Focus on sanitation
Time is running out for our water and sanitation petition! And as we near the end of our themed week we blog a bit about sanitation in particular. Also today, we’ve posted a great article on a markets perspective of health systems in conflict zones. It’s a bit of a departure from what’s usually on our website but that makes it all the more interesting! As ever, keep sending in your articles, blogs and ideas!
Picture courtesy of the World Toilet Organisation
Water and sanitation go hand in hand in improving health and quality of life but while both are unduly neglected in international discourse, sanitation is certainly the poor cousin of the two. It is much more common to see photos of smiling people surrounding a new water pump than a new pit toilet, reflecting the fact that sanitation is one of “the last taboos”. In fact the UN General Assembly was so concerned by the lack of progress towards the sanitation target of MDG7 that 2008 was declared the International Year of Sanitation in the hope of fostering political will on this topic.
This year’s WHO/UNICEF report on sanitation describes the continuum of sanitation conditions; open defecation, unimproved facilities (where there is not hygienic separation between humans and excreta), shared facilities and improved facilities (with hygienic separation of excreta, such as pit latrines, septic tanks or sewer systems). 2.5 billion people are still without access to improved sanitation facilities but for an astonishing 1.5 billion people (about 87% of them in rural areas) open defecation is the norm. As well as the considerable health implications, poor sanitation impacts on vulnerable groups, particularly women (see last week’s blogs), and on the wider concept of human dignity.
One of the most striking examples of the sanitation crisis is the Kibera settlement in Nairobi, Kenya, one of sub-Saharan Africa’s largest slums with between 500,000 and 1 million inhabitants. Some people use shallow, overflowing pit latrines or buckets but the area is also notorious for its “flying toilets”, used by two out of three of the population, where people defecate into plastic bags which are then thrown into ditches or onto the street. In general though, sanitation coverage is better in urban areas than rural areas (with 79% and 49% coverage respectively). In addition to the consideration logistical challenges imposed by introducing improved sanitation, there is also often a need to change people’s behaviour. Specific education in schools is usually a very successful way of promoting good hygiene but wider community approaches can also be very effective. A recent press article highlighted a “name and shame” scheme where human faeces were publicly labelled with the owner’s name to try and make open defecation socially unacceptable. Even a few individuals practicing open defecation can increase the exposure of the whole community to worms, hepatitis and other diseases. Safe collection of waste also has other advantages as it can be used after processing as a cheap, nitrogen-rich fertiliser.
While many organisations work on both water and sanitation, there are others that focus solely on sanitation. Indeed, while the two are closely linked in terms of cause and effect they require very different expertise. The World Toilet Organisation (World Toilet Day marks their founding day) is an international coalition of 151 organisations from 53 countries that have a central focus on sanitation, and is involved in everything from research into ecologically sustainable sanitation to widespread implementation and raising the profile of sanitation. If the health benefits of better sanitation are not enough to motivate governments, the economic benefits are increasingly being concretely demonstrated. A recent report, for instance, showed that poor sanitation and hygiene cost Indonesia $6.3 billion in 2006 (2.3% of GDP). It is high time to put toilets on the international agenda.