"Most of the cyclone-affected people are using unsanitary latrines .We need to help them build sanitary latrines to promote good hygiene practices," Prasad Bhagwan Sevekari, WASH cluster coordinator for the UN Children's Fund (UNICEF), told IRIN in Yangon, the former capital.
When Cyclone Nargis hit the delta on May 2-3, leaving more than 140,000 dead or missing and affecting another two million, most of the latrines in Yangon and Ayeyarwady divisions collapsed, while others are still unsafe.
According to the Post-Nargis Joint Assessment (PONJA) report, damage to latrines was extensive, with up to 40 percent of respondents in Yangon, and up to 45 percent in Ayeyarwady divisions, having switched from pit latrines to open defecation.
The report also said the proportion of households practising unsanitary defecation - open defecation, floating latrines or trenches - almost doubled to 40 percent.
Before the cyclone, only 6 percent of respondents in Yangon Division and 11 percent in Ayeyarwady Division used open defecation. Though latrine use was common, few were sanitary, with the use of straight drop or floating latrines widespread, which is as risky as open defecation for the spread of waterborne diseases.
"The use of floating latrines could spread such waterborne diseases as diarrhoea, dysentery, hepatitis, and skin diseases since most of the people use river water as a source for drinking and household use," a government health official told IRIN.
However, the rainy season made it impossible to build new latrines so people had to share communal latrines built by UN agencies and NGOs.
"Now is a good time to build the sanitary latrines as the rainy season is almost over," Sevekari said.
At the same time, people need to be educated about why they should use sanitary latrines and how to maintain them, the UNICEF official said.
In an effort to help build the sanitary latrines, the UN organisation and its partners are providing latrine kits. People prefer bamboo-based latrines as they cost less compared with brick and wood-based latrines, Sevekari said.
"What they mainly demand is vent pipes," he said. So far, UNICEF and its partners have provided more than 70,000 vent latrine pipes to the cyclone-affected villagers.
"We want the people to have a sense of ownership, so we make them build themselves by providing the essential kits that they can't afford," Win Zaw Oo, Cyclone Nargis emergency response manager from World Vision, told IRIN.
World Vision has built model household latrines in 255 villages in Bogale, Pyapon, Dadaye, Kyaitlat and Hygyi on the basis of one latrine for one village to meet immediate needs.
Win Zaw Oo also said people's chief concern was the vent pipe as bamboo, the principal building material, was readily available. Thus the cost of a latrine was about US$20, depending on location (because of transportation costs).
However, health personnel are concerned that persuading people to use the sanitary latrines properly will remain a challenge because of privacy issues - most rural people were shy of using a latrine in a public place.
On the road between Pyapon and Bogale, 47-year-old Thaung Tan said he and his neighbours would use the stream that was also a water source for the household as well as a waterway. He also said they would defecate in open spaces while working in the fields, after making sure there was no one around.
"It's taking time to transform their behaviour," Aye Win, WASH manager of World Vision, said.
"First, we'll help them build the sanitary latrine. Then, we'll advocate the value of it and persuade them [cyclone-affected people] to use it . Thus, we should take advantage of the cyclone impact to transform their behaviour."