Sustainable sanitation begins with a toilet that is accessible, that captures human waste in a safe manner, and that offers a dignified and private space for cleaning up. Everyone must have access to a toilet. In 2018, a little over half of Tshangka gewog’s (group of villages) residents had access to an improved toilet (58%). Today, everybody enjoys this access.
This success was achieved under the leadership of the Ministry of Health’s (MoH) Rural Sanitation and Hygiene Programme (RSAHP) in collaboration with SNV and the Australian Government. The RSAHP mobilised the support of different stakeholders to reach the goal of 100% improved toilets, such as Tshokpas (village representatives), masons, the gewog administration, and health assistants like myself. Over a short period of time, the community’s state of sanitation and hygiene reached the target of 100% improved toilets.
Along with my health assistant colleagues, I participated in RSAHP activities. Together, we identified underprivileged and economically deprived households that required focused support from RSAHP. Our scoping exercise was followed by two-day Community Development for Health (CDH) trainings that we conducted ourselves. In these trainings we aimed to raise awareness and impart the knowledge and skills behind achieving better sanitation and hygiene conditions. Shortly after completing the CDH trainings in 15 clusters across all villages, households started to build pour flush toilet themselves. Some even took the initiative to request our teams to validate the quality standard of their facilities.
Drawing water next to toilet at Dagana district (SNV/Aidan Dockery)
The COVID-19 pandemic that followed, however, almost slowed down the momentum of the sanitation drive. Safety measures that were put in effect made it more difficult for people to avail of the materials required to complete toilet construction. There were also households that could not afford to build toilets themselves, even before the pandemic. To make sure that no household was left behind, health assistants reached out to local contractors and the gewog administration for donations in kind (materials and services). Toilet pots, cement, CGI sheets, and other materials for toilet construction were pooled and local masons were engaged to build the toilets of struggling households (i.e., households with disability, single households, households in extreme poverty, etc.).
‘I have nothing and can do nothing. I cannot work like before and my earnings are too little. If I invest in a toilet, then I cannot fill my belly. That is why, I failed but I didn’t expect people to come and construct my toilet. You all did it whole heartedly, so I am grateful for your kind action to me. Now, I am happy that I also get a chance to use the same toilet as other people in our village. I will take care of the structure and clean my toilet every day. Thank you everyone. I have nothing to give you all but my heartfelt prayers and good wishes’ – Benzangma Subba, 45-year-old household member
Thanks to the generous contributions of local contractors and gewog administrators, improved pour flush toilets were delivered by the doorsteps of households that needed extra support.
‘I am very fortunate to be a Bhutanese citizen and to have a government that has great concern over old aged people like me. I never expected, in my lifetime, to step into such an expensive toilet. I am very grateful to the masons, health assistants, and Dasho Dzongda for addressing my situation.’ - Tandin Om, 78 year-old household member
During the year, Tsangkha gewog became certified as one of four gewogs to achieve 100% improved sanitation – even during COVID-19 times. Because of COVID-19, people have also become more conscious of and have greater motivation to wash their hands with soap.
As for my next steps, I commit to monitoring the continuity of good sanitation and hygiene behaviour and practices, and to support the community in ensuring the longevity of their facilities.
Contributor: Gyembo Dorji, Health Assistant, Tshangka PHC
 In Tshangka, Dagana, Central, sanitation and hygiene interventions are supported by SNV, with financing from the Australian Government’s Water for Women Fund.
 This story is part of an SNV in Bhutan SSH4A blog series by local government, health care, and community partners. In this series, partners reflect on the success of Community Development Health (CDH) workshops in encouraging villages, sub-districts, and whole districts to prioritise their sanitation and hygiene conditions.
For more information on SNV’s CDH-related activities, contact: Thinley Dem, Behavioural Change Communications Advisor, SNV in Bhutan