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Published on: 06/05/2011

Open defecation and unsafe latrines together account for a high toll taken by water-borne diseases in South Asia. In fact, between 2008 and 2011, that is, the interval between SACOSAN III held in New Delhi and SACOSAN IV that recently concluded in Colombo, 750,000 children under 5 succumbed to diarrhoea, dysentery and jaundice in the region. In spite of the 2008 Delhi Declaration by governments in South Asia recognising access to safe drinking water and sanitation as a human right at SACOSAN III, progress in sanitation remains tardy and uneven.

Although faring better than most in numbers, India manages only 68 per cent sanitation coverage for its people. Open defecation remains a major public health concern for the emerging economic superpower with 6 per cent of its GDP, (US $ 53.4 billion), wasted annually due to lost productivity, healthcare provision, and other consequences of poor sanitation - according to the World Bank’s Water and Sanitation Program (WSP) .

The SACOSAN series of conferences is an acknowledgement by governments in the region that investing in improved sanitation can bring down the expenditure on public health bills, as well as restoring the dignity of poor and excluded groups. Heightened awareness of the need for improved sanitation has spelt a new dawn for the peoples of the region, especially the poorest, underlined by the UN recognising this as a human right and countries in the region committing themselves to MDG 7.

This was illustrated by accounts from the front line. Himani Mistry from the Sunderbans of Bangladesh described how her village continued to face the problems wrought by natural disasters, especially due to saline water from the seas. Having realised that sanitation is a human right, Himani spoke of making others aware of it. To her, it meant being free of the constant scourge of skin diseases that were contracted during menstruation, and expensive treatment that had to be sought from far-off hospitals.

A girl in Bangladesh washes sanitary pads by hand. Menstrual hygiene issues are critical in South Asia

K. Rajamouli of Gangadevapalli (Andhra Pradesh) has led his village to achieve thestatus of total sanitation, become free from child labour and 100 per cent literate. His view was that communities cannot achieve this on their own. “Each community’s micro-plan needs to be supported by the government. Local bodies need to be capacitated to get the best results.”

Rajamouli’s prescription was more than vindicated by the success achieved by the Orangi Pilot Project of Pakistan, and the community led total sanitation approach that has enabled Bangladesh bring down open defecation from 42 per cent in 2003 to 6 per cent in 2011.

Lack of sanitation is not just troublesome. For women in patriarchal South Asia, it means suppressing a natural urge and making do with makeshift arrangements. In times of disaster, when people have to be bundled into overcrowded relief camps, women suffer most. 

The issue of WASH (Water, Sanitation and Hygiene) in schools was graphically depicted in a skit presented by Sri Lankan children. It was delightful to have adolescents overcome their diffidence and talk of an issue that prevents millions in South Asia from regularly attending school since they cannot relieve themselves in the open. Exclusion in the context of gender equity brought into focus the needs of the physically handicapped. Nepal’s success in introducing designs friendly for the wheelchair-bound inspired the other participating nations enough to have a special mention in the Colombo declaration on making provision for designs for the excluded.

It was also interesting to learn about how odour-free ECOSAN toilets could be used to replace the high carbon-emission pit latrines, and prove a boon in coastal areas and islands that have a high water table (since groundwater can easily be contaminated by human waste from latrines).

Opting for improved sanitation can also serve as a solution to the problem of untouchability that plagues Pakistan, India and Bangladesh, as is being done by Sulabh International through their network of toilets. It can also serve to uplift those who traditionally clean and maintain toilets and sewers. As a civil society professional maintained at the conference, “Why don’t we assign value to their services, and let them earn from maintaining public toilets?”

Interestingly, for a gathering of over 450 delegates from all over the region, debating on a millennium development goal with direct repercussions on public health, the media coverage and general publicity was abysmal. With the heads of state keen to increase allocations for sanitation, and SACOSAN set to be linked to the SAARC (regional cooperation) process, it is high time the media got interested.

Related web site: South Asia Conference on Sanitation IV

By Rina Mukherji, freelance journalist

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