Water Spouts will speak volubly and endlessly about all the issues concerning water. The ongoing degradation, and growing scarcity, of the water supply here in the US, and the rest of the world. The continued absence of potable water in so many parts of the world. The work being done by NGOs, and charities, in the third world, to help alleviate the situation. The emphasis on WASH ( Water, Sanitation, and Hygiene ) so health and healthy water are maintained. "Water Spouts" will spout it all out.
"Governments do not prioritize hygiene in their policy and budgeting, in the school curriculum, in promotion activities," the United Nations Special Rapporteur on the human right to safe drinking water and sanitation, Catarina de Albuquerque, emphasized on Global Handwashing Day.
"All too often, when we consider water and sanitation, the importance of good hygiene, including handwashing, is forgotten," Ms. de Albuquerque said. "However, in times of global health threats, the life-saving potential of handwashing must be explored. During the 2009 A virus flu pandemic, global leaders were very conscious of handwashing's vital importance."
As the 2015 deadline for the achievement of the United Nations Millennium Development Goals approaches, the independent human rights expert urged world leaders "not to lose sight of the centrality of good hygiene for the full realization of the human rights to water, sanitation, health, as well as for dignity and development."
Good hygiene is essential to prevent the spread of water-borne diseases, one of the main causes of infant mortality. Encouraging good handwashing habits among children can act as a 'do-it-yourself' vaccine against diarrhoeal disease, for a lifetime's protection, preventing more deaths and illness than any other medical intervention.
"Women's needs should be also considered and incorporated in the delivery of water and sanitation services if we want to attain gender equality," Ms. de Albuquerque stressed, making clear that, with adequate menstrual hygiene management, adolescent girls do miss school days during their menstruation.
"I call on all to prioritize handwashing and hygiene in the post-2015 development framework," the rights expert appealed as world governments start to set priorities and to make trade-offs in the context of discussions in respect of the next generation of global development goals.
"Water and sanitation services have little value if not accompanied by the necessary resources which can be committed to promoting hygiene, to ensuring that sufficient water and the necessary soap is available for handwashing at the appropriate times – particularly before eating and preparing food and after using the toilet," the UN Special Rapporteur said. "It all begins with soap and water."
As unclean water and sanitation is the world´s second biggest killer of children, the World Bank official on Wednesday urged countries in South Asia to evolve out a common strategy to tackle this problem in the region.
"Policy priority, insufficient funding, rapid urbanization and lack of public awareness have mainly impeded attainment of long-term sustainability of water supply and sanitation in South Asia," said Tahseen Sayed, World Bank country manager for Nepal.
"Weak institutional capacities are other problems for us in the region to attain our goal of reducing number of people who do not have access to drinking water and sanitation," she stated
Sayed was speaking at the South Asian regional conference on drinking water and sanitation, which kicked off in Kathmandu on Wednesday.
The three-day conference is being attended by more than 100 experts and officials from the different countries of the region. Through the conference, they hope to identify a common strategy to mitigate challenges seen in access to drinking water and sanitation in rural areas and also identify the workable institutional models for the region.
According to the World Bank, more than 500 million people do not have access to sanitation and 250 million people to drinking water in South Asia, which is home to 1.6 billion people.
"Despite its economic success, South Asia, now, represents the largest concentration of the world´s poor, as well as those lacking access to safe water and sanitation," said its statement.
According to the Bank, the conference will discuss on identifying sustainable ways of water supply, increasing sanitation access and reducing challenges -- challenges of declining water quality and quantity. "It will also focus on developing partnership between public and private sector to advance rural water and sanitation," Sayed said.
Janak Raj Shah, member of the National Planning Commission (NPC) said that the inadequate coordination among major players in the field of water supply and sanitation, weak implementation of the program and lack of proper approach to handle the projects were major hurdles of water supply and sanitation in Nepal. “
"We are lagging behind to achieve our targets under millennium development goals on sanitation and water supply," Shah said. The government has targeted to increase access to water supply and sanitation to 53 percent of the total population by 2015. myrepublica.com
Indian Muslim boys react to the camera as they walk home from school on a street in New Delhi, India,
India’s Supreme Court has ordered that schools nationwide must be provided with toilets and drinking water within six months, calling it part of children’s right to an education.
The court said in the judgment seen by AFP on Saturday that research showed wherever toilet facilities are inadequate, parents are reluctant to send their children to school – especially if they are girls.
Lack of toilets and drinking water “clearly violate the right to free and compulsory education of children,” the court said in the judgement handed down earlier in the week.
The court stated children need to “study in a clean and healthy environment” and said its ruling applied to state and privately run schools.
State governments must provide “toilet facilities for boys and girls, drinking water facilities, sufficient classrooms, appointment of teaching and non-teaching staff etcetera, if not already provided, within six months”.
The top court was acting on a petition filed in 2004 by a charity organization but still not implemented despite several rulings.
An activist group, Right to Education Forum, reported in April that one in 10 Indian schools lack proper drinking water facilities while 40 per cent do not have toilets.
In 2010, India launched a landmark education program obliging all states in the world’s second most populous nation to provide free schooling for every child between the age of six and 14 but child labour remains common.
Critics of India’s ramshackle education system also say the nation’s schools suffer from poor infrastructure and rampant teacher absenteeism, raising fears of tens of millions of badly educated young people unable to find jobs.
The problem of lack of basic sanitation is also widespread in Indian homes with census data showing more households in the country of 1.2 billion people have a telephone than a toilet.
Some 47 per cent of India’s 330 million households have toilet facilities while 63 per cent of homes have phone connections – mostly mobiles – showing how the nation’s rapid communication revolution has spread through society.
Ever had to queue for the bathroom? Ever been annoyed with being asked to pay for using the loo in a club? Ever disliked the smell in a public toilet?
Try Kroobay a slum in Freetown, Sierra Leone. There are exactly four public toilets for a population of 12,000. If you want to use them you are asked to pay 1000 Leonie, which is about what you would pay for a cheap meal on the street or what a poor person has to survive on. Sometimes they are cleaned, but only with water for lack of detergent.
In Kroobay, nobody has a toilet in their shack. So, what do people do when they want to “ease themselves”? One way of solving this human problem is to “DHL it”. Well, there surely is a DHL office somewhere in the business district of Freetown. But in Kroobay, “DHLing it” means, taking a plastic bag, doing what you need to do and then….well in Nairobi’s biggest slum they call this the “flying toilets of Kibera”.
Before we forget: Hands ought to be washed after the “business”. Well, you will not be surprised that none of the inhabitants of Kroobay has a tap in their hut. There is a public water pump in the slum. Primarily young girls come here daily to fetch water balancing 25 liter buckets on their heads and leaking jelly cans in their hands. Since even at public pumps the water is not safe, an Oxfam trained volunteer chlorinates it for them. The water, which is supplied by the Freetown Municipality is pumped through tiny tubes – called “spaghetti pipes” – all over the sprawling 1.5 Mio city. The problem: the further you are away from the water company, the more expensive und unsafe the water gets. If you do not happen to live close to a water pump, you rely on a number of private intermediaries who supply water at mark up prices. In essence, the poorest people in the slums of Freetown pay up to 100 per cent more for their water than the better off who simply turn on the tab in their own private bathroom. Not surprisingly people sometimes cut the tubes to access water for free. Tubes – which in rainy season often lead through poodles of smelly liquids and stinking solids – are then not protected against the invasion of germs.
Child mortality in Sierra Leone is amongst the highest in the world with every tenth child dying before they reach their fifth birthday. Waterborne diseases are the leading cause of death for poor people, notably small children. As you read this, Sierra Leone experiences yet another Cholera outbreak. Since its start 93 people have died in Freetown alone. Does that surprise you?
Having just returned to New York from Maputo, the capital of Mozambique, I'm reminded how lucky we are in this city to have reliable water and sanitation services. Thanks to investment in water pipes and sewers in the 19th century, diarrheal diseases that ran rife through our city a few generations ago have all but been eliminated, and we take it for granted that safe drinking water is available at the turn of a tap.
As in many other large cities across the developing world, Maputo is facing rapid growth of low income settlements and major challenges in providing the population with access to safe water and sanitation. The latest data (UNICEF/WHO 2012) show that only 77 percent of Mozambique's urban population has access to improved water sources. The situation is even grimmer when it comes to sanitation, with only 38 percent of the urban population having access to safe sanitation.
The country has one of the highest infant mortality rates in the world with 86,000 children dying before their first birthdays every year. Diarrhea is one of the leading causes of child deaths and 44 percent of children under five are undernourished.
Increased investment in providing access to safe water and improved sanitation dramatically impacts child survival. In low-income areas of cities like Maputo, that is often a complex task. High population density, transient populations, and poor quality housing are part of the problem and present challenges to those striving to improve water and sanitation infrastructure.
Often in low-income urban neighborhoods the provision of piped water to homes is simply too expensive for ordinary families to afford. One way of tackling that problem is by helping local residents band together and negotiate affordable payment plans with water service providers with the help of local NGOs.
Last week I visited the community of Costa do Sol on the northern periphery of Maputo and found that a community water users' association, ACODECOS, established with the help of WaterAid and local partner organization ESTAMOS had achieved great success in expanding the number of household water connections over a five year period, with very positive results for the health of the community, particularly children. Data given to us by the Ministry of Health showed that the number of cholera cases had dropped from 371 in 2003/4 to only 21 in 2008/9.
One reason why this was achieved was ACODECOS' successful negotiation of a reduction in the household connection fee to $50 (from Aguas de Mozambique, a private company receiving 75 percent of its investment from government) that can be paid in installments.
Local resident Francesca Nhantos (shown in the photo at the top) told me that having piped water available in the home had transformed her life. "Before we had the standpipe, a water truck came to the village once a week and we had to pay 5-7 meticais (20 cents) for 20 liters of water and we weren't sure how clean it was so we had to boil it."
As Arminda told me, other changes, such as the installation of latrines, hygiene education, the provision of drinking water and toilets in schools and the disposal of solid waste, have also helped to dramatically improve the health of the community.
With the absence of piped sewerage in densely populated low-income urban communities, disposal of fecal sludge from latrines also poses a major challenge. Last week, I visited a pilot project managed by Water and Sanitation for the Urban Poor (WSUP), an organization working closely with WaterAid. This project shows how offering loans to small businesses can help with the development of affordable waste management services.
Paulo Biane Vaiene from the Maputo community of Maxaquene is one such entrepreneur benefiting from financial assistance. His small enterprise UGSM Vaiene started emptying small septic tanks using a small pump and tank called a "gulper" that was pulled by a donkey. With a loan from WSUP, he was able to buy a truck that has allowed him to cover more clients and expand his radius of operations. Business is thriving, more households can now take advantage of his services, which cost around $20 and are required twice a year, and public health is safeguarded by the safe disposal of the waste.
Just as Paulino has demonstrated that fecal sludge removal can be a profitable business, there are opportunities to develop small businesses selling a selection of toilet designs to families. A range of viable technologies has been developed, but business models need to be developed with finance plans to ensure that options are affordable to all families regardless of income. We found that all needed construction skills exist in the communities, so the focus needs to be on ensuring these skilled laborers are able to find employment that not only helps their families out of poverty but also helps communities stay healthy and meet their basic needs.
These experiences show how innovative financing models can impact on health in low-income urban communities. When water connection charges are not only reduced but split into installments, poor families can afford to get linked to the municipal piped water system, and the support of small private service providers ensures families have access to effective and affordable fecal sludge removal services until the sewage network can be expanded.
These examples also show the importance of linking larger systems — such as pipes for the water utility or waste management and sewage systems — with community and household-based needs and approaches. Reducing poverty and protecting people's health and well-being requires a combination of efforts, from local capacity building and small business development to larger-scale infrastructure development. I was inspired by the efforts being made by NGOs and community-based organizations to build healthy communities. The skills, the demand, and the creativity are there. We have so many opportunities now to make the most of them.
The report announces that the world has met the Millennium Development Goal (MDG) target of halving the proportion of people without access to safe drinking water, well ahead of schedule. However, the sanitation target will not be met if current trends continue. Analyzing access to drinking water and sanitation by regional trends, urban-rural disparities, and alternative indicators of progress, the report assesses progress, reports inequities, and reveals continuing challenges.
Focus Area
Monitoring and Evaluation; WASH (general)
Key Findings
An estimated 89% of the global population now uses improved drinking water sources; however, 780 million people are still unserved, huge disparities exist, and complete information about drinking water safety is not available for global monitoring. Tweet this »
Globally, 63 percent of the population uses improved sanitation facilities, an increase of 1.8 billion since 1990; however an estimated 2.5 billion people are still without improved sanitation, nearly three-quarters of them living in rural areas. Tweet this »
Global figures mask disparities between regions and countries and within countries -- for example, only 61% of people in sub-Saharan Africa have access to improved water supply sources compared with 90% in Latin America and the Caribbean, Northern Africa, and large parts of Asia. Tweet this »
In many countries, the wealthiest people have seen the greatest improvement in water and sanitation access, while the poorest lag behind. Tweet this »
Monitoring challenges lie ahead, as safety and reliability of drinking water supplies and the sustainability of water supply sources and sanitation facilities are not addressed by the current indicators used to track progress.
Worldwide, 780 million people still lack access to clean water. 2.5 billion people, including almost 1 billion children, live without even basic sanitation. WASHfunders.org (http://washfunders.org/), a robust new web portal powered by the Foundation Center, helps funders working on water, sanitation, and hygiene to collaborate and to learn from one another
A traveling village fair is scheduled to kick off next week in India, but instead of cotton candy and tchotchkes, it will sell an important message: Use soap to wash your hands, and don’t defecate in the open.
India faces a severe sanitation crisis. More than half of all households have no toilet facilities, according to the latest census figures, a rate that has worsened in the last decade. Earlier this year, the government announced an ambitious goal to end open defecation in the country within 10 years. But it was only on Friday afternoon that the campaign got a bit of glamour: Vidya Balan, a popular actress, was introduced as something of a brand ambassador, to promote the distinctly unglamorous issues of sanitation and hygiene.
“We have to inspire more and more people to make our country open-defecation-free,” she said, sparkling under the flash of cameras in the capital.
Starting next week, Ms. Balan will appear in radio and television advertisements in which she cajoles villagers to use toilets. In one ad, she notes that brides in India are too shy to lift their veils, much less to defecate in the open.
Ms. Balan said she was drawn to the cause after reading the statistics on sanitation. Advocacy groups say that open defecation has led to the deaths of more than 1,000 children from preventable diarrhea every day. It is also said to have caused a loss of 6.4 percent of G.D.P., due to higher health costs and lower productivity.
India has struggled with sanitation for decades. Critics of government policy contend that people decline to buy toilets not due to their price but because the government fails to supply running water.
Jairam Ramesh, the minister for sanitation and rural development, whose strategy has included raising awareness and pouring funds into village councils if they meet their toilet targets, acknowledged to India Ink on email that running water is a problem but said it wasn’t the primary one.
“In India people always like to externalise the reasons for inaction,” he said. ”Behavioral change is of paramount importance.”
At the news conference Friday where Ms. Balan appeared, Mr. Ramesh said that for the next five years, his ministry of clean water and sanitation would have a budget of about $20 billion. “There’s no shortage of funds,” he said. “If there’s a shortage, it’s of resolve.”
The traveling village fair – whose purpose, besides encouraging good hygiene, is to increase awareness and demand for sanitation facilities in rural areas – is being promoted and facilitated by Mr. Ramesh’s ministry, but its funding comes from a host of organizations, including the Bill & Melinda Gates Foundation, which together raised a little more than $2 million for it.
The concept for the fair was developed by Quicksand, an Indian consultancy, and WASH United, a nongovernment organization that often uses sports stars as ambassadors to promote hygiene.
Organizers said they would use two Indian passions, cricket and Bollywood, to generate excitement about the awareness drive, with stars from both fields to join the fair. They will also use more standard village fair diversions, like a game in which players knock down cans that look like germs.
Ms. Balan promised to make an appearance during the fair, which is scheduled to travel through five states over 51 days. Called the Nirmal Bharat Yatra, which loosely translates as “Clean India Journey,” the fair will stop at a couple of places associated with in India’s independence movement to make the point that India now needs to become free from poor sanitation.
The last stop will be Bettiah in the state of Bihar, the birthplace of Mahatma Gandhi’s satyagraha, his tactic of nonviolent resistance. It’s a fitting end. Gandhi himself often stressed the importance of sanitation.
Experts have crafted tentative development goals to improve sanitation for the 1.1 billion people who are forced to practise open defecation due to poor water supplies, a lack of toilets and absent sewage systems.
A report by the World Health Organisation (WHO) and UNICEF, the U.N. children's agency, says at least 15 percent of the world's population regularly defecates in fields, forests, bushes, bodies of water or other open spaces, putting health at risk.
The combined effects of improper sanitation, unsafe water supply and poor personal hygiene are responsible for 88 percent of childhood deaths from diarrhoea and are estimated to cause more than 3,000 child deaths per day, UNICEF says.
It is a problem sanitation experts are hoping will be properly addressed in the next set of global development targets to replace the current U.N. Millennium Development Goals (MDGs) in 2015
One goal could be to eradicate open defecation by 2030, says Clarissa Brocklehurst, a consultant for a working group tasked with establishing sanitation targets for 2015 and beyond.
"One of the reasons why I'm so keen on an open-defecation goal is because it is achievable," said Brocklehurst of the Sanitation Working Group with theJoint Monitoring Programme (JMP) led by WHO and UNICEF.
"If you had a big country like India say, 'We will eliminate open defecation in the next 15 to 25 years', the number of children's lives that would save would be just astronomical."
HEALTH DANGERS
Although the proportion of people who defecate in the open is actually decreasing, due to population growth, the absolute number has stayed the same for several years, the U.N. study said. Overall, some 2.5 billion people do not have proper sanitation facilities, almost three-quarters of them living in rural areas.
Open defecation is still practised by a majority of the rural population in 19 countries, the report said. Nearly 60 percent of those practising open defecation - 626 million people - live in India. Indonesia ranks second with 63 million defecating in the open and Pakistan third with 40 million.
"A lot of people practise open defecation as the default behaviour," Brocklehurst told AlertNet.
"I'm not saying they like it, but in order to get people to understand why they should abandon open defecation – the toll it's taking on their health, their children's health and to make the investments necessary to pull themselves out of open defecation – that's a big job."
A makeshift latrine in Dhaka, Bangladesh: WaterAid
The 7 billionth person on Earth has already drawn his or her first breath, at least according to estimates by the United Nations. Assuming all systems are in working order, that baby will also create its first output that same day, in the form — to put it delicately — of a dirty diaper.
That dirty diaper is only the tip of an iceberg of human manure produced around the globe every day. It might seem a reasonable question to ask how humanity will deal with this output of feces as the world's population creeps toward 10 billion by 2100. But that question presumes we have the poop problem under control now. Here's the bad news: We don't.
Approximately 2.6 billion people around the world lack any sanitation whatsoever. More than 200 million tons of human waste goes untreated every year. In the developing world, 90 percent of sewage is discharged directly into lakes, rivers and oceans. And even in developed countries, cities depend on old, rickety sewage systems that are easily overwhelmed by a heavy rain.
All this untreated sewage adds up to a major public health crisis that kills an estimated 1.4 million children each year, according to the World Health Organization. That's one child every 20 seconds, or more than AIDS, malaria and tuberculosis combined. Despite this massive death toll, sanitation hasn't gotten the same attention as other world development goals. The United Nations, which set a goal to halve the number of people without basic sanitation by 2015, now calls that target "out of reach."
"Sanitation is not a sexy issue," said Dan Yeo, a senior policy analyst at WaterAid, a nongovernmental organization dedicated to hygiene, water and sanitation issues. "It's about s---, and that's not particularly attractive. It's a taboo to talk about in a lot of contexts." [See images of the world's toilets]
Learning to talk about toilets
That taboo is one reason that sanitation hasn't taken off as a major issue in the public's mind, Yeo said. But providing sanitation is also more complex than "if you build it, they will come," according to Rose George, the author of "The Big Necessity: The Unmentionable World of Human Waste and Why It Matters" (Metropolitan Books, 2008).
"The assumption was that latrines would be used and that everyone needs a flush toilet," George told LiveScience of early sanitation efforts. "People not necessarily wanting latrines was provedin India when the government provided millions almost free in the 1980s, and then millions of these kind-of-adequate latrines got turned into goat sheds or storage areas, because people are used to just going and crapping in the bush."
"Crapping in the bush," also known as "open defecation," is a major problem, George said, because the pathogens from the feces invariably end up tracked back into the village, often contaminating the community water supply.
Open defecation also puts people in rural areas such as sub-Saharan Africa at risk for snakebites as they go tramping into the bushes in the dark, George said. Women looking for a private place to go are at risk of being followed and sexually assaulted, she said. According to WaterAid, many women in Africa wait until nightfall to relieve themselves, putting themselves at risk of urinary tract infections, because propriety dictates that women don't go where someone might see them. [Sidebar: Top 16 Countries Without Sanitation]
To tackle the open-defecation problem, aid organizations had to learn to work with the people on the ground to explain why sanitation matters, Yeo told LiveScience. In Bangladesh, for example, WaterAid works with a local music-theater performance troupe that puts on sanitation-related skits for schoolchildren.
In her travels, George uncovered enormous cultural differences in the way people think about using the bathroom. In China, for example, plenty of public bathrooms lack doors on the stalls — or even stalls. Meanwhile, Americans happily use toilets in stalls with large gaps below, above and on either side of the door, a fact that seems bizarre in George's native Britain. In the U.K., she said, public toilet stalls are completely closed off.
"You have to understand that it's about software — psychology — as well as just the hardware of putting in pipes and toilets," George said.
Providing the plumbing
But the hardware matters, too. For one thing, the latrines can't be more disgusting than the alternative they're replacing, George said. Who wants to hang out in a dank, fly-infested latrine when you could just move your bowels down by the river?
Urbanization is another challenge, Yeo said. According to the U.N., the proportion of people living in urban slums around the world has declined from 39 percent in 2000 to 33 percent in 2010. But the absolute number of people living in slums is actually growing, with about 828 million slum-dwellers worldwide in 2010.
In many cases, these slums are informal communities that local governments would rather not recognize officially, Yeo said.
"They're often on land they don't own, and they aren't recognized as having the rights to that land," he said.
That makes officials reluctant to solve the sewage problems in these slums, since adding them to the grid would amount to tacit approval of their existence, Yeo said.
Meanwhile, just the physical layout of urban slums makes adding latrines difficult. A high density of human beings means a high density of human waste. Narrow streets make it tough to get latrine-emptying trucks into the area. In urban settlements, Yeo said, it's often important to encourage planning by local governments so these engineering problems don't blindside cities later on. [Read: How Many People Can Earth Support?]
Sewers and 'fatbergs'
Investing in sanitation is by any measure a winning bet: According to the U.N., for every dollar invested in sanitation, $8 are returned in reduced public health costs and lost productivity due to disease. According to WaterAid, a $30 donation buys one person access to both clean water and sanitation.
The availability of a toilet can have wide-ranging effects, George said. In developing areas, she said, up to 20 percent of girls drop out of school, because they have no place to relieve themselves. Providing a latrine can mean the difference between illiteracy and education.
But while the developing world undoubtedly bears the burden of poor sanitation, it would be a mistake to think that developed countries have it all figured out, George said. Urbanization and population growth have taken their toll on the crumbling sewer systems beneath many municipalities, she said, and many sewer systems are forced to releaseuntreated sewage when a sudden downpour swamps the system.
"In the U.S., there's a massive, multimillion-dollar gap between the funding that is needed to maintain the sewer system and what is being given," George said. "Even a five-minute rainstorm can overwhelm the sewer system."
Even worse, she added, people's "out of sight, out of mind" attitude means they abuse the sewer system we do have.
"I've been down the London sewers, and all the 'flushers' who work down there say, 'We don't mind the s---, but we do mind the fat,'" she said.
The fat, George said, is household and restaurant grease that gets poured down drains and congeals into enormous "fatbergs," floating chunks of grease and oil. These grease bombs wreak havoc on an already strained system.
"We think we have it all sorted in the West," George said. "But we absolutely don't."
This video shows the International Federation Global Water and Sanitation Initiative (GWSI) in action at the Zambia Red Cross Society "Rural Water Supply Sanitation and Hygiene Promotion Project"
In our world today:
• more than one billion people do not have access to clean water;
• over two billion people do not have adequate sanitation facilities;
• some four million people die each year from diseases associated with the lack of access to safe drinking water, inadequate sanitation and poor hygiene
• 4,000 children under five years old die every day from those same associated diseases.
Added to this, in times of disaster and crises, the urgency to meet basic water and sanitation needs saves lives, reduces diseases and restores dignity. The overall water and sanitation challenge is best expressed in the UN Millennium Development Goals (MDGs), in particular goals 2, 3, 4 and 7, which have water and sanitation components. Our response is therefore to set our targets as a contribution to meeting those goals.
The Global Water and Sanitation Initiative (GWSI)
Over the last ten years, the International Federation has established and consolidated a water and sanitation vision, policy and capacity to better address two principle global challenges.
1. Acute water and sanitation challenges, mostly related to crises and disasters, where there is the urgency to provide basic needs to save lives, contain or reduce health threats and restore dignity.
2. Chronic water and sanitation challenges, mostly related to the fact that still a large proportion of the world's poor do not have access to adequate safe water and sanitation, causing death, disease and loss of productivity. Around four million people die every year as a result of poor water and sanitation access; many are children under five years of age.
The GWSI outlines a common approach among National Societies to establish larger-scale, longer-term sustainable water and sanitation programs to contribute more effectively in meeting the UN Millennium Development Goals (MDGs).
The GWSI, in combination with the MDG initiative and the launch of a second UN decade for water (2005-2015), intends to generate more available resources for Red Cross and Red Crescent water and sanitation projects. During this time, the International Federation plans to target at least an additional five million vulnerable
A resident washing clothes on the banks of the Ciliwung River in Jatinegara, East Jakarta.
When the Water and Sanitation Program, a World Bank initiative, embarked on a project in 2007 to improve residents’ access to toilets in East Java, the scale of the challenge was daunting.
At the time, says Almud Weitz, the WSP’s principal regional team leader, about nine million people there did not have access to a toilet — nearly a quarter of the country’s second-most populous province.
“We didn’t just want to run our program in one district for a year,” she says.
“We wanted to go into all 29 districts at once, and the provincial administration was committed to the plan.”
Prior to the WSP’s arrival, the administration had rolled out a smaller project to allow selected households to buy toilets at subsidized prices.
“They chose the people who would be eligible for the subsidy in the hope that it would encourage other households to get a toilet,” Weitz says. “But it didn’t work.”
The lesson here, she goes on, is that given the extent of Indonesia’s decentralization and large population, campaigns like this must be carried out on a massive and coordinated scale, with small pilot projects no longer effective.
“Indonesia needs to campaign on a mass basis, it can no longer afford to carry out small projects or individual projects. Everything must be done at once, especially if you want to change public attitudes toward sanitation.”
Ambitious target
Weitz says that changing attitudes is the key to improving sanitation in Indonesia, where 109 million people still lack access to sanitation and clean drinking water, according to the government.
“You don’t need much [funding] for sanitation, especially when you focus on behavioral changes,” she says.
“Indonesia has increased its budget allocation for sanitation, but it would be more cost-effective if directed toward behavioral changes because you need it for training and capacity building. It would be expensive to buy infrastructure.”
Weitz, speaking on the sidelines of the ongoing Third East Asia Ministerial Conference on Sanitation and Hygiene taking place in Bali, says the government needs to focus on ending the practice of open defecation in the country by 2014 — a target that she acknowledges is “very ambitious.”
“But, if it’s not [achieved] in 2014, even if it’s [the year] two-thousand-something, it is still good to focus on open defecation.
“It doesn’t mean give up … but there should be a substantial increase because right now, 60 million people in Indonesia have no toilet whatsoever. They go out in the bush and the river. That’s a large number and a lot of them are still on Java.
“The problem in Indonesia is that this country has a lot of rivers, you can go out in the river,” Weitz adds.
“In the old days, that was fine. Everybody went to the river. It was good when Indonesia had maybe 100 million [people], not with 200 million. Now, the river is way way, way overloaded, polluted, not only household pollution but also industry. These rivers are very, very dirty.”
Cycle of poverty
The issue of open defecation has been one of the main topics at the conference, with health administrators warning that unless it is eradicated, it will continue to fuel sanitation problems that will ultimately hamper economic development.
Athula Kahandaliyanage, the director of sustainable development at the World Health Organization’s Southeast Asia office, said on Monday that countries in the region were on track to achieve their UN-mandated Millennium Development Goals on sanitation, but could be tripped up by the perennial problem of open defecation.
“According to projections of improved sanitation coverage, the MDG target of 68 percent for East Asia as a whole may be exceeded by 8 percent in 2015,” he said.
“But despite these important gains, almost 700 million people in East Asia still lack access to improved sanitation facilities and nearly 100 million of that practice open defecation.”
Kahandaliyanage also noted that diarrheal diseases, often stemming from open defecation and poor hygiene, were a major cause of death in the region.
“In East Asia, about 450 million cases of diarrhea occur each year and the number of deaths attributed to diarrhea amounts to almost 150,000 per year,” he said.
“These diseases not only threaten lives but also keep children from school and adults from work, thereby perpetuating the cycle of poverty.”
Angela Kearney, the Unicef representative to Indonesia, also called for an increased focus on tackling open defecation.
“First, we need to address the significant inequities in sanitation and water coverage,” she said on Monday.
“The poorest and the most disadvantaged among us still do not have access to water and sanitation of a standard that will help them live strong and productive lives. And second, we need to put an end, once and for all, to open defecation.”
Rp 200 per person
The government acknowledges that state spending on sanitation remains very low.
Emah Sudjimah, a Public Works Ministry official responsible for environmental health in human settlements, said prior to the start of the conference that the ideal level of investment in Indonesia’s sanitation infrastructure was Rp 54,000 ($5.64) per capita per year.
But the actual amount being put in, she said, was just Rp 200 per capita per year.
She also said regional investment in sanitation should be 4 percent to 10 percent of budgets, but most administrations across the country allocate less than 2 percent.
Emah noted that because of the low spending, Indonesia lagged its neighbors in terms of its sanitation infrastructure.
She pointed out that only 12 cities in Indonesia, out of 497 cities and districts, had a wastewater processing network, compared to 98 percent in Malaysia.
Under the MDGs, Indonesia must increase the proportion of rural households with access to proper sanitation to 55 percent by 2015. However, Emah said there was little hope of attaining the target, given that the current level was 38 percent.
“To increase the current number by another 17 percent will quite frankly be very difficult,” she said.
In her opening speech at the sanitation conference on Monday, Health Minister Nafsiah Mboi said 76 percent of urban residents had access to sanitation and clean water, compared to 47 percent of rural residents, who account for the majority of the country’s population.
Filmed in Indonesia, this video features how Scaling Up Rural Sanitation began campaigns to raise consumer demand for sanitation amid competing priorities among community members. Why would you want to spend 15 percent of your annual income on something that you felt you did not need? Especially when there were so many other priorities to spend on?
Halimo Ali cares for her four young children alone, since her husband died in the brutal conflict that still rages in her native Somalia. In 2011 she fled drought and violence, making the 8 day journey by truck to Boqolmayo refugee camp in Ethiopia.
Once at the camp Halimo was deeply concerned that she needed to repeatedly take her children to the medical clinic for treatment as they were constantly falling ill and suffering from malnutrition.
Boqolmayo camp was built to accommodate 20,000 refugees, yet today nearly 40,000 people live there, placing a massive strain on the water supply and sanitation services in the camp. Diseases related to poor water, sanitation and hygiene practices such as skin diseases, eye infections, diarrhoea and intestinal worms were a frequent feature of life in the camp.
Since March 2012 International Medical Corps, with generous support from UNOCHA and UNHCR, began a series of activities in Boqolmayo camp to improve the hygiene and sanitation infrastructure and promote behavioural change amongst refugees.
The jerry can used by Halimo and her family before International Medical Corps cleaned and disinfected it. A dirty water vessel increases the risk of contracting water-related diseases.
Prior to the visit to her home by International Medical Corps trained Community Hygiene Promoters (CHP) Halimo had been fetching water using an old and dirty jerry can. She had no idea that this could be linked to the recurring bouts of diarrhoea that her children had been suffering.
The CHPs advised Halimo about proper hygiene and sanitation practices, including hand washing at critical times, proper utilisation of latrines, safe solid and liquid waste disposal and proper storage and handling of water. Following this visit, Halimo started to attend International Medical Corps’ awareness raising tea talks and for the last three month has been cleaning her compound, washing her and her children’s hands using soap and is cleaning her Jerry cans every other day.
“My children are healthy and growing well, and my first child is now in school!!!” says Halimo.
International Medical Corps implements similar hygiene and sanitation programmes in the Kobe and Melkadida refugee camps in Ethiopia. These programmes are particularly targeted towards families with children under 5 years old and those suffering from acute malnutrition as these groups are particularly vulnerable to diseases related to poor water, sanitation and hygiene practices.
