Monday, October 26, 2009

Fixing Sanitation Crisis in India

Guest Post by Dost_Mittar

A simple solution to a disgusting problem
"The toilet is a part of the history of human hygiene which is critical chapter in the growth of civilization."
[Dr. Bindeshwar Pathak]

Anyone who has seen the blockbuster film “Slumdog Millionaire” would remember one scene above all others. I am referring, of course, to the “potty scene” where the young Jamal is shown relieving himself in an open pit. The scene caused a lot of adverse reaction in India as unrepresentative of true India. But according to a joint study conducted by the World Health Organization and UNICEF, 665 million Indians, or nearly two-thirds of them defecate in the open. I am not sure if these 665 included people using indoor toilets without plumbing; if it did not, then the number of Indians defecating in an unhygienic manner is even greater.

I love traveling by train when I am in India and have many enchanting childhood memories of such travel. But one of the less enchanting memory is of seeing people relieving themselves in the open whenever the train passed some open areas in the mornings. Some of these people would stand up holding their pajamas or dhotis to protect their dignity at the sight of the approaching train; most would carry on without paying any attention to those seeing them perform one of their most private functions. I never thought of this as anything abnormal and it took a foreigner for me to realize how demeaning this scene was. That was when I read V.S. Naipaul’s “An Area of Darkness”. Naipaul, a Trinidadian of Indian origin, was aghast at seeing such scenes when traveling through India for the first time. I realized then that what I had taken as something natural was somewhat unique to India and Indians. Whereas people in other undeveloped countries may be forced into defecating in the open, they won’t accept it as something normal as we do.

Another thing unique about India is the way we treat those who take care of our excrement. During my childhood in Lyalpur as well as the first decade of my stay in Delhi, our house and, indeed, the street on which we lived did not have indoor plumbing. A woman came to manually scrape our excrement with a pick-up and transfer it to a larger basket -tassla- which she carried outside on her head. Like everyone else, I also avoided her touch as if touching her would somehow make me touch the feces that she just cleaned and carried. She was not allowed to touch our water taps, we would pour water in a bucket reserved for this purpose while she stepped a couple of steps away from us. It never occurred to me that there was something wrong in my behaviour: But it did so to a Brahmin kid growing up in a village in Bihar. Bindeshwar Pathak, a six year old boy, wondered what would happen if he touched such a person. When he did, his mother was hugely upset with the sacrilege he had committed and made him swallow cow dung and urine and bathe in the water of the holy Ganga to purify him from his “polluting” activity. He realized that "If they (scavengers) continue to clean human excreta, they will not be accepted into society."

People who clean and carry human human waste, which we euphemistically call night soil, have been known by various names. We used to call them bhangi or bhangan. In military cantonments, they began to be called jemadar or jemadarni for some obscure reason. Gandhi called them harijan or children of god. But it was the British who coined a term for them for their census purposes which has become a standard expression in Indian English. That term is Scavenger. The dictionary meaning of scavenger is “an animal or other organism that feeds on dead organic matter” or “a person who searches through and collects items from discarded material”. In India, however, the word generally means the person who manually cleans toilets.



Mahatma Gandhi was perhaps the first Indian who recognized the indignity of the job of a scavenger. As anyone who has seen the film “Gandhi” would know, he started the practice of cleaning after himself when he was in South Africa; not only that, the male chauvinist in him forced his wife to do the same, bringing tears to her eyes. Later on, when he started his Sabarmati Ashram, he made it a rule that all inmates of the Ashram would clean their own toilet.

Dr. Bindeshwar Pathak is a Gandhian. Gandhi lived among the “harijans” so that he could experience first hand the humiliating conditions under which they lived. Pathak did the same. He lived among scavengers for three years to be able to feel their pain. He realized that the only way to get rid of the unhygienic state of toilets and to improve the lot of the scavengers was to develop a low cost sanitary toilet which was affordable by ordinary households and, at the same time, eliminated the need for scavengers to carry human waste. He then founded a movement called “Sulabh International” and developed a simple, low-cost toilet which cost approximately Rs. 700 and could be installed anywhere, including villages without any plumbing. This toilet uses only 1.5 litre of water for flushing as against 10 litres by a conventional toilet. The toilet “system” consists of two pits: when the first one fills up, it is closed and the other one is used. The closed toilet dries up in two years when it is ready to be used as fertilizer and for conversion into biogas for heating, cooking, and generating electricity.

Sulabh international has succeeded in raising the percentage of rural population with access to a toilet from 27% to 59%. The movement has also installed 5500 public toilets in the cities and places of tourist attraction throughout the country. Anyone who has used public toilets in India knows how filthy and nauseating they are. Public toilets built and maintained by Sulabh charge a nominal amount for their use but they are much cleaner than other public toilets and a boon to visitors with a need to go. The system has since been exported to many developing countries of Asia and Africa. It has been recommended by the United Nations HABITAT and Centre for Human Settlements, as well as by the United Nations Development Program (UNDP). Sulabh International Social Service Organization has launched operations in Bhutan and Afghanistan. It has, together with UN-HABITAT, trained engineers, architects and others from 14 countries in Africa. It is planning to work in Ethiopia, Cambodia, Laos, Angola, Madagascar, Dominican Republic, and Tajikistan.

The Sulabh system removes the need for scavenger; therefore, Pathak’s organization started training schools to prepare them for alternative jobs. These included a training school for women in Rajasthan to train them in tailoring, embroidery, food-processing and beauty treatments. Some of these women went to New York City to participate in a fashion show held at the U.N. headquarters to celebrate the International Year of Sanitation.

In recognition of his services for efficient water management, Dr. Pathak was awarded the 2009 Stockholm Water Prize. The award was created in 1990 to recognize achievements in water science, water management, water action or awareness building and carries a cash prize of $150,000. If India could produce another 100 Pathaks, it could really begin to shine.

Although the practice of manual scavenging became illegal in India in 1993, there are still 115,000 scavengers working in the country today.

Dost_Mittar, the author, is a Canadian of Indian origin. He is a retired policy analyst with the Canadian government living in Ottawa. He does consulting work, mostly with governments, if and when "I get an assignment without looking for it. My hobby is to get away from Canadian winters as much as possible".

Here's a video clip of Indian environment minister Jairam Ramesh saying "if there was a Nobel Prize for dirt and filth, India would win it hands down":



Related Links:

WHO-UNICEF Sanitation Study in India

Sulabh Toilet Museum

Food, Clothing and Shelter in India and Pakistan

Do South Asian Slums Offer Hope?

Can Slumdog Success Help Poor Children?

Mumbai's Slumdog Millionaire

Pakistan's Total Sanitation Campaign

Caste System: India's Apartheid

No Toilet, No Bride

Poverty Tours in India, Brazil and South Africa

South Asia's War on Hunger Takes Back Seat

Bollywood and Hollywood Mix Up Combos

Grinding Poverty in Resurgent India

Pakistani Children's Plight

Poverty in Pakistan

47 comments:

Zen, Munich, Germany said...

India is shining - the biggest problem of the country is the internet connection speed and revisionist mentality of Indian Muslims who are unwilling to adapt modernity. I am getting enlightened ;-)

Nevertheless I really doubt this 665 million thing - how can we trust surveys in a rural populous country like India where the line between open air toilet and a modern toilet is quite thin...

Riaz Haq said...

Zen,
I am glad to see Mr. Pathak doing something about it, rather than simply denying the existence of the problem. South Asia can use many more committed social entrepreneurs like this extraordinary gentleman.

dcruncher4 said...

And I will be equally delighted when intellectual muslims of Pakistan see what is the root cause of all problem in Pakistan (incl. complete lack of progress).
Hint: The first 3 letter of that problem is ISL.
But hey no one can dare say that if he wants his dead to remain above the neck.

Riaz Haq said...

dcrunchr: "The first 3 letter of that problem is ISL.
But hey no one can dare say that if he wants his dead to remain above the neck."

This is off topic but I'll respond to it any way...just once.

Muslims have seen over a thousand years of glory followed by a couple of hundred years of darkness in Islam's 1400 year long history. The fundamentals of Islam have not changed, only the practitioners have....not all of them, but enough of them to impede progress, particularly in the post-colonial period.

Anonymous said...

Check this website. Per this site India is ranked 45, China 75 and Pakistan 99 in prosperity index.

http://www.prosperity.com/rankings.aspx

You can read about the above in forbes.

http://www.forbes.com/2009/10/26/legatum-institute-prosperity-index-democracy-opinions-columnists-joel-kotkin.html

Anonymous said...

Congratulations on the latest set of explosions to rock you country.

Best wishes from India

Riaz Haq said...

Anon: "Per this site India is ranked 45, China 75 and Pakistan 99 in prosperity index."

These index bears no resemblance to the reality on the ground or the reports from various UN agencies concerned with hunger, poverty, education, sanitation and healthcare.

You are free to believe Forbes, a conservative American publication that celebrates the extreme excesses of capitalism, while downplaying the basic welfare of the ordinary folks.

Riaz Haq said...

Anon: "Per this site India is ranked 45, China 75 and Pakistan 99 in prosperity index."

These index rankings bear no resemblance to the reality on the ground or the reports from various UN agencies concerned with hunger, poverty, education, sanitation and healthcare.

But you are free to believe Forbes, a conservative American publication that celebrates the extreme excesses of capitalism, while downplaying the basic welfare of the ordinary folks.

Anonymous said...

http://blog.dawn.com:91/dblog/2009/10/28/attacking-our-way-of-life/

Actually riaz you could throw some light in the same line on the terror and impact on the same in the life of ordinary pakistani

Riaz Haq said...

Anon: "Actually riaz you could throw some light in the same line on the terror and impact on the same in the life of ordinary pakistani"

Thanks for sharing it. It talks about the terrible results of the powerful insurgency Pakistan faces, and expresses frustrations shared by many in the poor governance and the absence of leadership by the political parties.

However, it says nothing about a sanitation emergency, which is the subject of this post.

Riaz Haq said...

Here is a story by Rahimullah Yusufzai, a respected journalist who recently visited in India and wrote in the News as follows:

"I fear there will be a bloody revolution in India," a retired Indian military officer remarked to this writer and other guests during a recent visit to New Delhi. It was shocking to hear the comment from a soldier, in a country that supposedly had given a voice to its huge population and was believed to be all-inclusive.

It is obvious that India's much-praised democracy hasn't brought any real change in the lives of millions of Indians. That some of the poorest men and women are now up in arms in parts of India is evidence enough that democratically elected governments must do more to provide rights and justice to the rural poor and ensure even-handed development in different parts of the country.

The Naxalite violence in India has caused pain to most thinking Indians. For them it is a matter of anguish that a growing number of Indians are disillusioned with their country's democracy and see no hope of benefiting from India's steady economic progress. They have picked up the gun to fight for their rights.

The Maoist-linked violence is spreading and engulfing new places. The vast region affected by the insurgency include the states of Chhattisgarh, Jharkhand, Bihar and West Bengal and runs south through Orissa, Maharashtra and Andhra Pradesh. It is usually called the "Red Corridor" because the leadership for the rebels is provided by communist cadres labelled as Maoists. The Communist Party of India (Marxists-Leninists), despite suffering splits, is still the standard-bearer of the rebels.

According to reports in the Indian media, more than 220 districts in 20 or so states are now affected by Maoist-linked violence. Indian intelligence agencies believe the movement has at its disposal 20,000 armed cadres and over 50,000 regular members. Apart from the rural poor, indigenous tribes such as the Girijans in Andhra Pradesh and Santhals in West Bengal have been flocking to the Naxalite movement. The movement has appeal for the dispossessed and the under-privileged. In the words of its present leader, Mupalla Laxman Rao, in hiding somewhere in eastern India and better known as Ganapathi, his party's influence has grown stronger and it was now the only genuine alternative before the people of India.

The Naxalite movement began as a peasants' uprising in May 1969 in the village of Naxalbari in West Bengal. It was initially led by 49-year-old Charu Mazumdar and its aim was to seize power through an agrarian revolution by overthrowing the feudal order. Mazumdar died in police custody 12 days after his arrest in Calcutta in 1972 and became a hero to Maoist cadres that have increased in number and strength over the years despite splits in the movement. The Naxalite insurgency has sprouted after every defeat and is now stronger than ever.

India's share of the world's poorest people has increased to 39 percent from 25 percent in 1980. In comparison, the Below Poverty Line population worldwide has decreased from 1,470 million to 970 million. There are reportedly 301 million Indians below the poverty line, just 19 million less than in 1983. The Human Development Report by the UN has been ranking India among the lowest 60 or 65 countries in the list of 193 nations that are part of the annual study. India's poor performance on this score was in spite of the around nine percent growth rate in its GDP. There are reports in the media about farmers committing suicide or selling their wives to pay mounting debts. Though the recorded figures of such cases aren't high in a big country such as India with 1.17 billion people, it still indicates the desperate state of certain communities.

Riaz Haq said...

This is from CNN today:

New Delhi, India (CNN) -- Most Indian mothers want their daughters to marry decent men who make a good living. Now, in parts of rural India, women have a new -- and rather unusual -- demand for matrimony: a toilet.

"No toilet, no bride," has become a rallying cry for women raising a stink about the lack of a basic amenity.

They see it as a human rights issue, especially in villages where plumbing can be nonexistent.

It was that way in Sunariyan Kalan in the northern state of Haryana. Sumitra Rathi said village women had no choice but to relieve themselves without privacy.

They would go before sunrise or hold it in until darkness fell once again to avoid being seen. Or they would walk out to the fields and endure embarrassment. They don't want their daughters to face the same indignity.

"Many of them do make serious inquiries from the families of grooms about latrines," she said.

As a member of the local council, Rathi has helped build toilets in 250 houses in Sunariyan Kalan since 1996.

Still, about five dozen homes lack covered bathrooms.

The problem is so big in India that the country would need to construct 112,000 toilets every day if it wants to meet its sanitation goal by 2012, according to the Ministry of Rural Development.

Even as India emerges as a global economic power, millions of its citizens still live in poverty. The government estimates that less than 30 percent of villagers have access to latrines, which poses serious health risks and increases the threat of deadly diseases like typhoid and malaria.

To help overcome the enormity of the sanitation challenge, the government is offering incentives to encourage villagers to build bathrooms. The poorest

of the poor in Haryana stands to receive Rs. 2,200 ($48) for each toilet they install, said P.S. Yadav, a state coordinator for the sanitation campaign.

The incentives are especially attractive to women, for whom the problem transcends health issues.

Local women, often illiterate, have taken a keen interest in bathroom construction, said Roshni Devi, the council chief in Haryana's Kothal Khurd village.

And through it, they have gained a sense of self, making the lowly toilet seat feel more like a lofty throne.

Moin said...

Riaz:

Very nice. Proper santiation is a key step to developing a modern ( not civilized) socieity.

When I was in Bangaldesh in 2007 I tried to impress on my rich friends to start a movement to teach proper hygiene to the poor and the slum dwellers. This step alone will eradicate so many epidemics that create havoc with the population. Of course, the other component of my 'lecture' was to get a supply of clean water to the slum areas.

Clean water and proper sanitation were not always present in the West either. Even though a patent was issued in 1775 for a flushing water toilet it did not become popular until 60 years later in Europe. It was really after 1879 with the invention of light bulb and soon after with the commercial distribution of electricity to homes and businesses that supply of clean water became possible. Before then, even in Europe and America conditions were miserable regarding sanitation. People commonly went out to relieve themselves and night soil was a commonly used term. In NY City men would carry pots in the streets of Manahattan and people would pay them a few cents to relieve themselves in it. Outhouses were a standard part of all homes and businesses. During winter season, when the rich and wealthy had a party or a wedding in their Mansions it was not uncommon for guests to relieve themselves in the stairwells rather than take a walk in the cold to the outhouse.

In the 1960's when I lived in Bangladesh I remember that some of the well to do and upper class locals who lived in areas where there were no public sewer lines had outhouses also. And a Bhangi would come each morning to clean out the outhouse vats.

In Karachi in the slums and poor areas, as late as 2003, I saw children defecating in public, sitting over drainage ditches, on the side of the streets.

Riaz Haq said...

Here's traveler-blogger Sean-Paul Kelly talking about lack of sanitation in India:

In my opinion the filth, squalor and all around pollution indicates a marked lack of respect for India by Indians. I don't know how cultural the filth is, but it's really beyond anything I have ever encountered. At times the smells, trash, refuse and excrement are like a garbage dump. Right next door to the Taj Mahal was a pile of trash that smelled so bad, was so foul as to almost ruin the entire Taj experience. Delhi, Bangalore and Chennai to a lesser degree were so very polluted as to make me physically ill. Sinus infections, ear infection, bowels churning was an all to common experience in India. Dung, be it goat, cow or human fecal matter was common on the streets. In major tourist areas filth was everywhere, littering the sidewalks, the roadways, you name it. Toilets in the middle of the road, men urinating and defecating anywhere, in broad daylight. Whole villages are plastic bag wastelands. Roadsides are choked by it. Air quality that can hardly be called quality. Far too much coal and far to few unleaded vehicles on the road. The measure should be how dangerous the air is for one's health, not how good it is. People casually throw trash in the streets, on the roads. The only two cities that could be considered sanitary in my journey were Trivandrum--the capital of Kerala--and Calicut. I don't know why this is. But I can assure you that at some point this pollution will cut into India's productivity, if it already hasn't. The pollution will hobble India's growth path, if that indeed is what the country wants. (Which I personally doubt, as India is far too conservative a country, in the small 'c' sense.)

Riaz Haq said...

Here's a Daily Mail report today about the continuing misfortunes of Slumndog child star Rubina Ali:

She's the child star of one of last year's highest grossing movies, but Rubina Ali has been left homeless for the second time in a year.

The Slumdog Millionaire actress, 10, and her family had to sleep in the open air after their home in India was demolished to make way for a new railway line.

This comes despite the promise of a new luxury apartment paid for by a trust fund set up by the hit film's director Danny Boyle.

Read more: http://www.dailymail.co.uk/tvshowbiz/article-1239683/Slumdog-Millionaire-star-Rubina-Ali-sees-shanty-town-home-demolished-SECOND-time-year.html#ixzz0bI3YX8Oc

Riaz Haq said...

Here's a Bloomberg report on India's sanitation crisis:

March 4 (Bloomberg) -- Until May 2007, Meera Devi rose before dawn each day and walked a half mile to a vegetable patch outside the village of Kachpura to find a secluded place.

Dodging leering men and stick-wielding farmers and avoiding spots that her neighbors had soiled, the mother of three pulled up her sari and defecated with the Taj Mahal in plain view.

With that act, she added to the estimated 100,000 tons of human excrement that Indians leave each day in fields of potatoes, carrots and spinach, on banks that line rivers used for drinking and bathing and along roads jammed with scooters, trucks and pedestrians. Devi looks back on her routine with pain and embarrassment.

“As a woman, I would have to check where the males were going to the toilet and then go in a different direction,” says Devi, 37, standing outside her one-room mud-brick home. “We used to avoid the daytimes, but if we were really pressured, we would have to go any time of the day, even if it was raining. During the harvest season, people would have sticks in the fields. If somebody had to go, people would beat them up or chase them.”

In the shadow of its new suburbs, torrid growth and 300- ­million-plus-strong middle class, India is struggling with a sanitation emergency. From the stream in Devi’s village to the nation’s holiest river, the Ganges, 75 percent of the country’s surface water is contaminated by human and agricultural waste and industrial effluent. Everyone in Indian cities is at risk of consuming human feces, if they’re not already, the Ministry of Urban Development concluded in September.

Economic Drain

Illness, lost productivity and other consequences of fouled water and inadequate sewage treatment trimmed 1.4-7.2 percent from the gross domestic product of Cambodia, Indonesia, the Philippines and Vietnam in 2005, according to a study last year by the World Bank’s Water and Sanitation Program.

Sanitation and hygiene-related issues may have a similar if not greater impact on India’s $1.2 trillion economy, says Guy Hutton, a senior water and sanitation economist with the program in Phnom Penh, Cambodia. Snarled transportation and unreliable power further damp the nation’s growth. Companies that locate in India pay hardship wages and ensconce employees in self- sufficient compounds.

The toll on human health is grim. Every day, 1,000 children younger than 5 years old die in India from diarrhea, hepatitis- causing pathogens and other sanitation-related diseases, according to the United Nations Children’s Fund.

‘Sanitation Crisis’

For girls, the crisis is especially acute: Many drop out of school once they reach puberty because of inadequate lavatories, depriving the country of a generation of possible leaders.

“India cannot reach its full economic potential unless they do something about this sanitation crisis,” says Clarissa Brocklehurst, Unicef’s New York-based chief of water, sanitation and hygiene, who worked in New Delhi from 1999 to 2001.

Riaz Haq said...

Here's a recent piece from London's Telegraph newspaper about lack of toilets in modern India:

No one would ever call Radha Jagarya fortunate. The 45-year-old widow and her four children live on the pavement in an upmarket south Mumbai suburb, scraping a living by selling flowers to passing motorists.

But in terms of public toilet provision, the family is well-served compared with other areas, with an adequate communal block a five-minute walk away near the US Consulate and another under a busy road in the opposite direction.

n slum areas, in which more than half of Mumbai lives, an average of 81 people share a single toilet. In some places it rises to an eye-watering 273.

Unsurprisingly, it is still common to see people squatting by roads and railway tracks or along the coast, openly defecating in the city that drives India's economy and where some of the world's richest people live.

The UN estimates that 600 million people or 55 per cent of Indians still defecate outside, more than 60 years after Mahatma Gandhi, the scrupulously clean independence leader, first talked of the responsible disposal of human waste.

Jack Sim takes a very keen interest in such matters. As the founder and president of the World Toilet Organisation (WTO), he has made it his mission to improve sanitation across the globe.

For him, India has "a lot of work to do" to improve sanitation, not just because of its impact on health and the spread of diseases such as diarrhoea, which Unicef reports kills 1,000 Indian children aged under five every day.

It also tarnishes the image of a country that likes to portray itself as an emerging world economic superpower, the Singapore businessman said on a visit to Mumbai, where he was promoting World Toilet Day on November 19.

In particular, Sim questioned whether the authorities in New Delhi were doing enough to provide adequate public facilities for the 2010 Commonwealth Games, which will draw tens of thousands of foreign visitors.

"If you don't have good toilets to welcome tourists, they don't come and won't go to all your beautiful sites," he said.

Public lavatory provision in Mumbai - and other cities - faces the same problem as housing, water and other basic services: supply cannot keep up with demand as India's population increases exponentially.

In March, Mumbai's municipal authorities said there were 77,526 toilets in slum areas and 64,157 more were needed. Work is in progress to build only 6,050.

Yet the UN's Mumbai Human Development Report 2009, published earlier this month, points out that even where public lavatories exist, most have no running water, drainage or electricity, making them unhygienic and unusable.

Embarrassment means women and girls often wait all day until it is dark to go to the toilet, increasing their chances of infections and exposing them to violence or even snake bites as they seek out remote places.

Poor sanitation and the illnesses it causes cost the Indian economy 12 billion rupees (£154 million) a year, according to the health ministry.

Sim, who sees links between public lavatories and social development, wants the issue pushed up the political agenda, urging people to "talk more about toilets".

Riaz Haq said...

Here's a BBC report about British aid to India used in building toilets in Mumbai:

International development aid is one part of the UK budget unlikely to be cut in a squeeze on public finances. But questions are being asked about how aid is used, and which countries need it. India last year got almost £300m from the UK, some of it spent on toilets in the country's financial capital, Mumbai.

The stench from the stagnant, fetid stream of the Queresh Nagar slum in Mumbai hits you as soon as you get out of the car.

The slum itself is bustling and vibrant. There is a line of shops with living quarters above. The stream is behind, the water a murky grey with insects buzzing on top. Some residents have rigged up filthy plastic covers at the back of their homes for privacy. But the children scamper around using the stream, or whatever ground they can find on the disused rail track behind, for a toilet.

"We have to live in these conditions," says La La Nawab Ali, who is showing me around.

"What can we do? You can see the state of it. This is Mumbai."

In another slum at Munjul Nagar, residents show letters, many signed with thumb prints, asking the authorities to finish building a toilet block that has been left half-finished. A similar stench pervades the air.

"It's an extremely difficult and helpless situation," explains Prasad Shetty, an urban planning consultant. "It's an extremely embarrassing undignified demeaning kind of experience for them."

Most of the funding for the sanitation project initially came from the World Bank and was then was taken over by the Mumbai government.

A small amount of British aid goes from the UK Department of International Development (DFID) through charities in England and India, mainly to train people to maintain their community toilet blocks. But many in the slums say they know little or nothing about it.

"You foreign people from over there, you keep on sending so much money," says one angry slum resident. "But the poor person sees nothing."

Riaz Haq said...

More people in India, the world’s second most crowded country, have access to a mobile telephone than to a toilet, according to a set of recommendations released today by United Nations University (UNU) on how to cut the number of people with inadequate sanitation.

“It is a tragic irony to think that in India, a country now wealthy enough that roughly half of the people own phones, about half cannot afford the basic necessity and dignity of a toilet,” said Zafar Adeel, Director of United Nations University's Institute for Water, Environment and Health (IWEH), and chair of UN-Water, a coordinating body for water-related work at 27 UN agencies and their partners.

India has some 545 million cell phones, enough to serve about 45 per cent of the population, but only about 366 million people or 31 per cent of the population had access to improved sanitation in 2008.

The recommendations released today are meant to accelerate the pace towards reaching the Millennium Development Goal (MDG) on halving the proportion of people without access to safe water and basic sanitation.

If current global trends continue, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) predict there will be a shortfall of 1 billion persons from that sanitation goal by the target date of 2015.

“Anyone who shirks the topic as repugnant, minimizes it as undignified, or considers unworthy those in need should let others take over for the sake of 1.5 million children and countless others killed each year by contaminated water and unhealthy sanitation,” said Mr. Adeel.

Included in the nine recommendations are the suggestions to adjust the MDG target from a 50 per cent improvement by 2015 to 100 per cent coverage by 2025; and to reassign official development assistance equal to 0.002 per cent of gross domestic product (GDP) to sanitation.

The UNU report cites a rough cost of $300 to build a toilet, including labour, materials and advice.

“The world can expect, however, a return of between $3 and $34 for every dollar spent on sanitation, realized through reduced poverty and health costs and higher productivity – an economic and humanitarian opportunity of historic proportions,” added Mr. Adeel.

http://www.un.org/apps/news/story.asp?NewsID=34369&Cr=mdg&Cr1#

http://finalizations.com/sewage-water-pollution-and-its-environmental-effects.html

Riaz Haq said...

Pakistan's water quality is not good, but it is significantly better than in India.

On page 288 of his book "Water management in India" the author P. C. Bansil quotes a UN study that says India ranks a poor 120 on a list of 122 countries in water quality.

India's neighbors Bangladesh, Nepal, Sri Lanka and Pakistan rank much better at 40, 64, 78 and 80 respectively.

http://books.google.com/books?id=u7ojYC9csS8C&pg=PA288&lpg=PA288&dq=India+ranks+a+poor+120+in+a+list+of+122+countries+ranked+for+their+water+quality&source=bl&ots=_m4oQAa7kK&sig=r-qPJRUB2Xg1u3wQQ0FphcATDe8&hl=en&ei=oyLVS7j7GYqiswPIyrScCg&sa=X&oi=book_result&ct=result&resnum=2&ved=0CAoQ6AEwAQ#v=onepage&q=pakistan%20water%20quality&f=false

Riaz Haq said...

It seems that India is beginning to recognize the seriousness of sanitation crisis, according to UNICEF. Here's recent news:

Lizette Burgers, the Chief of Water and Environmental Sanitation of UNICEF has said India is heading towards achieving Millennium Development Goal in sanitation as it has put sanitation on national agenda.

Addressing a press conference here, Burgers said: “In the case of sanitation, the total sanitation campaign has succeeded in putting sanitation on the national agenda.

Sanitation has been showing an increasing trend since 1999. The latest …programme data indicates a sharp acceleration from 2006 onwards and we are hopeful that with further dynamics and sustained supportIndia is inching closer to the MGD target.” Rural Development Minister of West Bengal Chandra Prakash Joshi said the state had achieved the MGD goals for drinking water.

“I am happy to say that we have achieved the MGD for drinking water by providing 84 percent of our rural population with access to improved sources of water as compared to goal of 83 percent. However, there is much more to achieve, our goal is to provide every household with an improved source of drinking water by 2012. Our challenge is also to meet the increasing demand from the rural areas to provide piped water and household tap connections. In this sense, we have quite some distance to go,” Joshi added.

He further said that provision of sanitation and a clean environment are important to improve health of the people and reduce the incidence of diseases among children.

The Programme focuses on sharing India’s development experience and its drive towards achieving the MDGs for water and sanitation. Experts from around 18 countries would visit different states to study aspects of water safety and sanitation.

The groups would be visiting Orissa, Jharkhand, West Bengal, Karnataka, Tamil Nadu, Uttar Pradesh, Assam and Madhya Pradesh. (ANI)

http://breakingnews.gaeatimes.com/2010/04/13/sanitation-now-on-national-agenda-in-india-says-unicef-representative-21203/

Riaz Haq said...

In 2009 HDR, the rankings of countries in terms of population WITHOUT access to improved water source, the rankings are as follows:

India 78 (11%)
Bangladesh 106 (20%)
Nepal 79 (11%)
Pakistan 74 (10%)

Water quality reported by UNESCO is not the same as access. The two are different, mainly due to the relative affordability.

The water quality is bad in some European nations such as Belgium, but access to clean water is 100%, and it is achieved through bottled water that the population there can afford.

If you look at the water quality rankings, you'll realize the difference.

Riaz Haq said...

"Everyone has different standards about cleanliness. The Westerners have different standards, we have different standards," said the Delhi Commonwealth Games Chief Lalit Bhanot in response to criticism that "the facilities are filthy and unhygienic", according to the BBC.

"This is a world-class village, probably one of the best ever," Bhanot added.

Delegates who visited the tower blocks where athletes will live during the games have described them as filthy, with rubble lying in doorways, dogs inside the buildings, toilets not working and excrement "in places it shouldn't be".

Speaking at a news conference in Delhi, Lalit Bhanot, secretary general of the Delhi organizing committee, said the authorities understood the concerns shown by some member countries and the Commonwealth Games Federation (CGF).

But he suggested that the complaints could be due to "cultural differences".

New Zealand chef de mission Dave Currie has suggested the Games might even have to be canceled.

He told New Zealand commercial radio on Tuesday: "If the village is not ready and athletes can't come, obviously the implications of that are that it's not going to happen.

"It's pretty grim really and certainly disappointing when you consider the amount of time they had to prepare."

New Zealand, Scotland, Canada and Northern Ireland have demanded their teams be put up in hotels if their accommodation is not ready.

Commonwealth Games England has called for "urgent" work on the facilities, raising concerns about "plumbing, electrical and other operational details".

I think the world is expecting too much of a nation where two-thirds of the people still def ecate in the open.

The BBC's Mark Dummett in Delhi says the Indian government had hoped that hosting the Commonwealth Games would highlight the country's strengths.

But many Indians now worry that the opposite has happened, and that the country's weaknesses have been very publicly exposed by the many problems, delays and allegations of mismanagement in the build up to the Games.

Riaz Haq said...

Here's a Times of India report about a dog declared Dalit and abandoned by an upper caste family:

BHOPAL: A dog's life couldn't get worse. A mongrel brought up in an upper caste home in Morena was kicked out after the Rajput family members discovered that their Sheru had eaten a roti from a dalit woman and was now an "untouchable". Next, Sheru was tied to a pole in the village's dalit locality. His controversial case is now pending with the district collector, the state police and the Scheduled Caste Atrocities police station in Morena district of north MP.

The black cur, of no particular pedigree, was accustomed to the creature comforts in the home of its influential Rajput owners in Manikpur village in Morena. Its master, identified by the police as Rampal Singh, is a rich farmer with local political connections.

A week ago Sunita Jatav, a dalit woman, was serving lunch to her farm labourer husband. "There was a 'roti' left over from lunch. I saw the dog roaming and fed it the last bread," Sunita said. "But when Rampal Singh saw me feeding the dog and he grew furious. He yelled: 'Cobbler woman, how dare you feed my dog with your roti?' He rebuked me publicly. I kept quiet thinking the matter would end there. But it got worse," she said.

On Monday, Rampal ex-communicated the dog. A village panchayat was called, whi- ch decided that Sheru would now have to live with Sunita and her family because it had become an untouchable. Sunita Jatav was fined Rs 15,000.

An outraged Sunita and her brother Nahar Singh Jatav rushed to Sumawali police station. They were directed to take the matter to the SC/ST Atrocities police station in Kalyan. "When we went there, the officer asked us why we fed the dog," recalls Nahar. "So we went to the DSP in the SC/ST Atrocities department and submitted a memorandum to him, as also to the district collector. But no one has registered our FIR so far.

DSP SC/ST Atrocities (Morena), Baldev Singh, recalls, "We got a complaint in which it has been alleged that a dog was declared untouchable and a dalit family fined for feeding it. We are investigating the allegation," said the officer.


Read more: Dog cast(e) away after dalit touch - The Times of India http://timesofindia.indiatimes.com/india/Dog-caste-away-after-dalit-touch/articleshow/6617039.cms#ixzz10QQz6CQl

Riaz Haq said...

Here's an LA Times story on "Chalta Hai" attitude that was at the root of the mess in lead up to the CWG 2010:

The international embarrassment that India suffered in the run-up to the Commonwealth Games — marred by massive cost overruns, a collapsed bridge and widespread corruption allegations — has focused attention on a stubborn cultural condition that if not checked, analysts here say, could undercut India's superpower ambitions.

An attitude referred to in Hindi as "chalta hai," which translates to "it goes" but can mean "don't be bothered," "whatever," "it'll do," or "don't fret (such problems as corruption, delays, shoddy quality)."

Or in the words of one commentator: "It's OK dude, who cares?"

As the Games' closing ceremony wrapped up Thursday, the attitude appeared to be borne out. Chaos reigned until opening day of the international sports competition, but India ultimately pulled it off. There were no major terrorist attacks, India won 38 gold medals and dancing and marching bands wowed the closing crowd.

As the hangover sets in, however, some wonder why it took prime ministerial intercession to get toilets cleaned in the athletes village, why Indian planning compared so poorly with neighboring China's hosting of the 2008 Summer Olympics and whether a wing-it attitude befits a nation with such talent, potential and prospects.

"It doesn't matter if we're a growing superpower or the stock market's at record levels," said Vinod Mehta, editor in chief of the Outlook media group. "What these Games showed is that we've hit the limit on chalta hai."

Some see the attitude growing out of Hindu fatalism and rigid social hierarchies.

"It's a sense of 'que sera, sera,' pre-destination, you're born upper or lower caste," said Ravinder Kaur, a sociologist at the Indian Institute of Technology.

Others cite India's huge population and limited resources, which can leave individuals feeling powerless. "It's a coping device," said Amita Baviskar, a sociology professor at Delhi's Institute of Economic Growth.

For Santosh Desai, president of McCann-Erickson India, chalta hai is epitomized by a story his father recounted of a classmate who stole test answers, then only bothered to memorize the bare minimum required to pass.

Most cultures have something similar of sorts, including the Latin American "manana" and the Middle Eastern "bukrah, insha Allah" ("tomorrow, God willing") attitudes.

India's slack Games preparations epitomized chalta hai thinking, analysts said, but examples are widespread in India.

Riaz Haq said...

A US NIH funded study published in Lancet says over 200,000 Indians die of Malaria among 1.3 million infectious disease deaths reported in the country, according to a report by the BBC:

he number of people dying from malaria in India has been hugely underestimated, according to new research.

The data, published in the Lancet, suggests there are 13 times more malaria deaths in India than the World Health Organization (WHO) estimates.

The authors conclude that more than 200,000 deaths per year are caused by malaria.

The WHO said the estimate produced by this study appears too high.

The research was funded by the US National Institutes of Health, the Canadian Institute of Health Research and the Li Ka Shing Knowledge Institute.

The new figures raise doubts over the total number of malaria deaths worldwide.
Difficult diagnosis

Calculating how many people die from malaria is extremely difficult. Most cases that are diagnosed and treated do not result in fatalities.

People who die of extremely high fevers in the community can be misdiagnosed and the cause of death can be attributed to other diseases and vice versa.

As most deaths in India occur at home, without medical intervention, cause of death is seldom medically certified.

There are about 1.3 million deaths from infectious diseases, where acute fever is the main symptom in rural areas in India.

In this study, trained field workers interviewed families, asking them to describe how their relative died. Two doctors then reviewed each description and decided if the death was caused by malaria. This method is called verbal autopsy.

Some 122,000 premature deaths between 2001 and 2003 were investigated.

The data suggests that 205,000 deaths before the age of 70, mainly in rural areas, are caused by malaria each year.

Riaz Haq said...

While a mere 14 percent of people in rural India - that account for 65 percent of its 1.1 billion population - had access to toilets in 1990, the number had gone up to 28 percent in 2006. In comparison, 33 percent rural Pakistanis had access to toilets in 1990 and it went up to an impressive 58 percent in 2006, according to UNICEF.

Why is it that Pakistan has had more success than India in improving sanitation?

Both India and Pakistan have Community-Led Total Sanitation (CLTS) campaigns supported by UNICEF, with the aim of creating open defecation free villages through education and funding. For reasons which are not obvious, it seems that the strategy has produced better results in Pakistan than in India so far. One possible reason may be that CLTS India is state driven versus CLTS Pakistan is driven by community champions.

Here is the link to a paper by Lyla Mehta that sheds light on it:

http://www.dfid.gov.uk/R4D/PDF/Outputs/RIPPLE/working-paper-12.pdf

Riaz Haq said...

Here is a Bloomberg report on World Bank findings released today on the cost of missing toilets in India:

A lack of toilets costs India more than $50 billion a year, mostly through premature deaths and hygiene-related diseases, a study found.

Illness, lost productivity and other consequences of fouled water and inadequate sewage treatment trimmed 6.4 percent from India’s gross domestic product in 2006, or the equivalent of $53.8 billion, according to the study by the World Bank’s Water and Sanitation Program.

The finding suggests India bears a higher cost than other Asian countries from inadequate collection of human excreta: $48 per person, compared with $9.30 per person in Vietnam, $16.80 in the Philippines, $28.60 in Indonesia and $32.40 in Cambodia, the study’s authors found. More than three-quarters of the premature mortality-related economic losses are due to deaths and diseases in children younger than 5, according to the report.

“For decades we have been aware of the significant health impacts of inadequate sanitation in India,” Christopher Juan Costain, the program’s team leader for South Asia, said in a statement yesterday. “This report quantifies the economic losses to India, and shows that children and poor households bear the brunt of poor sanitation.”

Inadequate Sanitation

Diarrhea among children younger than 5 years accounts for more than 47 percent of the total health-related economic impacts, the study found. Premature mortality and other health- related impacts of inadequate sanitation were the most costly at $38.5 billion, 72 percent of the total economic burden, followed by productive time lost to access sanitation facilities or sites for defecation at $10.7 billion, or 20 percent, and drinking water-related impacts at $4.2 billion, or 7.8 percent.

“The cost is more than I expected,” Clarissa Brocklehurst, water, sanitation and hygiene chief at the United Nations Children’s Fund, said in a telephone interview from New York. “Yet, if you know the scale of open defecation in India, it’s not all that surprising.”

More than half of India’s 1.17 billion people were mobile- phone subscribers, yet only 366 million people had access to proper sanitation in 2008, a study published in April by the United Nations University, a UN research organ, found.

Eighteen percent of India’s urban population and 69 percent of rural dwellers defecated daily in fields, bushes, beaches and other open spaces, according to a March report by the World Health Organization and Unicef.

“It’s a long hard slog to change social norms around open defecation, to create an enabling environment where everybody can buy a toilet,” said Brocklehurst, who has lived and worked in New Delhi. “There is no glitzy solution.”

Riaz Haq said...

Here are some excerpts from a NY Times review of "GREAT SOUL: Mahatma Gandhi and His Struggle With India" by Joseph Lelyveld:

Some years ago, the British writer Patrick French visited the Sabarmati ashram on the outskirts of Ahmedabad in the Indian state of Gujarat, the site from which Mahatma Gandhi led his salt march to the sea in 1930. French was so appalled by the noisome state of the latrines that he asked the ashram secretary whose job it was to clean them.

A sweeper woman stopped by for an hour a day, the functionary explained, but afterward things inevitably became filthy again.

But wasn’t it a central tenet of the Mahatma’s teachings that his followers clean up after themselves?

“We all clean the toilets together, on Gandhiji’s birthday,” the secretary answered, “as a symbol to show that we understand his message.”

Gandhi had many messages, some ignored, some misunderstood, some as relevant today as when first enunciated. Most Americans — many middle-class Indians, for that matter — know what they know about the Mahatma from Ben Kingsley’s Academy Award-winning screen portrayal. His was a mesmerizing performance, but the script barely hinted at the bewildering complexity of the real man, who was at the same time an earnest pilgrim and a wily politician, an advocate of celibacy and the architect of satyagraha (truth force), a revivalist, a revolutionary and a social reformer.
--------
As Lelyveld shows, the outcomes of Gandhi’s campaigns in South Africa were neither clear-cut nor long-lasting: after one, his own supporters beat him bloody because they thought he’d settled too quickly for a compromise with the government. But they taught him how to move the masses — not only middle-class Hindu and Muslim immigrants but the poorest of the poor as well. He had, as he himself said, found his “vocation in life.”

Soon after returning to India in 1915, Gandhi set forth what he called the “four pillars on which the structure of swaraj” — self-rule — “would ever rest”: an unshakable alliance between Hindus and Muslims; universal acceptance of the doctrine of nonviolence, as tenet, not tactic; the transformation of India’s approximately 650,000 villages by spinning and other self-sustaining handicrafts; and an end to the evil concept of untouchability. Lelyveld shrewdly examines Gandhi’s noble but doomed battles to achieve them all.

He made a host of enemies along the way — orthodox Hindus who believed him overly sympathetic to Muslims, Muslims who saw his calls for religious unity as part of a Hindu plot, Britons who thought him a charlatan, radical revolutionaries who believed him a reactionary. But no antagonist was more implacable than Bhimrao Ramji Ambedkar, the brilliant, quick-tempered untouchable leader — still largely unknown in the West — who saw the Mahatma’s nonviolent efforts to eradicate untouchability as a sideshow at best. He even objected to the word ­Gandhi coined for his people — “Harijans” or “children of God” — as patronizing; he preferred “Dalits,” from the Sanskrit for “crushed,” “broken.”
---------
Gandhi is still routinely called “the father of the nation” in India, but it is hard to see what remains of him beyond what Lelyveld calls his “nimbus.” His notions about sex and spinning and simple living have long since been abandoned. Hindu-Muslim tension still smolders just beneath the uneasy surface. Untouchability survives, too, and standard-issue polychrome statues of Ambedkar in red tie and double-breasted electric-blue suit now outnumber those of the sparsely clothed Mahatma wherever Dalits are still crowded together.....

Riaz Haq said...

India's dirty big mess exposed to the public, reports The Australian:

...India is where human waste, discharged along the vast, 65,000km rail network, corrodes the tracks to such an extent the rails have to be replaced every 24 months instead of having a normal 30-year lifespan. This is the human waste left by the 20 million passengers carried each day by Indian Railways.

India is where staggering numbers tell a story of squalor that lies behind so much of the controversy and apprehension surrounding next month's Commonwealth Games.

More than six decades after India won its freedom from British colonial rule, 55 per cent of its people - by one count 638 million - do not have access to a toilet of any kind and defecate in the open.

Paradoxically, more people have access to mobile phones in India than to basic sanitation. A recent estimate suggested about 366 million people have access to sanitation while there are about 600 million mobile phones in service in the emerging economy.

"It is a tragic irony to think that in India, a country now wealthy enough that roughly half of the people own phones, about half cannot afford the basic necessity and dignity of a toilet," a UN report has stated.

It is hardly surprising that India's Environment and Forests Minister Jairam Ramesh has said: "If there is a Nobel prize for dirt and filth, India will win it, no doubt." He is right.

Outside of the glitz of the sumptuous hotels where many tourists stay, the reality is that despite the great strides India has achieved in some areas, hygiene standards in India remain abysmal. The notorious malady known as "Delhi belly" is rampant.

Indians have been let down severely by successive governments since independence. The sort of mindset that has allowed filth to spoil Commonwealth Games preparations is testament to that failure.

N. R. Narayana Murthy, an eminent Indian and founder of Infosys Technologies, has summed up that failure thus: "The enigma of India is that our progress in higher education and science and technology has not been sufficient to take 350 million Indians out of illiteracy. It is difficult to imagine that 318 million people in the country do not have access to safe drinking water and 250 million people do not have access to basic medical care. Why should 630 million people not have access to acceptable sanitation facilities?"

-----
"It is common to find sumptuous luxury apartments in buildings that are filthy, rotting and stained, whose common areas, walls and staircases have not been cleaned in generations. Each apartment owner is proud of his own immediate habitat but is unwilling to incur responsibility or expense for the areas shared with others, even in the same building.

"This attitude is also visible in the lack of a civic culture in both rural and urban India, which leaves public spaces dirty and garbage-strewn, streets potholed and neglected, civic amenities vandalised or not functioning. The Indian wades through dirt and filth, past open sewers and fly-specked waste, to an immaculate home where he proudly bathes twice a day."


http://www.theaustralian.com.au/news/opinion/indias-dirty-big-mess-exposed-to-the-public/story-e6frg6zo-1225929083779

Riaz Haq said...

Here's a NY Times story on dysfunction in Gurgaon, India:

Gurgaon, located about 15 miles south of the national capital, New Delhi, would seem to have everything, except consider what it does not have: a functioning citywide sewer or drainage system; reliable electricity or water; and public sidewalks, adequate parking, decent roads or any citywide system of public transportation. Garbage is still regularly tossed in empty lots by the side of the road.

With its shiny buildings and galloping economy, Gurgaon is often portrayed as a symbol of a rising “new” India, yet it also represents a riddle at the heart of India’s rapid growth: how can a new city become an international economic engine without basic public services? How can a huge country flirt with double-digit growth despite widespread corruption, inefficiency and governmental dysfunction?

In Gurgaon and elsewhere in India, the answer is that growth usually occurs despite the government rather than because of it. India and China are often considered to be the world’s rising economic powers, yet if China’s growth has been led by the state, India’s growth is often impeded by the state. China’s authoritarian leaders have built world-class infrastructure; India’s infrastructure and bureaucracy are both considered woefully outdated.

Yet over the past decade, India has emerged as one of the world’s most important new engines of growth, despite itself. Even now, with its economy feeling the pressure from global inflation and higher interest rates, some economists predict that India will become the world’s third largest economy within 15 years and could much sooner supplant China as the fastest-growing major economy.

Moreover, India’s unorthodox path illustrates, on a grand scale, the struggles of many smaller developing countries to deliver growth despite weak, ineffective governments. Many have tried to emulate China’s top-down economic model, but most are stuck with the Indian reality. In India, Gurgaon epitomizes that reality, managing to be both a complete mess and an economic powerhouse, a microcosm of Indian dynamism and dysfunction.

In Gurgaon, economic growth is often the product of a private sector improvising to overcome the inadequacies of the government.

To compensate for electricity blackouts, Gurgaon’s companies and real estate developers operate massive diesel generators capable of powering small towns. No water? Drill private borewells. No public transportation? Companies employ hundreds of private buses and taxis. Worried about crime? Gurgaon has almost four times as many private security guards as police officers.

“You could call it the United States of Gurgaon,” said Sanjay Kaul, an activist critical of the city’s lack of planning who argues that Gurgaon is a patchwork of private islands more than an interconnected city. “You are on your own.”

Gurgaon is an extreme example, but it is not an exception. In Bangalore, outsourcing companies like Infosys and Wipro transport workers with fleets of buses and use their own power generators to compensate for the weak local infrastructure. Many apartment buildings in Mumbai, the nation’s financial hub, rely on private water tankers. And more than half of urban Indian families pay to send their children to private schools rather than the free government schools, where teachers often do not show up for work.


http://www.nytimes.com/2011/06/09/world/asia/09gurgaon.html?_r=1&scp=1&sq=gurgaon&st=cse

Riaz Haq said...

Lack of water and toilets are a major problem for Anna Hazare supporters in New Delhi, according to media reports:

As droves of people flocked to Ramlila Maidan to voice their support for Anna Hazare, lack of water and sanitation facilities at the venue tested the resolve of quite a few supporters.

With the protests probably stretching over more than two weeks, protesters hope that arrangements will be made soon for clean drinking water and medicines to alleviate the suffering of the people flocking to support the movement.

According to the agreement reached between Team Anna and police, the organisers have to arrange for drinking water, medical aid and mobile toilets.

A protester at the venue said, "There is no water and toilets are in a deplorable condition. People, especially women, who have come from outside Delhi are suffering terribly here."

Scarcity of water and sanitation facilities at the venue have created trouble for the Gandhian's supporters, with one fainting and being rushed to a hospital.

One Vishnu Dutt Sharma from Uttar Pradesh who is fasting in the city collapsed in the morning and was rushed to LNJP hospital where he is being treated. "He did not have food or water for three days. He fell unconscious," an agitator said.

A doctor at the venue said the basic problem was scarcity and the quality of water the protesters were drinking.

"There is no proper arrangement for water supply and people are not carrying bottled water. So they are facing problems," he said.

To provide relief, a group of doctors from Indian Medical Association have set up camp at the venue to ensure round-the-clock emergency medical care free of cost to the supporters.

Dr AP Singh of IMA said, "We have volunteered to provide free medical services because we support the cause of Hazare and his team. Corruption affects everybody, including us and we feel that if we can contribute in some way to this movement, we would have done our part."

Dr Sachin Bhargav, another doctor, said, "we are providing medicines free of cost, and paying for them from our own pockets, because we believe in Anna's cause, and sympathise with the poor people who have come here from villages all over India."

Armed with medicines for common ailments like dehydration, gastro-enteritis and fever, the doctors have treated over 400 patients since the protest began at Ramlila Maidan, and referred around 10 patients to nearby hospitals.

The doctors have put their own practise at stake to volunteer at the Maidan.

"The government is not providing proper facilities because it wants the people to leave as soon as possible. Despite this, people won't leave, and we won't rest till the government agrees to Hazare's demands," Amina Khan, a nurse, alleged.

The doctors are also playing a part in ensuring that the crowd doesn't go out of control. Singh said, "If any supporter becomes too aggressive or starts hyperventilating, volunteers bring him to us, and we give them medicines to calm them down, thus preventing any untoward incident."


http://www.dnaindia.com/india/report_lack-of-water-sanitation-test-resolve-of-anna-s-supporters_1577883

Riaz Haq said...

Here's an excerpt from Britain's DFID report on open defecation around the world:

58% of the open defecation in the world takes place in India. It is an absolutely astonishing phenomenon. Even just rural India is more than double the open defecation in the whole of
sub-Saharan Africa. The WSP, the Water and Sanitation Programme at the Bank, have recently done an assessment of the costs of this to India, and every
year they estimate $54 billion, which is $48 per head, which is far higher than any other countries in the
region.


http://reliefweb.int/sites/reliefweb.int/files/reliefweb_pdf/node-420188.pdf

Sense of public hygiene is worst in India among its neighbours – a recent study revealed that India hosts 58% people of the world of open defecation compare to 5% for china, Indonesia and 4.8% for Pakistan. Economic growth is not reflecting improvement in public hygiene.

http://esa.un.org/iys/docs/san_lib_docs/Scaling%20Up%20Rural%20Saniltation.pdf

http://www.thehindu.com/news/national/article2494536.ece

http://www.who.int/water_sanitation_health/monitoring/jmpfinal.pdf

Riaz Haq said...

This is one statistics that will put India in the poor light. A report by WHO-UNICEF says that Indians comprised 58 percent of all people who defecate in the open. However, the worldwide figures show a decline from the previous years’. The report points out that open defecation worldwide is on decline from 25 per cent in 1990 to 17 per cent in 2008.

Some of the key findings of the report:

Around 638 million people do not have access to toilets in India followed by Indonesia (58m), China (50m), Ethiopia (49m), Pakistan (48m), Nigeria (33m) and Sudan (17m).
18 percent of urban India still defecates in open while the percentage of rural India is as high as 69 percent.
At least 44 percent of the population defecates in the open only in South Asia.
Unsafe water, sanitation and hygiene claim the lives of an estimated 1.5 million children under the age of five each year.
It also underlines that open defecation leads to deadly diarrhoea and other intestinal diseases which kills hundreds of thousands of people worldwide every year.
The report also says with only five more years to go until 2015, a major leap in efforts and investments in sanitation is needed to fulfill the targets of Millennium Development Goal.

The report also says with only five more years to go until 2015, a major leap in efforts and investments in sanitation is needed to fulfill the targets of Millennium Development Goal.

Read the entire report here

http://www.governancenow.com/views/think-tanks/open-defecation-%E2%80%93-india%E2%80%99s-shame

http://www.unicef.org/media/files/JMP-2010Final.pdf

Riaz Haq said...

UNICEF says India tops the world in open defecation, according to the Times of India:

NEW DELHI: With India facing the slur of topping the global list in open defecation, the Centre is keen to put the sanitation programme back on the centrestage by sensitizing the population about public hygiene.

The Union rural development ministry along with states will organize a month-long campaign from October 2, the birth anniversary of Mahatma Gandhi, to create awareness for its flagship scheme of Total Sanitation Campaign.

According to a UNICEF survey, 58% of the world's population practicing open defecation lives in India while China and Indonesia come a distant second by accounting for just 5% of the world numbers. Pakistan is down to third with 4.5%, tied with Ethiopia.

The numbers are astounding as the prosperity of liberalized India does not seem to translate into better sanitation.

RD minister Jairam Ramesh said, "I consider these numbers a matter of great anguish and shame. We must make sanitation a political campaign like Gandhiji did. Kerala, Sikkim, Maharashtra, Haryana and Himachal are doing well but other states have to pick up significantly."

There is little denying the anguish given that the numbers do not tie up with the sanitation standards expected of improving financial economy as well as urbanizing India.

As per national population figures, 54% of India's population practices open defecation against China's 4%.

The national figures do push up numbers in smaller and poor countries. Like Indonesia has 26% of its population practicing open defecation as against its contribution of only 5% to the world population. The national figure stands at 60% for Ethiopia, 28% for Pakistan and 50% for Nepal.

Neighbouring Sri Lanka, in contrast, has only 1% of its citizens going to toilet in the open.

Ramesh said, "We are going to focus now on `nirmal gram abhiyan' -- today 25,000 nirmal grams are a tiny fraction of 6 lakh villages. These nirmal grams are in Maharashtra and Haryana. Maharashtra is a success of social movements while Haryana an example of determined state government action."

As part of the awareness drive, the states have been asked to take active interest with chief secretaries issuing directions for the awareness drive up to the panchayat level. It may include household contact programme and gram sabha meetings to highlight the benefits of an environment free of open defecation. The panchayats would also train masons to construct toilets.


http://timesofindia.indiatimes.com/india/With-58-figures-India-tops-in-open-defecation/articleshow/10200781.cms

Riaz Haq said...

Minister says India’s rank as No. 1 country for open defecation a source of national shame, according to Washington Post and AP:

NEW DELHI — India’s rural development minister is pushing a campaign on public hygiene, after a recent survey revealed that India accounts for 58 percent of the world’s population practicing open defecation.

Jairam Ramesh says the revelation is a source of national shame and a “sad commentary” on society’s failure to address the issue through education and better sanitation.

The government says it spends $350 million a year to build rural toilets, but some 638 million still rely on fields or quiet corners.

The UNICEF report puts China and Indonesia in second place, with each representing 5 percent of the world’s 1.1 billion open defecators.

Ramesh said Sunday that filth was polluting the environment as well as public spaces, and Indian rivers had become sewers.


http://www.washingtonpost.com/world/asia-pacific/minister-says-indias-rank-as-no-1-country-for-open-defecation-a-source-of-national-shame/2011/10/02/gIQAdWTqGL_story.html

Riaz Haq said...

Bollywood star Shahrukh Khan to champion sanitation campaign in India, reports The Guardian:

Sanitation and hygiene are sensitive and unpopular subjects, but funding them is essential to fighting disease, ensuring basic rights and meeting millennium development goals.

It is hardly the most glamorous role for Shah Rukh Khan, yet "the king of Bollywood" has agreed to lend his name to the cause of sanitation and hygiene, the laggards in the millennium development goals.

Basic sanitation, covering subjects such as toilets, latrines, handwashing and waste, is not an MDG in its own right, instead falling under MDG7 on ensuring environmental sustainability. But sanitation and hygiene have been the poor cousins in the global Wash (water, sanitation and hygiene) work and programmes, outfunded by as much as 13 to one, even though it could be argued that most water-related diseases are really sanitation-related diseases.

As the UN secretary general, Ban Ki-moon, said in June, sanitation is a sensitive and unpopular subject, so it is unsurprising it fails to garner much public or official attention – although the UN declared access to water and sanitation a fundamental right in 2010 and there is a UN rapporteur on the human right to safe drinking water and sanitation.
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The problem is stark. As many as 1.2 billion people practice what the UN politely describes as "open defecation". They go to the toilet behind bushes, in fields, in plastic bags or along railway tracks. The practice poses particular problems for women and girls, who can be subject to physical and verbal abuse or humiliation. Sexual harassment and rape are also a risk for women who wait until dark to relieve themselves.

There is a link between sanitation and girls' education as well. Separate toilets at school mean more girls are likely to attend in the first place, and more are likely to stay on after puberty to complete their education. The UN's Water Supply and Sanitation Collaborative Council (WSSCC), based in Geneva, suggests that some money from education budgets should go towards providing toilets for students and teachers, with separate facilities for girls, to maximise the impact of the increase in education spending.

Better sanitation would also save lives, as 1.6 million children die every year from diarrhoea, a disease that could be prevented with clean water and basic sanitation. The UN says improving the disposal of human waste can reduce illness due to diarrhoea by 34%. When combined with hand-washing, this impact can be doubled.

As Timeyin Uwejamomere wrote on the Poverty Matters blog this week, a lack of basic toilets and waste management is a severe public health hazard, especially in a dense urban environment where diseases like cholera can spread like wildfire. He noted that in sub-Saharan Africa more children die from diarrhoeal diseases caused by a lack of sanitation and safe water than they do from measles, HIV and Aids, and malaria combined.
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In a sign that sanitation is receiving greater attention, the WSSCC is holding its first-ever global forum on sanitation and hygiene, starting on Sunday in Mumbai, bringing together activists, business leaders, health professionals and governmental officials. This follows a drive launched by the UN in June to accelerate progress towards the goal of halving, by 2015, the proportion of the population without access to basic sanitation.

Indicative of the increasing focus on water, sanitation and hygiene, the UK's Department for International Development is increasing bilateral aid on the problem. Based on Guardian analysis, spending will go up to £113.8m by 2014-15 from £82.9m in 2010-11, a 32% rise. So hats off to Shah Rukh Khan for his willingness to sign on to the Wash cause.

Riaz Haq said...

India will not reach its Millennium Development Goal on sanitation before 2047, while Bangladesh, Pakistan and Nepal will not achieve the target before 2028, according to a United Nations report released on the eve of World Toilet Day 2011.

The WaterAid report titled "Off-track, off-target: Why investment in water, sanitation and hygiene is not reaching those who need it most" says that 818 million Indians and 98 million Pakistanis lack access to toilets. It also reports that 148 million Indians and 18 million Pakistanis do not have adequate access to safe drinking water.

http://www.riazhaq.com/2011/11/india-pakistan-off-track-off-target-on.html

Riaz Haq said...

It is official: India has the world's most toxic air, according a news report in The Hindu:

In a study by Yale and Columbia Universities, India holds the very last rank among 132 nations in terms of air quality with regard to its effect on human health.

India scored a miniscule 3.73 out of a possible 100 points in the analysis, lagging far behind the next worst performer, Bangladesh, which scored 13.66. In fact, the entire South Asian region fares badly, with Nepal, Pakistan and China taking up the remaining spots in the bottom five of the rankings.

These rankings are part of a wider study to index the nations of the world in terms of their overall environmental performance. The Yale Center for Environmental Law and Policy and Columbia's Center for International Earth Science Information Network have brought out the Environment Performance Index rankings every two years since 2006.

In the overall rankings — which takes 22 policy indicators into account — India fared minimally better, but still stuck in the last ten ranks along with environmental laggards such as Iraq, Turkmenistan and Uzbekistan. At the other end of the scale, the European nations of Switzerland, Latvia and Norway captured the top slots in the index.

India's performance over the last two years was relatively good in sectors such as forests, fisheries, biodiversity and climate change. However, in the case of water — both in terms of the ecosystem effects to water resources and the human health effects of water quality — the Indian performance is very poor.

The Index report was presented at the World Economic Forum currently taking place in Davos, where it's being pitched as a means to identify the leaders and the laggards on energy and environmental challenges prior to the iconic Rio+20 summit on sustainable development to be held in Brazil this June.


http://www.thehindu.com/sci-tech/energy-and-environment/article2837739.ece

http://epi.yale.edu/epi2012/rankings

Riaz Haq said...

A newly-wed woman in a village in the Indian state of Madhya Pradesh recently left her husband's home because the house had no toilet, reports BBC:

Anita Narre returned eight days later after her husband, a daily wage worker, built one with savings and aid from villagers.

An NGO announced a $10,000 reward for Mrs Narre for her "brave" decision and forcing her husband to build a toilet.

More than half a billion Indians still lack access to basic sanitation.

The problem is acute in rural India and it is the women who suffer most.

Mrs Narre's husband, Shivram, said he was not able to build a toilet at home because of lack of money.

He admitted that his wife returned home only after he constructed one with his savings and "some support from the village council".

"It is not nice for women to go outside to defecate. That's why every home should have a toilet. Those who don't should make sure there is one," Mrs Narre told the BBC.

Many people in India do not have access to flush toilets or other latrines.

But under new local laws in states like Chhattisgarh, representatives are obliged to construct a flush toilet in their own home within a year of being elected. Those who fail to do so face dismissal.

The law making toilets mandatory has been introduced in several Indian states as part of the "sanitation for all" drive by the Indian government.

The programme aims to eradicate the practice of open defecation, which is common in rural and poor areas of India.

Special funds are made available for people to construct toilets to promote hygiene and eradicate the practice of faeces collection - or scavenging - which is mainly carried out by low-caste people.

http://www.bbc.co.uk/news/world-asia-india-17022847

Riaz Haq said...

Here's a BBC report on power cut and sanitation problems at the Indian parliament:

A foul smell emanating from sewage in a toilet in India's upper house of parliament, the Rajya Sabha, forced it to adjourn twice on Thursday.

Congress party lawmaker Rama Chandra Khuntia first complained of the smell when a minister was replying to a question in the House.

The first adjournment lasted for 15 minutes. But the continuing stink forced lawmakers to exit again.

Mr Khuntia told the BBC the smell was due to "poor maintenance".

"Everyone in the Rajya Sabha, panicked. Initially, we thought it was a gas leak. But then we realised the stench emanated from the toilet."

"We were told the smell from a toilet adjacent to a canteen found its way inside the House through air-conditioning ducts," Mr Khuntia said.

The incident comes three days after brief power cuts interrupted parliament proceedings.

Television news channel NDTV quoted the main opposition party BJP's Ravi Shankar Prasad as saying: "We talk of nuclear safety, we should at least ensure safety of smell in the House."


http://www.bbc.co.uk/news/world-asia-india-18024831

Riaz Haq said...

Here's a story in The Hindu on shining new Chennai airport's stinking toilets:

A constant complaint at the Chennai airport, is the state of its toilets — those in the old domestic terminal as well as the ones in the international terminal. Every day, passengers fork out thousands of rupees for their fares, part of which goes towards the maintenance of the airport. The airport’s toilets though, are constantly in an abysmal state.

The stench emanating from them has compelled several frequent flyers to do without using them.

“Toilets at the airport here are some of the worst, compared to those in other cities. When Mumbai and New Delhi can maintain their airports so well, why is there a problem here?” asked Ananya Rajan, a frequent flyer from Chennai to Delhi.

Tissues are strewn all over inside the toilets, and dustbins overflow as there is no proper disposal of waste. Often, the soap dispensers don’t work, say several passengers.

“It always smells bad. The authorities could at least spray air-fresheners inside from time to time. I’m forced to do away with using the toilet many times because of the odour,” said a passenger who did not wish to be named. She added that the toilet closets were stained and the seats unclean.

“All of us know about the condition of the toilets here, but we are not able to do anything about it. In fact, even we hesitate to use them,” an airport official said.

Airport director H.S. Suresh said, “While some toilets have already been renovated, some are being done at present. We will see to that the issue is resolved very soon.”


http://www.thehindu.com/news/cities/chennai/article3859678.ece

Riaz Haq said...

Here's a Reuters' piece on absence of hygiene in India:

My Indian friends and I joke around a lot about me as the typical white American guy visiting India. Cows! Con men! Colors! Most people I’ve met in India have restricted their reactions to my westerner-in-the-east experiences to gentle teasing. When I stuck a picture of a man urinating in public on my Facebook page, calling it one more picture of what you see everywhere you go in India, people weren’t as patient. What was I doing? Insulting the nation? Focusing on the ugly because it’s what all the westerners do when they visit India? Why does India provoke such visceral reactions in visitors?

Public urination, public defecation, dirt, garbage, filth, the poor living on the street — talking about these things, even acknowledging that they’re in front of your face, risks making your hosts unhappy, and possibly angry. It’s the third rail of India, and the voltage can be lethal. That’s why I was surprised when B.S. Raghavan decided to touch it with all 10 fingers.

Raghavan’s column in The Hindu Business Line newspaper begins with this headline: Are Indians by nature unhygienic?

Consider these excerpts:

From time to time, in their unguarded moments, highly placed persons in advanced industrial countries have burst out against Indians for being filthy and dirty in their ways of life. A majority of visitors to India from those countries complain of “Delhi belly” within a few hours of arrival, and some fall seriously ill.

There is no point in getting infuriated or defensive about this. The general lack of cleanliness and hygiene hits the eye wherever one goes in India — hotels, hospitals, households, work places, railway trains, airplanes and, yes, temples. Indians think nothing of spitting whenever they like and wherever they choose, and living in surroundings which they themselves make unliveable by their dirty habits. …

Open defecation has become so rooted in India that even when toilet facilities are provided, the spaces round temple complexes, temple tanks, beaches, parks, pavements, and indeed, any open area are covered with faecal matter. …

Even as Indians, we are forced to recoil with horror at the infinite tolerance of fellow Indians to pile-ups of garbage, overflowing sewage, open drains and generally foul-smelling environs.

There’s plenty more that you can read in that story, but I’ll direct you to the article. I’ll also ask you some questions:

Some people say you shouldn’t point out these problems, and that every country has problems. Do you agree with this statement? Why?
Does anyone disagree with Raghavan’s descriptions of these sights and smells?
Is this even a problem? Or should people get used to it?
Should visitors, especially ones from countries where people are generally wealthier, say nothing, and pretend that they don’t see unpleasant things?

As for me, I can say this: I got used to it, but I would be lying if I said I didn’t notice it. Indians notice it too. Otherwise, people wouldn’t suggest public shaming campaigns against people urinating in public, they wouldn’t threaten fines for doing it, and they wouldn’t respond with relief to plans to finally make sure that toilets on India’s trains don’t open directly onto the tracks. Of course, these are people in India. It’s a family, taking care of business the family way.

As for me, the message usually seems to be: “If you don’t love it, leave it.” It would be nice if there were some other answer. Acknowledging problems, even ones that are almost impossible to solve, makes them easier to confront.


http://blogs.reuters.com/india/2012/11/17/indians-inherently-unhygienic-indian-writer-touches-third-rail/

Riaz Haq said...

Here's a Reuters' blog post on lack of hygiene in India:

My Indian friends and I joke around a lot about me as the typical white American guy visiting India. Cows! Con men! Colors! Most people I’ve met in India have restricted their reactions to my westerner-in-the-east experiences to gentle teasing. When I stuck a picture of a man urinating in public on my Facebook page, calling it one more picture of what you see everywhere you go in India, people weren’t as patient. What was I doing? Insulting the nation? Focusing on the ugly because it’s what all the westerners do when they visit India? Why does India provoke such visceral reactions in visitors?

Public urination, public defecation, dirt, garbage, filth, the poor living on the street — talking about these things, even acknowledging that they’re in front of your face, risks making your hosts unhappy, and possibly angry. It’s the third rail of India, and the voltage can be lethal. That’s why I was surprised when B.S. Raghavan decided to touch it with all 10 fingers.

Raghavan’s column in The Hindu Business Line newspaper begins with this headline: Are Indians by nature unhygienic?

Consider these excerpts:

From time to time, in their unguarded moments, highly placed persons in advanced industrial countries have burst out against Indians for being filthy and dirty in their ways of life. A majority of visitors to India from those countries complain of “Delhi belly” within a few hours of arrival, and some fall seriously ill.

There is no point in getting infuriated or defensive about this. The general lack of cleanliness and hygiene hits the eye wherever one goes in India — hotels, hospitals, households, work places, railway trains, airplanes and, yes, temples. Indians think nothing of spitting whenever they like and wherever they choose, and living in surroundings which they themselves make unliveable by their dirty habits. …

Open defecation has become so rooted in India that even when toilet facilities are provided, the spaces round temple complexes, temple tanks, beaches, parks, pavements, and indeed, any open area are covered with faecal matter. …

Even as Indians, we are forced to recoil with horror at the infinite tolerance of fellow Indians to pile-ups of garbage, overflowing sewage, open drains and generally foul-smelling environs.

There’s plenty more that you can read in that story, but I’ll direct you to the article. I’ll also ask you some questions:

Some people say you shouldn’t point out these problems, and that every country has problems. Do you agree with this statement? Why?
Does anyone disagree with Raghavan’s descriptions of these sights and smells?
Is this even a problem? Or should people get used to it?
Should visitors, especially ones from countries where people are generally wealthier, say nothing, and pretend that they don’t see unpleasant things?
As for me, I can say this: I got used to it, but I would be lying if I said I didn’t notice it. Indians notice it too. Otherwise, people wouldn’t suggest public shaming campaigns against people urinating in public, they wouldn’t threaten fines for doing it, and they wouldn’t respond with relief to plans to finally make sure that toilets on India’s trains don’t open directly onto the tracks. Of course, these are people in India. It’s a family, taking care of business the family way.

As for me, the message usually seems to be: “If you don’t love it, leave it.” It would be nice if there were some other answer. Acknowledging problems, even ones that are almost impossible to solve, makes them easier to confront.


http://blogs.reuters.com/india/2012/11/17/indians-inherently-unhygienic-indian-writer-touches-third-rail/

Riaz Haq said...

Here's a Time magazine story of a finding that Indian children's exceptionally short heights are attributable to poor sanitation in India, not malnutrition:

Children in India are exceptionally short, with their stunted growth historically attributed to malnutrition. However, new evidence is suggesting that food, or lack of it, is not the cause. Noticing that Indian children were smaller than their counterparts in Sub-Saharan Africa — who are, on average, poorer and hence less well fed — researchers have been coming to the conclusion that diseases stemming from poor sanitation are more to blame than diet.

More than half of India’s population — over 600 million people — do not use a toilet because sanitation is inaccessible or unaffordable. At the same time 61.7 million Indian children are stunted, the highest prevalence in the world.

The atrocious hygiene that results from widespread lack of sanitation is made worse by the density of the population. With large numbers of people openly defecating, fecal-oral-transmitted infections are common, leading to diarrhea, with such diseases draining growing children of vital nutrients. Growing up in environments teeming with fecal pathogens has a permanently debilitating effect, experts say. Overtime, a large build-up of fecal germs in the body can also manifest as severe intestinal diseases.

Last month, a group of economists, epidemiologists, pediatricians and nutritionists gathered at a conference in New Delhi to push for recognition of poor sanitation as the cause of child stunting in India. “It was striking that each of them [participants] had something to say about sanitation being important for child health,” Sangita Vyas, of the Research Institute for Compassionate Economics, which coorganized the meeting, told TIME. Such claims emerge at a time when the results of a massive government survey into the availability of sanitation have become available and converged with long-standing epidemiological literature.

Rural Indians remain hard to convince that this is a health epidemic, researchers say, because stunting creeps through communities, affects “everybody on average” and there are “no real dramatic cases,” Princeton University economist Dean Spears, who is currently at the Delhi School of Economics, told TIME. “The sorts of dramatic tragedies that persuade people [to change] don’t happen,” he says.

(MORE: Are Toilets a Feminist Issue? Why the Burden of Bad Sanitation Falls on Women)

A few years ago, a government sanitation program was implemented in half of 60 villages in Ahmednagar, Maharashtra, Western India. After the program, Spears and fellow economist Jeff Hammer found on average, that the height of children in the experimental group had increased by about one centimeter, relative to those in the 30 villages where the program had not been introduced.

“Widespread child-stunting in India is a human development emergency,” Spears says. “It matters for everybody.”


http://world.time.com/2013/09/09/poor-sanitation-not-malnutrition-may-be-to-blame-for-indias-notoriously-stunted-children/

Riaz Haq said...

@UNICEFIndia Is Inviting #India to a Poo Party #IndiaElections #Sanitation #hygiene #Toilettes https://news.vice.com/articles/unicef-is-inviting-india-to-a-poo-party … via @vicenews

Riaz Haq said...

NY Times: India's malnutrition and stunting due to poor sanitation.


SHEOHAR DISTRICT, India — He wore thick black eyeliner to ward off the evil eye, but Vivek, a tiny 1-year-old living in a village of mud huts and diminutive people, had nonetheless fallen victim to India’s great scourge of malnutrition.

His parents seemed to be doing all the right things. His mother still breast-fed him. His family had six goats, access to fresh buffalo milk and a hut filled with hundreds of pounds of wheat and potatoes. The economy of the state where he lives has for years grown faster than almost any other. His mother said she fed him as much as he would eat and took him four times to doctors, who diagnosed malnutrition. Just before Vivek was born in this green landscape of small plots and grazing water buffalo near the Nepali border, the family even got electricity.

So why was Vivek malnourished?

It is a question being asked about children across India, where a long economic boom has done little to reduce the vast number of children who are malnourished and stunted, leaving them with mental and physical deficits that will haunt them their entire lives. Now, an emerging body of scientific studies suggest that Vivek and many of the 162 million other children under the age of 5 in the world who are malnourished are suffering less a lack of food than poor sanitation.

Two years ago, Unicef, the World Health Organization and the World Bank released a major report on child malnutrition that focused entirely on a lack of food. Sanitation was not mentioned. Now, Unicef officials and those from other major charitable organizations said in interviews that they believe that poor sanitation may cause more than half of the world’s stunting problems.

“Our realization about the connection between stunting and sanitation is just emerging,” said Sue Coates, chief of water, sanitation and hygiene at Unicef India. “At this point, it is still just an hypothesis, but it is an incredibly exciting and important one because of its potential impact.”

This research has quietly swept through many of the world’s nutrition and donor organizations in part because it resolves a great mystery: Why are Indian children so much more malnourished than their poorer counterparts in sub-Saharan Africa?

A child raised in India is far more likely to be malnourished than one from the Democratic Republic of Congo, Zimbabwe or Somalia, the planet’s poorest countries. Stunting affects 65 million Indian children under the age of 5, including a third of children from the country’s richest families.....
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No Indian city has a comprehensive waste treatment system, and most Indian rivers are open sewers as a result. But Varanasi, India’s oldest and holiest city, is so awash in human waste that its decrepit condition became a national issue in recent elections. The city’s sewage plants can handle only about 20 percent of the sewage generated in the city, said Ramesh Chopra of Ganga Seva Abhiyanam, a trust for cleaning the river. The rest sloshes into the Ganges or fetid ponds and pits.

Millions of pilgrims bathe in the Ganges along Varanasi’s ancient riverfront, but a stream of human waste — nearly 75 million liters per day — flows directly into the river just above the bathing ghats, steps leading down to the river. Many people wash or brush their teeth beside smaller sewage outlets.

Much of the city’s drinking water comes from the river, and half of Indian households drink from contaminated supplies.

“India’s problems are bigger than just open defecation and a lack of toilets,” Dr. Laxminarayan said.


http://www.nytimes.com/2014/07/15/world/asia/poor-sanitation-in-india-may-afflict-well-fed-children-with-malnutrition.html?_r=0