Ecosan toilet in Mtandire settlement, Malawi                                                          

In almost every major city in the south, Slum Boards, Housing Authorities and Municipalities are charged with building and maintaining toilet blocks in low-income neighbourhoods and slums. Engineers tender for contracts and handle issues of location, design, and construction; municipalities hire external staff (that has no investment in the upkeep) for cleaning and maintenance; and community members are entirely left out of all decision-making processes, and therefore have no sense of ownership. This leads to a situation were the quality of construction is frequently poor, the availability of water is limited, and access to drainage is inadequate. All these problems lead to the early destruction and deterioration of the few working toilets blocks in the city.

The consequences of this approach are obvious: in most cities, there are few operational toilet blocks and slumdwellers are forced to shit in the open. Women must wait until dark to defecate in order to protect their modesty (and often suffer from gastric disorders). Children will squat anywhere and everywhere leaving excrement throughout the settlement. Families, quite literally, are forced to live in shit, suffering from poor health conditions and the spread of disease. In order to alleviate potential public health crises and restore human dignity, SDI affiliates have pioneered a people-driven approach to water and sanitation, building toilets in a way that reifies community capacity

Federations in India, Cambodia, South Africa, Kenya and Uganda have brokered deals with local authorities to design, construct and maintain toilet blocks. Engineers and Municipal officials frequently visit the construction sites - those with insights into the actual needs of the communities are usually available for guidance and support, and those preoccupied with bureaucratic regulations tend to obstruct and control. Both approaches provide opportunities to learn, and in most instances, even the most resistant officials are won over by the Federation's success.

Federation built and managed toilets have had a profound impact on the health and environment of the slums, and more than is commonly recognized, have instilled a sense of pride and confidence in communities. In an interview, Savita Sonawane, a leader in Pune, India, summed it up by saying: "In the beginning, we did not know what a drawing or a plinth was. We did not understand what a foundation was or how to do plastering. But as we went along, we learnt more and more and now we can build toilets with our eyes closed."