient households will automatically provide it. It’s with this in mind that the Manila Water Foundation (MWF) pursued its integrated WASH (water access, sanitation, and hygiene) program intervention in Sitio Monicayo in partnership with local private firms and the city government of Mabalacat. Targeting the 45 Aeta families living in the sitio, MWF took a systematic approach by starting with an education campaign to explain groundwater contamination. This proved critical, as I had heard of past failed efforts to provide water-sealed toilets in Aeta communities, with a social anthropologist friend explaining to me that defecating on soil or sand is supposedly a “cultural habit” that would be very hard to change.

Having prepped the community as such, MWF went on to pursue a participatory effort, wherein it ensured that the recipient residents took part in the construction of the needed septic tanks. Tanglao, who was one of the beneficiaries, dug out the land himself where the septic tank of his toilet was built. He thus has a direct stake in the program’s success.

As Health Secretary Francisco Duque III points out: “It’s the same when we buy our own cell phones. We take care of it because the money we used to buy it came from our own pockets.”

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