Safely managed sanitation is considered expensive and difficult for most people in five USAID IUWASH PLUS supported Kelurahan (urban villages) in Tebing Tinggi City, namely Mekar Sentosa, Sri Padang, Bandar Utama, Karya Jaya, and Tualang. Although open defecation is not widely practiced in this area, most people still use gooseneck latrines without septic tank, which actually can be categorized as open defecation. Consequently, risk of fecal contamination to the environment is high.
To minimize the risk of fecal contamination in these five Kelurahan, the Health Office of Tebing Tinggi City in collaboration with USAID IUWASH PLUS promoted safely managed sanitation, which covered topics such as septic tank use and scheduled desludging services. The campaign was launched in May 2017, and it aimed to encourage community members to stop practicing open defecation and unsealed septic tank users to switch to latrines with septic tank, as the first step of safely managed sanitation.
However, changing people’s behavior is not easy. It needs effective approaches to trigger their own desire for change. Aware of this need, USAID IUWASH PLUS supported the Health Office of Tebing Tinggi City to conduct participatory assessment and triggering as part of the safely managed sanitation promotion in the five Kelurahan. In this activity, the community members mapped their surroundings and verified the results through transect walk, while observing the environment and discussing what had to be done to change people’s behavior and improve access to sanitation facilities.
The participatory assessment and triggering made the community members learn about behaviors which potentially harm the environment and cause fecal contamination to the people’s daily activities, such as eating and drinking. They also learned about the importance of using septic tank for their health and the environment.
After joining the discussions and promotion on safely managed sanitation held a few times in those kelurahan, some community members started to realize the benefits of latrines with septic tank. Suryawati, a resident at Kelurahan Mekar Sentosa, is among other community members who changed her perspective. The participatory assessment and triggering opened her eyes that the bottomless latrine she used threatened her family’s health. Since then, she is eager to install a septic tank.
There is a similar case with Rahmawani, a staff of Tebing Tinggi Health Office. Although she is aware of safely managed sanitation, she has yet to implement it. After participating in the series of safely managed promotion activities, she is committed to change and build a septic tank. “I understand that if I want to change people’s behavior, I have to change myself first,” she said.
Suryawati’s and Rahmawani’s strong commitment to change was then realized by building septic tank using their own funds in January 2018. USAID IUWASH PLUS also used this septic tank building process to train handymen, cadres, and other community members to build a septic tank.
These women’s initiatives to change have gradually inspired other people in Kelurahan Mekar Sentosa, such as Dasopang who works for the Office of Religious Affairs. He followed their example to build a septic tank using his own funds. “It is good for family’s and children’s health. I can afford to build the septic tank after saving for months,” said Dasopang.
The participatory assessment and triggering activities also successfully triggered other community members who want to change but could not afford to build the septic tanks immediately. Some of those people initiated a saving movement to build septic tanks. For example, 15 women in Kelurahan Mekar Sentosa save Rp2,000 every day. Similarly, 11 women in Kelurahan Karang and 10 staff of Puskesmas Teluk Karang also saved their money to build septic tanks. To help these people build septic tanks sooner, USAID IUWASH PLUS encourages them to seek external financing resources, such as Corporate Social Responsibility (CSR) programs and micro credits.
The local government appreciated the changes in people’s behavior to implement safely managed sanitation. In March 2018, the Tebing Tinggi city government awarded Suryawati and Rahmawani with a certificate of appreciation for their initiatives to change using their own financial resources.
A month later, the city government used the septic tank building process at Dasopang’s house to appreciate the people who have made changes. “Tebing Tinggi City is aiming at Open DefecationFree by 2019. I hope everyone can support and coordinate well so that the city will achieve Kota Sehat Tingkat Tinggi (Third Grade Healthy City) status,” said the Mayor in his remarks read by the General Administration Assistant.
(Susilawaty/ USAID IUWASH PLUS)
Available in 
