latrines

Haiti’s toilets: no joking matter

The Red Cross employs local workmen to build latrines

© Amanda George/ BRC

In the UK, we accept toilets as an essential part of life, but it’s not often we sing their praises. The most publicity the humble lavatory gets is probably in the form of toilet humour. What goes on behind the bathroom door is shrouded in embarrassment, secrecy and a wide array of euphemisms, ranging from spending a penny to powdering your nose.

Hardly surprising then, if we sometimes forget how serious sanitation is. The fact is: toilets help save lives. From the gold-plated WC to the bog-standard public loo, they all ensure potentially harmful human waste is disposed of safely.

Most UK residents can take for granted that they’ll never be more than a few minutes from a functioning toilet. However, even before the 2010 earthquake, Haiti only had one toilet for every 1,000 people.

What do you get if millions of people don’t have sanitation?

With the worst sanitation in the western hemisphere, there are millions of people across Haiti without access to a toilet. Poor sanitation, compounded by the earthquake’s destruction, had devastating consequences; the cholera outbreak that began in Haiti last year has already killed 6,000 people.

The British Red Cross responded to the outbreak by setting up a cholera treatment center and oral rehydration points. It also started a cholera prevention education campaign that had reached over 214,000 people by the end of July 2011.

Once local communities made the connection between lack of sanitation and disease, demand for toilets was high. So, to complement the cholera response and recovery work it was already undertaking, the Red Cross started a programme to build toilets in the rural communities of Les Anglais, Coteaux, Chardonnieres and Port à Piment.

Why did the community build a latrine?

Jean Eubert Amardy, a Red Cross field officer, says: “People just go to the bathroom anywhere, and this leads to unsanitary conditions. Building latrines is one of the best ways to counter disease and keep people healthy.

“In some ways, the cholera outbreak that highlighted this situation has provided an opportunity to make a difference to the local sanitation situation and to tackle the causes of cholera and other diseases, and not just the symptoms.”

Edma Maguerite sitting upon her half-built composting latrine

© Amanda George/ BRC

The project has built toilets for both vulnerable households and schools. It has worked with local communities to find affordable solutions that take into account environmental factors such as soil type.

Edma Maguerite has been hosting family members displaced by the earthquake. Local workmen employed by the Red Cross have just finished building her a composting latrine. She says: “We have never had a toilet so we are very satisfied that we will soon be able to have our own. This will make a big difference to our lives.”

Find out about our work to improve water and sanitation in Haiti

Read stories from survivors we helped after the earthquake

Discover how we help people rebuild their lives after a disaster

Send in the clowns: local performers promote hygiene in Haiti

Cathy Ayer is part of a British Red Cross team in Haiti helping improve sanitation for earthquake survivors. She sent back this story on some of the more unusual ways they’ve found to make toilets fun.

Clowns. Funny guys that fall over a lot. Baggy pants. Little tricycles. Honking. More likely to be found in a circus than a camp for earthquake affected people. That was my experience of clowns until this morning when I attended a Red Cross hygiene promotion session in Automeca camp in Port Au Prince.

Automeca camp is currently home to approximately 10,000 people, densely populated in the centre of town with ramshshackle shelters squeezed tightly together. The British Red Cross sanitation team has been working in this camp for over 4 weeks for people made homeless by the earthquake. We have erected latrines and hand washing facilities so that people now have a safe and secure place to go to the loo. We have also undertaken a large hygiene promotion campaign with the residents of the camp. Hygiene promotion is all about delivering essential messages on how to maintain good hygiene to keep you and your family healthy, such as correct use of latrines, hand washing and storage of water. These things are absolutely vital…but is talking about going to the toilet sexy?

This is why hygiene promoters have to be extremely creative. They have to get the key messages out in such a way that it is interesting, engaging, clear, easily understood and makes people want to tell their friends and practice good hygiene. Today I saw Red Cross volunteers conducting a hygiene promotion session using glitter on people’s hands to demonstrate how harmful bacteria can be spread from person to person if they don’t wash their hands. They taught the people songs about why hygiene is good and everyone joined in singing and clapping their hands!

I then wandered over in to the centre of Automeca camp for the main attraction…the clowns! Liz, our hygiene promoter had found a group of local, professional performers, living in another camp in Port Au Prince, who have a clown act and she asked if they would join us to speak to the people in Automeca to promote hygiene. I was not sure what to expect…red noses? make up? Twirling bow ties? Instead I found something much more hilarious. A young guy dressed as an old man complete with white beard, an old man dressed as a baby (man size nappy included) and a scruffy clown with comedy breeches.

Hundreds of people gathered to see what was going to happen with these odd individuals. They had a loud speaker, and the girls in the group explained to the audience that they were here with the Red Cross to give them important information on health and hygiene, then the guys launched in to their fast paced comedy Creole routine. The “baby clown” spoke in a high pitched baby voice and had the crowd in hysterical laughter! The old man scolded the baby for not knowing how to use a latrine properly and instead invited the audience to contribute ideas on how it should be done properly. Members of the audience were pulled in to the act and everyone participated in agreeing what was good hygiene and what wasn’t.

A man with a loudspeaker talks to a crowd in HaitiEmpowering people with the knowledge to keep themselves healthy in very difficult circumstances in these camps is very rewarding but what really touched me was the reaction of the kids to the clowns. Thousands of kids live in these camps across Haiti. Many will have lost parents and guardians, all are vulnerable and the trauma they experienced during the earthquake and since is hard to imagine. A group of hygiene promoting clowns is not going to take away all that trauma but if they can make them smile and laugh and perhaps forget their situation for a short time, it is a wonderful thing.

Images © Cathy Ayer/British Red Cross

A snapshot of Haiti: from toilets and tarpaulins to pride amidst poverty

AlastairAlastair Burnett, our recovery manger, just sent this candid account of what he’s been seeing in Haiti:

So it is 0530 and I am in my tent in the Red Cross base camp close to the airport in Port au Prince. I wouldn’t ideally be up at this time, but the noises of the aircraft taking off, the noises from others within the tent and the heat means that once you are awake at this time, there is no going back to sleep.

I arrived here from Santo Domingo in the Dominican Republic. Flying over Port-au-Prince was fascinating. In must have been a very striking looking city even before the earthquake, with hills to the back and the sea to the front, but flying in what strikes you is the clearly massive destruction many parts of this city has experienced. This was further compounded over the course of my first day as I visited camp after camp of internally displaced people (IDP). Discussing with colleagues, and many of us have seen a lot of areas of destruction whether that be in Africa, Asia or Europe, we all agreed that none of us have seen anything like this. The only way to really describe it is to think back to old black and white footage of cities like Berlin and Dresden at the end of the Second World War. This city looks as though it has had a war fought through it.

Destruction in the streetsThe Red Cross has a camp, in the grounds of what was destined to be the Hilton Hotel, close to the airport. The shell of the Hilton building is now our offices. Don’t get me wrong, there is no breakfast in bed here – it is a concrete shell with no windows or proper floors, functioning sanitation, water or power. However, people have done a great job getting this area operational and it is now home to over 250 Red Cross staff from across the world, ranging from doctors and nurses to logisticians and water engineers. There are two canteens, toilet and shower blocks and wireless internet access.  Scores of tents are neatly arranged around the concrete structure. It is far from 5 star but it provides safe and secure location for people to work from, which of course is so important in these situations. The camp empties out during the day but begins to fill up again from 1800 as it begins to get dark and the curfew that we apply to staff comes into force.

I spent yesterday with one of the sanitation engineers the British Red Cross has provided to the relief operation. He was carrying out a survey of some of the camps in which people have gathered, there are about 800 of them now ranging in size from a few hundred people to tens of thousands.  The situation in these camps is terrible. People lack adequate materials for shelter and for some people their shelter consists of little more than a bed sheet strung over a piece of string. Some of the lucky few have received some tarpaulin, which provides greater protection from the sun and the rain, as well as a better degree of privacy, and an even smaller minority a tent, although these are relatively few and far between, for a range of reasons.

The work of the Red Cross is largely evident in the water it is providing to these camps, a huge amount has clearly been done in this area. We are currently trucking in large amounts of water on a daily basis and, through the emergency water facilities we have brought into the country, providing about a million litres of water a day to these camps. We have also provided some basic household items for people (cooking sets, soap etc) as well as some sanitation facilities.

The sanitation situation is very poor.  In many places people simply have no where to go to the toilet. Some camps have a small hole in the ground that needs to be shared by hundreds of people.  Other camps, some in the grounds of schools or colleges, may have one toilet but these rapidly become blocked and unusable. Piles of rubbish can be seen around these camps, as well as growing amounts of standing water.

The rainy season will start in a couple of months, and we have to see how we can do more to address some of these immediate issues. I came here with shelter in mind as a priority. In fact I was wrong, it is the sanitation needs that are the greatest, although everything here at the moment is urgent.

latrinesWithout improved sanitation there is a high risk of the outbreak of disease in the densely packed camps people are living in. Cholera in particular could spread very quickly. One camp I went to today had eight toilets for 2,000 people. But of course for many people those facilities are inaccessible as they are located on just one side of the camp. There are many issues to consider in regard to location of toilets – not just health and hygiene, but also protection for women and children if such facilities are not easily available. People have a good understanding of basic hygiene issues – you can see that around you when you walk around – but lack the hardware to be able to put that into practice, and again, you can see that when you walk around. So – toilets, and lots more of them, as soon as possible.

Waste management also needs to be addressed – piles of waste attract rats. Rats spread disease.  We have to look at how peoples waste can be better managed and work with the communities to help them on that. Again, many people understand that and have asked us for the tools to enable them to improve their current squalid living environments.

Vector control is also an issue – ensuring there are no pools of standing water is pretty much the number one thing in this to stop mosquitoes breeding. In a country where malaria and dengue fever is endemic we have to work with the communities to minimise the risk of major outbreaks.

Shelter here will be a nightmare. People are displaced in a number of different ways. I went to one location where many houses are still standing but there are just thousands of people camped in the road outside their homes as they do not want to return inside. Others are camped by the ruins of their homes in small groups. Others, gathering in their hundreds, in the grounds of churches or schools. The big camps, containing up to 10,000 people are located in former parks or other public spaces. Some people who fled the city in search of work are now returning and new camps of people are springing up all the time. People’s shelters are very basic and back to back – there is no security, there is no privacy and there is no dignity for the occupants. The risk of fire is huge and the space so cramped it is hard to think of ways to improve the conditions. For people who have endured years of political and social unrest, as well as in many cases chronic poverty I personally feel they deserve better. Despite the challenges this country has faced, and its poor image to the outside world, many of these people still maintain a level of pride in themselves that they should not be allowed to lose. It may be one of the most important things to help them through the years to come, and rebuilding their lives will take years.

Well, it is getting light and I have things to do. I will write more when I get a chance later.

A view from Haiti

On Friday, my colleague Sarah wrote about the importance of toilets after a disaster like the Haiti earthquake. David Peppiatt, our international director, is in Haiti now and has sent back a vivid description of why they’re so needed.

Some early reflections at the end of my first day, which was spent mostly at base camp meeting with Red Cross and Red Crescent delegates and then a visit to La Piste camp, where our  mass sanitation emergency response unit is working.

I cannot emphasise enough the enormous scale of this operation. There are 500 Red Cross delegates on the ground with more on their way.  There’s a constant flow of people through base camp coming from Red Cross and Red Crescent National Societies around the world..  Base camp infrastructure and coordination are huge tasks alone – can you imagine having to provide tents, food, water and toilets for a few hundred aid workers on the edge of a city of rubble?

Steaming rubbish in Haiti camp

Conditions in the camps earthquake survivors are living in are shocking.  Overcrowded.  Filthy.  People sleeping under scraps of plastic, old sheets draped over some precarious frame of wood,  pieces of timber or whatever they have recovered from the rubble.  What struck me most was the human waste scattered throughout the camp.  The stench in places was repulsive.

Our mass sanitation team is working around the clock to dig latrines in the camp. It’s encouraging to see some already up and in use. They’re working to get 100 up by the end of next week.  The public health team went in today to deliver hygiene promotion messages – translated into Creole and posters put up on toilets about washing hands.  They’ve sent out thousands of SMS messages with public health advice and also launched a public health campaign on the radio.

La Piste

Shelter is proving very problematic. People are extremely vulnerable in these makeshift shelters for long – little protection, unsafe and no dignity. The looming rainy season followed by hurricanes make this a matter of urgency and huge responsibility for the Red Cross as we lead the shelter response in Haiti.

As for the earthquake damage and destruction, words fail to describe what you see. It is like those desperate images of a bombed city where huge swathes have been decimated, destroyed and turned into mountains of rubble and debris.  It will surely take many months, if not years in some places, to clear the damage and debris before the rebuilding can begin.

Follow updates from the mass sanitation team on the British Red Cross international blog.

Haiti earthquake: talk about life-saving toilets

Line-of-womenOkay so toilets may not be the first thing you think of when it comes to life-saving equipment, but think again. Without decent sanitation facilities, diseases like cholera can spread like wild fire and as was seen in the Zimbabwe crisis last year – thousands of people can die as a result.

In an article on Reuters AlertNet, the UN reports that 7,000 latrines are urgently needed in Haiti to help prevent the spread of disease.

My colleague, Sharon Reader, is currently in Port-au-Prince with our sanitation emergency response unit. Listen in as I speak to her and find out how it’s all going.

Image © Joe Lowry/IFRC

side effects of phytoceramides glowing skin vitamin supplements what is the best aging cream vitamins for the skin anti aging miracle