Sanitation saves lives: scenes from Sumba

By Cory Rogers

© Cory Rogers / UNICEF / 2017

Some dangerous habits are easy to understand, like driving without a seatbelt, or smoking tobacco.

Others, like defecating in the open, seem abstract, even innocuous by comparison. But make no mistake — they can be just as deadly.

Each year, 150,000 Indonesian children die before reaching the age of 5. Most of these deaths could be avoided by ditching practices like open defecation and neglecting to wash one’s hands. Bacteria such as E. Coli and salmonella flourish in these unsanitary conditions, contaminating the food and water that families eat and drink. Once consumed, the bacteria triggers diarrhoea, impeding the ability for children to process nutrients.

In the worst cases, this diarrhoea not only leads to stunting as the nutrients in their bodies are flushed away — but also to death.

“About 40,000 of the 150,000 under-5 deaths in Indonesia are caused directly by diarrhoea, which can be drastically reduced by good sanitation,” says Lauren Rumble, UNICEF Indonesia Deputy Representative.

Pneumonia, also linked to poor sanitation, is another child-killer.

“We know that toilets and hand soap can prevent many of these deaths,” Rumble adds. “The challenge we face is improving access for all children.”

To mark World Toilet Day, UNICEF Indonesia joined government officials in East Nusa Tenggara Province’s (NTT) Sumba Barat Daya District to celebrate local strides in the fight to end open defecation.

The occasion was also used to inaugurate ‘Tinju Tinja Squad’ — a new phase in the Tinju Tinja campaign that mobilises young people to become local champions in the fight to end open defecation.

“This is an opportunity for young people to take the lead,” says Rizky Syafitri , UNICEF Indonesia Communication for Development Specialist. “A chance for them to join a national community of sanitarians whose work does save lives.”

© Cory Rogers / UNICEF / 2017

Over 200 high schoolers from Sumba Barat Daya joined government officials and the UNICEF team for a talk show titled ‘Protecting Children from the Dangers of Open Defecation’, held in the district capital of Tambolaka. Among others, Jhon Octovianus, head of the Sumba Barat Daya Development Planning Agency (centre left, gold shirt), Ibu Bupati Ratu Wulla Talu (centre, standing in black and gold-patterned shirt) and Melanie Subono (sitting, centre), UNICEF Champion for Children and Tinju Tinja Ambassador, spoke at the event, elaborating upon the hidden costs of poor sanitation.

© Cory Rogers / UNICEF / 2017

Students were invited to hang their hopes for the future onto a ‘wish tree’. This teenager wrote that she hoped “Good sanitation would become [recognized as] the first step to progress in regions.” Research shows poor sanitation is not only deadly, but costly in Indonesia — to the tune of Rp56 trillion a year, or some 2.3 per cent of GDP.

Ensuring schools have enough toilets is key to creating safe learning spaces. Not only do they contain the spread of bacteria, but for girls, they provide essential privacy during menstruation; without them, many girls are afraid to go to school for fear of bullying, disrupting their education. Here, UNICEF Indonesia Tinju Tinja Squad Ambassador Melanie Subono shares a laugh with primary school children at Kanelu Elementary School, where eight new bathrooms have been installed as part of the government’s commitment to sanitation access.

© Cory Rogers / UNICEF / 2017

With support from UNICEF, and in partnership with the local government and UNILEVER, Kanelu School also installed a group hand-washing station, which has made the activity fun and communal for students.

© Cory Rogers / UNICEF / 2017

“Punch the Poo!” these primary school students yell, repeating the Tinju Tinja campaign slogan. Since its launch in 2014, the Tinju Tinja campaign has mobilized over 10,000 actions to end open defecation in Indonesia, where 31 million people still defecate outdoors. Research from the WHO shows that high incidence of open defecation is correlated to high incidence of under-5 deaths.

© Cory Rogers / UNICEF / 2017

This year, Tinju Tinja inauguared Tinju Tinja Squad, a new phase in the campaign. This is Mathilda Aeirce Bani, 19, one of 500 Tinju Tinja Squad members selected from a pool of some 4,000 applicants nationwide. Mikael Sene, a pastor and professor, and Kanis Blikololong, who works with a local NGO, were also selected as Tinju Tinja Squad members from Sumba Barat Daya.

© Cory Rogers / UNICEF / 2017

The campaign is helping local governments like Sumba Barat Daya support village leaders in the fight to end open defecation. Here, Pak Jhon Octovianus gives a speech honouring 35 village heads who helped end open defecation in their communities. This was done by encouraging heads of households to build toilets, with UNICEF and the local government providing technical and financial support.

© Cory Rogers / UNICEF / 2017

Sumba Barat Daya Bupati Markus Dairo Tallu was instrumental in setting the district on a path to progress with a 2017 decree on community-based sanitation. As a result, government funding rose from zero in 2013 to over Rp 1.3 billion (USD$100,000) this year. Here, he and UNICEF Indonesia Representative Gunilla Olsson unveil a placard proclaiming 35 villages as ‘ODF’, or Open-Defecation Free — representing a fifth of all villages in the district.

© Cory Rogers / UNICEF / 2017

During the ODF celebration ceremony, Mathilda was given a Tinju Tinja Squad education kit. The kit includes an official T-shirt, ID card and materials that will help her teach children about the importance of using toilets and washing hands. “In my community most adults and adolescents already use toilets, she says. “It is the young children who I have to teach.”

© Cory Rogers / UNICEF / 2017

“The risks that come with poor sanitation are totally preventable, communities just need to be supported, and encouraged to build toilets and practice good hygiene,” says UNICEF Indonesia Chief of WASH Aidan Cronin.

“The progress in Sumba Barat Daya shows how political leadership, merged with grassroots engagement, can make big progress in a short amount of time. We hope to use the success in NTT to inspire bupatis , parliaments and communities across the country to invest in sanitation, too,” he says.

It’s no exaggeration to say that the lives of many young children depend on it.

For more on our sanitation work please visit the UNICEF Indonesia YouTube channel.