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June 16, 2014

Connecting Households One Toilet At A Time: The Story of Tinambac

     Among the many challenges faced by any rural community in the Philippines is the lack of proper sanitation. In an archipelagic country blessed with so many natural resources, access to potable drinking water can be very challenging. Of course, its twin problem is access to toilets. Whether it is a coastal community or a village in the uplands, many Filipinos still live in houses that don't have toilets. One can just imagine how they would dispose of their human waste.

     One mayor was faced with the same problem. Mayor Owe Velarde, the mayor of a town called Tinambac in Camarines Sur, used to be a village chief (barangay captain) for a long time before he climbed up the political ladder. During his service as a village chief, he was already aware of the problem of his people. When he became Mayor, one of his projects was to provide his community members access to water and toilet. He provided at first individual households with their own toilets and septic tanks. Later, he shifted to constructing communal or public toilets shared by a cluster of 10 or more households in a village. Both of these approaches proved to be not only expensive but had low acceptability among the people.

     It appeared that for some time, Mayor Owe gave up in pursuing the vision even further. Sometime in 2012, Mayor Owe began a partnership with the foundation where I worked for: Zuellig Family Foundation. Through the Community Health Partnership Program, local chief executives together with their municipal health officers and community leaders, undergo not only lectures and inputs in local health systems development but also leadership development. Mayor Owe was inspired to once again re-focus and even intensify further his priorities on health initiatives. Among his many initiatives was a partnership with the Catholic Church in promoting Responsible Parenthood.

Mayor Owe, center, with fellow Mayors

     During the most recent Module, Mayor Owe and the rest of the participants underwent one session which somehow made a huge impression on him. I facilitated a session on deepening their understanding of their health situation using a method called Interrelationship Digraph. I asked them to focus on their current and remaining health challenges and to think of factors that bring about the persistence of these challenges. The process was simple to follow for a non-medical and non-technical person like a mayor. So, after we finished that session, Mayor Owe approached me and asked me if he could also do it with his own health workers back home. I said he could of course and since their workbooks contain the instructions on how to go about the process include how to analyze and synthesize the output, I told him that he could actually facilitate it himself together with his two other doctors.

     Sure enough, a few weeks later, I received pictures on facebook of the Mayor and his two health officers conducting a workshop with the health workers and community leaders using the interrelationship digraph process. The Mayor told me later that the workshop was so successful in opening the eyes of his community leaders. The Mayor said that the outputs of the process revealed that one of the major drivers of the health problems in the communities was lack of access to sanitary toilets.

Mayor Owe facilitating a workshop in Tinambac

Community Leaders of Tinambac analyzing their health situation

     With his passion re-fueled, Mayor Owe returned once again to his previous vision of providing his people access to sanitary toilets but this time with allies from the community leaders themselves who was sold to the importance of sanitary toilets due to the workshop the Mayor facilitated. Mayor Owe decided to start small and focused on one pilot area, a coastal community called Bagacay. Mayor Owe, together with the village chief and her members of the council, met many times to discuss how they would address the problem of no sanitary toilets. They studied the challenges of the past and why the concept of sanitary toilets failed before. For the municipality, providing each household a toilet and septic tank of their own was just too expensive. It was cheaper to establish communal toilets but due to lack of ownership of the community, the communal toilets would end up not being maintained.

     Then a sudden thought came to the Mayor. What about individual household toilets but shared or communal septic tanks? Septic tanks are usually far more expensive and more exhaustive to construct. What if houses would share septic tanks but would have their own toilets? It was an idea Mayor Owe was willing to try. Consulting with his officials and community leaders of Bagacay, the local government earmarked around 350,000 Pesos (around 8100 US$) to construct around 6 to 8 septic tanks and distribute toilet bowls to around 40 households in the coastal village. Some households already had toilets of their own.

     The Mayor is no engineer. He is a commerce graduate but because of his deep ownership of the problem, he was hands on even on the design of the "Octopus" comfort rooms. The community leaders did their part. They established their own village health board and provided information that would help the municipality identify beneficiaries and design the lay-out of the pipes and septic tanks. When the municipality was able to purchase the supplies, the community got involved in constructing the communal septic tanks.

Mayor Owe inspecting a septic tank.

This septic tank is connected to 8 households.

     In a span of less than one month, around 6 septic tanks were already constructed and ready to service 6-8 households each. The families then started to work on their respective toilet rooms. A village or municipal sanitary inspector would come to ensure that the households have already constructed their toilet rooms. By the time the village celebrated their patronal festival (Feast of the St. Anthony of Padua), the coastal village of Bagacay already had 100% households with access to sanitary toilets.

     I happened to visit the place a day after their local fiesta and the Mayor gave me a tour of the project. I also asked the families that we visited and all them said that it was a huge difference having a sanitary toilet of their own. It was very clear that all the families living in the village were very poor. Fishing was their main source of livelihood. We had early dinner at the house of the village chief. Because of the success of the project, other villages are already asking the mayor if he could already expand it to their areas. The village chief of Bagacay meanwhile already earmarked 100,000 pesos (2300 US$) to launch the same project in the other zones. I asked the mayor if this Octopus method of connecting toilets to a shared septic tank was indeed cheaper. He told me that he used to spend around 15,000 pesos (350 US$) per household to construct toilets and individual septic tanks. If he would have done the same, 40 households would cost him around 600,000 pesos (14,000 US$). With his Octopus CR, he only spent 350,000 pesos for the same number of households. That's about 8,750 pesos (203 US$), which is way cheaper.

A mother and her children, her family is one of those families benefiting from the Octopus CR

Mayor Owe showing a toilet room

Mayor Owe inspecting a pipeline connecting two households to a common septic tank

    "And this began because of what you taught us during the last Module," Mayor Owe would tell me. For the mayor, that workshop became a spark that re-ignited a vision. The constant dialogue with his people became an opportunity for him to learn from them directly what they think are the more urgent matters when it comes to their health. He knew that the problem was no access to sanitary toilets but he was patient enough to allow his community leaders to realize it on their own through a series of workshops and dialogues he facilitated together with his municipal health officers.

This is a septic tank with a toilet room on top of it. 

The village chief, second from the left, chatting with the community of Bagacay

     Mayor Owe is just one of many mayors who are partners of ZFF and are into the same kind of innovative thinking to address their own health challenges. They are a new breed of politicians whose desire to serve the poor and vulnerable is definitely authentic. If we can multiply them, then we could transform the country.

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