Thorsten Kiefer harnesses the role model status of sport superstars, the power of fun, interactive gaming experiences and cutting edge communication to tackle persisting taboos and charge the “ugly” issues of sanitation and hygiene with positive emotion—in order to make improved solutions a shared aspiration and to facilitate life-saving behavior change around these issues amongst all target groups.
The New Idea
Thorsten promotes sanitation and hygiene in sub-Saharan Africa and South Asia, the two world regions most affected by preventable diseases caused by poor sanitation and hygiene conditions. Using the role model status of sport superstars, a unique set of interactive sanitation and hygiene games, and strictly positive cutting edge communication, he has created a new framework that changes water, sanitation, and hygiene (WASH) issues and facilitates behavior change mind sets around sanitation and hygiene issues. The key element of Thorsten’s work is that instead of working with the typical top-down health-based messaging traditionally used in the WASH sector, Thorsten consistently links sanitation to so-called higher level human needs and desires to make toilets and good hygiene aspirational behavior, cool and sexy. Using simple, fun, easy to implement, and effective messaging combined with buy-in from stars as role models, Thorsten creates a broad movement under the roof of his WASH United Club, allowing children and other key stakeholders to become members when proving knowledge and committing to its mission of behavior change and improved sanitation and hygiene solutions. His approach starts with young people in schools and strategically involves all other target groups important for the advancement of effective sanitation and hygiene infrastructure and practice.
Through attractive storytelling and opportunities for co-branding as an incentive for further spread and active stakeholder involvement, Thorsten effectively tackles taboos, fosters commitment among politicians, and generates sustained interest of mainstream media and citizen organizations (COs) for WASH issues. His goal is to effectively train one million children and reach about one billion people with clear and positive messaging on WASH by 2016, thereby creating large-scale bottom-up demand for effective sanitation and hygiene solutions. Within two and a half years, Thorsten and his partners have trained close to 60,000 children and adolescents in nine sub-Saharan countries and India and reached approximately 250 million people through innovative campaigns and media collaborations.
Poor sanitation infrastructure and a lack of demand for it leads to massive open defecation as a standard practice in many countries. The consequences are serious: one gram of human excrement contains up to 10,000,000 viruses, 1,000,000 strains of bacteria and 1,000 parasite cysts. The consequences are serious and children are especially at-risk for disease caused by poor sanitation: statistics show that each year, children miss 443 million days of school due to sanitation-related illnesses. At any given time, every other hospital bed in Africa is occupied by a patient suffering from preventable diarrhea. According to a 2010 study released by The Lancet medical journal, diarrhea has overtaken respiratory tract infections to become the single biggest killer of children in Africa. According to UNICEF/WHO statistics, preventable diarrhea caused by dirty water, lack of toilets, and poor hygiene is leading to the death of more children in Africa than malaria, measles, and HIV/AIDS combined. More than 40 percent of diarrhea cases among school children result from transmission in schools rather than homes. The situation will only worsen as patterns of urbanization continue without effective sanitation and hygiene intervention.
Despite these grave statistics, sanitation and hygiene have not received the high-level priority they require to improve the situation globally. Millennium Development Goal 7C is the most behind in being met: 2.6 billion people around the world still lack access to improved sanitation. Breaking the cultural taboos that keep stakeholders from addressing the issue—individually as well as systematically—is key to transforming the field. The rational and health arguments used in current educational and public awareness raising programs have not yet succeeded in creating large-scale awareness for the need and demand for improved sanitation, let alone trigger a broader societal movement for sanitation and hygiene. They are often poorly adapted to the local context, but most importantly they fail to appeal to the human needs and desires that can fundamentally change the attitudes toward sanitation and hygiene.
It is well known that the simple act of hand washing with soap (or ash, sand, or mud) at critical times can reduce the occurrence of deadly diarrhea by up to 40 percent. In addition, promoting the proper use of existing toilets would decrease open defecation and the related health risks. Improving individual hygiene knowledge and practice is a simple yet effective tool in unleashing systematic change. Since rational arguments based on health risks are not effective and political priorities are often misaligned, transforming sanitation, hygiene infrastructure, and practices require a new way of thinking: sanitation and hygiene must be made an aspiration. This can be achieved through a playful and fun approach to the issue refraining from rational arguments about long-term health benefits, but instead focusing on higher level human needs and desires (i.e. being attractive, being modern, being accepted by one’s peers, etc). In addition, if this approach were embedded in a broad movement allowing the issue to constantly move onto the agenda of communities and stakeholders, bottom-up demand could be systematic, taking the issue to a different level of attention and action.
Through WASH United, Thorsten is (i) creating a large-scale and broad movement based on easy, fun and interactive messaging involving superstar role models, which makes WASH an aspiration for everyone involved (ii) applying this framework to different cultural contexts as a result of its flexibility and (iii) working with key multipliers, levers, and mavens to trigger follow-up action to improve sanitation and hygiene infrastructure and practice sustainably.
Thorsten created the WASH United Club, designed to form the strategic roof for this broad societal movement for WASH. The club idea links ordinary people, stars and political decision-makers in the fight for WASH for all and creates a joint commitment. Thorsten incorporates local “stars” from the sports world and from entertainment with a wide following among young people. In Africa, he has plans to attract additional football heroes, but also to expand to other sports that are popular among specific target groups, such as netball for girls. For his launch of WASH United in India, he has already signed up well-known Bollywood actors and cricketers as club members, to serve as role models for change in mind sets and behavior.
Within his WASH in Schools programs, the WASH United Club serves as an incentive for kids. To become members of the same club as their idols, they take part in an interactive curriculum that includes games such as the World Toilet Cup, Blue Hand Game and Hand Washing Challenge, which promote good hygiene and sanitation practices through fun and play. Repeated action throughout the school year and peer-trainer teaching reinforces the knowledge and assures WASH United’s sustainability. Once a WASH United Club member, kids subscribe to the club rules: to practice good hygiene and sanitation behavior and to spread the word. The WASH in Schools program is implemented through cooperation with local partners who know local stakeholders, structures, and contexts. So far, WASH United has reached close to 60,000 young people in nine sub-Sahara African countries (Mali, Ghana, Burkina Faso, South Africa, Uganda, Ethiopia, Lesotho, Kenya, and Tanzania) and India.
Evaluations of the first implementation phase reveal increased knowledge and behavioral change among children who have participated. It also showed that they passed on the messages to their parents. In the next implementation phase, Thorsten plans a broad range of measures to further improve monitoring and evaluation, including focus group discussions, structured observations, and polling. Through mobile phone-based data collection, the quality of the data will increase. Additionally, an external scientific study will document the impact of the new large-scale campaign and WASH in Schools program in India. In the future, Thorsten plans to include a broader range of WASH issues into the curriculum, including menstrual hygiene management.
To increase the individual and societal relevance of sanitation and hygiene, WASH United runs public awareness campaigns in its target countries (and soon will do so also in the global North) based on positive, aspirational, and sometimes humorous communication with the WASH champions involved. Linking WASH in Schools with the campaign increases the impact through interdependency: kids become members of the WASH United Club in schools, while parents learn about WASH United via other channels, such as the radio. According to media data, WASH United messaging has reached more than 250 million people within two and a half years, which sets the stage for increased attention and demand in the future. Thorsten combines this bottom-up approach with a top-down strategy: by directly addressing policymakers, he raises political attention for WASH. More than fifty politicians, including all the respective ministers of all the target countries in sub-Sahara Africa, have become active Champions for WASH. Incentivized by the positioning and public attention it provides, these mavens are critical for putting sanitation on the political agenda and encouraging policymakers to improve the hygiene and sanitation situations in their countries.
Not only have local implementation partners built upon the basic WASH United structure in their communities while deepening local involvement (i.e. in Lesotho where the local WASH Champion works with the women’s national team for sanitation improvement in stadiums), there is even cooperation with hardware providers as strategic levers. For example, Ashoka Fellow David Kuria and Thorsten have combined forces to promote both WASH United and Ecotact.
Thorsten has just expanded his model to India, adapting his key triggers to the local context and implementing the “The Great WASH Yatra,” a WASH traveling circus that makes use of cricket and Bollywood in order to promote the WASH United principles. Within the Yatra, close to 10,000 children and youth have been trained, as well as an additional 160,000 people have participated in the Yatra-Carnival. Media has reached more than 200 million people. In addition, the Indian government with its Nirmal Bharat Abhiyan campaign (Total Sanitation campaign) not only participated in the Yatra as a main partner, but also wants to continue to use WASH United methods and messaging for their program development afterwards.
Thorsten continuously seeks out opportunities to piggyback his model onto other established structures in order to scale his impact. He envisions one day being a serial software innovator for the WASH sector. For the cricket world cup, for example, he wants WASH to become the central social topic. Thorsten’s principle is to build off of the existing infrastructure created by COs and networks that already promote WASH and development through sport. He offers a new framework for messaging and holistic trainings that change different stakeholders’ attitudes toward hygiene and sanitation, all strengthened by a price model based on the purchasing power of the respective partners. For his media work, for example, Thorsten would rather work with media co-creators than buy expensive advertising space. Furthermore, Thorsten is putting the topic on the public, private, and political agenda in the North through partnerships beyond the traditional WASH sector. His project Hotels4WASH will turn hotels into ambassadors for WASH. The costs saved by reusing towels in hotels are partially invested into WASH projects—thereby generating revenue for WASH United to scale its work as well as raising awareness for his actions and goals.
In ten years, Thorsten wants every organization in Africa, South Asia, and beyond to be able to use the WASH United approach to change individual sanitation and hygiene behavior, raise the demand for good sanitation, and keep stakeholders actively involved through the WASH United Club. He envisions it to become a global mass movement for sanitation and hygiene for all, with millions of active club members—from school children to market women, from football starts to Heads of State—all working to promote sanitation and hygiene for all at all levels.
Thorsten’s father traveled regularly for work, which sparked Thorsten’s interest in other cultures at an early age. After completing his high school degree and motivated by an ambition to promote justice and human rights at international level, he studied law. His interests in human rights and the environment, increased after studying in Venezuela for a year, where he met both inspiring teachers and also witnessed serious human rights violations. Thorsten completed his studies in Amsterdam with his thesis on the human right to safe drinking water and sanitation and became drawn to sanitation as an issue in urgent need of attention.
Thorsten realized that to really influence the sector he had to be an expert on the topic, so he worked for the Center on Housing Rights and Evitions, then a leading international CO in the area, and later for the UN Special Rapporteur on the human right to safe drinking water and sanitation. Despite his passion for the topic, he craved a new kind of impact in the field, yet he also understood the hurdles that traditional WASH activities faced in achieving impact. Thorsten knew he needed a different approach based on exciting communication and strong role model integration to really address the neglect of sanitation and hygiene. Inspired by Ashoka Fellow Jack Sim and his creative approaches to the field, he came up with the idea of WASH United. Thorsten initially worked on WASH United in 2009 under the umbrella of another CO, Bread for the World. In the fall of 2011 he launched his own CO with the aim of independently bringing more creative and entrepreneurial approaches to the field of WASH. Within the first half year, he created a strong team of eight working from Berlin and another eight country coordinators working from African countries, as well as six staff in India.
Thorsten envisions WASH United becoming an innovation generator for the WASH sector, with a focus on WASH in Schools, large-scale public awareness raising campaigns, and behavior change communication. Using franchise models and open source, he aims to scale his approach to a broad range of organizations. Within only two years, WASH United has rapidly expanded its network, working with almost 100 national and international partners. The numerous requests by partners to cooperate with WASH United and to adopt its approach exhibit the great need for Thorsten’s innovative WASH software. Thorsten is known in the field for his creativity and ability to think outside of the box, as well as for his passion and persistence. He does not easily take “no” for an answer. Propelled by his entrepreneurial spirit, Thorsten can have impact that is difficult for established organizations that may be more risk averse or restrained by bureaucratic systems.