Households in indigenous communities in Panama are upgrading their sanitation systems to reduce health risks. A study looked at how these upgrades affect the operation and maintenance of the systems. They found that while most pit latrines were in use, many were not being operated correctly. People were interested in using composting latrines for the benefits of compost, but barriers included lack of experience and reluctance to work with waste. The study suggests that training and demonstration projects are important for introducing more advanced sanitation technologies in rural areas.