There are no specific gender and poverty aspects in current waste water disposal. Households are formally required to have soak pits, but their presence and conditions are not checked. The cities construct drains in the central parts. Individual communities and/or households outside these city parts sometimes take the initiative to construct drains but there is no systematic strategy and program.
4.Strengthening Gender Mainstreaming at National Level
National Hand Washing Campaign
For the National Hand washing Campaign, the following adjustments on gender mainstreaming were arrived at through discussions in ISSDP and WSP:
1. Target audience
While it makes sense to focus hand washing messages on female caregivers, it does leave out the supportive roles that husbands have to play in enabling better hand wash behaviour of the female care givers. Hence it has been discussed to include a separate and modest budget line for developing and spreading special messages and sessions for husbands/fathers on their roles as caretaker supporters, especially in helping to soap, water storage containers and safe water connections/buy safe water/ improve traditional water sources for hand washing such as dug wells and rainwater.
Here it was discussed to specify the message into “wash both hands with soap at critical times and to stress that washing is done with running or poured safe water. The first aspect may need to be added because of the not uncommon practice to wash only the left hand. From the literature there is no consensus on the risks from washing hands with soap and polluted water, such as river water (Shordt, 2006). However, especially poor families buy tap water only for drinking and cooking and keep a container with river water for other uses, such as washing utensils, laundry and personal hygiene. A compromise may be not to mention tap water explicitly but to include in the scenes and soundtracks that hands being washed under a running tap or soapy hands are rinsed with water poured from a kettle or jar filled with tap water.
3. Below-the-line (BTL) sessions
In Below-The-Line group sessions, this aspect can be addressed quite well, e.g. through a sorting activity on hand washing ingredients, in which groups place drawings of implements, water sources and washing media in the perceived correct order, ranging from best (soap & tap or spring water from the tap or poured from a kettle or jar over hands over a basin) via less good (ash and tap water, soap and well or river water) to worst (only river water without soap). Annex 3 contains a number of participatory tools on sanitation, hygiene and community decision-making with gender and poverty mainstreamed. An outcome of hands-on use of the hygiene tool with women and men was that fathers pledged that they would support hygiene at home (e.g. by financing water connections and toilets and educating children and the women concluded that they should become more active in community decisions if they want sanitation and hygiene to enter, and remain on the community agenda.
4. Gender in materials
Male caretakers should be included in some media scenes, audios and illustrated materials.
5. Group methods
From the strategy document it is not clear on which educational methods the cadres will be trained. The risk exists that they will be trained and use one-way didactic teaching. In Denpasar, for example, the approach seen to be used for hygiene promotion was lecturing in a formal setting. Department heads and local leaders (all men) were sitting on a podium and addressed a room full of cadre (mainly women) who were sitting in rows facing the podium with a path in the centre. The content of their address was very general and it is unlikely that the women cadres learned anything new. Using more up-to-date participatory training methods and materials is essential if the cadres are to apply such methods themselves.
It is recommended that cadres facilitate sessions with PLA (Participatory Learning and Action) methods and activities. Such activities help care givers understand the links between faeces and diarrhoea and help them commit themselves to practice safe hand washing for emotional plus rational reasons – rational in terms of practical, not academic, understanding of:
Why they will wash hands;
With what and how they will do this and why;
When they will do this and why;
What stimulates and hinders hand washing with soap and how they can overcome hindering factors;
How they will share their knowledge and action with others.
Hand washing leaflets are best designed for recall and reinforcement after sessions and to be able to repeat the learning activities with others rather than as general hand-outs.
For training the cadres, it will be best to use the same hands-on learning program with the same length and contents for all levels: master trainers, trainers of trainers and cadre, and not the usual cascade training in which most goes to the few at the top and least to actual target groups (Figure 2).
Figure 2. Length and depth of training at four levels: cascade and equity models 7. Impact Measurement
Measuring and analysing behaviour change by approaches, type of media and staff accessed, methods and subjects of promotion and caretakers’ sex, age, position in household, and socio-economic class and including cost calculations to determine cost-effectiveness.
National Sanitation Awareness Campaign
The following adjustments to this campaign have been discussed:
The message of a clean and healthy environment has a private and a public dimension. These two dimensions need to be brought in more clearly. Sanitation is not only a private mater, but also a matter of a clean public environment for greater well-being and better public health. This second aspect is least developed in people’s perceptions and norm, so it needs to be clearly brought in. Part of this is the public-private partnership between the authorities at different levels, the citizens (male and female, adolescents and adults) and the formal and informal private sector as major stakeholders.
2. Target groups
The current strategy excludes women household heads from decision-making on sanitation at both the household and community level. This is not in line with the gender strategy as set out in especially the SUSEA Indonesia log frame and concentrates on a conservative gender relationship. It does not do right to what women expressed in FGDs and men in FGD supported as a positive development: if women get a more equal say in decision-making at home and in the community, sanitation will have a greater priority. It is further inequitable that adolescent boys of 15 years and older will be targeted as the future decision-makers, while adolescent girls are not.
3. Message for household level
Taking the above into account, the adjusted message (spread in separate approaches to women and men) concerning household level sanitation could be that “a responsible couple has a health home, in which the woman already cares for a clean and healthy environment and the man now takes his responsibility to support her”.
4. Message for community level
For the community level, the message could be that a clean and healthy environment is also a community matter, on which women and men should jointly decide in the community assemblies and RT leadership1.
5. Gender “image”
For conveying a message of gender equality, much will depend on the ‘scenes’ depicted in TV and radio spots and stories and in print. Will it be that of the man/men alone, that of the couple, and community women and men planning and taking action? The gender roles in this planning and action can be traditional (women dealing with women’s issues such as health and men with men’s such as investments), but also more progressive, e.g. women and men jointly choosing the type of technology and service options at household and community level that reflects the interests and will meet the demands of both.
6. Position of single women
A disadvantage of an exclusive focus on a male-female (couple) approach is that it may add to the psychological burden of single women. They must from necessity make investment decisions themselves and often live in more difficult social and economic conditions than married women. Statistics from 1999 show that women head 13.2% of households in Indonesia (Zulminarni, undated). It may help to include examples of single women successfully undertaking/obtaining sanitation improvements and making a reasonable livelihood in the sanitation sector, e.g. from solid waste recycling.
7. Poor-inclusive focus
Special attention will be needed to tailor the printed materials to the conditions of also poor people, including low or no literacy. The campaign can further position both women and men in the informal private sector as valuable actors and stakeholders, who combine low-cost and environmentally and economically important service delivery with earning a livelihood for themselves and their families.
8. Links with action
Because only one package will be made, the campaign will have to set out clearly how people (women and men) can take action for expressing and effectuating demand for improved household and community sanitation once their awareness has been raised.
Taking the lead from the CLTS (Community-Led Total Sanitation) campaign, one of the actions that the sanitation awareness campaign might stimulate is that families (men and women, boys and girls) make a ‘household sanitation walk’ and communities a ‘community sanitation walk’ to count the number of houses and streets with unacceptable excreta disposal, solid waste disposal and drainage conditions.
Case 9 – Community Led Total Sanitation in peri-urban Community of Payakumbuh
Kelurahan Balai Panjang is a poor resettlement community of earthquake victims in Payakumbuh, Sumatra. None of the 40 wooden houses had any form of toilet. Puskesmas (Community Health Centre) staff started a sanitation promotion campaign here and in five other Kelurahans. Within three months, 30 of the 40 households have made a toilet with a soak pit, ranging from a simple wooden floor with a hole to a ceramic pour-flush toilet pan set in a small cemented and tiled raised platform. Two community women emerged as natural leaders and have taken over promotion. The Puskesmas workers keep a weekly scheme in which the commitment of each remaining household towards toilet completion during the week is written down. The city sanitation strategy includes a plan and ToR for the assessment of costs, effectiveness, sustainability and equity of the CLTS and foresees the expansion of an improved approach as part of its City Sanitation Strategy.
9. Campaign implementation
Since BAPPEKO is the coordinating agency at city level, this institution could be the responsible agency for the campaign at city level. Monitoring should not only be the responsibility of MPW but also of MoH and MoHA, both of whom could be involved at community level.
10. Impact monitoring
ISSDP and the Pokjas could also consider carrying out a participatory evaluation which assesses especially the access, recall and response of women and men in poor communities to the campaign.