Why did the toilet paper roll down the hill? To get to the bottom.

Why did the toilet paper roll down the hill? To get to the bottom.

Has that joke left you flushed with amusement? Or was it a flash in the pan? Do you feel you got a bum deal from a supposedly serious editorial? Puns and humour abound whenever toilets or poop come into the conversation, and that’s understandable: over the last couple of hundred years the natural, inevitable act of defecation has been locked out of polite society, to be talked about only with humour or embarrassment. As India’s Rural Development Minister Jairam Ramesh recently said that “when we talk about sanitation we can only giggle.”

But that is about to change, because today is the first ever UN-endorsed World Toilet Day.

A latrine stands alone in the expanded area of Kobe refugee camp in Dolo Ado refugee camp
A latrine stands alone in the expanded area of Kobe refugee camp in Dolo Ado refugee camp © UNICEF Ethiopia/2012/Ose

That may make you laugh too. After all, there are UN days for Africa Industrialization, Philosophy and Television, and that’s just in November. But behind the humour of toilets and pooping, there are some deadly serious facts and figures that make it obvious why 100 countries – from Afghanistan to Viet Nam – came together earlier this year to pass the resolution that enshrined an official UN World Toilet Day for the first time in history. Here is one figure: 10 million viruses. That’s the number that can be found in only one gram of human faeces. Here is another: 2.5 billion. That’s how many people around the world still have no decent sanitation. One billion of them must do something called “open defecation”, or pooping in the open, in fields, on roadsides, on railway tracks. Every day, nearly two billion tons of human faeces, with a dizzying number of potential viruses, bacteria and worm eggs, are lying around our planet ready to be trodden on, touched or ingested in water and food. The consequences are easy enough to calculate: Diarrhoea, caused by that contaminated food, water and environment, is still the second deadliest killer of children in the world, killing 1,600 children every day. Only pneumonia and respiratory infections are more deadly (by the way, World Pneumonia Day is in November too). Women and girls get a particularly raw deal, having to find somewhere safe to defecate in darkness for modesty’s sake, putting them at risk of rape and animal attacks (linked to another UN day in November focussing on violence against women). That children are dying from something as seemingly trivial as diarrhoea, or girls are getting raped because they have to find somewhere to do their toilet business: neither of those facts should make you giggle (International Children’s Day is also in November).

Yet the attention and funding given to sanitation and diarrhoea – which is easily preventable with adequate sanitation, safe water and good hygiene – have for decades been dwarfed by that given to other causes and challenges such as HIV/AIDS. When the Millennium Development Goals – a set of targets to reduce poverty and better maternal health and education amongst other things – were signed in 2000, sanitation wasn’t even mentioned. (It was added in the 2002 Johannesburg summit.)

Kanu Fanta, 30, mother of 6, washes her hands at a latrine at her house
Kanu Fanta, 30, mother of 6, washes her hands at a latrine at her house in Amari Yewebesh Kebele of Amhara Region in Ethiopia © UNICEF Ethiopia/2013/Ose

Luckily, there is much more to celebrate now than ten years ago. Since 1990, 1.9 billion people have gained access to improved sanitation (although population growth means the number without scarcely changed). Even so, on average, 26,000 Africans gained access to sanitation every day, and there are 244 million fewer people defecating in the open worldwide. Also, we’re doing our sums better. The World Bank’s Water and Sanitation Program has launched an Economics of Sanitation Initiative that is producing figures to dazzle any treasury minister, calculating that a country can lose 1.5% of its GPD to costs incurred by poor sanitation (economic loss, hospital costs. Kenya loses $324 million a year in this way. India is $54 billion out of pocket (that’s the entire GDP of Croatia). But we can look at those figures from another angle: if we can figure out how to install adequate sanitation for 2.5 billion people, we can save $260 billion a year. Investing $1 in installing sanitation can save up to $5 in economic losses avoided. No matter how you do your sums, that’s a bargain.

Other cheering connections are being made between sanitation and other fields and departments. After research showing that sometimes up to a quarter of schoolgirls drop out of school permanently because of the simple lack of a toilet (usually when they begin menstruating), WASH – water and sanitation and hygiene – in Schools initiatives have multiplied. Experts in malnutrition now understand that sanitation plays a vital role in both the problem and the solution. Improving sanitation can reduce stunting and improve nutrition, the economy and development.

So do laugh by all means. All these new connections and understandings are causes for jubilation, and World Toilet Day is a wonderful way to celebrate them. It’s also a new spotlight on a public health crisis that has been hidden by shame for far too long. If jokes work at getting people to turn their attention to sanitation, let’s keep telling them.

Michel Jarraud, Chair of UN-Water, and Secretary-General of the United Nations World Meteorological Organization (WMO)

Hon. Anna Kajumulo Tibaijuka, Minister of Lands, Housing and Human Settlements Developments, United Republic of Tanzania, and Chair of the UN-hosted Water Supply and Sanitation Collaborative Council (WSSCC)

HRH Prince El Hassan bin Talal, Chair of UNSGAB, the United Nations Secretary-General’s Advisory Board on Water & Sanitation

Preterm babies may be saved with simple inexpensive measures

Preterm birth is a global problem affecting families across the world. More than 60% of preterm births occur in South Asia and sub-Saharan Africa. However, the problem of preterm births is universal, with both the United States and Brazil ranking among the top 10 countries with the highest number of preterm births in the world.

Nearly 3 million babies are born every year in Ethiopia and 10% of them are born prematurely or with low birth weight. Newborn death contributes to 42% of under-five mortality. (EDHS2011) Preterm babies are the most vulnerable and at risk of death and disability within minutes of birth.  Preterm birth is a leading cause of newborn mortality globally as well as in Ethiopia.

A premature baby born in Yekatit 12 hospital
A premature baby born in Yekatit 12 hospital ©UNICEF Ethiopia/2011/Pudlowski

More than 75 per cent of preterm babies may be saved with simple inexpensive measures that do not need high technology.  Quality of care and competent health care providers, particularly skilled birth attendants, are essential requirements for providing care for both mother and baby. Many complications can be prevented by focusing on care during pregnancy, labour, birth and days after birth – a critical time to save lives of women, new-borns, and prevent stillbirths. Essential new born care including warmth, hygiene and feeding is important for all newborns but especially for those born premature.

UNICEF Ethiopia together with its partners is supporting the following intervention strategies which include care of the preterm babies

  • Integrated community case management: more than 29,500 HEWs (Health Extension Workers) are trained in extra care of the premature baby and resuscitation skills over the last three years
  • Community Based Newborn care by HEWs (launched March, 2013) that mainly focuses on preterm management, antibiotic treatment for infections and asphyxia management.
  • Establishing and supporting Newborn Care Corners in health centres and Neonatal Intensive Care Units in key referral and teaching hospitals

World Prematurity Day is observed on 17 November 2013. This year, World Prematurity Day will also highlight the important work of the Every Newborn Action Plan, that aims to improve newborn health and to reduce maternal and child mortality by uniting the work of all actors, including parent and community groups. Learn more at www.everynewborn.org

Protect the Goal: NO CHILD SHOULD BE BORN WITH HIV/AIDS

Sport has great appeal to young people, who are particularly at risk of HIV infection, and can be an avenue to convey life-saving messages. Sport leagues and matches bring communities together, providing an ideal space for AIDS awareness campaigns on prevention reaching large numbers of people.

Federal Ministry of Health, UNAIDS and UNICEF have developed a Public Service Announcement (PSA) featuring the Ethiopian National Team. The video which conveys the message “ Protect the Goal: NO CHILD SHOULD BE BORN WITH HIV/AIDS” has been aired on Ethiopian National Television (ETV). Waliya’s captain Degu Debeb in the PSA calls on every one “to play a role that no child should be born with HIV/AIDS”.

Ethiopia and its partners working together to achieve MDG 5

By Loza mesfin/WHO

Anneka Knutsson, Head of Development Cooperation (SIDA), signs ‘Accelerating Progress for Maternal and Newborn Health’ programme document
Anneka Knutsson, Head of Development Cooperation (SIDA), signs ‘Accelerating Progress for Maternal and Newborn Health’ programme document © WHO/2013/Loza Mesfin

Five United Nations agencies, known as UNH4+ (UNAIDS, UNFPA, UNICEF, UN Women and WHO) and the Federal Ministry of Health signed an agreement with the Government of Sweden (through the Swedish International Development Agency – Sida) on the work plan for a joint project on reproductive, maternal, newborn and child health in Ethiopia, 2013-2015. The signing ceremony took place in the presence of Hon Dr Kesetebirhan Admasu, Ethiopian Minister of Health, at the African Union Conference Center during the historic International Conference on Family Planning.

Speaking at the signing ceremony, Dr Kesetebirhan appreciated the support of development partners in the Government’s efforts to reduce maternal and newborn mortality. He further expressed his satisfaction at how the partnership is supporting the Government’s initiative, with the Government in the driving seat. “With such country ownership and continued support of partners, the achievement of MDG 5 is not out of reach,” he underscored.

WHO Representative, Dr Pierre M’pele speaks at launch of joint project on reproductive, maternal, newborn and child health in Ethiopia,
WHO Representative, Dr Pierre M’pele speaks at launch of joint project on reproductive, maternal, newborn and child health in Ethiopia,

Also speaking at the event, WHO Representative, Dr Pierre M’pele recalled that Ethiopia has already achieved MDG 4 two years ahead of schedule by reducing child mortality rates, and affirmed that the joint program comes “At the right time to strengthen the partnership of the UN agencies delivering as one and Sida with the Federal Ministry of Health to work together to achieve MDG 5.”

In its endeavor to maximize the impact of its support to the Government of Ethiopia, the United Nations Country Team (UNCT) is working with the principle of Delivering as One and strengthening joint efforts of the UN agencies in advancing priority areas within the development agenda. Both the Government of Ethiopia and the UNCT recognize maternal and newborn health as one of the top priority areas that require the concerted efforts of all stakeholders in the few years remaining of the MDGs. This work plan for the Sida/H4+ grant contributes to filling gaps in the current joint efforts by UN agencies in supporting the FMOH for implementation of the National Road Map for Accelerating Reduction of Maternal and Newborn Mortality and Morbidity, and thereby pave the way for Ethiopia to meet MDG 5 of by 2015, reducing maternal mortality ratio and increasing access to reproductive health.

This blog post is extracted from World Health Organization Ethiopia Country Office media release.

Ethiopia takes action against rotavirus

In September, Ethiopia and UNICEF announced that the country had reduced its under-five mortality by two-thirds between 1990 and 2012 – the required reduction for meeting the target of Millennium Development Goal 4 (MDG 4) on child survival.

“Ethiopia is becoming a development leader on the African continent, the success is driven by political commitment, advances in science and technology and improvements in health, nutrition and family planning services, particularly in the rural areas,” said Peter Salama, UNICEF representative in Ethiopia. Read more

Ethiopia Set to Save Children from Diarrhoea

This content originally appeared on newbusinessethiopia.com

Minister of Health, H.E. Dr. Keseteberhan Admassu makes official launching statement of Rotavirus Vaccine introduction to Ethiopia“Diarrhoea takes the lives of more than 38,500 Ethiopian children under-five each year, rotavirus being responsible for close to two-thirds of the deaths,” said Ethiopia’s Minister of Health Dr Admasu Kesetebirhan. “Providing rotavirus vaccines to our children and integrating them with appropriate diarrhoeal disease control interventions will further support our efforts to reduce child mortality.”

Ethiopia has undertaken significant work to introduce the rotavirus vaccine nationally. It has significantly expanded its cold chain facilities nationwide and deployed health extension workers to provide immunisation services in each village with at least 5,000 people, in a country with 84 million people spread across 1.1 million square kilometres.

“Ethiopia is becoming a development leader on the African continent, the success is driven by political commitment, advances in science and technology and improvements in health, nutrition and family planning services, particularly in the rural areas,” said Dr Peter Salama, UNICEF representative in Ethiopia. Read more

Rotary International guests from US and Canada visit UNICEF Ethiopia to support polio eradication efforts

By Shalini Rozario

Group photo: Rotary International guests from US and Canada visit UNICEF EthiopiaOn 12 November 2013, members of Rotary International’s Polio Advocacy Group paid a visit to UNICEF Ethiopia to meet with Dr. Peter Salama, UNICEF Representative, to discuss the status of the wild polio virus circulation within the Horn of Africa and to learn more about UNICEF activities and contribution.

UNICEF welcomed the visitors with much appreciation for their dedication and interest in immunization efforts. A presentation was given by Dr. Salama on the overview of UNICEF response alongside a short film on community engagement for polio immunization highlighting communication activities supported by polio partners including Rotary International and the National Polio Plus Committee. Following the presentation, the discussion included topics such as access challenges to reach remote communities; flexible funding for the evolving outbreak and how broader strategies could help to maximize large scale community participation and support to polio, routine immunization and child survival generally.

Community Engagement for Polio Immunization in Ethiopia

The Rotary Advocacy Group is part of a larger group of 45 Rotarians from the United States and Canada who are visiting Ethiopia this week to demonstrate their interest and support for the polio eradication efforts.

Globally, Rotary International has supported polio eradication efforts for the last 34 years and is one of the Global Polio Eradication Initiative Partners alongside the World Health Organization, US Centers for Disease Control and Prevention and UNICEF.

See photos from the visit here.