Global Handwashing Day

Wash Your Hands

Mom's sage advice, and the way out of poverty.

Unsafe water, then inadequate sanitation, then dirty little hands, then feces goes from food and fingers into mouths, and diarrheal disease is transmitted. Kids are sick, stay out and drop out of school, don't learn, don't earn, and the cycle of poverty continues.

So...

Happy Global Handwashing Day!

Data point: the Lancet Infectious Diseases Journal reported that 42-47 percent of all diarrheal transmission could be stopped by handwashing with soap (Curtis, Val, & Sandy Cairncross. (2003, May). "Effect of washing hands with soap on diarrhoea risk in the community: A systematic review." Lancet Infectious Diseases Journal 3(5), 275-81.)

A couple of examples of the good work being done to alleviate poverty through simple handwashing campaigns:

Madagascar

In Madagascar 19,300 primary schools will participate in a week-long event. Handwashing with soap activities involving schools and the community, culminate on October 15th with 3.5 million children washing hands with soap at noon. President Ravalomanana will lead the Day. Three Ministries have issued a joint statement to the Prime Minister to officialize Global Handwashing Day. A parade of schoolchildren through the capital is planned for October 15th.

Panama

The Ministry of Education and the Ministry of Health are supporting an event on October 15th in an elementary school close to Panama City. Children will wash their hands together with high representatives from both Ministries.

The Girl Effect - Best Video Ever

Best video EVER. Watch this. Two minutes of your life. Girl Effect... Very powerful. And directly related to safe drinking water and sanitation. No Girl Effect if she's hauling water on her head for her childhood. No Girl Effect if she has to drop out of school because her school doesn't have single gender sanitation facilities. Seriously - sit down and watch it.

And register to vote while you're at it.

American Prospect - Special Report on the Global Freshwater Crisis

The American Prospect published a special report on "The Global Freshwater Crisis" this month. It's a good, wide-ranging report on the global water situation, which many if not all of the authors agree is indeed a crisis. I'd suggest in particular Roger Stone's interview of Peter Gleick here, the interesting piece on a successful private water company in Manila here, and just perhaps yours truly's piece on the unprecedented opportunity this generation has to get it right with water here.

Save The Date - March 12, 2008

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Save the Date -- March 12, 2008

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For: The Launch of a Water, Sanitation and Hygiene (WASH) in Schools Initiative

Where: The National Geographic Society Auditorium, Washington, D.C.

When: Wednesday, March 12, 2008, 9:00am - 11:00am

Water Advocates and a growing list of non-governmental organizations, foundations, corporations, and schools will launch a Water, Sanitation and Hygiene (WASH) in Schools Initiative on Wednesday, March 12, 2008 at the National Geographic Society Auditorium in Washington D.C. While much is already being done for WASH in Schools, there is still an enormous unmet global problem - half the world's schools lack adequate water and sanitation. This initiative will focus on expanding WASH to 1,000 schools in developing countries while creating the momentum to help as many additional schools as possible worldwide. Water Advocates encourages interested corporations, foundations, organizations, and individuals to use this event as a platform to highlight their activities or to pledge their support to do more for WASH in Schools.

Doors will open at 8:30am and a half hour social will follow the event.

Media interview opportunities will be available from 11:00am - 11:30am.

Water, Technology and the World Bank's 2008 "Global Economic Prospects" report

As interested as I am in basic and applied research, new technologies, and ways to get them to market, I am not particularly excited about new water-related technologies just for the sake of new technology. I am far more interested in the scale up, out and over of existing appropriate technologies, particularly in the developing world where people suffer not from a lack of solutions but a lack of diffusion of those solutions.










The World Bank has some very insightful things to say about all of this in its recent Global Economic Prospects report:

Page 12: One of the recurring themes in this report is that “even relatively simple technologies can have far-reaching development impacts…For example, the dissemination of the simple skills required to build rainwater collection systems can improve access to clean drinking water and reduce the incidence of disease.”

Page 55: “In developing countries, the diffusion of such technology as water and sanitation systems…(has) been tremendously important for improving household well-being, but such innovations will affect output (blogger’s italics) only over time as improved child health eventually pays off in terms of greater adult productivity (source: Alderman, Hoddinott, and Kinsey 2006; Behrman and Rosenzweig 2004; Glewwe, Jacoby, and King 2001). These technologies may also have important noneconomic societal benefits, such as improved gender equality, which are not recorded in GDP because women are more likely to engage in nonmarket production, or may appear only with a lag as improved health technologies facilitate women’s entry into the labor force over time (source: Bailey 2006; Miller 2005; Schultz 2007).”

Page 57: “A recent study of Rwanda identified simple technologies whose greater use could have a substantial impact on development. For example, the study identified a lack of qualified plumbers and water sanitation technicians as a major factor holding back the implementation of simple rainwater collection strategies that have helped improve the quality of drinking water supplies in neighboring countries.”

Examples of the diffusion (or more correctly, lack thereof) of watsan technologies appropriate for Rwanda include:

• Roof water harvesting: only on limited scale for households
• Boreholes: few and expensive
• Hand pumps: imported from region or India
• VIP and Ecosan latrines technology: available, limited uptake

To repeat, “even relatively simple technologies can have far-reaching development impacts.” And the World Bank, the U.S. government, other international donors, and most importantly the Rwandan government itself should see to it that those simple technologies get to where they are most needed.

What could happen if happen if more financial and technical resources were available to more broadly diffuse the known solutions to Rwanda’s water and sanitation challenge? Rwanda is not racing for the cure for its water and sanitation challenge – they have the cure in their hand – e.g. they and the rest of the world have been putting into practice rainwater harvesting for millennia. Rwanda needs to scale it out and over. Perfect segue to my closing remarks:

I shouldn’t be surprised by the accurateness and relevance of these ideas coming from the World Bank, considering its mission of “global poverty reduction and the improvement of living standards.”

However, considering the controversy over many of its policy and fiscal recommendations and requirements in the developing world, and the irrelevance or worse of some of those in many cases for its primary mission of alleviating poverty, I find the simple ideas in this report refreshing. The next step is to make those recommendations happen, and my hope is that the US government is taking a step toward making those happen with its recent funding of the Water for the Poor Act.

Donde esta el baño?

What is the first thing you learn in any foreign language, other than perhaps the name of the most popular intoxicating beverage in the country (e.g. cerveza, vino, slivovitza)? It is:

"Where is the bathroom?"

If that isn't the best way to communicate the primacy of sanitation I don't know what is. Brilliant (thanks David!)

OK - now imagine that the answer, in whatever language, is "We don't have one, or any paper, or any water." NOW what would you like to be able to say in that foreign language? You will find those phrases here.

I should change the name of this blog to Blogging on Sanitation the way recent events have been going...

Since you asked...

This is what keeps me awake at night (or at home on a Friday evening):

No matter how much I do, or anyone I work with or consort with does, no matter how much the international donor community does to support safe drinking water and sanitation around the world, no matter if every international donor dollar is spent in exactly the right, highly coordinated way, all we can hope for is for all of those resources collectively to be the cherry on top of the cake, or at best a little gas to get the water development engine going.

Where's the real money? Approximately 70 cents of each dollar that is invested in water/sanitation/hygiene in the developing world comes from public sector finance in developing countries themselves - Ghanaian, Nicaraguan, Vietnamese, Indian taxpayer dollars/rupees/cedis etc. Ten percent give or take comes from the international donor community, with the rest coming from international and domestic private investments in water and sanitation infrastructure.

The end game - universal coverage of water and sanitation, like we enjoy in the States, Europe, Japan - must be played and won by the developing country governments themselves. They must do a much better job of prioritizing water/sanitation in their own budgets over the long run, and do a better job of prioritizing water in international aid requests in the short/medium term (e.g. Millennium Challenge Corporation compacts). [So shouldn't I/we be lobbying those governments instead of the donor community here? Now you try to get some sleep with that question hanging over your head...]

Government subsidies, tax incentives, and grants are all partial answers to how developing country governments should tackle this problem. There are also a number of regulatory paths to take, and I just read of a couple more today:

The Disease Control Priorities Project (DCPP) is an "ongoing effort to assess disease control priorities and produce evidence-based analysis and resource materials to inform health policymaking in developing countries." They recently published a very insightful piece on Water, Sanitation, and Hygiene: Simple, Effective Solutions Save Lives.

It's a clear, short (4pp!) paper detailing both the problem and at least hinting at some interesting partial solutions. One example: with respect to sanitation infrastructure (e.g. building pit latrines), government subsidies are often unruly, inequitable and highly politicized. The DCPP recommends a regulatory approach to address the challenge:

In Bobo Dioulasso, Burkina Faso, for example, the local administration withdrew land tenure rights from owners who did not build a latrine on their plot within a specified time. As a result, 90 percent of households now have their own latrine. Another effective regulation requires landlords to provide latrines for their tenants.

Yay. Another opportunity for developing country governments to more effectively encourage the construction of pit latrines is through what is commonly known as social marketing, much and well-practiced by Population Services International in the donor arena. Governments are encouraged by the DCPP to promote latrines by almost any means possible, as it is perhaps the most cost-effective way to ensure their construction. It is also likely to come out ahead in any cost-benefit analysis. Pit latrines do NOT sell themselves, so governments stepping in to make them more compelling one way or another is part of the solution. And the scale of the solution matches the scale of the problem and I get to go out on Friday nights...

I also have self-doubts about the fact that if only the world's agriculture were 10% more water efficient, there might not be a drinking water supply problem at all, so maybe I should be working on that issue?!? But that's for another post.

Homo sapiens vs. "lower primates"

The Washington Post published a very interesting piece this weekend:

In an Eastern Congo Oasis, Blood Amid the Greenery
In Africa's Oldest National Park, Gorillas Are Being Killed and Their Guardians Are Endangered, Too

Plenty of justifiable disgust with poachers, and I agree with that. But poachers are the symptom of a much more grave problem, the insecurity of the local populations of homo sapiens.

As I commented on the WP site, "At the risk of starting a flame war, let me suggest that we see homo sapiens as part of the solution, not just part of the problem. The better off humans are in that part of the world, the less likely they are to threaten "lower" primates."

One of the most effective ways to enhance basic human security in many parts of sub-Saharan Africa is to see that the locals have sufficient access to safe drinking water and sanitation. As an example, see what Daryl Hannah is doing in Rwanda:

Daryl Hannah Turns It On for World Water Day

The more safe drinking water is available in human villages, the less frequently those humans need to encroach on gorilla habitat. The unfortunate reality is that when homo sapiens encounter other primates, homo sapiens typically win. We should do what we can to avoid those instances, as should the local and national government authorities in Rwanda, Uganda and elsewhere.

The one other thing I would add in this forum is that if human waste in the villages is treated properly (e.g. pit latrines), the more likely that the bodies of water supporting the gorilla habitats will remain at least relatively unspoiled, so it is important to not omit consideration of environmental sanitation as well.

John Edwards first of 2008 U.S. field to tackle safe drinking water

Democrat John Edwards recently became the first (of many - stay tuned for reports on Brownback, Obama and others) of the 2008 U.S. presidential contenders to thoughtfully tackle the global safe drinking water and sanitation issue.

His campaign website includes the following commitment:

"Invest in Clean Water: The World Health Organization has found that every $1 invested in clean water yields an economic return of $8. Edwards will double the U.S. investment in clean water. He will also convene an international summit of government, businesses, and non-profits to agree on necessary investments to make water safe worldwide by 2015."

The return on that one dollar investment may be even higher in many instances as reported here. These are both direct financial returns to individuals, families and communities, as well as significant time savings and healthcare cost savings.

For a broader look at the 2008 field and what the candidates are doing to prioritize solutions to global health challenges and extreme poverty, check out One Vote '08.