Latrines here, latrines there, latrines everywhere

I am in Burkina Faso for a month, preparing for our study abroad program here, Reading West Africa. I went over the weekend down to the village of Bereba, where Leslie and I have a house. Not much has changed (since last year, or even in 15 years since we first starting having a residence in the village)... except.... the first public latrines were build, just outside the market. They are going to be for pay... next visit I'll learn more. The interesting thing is that latrines have really taken off, but only over these past 15 years. When we first came to Bereba in the mid-1990s, even though the village is pretty developed and a small administrative center, many people still used a corner of the compound and some straw as latrine. By contrast, when I was in Sudan and in mid-1980s, UNICEF and other NGOs had been promoting latrines for some time. Interestingly, in one of the libraries we sponsor through FAVL (www.favl.org) the team had build two latrines, one for girls and one for boys. The did not have roofs, though. There was a vent however. I asked why there was a vent if there was no roof. "To let the gases escape from the pit." "But there is no roof, so the gases can just come through the hole." "Hmmmm." Then my village didact self took over, explaining about putting a roof on and flies coming into the pit and going up the vent and being trapped in the vent by a mesh, just the way villagers in Sudan had explained it to me 20 years ago. So the knowledge came full circle, from some development expert to a villager to a development expert and back to a villager. Sweet.

Article on latrines in south sudan.

And since we have to prove everything by a randomized trial....

Role of flies and provision of latrines in trachoma control: cluster-randomised controlled trial.

Lancet. 2004 Apr 3;363(9415):1093-8.

Emerson PM, Lindsay SW, Alexander N, Bah M, Dibba SM, Faal HB, Lowe KO, McAdam KP, Ratcliffe AA, Walraven GE, Bailey RL.

Medical Research Council Laboratories, PO Box 273, Banjul, The Gambia. p.m.emerson@durham.ac.uk

BACKGROUND: Eye-seeking flies have received much attention as possible trachoma vectors, but this remains unproved. We aimed to assess the role of eye-seeking flies as vectors of trachoma and to test provision of simple pit latrines, without additional health education, as a sustainable method of fly control. METHODS: In a community-based, cluster-randomised controlled trial, we recruited seven sets of three village clusters and randomly assigned them to either an intervention group that received regular insecticide spraying or provision of pit latrines (without additional health education) to each household, or to a control group with no intervention. Our primary outcomes were fly-eye contact and prevalence of active trachoma. Frequency of child fly-eye contact was monitored fortnightly. Whole communities were screened for clinical signs of trachoma at baseline and after 6 months. Analysis was per protocol. FINDINGS: Of 7080 people recruited, 6087 (86%) were screened at follow-up. Baseline community prevalence of active trachoma was 6%. The number of Musca sorbens flies caught from children's eyes was reduced by 88% (95% CI 64-100; p<0.0001) p="0.04)" n="14)" p="0.01)" p="0.210)">