A development practitioner's diary #2: what room do we have?

Recently I have been involved in a multidonor-funded sanitation project in East Java, in addition to my ongoing donor-related work, which has been more analytical. There are many non-technical issues that I think are too important to miss. In real world, those non-technical issuses are important, sometimes very important, for the success or failure of a research or an intervention program. I am going to share some of the experience in this 'Field diary' series. Earlier I have shared a first story; hence this post is the second one... (a.p.).

My friend -- that dumbfounded psychologist in Australia -- and I were chatting about the sanitation project. We talked about the background and objectives of the study, and how the intervention will (or is expected) to work. After exchanging several lines, he raised an important point. Here's an excerpt of the conversation.

DP: "Do you know what makes the villagers don't build their own toilets?

AP: "They said they don't have money. But looks that it's not the case as they can afford to buy cellphones, and some of the houses have ceramic floors or permanent walls. So looks like cultural aspects or lack of information matter."

DP: "Does the project try to find out what is the main reason for not having toilets?"

AP: "No -- the intervention aims to create or trigger demand for proper sanitation."

DP: "But how do you know that intervention works if you don't find out the real reason first?"

AP: "I'll tell you what. This is a development project, not a pure academic research... If you know what I mean, or try to read between the lines..."

DP: "Ah yes, got it... I should have thought more pragmatically...."

Moral of the story: in most cases, if we're running a development project, the constraints for what activities to do or what information to look for have already been set. Although sometimes we can play around with the constraints, or piggyback with an existing project, to do other activities or look for other information. I'll tell you in other posts.

These things do happen...

You have carefully calculated your sample size based on some criteria (power calculation, impact size, budget, etc.). You have randomly assigned your samples into treatment and control groups. Your counterpart, in this case District governments, have agreed to commit to the random assignment.

Then, one morning, your local government contact called you:

How are you? Been a while since the last time we talked. By the way, sorry to inform you, but we have decided to give treatment to village X. I know, initially it was a control village. But we thought that the village is in a desperate need to get treatment. So, in fact, we have already started treating village X.

And this was not the first time you received that kind of surprise phone call. And out there, many still believe that a big donor like the Bank is a kind of super institution that is able to dictate governments here and there to get what it wants.

Note: anyway, in randomized trial, there are ways to deal with this; you can choose to apply the Intention to Treat analysis, or the Treatment of the Treated.

Of toilets, faeces and open defecation

Yes, I've been absence for a while from this cafe. Unlike Sjamsu, I haven't been performing in The Police and Queen nights. Unlike Aco, I haven't been winning any awards. Unlike Ujang, I was happy that Liverpool has beaten MU and Chelsea.

I have been traveling recently to some places, mainly to East Java, for a rural sanitation project in eight kabupatens. I visited some villages, and in many villages I found that only 1 every 9 or 10 households that have in-house toilets. They do most of their business in the river or bushes. Of course, it is easy to think the relations between open defecation, health problems, human capital, and productivity. We may also hypothesize that poverty is the reason why they don't have in-house toilets.

However, most of them have brick or concrete houses, sometimes with ceramic floors. And almost every household have at least one cell phone. So cost (supply) can not be the constraint -- demand looks to be a bigger problem. This may be due to 'culture-related' sanitation behavior, lack of awareness, or whatever reason. The point is, if you just simply build public toilets or subsidize people to build one in their house, such intervention may not work. People will just go back to the river or bushes.

This is where I agree to our friends Tirta (and Roby, among others), that psychology and understanding the nature of social interaction is important. In fact, the project in which I am involved aims to create demand for proper sanitation. What we do is, open community meeting, we ask the villagers to: 1) draw their local map, 2) ask them to identify which houses have toilets, and where do the rest go for defecating, 3) invite them to do some mental exercise in counting how much faeces they are producing in a day, week, month and in a year. After that, we ask them who wants to build toilets equipped with septic tank.

If 1-3 don't work, we then ask them to go to the spots where the villagers do their usual business. If this also don't work, the strategy is to take real, fresh, faeces in front of them then discuss the possible transmission of virus and bacteria to human's body. (Well, if this also doesn't work, then, from the perspective of the project, we're in a deep shit...).

Of course, this efforts may or may not work. Despite all the campaigns, maybe only a few people want to build toilets in the end. Even though many people build their own toilets, their health situation may not improve. This is why we are doing an impact evaluation (in fact, I am involved in the evaluation side of the project, not the shitty activities one). After collecting the baseline data, in a few months up to a two-year period, we will be collecting some data on the health status. Then we will compare the data in the 'treated' and 'control' villages. We'll see the result in 18 months...