Curbing open defecation among children in Myanmar

People living in internally displaced population (IDP) camps face many difficulties. One of the key challenges is open defecation which was found to be adversely affecting the health and well-being of IDP camp residents in Rakhine. The lack of space and “temporariness” of the camps were barriers to constructing strong and permanent latrines. Also contributing to sustained OD were habits, cultural preferences, customs, and issues of privacy and mental health. OD was most prevalent among babies and young children.

Three to 5 year olds did not have independent access to latrines, as latrines were usually padlocked and young children were not trusted with the key. Even when latrines were not locked, doors were hard to open and the pans were too wide for them to straddle. Adults would shoo them away for fear that they would dirty the latrines, leading them to defecate outside the latrines. Babies generally do not wear diapers and defecate wherever they are, and their mothers would throw the feces around the latrines or just kick some sand over wherever it lay.

Developing a multi-pronged solution to the challenge

Our team spent over 30 days in the IDP camps of Sittwe, to conduct user research and to ideate and test prototypes to reduce open defecation. A co-creation session with members of the WASH Cluster helped develop five interventions that were tested in the camps.

Potty hubs: To address the access and infrastructure barrier, latrine pit lids were redesigned to include 2 or 3 pans and potties. Three Potty Hubs were constructed for prototype testing. In just 2 hours, 34 children, of which 55% were under 5, were observed using the Potty Hub.A key feature of the Potty Hub is a child size seat.

Poop bins: To provide mothers a place to dispose of baby feces, two versions of Poop Bins were designed. One version required regular emptying and the other would be left to decompose once full. Environmental cleaners stated that after 4 days, the latrine areas with new Poop Bins were at least 30% cleaner with less open defecation.Testing the Poop Bin intervention with camp residents and getting early feedback. 

Latrine handles: To find a quick fix to the wide latrine pans (unsafe for children), we came up with 3 designs for handles to make it easier for children to balance whilst squatting. User interviews revealed that the handles made it easier for children to independently use the latrine. In addition, older and disabled people also found the bars helpful.Handles designed for children proved useful for anyone who needed balance support.

Latrine helpers: To provide more physical support, a community-led latrine duty rotation system was created. Two versions were tested: (1) out-of-school girls helped kids use the latrines, in return they were given skills training classes and (2) parents sharing one block of latrines were assigned to assist kids in using the latrine for one hour a day. The Latrine Helpers helped 50-60 kids to use the latrine a day.

Hygiene promotion tools: New culturally and age appropriate tools were developed to encourage potty training and latrine use. Stories of “Wise Imam Faruk and The Secret to Being a Big Kid” were successfully tested along with new behavioral cards and the poop dance.

With the positive reception, members of the WASH Cluster decided to invest in piloting the potty hubs, latrine handles and hygiene promotions tools.

Children learning new behaviours through stories and dance.