“A Healthy and Productive Mahatsinjo”

MCDI
Medical Care Development International
3 min readMar 28, 2018

In the rural commune of Mahatsinjo in Madagascar, sanitation is a hot topic. Over the past year, the community’s mayor, Mr. Rakotombahoaka, has taken pride in the efforts of his community to improve their sanitation practices, including their use of fly-proof latrines and improving their consistency in handwashing. With the help of MCDI’s Global Sanitation Fund project in Madagascar, Fonds d’Appui pour l’Assainissement (FAA), Mahatsinjo was declared Open Defecation Free (ODF) in December 2017.

Commemorative poster declaring Mahatsinjo Open Defecation Free (ODF), “Community of Mahatsinjo, an Open Defecation Free Community.”

Becoming ODF has been a remarkable achievement for this community that has had even greater benefits than simply becoming more sanitary — it has been key to preventing the rapid spread of disease. Between August and November 2017, over 2,300 people in Madagascar were infected with the plague, both pneumonic and bubonic strains, which resulted in over 200 deaths. While the plague is endemic to Madagascar, this year’s outbreak was the largest in recent history.

Rakotombahoaka suggests that the efforts to improve sanitation within his community prevented the outbreak from affecting his village, declaring, “The nation of Madagascar is currently facing extreme difficulties with an outbreak of the plague. However, our community has been spared from this deadly disease due to the high level of cleanliness that has taken hold in each of our households and villages.”

At an event held to ensure the participation of local community leaders in the movement towards an ODF Madagascar, Rakotombahoaka acknowledged the importance of the Community-Led Total Sanitation (CLTS) movement within Madagascar led by MCDI. After a “triggering” process, which pushes the village to acknowledge the need for improved sanitation within their community, and a community effort to improve sanitation conditions within the community, Mahatsinjo has improved the cleanliness of their households, surrounding villages, public markets, schools, churches and even the local health center.

Mr. Rakotombahoaka, the mayor of Mahatsinjo, at an event celebrating Mahatsinjo’s ODF status.

These efforts to promote a more sanitary environment spared Mahatsinjo from the drastic effects of the plague experienced by other surrounding areas of Madagascar, and the community has taken notice of the positive effects that improved sanitation has had on their lives. In his speech, Rakotombahoaka said of the efforts against the plague, “We have won this fight and we hope never to return. Our new motto is ‘A Healthy and Productive Mahatsinjo.’”

The commune of Mahatsinjo.

MCDI continues to work towards a completely ODF Madagascar. Since 2010, over 16,000 villages have been declared ODF, and the FAA project is slated to continue until 2020. Sustainability of the ODF environment within a village or community is an essential step that has been the focus of much of the FAA’s recent work. In a 2016 reflection paper, “Sanitation and Hygiene Behaviour Change at Scale: Understanding Slippage,” the FAA program analyzed and presented their methods towards preventing regression of sanitary practices by ODF communities, or “slippage.”

By following a strict protocol of effective pre-triggering, triggering both at the community and institutional levels, and following up after triggering sessions, the FAA program has been very successful in sustaining its high number of ODF villages. With a proven track record of high success in both developing ODF environments and sustaining them long-term, confidence runs high that Mahatsinjo will also be able to maintain their healthy and productive environment.

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MCDI
Medical Care Development International

Global health nonprofit that improves the health of vulnerable populations through integrated, sustainable and locally driven interventions.