Hesperian Health Guides
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Some health workers believe health problems and death from poor sanitation can be prevented only if people change their personal habits, or "change their behaviors," for staying clean. But promoting behavior change often fails because the conditions people face in their daily lives, such as poverty, or a lack of clean water or decent toilets, do not change. And when their behavior does not change, the people themselves are blamed for their own poor health.
Experts may offer technical solutions, such as modern toilets that use no water, or costly sewage treatment systems. But just because these technical solutions may work elsewhere does not mean they will respond to the traditions or conditions of the community. Some of the toilets in this book may not be right for some communities. Offering technical solutions without understanding people’s cultures, living conditions, and real needs can create more problems than it solves.
Diseases caused by poor sanitation will continue if people are blamed for their own poor health or if technical solutions that ignore local conditions are promoted. To improve health in a lasting way, health promoters must listen carefully and work with people in the community to develop solutions based on their needs, abilities, and desire for change.