In Indonesia, around 25 million people do not use the toilet when defecating. One in three people does not have access to flush toilets, latrines, or septic systems. Instead, they defecate in fields, bushes, forests, ditches, roads, canals, or other open spaces.
Research shows that poor sanitation threatens children’s health, causing diarrhoea in Bandung, Indonesia and infection with giardiasis (digestive disorders due to parasitic infections in the small intestine) in Timor Leste.
Also, previous research in Jakarta, East Nusa Tenggara and West Nusa Tenggara shows that inadequate toilet facilities and school infrastructure cause female students to change sanitary pads during menstruation rarely. Consequently, they are at risk of experiencing reproductive health problems. Some do not continue their studies.
Health communication for toilet campaign
Clean water and sanitation for all, which includes access to sanitary toilets, are part of the Sustainable Development Goals.
Communication plays a vital role in changing the views and behaviour of individuals and communities who do not have or use toilets. But, campaigns on the importance of healthy toilets are lacking in Indonesia.
UNICEF provides a communication program campaign guide on sanitation using the (ACADA: Assessment, Communication Analysis, Design, and Action) model. Governments and non-governmental organisations can combine this model with the principle of health and risk communication involving community engagement.
Governments and non-governmental organisations that hope to succeed in implementing sanitation programs need to understand the role of customs, beliefs, and community participation in constructing toilet facilities.
There is a myth developed in some areas, for example, there should be no holes in the village, so there are no toilets or WC in the village.
Therefore, program managers need to involve the community in creating a communication strategy before carrying out a campaign. Toilet health and sanitation promotion programs must avoid shaming local culture.
Communication between program managers and local communities can provide good opportunities in the toilet prototyping process from the beginning of the design process. Involving the local community in visualising toilet design has been successful in public toilets in Pune and Mumbai, India.
For Indonesia, we need a toilet design solution that suits local people’s needs.
To involve communities to create communication channels sensitive to local cultures and languages, program managers can use the Health Belief Model (HBM) theory.
Based on HBM, two main things influence whether a person will adopt certain behaviours to protect his/her health.
First, they must personally feel vulnerable to the disease, so they should perceive that they are at risk. Second, the person must believe that the recommended measures will be effective in reducing the risks and the benefits outweigh the costs of contracting the disease.
This model also identifies psychological, structural, or financial barriers that influence health behaviour. For example, HBM will help program managers identify what attitudes, lack of access or resources that stop a family from building a toilet at home.
In Slaeng, Cambodia, a village leader used these strategies and tactics to change the community’s behaviours using toilets.
Toilet can protect our health
Every day 14 thousand tons of faeces pollute water bodies in Indonesia.
This is caused by overflows and leaks from pipes and septic systems, improper disposal and handling cause untreated human waste to contaminate the environment as well as inadequate toilets and the behaviour of people who practice open defecation.
Increasing access to sanitation facilities and toilets can reduce infection and death rates, especially in maternal and child health.
Also, hygienic bathrooms and toilets with clean running water, sinks, and soap can help women and girls through menstruation safely and healthily.
Toilet and sustainable sanitation
The effects of climate change also threaten water infrastructure, sanitation, and hygiene. When floodwater contaminate wells used for drinking water or damage toilets, human waste can spread to the community and food plants.
We need sustainable sanitation that’s resistant to external shocks such as flooding, water shortages, and sea-level rise.
Approximately 80% of the community’s waste-water flows back into the ecosystem without being treated or reused. Sustainable sanitation systems capture, transport, treat, dispose, and safely reuse human waste.
Managing human waste through safe and environmentally friendly toilets is the key to reducing the impact of untreated waste-water.