Cash rewards spur poor communities to pay for sanitation projects

The East Meets West Foundation tries cash awards to encourage families and communities in Vietnam and Cambodia to build latrines and hand-washing devices.

By Nicole Wallace, The Chronicle of Philanthropy / September 12, 2012

An international aid charity is taking an unorthodox approach to helping people in Cambodia and Vietnam improve sanitation and hygiene: It asks beneficiaries to help pay for the construction of latrines and hand-washing stations, but then gives them cash rewards when they get results. The effort will now spread, thanks to a $10.9-million grant from the Bill & Melinda Gates Foundation.

The East Meets West Foundation, in Oakland, Calif., works with local groups to provide hygiene education, train masons to build high-quality latrines, and broker low-cost loans that families can use to install latrines and hand-washing devices. Families receive a $10 rebate to help offset construction costs after an independent group has verified that the latrine is in place.

Communities also get incentives: They receive cash awards to be put toward public-works projects, such as roads and sanitation facilities in schools, when the percentage of households that have latrines and hand-washing devices hits 30 percent, and the communities receive more money when those rates reach 95 percent.

Millions of people in Vietnam and Cambodia lack sanitation facilities, and the cost of building them ranges from $50 to $250 per household, depending on the region, says John Anner, the organization’s president.

“There’s simply no way that philanthropy is going to fill that gap or that the government is going to put up that kind of money,” says Mr. Anner.

Beneficiaries bearing part of the cost helps scarce grant dollars go further, he says, and scale is important because the benefits of improved sanitation, such as better health and cleaner water, depend on large numbers of people in the community adopting good hygiene practices.

East Meets West says it will be able to use the Gates grant to bring hygiene education and well-built latrines to 344,000 households, or more than 1.7 million people.

Mr. Anner says that the number of participants in areas where the organization has already offered the program has consistently exceeded its forecasts.

“Everybody knows that when you’re sick you can’t go to work; kids can’t go to school,” he says. “Medical costs are paid for out-of-pocket in a lot of these places, and they can be very, very high.”

The loans also help the charity identify people who will take the project seriously and keep the facilities in good repair, says Mr. Anner.

“Straight-up charity makes it very difficult to distinguish between people who really, really want what you have to offer and people who are just willing to take anything’s that free.”