Shit, this is my job – Part 4 The flossing problem

Community Led Total Sanitation (CLTS) is all about behaviour change: people deciding by themselves that it is not acceptable to use the bush to shit and so they construct and use latrines, drop hole covers and hand washing facilities. Latrines are commonly being adopted in communities where CLTS has been introduced. Covers and hand washing facilities are built but are not being used very often, and if they break they might not even be fixed.

Why are latrines being more successful than drop hole covers and hand washing facilities?

To help answer this question I like to think about some characteristics of behaviour change (these are some I put together, there are many books that talk about the factors to create behaviour change)

• Adopting new habits can be a slow process.
•  In general behaviour change is done in steps.
• Changes of behaviour that bring direct benefits and satisfaction are easier to occur and maintain.

The second thing I like to think about to answer the same question is the flossing problem (try to answer the following questions – what about posting them as comments?):

What are the benefits of brushing your teeth? What are the benefits of flossing?

You probably brush your teeth multiple times day. Why?

Now, how often do you floss? Why is that?

These are some of my conclusions for the flossing problem:

People will usually brush their teeth as they see direct benefits and enjoy the “clean” feeling. Flossing requires time investment and in comparison it does not bring as many immediate rewards. Therefore a much smaller percentage of the population flosses regularly even though they know they should floss. When you go to see your dentist, she (in my case) does not need to remind you to brush your teeth, but she will for sure remind you about flossing. And it works, right after visiting my dentists I’m flossing very often, but as time goes by…

Flossing is a more difficult habit to pick up (maybe because of the problem of investment versus rewards), and you need to be reminded about it often.

A traditional latrine and drop hole cover

With sanitation we face the same problem. People will readily adopt latrines as they are more comfortable and dramatically decrease occurrence of diarrhea and cholera. Washing hands after using the latrine is a much harder behaviour to install even if the people know why they should do it. When talking to different families in the communities I visit, they tell me about the importance of using hand washing facilities and drop hole covers, but when visiting their latrines I find many times that the drop hole cover is not being used and that the hand washing facility does not even work.