SulabhENVIS Centre

Countries with the greatest unmet sanitation and water needs most often receive little or no aid

WASHINGTON, D.C. 21 April 2010 – Between 1997 and 2008, aid commitments for sanitation and water fell from 8% of total development aid to 5%, lower than commitments for health, education, transport, energy and agriculture, according to the latest UN-Water Global Annual Assessment of Sanitation and Drinking-Water (GLAAS) report, launched today by UN-Water and the World Health Organization (WHO).

This drop occurred despite compelling evidence that achieving the water and sanitation target of the Millennium Development Goals (MDGs) would lower health-care costs, increase school attendance and boost productivity. Despite these clear benefits for human and economic development, many countries and donors are still not allocating sufficient attention and resources to water and sanitation.

“Neglecting sanitation and drinking-water is a strike against progress. Without it, communities and countries will lose the battle against poverty and ill-health,” said Dr. Maria Neira, WHO Director of Public Health and Environment.

Improved access to sanitation and water produces economic benefits that range from US$ 3 to US$ 34 per US$ 1 invested, increasing a country’s gross domestic product (GDP) by an estimated 2% to 7%.

“Unsafe water, inadequate sanitation and the lack of hygiene claim the lives of an estimated 2.2 million children under the age of 5 every year. Of these deaths, 1.5 million are due to diarrhoea, the second leading contributor to the global burden of disease,” said Dr. Neira. “The impact of diarrhoeal disease in children under 15 is greater than the combined impact of HIV and AIDS, malaria, and tuberculosis,” she added.

The findings from the UN-Water GLAAS report will be presented at the first annual High Level Meeting of Sanitation and Water for All, hosted by UNICEF on 23 April in Washington, DC. The High Level Meeting provides a forum for Ministers of Finance from developing countries, accompanied by Ministers responsible for sanitation and water, and representatives from donor countries to gain a greater understanding of the linkages between water, sanitation, and economic growth, in order to commit the appropriate resources, as well as to promote a culture of mutual accountability, partnership and shared responsibility.

At this groundbreaking event, governments, donors, multilateral agencies, and civil society organizations will discuss challenges, share best practices and commit to bringing safe drinking-water and adequate sanitation to the unserved. The participants will focus on the UN-Water GLAAS recommendations: greater political prioritization for sanitation and drinking-water, better resource targeting, strengthening of systems, and development of stronger partnerships at all levels.

“This high level meeting represents a watershed in our sector. As a global partnership, Sanitation and Water for All will involve the people who make decisions about investments, and who can change the outlook for the sector. We firmly believe giving priority to sanitation and water and tracking our progress together will aid development and give new hope to countries who struggle to reach their poorest citizens, including vulnerable children, with these essential services,” said Ms. Clarissa Brocklehurst, UNICEF Chief of Water, Sanitation and Hygiene (WASH).

“UNICEF is delighted by the enthusiastic response we have had from invitees, and we look forward to a landmark first meeting with 35 ministers from twenty developing countries and twelve major donors,” she added.

“UN-Water is proud that the GLAAS report will help drive change in the sector, and our members are poised to support the work of development partners and members states,” said Dr. Zafar Adeel, who chairs UN-Water, a group of 27 UN organizations working on various aspects of water.

Most Hospital Acquired Infections (HIA) are spread by indiscriminate spitting by those visiting hospitals, says a new survey conducted by the Department of Neurosciences of AIIMS.

The survey revealed that over 90 per cent visitors spit inside the hospital building. "The survey was conducted a student as a part of his coursework. HIA have been a cause of concern, especially in government hospitals where relatives of patients are not sensitive to such matters. At AIIMS, we found that attendants spat even in corridors outside the ICU and isolation wards," Dr Bir Singh, Professor of Community Medicine at AIIMS, said.

While no official survey has been conducted across hospitals, experts maintain that the situation is same in other hospitals, putting patients at severe risk.

"People suffering from respiratory problems like tuberculosis, pneumonia, swine flu are carriers of these infectious diseases, besides being vulnerable themselves," Singh said. "Their sputum lying in open is the biggest threat to a healthy person, leave alone hospital patients," added Dr Singh.

"Ninety per cent of the visitors spit as a matter of habit, 10 per cent chew tobacco," Dr Manjari Tripathy, Department of Neurology, Neurosciences Centre, said.

"We organise regular talks, put up posters, provide spittoons and also install cautionary signboards against the habit, but all these have proved useless," she added.

Cellphones and toilets reflect the two facets of India. While mobiles are a manifestation of the recent revolution in the information technology, the poor sanitation conditions prevailing in the countryside are reflective of a cultural delusion.

The number of cellphones, which was 0.35 per 100 persons in the year 2000-01, has skyrocketed to 45 per 100 persons now. More than 545 million cellphones are operational in India. The number is expected to rise to one billion by 2015.

Unfortunately, though riding high on economic growth, India remains largely an unhygienic state plagued by tropical diseases and unsanitary conditions. Some 110 million households remain without access to toilets or with no safe way to dispose of human waste and many defecate in the open fields or near the water sources where from they draw water.

Dirty water and lack of toilets and proper hygiene kill 3.3 million people around the world of which India has a significant proportion. Only 86 per cent of the population of India has access to improved water supply, and the duration of this supply averages only 4.3 hours a day.

According to a study conducted by the National Council for Applied Economic Research in 2004-05, morbidity is reported to be lower in households using clean fuels instead of firewood, piped water instead of open source water and flush toilets. Unfortunately, the majority of Indian houses (62 per cent) have none of these amenities and only 7 per cent have all the three.

Though the mobiles have changed from the first to third generation, the level of sanitation in India has not changed much. Open drains in villages still give you filthy smell with breeding colonies of mosquitoes. Cow dung, which could be organically used to increase fertility of the impoverished soil, is still used in “chullahas”.

In the urban areas, a major fallout of the robust consumption-driven economic growth is the generation of growing amounts of municipal waste. Many cities and towns are overwhelmed by the increasing volume of waste. Only 25 per cent of the total sewage generated in the urban areas is treated before being released into the rivers and water courses. In old cities the sewerage has become inadequate to carry the increasing load of waste. As a result, it leaks and contaminates the drinking water supply.

In March, 1999, the Supreme Court intervened to bring about India’s Municipal Solid Waste (Management and Handling) Rules 2000 providing a clear roadmap for all urban areas for daily doorstep collection and minimising the waste quantities by recycling and stabilising all biodegradable waste for use as compost, but the progress has been slow. The containers carrying solid waste breakdown in the middle of the road. Composting and land-filling are the exception rather than the rule.

Plastics, electronic trash and biomedical refuse are the new generation urban wastes. Not many states have banned the use of plastic carrybags, which continue choking drains and spreading dirt and filth. Feral cows, dogs and boars can often be seen around the heaps of garbage devouring the remains of households thrown in polybags. E-waste is one of the fastest growing waste streams, with people changing their computers, television sets and mobile phones more frequently than ever before. According to one estimate, about 20-50 million tonnes of e-waste is generated annually worldwide to which India contributes 4.00 lakh tonnes a year.

Most of the components in electronic devices contain lead, cadmium, mercury, PVCs, brominated flame retardants (BFRs), chromium, beryllium and phthalates. Long-term exposure to these substances can damage the nervous system, kidney and bones, and the reproductive and endocrine systems. Indiscriminately dumped components can pollute the ground water. Unfortunately, a legal framework on the principle to reduce, reuse and recycle e-waste is not available in India, whereas global initiatives to phase out chemicals from electronic devices started in 2006.

Sanitation means eradication of water-borne diseases like diarrhoea, cholera and hepatitis, gain in productive time, saving the cost of medicines and better health and prosperity. Improved sanitation, including hand washing with soap and water purification, could worldwide save the lives of 1.5 million children, who suffer from diarrhoeal diseases each year.

The UN Millennium Development Goals include a target to reduce by half the proportion of people without access to basic sanitation by 2015. The main focus of the programme is to remove the stigma around sanitation, discuss the importance of sanitation, highlighting poverty reduction, health and other benefits that flow from better hygiene, household sanitation arrangements and wastewater treatment.

The only way to clean up India is to involve communities and popularise environment friendly human-waste disposal systems such as developed by Sulabh International that are cost-effective for the average Indian household. Only a clean India can be healthy and incredible.

The writer is the Chief Conservator of Forests, Punjab

Source: The Tribune, New Delhi, Wednesday, April 21, 2010

“Popular education about the health dangers of poor sanitation is also needed. But this simple measure could do more to save lives, especially those of young people, improve health and help pull India and other countries in similar circumstances out of poverty than any alternative investment. It can also serve as a very significant boost to the local economy,” he added.

The report is produced by experts who prescribe ways to meet the Millennium Development Goal (MDG) on sanitation by 2015. The research shows roughly 366 million people (31 per cent of the population) in India had access to improved sanitation in 2008. Other data, meanwhile, shows 545 million cellphones are now in service in India’s emerging economy.

Worldwide, some 1.1 billion people defecate in the open and data shows that progress in creating access to toilets and sanitation lags far behind world MDG targets, even as mobile phone connections continue their march towards the predicted 1 billion in India by 2015, according to the study.

The report says it costs about 300 dollars to build a toilet, and worldwide an estimated 358 billion dollars is needed between now and 2015 to reach the MDG for sanitation. “The world can expect, however, a return of between 3 and 34 dollars for every dollar spent on sanitation, realised through reduced poverty and health costs and higher productivity, an economic and humanitarian opportunity of historic proportions,” said Adeel.

If current global trends continue, the World Health Organisation and UNICEF, in a report titled “Progress on Sanitation and Drinking Water” in March, predicted a 1 billion person shortfall from the sanitation goal in 2015 — with about 2.7 billion people lacking access.