Turning Coffee into Water

Thanks to a wee bit of lobbying (it was actually a very easy sell), the Clinton Global Initiative organized a breakfast/coffee table discussion on Safe Drinking Water which I had the pleasure of moderating today.

As I was tasked with reporting back to the appropriate authorities at CGI, my careful note-taking has revealed some compelling ideas from the table:

1) First of all, the suggestion was made to encourage the Clinton Global Initiative to better prioritize the global safe drinking water, sanitation and hygiene issue throughout all of the tracks (Global Health, Poverty Alleviation, Education and Energy/Climate Change for 2007 - tbd for 2008). Water is everywhere, but is rarely addressed directly and specifically (with an increasing number of exceptions like P&G’s PUR commitment, WaterHealth International’s commitment with Dow). The availability of water and sanitation will make all other sustainable development efforts, regardless of who funds them, more successful initially and more sustainable over the long run.

2) There needs to an increased advocacy effort to raise awareness of safe drinking water and sanitation as a major public health challenge, both in the developed and developing world. In particular, this awareness-raising needs to focus on the solutions to water and sanitation challenges, not just attest to the gravity of the problem. One participant focused specifically on ways to broadcast the water, sanitation and health message throughout the developing world, and getting those governments to better prioritize the issue in their own budgets. One useful precedent is the International Network to Promote Household Water Treatment and Safe Storage. Use such a tool to raise public awareness of the safe water issue throughout the world, use it to educate policymakers, use it to urge corporations, civic organizations, faith communities and private givers to focus on the opportunity to address the cause of development challenges, not just on the symptoms.

3) There is a bottleneck in delivering health-related products and services across the board. Think bednets, vaccines, pharmaceuticals. Also think safe drinking water, latrines, hygiene promotion programs. Although a debate emerged around the issue, the table’s thinking was that there is a reasonable amount of new, innovative and sustainable ideas in the water and health sector, and what is now needed are innovative ways of scaling those doable solutions up, out and over. One example was raised of using village health shops on a grand scale around the world to promote not just bars of soap but hygiene promotion messages. And the option of bolting on microfranchised water purification systems to such village health shops was discussed, as well as using these shops as a foundation from which to deliver social marketing techniques aimed at increasing the number of people with access to improved sanitation systems (e.g. pit latrines). And how about Trainers Without Borders to deal with some of the lack of institutional capacity to grow the sector?

4) Behind every commitment at CGI this year, and there have already been a LOT, there is an exceptional narrative story that if told eloquently and broadly will result not only in progress in the water sector, but additional such commitments at next year’s CGI.

More soon. However, a quick news flash: Bill Clinton announced in a press conference this morning that CGI intends to expand to Asia this year (they are shooting for a meeting in Hong Kong). One might consider lobbying CGI Hong Kong to make sure that the 700 million Indians without improved sanitation are represented, and that the 23% of Chinese (300 million!) without safe drinking water are well-represented in Hong Kong.

Clinton Global Initiative Part 2: Water!

Hot from the Press Office of the Clinton Foundation:

Opening Day of Third Annual CGI Brings Commitments in Every Focus Area Affecting Lives Around the Globe

One commitment caught my eye:

Procter & Gamble, working with partner organizations in the Children’s Safe Drinking Water program, will provide sachets to purify an estimated 2 billion liters of water. By using the easily accessible system, the program will help prevent 80 million days of diarrhea illness and save 10,000 lives by 2012. The $20 million project follows a 2006 commitment by P&G to work with partners to provide safe drinking water and hygiene education to 1 million children in Africa by 2009.

Great to see that first CGI commitment to water, building on P&G’s meeting its commitment from last year.

But wait…

The Dow Chemical Company will provide $30 million of loan guarantees to support the financing of up to 2,000 community water systems, serving 11 million people in India through WaterHealth International (WHI). For the past two years, WHI has provided sustainable, low cost community-based water systems to rural villages in India. WHI has installed 100 systems and partners with local NGOs to provide water and sanitation education. Dow’s commitment will help to extend WHI’s reach well beyond the current projections of 3,000 systems over the next five years.

And one more commitment to ponder:

Lalique will establish a fundraising campaign, BELIEVE, that will collect donations from a percentage of sales revenue taken from each brand’s exclusive products and services. Funds gathered from donations will be shared with an alliance of poverty alleviation charities that relieve the needs of people in developing countries. Lalique’s CEO, Guillaume Gauthereau, was inspired to make this commitment by remarks made at a CGI press conference in early 2007 where it was stated that $1 in the developing world is equivalent to $100 in developed economies. BELIEVE aims to raise $1 million to alleviate poverty.

Who wants to go see Monsieur Gauthereau and brief him on safe drinking water and sanitation, and its tremendous multiplier effect on sustainable development throughout the developing world?

I am surprised in this writing about how heavily weighted these commitments are toward the role the corporate sector plays in global development. Private foundations tomorrow perhaps.

And will tomorrow see a major CGI commitment to diarrhea? Sleepless night ahead…

Clinton Global Initiative Part 1: Water, water, nowhere

Sorry for the gap in posts – have been on the road a lot lately, including a couple of very interesting visits to water development groups in Guatemala – check out Agua del Pueblo here or google them to find out more about their work for those of you interested in Guatemala. They are primarily funded by a bilateral relationship with the Spanish government now, but looking to diversify and expand their work with water, sanitation and hygiene promotion.

I’m blogging today from right in the middle of the 2007 Clinton Global Initiative, waiting patiently for a direct mention of water, sanitation, hygiene, diarrhea, cholera, or anything… Throw me a bone people! There has been a great deal of optimistic, inspiring discussion in the plenary and breakouts so far from 52+ current and former heads of state and probably 1000 other people, representing 600+ commitments, tens of millions of lives impacted or saved, in over 100 countries.

Five significant commitments have been made public so far, the most interesting of which is the “Global Campaign to Reduce Maternal and Child Deaths in Poor Countries” launched by Norway’s Prime Minister Jens Stoltenberg with others.

Finally, a discussion early this afternoon in the Global Health session about Prime Minister Stoltenberg’s commitment elicited an interesting remark from CARE’s President and CEO Helene Gayle. She suggested that in order to meet the goals laid out by the Prime Minister, it is necessary to take a broader approach to child and maternal health, and focus on the causes of that mortality and morbidity – and she mentioned safe water and sanitation specifically.

More to come.

PS Off to question Jane Goodall about the nexus of biodiversity conservation (viz. great apes) and homo sapiens need for safe drinking water. See earlier related post here.

PPS Best quote ever: Development is about much more than safe water, but never about less.

Faecal Attraction Redux

Just when you thought it was safe to take the provenance of your drinking water and the disposal of your feces for granted, I give you:

Faecal Attraction: Political Economy of Defecation

This is worth three minutes of your time. Watch, then continue below...

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Unfortunately this lack of knowledge is not unique to India - most of us in the West would be hard pressed to answer the same questions with any more eloquence.

Here are a couple of select Youtube comments so you don't have to read through them all:

• Super! although it would be great if you also gave us the answers to the questions being asked...coz i don't know shit either(pun intended!)!
• Hmmm
• So...this wonderful video only offers the problem, not the solution. WHAT THE F___ IS THE SOLUTION? MAKE A VIDEO ABOUT THAT.
• this is nice probably they should put this on tv

Agreed that it belongs on TV (a 30 minute documentary in prime time would be a good start).

Agreed that the video only offers education and awareness-raising. For some answers to these questions (at least in the US), I offer:

From the U.S. Environmental Protection Agency:

"Drinking water can come from either ground water sources (via wells) or surface water sources (such as rivers, lakes, and streams). Nationally, most water systems use a ground water source (80%), but most people (66%) are served by a water system that uses surface water. This is because large metropolitan areas tend to rely on surface water, whereas small and rural areas tend to rely on ground water. In addition, 10-20% of people have their own private well for drinking water. To find the source of your drinking water, check your annual water quality report or call your water supplier."

Also visit EPA's Local Drinking Water Information page.

Now, where does your poo go?

The Water Environment Federation is a leading source of water quality information. They deal with the least sexy thing that we all take for granted: pipes - to bring us clean water and to take dirty water far away and treat it. WEF's newest campaign is called "Water is Life, and Infrastructure Makes It Happen."

WEF's job is to take the mystery out of where your poo goes. Click here for a nice Flash diagram of wastewater treatment - believe it or not this stuff is reasonably entertaining.

Be in the Know...Go With the Flow

So how do you solve the sanitation problem in many parts of the world? Here is a good start - from the most simple (latrines) to one of the seven wonders of the industrial world, London's sewage system.

And one of my perennial favorites: Sulabh International and their two-liter pour-flush latrines.

15,200 miles to go for safe drinking water

The New York Inquirer is duly impressed by several statistics associated with the Blue Planet Run: the 15,200 miles the BPR runners are putting in around the world to raise awareness of the global safe drinking water and sanitation challenge, over four continents and 95 days.

Even more meaningful statistics, however, compellingly link the issues of safe drinking water and human mobility:

• Poor women in Africa and Asia walk an average of six kilometers a day to collect water.


• Poor rural women in developing countries may spend eight hours a day collecting water, carrying up to 20 kilos of water on their heads each journey.

We have all seen and cooed at the glorious, romantic photographs of women in the developing world carrying those buckets of water on their heads with a baby strapped to their backs while dressed in colorful saris.



You think that’s romantic? You try it. A twenty liter bucket of water weighs 45 pounds, in some cases half the body weight of the woman carrying it. Add wild animals, snakes, and unduly interested men to the commute, and you’ve got a recipe for trouble.

The Blue Planet Run is performing admirably in raising ‘name recognition’ of the global health crisis of unsafe water and inadequate sanitation (which remains largely unreported in the U.S.) Name recognition will get an issue far, but not far enough (who hasn’t heard of Howard Dean?). It is up to everyone now to capitalize on the awareness that has been raised by the Blue Planet Run and move toward meaningful political and financial support:

• How can we keep each of the actors who designed sneakers for the campaign engaged in the issue (Hilary Swank, Courteney Cox, Rosie O’Donnell, Lance Bass, Alan Cumming)? Thanks to the Blue Planet Run they are now aware of this issue, and likely interested in doing more.
• How can we all encourage the New York Giants, also supporters of Blue Planet Run, to dedicate a day at the field to global safe water?
• How can the Blue Planet Run Foundation best prepare for its 2009 round-the-world footrace, which is expected to travel through the southern hemisphere? What can the world community do now to encourage the governments in the countries through which the 2009 runners will travel to greet those runners with increased budgetary commitments to water and sanitation infrastructure, particularly in rural communities? How many of those countries will commit at that point to universal coverage of water and sanitation (such as we enjoy in the US, Europe and Japan)?

Faecal Attraction

So I’m reading a book about poo, and its contribution to civilization. Somehow this got left out of my undergrad class on Western Civilization at Georgetown.

The book I reference is Poop Culture: How America Is Shaped By Its Grossest National Product. I haven’t reached the end yet, but I don’t expect any real surprises – I think I know how this one ends. It’s an awfully interesting read, with insights about poo that I hadn’t considered (or wanted to). We all would benefit by paying closer attention to this issue, and Poop Culture adds some interesting blue-sky approaches to human waste treatment that we should consider – e.g. converting it to energy.

Executives from the Water Environment Federation consistently and justifiably argue that what separates developed from developing countries is not human rights, respect for the environment, or Internet access but PIPES – unglamorous infrastructure. E.g. what happens to poo once it leaves the body?

My challenge is seeing that what happens to that poo around the world doesn’t result in unnecessary mortality and morbidity such as from diarrheal diseases. Over 2.6 billion around the world lack adequate sanitation facilities, or quite literally a place to go to the bathroom. This doesn’t mean that they are NOT going to the bathroom, but rather that 2.6 billion people do so in a way that often negatively impacts their health and the health of their neighbors, kids, passersby. Many organizations are struggling with a way to make this massive public health challenge more compelling. What would make it as cool to talk about poo/defecation/shit at cocktail parties as it is to talk about HIV/AIDS?

Dave Praeger’s book gives us a hint, or at least a lesson to be learned from history:

“By the end of the nineteenth century, state and social reformers in both England and America were working hard to spread the flush toilet across society and alleviate critical sanitary threats. Much of the strategy involved the state extending and maintaining modern sewer and water infrastructures, but reformers still needed to convince skeptics that the new bathroom technology was a boon and not a power-grab by the government. To overcome resistance in people who had been pooping in privies or chamber pots all their lives and were quite content with them, they associated health, happiness, refinement, and civilization with the flush toilet. The corollary of that, of course, was that people who didn’t use flush toilets were the opposite.”

This approach hits close to that of today’s social marketing experts, primus inter pares PSI. Social marketing is defined as “the systematic application of marketing alongside other concepts and techniques to achieve specific behavioral goals for a social good.” The bottom line is that 2.6 billion people need the health benefits associated with improved toilet facilities – the best way to make that happen may well NOT be preaching about those health benefits, but rather finding clever ways to make toilets/pit latrines more cosmopolitan, hip, cool, fun, refined, or alternatively to make it embarrassing to NOT have one.

So what can we learn from PSI’s approach and late nineteenth century America and England. Hopefully a lot – precisely zero people died from cholera in these two countries in 2007.

Comfortably Numb

Hello…hello…hello.
Is there anybody in there?
Just nod if you can hear me.
Is there anyone home?

The world’s gravest public health crisis is unsafe drinking water and inadequate sanitation. Diseases related to this problem kill 5x more kids than HIV/AIDS, and twice as many as malaria. Four billion cases of debilitating diarrhea occur each year, and diarrheal diseases alone kill well over two million kids on an annual basis.

So, the good news: The world came together last week at the Stockholm International Water Institute’s World Water Week to discuss precisely this issue.

And the bad news: the three of you who read this blog are hearing more about World Water Week through this medium than most other people through what I'll humbly call more popular media.

Those mainstream media may well tackle water and climate change, ocean conservation, the bottled water industry, water as a human right, privatization and related issues. But they shy away from unsafe water as the gravest – and most solvable – global public health challenge. This was manifested by the paucity of coverage of World Water Week in at least the U.S. media. Neither The New York Times nor The Washington Post had even a poorly-turned phrase on World Water Week. The only Associated Press story picked up (according to a Google news search) in the U.S. media focused entirely on bio fuels, never even mentioning the severity of this global problem. (Way to go John Sauer at Water Advocates for tracking this.)

Solving the world’s drinking water and sanitation crisis is difficult – it is not a soundbite or silver bullet issue. As my cohort Dennis Warner of Catholic Relief Services says, it’s not rocket science – it’s harder than rocket science. How long did it take to train your kids to wash their hands after they use the bathroom? Do you wash your hands after each trip to the john even today? What’s our water infrastructure financing gap in the U.S. up to now?

But solving this problem is possible. How many English die of cholera in 2007? How many Japanese die of diarrhea? How many Americans have guinea worm, schistosomiasis or malaria?

The unsafe water issue will soon drive the international development agenda itself – it’s unfortunately a matter of time before the media are forced to come to terms with this global challenge whether they like it or not.

I suggest instead that the 1.1 billion people without safe drinking water throughout the developing world need the U.S. and European media to lead the target. As the NYT looks to the FT for story ideas, and as the Economist looks to The New Yorker, one well-placed story on unsafe water as the world’s biggest cause of preventable infant/child mortality and morbidity will punch well above its weight (and win a Pulitzer or two, people).

Some get it: one particularly insightful, clever piece comes from Carl Ganter at the Pacific Institute’s Circle of Blue: Navigating the Mainstream: The Challenge of Making Water Issues Matter. Read it and visit Circle of Blue. Seriously.

Another: Gil Garcetti (yes, that Gil Garcetti) is now an amazing professional photographer covering the world’s water crisis. See his new book Water is Key.

Another: Matt Damon’s new movie Running the Sahara is scheduled for release this fall.

There are stories lined up - there are high profile testimonials lined up – there are convincing water experts lined up. If that’s not enough, there’s always the crushing grip of reason which is tightening. We need to act – there are billions of the world’s poorest waiting for their governments to properly prioritize this issue. There is an opportunity for the Western media to get out ahead of this issue and pull the world along.