In the last three years, a largely unnoticed foreign aid project has delivered sanitation to 5.4 million people around the world, helping prevent thousands dying from cholera, dysentery, and other diseases. And it achieved all of this without paying for a single toilet.
The Global Scaling-Up Sanitation Initiative, a marriage of Madison Avenue marketing and Main Street self-reliance, aims to drastically decrease the number of people without access to basic sanitation in the developing world, estimated at 2.5 billion people by the United Nations.
Rejecting the approach of most aid efforts, it has focused almost exclusively on building new attitudes—not new infrastructure—in countries from Tanzania to Indonesia. The key is convincing communities about the dangers of open sewage through marketing and education, sometimes employing stunts such as recruiting kids to scatter bright yellow curry powder on feces in villages, thereby creating a demand (and business model) for sanitation projects. Although the program offers technical assistance and token government plaudits, usually in the form of certificates or (in India) busts of Mahatma Gandhi, local communities design, build, and fund their own latrines for about $20 to $30 each.
So far, this new strategy is posting some impressive results: 40 million reached through mass media campaigns and millions contacted directly. If successful, the initiative may roll out worldwide. Researchers are analyzing a host of metrics (at least a quarter of the budget is dedicated to monitoring alone) that should be available for review once the intitiative wraps up November 2011.
The approach was founded on decades of failure. "There is not a single example in my 30 years in the field where a successful small scale pilot got scaled up," says Eduardo Perez, a sanitation specialist at the World Bank and a leader of the initiative. After seeing billions of dollars poured into public sanitation efforts, Perez and others realized the problem was too big for any organization or government to tackle alone. They may have been approaching the problem all wrong in the first place: Even when projects did work, they reached at most tens of thousands of people, not millions, and many latrines ended up abandoned or broken.
The data may show attempts to change the "hardware"—building thousands of aid-funded latrines in the developing world—are nothing compared to changing minds in terms of effectiveness, says Alexandra Orsola-Vidal, an impact evaluation specialist with the project. "It’s up to [the communities] to pay for proper hygiene and facilities," she says. "It's a public health campaign: You should wash your hands with soap, but I’m not going to pay for your soap and water."
The approach could do more than help the billions of people without proper sanitation. It could inspire a new approach to spending billions in public aid.
[Image: Milaap.org's Flickr stream]