It was a rare sight: members of the Indonesian Council of Islamic Scholars (in Indonesian known as Majelis Ulama Indonesia) in their distinctive peci hats sat alongside Government health officials from 13 provinces of Indonesia to discuss an unconventional topic: toilets.
Organised by the Minister of Health, the meeting unveiled an innovative approach to improve sanitation in Indonesia – a Fatwa, or Islamic decree by the Council which stresses the importance of good sanitation facilities and hygiene practices. The decree also allows the use of the Council’s charity funds (Zakat) to provide financial support to the poorest and most vulnerable families for better latrines.
Indonesia has a huge problem with open defecation, where people do not defecate in a toilet but in the open, on the beach, into river and so on. A WHO/UNICEF Report (2015) estimates that over 51 million people do not use latrines in the country – the second highest number in the world. However, open defecation is practised mostly by the poorest populations and they bear the heaviest burden. In particular, children - already vulnerable and marginalized - pay the highest price in terms of their survival and development.
Open defecation leads to increased rates of diarrhoea and pneumonia – two of the main causes of under-5 child deaths in the country. Poor sanitation affects water quality as excreta can often contaminate poorly protected water sources. Such contamination of drinking water, the absence of toilet-use and poor personal and communal hygiene including no habitual handwashing with soap at critical times exacerbate not only diarrhoea but also pneumonia.
In addition, Indonesia has almost 9 million children affected by stunting or children suffering from chronic malnutrition – which is the 5th highest in the world. Stunting has a lifelong negative and irreversible impact on their physical and cognitive development. Many stunted children perform more poorly at school than their peers, with consequences for their economic and social opportunities in later life. Surveys by UNICEF Indonesia show that the risk of stunting is much higher when a household does not use an improved latrine. Hence, efforts to reduce stunting need better sanitation.
The Government of Indonesia targets 2019 as the year to be free of open defecation. The meeting highlighted that this target cannot be achieved by Government, civil society or communities in isolation – it needs everyone, including the religious leaders and general public, to realise the importance of the goal and to get fully behind it. That is why the Council was there to introduce the Fatwa.
The Ministry of Health’s own initiative titled Community-led Total WASH program (Sanitasi Total Berbasis Masyarakat) focuses around five key issues in rural Indonesia: use of toilets, washing hands with soap, safely storing and handling drinking water and then solid and liquid waste management. Such initiatives, especially at the community level where the entire community together realizes the need, can lead to rapid acceleration in sanitation and hygiene. But this needs intensive follow-up at ground level, as UNICEF has seen from its work in Papua, East and West Nusa Tenggara, South Sulawesi and Aceh. The Fatwa can give that extra push that is needed.
Pak Hayu, the head of the Environmental resources committee of the Council, has been a champion for this Fatwa. With technical support from UNICEF, he developed a guidance book on the importance of water, sanitation and hygiene (WASH) in Islamic teaching last year signed by the Council, the Ministry of Health and UNICEF. In addition, the Council has developed a book of sermons for local religious leaders to provide spiritual guidance on WASH at Friday prayers and to urge people to change their unsafe sanitation and hygiene habits. As a result, the Fatwa on WASH was developed. Recognising the importance of the work, the Ministry of Health has put their own national budget funds to roll out this guidance in all provinces of Indonesia.
This is great progress. This type of innovative partnership can help to ensure that all children in Indonesia are born into an environment that will not contribute to them being stunted; where they will no longer suffer from repeated episodes of diarrhoea; and where all girls can use toilets and avoid open defection, making them free from harassment and embarrassment as they enter puberty.
The meeting also discussed a series of challenges and agreed on follow-up actions towards improving coordination across all stakeholders, changing behaviours and attitudes and reaching the most disadvantaged for better sanitation and hygiene, thus creating a healthier next generation.
Documents mentioned in the blog can be found at the links below: