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'One fly is deadlier than one hundred tigers'

In a new report, the Water Supply and Sanitation Collaborative Council records the experiences of community workers from Africa, Asia, and Latin America on the all-important issues of safe water, sanitation and hygiene

 According to a new report released by the Geneva-based Water Supply and Sanitation Collaborative Council (WSSCC), the main problem in ensuring safe water, sanitation and hygiene to all is not lack of resources but a reluctance to learn from past failures and listen to those who have pioneered new approaches.

The report titled 'Listening' presents the voices of 40 people working with communities across Africa, Asia and Latin America to achieve UN water and sanitation goals.

Lack of water and sanitation is the world's number one health problem. This year, 2.2 million children will die as a result of waterborne diseases, says the WSSCC.

In India, an estimated 591,500 children die from poor hygiene every year -- the highest in the world. In Bangladesh, an estimated 21,000 children die annually due to poor hygiene; in Pakistan the number is 135,000.

As many as 769.4 million people in India do not have access to proper sanitation, and for 171 million people improved water supply is a distant dream.

The total amount of excreta not being disposed off safely, in India, is as high as 72%, next only to Afghanistan, the Congo, Ethiopia, Niger and Rwanda. This would fill up 14,70,308 oil barrels every day!

China produces the largest amount of excrement per year -- 122.3 millions metric tonnes. Sixty per cent is not safely disposed of.

The large percentage of unsafe disposal is reflected in the health impact figures for India. The percentage of children suffering abnormal growth is 47% in India, compared to South Africa's 11%. In South Africa, 5.7 million people do not have access to proper sanitation.

The WSSCC report condemns the international community for serious lapses in development over the last 50 years. Despite decades of effort, and billions of dollars, 2.4 billion people still have no proper access to sanitation.

Almost all 40 contributors to the report believe that the main reason for this failure has been the attempt to 'deliver' solutions from the outside -- usually in the form of installing hardware -- to communities that have no involvement in or ownership of the process.

In the Indian state of West Bengal, barely 12% of the rural population have access to a toilet.

In the late 1980s, Unicef and Ramakrishna Mission started a pilot project in West Bengal's Medinipore district to address problems of sanitation. The strategy included visiting families individually to convince them about the need for proper sanitation. The campaign used schools, local government publicity posters, 'wall writing', village meetings and radio and TV broadcasts to spread its message.

In 1993, the West Bengal government replicated the Medinipore model across the state. The key tasks of marketing sanitation and meeting demand were delegated to a new and radically different institution: the rural sanitary mart.

Sanitary marts provide a focal point in the campaign to promote the construction of toilets. They are run by local people trained at the district or state level, who generate awareness, create demand and offer after-sales help to users. They also train people in the manufacture and installation of toilets .

There are now more than 300 sanitary marts throughout West Bengal, providing valuable employment to thousands of young local people, especially women. Access to sanitary toilets is 43%.

Gilbert Nkusi, Unicef programme officer for water and sanitation, based in Antananarivo, Madagascar, has worked with both government and civil society and is a member of the Madagascar 'Wash' Committee. He argues that progress towards water and sanitation goals depends on decentralising responsibility for basic services and, at the same time, building the capacity of local governments.

"Twenty-eight thousand children are dying every year from inadequate sanitation and hygiene, and the Government of Nepal is not doing everything it can to save those children," says Umesh Pandey, Nepal's leading voice in the campaign for water, sanitation and hygiene for all.

According to Pandey, hygiene remains a neglected area confined to 'water projects' by both government and civil society groups. A tiny fraction of the total budget for the sector -- something like 4% -- is set aside for sanitation and hygiene promotion. Pandey also believes that civil society groups are reluctant to pressure the government on the issue of sanitation because they consider it a 'dirty' word. Even journalists are unwilling to print articles about things as unglamorous as excreta, toilets, taps and washing hands, he adds.

In Bangladeshi villages, imaginative new techniques allowing communities to see themselves as others see them have succeeded in putting a stop to the age-old practice of defecating out in the open. The result has been a 'demand' for water and qualitative sanitation by villagers who were given a chance to share their experiences to develop new approaches to the problem.

One man from Nawgaon district in Bangladesh came up with the slogan, 'One fly is deadlier than one hundred tigers' to help people grasp the dangers of faecal contamination. This is now being used all over Bangladesh.

Maharashtra, the first Indian state to pilot the approach of Community-Led Total Sanitation (CLTS) , has gone a step further with signs that read: 'Daughters from our village are not married into villages where open defecation is practised.'

"Once feelings of self-respect are ignited," says Kamal Kar, a consultant in social and participatory development working in Asia and Africa, "the community will carry the project forward with real drive and determination -- there is no inertia, no passivity."

"No progress is possible," says Jockin Arputham, president of India's National Slum Dwellers Federation, "until the urban authorities stop trying to hand down centrally-planned solutions. The urban elite still clings to the notion that they are the greatest experts in solving problems faced by the poor. It is an attitude that has led to thousands of failed projects."

Almost all the publication's participants agree that the old approach to providing water and sanitation services is fatally flawed. Increasing the available funds for large-scale, delivery-oriented infrastructure will achieve little without a rethink on how and on whom the funds are spent.

A hallmark of the new approach to the problems of water and sanitation is the recognition that women are most likely to form the basis of the solution. There is widespread consensus that the women of a community are the rock on which real demand and real participation is built. It is women who have to cope with frequent family illness; it is women who have to fetch and manage water; and it is women who have the greatest need for private and safe toilets.

Some measures suggested by the contributors for better and sustained implementation of sanitation programmes in order to attain the Millennium Development Goal of halving the proportion of people without safe drinking water and basic sanitation by 2015, include:

  • Community-led water and sanitation programmes require community-led monitoring and feedback. The government must monitor national progress, both to guide its own policies and investments and to fulfil its commitments to achieving agreed goals.
  • Government should lay down rules for the regulation of private enterprise.
  • Both national and local governments should contribute to the fundamental task of demand-creation. They should insist that major public institutions such as schools, health centres and other civil institutions become learning and demonstration centres for good hygiene and its benefits. To this end, Unicef and the WSSCC have launched a 'Wash in Schools' campaign with the aim of promoting hygiene education and safe water and sanitation facilities in all primary schools.
  • Donor agencies must support local authorities working with community organisations wherever possible.
  • The progress towards water and sanitation goals must be measured not by counting the number of taps and toilets and dividing them by the total population served, but by recording changes in use, behaviour and, above all, improvements in health.

(InfoChange News & Features, March 2004)