Lack of toilets dangerous for everyone, UNICEF says

Girls' toilet at Beseka ABE Center in in Fantale Woreda of Oromia State
Girls’ toilet at Beseka ABE Center in Fantale Woreda of Oromia State ©UNICEF Ethiopia/2014/Ose

NEW YORK/Addis Ababa, 19 November 2014 – Slow progress on sanitation and the entrenched practice of open defecation among millions around the world continue to put children and their communities at risk, UNICEF warned on World Toilet Day.

Some 2.5 billion people worldwide do not have adequate toilets and among them 1 billion defecate in the open – in fields, bushes, or bodies of water – putting them, and especially children, in danger of deadly faecal-oral diseases like diarrhoea.

In 2013 more than 340,000 children under five died from diarrhoeal diseases due to a lack of safe water, sanitation and basic hygiene – an average of almost 1,000 deaths per day.

“Lack of sanitation is a reliable marker of how the poorest in a country are faring,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene (WASH) programmes. “But although it is the poor who overwhelmingly do not have toilets, everyone suffers from the contaminating effects of open defecation, so everyone should have a sense of urgency about addressing this problem.”

The call to end the practice of open defecation is being made with growing insistence as the links with childhood stunting become clearer. India, with 597 million (half the population) practising open defecation, also has high levels of stunting. Last week, UNICEF convened a conference in New Delhi called ‘Stop Stunting’ to call attention to the effect of open defecation on the entire population, particularly children. UNICEF’s ‘Take Poo to the Loo’ campaign in India also works to raise awareness of the dangers associated with open defecation.

Asfaw Legesse a model in his community washes his hand after using a latrine.
Asfaw Legesse a model in his community washes his hand after using a latrine. ©UNICEF Ethiopia/2014/Sewunet

“The challenge of open defecation is one of both equity and dignity, and very often of safety as well, particularly for women and girls,” Wijesekera noted. “They have to wait until dark to relieve themselves, putting them in danger of attack, and worse, as we have seen recently.”

Compared to other African countries, Ethiopia has made huge progress in reducing open defecation rates from 92 per cent in 1990 to 37 per cent in 2012. The Joint Monitoring Programme (JMP) 2014 report from UNICEF/WHO confirms that Ethiopia is leading the charge in Africa in reducing open defecation.The community total sanitation and hygiene approach, supported by UNICEF and utilizing the 38,000 Health Extension Workers in the country, has greatly contributed to this success.

“The challenge of improving sanitation levels to ensure that the minimum standards of toilet construction remains in many rural areas across Ethiopia. With the rapid urbanisation of the country there is also a need to “reinvent the toilet” to make it affordable, durable and appropriate for high density urban dwellings. UNICEF is advocating for these, and greater focus on toilets in schools and health centres nationwide, to ensure greater access to improved sanitation,” said Patrizia DiGiovanni, Acting Representative of UNICEF Ethiopia.

UNICEF’s Community Approaches to Total Sanitation addresses the problem at the local level by involving communities in devising solutions, and has led to some 26 million people across more than 50 countries abandoning the practice of open defecation since 2008.

Eighty-two per cent of the 1 billion people practising open defecation live in just 10 countries: India, Indonesia, Pakistan, Nigeria, Ethiopia, Sudan, Niger, Nepal, China, and Mozambique. The numbers of people practising open defecation are still rising in 26 countries in sub-Saharan Africa, though they have declined in Asia, Latin America and the Caribbean. In Nigeria, numbers of open defecators increased from 23 million in 1990 to 39 million in 2012.

Globally, some 1.9 billion people have gained access to improved sanitation since 1990. However, progress has not kept up with population growth and the Millennium Development Goal target on sanitation is unlikely to be reached by 2015 at current rates of progress.

The inter-governmental Open Working Group on the post-2015 Sustainable Development Goals have recommended that the new goals include a target of achieving adequate and equitable sanitation and hygiene for all and ending open defecation by 2030.

Safe water and sanitation services for South Sudanese mothers and children

By Demissew Bizuwerk

Fetching safe drinking water in Tirgol town
South Sudanese asylum seekers fetching safe drinking water in Tergol town, Gambella region of Ethiopia ©UNICEF Ethiopia/2014/Bizuwerk

TERGOL, AKOBO WOREDA (GAMBELLA REGION), 15 March, 2014- As the searing heat of the afternoon sun begins to ease, a group of women carrying jerry cans and plastic buckets start to descend into a small compound where they have access to clean water from two water points. The small compound is one of two sites where UNICEF has installed two emergency water treatment facilities (EMWAT kits) through its implementing partner, ZOA International, in Tergol town, in the Akobo district of the Gambella region, western Ethiopia.

Tergol is a small town by the Akobo River that marks the border between Ethiopia and South Sudan. Tergol has been under the spotlight since mid-December last year after thousands of South Sudanese asylum seekers crossed over into the town after being displaced by conflict in Africa’s youngest nation.

According to UNHCR, close to 66,000 asylum seekers crossed into Ethiopia by the beginning of March 2014. Akobo has received 34 per cent of this number, which is the second largest arrival rate after Pagak where 33,000 South Sudanese civilians displaced by conflict have entered. These asylum seekers are in a critical situation and need immediate humanitarian assistance including the provision of clean drinking water and sanitation services.

In Tergol, the host community has entirely depended on the Akobo River for its water needs as there has never been a facility to provide safe drinking water. However, this situation has been recently improved. With UNICEF’s support, EMWAT kits have been built and are now supplying clean drinking water to the Tergol community as well as to the thousands of South Sudanese asylum seekers. Water from the nearby river is purified and supplied by the first reservoir built by the emergency kit, the purified water is then transferred into a second reservoir where it is chemically treated before it is reticulated to the water access points. Each EMWAT kit has a capacity for providing 20,000 litres of clean water and the kits can be re-filled every two hours depending on the rate of demand.

Safe water for mothers and children

Nyathak Minyjang (with black dress), one of South Sudanese asylum seekers, comes to the water point at least three times a day.
Nyathak Minyjang (with black dress) comes to the water point at least three times a day. She fetches water for cooking, bathing and drinking. The emergency water treatment facility which is built with the support of UNICEF provide clean drinking water to South Sudanese asylum seekers and the host community in Tergol ©UNICEF Ethiopia/2014/Bizuwork.

While the women gather around the water points, they talk to each other as clean water fills their buckets and jerry cans. The women then help one another to balance the vessels on top of their heads.

When it is Nyathak Minyjang’s turn, a 25-year-old mother of four, she places her plastic bucket under the tap and holds the hose down to pour in the clean water. Prior to the response, Nyathak had lived on the South Sudan side of Akobo before coming to Tergol with her four children. Her only previous access to water was a river. She never imagined that she would have access to clean drinking water from a tap. “We used to drink water from a river. My children would regularly get sick and I would get sick too”, she says. “The quality of the water here is very nice.” Nyathak comes to the water point at least three times a day.  She fetches water for cooking, bathing and drinking. Most importantly, she applies the lessons she learnt about personal hygiene from community hygiene promoters. She is also keen to keep her children clean.

Nyarout Gazwech, a 21-year-old mother of two boys, is also very happy about the supply of clean water. She came from the South Sudan city of Malakal a month and a half ago, leaving her two brothers and her mother behind when the conflict intensified.  During her long trek to Tergol, she and her children had no option but to drink unsafe water. “My children were having diarrhoea after drinking the river water.  Here we have clean water and my boys will not get diarrhoea again,” she says.

Comprehensive WASH approach

UNICEF in partnership with UNHCR, the Government Administration for Refugee and Returnee Affairs (ARRA), the Gambella Region Water Bureau, and its implementing partner ZOA supports the provision of safe water to the host community and asylum seekers in Tergol. UNICEF’s response has followed its Water Sanitation Hygiene (WASH) strategy by increasing equitable and sustainable access to safe water and basic sanitation services, as well as promoting improved hygiene in Tergol.

“We are providing clean water to the asylum seekers and to the host community. Furthermore, we teach them about safe hygiene practices such as the importance of hand washing and using latrines,” says Nigussie Yisma of ZOA who is coordinating the WASH interventions in Tergol.

Apart from Tergol, UNICEF also supports WASH interventions at the entry point in Pagag and in the Lietchor refugee camp. One EMWAT kit has been installed at the Pagag entry point and is providing clean drinking water to the asylum seekers and the host community.  Similarly, five shallow water wells have been drilled in the Lietchor refugee camp to increase access to a sustainable source of clean water for the refugees.  Moreover, water purification chemicals and emergency sanitation facilities are being distributed while hygiene promoters continue teaching the community and asylum seekers about safe personal and environmental hygiene practices.

Local capacity building

A women in Tergol town, Akobo Woreda, carries water to her home.
South Sudanese asylum seeker in Tergol town, Akobo Woreda, carries water back from a water point built with the support of UNICEF ©UNICEF Ethiopia/2014/Bizuwerk

When the emergency response was launched in January 2014, community hygiene promoters were trained and they taught the community and asylum seekers about the benefits of safe hygiene practices. Furthermore, 40 communal latrines have been built in close proximity to the host community as well as where asylum seekers are staying.

“We have been taught about personal hygiene and the importance of hand washing before cooking and after using the toilet,” says Nyathak “They [hygiene promoters] also told us this can prevent our children from getting diarrhoea.”

In order to keep the facilities running smoothly, local water technicians have been trained on the management and maintenance of the water facilities to safeguard smooth operation. The water technicians are responsible for regularly monitoring the water levels and the quality of the drinking water.

Water purification chemicals and accessories are also readily available to the community.

Clean and safe drinking water is essential for life and is also bringing renewed hope for people like Nyathak and Nyarout after being displaced by the conflict in South Sudan.

‘Toilets’ shouldn’t be a dirty word

This article originally appeared on Trust.org

In this 2011 file photo, a toilet is seen in a house destroyed by the January 2010 earthquake in Port-au-Prince REUTERS/Eduardo Munoz

WaterAid’s Director of International Programmes Girish Menon opened today’s debate on Water, Sanitation and Sustainable Energy in the Post-2015 Development Agenda at the UN General Assembly in New York.

Here are his reflections on why sanitation and water are so critical in the post-2015 process:

I spent this morning talking toilets at the UN.

Of all the potential topics of conversation with global decision-makers, needing the toilet might not be high on your list. We all do it on a daily basis but in polite conversation, it appears we’d prefer not to talk about it.

Whether we like it or not, the silence surrounding how we dispose of our bodily waste has to be broken. The health, prosperity and wellbeing of 2.5 billion people rests on it – 2.5 billion people who right now have nowhere to go to the toilet.

This lack of basic sanitation facilities causes diseases that kill 2,000 children under the age of five every single day. As well as gross indignity, women and girls in particular face sexual harassment and even violence when defecating in the open.

It’s a sign of how far we’ve come that today’s debate happened at all – that sanitation is now recognised as worthy of discussion at the highest level.

But there’s much further to go…

Put toilets at the centre of new goals

When the Millennium Development Goals were first agreed in 2000, sanitation wasn’t included. It was added later, as an afterthought. And now, progress towards the sanitation MDG target is massively off-track – in fact, it is one of the most off-track targets of all.

When the MDGs expire in 2015, a new set of ‘sustainable’ development goals and targets will replace them. It is vital that sanitation, along with safe water and hygiene, is at the forefront of this new framework.

So it’s been encouraging to hear key decision-makers in the UN acknowledging this today.  Sitting next to me this morning was the President of the General Assembly His Excellency John Ashe who said that sanitation is one of “the pre-eminent development challenges of our world”. Minutes later, Secretary-General Ban Ki-moon added, “Access to water, sanitation and hygiene must feature prominently in the post-2015 agenda.”

For the last three years, the water and sanitation sector has been discussing possible targets for the post-2015 framework. 200 organisations from around the world, including WaterAid, have come together in a process facilitated by the World Health Organisation and Unicef’s Joint Monitoring Programme. This consultation has led to a Furthermore, it includes a target on water and sanitation so that by 2030:

  • No one practises open defecation.
  • Every household, every school and every health centre has drinking water, sanitation and hygiene.
  • The proportion of the population without access at home to safely managed drinking water and sanitation is halved.
  • Inequalities in access are progressively eliminated.

I’d recommend that anyone interested in this process read more about the targets and the consultation in this document.

This crisis can be tackled

But of course, none of this will be easy.

It needs member states to hold true to the ambition of creating a post-2015 framework that can both eradicate extreme poverty and achieve sustainable development.

It requires convincing donor and developing country governments to increase their financing for water, sanitation and hygiene.

It requires us to get better at making projects sustainable, so that the taps and toilets built today are still working in a decade’s time.

It requires us to move beyond serving just the easy-to-reach, to include all those who live in rural and remote areas, or who find their access limited by disability, gender, or ethnicity.

But it is possible.

I quoted Nelson Mandela this morning and his words seem entirely appropriate: “It always seems impossible until it is done.”

This crisis can be tackled if national governments, donors, NGOs, civil society coalitions and the private sector work together to transform the lives of the world’s poorest people.

Time to act

All over the world, people now recognise the importance of safe sanitation not just to the world’s poorest people but to all of us. Two million people have called for governments to commit to reaching everyone, everywhere with safe water and sanitation.

Today I heard leaders at the UN talk toilets.

Now it is time to act.