A new WASH program in the Philippines is aiming to teach the development community how to deliver sustainable sanitation and hygiene programs in semi-urban environments — without any financial backing.
Earlier this month, Dr. Hana Badando of the San Beda College in Manila introduced her initiative for the municipality of Silang in Cavite, a province in southern Luzon, to an audience of development experts, government officials and researchers at the 2017 Research for Development Impact conference in Sydney.
When it comes to delivering sustainable change, semi-urban environments are a challenge, Badando said, but she is determined to persist and bring transferable knowledge that can help developing communities in the Philippines and the world.
In the 1970s and 1980s, slum areas were relocated to Silang from central Manila, creating 11 semi-urban barangays, or villages, which have since suffered from little economic or political support.
Over the past 10 months, staff and fourth year medical students from the Extension Service Program of the College of Medicine of San Beda, in collaboration with the Canossa Health and Social Center Foundation, have been implementing health and sanitation programs that foster behavior change in five of the barangays. Nearly 20,000 people are being supported by the community-driven program. For San Beda College and the Canossa Health and Social Center Foundation, the funding only covers small snacks for the field staff.
The program is modeled on successful behavioral change initiatives that have taken place in rural regions of the Philippines over the past few years. In one province, interventions have ended open defecation in entire villages. Using a range of tools including group programs, one-on-one education and reward systems, Badando and her team aim to trigger collective action and drive sanitation behavioral change.
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But in a semi-urban environment, the challenges for the program become greater due to the larger number of people living and operating within communities, limited space and transient populations leading to less social cohesion. Sanitation and hygiene change needs to occur in all aspects of daily life — and in a semi-urban environment this means developing change at home, school and work. It also means ensuring there is support from local services and government for it to be sustainable.
The comparative difference when the program was shifted from a rural setting to a semi-urban environment has been monumental for Badando.
“I have done this type of work in a rural setting and it took just a few months to get complete engagement and bring about a lasting impact,” she told Devex. “But here, I want to cry. It is very difficult to deal with all the elements and challenges in a semi-urban setting.”
Despite the short time frame in which the project has operated, the barriers she has faced are already providing important lessons on partnerships and the support required for success.
Keep it local
A key lesson for Badando is to have community-driven ideas and initiatives where the people the program is supporting set the agenda and are responsible for resourcing and supporting it. Community WASH groups and group activities to clean alleys and build better sanitation infrastructure are some of the initiatives developed by the communities themselves.
Local schools and daycare centers are part of the program to ensure improved sanitation and hygiene is part of everyday aspects of children’s lives. As adults have often blamed children for dirty surroundings, they have been an important inclusion. And daycare teachers have been particularly supportive of the program.
“When they found out this program existed, there was a spark in their eyes,” Badando said. “They finally had support.”
It has also been important to reduce external influences to maintain independence and local authority. So far, external donors — both national and international — have not been involved in funding the program, and Badando believes that is a good thing.
“This is not donor driven; we are mainly [experimenting],” she said. “Not having any donor makes it easier for us to build partnerships with actors in the area. For example, we are looking at partners with local NGOs to improve our reach. But with donors, we may become constrained with the work we are doing or directions we are heading.”
Understand the politics
A second key lesson is to understand the local politics. As WASH initiatives become more urban, there is greater reliance on the support of the local government for assistance.
Nationally, the government of the Philippines has a strong agenda supporting WASH programs, including partnering on SDG action 1665 to teach basic sanitation and hygiene to communities and school children. But within the Philippines, availability of funding at the national level does not always filter down to the communities. Local governments and their leaders have differing priorities — sometimes due to corruption.
“At the national level, government acts more as a policy making body and provide assistance in implementing programs, including health,” Badando explained. “At the local level, each leader has their own priority. If sanitation is not it, even if there is money and a mandate that money can be used for these purposes, funding is not provided and there is little that can be done.”
In a rural setting, influencing local leaders and the community was simple — community spirit where people help each other without expecting anything in return, Badando said, was a huge driver for change in the Philippines.
“In rural areas they help each other build facilities, contribute their own money and more — because they really want improved sanitation services,” she said. “And local leaders are supportive to drive long-term change.”
In a semi-urban environment, the communal mission is not as evident. And in the barangays where the program is operating, residents are not a powerful political voice that influence local government.
“People here are paying to get their garbage collected,” Badando said. “If they are lucky, it’s once a week. If they are unlucky, it’s once every two months.”
Despite strong support from schools and community groups, there are things local populations cannot do without government support, including collecting garbage. The roadblock for lasting change is a political one.
Be persistent — annoying even
Despite the challenges, Badando and their team are determined to persist and rise above them to demonstrate how to successfully install health initiatives in semi-urban communities. It is a lesson she urges anyone working in WASH to employ.
Persistence, as well as annoyance, are a key part of the program plan for San Beda College and Canossa Health and Social Center Foundation.
“We have medical students who are going there on a daily basis trying to annoy the community,” Badando explained. “If we don’t, we risk them slipping back into their old behaviour and the work will be for nothing.”
Badando is persistent in making the program to be community driven. Persistent in overcoming barriers. Persistent in driving political change. And persistent in delivering sanitation and hygiene change at scale. Six barangays in Silang are still to be included in the program if the program is a success — and Badando will continue to push for those communities to be safer for its residents to live in.
The program will implement and test motivation measures, including rewards and prizes to people demonstrating continual improved sanitation and hygiene practices. But Badando says individual determination and collective community action are required for sustainable change. And persistence of herself and her team, not money, will be the key to long-term success and the ability to break through the political roadblocks.
Update, June 29, 2017: This article has been updated to clarify specifics of the program.
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