By: Ramzan Chandio
KARACHI – In the total 2.8 million people affected in recent rains in 15 districts of the country, at least 1.4 million are children, who may fell victim to water-borne and other diseases, such as diarrhoea, malaria, measles, polio and pneumonia.United Nations International Children’s Emergency Fund (Unicef) has cautioned on Friday, pointing out that displacement due to damaged or destroyed homes is a serious concern for the health of vulnerable children, as the loss of access to safe water increases the likelihood of contracting and spreading water-borne and other diseases in rain-hit areas.Stating about their aid mission in the rain-hit areas, Unicef’s Deputy Representative for Pakistan, Karen Allen said here that Unicef has begun reaching 183,000 flood-affected people every day with safe drinking water in Punjab, Balochistan and Sindh provinces after heavy monsoon rains caused widespread flooding.
The Unicef response supports the government of Pakistan’s ongoing flood response in the worst-hit districts.Sharing the data, the Unicef said that the preliminary satellite imagery results from the Multi-Sectoral Initial Rapid Assessment – a joint initiative between the government and the humanitarian community–indicate that 2.8 million people in 15 districts have been affected by the latest floods, including 1.4 million children, of which 392,000 children are under the age of five.“Children from very poor families are among the worst affected by the severe flooding and they need our immediate help,” said Karen Allen, continuing, “the Unicef urgently needs $ 15.4 million to both scale up its water, sanitation and hygiene response to reach around 400,000 people over the next three to six months and to provide critical education, child protection, health and nutrition services.”Using funds from an emergency loan facility, Unicef and partners have begun providing safe water via water trucking to 59,000 people in Jacobabad and Kashmore districts of Sindh province, to 120,000 people in Jaffarabad and Naseerabad districts in Balochistan and 4,000 people in Dera Ghazi Khan district of Punjab province. The Unicef and partners have also installed water bladders in Jacobabad. In addition, 23,200 families in flood-affected districts of Balochistan, Sindh and Punjab will be provided with hygiene kits comprising soap, sanitary towels and water purification tablets this week, as well as jerry cans and water buckets to support safe water storage and prevent outbreaks of water-borne diseases.Unicef has also cautioned that displacement due to damaged or destroyed homes is a serious concern for the health of vulnerable children in terms of spreading water-borne and other diseases. Accordingly, in addition to responding by providing safe drinking water and sanitation, Unicef and partners are assisting the government with life-saving health and nutrition interventions.The Multi-Sectoral Initial Rapid Assessment results indicate that three quarters of children in five seriously affected districts are missing out on schooling, as schools have been damaged or destroyed or are being used to shelter displaced families. Unicef and partners are awaiting funds in order to establish temporary learning and protective spaces where children can continue their learning in a safe environment.“Some of the affected children are living in areas that are experiencing devastating flooding for the second or third time over the past three years, and these new floods have disrupted their recovery,” said Allen. “The government and humanitarian partners, including Unicef, are providing emergency assistance, but it is essential that we both continue and scale up the response to meet the huge needs of children and their families left vulnerable by these new floods. We are calling on the generous partnership of the international community to help us meet these needs,” Unicef concluded.
By Aoun Sahi
In July 2010, the General Assembly of UN adopted a resolution recognising that access to safe and clean drinking water and sanitation is a human right. Pakistan voted in favour of the resolution. This is not the first time that Pakistan has made such pledges on an international forum. In November 2008, during the third South Asia Conference on Sanitation (SACOSAN) Pakistan, along with other SAARC countries, not only admitted that access to sanitation and safe drinking water is a basic human right but also promised to include water and sanitation as a basic right in the constitution.
The other major commitments the government of Pakistan made during Delhi SACOSAN were to accord priority to sanitation, to improve conditions of sanitary workers, and to achieve MDGs on Sanitation in a time-bound manner. The Delhi declaration also promised to ensure basic access to sanitation facilities to all by reducing disparities through appropriate budgetary policies, with active participation, contribution, decision-making and ownership by communities.
SACOSAN is the only political platform in South Asia region that talks about sanitation. The overall goal of the SACOSAN process was to accelerate the progress of sanitation and hygiene in the south Asia region so as to enhance its peoples’ quality of life in realizing the MDGs.
The fourth SACOSAN is scheduled to be held in Sri Lanka from April 4 to 8 this year. So far, it seems all governments in the region, except Sri Lanka and Maldives, have failed to fulfill their commitment on sanitation. According to the WHO, 1.027 billion (64 percent) out of 1.595 billion in South Asia who do not use improved sanitation facilities and are exposed to severe health risks as well as adding to environmental pollution.
The urban-rural disparity in the use of improved sanitation facilities is another important concern. The majority of the people who do not have access to water are located in rural areas. In Pakistan, 72 percent urban population has access to sanitation facilities while the number is only 29 percent for the rural population.
Pakistan is committed to achieving the MDG target by 2015 of halving the proportion of people without sustainable access to safe and improved sanitation. Given the baseline of 33 percent improved sanitation coverage in 1990 according to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP), the MDG target for Pakistan is 67 percent improved coverage.
Both the costs associated with lack of access to safe water and basic sanitation and benefits derived from improved access are very important for poor people. The ratio of economic returns from every US $1 invested in water and sanitation is estimated at $9 in developing countries (WHO 2008). Despite these benefits, almost all countries in South Asia are off-track in achieving the sanitation related MDGs.
With the current rate of work on sanitation Pakistan will be able to achieve sanitation related MDGs by 2028 instead of 2015. Ironically, Pakistan’s national sanitation policy 2006 promises that 100 percent population will be served with sustainable access to improved sanitation. It is interesting to mention that during Delhi SACOSAN (2008) then environment minister of Pakistan, Hameed Ullah Jan Afridi, declared that Pakistan was not only well on its way towards meeting the MDGs target for sanitation, but would also surpass it soon.
Pakistan is amongst the countries with highest number of people with no access to improved sanitation facilities. There is little separation of industrial waste from municipal waste in Pakistan, with both flowing directly into open drains and then open water bodies. The Pakistan Strategic Country Environmental Assessment notes that nullahs and storm-water drains collect and carry untreated sewage which then flows to streams, rivers and irrigation canals, resulting in widespread bacteriological contamination.
About 2,000 million gallons of sewage is being discharged to surface water bodies every day. It notes that while some sewerage collection systems exist, collection levels are estimated at 50 percent overall in country (and only 20 percent coverage in rural areas), with only 10 percent effectively treated. Treatment plants exist only in a few cities, and few are fully functional. In katchi abadis, almost all wastewater is disposed of through open, unlined drains.
There is no formal solid waste management system that exists in rural areas. As villages grow and urban morphology shifts, this has become a growing problem in large villages and urban areas which are rapidly assuming an urban form. It is estimated that only about 50 percent of solid waste is actually collected with the remaining dumped at roadsides, in drains and at dump sites.
Collection efficiency varies and coverage in higher income areas is generally considerably higher than in low-income ones. Some 250,000 tons of medical waste is produced annually in Pakistan, and mixing of medical waste with municipal solid waste poses further problems. While hospital incineration practices are improving, this remains a serious issue. Agricultural and industrial waste also pose a serious issue. It is estimated that between 1000-1500 tons of outdated pesticides are in stock in Pakistan. Disposal of hazardous waste remains the responsibility of local governments that are ill-equipped to adopt consistent procedures or to regulate the private sector. Uncollected and unsafely disposed of waste poses a serious public health risk through clogging of drains, formation of stagnant ponds, and contamination of soil and water.
The Pakistan Strategic Environmental Assessment (World Bank, 2006) estimates, that of the costs to the national exchequer of environmental degradation, the highest is from water and sanitation. Child mortality in Pakistan remains high in relation to other countries. Although there has been a decline from 117 per 1000 live births in 1986-1990, to 94 per 1000 live births in 2002-2006 showing a 20 decline in 16 years, this still means that one in 11 children will die before reaching the age of 5.
Under-5 mortality is 28 percent higher in rural areas. Water and sanitation related diseases are responsible for some 60 percent of the total number of child mortality cases in Pakistan. It is estimated that the total health costs from these two diseases alone is Rs114 billion or 1.75 percent of GDP. NGOs working on water and sanitation in Pakistan are of the view that the cost to the national exchequer from these two diseases alone is far greater than the resource allocation to water and sanitation.
Access to improved sanitation for all seems a distinct dream at the moment as no political will is there to solve these issues. Our policy makers need to understand that they should spend money on improved sanitation facilities. Civil society organisations hope that Pakistan’s country paper in upcoming SACOSAN in Colombo will be based on ground realities and the government will accept that it has failed to fulfill its commitments made in Delhi SACOSAN in 2008.
Each day poses new threats and new questions for Jahan Ara, 33: Whether to eat food cooked beside the rolling sewage near her home or stay hungry and avoid disease? Whether to save money for a proper toilet or feed her children or send them to school? Her daily routine begins by gingerly walking over a narrow bamboo bridge to a ‘toilet’ that is perched precariously on stilts over a highly polluted lake. She cooks the family meals in her kitchen, which is barely five metres away from the toilet, and amongst all this filth, her kids manage to find some space to play in their free time.
Jahan Ara, who is six months pregnant, lives in a one-room shanty made of corrugated steel sheets in Dhaka’s largest slum located near the posh Gulshan Lake area of the Bangladeshi capital. Walking past the high-rise buildings, mega showrooms and sprawling homes that line both sides of the street in the heart of town, a sudden turn changes the scenario completely. The lanes become narrower and dirtier; instead of the concrete walls and glass windows are steel sheets with small holes cut out in them for windows.
This is the Korail slum, spread out over 90 acres of government land. According to Salina Bagom, Chairman of the Nogor Bostibashi Unnayan Songastha (Urban Slum Development Organisation), Korail came into existence about 25 years back and today has a population of 78,000. In the one-room, 100-200 sq. ft. dwellings, families with an average of five members, have created a life for themselves.
Unfortunately, the lived realities in these narrow lanes – no wider than three to five metres – are pathetic. For residents like Jahan Ara, spaces between lanes lined with steel sheets serve as bathing areas or kitchens. For her children, Shamim and Shahab, and their friends, these gullies double up as play areas, where they practice cricket regularly. And in these very narrow alleyways there are around 800 shops operating – be it a barber’s shop or a tailor’s, a general merchant or a medicine store. In fact, there’s also a dentist’s clinic, a community centre and a coaching centre here.
Nonetheless, when it comes to basic amenities, the 16,000 families of Korail are struggling. Not only are they grappling with severe sanitation and water problems, they don’t have any access to government-run health or educational institutions either. Says Abdul Mannan, a community leader, “The problem is that we are considered illegal residents and, therefore, we are not entitled to any government facilities like health, education, water, sanitation, and so on.”
Mannan is not wrong. A visit to Korail will reveal that it has just one government-run health centre, while there are no state schools at all. Of course, to fill in these service gaps, there are at least 30 formal and informal community-run schools functional in the slum as well as several local health ‘clinics’, though no one is sure of their authenticity. Obviously then, the health indicators are very poor here, with residents regularly suffering from debilitating ailments such as jaundice, skin infections and gastro-enteritis.
Dismal sanitation is the other big challenge in this area, one which especially affects the women and children. These days, a heavily pregnant Jahan Ara constantly fears slipping and falling off the narrow bamboo bridge on her way to the toilet, built after spending a precious BDT 1,000 (about US$ 13). In fact, more than 70 per cent of the slum dwellers, who do not have proper toilets, face similar insecurities.
Like their homes, the toilets-on-stilts, built over the Gulshan Lake, are steel sheets and bamboo structures. Fitted inside the small, one-square-metre space is a squat toilet fashioned with two heavy stones with a hole in the middle into which a four-inch plastic pipe is attached. The other end of this pipe opens into the lake.
Realising the urgent need for building proper toilets here, Salina Bagom, who has been working in Korail ever since the slum came into existence, and who acts as a bridge between the civil society organisations (CSOs) operating in the area and the local community, has facilitated the operation of a sanitation project, Advancing Sustainable Environmental Health, spearheaded by Dushtha Shasthya Kendra (DSK), a Bangladesh-based NGO, and supported by Water Aid, a UK-based charity organisation.
Under this project, 5,000 households are being targetted for toilet construction and hygiene promotion. The average cost of building a proper toilet comes to around BDT 10,000 (120 dollars) and the community is being motivated to contribute money to build one toilet among 10 households.
When Jahan Ara heard about this proposal, she eagerly volunteered to collect the funds. However, with only six families in her lane, it’s unlikely that her dream of a proper toilet will be fulfilled. “I am collecting money to get a proper toilet but do not know whether I will ever get one,” she wonders.
Jahan Ara’s husband, Abul Kalam, has a push cart and can manage to earn around BDT 5,000 a month. A major chunk of this money goes into buying medicines, because her children fall ill frequently. Whatever is left goes into buying food and water.
In Korail, residents have to buy drinking water, though they can ill afford it. Though there are plastic pipes with drinking water supply coming into the slum – incidentally, these have been laid in the filthy Gulshan Lake – this is not official. An arrangement has been worked out with private vendors, who have provided illegal water connections for which each family pays at least BDT 600 per month.
Says Kalam, “It is an irony that people living in well-to-do areas across the lake avail our services – we drive their cars, maintain their gardens and clean their houses – but none of them ever bother to think about us; of the dismal conditions in which we are leading our life.”
Life of dignity
Community leader Mannan also feels that such severe neglect on the part of government authorities can only mean that they may be thinking of getting the slum site vacated. However, he has a proposal in mind. “We are demanding that the government make multi-storey buildings on at least 20 acres of land where we all can live properly,” he says. And for this, the slum dwellers have filed a petition for a stay order in the court. Unfortunately, Mannan’s prediction has come true – recently, more than 2,000 shanties in Korail, and adjoining areas, were razed to the ground in an eviction drive carried out at only a few hours’ notice, rendering thousands homeless.
Jahan Ara has the final word: “Just because we are poor it does not mean that we do not deserve a life of dignity. We also need potable water and proper toilets. Even my children deserve a decent education and something as basic as a playground.”
Fri, Jul 13th, 2012 5:12 pm BdST
Nurul Islam Hasib
Dhaka—The government plans to raise awareness on water safety using textbooks in primary students to prevent infectious diseases that experts say can cause malnutrition.
Zuena Aziz, Additional Secretary at the Ministry of LGRD, said from the next year the back cover of the science book of class III, IV and V would be printed with pictorial messages on water safety.
“We have requested the Ministry of Education, they told us they will do it from the next year,” she said at a workshop on developing action plan for ‘improving hand washing behaviour linked to child feeding’ on Thursday.
Experts say many of the diarrhoea and respiratory infections of children under 2 years of age in Bangladesh are preventable if mothers and caregivers wash their hands with soap before feeding babies homemade food after six months of age.
But research suggests scanty knowledge about the link between hand washing and infectious diseases. An Alive & Thrive and ICDDR,B joint research showed over 80 percent mothers of under-2 children do not believe washing hands with soap before food preparation and feeding the child can check diarrhoea.
It also found almost none knew the link between respiratory infections –cough, cold, pneumonia – and hand washing.
Dr Khairul Islam, Country Director, Wateraid Bangladesh, told bdnews24.com that infections stunted children’s growth with severe burden of malnutrition despite progresses in different health indicators.
He said there were systems to follow from water collection to drinking to avoid contamination.
For instance, he said water might be contaminated even after it was safe at the source point ‘if the pot or pitcher is dirty.’
“Even after maintaining all measures water can be contaminated during serving, if proper attention is not given.”
He spoke of restaurants where waiter usually serves at least five glasses of water at a time dipping each finger in each glass.
“There are five points of water safety protocol,” he said, “from collection, transportation, storage, serving, to drinking.”
As Wateraid works closely with the Ministry of LGRD, the Country Director said the pictorial messages on the back of textbooks would focus on those five points.
According to Bangladesh Demographic and Health Survey, 36 percent children under-5 are underweight, 41 percent stunted and 16 percent wasted or too thin for their height.
The National Nutrition Services is developing the action plan with the help of Alive and Thrive to ensure hand washing before child feeding.
August 08, 2012
KATHMANDU-The first national summit on drinking water and sanitation concluded on Tuesday with a Kathmandu Declaration urging the concerned actors to work together to achieve the national target of universal access to sanitation by 2017.
The two-day meet was jointly organised by the Federation of Water and Sanitation Users’ Nepal (FEDWASUN) and various government, non-governmental and donor agencies working in the sector.
The declaration stresses the need to work together and strengthen the coordination in areas such as participatory policy-making, capacity enhancement of the sanitation user groups, institutional development of FEDWASUN, and implementation of the programmes and services through the users’ network. Promotion of social campaigns on sanitation and cleanliness, and documentation of vital achievements in the sector are among other priorities of the declaration.
According to the statistics provided by the Department of Water Supply and Sewerage (DWSS) under the Ministry of Physical Planning and Works in 2010, still around 57 percent of the total population is deprived of basic sanitation facilities and around 20 percent people lack access to safe drinking water. A majority of the existing water supply infrastructure is either dysfunctional or lacks proper repair and maintenance.
Kamal Adhikari, sociologist at the DWSS and writer of the book ‘Sanitation in Nepal—Past, Present and Future’ launched during the summit, stated that the efforts for mainstreaming the strengths of communities in the sanitation sector activities are methodologically weaker.
Most of the programmes, he alleged, are the continuation of customary works of organising rallies and processions, gatherings and distribution of pipes and pans for latrines in public functions and the results are almost futile.
“There is a need for increasing the capacities, skills and facilities, and enabling institutional set-up to let the people internalise the values of sanitation and empower them to develop positive behaviours,” said Adhikari.