Untold Stories

Even in the under-reported water and sanitation sector, we are constantly bombarded by stories and reports about what doesn’t work, what hasn’t worked, how we are failing as a planet to meet the water and sanitation MDGs. So in a belated Happy Thanksgiving post, I offer a couple of stories and snaps that show the progress the sector is making in small but meaningful ways:

There is a child in school in Niger because she doesn’t have diarrhea thanks to an extraordinarily simple bucket half full of clean water and a little sliver of soap that she and her family use to wash their hands every day.

A woman’s hands in Guatemala are no longer calloused because her village recently acquired a borehole with a handpump. The story – more of a human dignity story than a water story - involves her coming up with gratitude to the project leader and insisting that he feel how soft her hands were. (Thanks to Gil Garcetti for the great photo.)

There is a village in Tibet that is 100% free of open defecation because of some bold little kids running around sticking ‘poo flags’ in each pile, with the names of their shamed depositors written on those flags.


There is a woman in Senegal who no longer has to wait until nightfall for cultural reasons to defecate, because her family invested $4 in a household pit latrine. I couldn’t find a picture of ‘less severe constipation’ or ‘fewer liver problems’ to post, but you get the point.

Onward.

Vaccinations vs. safe drinking water and sanitation

An interesting article in The Lancet late last year didn’t receive the attention that it – or at least one sentence in it – merits.

I’d like to change that with the help of my now six readers:In Vol. 368, Issue 9543 (Oct 7 – 13, 2006) The Lancet published an editorial to coincide approximately with the release of the UNDP 2006 Human Development Report “Beyond scarcity: Power, poverty and the global water crisis”.

The Lancet piece dealt with the primacy of water and sanitation in global development, and drew attention to the likelihood that the world will fail to meet the MDG on sanitation. It also highlighted the regional disparities which are masked by global progress on the water MDG (viz. progress in India and China masking a lack of such progress in subSaharan Africa). Also of note in the one page editorial was the continued/continuing lack of prioritization of water and sanitation in budgets throughout the developing world.

The sentence at the heart of the argument I want to make on this blog is:

"It is dangerously short sighted to pour immense time and resources into vaccinating children only for them to die a few years later from diarrhoeal illnesses."

I don’t care if the solution to the global safe drinking water and sanitation problem is not a “traditional” health intervention like passing out antiretrovirals or vaccinations. There is clearly not a silver bullet, or even a silver shotgun solution to the water challenge – each situation (unfortunately) requires its own unique solution. Those solutions involve fewer traditional health interventions, and more engineering and infrastructure projects, more behavioral change and education programs (think massive handwashing campaigns for women and kids like this one).

Public health officials in any country, state, province or elsewhere should support and lobby for these non-health initiatives to provide safe water and sanitation, as should the international donor community:

a) they save lives and livelihoods, and

b) less water-related mortality and morbidity frees up hospital beds, staff and other health care resources for those more traditional health interventions. A person sick from preventable waterborne diarrheal disease is occupying a hospital bed whose purpose would be better served by hosting an HIV or TB or malaria patient (plus that girl suffering from diarrhea would be better off in school thank you very much).

Health systems are burdened beyond capacity in many areas already – advocates for public health, water and sanitation throughout the developing and developed world should focus more cogently on preventing preventable illness.

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...

Beat the Rush

One of the things that keeps me awake at night is that the global safe drinking water and sanitation sector can't compete with Heifer International during the holiday buying frenzy and the end-of-year search for tax breaks. Buying two shares of a pig or a flock of chicks strikes me as more fun than buying a toilet or a pump.

But WaterAid comes close:

How about a puppet show for hygiene promotion for 31 quid, or a soap-making business for 100?

One of the keys to attracting more financial and political support for the water is telling the right stories to the right people, and making it fun. Go WaterAid.

World Dunny Day! Cheers!

I imagine that all six of my readers already know that it is World Toilet Day today, but just in case one of you out there just woke up, Happy World Toilet Day! Or as the Aussies say World Dunny Day.


To the 2.6 billion without such amenities, hold on, I'll be right out.

A Good Scratch

I made the mistake recently of asking a British friend of mine “What are the first three things you do in the morning?” His reply: “Well, I finish me gin from the night before, I smoke a ciggy, and I have a good scratch.”

I suspect that safe, clean water will be more important for those of us with less vigorous mornings.

Imagine your morning without water. Imagine your bathroom trip, your shower, your coffee/tea, imagine brushing your teeth without water. If you woke up and realized your home didn’t have safe water, what would your first three actions that morning look like? Forget the first three things – what is the first ONE thing you would do?

Water is vital not only to our morning rituals in the developed world; water is life in its barest essence. Water is security, human security.

Without water, women and families in Africa, Asia, Latin and Central America and elsewhere spend significant parts of their days NOT learning, NOT working, NOT being productive members of society, NOT watching their children play. We in the States are increasingly aware of this challenge abroad – throughout the developing world – and are increasingly active on behalf of the issue. Yet effectively tackling the global safe drinking water and sanitation problem is not as easy as driving to the local soup kitchen and ladling soup to homeless people on Thanksgiving - which reminds me - do that too. Ensuring that poor communities in Africa, Asia and elsewhere have safe water and sanitation is tough work – and requires money, political support, thoughtfulness, and patience. And of that list the most important may well be thoughtfulness.

The recent announcement of the Howard G. Buffett Foundation’s commitment to the sector - called the Global Water Initiative - is an important one, and one which displays many of the best – or at least emerging practices in the sector. It is also an announcement which merits MUCH more attention in the media than it received. John Sauer nailed it in The Huffington Post, trying valiantly to get this announcement the coverage it deserves.

$150m is important. Having a name like Buffett associated with its support for the global safe drinking water and sanitation sector is important in that it minimizes the risk of the next philanthropist getting on board. The focus on both water and sanitation is important. However, arguably more important are the Global Water Initiative's (GWI) efforts to streamline and decentralize decisionmaking throughout the entire process. Long before the formal launch GWI was consulting with a select group of several of the finest implementing organizations on the planet. Long before the launch the GWI was looking at ways not simply to build more systems but to catalyze systemic change in the world's most vulnerable communities. Long before its launch GWI was looking at ways not to measure quarterly or even annual results, but looking at what it could achieve over a ten year period and beyond. And long before its launch GWI was streamlining the process of distributing these grants and the process of receiving these grants in-country, so the focus could be on making the work itself as sustainable, as holistic and as inclusive as possible.

I myself would have chosen fewer countries to minimize dissipation of effort, and to make it more likely that this initiative will produce meaningful successes at scale - the sort of successes that generate headlines like "Every School in Guatemala Now Has Access to Safe Drinking Water" and "Every HIV/AIDS Clinic in Uganda Now Has Private Sanitation Facilities." It is money, it is political support, it is lots and lots of technical know-how and elbow grease that will push this sector onward. However, it is thoughtful initiatives like the Global Water Initiative that are likely to demonstrate not the gravity of the water problem or quick technical fixes, but how solvable the problem is if approached thoughtfully.

International Year of Poo

Hooleintelligence has it right - I have been delayed in my posting due to my being a little too excited about the upcoming International Year of Sanitation. I'm not so sure that getting all worked up about another UN Year for something is advisable, but at least I am not alone:

World Toilet Association General Assembly - tickets still available. Seriously. Go. (Seoul, Nov. 21 - 25)

'Mr. Toilet' builds commode-shaped house

World Toilet Summit in Delhi - Check out my friend Dave Praeger's updates from the World Toilet Summit here. Poop humor just never gets old.

So how can we determine whether we are making progress with the global sanitation challenge? How about when news about sanitation shows up in mainstream media and not in the "Offbeat News" or "News of the Absurd."

And now the underlying harsh reality of this post: what kills and sickens more people, water or inadequate sanitation? A recent UNICEF report answers that clearly:

Reduction in diarrhoeal diseases morbidity resulting from improvements in drinking water and sanitation services:

• 25% from improved drinking water
• 32% from improved sanitation
• 45% from improved hygiene (viz. handwashing)
• 39% from household water treatment

Yes, we need all three. But we need an invigorated response to the global sanitation challenge. But Blogging on Sanitation.blogspot.com doesn't have the cachet that toilets deserve.