An assessment of the Carter Center’s latrine project in
Niger, undertaken to reduce incidence of trachoma, has shown encouraging
results. After one year, household latrines are widely accepted,
used and maintained.
The Carter Center’s Trachoma Control Program began its latrine project
early in 2002 to rid rural villages of breeding sites for flies that transmit
the world’s most common preventable cause of blindness. The trachoma-control
team provides materials and supervises the construction of household latrines.
When the project began, fewer than 5 percent of households in rural communities
had covered latrines. Now more than 2,900 latrines have been built in more than
50 villages, and as many as 1,000 more households will build latrines as materials
“We needed to learn how well people are accepting latrines, whether they
maintain the latrines and how hygiene education has had an impact on the communities.
The results are promising,” said the center’s Mamadou Diallo, a physician
from Mali with a masters of public health from the University of California at
Berkeley and a graduate of the CDC’s Epidemic Intelligence Service.
Beginning in June 2003, the trachoma control team visited 200 households, interviewing
resident adults and meeting with village leaders. They found that latrines are
welcomed and accepted for different reasons. Specifically, they found:
• More than 90 percent of adult men and women reported always using latrines.
• Eighty-two percent of those surveyed chose to use them for proximity and
• Only 5 percent cited disease prevention as the reason for using latrines.
• Seventy-five percent of the time, women are in charge of cleaning latrines.
While only a small percentage of villagers reported using latrines as a way to
prevent disease, Salissou Kane, resident technical adviser for the Trachoma Control
Program in Niger, is pleased with project results.
“Even though people are using latrines for reasons other than health, they
are still using them,” he said. “Later on we can help them connect
the impact of latrines on health.”
Forty-nine of 50 village leaders reported they would continue to build latrines
when the project ends.
Trachoma affects 146 million people, most of whom live in developing countries
in Africa, the Middle East and Asia. Only cataracts cause more blindness worldwide
but, unlike cataracts, trachoma can be prevented through improvements in personal
and environmental hygiene. The Carter Center’s Trachoma Control Program
works with ministries of health and other partners in Ghana, Mali, Niger, Ethiopia,
Sudan and Nigeria to promote improvements in personal and environmental hygiene
and to deliver antibiotics to people at risk for blinding trachoma.
In addition to the latrines in Niger, the Carter Center has built 7,900 latrines
in the five other African countries, learning along the way about cultural and
regional influences. In some countries, latrine lids get too hot. In southern
Sudan, where soils are very loose and moist, some latrines have collapsed. Center
staff found in Mali that separate latrines would have to be built in homes housing
more than one wife or family. Ethiopia and Ghana are experimenting with public