The toilet and the latrine, which helped revolutionize public health in New York, London and Paris more than a century ago, are among the most underused tools to combat poverty and disease in the developing world, says a United Nations report released yesterday.
"Issues dealing with human excrement tend not to figure prominently in the programs of political parties contesting elections or the agendas of governments," said Kevin Watkins, the main author of the report. "They're the unwanted guests at the table."
The human cost of that taboo, however, is more unspeakable than the topic itself, he said. Every year, more than two million children die of diarrhea and other sicknesses caused by dirty water and a lack of "access to sanitation."
That is the common euphemism for the reality that more than a third of the world's people — 2.6 billion — have no decent place to go to the bathroom, while more than a billion get water for drinking, washing and cooking from sources polluted by human and animal feces.
At any time, almost half the people in developing countries have one or more of the main illnesses associated with inadequate water and sanitation and fill half the hospital beds, the report said. They are plagued by diarrhea, cholera, typhoid, trachoma and parasitic worms.
The United Nations Development Program's annual attempt to measure human well-being focuses this year on the dearth of clean water and adequate sanitation for the world's poor. The report, "Beyond Poverty: Power, Poverty and the Global Water Crisis," lays out the grim facts. [YF: The title is actually "Beyond Scarcity," and the report is available at <http://hdr.undp.org/hdr2006/>.]
In Kibera, the sprawling slum in Nairobi, Kenya, people defecate in plastic bags that they dump in ditches or toss into the street — a practice known as "the flying toilet." In Dharavi, the vast slum in Mumbai, India, there is only one toilet per 1,440 people — and during the monsoon rains, flooded lanes run with human excrement.
Across the countryside in Asia and Africa, people are forced to squat in streams, backyards and fields, befouling the water they drink, the places where their children play and the plots where their food grows.
The report's authors estimate that it would cost $10 billion a year to halve the percentage of people without access to safe drinking water and to provide them with simple pit latrines. But that is less than half what rich countries spend annually on bottled water.
The report blames the governments of poor and rich countries for paying too little attention to this fundamental problem.
"Life-saving investments in water and sanitation are dwarfed by military spending," the report says. "In Ethiopia, the military budget is 10 times the water and sanitation budget — in Pakistan, 47 times."
The report also notes that since the mid-1990s, aid from wealthy nations for water and sanitation has declined in real terms, falling to 5 percent from 8 percent of overall development aid — "a marked contrast to education, where aid commitments doubled over the same period." Japan is by far the leader in aid for water and sanitation, providing $850 million in 2003 and 2004, a fifth of the total.
Some of the most innovative efforts to expand the availability of latrines and simple sewage systems have occurred in South Asia, the report says.
In Karachi, Pakistan, a local group began organizing slum dwellers lane by lane in 1980 to build sewer channels to collect waste from their homes. Entire neighborhoods then collaborated to construct larger channels, and the city eventually agreed to finance a trunk sewer line. The infant mortality rate in the slum, Orangi, has fallen to 40 deaths per 1,000 births, from 130 in the early 1980s.
In Bangladesh, more than 600 private groups work with communities to map the places where people defecate and the routes of disease transmission, helping to fuel demand for sanitation services. More than 3,000 small businesses have sprung up to produce, market and maintain cheap latrines.
In India, a private group called Sulabh has built thousands of public toilets and more than a million private latrines that cost as little as $10 each in more than 1,000 cities nationwide. The local authorities pay to build the public toilets, but user fees cover the costs of running them. The fee is about 2 cents, with free access for children, the disabled and the destitute.
-- Yoshie <http://montages.blogspot.com/> <http://mrzine.org> <http://monthlyreview.org/>