Easy enough for me to tell my latrine sob story, but let me give an even stronger piece of advice: really, really try to avoid being a refugee in a newly created camp that only has trench latrines. As an aid worker I’m supposed to encourage all refugees to use only the designated camp latrines. Getting, and keeping, human shit away from food and clean water is about as central a public health intervention as you can get. If you can do nothing else for a bunch of displaced people living in the middle of nowhere, establish a shitting field and make sure the community leaders enforce it. As a human being, and fellow lady to many of them, however, it’s pretty hard to push the trench.
A trench latrine is pretty much what it sounds like. A long hole is dug and everybody is supposed to do their business while perched on the edge. If you’re lucky there will be a his and hers and improvised privacy shelter made of plastic sheeting surrounding it.
There is a new camp here called Gendrassa. Half of the Jamam camp has to be relocated there since their original tent sites got flooded at the start of the rainy season. Since it’s relatively new there aren’t very many regular pit latrines….trench latrines dominate.
Trench latrines are an extreme, but regular camp latrines are no picnic either (probably no need to convince you of that.) As much as we in the aid community push latrine usage for personal and public health, there is seldom enough effort put into making them user-friendly, especially for women and children.
Latrine placement and design are huge influencers on who uses them and when. For instance, if you put the latrines on the periphery of the camp where soldiers might be stationed, it’s not likely women (or anyone) will use them at night. If you make them so dark inside you can’t see anything children won’t use them. One of the issues is that during an emergency everything needs to be done as quickly (and cheaply) as possible – there’s so much to do. But inevitably temporary solutions become permanent ones and a year later the focus shifts to other priorities. The latrines are already built. No need to revisit.
Sanitation is most important for women for a few different reasons: they’re the ones who cook and clean for the family, they get periods, and they fetch the water for the family, they require more privacy and they’re more vulnerable to sexual violence. Crazy as it sounds, some latrines are built with a lock on the outside, not the inside. Others have doors that open to the busy market where everyone can see who comes and goes. Many don’t have any water source nearby making it difficult for women to deal with their periods.
Someone on my team here is trying to change this. His name is Rink. He’s an experienced water and sanitation expert that’s been working in refugee and emergency settings for years. He’s doing his Masters thesis on gender-sensitive water/sanitation solutions for women in emergencies. After conducting many focus groups with women here in the camp he designed latrines and washing areas he thought could address their concerns. Construction is going on right now in six test villages and two control villages. After the latrines are built he’ll study whether the new design improves latrine usage (and by proxy, though this will be hard to demonstrate in real time, improvement in diarrhea rates for the camp.)
I won’t be around for the results but in the meantime I’m trying to help him gather descriptive background information about the experiment villages. One day Rink asked me if I’d heard anything about what was going on in Ayouk. He said on his past two visits that it seemed strange there weren’t people hanging out in the village – usually there’s kids playing, old men crouched together in a circle and women cooking outside their tents. In Ayouk, everyone seemed to keep to their tents, especially strange since they get so damn hot in the afternoon.
I hadn’t heard anything, but I asked my outreach workers the next morning. No one else had heard anything either. The next morning, however, Jalal the grandpa, pulled me aside in the middle of the morning meeting. My translator Thimoty explained: There is a man with mental problems who is killing many goats. Where was this happening? Ayouk. The outreach workers agreed – people in Ayouk were staying in their tents because they were afraid of the goat-killer.
I told the mental health officer (a psychologist from D.C.) so she and her team paid him a visit. They found him outside his tent eating Plumpy Doz. (Plumply Doz is the nutritional supplement we distributed to kiddos under three years old. This was off label usage.) Turns out he was only killing his own goats (otherwise he probably wouldn’t still be alive) so the crazy was somewhat contained. Yesterday he was finally convinced to come in the hospital to chat with the mental health team. Reports are that kids are playing in the dirt in Ayouk again. And though they don’t yet know it, the women of Ayouk are about to help influence latrine design for future refugee camps all over the world.