Today is world toilet days and we are trying to understand Why is sanitation (still) an issue, and how do we knock the obstacles down?
Why are we promoting access to toilets today?
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Because we need to remind the world about one of the biggest child killers. Every day, around 1400 children, die of diarrhoeal diseases caused by poor sanitation and unsafe water. It is more than AIDS, malaria and measles combined. Inadequate WASH is also highly correlated with malnutrition.
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Because inadequate sanitation makes people sick and when people are sick, they can’t work. It also has repercussions on household members who provide care and compensate for the lost labor. Companies lose productivity as well. Learn more
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Because when people are sick they strain already weak health systems. Learn more
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Because when children are sick they can’t go to school. Water-related diseases cost 443 million school days each year, and children in poor health suffer from reduced cognitive potential. This hurts their prospects for future earnings and makes continuing poverty more likely. Learn more or see an example
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Because with no access to toilets at home, women and girls are exposed to harassment and rape. Earlier this year in india, two teenage girls had walked out together at night to relieve themselves. In the dark, they were attacked, gang-raped and killed. Learn more
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Because access to toilets includes reduction in pollution of water resources and land and positive impact on inland and coastal fisheries, water ecosystems more broadly, and land values; potential for nutrient reuse, e.g. faecal sludge for fertilizer or biogas generation; opportunities to expand tourism due to a cleaner environment and lower health risks. Learn more
So why is sanitation still an issue?
Sanitation is technically, socially and managerially complex. There are many problems including:
The Silence around sanitation
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taboos, beliefs and preferences: Some people avoid digging latrines at their homes for fear of witches. Some people believe that a divorced woman using a toilet brings a curse. Some people prefer to defecate in rivers because it will immediately clean the anus without using toilet tissue which is costly. Learn more
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Pitching sanitation in the newsroom: Water and sanitation is less glamorous than sport or politics so vital and well investigated stories on sanitation remain inadequate in the media. Learn more
The lack of political will or capacity
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Sanitation is not a vote winner: Most countries nowadays are representative democracies, which means that elected officials represent the population interests. Sanitation should be a priority but with no popular demand (Learn more on page 28) political leaders privilege education, health, jobs … As a result sanitation is low on the political agenda. Learn more on page 30
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When there is good political leadership, technocrats are sometimes “tone-deaf” or unequipped to align with political leadership. Learn more
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There is a lack of efficient planification (Learn more page 4), of financing (Learn more page 23 ), of monitoring to create evidence for better decision making (Learn more 17), of alignment between the different monitoring systems (Learn more), lack of Human resources (Learn more page 10 ) …
The lack of adequate infrastructures
- Expensive capital cost but high economic return. At the household level, toilets are (or perceived as) too costly to build in the first place compared to other priorities. However, Sanitation is an investment with high economic returns. Learn more
- The cost and technicality of operation and maintenance. Countries like Azerbaijan, Serbia and Tunisia indicated that the gap is not covered at all. Unrecovered costs may result in the lack of preventive and corrective infrastructure maintenance, and higher major capital replacement expenses in the future. Learn more
- A complex Sanitation Value Chain. Even if toilets are built the entire sanitation service chain – the collection, transport and treatment of human excreta – is usually not even considered, leading to risks for environmental and human health. In developing countries it is estimated that 90 % of all human excreta is released untreated into the environment. Learn more
- Beyond the households. Sanitation in health facilities and school is not a given: WASH in schools lacks attention despite its impact on children’s health, school attendance, particularly for girls, and its contribution to fostering lifelong healthy hygiene habits. Learn more
How can we knock the obstacles down?
For World Toilet Day (and beyond), many campaigns are organized to raise awareness and break the taboos:
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At global level: We can’t wait, End open defecation, the urgent run, parlons toilettes, Keep your promises
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At national level: the election campaign,
The good news is that we can all contribute to the campaigns! And some of campaigns are showing unprecedented impact with real behavior change. As an example, in the indian state of Haryana, Women won’t marry men who live in house without toilet “No toilet, no bride”. Read more stories
Many are raising the profile of Sanitation on the political agenda
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Partnerships, organizations and public figures have greatly raised the profile of sanitation in the past few years: WSSCC, WashAdvocate, WaterAid, Susana, Freshwater Action Network… working together in partnerships like Sanitation and Water for All and with incredible WASH leaders like Matt Damon, UN DSG Jan Eliasson, Presidents Ellen Johnson Sirleaf and President John A Kufuor
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The WASH sector has been working collectively and intensively to profile sanitation as a priority on the post-2015 agenda. (Learn more) and it looks like we are getting closer to the goal,
To conclude, sanitation is more than ever a global development priority “If people don’t invest in sanitation the costs are going to be incredible and health is going to be a big issue” reaffirmed Bruce Gordon, WHO. Much remains to be done. But the WASH community needs to be smart about the way forward. Are the current approaches really cost-effective? Are these advocacy campaigns not preaching the converted? Are countries and implementing agencies reaching the unreached? To answer those questions, the Water Youth Network calls upon young people not only to ask questions to learn as much as possible but most importantly to question the system in order to improve it.
More resources for the fun:
Article by Elisa Dehove with special thanks to Marie R Sagen for her contribution
Poster: Marie R Sagen and Ole M. Ødegaard