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Shit shame? Addressing open air defecation in Mozambique

img_1256Climate problems may not be the top priority of the incoming US administration. But their effects are pretty darn obvious in places like Paquetequete neighborhood, in northern Mozambique, where the effects of draught, flooding, cyclones, pollution, and disease fully collide.  I just got back from a fascinating visit to this and other urban neighborhoods in the city of Pemba that are the focus of the USAID-funded Coastal Cities Climate Change Adaptation (CCAP) project.

Low-lying coastal cities like Pemba have been described as ground-zero img_1217for a range of climate unpredictabilities, with those in informal, poverty-affected neighborhoods most immediately affected. Households are severely short of fresh water, some spending three hours just to go and return carrying one load. Flooding, tripped by coastal cyclones and even by daily tides, means epidemics of infectious water-borne diseases like cholera and of endemic malaria.

Our ASU postdoctoral fellow Roseanne Schuster and I spent the last week training 26 incredibly sharp local university students in how to collect data on how people understand climate change in local neighborhoods.  The data is planned to form part of a baseline for the current CCAP projects, which aim to encourage families to invest in “climate-smart” houses and latrines* and discourage further destruction of the coastal mangrove forests that help protect against cyclones and flooding.

Mangrove forests are harvested to build houses, as firewood, and (with
beaches) used for daily ablutions. One key issue the program is dealing with is the very high percentage of the population that openly defecates in Mozambique. The data collection addresses this through bothimg_1242 traditional and cultural surveys, and in extended semi-structured interviews. Some of this is done obliquely: because frankly many people don’t really want to talk much about it.

From a global health perspective, open defecation in urban areas is always
a really, really bad idea and something to be stopped as the first step in development. But from a cultural and practical perspective, in places like Pemba, it is more of a grey issue.

First, not everyone has latrines to begin with. Even in homes with a latrine, some families have the senior adults use the latrine but send the children off to defecate outdoors.  Very low literacy rates also mean many are not fully aware of the health risks of open defecation. Even greyer is the observation that visiting the mangroves or beach for relief can be a valued social event, where friends and families enjoy the daily wander down to the water.

The efforts to teach that open defecation is wrong is a classic example where using shame can backfire.  In places without fresh water, like the illegally constructed homes oceanside at Paquetequete where a high tide is enough to flood homes, building any type of latrine is not just a stretch but a basic impracticality for struggling families. If development efforts emphasize that defecation is undesirable or disgusting, those who can’t meet the new standards become vulnerable in new ways because of the added social judgement.

img_1050Our work with the CCAP team is just beginning. But our hope is that by incorporating better cultural data — understanding in a more nuanced way what defecation and latrines mean in people’s daily lives — that we can help find ways that encourage health and climate adaptation without inducing stigma for those already the most vulnerable.  Next step is a full analysis of the data we are collecting this month. More soon, stay tuned.

*”Climate smart homes” are raised above ground level, similarly raised composting toilets, and rainwater catchment systems.



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Alex Brewis