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Research evidence points to a strong correlation between Community-Led Total Sanitation and Open Defecation-Free status and reduced risk of Ebola
"The study findings suggest that communities that reached Open Defecation Free status remained Ebola-free by adopting hygiene and sanitation practices, as well as other Ebola response behaviors that result in healthy outcomes, and that relationships, such as the use of Natural Leaders, may have played a key role in reducing Ebola risk at the community level.” said Piet deVries, Senior Technical Specialist at Global Communities and Liberia Country Director at the time of the epidemic. “Even beginning the Community Led Total Sanitation process helped build significant resistance to the Ebola outbreak through behavior changes and demonstrated the power of community-based preventative health. CLTS and similar approaches can also help communities be resistant to a host of other diseases, from dysentery to diarrheal diseases, and are highly cost-effective, compared to clinical services, for example. We believe we have identified an important source of resistance to a deadly disease, while also recommending that further research be undertaken to determine which behaviors, practices and relationships specifically led to this result.”