World's most effective health intervention
At USD 5 per DALY (disability adjusted life years, a unit
measuring the amount of health lost due to a disease or a condition) averted,
hygiene promotion is a veritable bargain. By comparison, a DALY costs an
average of USD 10 for insecticide-treated bed nets to prevent malaria; around $100 for condom promotion and distribution to prevent transmission of
HIV/AIDS; and from USD 80 to $800 for directly observed short-course
chemotherapy for endemic, infections or non-infectious tuberculosis. With the
burden of disease costing the world $4.1 trillion each year, such simple
hygiene acts as hand washing, safe disposal of shit, and good general hygiene
around food, domestic animals, and sick family members, are the world's most
cost-effective health interventions.
I'm a survivor! To be or not to be (Randomly)
England's
Stratford-upon-Avon, where the Bard of Avon,
William Shakespeare, was born around 1560, was not the kind of place one would
choose to enter this world. The putrid conditions in the village led to an
infant mortality rate that was so high that surviving past the age of 5 was
often a matter of random chance. As notable figures go, Shakespeare was not
alone in being a random childhood survivor. Nelson Mandela (b. 1918, Mvezo,
South Africa), Martin Luther King Jr. (b. 1929, Atlanta, USA) , Mohandas Gandi
(b. 1869, Porbandar, British India), Mother Teresa (b. 1910, Skopje, Ottoman
Empire), Eva Peron (b. 1919, Los Toldos, Argentina), and Kofi Annan (b. 1938,
Kumasi, Gold Coast) are but a few of history's greats whom the world can thank
for surviving past the age of five. Today, two million children die each year
before the age of 5 because of diarrhea.
Community-led total sanitation: the new and successful hot approach
One of the best feel-good stories in the effort to end open
defecation and help more people be served by sanitation is the ascendance of
CLTS, community-led total sanitation. CLTS represents a shift from centralized
top-down supply-driven approaches to decentralized, people-centred
demand-driven approaches. Developed in Bangladesh,
the approach takes advantage of the knowledge and opinions of rural people in
the planning and management of sanitation programmes in their own villages, and
success are being seen as the approach spreads into India
and Africa.
Wishing you could hide those pryin' eyes
Poor women and girls are hit hardest by the absence of
toilets. They care for the sick and are
in greatest physical contact with human waste. Lacking toilets in overcrowded
slums means going the whole day without relieving oneself and then risking
exposure – or even assault – at night, a humiliating daily routine that can
damage health. Menstruation adds considerably to the need for sanitary facilities.
Sexual harassment and rape are also a risk in rural areas, where women often
seek privacy in the darkness, and in refugee camps, which all too often fail to
provide safely located, women-only toilets. These realities absorb women’s
time, imperil their physical well-being, and limit their free and equal
participation in the economic and social life of their societies.
Weird math
The Global Water Partnership estimated in 2000 that, while
$13 billion was spent by donors on water, just USD 1 billion was committed
to sanitation. More recent figures from the Joint Monitoring Programme of WHO
and UNICEF suggest a proportion of eight to one. With 2.5 billion people
lacking sanitation, but 894 million lacking good drinking water, more
investment is needed in sanitation. Why has sanitation been the "orphan
child" in WATSAN (water and sanitation) funding and programmes?
Boom times behind that closed door
Improved sanitation in developing countries typically yields
about $9 worth of economic benefit for every $1 spent. That is an
impressive ratio, though it is still relatively unknown outside of the sector.
These benefits are mainly: saving time, reducing direct and indirect health
costs, increasing the return on investments in education, and safeguarding
water resources. The biggest element is the first one, saving time. People
without toilets at home spend a great deal of time each day queuing for public
toilets or looking for secluded places to defecate. The World Health
Organization estimates this time has an economic value of well over USD 100
billion each year.
What's in a number?
In our multimedia world, news reports inundate us everywhere
and at any time. For example, as of 2007, there were 2.5 billion mobile phones
in use. The same year, iTunes music sales exceed 2.5 billion. For its Olympic
effort, China
planted 2.5 billion trees in 2008. Carbon dioxide emissions from US power
plants are now at roughly 2.5 billion tonnes per year. The "Idol"
franchise is worth USD 2.5 billion. Sadly, 2.5 billion is also the number of
people unserved by sanitation around the world. Of these roughly 0.7 billion
are in India, 0.7 billion in
China, 0.7 billion in Africa
and the remainder in other places, including the Caribbean.
In reality, "unserved" means that 2.5 billion people wake up every
morning with nowhere to go to shit. 2.5 billion is a shockingly large number of people.
