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By Mark Bixler, Atlanta Journal-Constitution Staff

Latrine program a hit
Project deals with health, gender

Women's lib has come to rural Ethiopia from an unlikely source: the outhouse.

A Carter Center program to fight disease by promoting latrines has caught fire in Ethiopia. The center hoped for 10,000 new latrines last year, but villagers have built more than 90,000.

Women fueled the boom in a place where tradition lets men defecate in the open during the day but asks women to wait until dark so that no one will see, said Teshome Gebre, the Carter Center's point man in Ethiopia.

He talked up latrines during a Carter Center conference in Atlanta that ends today.

"One woman told us she was a prisoner of the daylight," Gebre said. "Another said, 'With the latrine, we are equal with the men.' "

The Carter Center encourages the use of latrines to fight trachoma, the world's leading cause of preventable blindness. Latrines reduce the amount of human waste in the open, taking away prime breeding grounds for flies that transmit the disease.

The center also fights trachoma in Ghana, Mali, Niger, Nigeria and Sudan, but its success in Ethiopia stands out, said Dr. Paul Emerson, who directs the Carter Center's fight against trachoma.

"If we really knew why this caught fire," he said, "we would bottle it up and ship it all over Africa."

Human waste helps spread many diseases, such as cholera and dysentery, but that is not common knowledge in parts of the developing world.

"Germ theory hasn't arrived in much of Africa," Emerson said.

Most of the 18 million people in Ethiopia's Amhara region, where trachoma is rampant, use fields or woods as bathrooms, Gebre said.

After extolling the latrine to community leaders in Amhara last year, Gebre saw his message catch on in village after village. One family would build a latrine and others, envious, would follow suit. Having a latrine became a status symbol.

"They look just like the outhouses people in Georgia were using 50 years ago," Emerson said.

Reducing human waste is just one part of a broader effort against trachoma, which affects 146 million people, mainly in Africa and Asia. The Carter Center and other organizations, under the direction of the World Health Organization, also encourage people to wash their faces. They distribute drugs donated by Pfizer, the pharmaceutical company, and in some cases, arrange for surgery.

Though health concerns motivate the Carter Center, many women in Ethiopia advocate latrines not as a weapon to fight disease but as a tool to promote equality. Also, women are more vulnerable than men to trachoma.

"It's really a gender issue," Gebre said.