Safe sanitation needs mindset change in Pakistan

from One World net

Mir Ghulam Shah

Until just a year ago, Jan Bibi and her five daughters aged between 6 and 18, began their day by getting up before sunrise, walking a couple of hundred metres from their home to a filthy enclosed communal space, digging a small hole and relieving themselves. The alternative was to find some thick bushes and tell someone to watch out for prying eyes.

In this primitive manner the women of Mir Ghulam Shah village in Sanghar district of Sindh Province, 300 km east of Karachi in Pakistan, answered nature's call.

In 2007, however, the Sindh Agricultural and Forestry Workers' Coordinating Organisation (SAFWCO) began building 289 low-cost toilets in eight villages. Her uneducated husband, Fazal Din, a farmer, decided to pay.

He still defecates in the field, believing that the latrine in his house is for the womenfolk.

Of paramount concern for him was that his daughters were harassed by males watching them while they relieved themselves.

Their latrine, in the far corner of their courtyard with a supply of water from the hand-pump (also installed recently), means that they no longer have to spend hours fetching water from the nearby canal. It has also made life easier during their monthly periods.

"Now all my worries are over," 45-year-old Bibi said. "Even if it's raining I don't have to fear stepping into a ditch of shit."

In September 2000, the United Nations General Assembly adopted the eight Millennium Development Goals that challenged the global community to reduce poverty and increase the health and well-being of all people.

In September 2002, the World Summit on Sustainable Development in Johannesburg reaffirmed these goals and added access to basic sanitation as a centerpiece of the poverty eradication commitments.

The target to halve the proportion of people without access to basic sanitation by 2105 was defined in the Johannesburg Plan of Action (JPOI).

The twelfth session of the United Nations Commission on Sustainable Development (CSD-12), held in New York in April 2004, reviewed the state of implementation of the goals and targets in the thematic areas of water, sanitation and human settlements.

On the basis of that review, CSD-13 in April 2005 recommended policy actions to be implemented by member States in addressing these challenges.

The international community will review progress towards the implementation of these recommendations during CSD-16 in May 2008.

Despite significant efforts by governments, progress on sanitation targets has been slow and uneven.

Recognising the impact of sanitation on public health, poverty reduction, economic and social development, and the environment, the General Assembly decided to declare 2008 the International Year of Sanitation.

The General Assembly encouraged member States as well as the United Nations system, to take advantage of the International Year to increase awareness of the importance of sanitation to promote action at all levels.

Low awareness

Lack of basic hygiene awareness is partly to blame for the fact that some 4,000 young children across South Asia die each day of a preventable disease like diarrhoea.

This situation could be improved (and hefty medical bills avoided) simply by following the golden rule of sanitation - hand-washing with soap after defecation and before eating.

The numbers

Although access to improved sanitation in South Asia has more than doubled from 17% in the 1990s to 37% in 2004, according to UNICEF and the World Health Organization, coverage remains low, with two out of three people still lacking basic sanitation.

This translates into 2.6 billion people (40% of the world's population) around the world without access to basic sanitation facilities, of which 1.9 billion are in Asia (900 million in South Asia).

In Pakistan an estimated 54% of the population has access to sanitary latrines (86% urban and 30% rural), according to government statistics.

However, this data masks the problem in rural areas where most of the country's over 150 million inhabitants live.

According to the Pakistan Institute of Development Economics, by 2015, 52.8 million people would be without safe drinking water and 43.2 million would have no access to adequate sanitation facilities.

And while Britain's Department for International Development (DFID) says Pakistan is largely on track in achieving its MDG to half the population without access to improved water and sanitation by 2015, the fact remains that more will be needed.

A survey of sanitation facilities in the country by Pakistan's Ministry for Environment revealed that only 0.08% of the country's GDP was spent on sanitation during the fiscal year 2002-2003, 0.09% of GDP during 2003-2004, and 0.1% during 2004-2005.

These allocations were insufficient to meet development targets in the water and sanitation sector, the report said.

With its National Sanitation Policy 2006, Pakistan aspires to create "an open defecation-free environment", but it is going to be an onerous task if almost 70% of people in rural areas are currently without latrines.

Mindset change

The reason why so many people do not have latrines cannot always be explained by financial constraints. As one woman put it aptly, "it is the poverty of our minds" that keeps them from adopting safe excreta disposal methods.

Working with rural communities for two decades, Suleman Abro, director of SAFWCO, knows all too well that behaviour change does not happen overnight. Neither can it be imposed.

"You have to bring people to the point when they begin to think it's an important issue, otherwise it's an exercise in futility," he said.

Mindful of that, the Rural Support Programme Network, one of Pakistan's leading NGOs - with access to rural communities in 93 districts - did just that when it initiated its Community-Led Total Sanitation initiative to end open defecation.

In this no-subsidy approach, volunteers from the community involve people in a sanitation drive and prod them into realising how harmful and disgusting their toilet habits are. This results in a desire to invest in a latrine and to stop littering.

A simple strategy that started in Bangladesh, and which caught on in India, is now gaining ground in Pakistan too, as well as in Indonesia, Cambodia and Nepal.