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AfricaSan 4: scattered highlights, and one lowlight!

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A huge conference like AfricaSan provides a wealth of information and learning for the enthusiastic sanitation groupie. But so much is packed into the three-day duration that it is impossible to take in everything – schedules are tight, and often overlap, which means that nobody manages to see all of their top picks, despite efforts to have thematic discussions running in parallel throughout the conference.

In my last technical session, on the development of a toolbox for Faecal Sludge Management, the chairman ruefully remarked at the end (to the 10-15 people present) that this session had been scheduled at the same time as another session on “shit flow diagrams” and their use to trigger faecal sludge management activities, so they had lost most of their audience to a bigger presentation on a related topic. However, later I spoke to someone who was at the presentation on shit flow diagrams and he said that there was an even smaller group at that session – so perhaps it was just declining interest (in FSM) at the end of the conference!

My strategy was to avoid topics that I know well, and instead attempt to see presentations on new and interesting topics, in the hope that these would broaden my knowledge and introduce me to learning that would otherwise remain outside my normal working area.

Shit flow diagrams
The “shit flow diagrams” were one such innovation. One friend suggested that these were triggering tools for urban sanitation, with the main difference being that they were used for institutional triggering (rather than community triggering) because of the more complex nature of urban sanitation problems.

The shit flow diagrams map the flow of excreta and its waste products through urban contexts in a graphic manner, with similar effects to the community mapping used in CLTS (to show where people defecate, and highlight potential contamination routes). Apparently the process also involves shit calculations, which emphasize the volume of excreta and faecal sludge generated in the city, echoing the excreta calculations made in the CLTS process. I’m now keen to learn more about these new tools, and how they are being used to trigger sanitation improvement in urban contexts.

Maternal health and sanitation
The London School of Hygiene and Tropical Medicine presented recent research on the relationship between sanitation and maternal mortality. The session focused on whether women give birth in settings with improved sanitation and improved water supply services, and how this affects maternal mortality.

The research found significant WASH effects on maternal mortality – reporting that women who give birth in settings with inadequate sanitation are three times more likely to die than those who give birth in settings with improved sanitation; similar but lower effects were found for improved water supply, with 1.5 times higher risk associated with giving birth in a setting with unimproved water supply.

In countries like Tanzania, where 70% of women give birth in settings with unimproved water and sanitation facilities, these findings recommend that investments in improved WASH in health posts, and promotion of the use of improved sanitation, hygiene and water supply in home birth settings, could have significant impacts on maternal mortality.

Lowlight: silo thinking?
After a few days of AfricaSan, it became clear that the same crowd tend to attend sessions around similar topics and run by familiar institutions. I’m sure this is not news to seasoned conference goers, but it soon became clear the negative impact that this effect has on the quality of the discussions and thinking in many sessions.

UNICEF folk tend to go to UNICEF sessions, and so on, which leads to lots of people with similar backgrounds, thinking and experiences (and biases) being in the same rooms at the same time. Everyone tends to agree with each other in these sessions, with few challenges to the received wisdom on offer. And even where there was opportunity and willingness for cross-fertilisation of ideas and approaches, the tight timing and squeezed sessions (caused by the regular over run of the morning plenary sessions) left insufficient time for genuine discussion or detailed questions.

I also realised that attending sessions on topics that you know well tends to disappoint – there is insufficient time to impart much knowledge or insight in a short session, and most sessions are aimed at participants with limited experience of the topic. By the second day, I realised that it was far better to go to sessions on topics that were new to me – everything was then interesting and novel, and I learnt a lot!

Chief Macha of Zambia: CLTS champion
A highlight was the chance to hear a presentation by Chief Macha from Zambia, a much-feted CLTS champion who led his chiefdom to become the first in Zambia to be verified as Open Defecation Free (ODF) across all its 105 villages. While Chief Macha was obviously not used to talking to a powerpoint slideshow, he enlivened the session by telling Kamal Kar (present in the audience) that he was “a great man” and “we learned a lot from your training”, but he also wondered “how can you start this, and then run away?” Fortunately, Chief Macha was there for the long haul, and was up to the task (and received lots of other support along the way)!

Just Poo it!
The most entertainingly named AfricaSan session focused on innovative and effective advocacy and behaviour change campaigns. Torsten from WASH United showed photos of satellite dishes sprouting from urban slums in developing countries, noting that many poor households now have access to technologies like satellite television and mobile phones, follow heavily sponsored football teams, and have regular contact with brands, products, advertising and marketing by big corporations like Coca-Cola, Unilever and their like.

The message was that even poor households are discerning about what is interesting, entertaining and relevant enough to spend their time on – they now expect professional messaging and content, are familiar with high-tech media, and give little time or attention to the more basic and paper-based campaigns favoured by many WASH programs.

It wasn’t entirely clear whether the new programs were really successful in the attempt to be more modern and demand-responsive, but examples were given of advocacy campaigns conducted through Twitter (which won’t reach luddites like me); handwashing campaigns that provided infant bibs emblazoned with “Did you wash your hands before feeding me?”; and mosquito nets printed with Lionel Messi’s face!

Who knows whether this brave new world will succeed, or whether the additional costs are really worth the effort. But it is good to know that innovation abounds, and that at least some people at the conference (those naming this session) have a good sense of humour!

Andy Robinson is an independent WASH consultant

Date: 15 June 2015