Better sanitation could save 2 million lives a year
By Kate Kelland
LONDON | Mon Nov 15, 2010 5:03pm EST
LONDON (Reuters) - Nearly 20 percent of the world's population still defecates in the open, and action to improve hygiene, sanitation and water supply could prevent more than 2 million child deaths a year, health experts said Monday.
In a series of studies on sanitation published as a cholera epidemic claims hundreds of live in Haiti, public health researchers from the United States and Europe found that this year 2.6 billion people across the world do not have access to even a basic toilet.
Unsafe sanitation and drinking water, together with poor hygiene, account for at least 7 percent of disease across the world, they said, as well as nearly 20 percent of all child deaths in the world.
Despite this, progress in improving safe water supplies and sanitation has been "painfully slow" in many developing countries, they said. They urged international donors, United Nations agencies, developing country governments and health workers to act now to reduce this "devastating disease burden."
Poor sewerage and sanitation can spread dangerous infections like viral hepatitis and cholera, an acute disease transmitted in contaminated water that causes watery diarrhea and severe dehydration and can kill within hours if not treated.
More than 900 people have died of cholera in Haiti -- which is still recovering from a devastating earthquake in January -- in an outbreak which experts believe was worsened by flooding caused by Hurricane Tomas this month.
The United Nations forecasts up to 200,000 Haitians could contract the infection as the outbreak extends across the country and says $163.9 million in aid is needed over the next year to fight it.
In the studies, published in the Public Library of Science (PLoS) Medicine journal, researchers said that of the 2.6 billion people who have no access to decent sanitation, two-thirds live in Asia and sub-Sahara Africa.
It also found huge regional disparities in sanitation coverage. While 99 percent of people in industrialized countries have access to good sanitation, in developing countries only 53 percent have it. Within developing countries, urban sanitation coverage is 71 percent while in rural areas it is 39 percent.
"Globally, around 2.4 million deaths could be prevented annually if everyone practiced appropriate hygiene and had good, reliable sanitation and drinking water," said Sandy Cairncross of the London School of Hygiene & Tropical Medicine, who led one of the studies. "These deaths are mostly of children in developing countries from diarrhoea and subsequent malnutrition, and from other diseases attributable to malnutrition."
A World Health Organization (WHO) report published in May found the world was on track to achieve a globally agreed Millennium Development Goal (MDG) on access to safe drinking water, but more needed to be done to improve levels of sanitation.
The MDG targets call for the proportion of people without sustainable access to safe drinking water and basic sanitation to be halved by 2015 from levels in 2000.
Paul Hunter of Britain's University of East Anglia, who led one of the PLoS studies said more research was needed to see which intervention measures could improve sanitation and health.
"But ... action must not wait for the outcomes of such research," he wrote. "We know enough now about the importance of improved water supply, sanitation, and hygiene ... to consider universal access to these services to be an urgent imperative."
(Editing by Susan Fenton)
Friday, November 19, 2010
Monday, October 18, 2010
Have you washed up?
Schools should insist that children wash hands to prevent infections
Marianne de Nazareth
Hand washing helps to contain the spread of infection. Washing of hands is a ritual most of us should be particular about in India before eating a meal. That's because we eat with our fingers. We tend to be careless when in a hurry and what's worse is we use unclean hands to feed others, especially children.
October 15 has been dedicated to Hand-washing Day across the world. Global Hand-washing Day aims at motivating children to imitate and spread proper hand-washing practices, and turn them into little “hand-washing ambassadors”. It follows that if the child is taught correctly, they will in turn teach the next generation. Studies also suggest that hand-washing promotion in schools can play a role in reducing absenteeism among primary school children.
Reduce diarrhoea
There is a simple explanation for that — hand-washing with soap has been cited as one of the most cost-effective interventions to prevent diarrhoeal related deaths and disease. A review of several studies by the Water Supply & Sanitation Collaborative Council (WSSCC), shows that hand-washing in institutions such as primary schools and daycare centres reduce the incidence of diarrhoea by an average of 30 per cent. Rates of hand-washing around the world are low. Observed rates of hand-washing with soap at critical moments – before handling food and after using the toilet - range from zero per cent to 34 per cent. “More than 1.5 million children under five die each year as a result of diarrhoea — it is the second most common cause of child deaths worldwide. Hand-washing with soap can save lives by reducing diarrhoea rates by more than 40 per cent,” explains David Trouba, the Programme Officer, WSSCC.
“Hand washing is quintessential in preventing transmission of infections. In the hospital, washing hands as doctors and nurses move from one patient to the next has reduced the spread of contagious diseases. It has also brought down the numbers of infections contracted by healthcare personnel. It is therefore an important means of bringing down respiratory and skin infections. We should remember to wash hands before each meal and also after we touch any object or person capable of transmitting infection. The method of hand washing whereby each finger and inter-digital space is washed thoroughly has to be mastered by all”, adds Jyothi a doctor from St John's Medical College and Hospital.
“On Hand-washing Day we appealed for a change in routine at two critical times in a day – hand washing with soap before eating and after defecation. The practice of hand washing is a behavioural change issue and hence ‘Hand washing Day' tries to bring this into focus every year world-wide,” says Deepinder Kapur of WSSCC.
Our schools should insist on spreading the concept of regular hand washing among their children. By teaching children to be clean, we can help save many young lives and prevent expensive unnecessary hospital treatment.
ends
Schools should insist that children wash hands to prevent infections
Marianne de Nazareth
Hand washing helps to contain the spread of infection. Washing of hands is a ritual most of us should be particular about in India before eating a meal. That's because we eat with our fingers. We tend to be careless when in a hurry and what's worse is we use unclean hands to feed others, especially children.
October 15 has been dedicated to Hand-washing Day across the world. Global Hand-washing Day aims at motivating children to imitate and spread proper hand-washing practices, and turn them into little “hand-washing ambassadors”. It follows that if the child is taught correctly, they will in turn teach the next generation. Studies also suggest that hand-washing promotion in schools can play a role in reducing absenteeism among primary school children.
Reduce diarrhoea
There is a simple explanation for that — hand-washing with soap has been cited as one of the most cost-effective interventions to prevent diarrhoeal related deaths and disease. A review of several studies by the Water Supply & Sanitation Collaborative Council (WSSCC), shows that hand-washing in institutions such as primary schools and daycare centres reduce the incidence of diarrhoea by an average of 30 per cent. Rates of hand-washing around the world are low. Observed rates of hand-washing with soap at critical moments – before handling food and after using the toilet - range from zero per cent to 34 per cent. “More than 1.5 million children under five die each year as a result of diarrhoea — it is the second most common cause of child deaths worldwide. Hand-washing with soap can save lives by reducing diarrhoea rates by more than 40 per cent,” explains David Trouba, the Programme Officer, WSSCC.
“Hand washing is quintessential in preventing transmission of infections. In the hospital, washing hands as doctors and nurses move from one patient to the next has reduced the spread of contagious diseases. It has also brought down the numbers of infections contracted by healthcare personnel. It is therefore an important means of bringing down respiratory and skin infections. We should remember to wash hands before each meal and also after we touch any object or person capable of transmitting infection. The method of hand washing whereby each finger and inter-digital space is washed thoroughly has to be mastered by all”, adds Jyothi a doctor from St John's Medical College and Hospital.
“On Hand-washing Day we appealed for a change in routine at two critical times in a day – hand washing with soap before eating and after defecation. The practice of hand washing is a behavioural change issue and hence ‘Hand washing Day' tries to bring this into focus every year world-wide,” says Deepinder Kapur of WSSCC.
Our schools should insist on spreading the concept of regular hand washing among their children. By teaching children to be clean, we can help save many young lives and prevent expensive unnecessary hospital treatment.
ends
Friday, October 15, 2010
Sensex aur shauchalaya
By Patralekha Chatterjee
We can thank Commonwealth Games organising committee general-secretary Lalit Bhanot for placing toilets firmly in the collective consciousness of this nation. “Their (Western) standard of hygiene and cleanliness could be different from ours so there is nothing to be ashamed about it”, Mr Bhanot wondered aloud at a press conference. Ever since those famous words, there is no escape from the toilet story in the Commonwealth Games Village.
The photos of paan-stained washbasins and bathroom floors, combined with dog poo-smeared bedsheets, have gone viral on the Internet as “toiletgate” takes over the conversations of an anguished middle class in the country.
The Sensex may have hit the magical 20,000 mark but disconcertingly, for many of us, the world at large is suddenly more concerned that more people in India have access to mobile phones than to basic sanitation.
Is the toilet a template for the state of a nation or civilisation?
“The toilet is part of the history of human hygiene which is a critical chapter in the growth of civilisation”, says Dr Bindeshwar Pathak, sociologist, toilet czar and the man who started the low-cost Indian toilet system, the globally-acclaimed Sulabh Shauchalaya model.
Contemporary literature also offers useful takeaways. In a cheeky aside, Isadora Wing, the brilliant, hilarious and outrageous heroine of American writer Erica Jong’s 1973 bestseller Fear of Flying, teases us with the history of the world through its toilets — the British toilet as the last refuge of colonialism where “for one brief moment (as you flush), Britannia rules the waves again”. German toilets observe class distinctions — rough brown paper for a third class railway carriage and white paper called Spezial Krepp in the first class, Jong’s young heroine observes. Isadora links Italian art to the swift way Italian toilets run, is foxed by French philosophy and the Gallic approach to merde (excreta) and is awe-struck by the aesthetics of the Japanese toilet — toilet basin recessed in the floor, flower arrangement behind, inspiring thoughts of Zen.
And Indian toilets? Well, well… One must remember this was the good-old or bad-old Seventies, depending on your politics. India was not an emerging power and Jong’s adventurous but Euro-centric heroine did not have the Indian toilet experience.
What would Jong say if she took a toilet tour of India today after listening to Mr Bhanot’s wise words?
The recent flood of toilet jokes makes us squirm since we are the targets but blunderbuss Mr Bhanot has also touched a raw nerve.
The riveting rise of the Sensex and the “cash and clout” image of India in the world is our outerwear where we sport a designer brand. The sanitation story is more like dirty inner wear which we don’t like to either talk about or change.
Middle-class Indians typically would not have paan-stained washbasins at home. And there is a fortune to be made out of tapping the bathroom vanity of young, rising India. But how many times have you seen the driver and the passenger in the Honda City ahead of you open the car door and spit out the remnants of a paan or chewing tobacco on the road? In my neighbourhood market — in a posh south Delhi enclave — there are spas, but few spittoons; garbage lies in front of stores peddling grand designs in urban living. What irks middle-class India is not that filth and squalor exist but that they are being showcased by a prying media, denting India’s image as an emerging power.
India’s Millenium Development Goals Report (2009) notes that the proportion of Indian households having no sanitation facility has declined from about 70 per cent in 1992-93 (24 per cent urban and 87 per cent rural) to about 51 per cent in 2007-08 (19 per cent urban and 66 per cent rural). But despite recent progress, access to improved sanitation remains far lower in India compared to many other countries with similar or even lower per capita gross domestic product (GDP). Bangladesh, Mauritania, Mongolia, Nigeria, Pakistan and Vietnam — all with a lower GDP per capita than India — are just a few of the countries that have achieved higher access to improved sanitation, says the Asian Development Bank.
India is among a handful of countries where open defecation persists. Through its Total Sanitation Campaign, the government has sanctioned projects for construction of what babudom calls individual household sanitary latrines in all of India’s rural districts. But a lot more action and oversight is needed on the ground to meet the national goal of eradicating open defecation by 2012.
Non-governmental organisations’ surveys suggest that many among those who have access to individual, community or shared toilets do not use the structure as a toilet. The reasons for non-use of toilets — poor/unfinished installations, no super structure and lack of behavioural change.
As in everything else in India, how and where you excrete is a matter of who you are and your position in the socio-economic pecking order. It comes as no surprise to learn that Scheduled Castes and Scheduled Tribes have lower access to toilets than upper castes.
Sociologists argue that this grim picture is not just about poverty. It has to do with the deeply-ingrained caste structure in India and notions of purity and pollution embedded in our psyche. First, children of so-called upper castes grow up hearing that cleaning garbage is the job of someone else, and that someone else is still often referred to by names that would put you in jail if uttered in public. Second, in an overcrowded country like India, far too many people also believe keeping your home clean is all you can do. What happens beyond is none of your concern — it is someone else’s job to keep the public places clean, someone who is still considered an untouchable deep down despite laws prohibiting untouchability.
Money alone will not change such a mindset. Without the collective will for change, Sensex will soar even as we trail behind poorer countries in basic sanitation. The India that shocks and agitates, however, also offers inspiration. Many tribal communities can teach us a thing or two about cleanliness. Mr Pathak built the first Sulabh public toilet in Bihar, his home state, in 1974. Now, almost 8,000 such toilets have been built and are maintained across the country. Sulabh toilet complexes also exist in Bhutan and Afghanisthan, and over the next five years Mr Pathak plans to implement the model in 50 other countries.
Patralekha Chatterjee writes on development issues in India and emerging economies and can be reached at patralekha.chatterjee@gmail.com
By Patralekha Chatterjee
We can thank Commonwealth Games organising committee general-secretary Lalit Bhanot for placing toilets firmly in the collective consciousness of this nation. “Their (Western) standard of hygiene and cleanliness could be different from ours so there is nothing to be ashamed about it”, Mr Bhanot wondered aloud at a press conference. Ever since those famous words, there is no escape from the toilet story in the Commonwealth Games Village.
The photos of paan-stained washbasins and bathroom floors, combined with dog poo-smeared bedsheets, have gone viral on the Internet as “toiletgate” takes over the conversations of an anguished middle class in the country.
The Sensex may have hit the magical 20,000 mark but disconcertingly, for many of us, the world at large is suddenly more concerned that more people in India have access to mobile phones than to basic sanitation.
Is the toilet a template for the state of a nation or civilisation?
“The toilet is part of the history of human hygiene which is a critical chapter in the growth of civilisation”, says Dr Bindeshwar Pathak, sociologist, toilet czar and the man who started the low-cost Indian toilet system, the globally-acclaimed Sulabh Shauchalaya model.
Contemporary literature also offers useful takeaways. In a cheeky aside, Isadora Wing, the brilliant, hilarious and outrageous heroine of American writer Erica Jong’s 1973 bestseller Fear of Flying, teases us with the history of the world through its toilets — the British toilet as the last refuge of colonialism where “for one brief moment (as you flush), Britannia rules the waves again”. German toilets observe class distinctions — rough brown paper for a third class railway carriage and white paper called Spezial Krepp in the first class, Jong’s young heroine observes. Isadora links Italian art to the swift way Italian toilets run, is foxed by French philosophy and the Gallic approach to merde (excreta) and is awe-struck by the aesthetics of the Japanese toilet — toilet basin recessed in the floor, flower arrangement behind, inspiring thoughts of Zen.
And Indian toilets? Well, well… One must remember this was the good-old or bad-old Seventies, depending on your politics. India was not an emerging power and Jong’s adventurous but Euro-centric heroine did not have the Indian toilet experience.
What would Jong say if she took a toilet tour of India today after listening to Mr Bhanot’s wise words?
The recent flood of toilet jokes makes us squirm since we are the targets but blunderbuss Mr Bhanot has also touched a raw nerve.
The riveting rise of the Sensex and the “cash and clout” image of India in the world is our outerwear where we sport a designer brand. The sanitation story is more like dirty inner wear which we don’t like to either talk about or change.
Middle-class Indians typically would not have paan-stained washbasins at home. And there is a fortune to be made out of tapping the bathroom vanity of young, rising India. But how many times have you seen the driver and the passenger in the Honda City ahead of you open the car door and spit out the remnants of a paan or chewing tobacco on the road? In my neighbourhood market — in a posh south Delhi enclave — there are spas, but few spittoons; garbage lies in front of stores peddling grand designs in urban living. What irks middle-class India is not that filth and squalor exist but that they are being showcased by a prying media, denting India’s image as an emerging power.
India’s Millenium Development Goals Report (2009) notes that the proportion of Indian households having no sanitation facility has declined from about 70 per cent in 1992-93 (24 per cent urban and 87 per cent rural) to about 51 per cent in 2007-08 (19 per cent urban and 66 per cent rural). But despite recent progress, access to improved sanitation remains far lower in India compared to many other countries with similar or even lower per capita gross domestic product (GDP). Bangladesh, Mauritania, Mongolia, Nigeria, Pakistan and Vietnam — all with a lower GDP per capita than India — are just a few of the countries that have achieved higher access to improved sanitation, says the Asian Development Bank.
India is among a handful of countries where open defecation persists. Through its Total Sanitation Campaign, the government has sanctioned projects for construction of what babudom calls individual household sanitary latrines in all of India’s rural districts. But a lot more action and oversight is needed on the ground to meet the national goal of eradicating open defecation by 2012.
Non-governmental organisations’ surveys suggest that many among those who have access to individual, community or shared toilets do not use the structure as a toilet. The reasons for non-use of toilets — poor/unfinished installations, no super structure and lack of behavioural change.
As in everything else in India, how and where you excrete is a matter of who you are and your position in the socio-economic pecking order. It comes as no surprise to learn that Scheduled Castes and Scheduled Tribes have lower access to toilets than upper castes.
Sociologists argue that this grim picture is not just about poverty. It has to do with the deeply-ingrained caste structure in India and notions of purity and pollution embedded in our psyche. First, children of so-called upper castes grow up hearing that cleaning garbage is the job of someone else, and that someone else is still often referred to by names that would put you in jail if uttered in public. Second, in an overcrowded country like India, far too many people also believe keeping your home clean is all you can do. What happens beyond is none of your concern — it is someone else’s job to keep the public places clean, someone who is still considered an untouchable deep down despite laws prohibiting untouchability.
Money alone will not change such a mindset. Without the collective will for change, Sensex will soar even as we trail behind poorer countries in basic sanitation. The India that shocks and agitates, however, also offers inspiration. Many tribal communities can teach us a thing or two about cleanliness. Mr Pathak built the first Sulabh public toilet in Bihar, his home state, in 1974. Now, almost 8,000 such toilets have been built and are maintained across the country. Sulabh toilet complexes also exist in Bhutan and Afghanisthan, and over the next five years Mr Pathak plans to implement the model in 50 other countries.
Patralekha Chatterjee writes on development issues in India and emerging economies and can be reached at patralekha.chatterjee@gmail.com
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