1. Two to Six Years after CLTS What Happened, Why, What Next www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Empowering people to help themselves with what they already have...

2. Many thanks to the generous people of PLAN-Cambodia and the World Toilet Organization offering guidance, transportation, translation, housing and friendship www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425

3. What did we do, why did we do it, and what do we want to accomplish? We interviewed 10 households in two villages (plus other individuals that gathered). One Village of 111 households had CLTS in 2007/8 with over half adopting pit latrines. One Village of 129 households had CLTS in 2009 with 65 adopting pit latrines. All members of all households, except one family of three, abandoned their pit latrines and returned to open defecation within one year. We asked WHY? We asked if they would ever build a pit latrine again and under what circumstances. We want to reduce the recidivism to open defecation and improve the success of future CLTS programs. www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425

4. Household dynamics The #1 household bought and is using a PF-Toilet The #10 household is using their pit latrine (for 6 yrs) www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425

5. Household dynamics www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Of the households interviewed

6. Household dynamics www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Household number $ (USD)

7. Defecation practices www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Of the 10 households interviewed

8. Defecation practices None of these people walk far to urinate They pee where they are working and around the house www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Note logarithmic scale 8 of 10 households interviewed open defecate; 3 walk a kilometer!

9. Defecation practices www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Of the 10 heads of household interviewed

10. Do you think pooping outside contributes to your family getting sick? www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 21 people responded to this question

11. In Sickness and In Health www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 This question was limited to the heads of household. Incredibly, they all said they loose one week of work a month due to diarrhea or taking care of someone who has it. They said they usually get diarrhea in the dry season. (note: this survey was at the end of the dry season and detail recollection is usually vague after two weeks.)

12. Is a pit latrine OK for you? www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Half of the heads of households said they would never build a pit latrine again due to the bad experience they had after CLTS. The other half said they would if they had help. This is the only pit latrine still being used (household #10). There were no flies or odor.

13. How do you feel when you poop in a pit latrine? www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 16 household members responded

14. Why don’t you rebuild your pit latrine? www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Multiple reasons given by the heads of 8 households for not rebuilding their latrine.

15. Comments All Heads of households interviewed built a pit latrines after CLTS. Only one household is still using their pit latrine – theirs was the only one built high enough not to flood. Fecal overflow during the rainy season results in disgust. People want help to rebuild their latrines = help to access 1) hardy-affordable materials, 2) affordable labor, 3) technical assistance, and 4) financial assistance for the poorest of the poor. www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425

16. Recommendations CLTS facilitators must tell people to build latrines strong and high enough to withstand the rainy season – elevation is a must – “know how high the water gets”. As a minimum design, CLTS facilitators should create access to one cement ring, one Pour-flush toilet floor (without the bowl), and one wooden floor-hole cover for CLTS participants – free to the ID-Poor. Suggest better pit lining designs during CLTS training. Conduct a two-day CLTS follow-up after the rainy season and respond to the participants comments. This will be the best time to critique designs. The CLTS presentation needs to be followed with better technical guidance during the latrine building period with follow-up to discuss maintenance and resolve problems, otherwise there will be abandonment after the first difficulty. www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 Read our full report on our web-site under “References”

17. Recommendations www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 One cement ring, one cement floor with a hole and a wood cover. This might facilitate expanding to a full pour-flush toilet kit at a later date.

18. Recommendations www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425 This is our suggestion for a revamped pit latrine design that will extend the pit fill time and offer a safe onsite method for sludge removal.

19. Thank you and good luck. www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425