Thursday, October 6, 2011

India Leads the World in Open Defecation

India's rivers have been turned into open sewers by 638 million Indians without access to toilets, according to rural development minister Jairam Ramesh. He was reacting a UNICEF report that says Indians make up 58% of the world population which still practices open defection, and the sense of public hygiene in India is the worst in South Asia and the world.



India(638m) is followed by Indonesia (58m), China (50m), Ethiopia (49m), Pakistan (48m), Nigeria (33m) and Sudan (17m). In terms of percentage of each country's population resorting to the unhygienic practice, Ethiopia tops the list with 60%, followed by India 54%, Nepal 50%, Pakistan 28%, Indonesia 26%, and China 4%.

18 percent of urban India still defecates in open while the percentage of rural India is as high as 69 percent of the population. It is the key reason why India carries among the highest infectious disease burdens in the world.

The number of open defecators in rural India alone is more than twice those in the whole of sub-Saharan Africa, according to a report by DFID, the UK's Department for International Development.

The World Bank has estimated that open defecation costs India $54 billion per year or $48 per head. This is more than the Government of India’s entire budget for health.

The UNICEF report says that with only four more years to go until 2015, a major leap in efforts and investments in sanitation is needed to reach the targets of Millennium Development Goals.

After the embarrassing headlines, it appears that Minister Ramesh is ready to step up the efforts to improve sanitation. He is quoted by Times of India as saying that "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."

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:

Haq's Musings

Fixing Sanitation Crisis in India

Food, Clothing and Shelter in India and Pakistan

Heavy Disease Burdens in South Asia

Peepli Live Destroys Indian Myths

India After 63 Years of Independence

Poverty Across India 2011

India and Pakistan Contrasted

33 comments:

sumanbasu said...

ok. India is the filthiest, dirtiest, most corrupt country in the world with hungriest, ugliest people performing the most brutal cast and religious practices.

Pakistan must be heaven compared to the hell-hole called India.

Then why do you need to reemphasize it every day, sir?
Should it not be evident?

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.
----------
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.
-------
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...

Here's the story of two Indias by World Bank's managing director Dr. Ngozi Okonjo-Iweala:

India’s global profile is rising—from a slow-growing poor country to a burgeoning economic power:

· India grew fast before the crisis--9% per year--and has resumed fast growth--8.6% in the fiscal year that ended in March.

· India is globally recognized as a key player in the IT revolution, and in sectors as diverse as pharmaceutical, cement, steel and space
---------
But there is also another India:

· India’s GNI per capita ($1170) is lower than that of 161 other countries. World Bank’s poverty numbers show 456 million people in India are poor—about one-third of the world’s poor, and more than in all of Sub-Saharan Africa.

· India lags significantly on health and nutrition targets: It is home to half of world’s underweight children, and it accounts for 1 in 5 maternal and child deaths worldwide.

· Social exclusion remains a stark reality—Scheduled Tribes lag twenty years behind the general population, Scheduled Castes ten years; gender norms can be quite restrictive and gender gap persists in realms such as child mortality and labor force participation.
The 9% growth hides an infrastructure crisis. Innovation in the private sector has often got around this—60% of firms and a large percentage of homes rely on back-up generation, and on an industry of logistical firms. But this has costs, and sooner or later infrastructure constraints will bite, and growth will slow, absent major change. This is especially true in urban areas.
PPPs are often hailed as a solution. Private participation in infrastructure took off in the early 1990s in telecoms and power supply. Highway, port, and airport concessions began to emerge in the late 1990s, with water supply and solid waste management following. We have been here before. In the 1990s Latin America had major infrastructural gaps, and PPPs were thought to be the solution (including by the World Bank). But gaps were effectively closed only in telecoms (which was not an issue for India) and in Chile (a small country with by far the best governance to manage private sector involvement). Elsewhere, there was insufficient private involvement, or private involvement that was high cost, often corrupt, and with frequent renegotiation to extract better deals from the state and society.

The lesson is that improving governance, and solving institutional problems, is unavoidable to improve infrastructure provision, and is necessary for effective private involvement.

The challenge here is so well-known that I do not need to dwell on it much. India has enormous untapped potential—productivity in Eastern states, for instance, is well below what it is in Punjab, and sustainability is an issue in states like Punjab.
-----------
V. Education: Focus on results, not inputs

The two Indias are very visible in education: Graduates of India's famed Institutes of Technology literally drive growth. But basic and secondary education are dismal. In fact, even in tertiary education quality is in islands of excellence, not widespread. The demographic dividend can turn into a demographic curse if the millions of young people entering the labor market every year are not equipped to take up the jobs that a fast-growing economy can create...

Najam said...

At Muzdalafa,they have now built many many decent toilets.But on my last Hujj,back in 1997 with some friends,at Muzdalfa ,late at night I noticed 2 Huge Sudanese men and women releasing their pressure few yards away from our temporary resting place
What are they doing? My wife asked.
Never mind,let's move from here .

Riaz Haq said...

Najam,

I think what you saw is the little league compared to the big league of open defecation in India.

Here's a Bloomberg report on sanitation in India:

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.

http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aErNiP_V4RLc&refer=exclusive

Moazzam said...

Riaz & Najm:

Amusing!

At least they have learnt how to shun any "mischief".

May be that's why they are next in line for the "super power" slot!

Riaz Haq said...

Moazzam,

India is home to the world's largest population of poor, hungry, illiterate and sick people after 64 years of independence.

I can't imagine a superpower with the excessive baggage of hunger, poverty, illiteracy and disease that India has.

http://www.riazhaq.com/2010/08/63-years-after-independence-india.html

Riaz Haq said...

Here are some excerpts from an NPR interview of Siddhartha Deb, the author of "The Beautiful and The Damned":

......
DEB: Well, I was interested in the changes that were happening there. Obviously, it's a lot of people experiencing change in new ways, in some sense, and I had gotten the impression that there was a very triumphalist version of this change, which is that the country is doing very well.

There was even a slogan that was coined by one of the political parties. It was called India Shining. And I was going back. I was writing feature articles. I was a freelance writer. And I was somewhat skeptical of this. It was pretty obvious that at the upper levels people were much better off materially than they had been in the past.

But certainly large numbers or swaths of people seem to be untouched or mired in the same poverty, or sometimes even worse because they could now see this incredible contrast. So I wanted to examine that. I wanted to do that by checking, by looking at the new rich. I wanted to look at people who were in the middle, people who were middle class.
----------

DONVAN: Well, and the style in which the book is written still reads like a novel. It is full of color and texture and even sights and sounds and smells.

DEB: Thank you. That was very much the intention, to write something like a nonfiction novel, if that's possible. So the facts aren't made up, they're very scrupulously researched. I've tried to be as accurate as possible, but I wanted the texture, the flavor of a novel, of people in motion in some sense.

DONVAN: Can I say that the story that you've written reads to me as a very sad story?

DEB: That would be - that's a fairly, I think, reasonable, actually, interpretation. I think it's a sad story to me too, in many ways.

DONVAN: Even among those who feel that you describe - you describe an engineer named Chuck who is building a house. He had lived in the United States, and he's now building a house in the American model. He gives you a tour. He even uses American language. This is the open-plan kitchen, this is the master bedroom.

And yet you portray him as - his desires as being somewhat hollow, as though he's not a happy man himself.

DEB: Well, I mean, I think Chuck would see himself as a happy man, and I think that's reasonable. I've tried to allow people that space. But yes, I as a narrator come in, and I do sometimes question what some of my characters are saying.

So when someone like Chuck says, you know, he did say this, that there are these incredible contrasts in India, but that's okay, we're kind of one big happy family, and I question whether that's really the case, when, you know, you have at the very top end of the country, say you have, say, something like 66 billionaires.

And these numbers might be slightly old, but there are probably a few more billionaires since I last checked. But 66 billionaires who seem to have something like 30 percent of the country's wealth.

On the other end, you have like 800 million people, over 800 million people living on less than $2 a day. When you have a country where 40 percent of the children under the age of five suffer from malnutrition, it seems to me that these contrasts aren't really healthy. They're not just differences. They are really like living different worlds within the same country.

So yes, I actually come in as a narrator, and I question when, say, Chuck is a character, he sees his life as striving and successful. And I think that's reasonable, again, but I also question the fact that this house, this special zone in which the house is constructed, is being built on what is a demolished village, and I have very hard questions......


http://www.npr.org/templates/transcript/transcript.php?storyId=141213308

Riaz Haq said...

Sanitation disastrous in India: Jairam Ramesh in Zee News:

New Delhi: Accepting that development of sanitation facilities in the country has been a "disaster", Rural Development Minister Jairam Ramesh Wednesday suggested enhanced government funding to deal with the issue.

"Sanitation is the biggest blot on the human development portfolio in India. The sanitation situation is disastrous," said Ramesh speaking at the release of UN Human Development Report 2011 here.

"We need massive public funding for sanitation," he said adding there has been marked progress in providing education, and some improvement in making health care and drinking water available in the country.

Making a comparison, Ramesh said while expenditure on water supply was Rs.20,000 crore annually, it was just Rs.2,000 crore on sanitation.

Success in providing education came because of the centre, which bears around 60 percent of the total spending on the sector today, he said.

"Out of 6 lakh villages in the country, only 25,000 are free from the practice of open defecation," the minister said, adding "People do not use toilets due to cultural reasons in many parts of the country."


http://zeenews.india.com/news/health/health-news/sanitation-disastrous-in-india-jairam-ramesh_14412.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

HopeWins Junior said...

Dr. Haq,

Our Pakistani Parliamentarians recently visited India (East Punjab).

And exactly as you have always maintained, they were SHOCKED to see widespread open defecation! Ha!

QUOTE on Page 4: "It was shocking to see so many people defecating on the roadside, and with an abandon that was somehow difficult to imagine for Pakistanis..."

Here is the article:
http://www.rediff.com/news/slide-show/slide-show-1-a-pakistani-s-first-hand-experience-in-india/20121023.htm

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...

Here's a NY Times report on salmonella contamination of Indian spices exported to US:

...The United States Food and Drug Administration will soon release a comprehensive analysis that pinpoints imported spices, found in just about every kitchen in the Western world, as a surprisingly potent source of salmonella poisoning.

In a study of more than 20,000 food shipments, the food agency found that nearly 7 percent of spice lots were contaminated with salmonella, twice the average of all other imported foods. Some 15 percent of coriander and 12 percent of oregano and basil shipments were contaminated, with high contamination levels also found in sesame seeds, curry powder and cumin. Four percent of black pepper shipments were contaminated.

Each year, 1.2 million people in the United States become sick from salmonella, one of the most common causes of food-borne illness. More than 23,000 are hospitalized and 450 die. Symptoms include diarrhea, fever and abdominal cramps that begin 12 to 36 hours after infection and can last three to five days. Death can result when infection spreads from the intestines to the bloodstream and affects vital organs. Infants and older people are most at risk.

Mexico and India had the highest share of contaminated spices. About 14 percent of the samples from Mexico contained salmonella, the study found, a result Mexican officials disputed.

India’s exports were the second-most contaminated, at approximately 9 percent, but India ships nearly four times the amount of spices to the United States that Mexico does, so its contamination problems are particularly worrisome, officials said. Nearly one-quarter of the spices, oils and food colorings used in the United States comes from India.

The findings, the result of a three-year study that F.D.A. officials have on occasion discussed publicly and recently published in the journal Food Microbiology, form an important part of the spice analysis that will be made public “soon,” agency officials said.

“Salmonella is a widespread problem with respect to imported spices,” Michael Taylor, deputy F.D.A. commissioner for food, said in an interview. “We have decided that spices are one of the significant issues we need to be addressing right now.”

Westerners are particularly vulnerable to contaminated spices because pepper and other spices are added at the table, so bacterial hitchhikers are consumed live and unharmed. Bacteria do not survive high temperatures, so contaminated spices present fewer problems when added during cooking, as is typical in the cuisine of India and most other Asian countries.
-------------
Salmonella can survive indefinitely on dried spices, and killing the bacterium on the craggy surface of dried peppercorns without ruining their taste is especially challenging.

Government officials in India emphasized in interviews that spices slated for export are often treated to kill any bacteria. Such treatments include steam-heating, irradiation or ethylene oxide gas. But F.D.A. inspectors have found high levels of salmonella contamination in shipments said to have received such treatments, documents show. Much of the contaminated pepper in the 2010 outbreak had been treated with steam and ethylene oxide and had been certified as tested and safe, officials said.

At another spice farm, in the village of Chemmanar, Bipin Sebastian is in the midst of a four-year transition to organic farming in hope of earning a premium price for his pepper, cloves, cardamom, turmeric and coffee. Mr. Sebastian says he has used government subsidies to buy tarps, netting and a machine thresher.

“We used to put our pepper directly on the ground,” Mr. Sebastian said. “Now, we put down tarps and netting over it to protect it from the birds. And I’ve been getting a higher price. It’s been great.”


http://www.nytimes.com/2013/08/28/world/asia/farmers-change-over-spices-link-to-food-ills.html

UNICEFIndia said...

In #India, >620m defecate in open - half the pop! Step forward @UNICEFIndia's inspired #poo2loo campaign http://uni.cf/17hVUrr #toilets4all

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

Anonymous said...

From World Health Organization:

Countries that account for almost three-quarters of the people who practice open defecation:
India (626 million)
Indonesia (63 million)
Pakistan (40 million)
Ethiopia (38 million)
Nigeria (34 million)
Sudan (19 million)
Nepal (15 million)
China (14 million)
Niger (12 million)
Burkina Faso (9.7 million)
Mozambique (9.5 million)
Cambodia (8.6 million).
India
with 626 million people who practice open defecation, has more than twice the number of the next 18 countries combined;
accounts for 90 per cent of the 692 million people in South Asia who practice open defecation;
accounts for 59 per cent of the 1.1 billion people in the world who practice open defecation;
has 97 million people without access to improved sources of drinking water, second only to China.


http://www.who.int/water_sanitation_health/monitoring/jmp2012/fast_facts/en/

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

Riaz Haq said...

#Pakistan improving sanitation way faster than #India: Study - The Economic Times http://ecoti.ms/7idC2a

NEW YORK: Pakistan has left India far behind in terms of improving water and sanitation access for their citizens, reveals a new performance index released on Friday.

While Pakistan was ranked five in the new index developed by The Water Institute at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health in the US, India occupied an unenviable 92nd position.

High performers also included China, El Salvador, Niger, Egypt, and Maldives. Russia, the Philippines and Brazil on the other hand, were low performers.


The index compares countries regardless of size and income level. By use this method the report deduced that a country’s gross domestic product does not determine performance in improving water and sanitation access for its citizens.

“This means that even countries with limited resources can make great strides if they have the right programmes in place,” said co-author of the report Jamie Bartram, director of The Water Institute at UNC.

“National governments, NGOs, and aid agencies can direct their resources toward building systems and capacity for action in countries that are lagging, and toward implementation where those capacities are in place and performing,” Bartram noted.

Read more at:
http://economictimes.indiatimes.com/articleshow/47212815.cms

Riaz Haq said...

#Pakistan improving sanitation way faster than #India: Study - The Economic Times http://ecoti.ms/7idC2a

NEW YORK: Pakistan has left India far behind in terms of improving water and sanitation access for their citizens, reveals a new performance index released on Friday.

While Pakistan was ranked five in the new index developed by The Water Institute at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health in the US, India occupied an unenviable 92nd position.

High performers also included China, El Salvador, Niger, Egypt, and Maldives. Russia, the Philippines and Brazil on the other hand, were low performers.


The index compares countries regardless of size and income level. By use this method the report deduced that a country’s gross domestic product does not determine performance in improving water and sanitation access for its citizens.

“This means that even countries with limited resources can make great strides if they have the right programmes in place,” said co-author of the report Jamie Bartram, director of The Water Institute at UNC.

“National governments, NGOs, and aid agencies can direct their resources toward building systems and capacity for action in countries that are lagging, and toward implementation where those capacities are in place and performing,” Bartram noted.

Read more at:
http://economictimes.indiatimes.com/articleshow/47212815.cms

Riaz Haq said...

The WaSH Performance Index is the sum of country performance values in the following components: water access, water equity, sanitation access, and sanitation equity.
Among most top performing countries, neither water nor sanitation dominated the overall Index value, suggesting improvements in water and sanitation do not necessarily come at the expense of the other.
Among the most populated countries in the world, Pakistan, China, and Nigeria were top performers (ranked 5, 11, and 18 respectively). Conversely, Russia, the Philippines and India were bottom performers (ranked 72, 83, and 92 respectively).
The WaSH Performance Index is the sum of country performance values in the following components: water access, water equity, sanitation access, and sanitation equity. Each of the components ranges from -1 to 1 meaning the overall WaSH index value can range from -4 to 4.


Top and bottom performing countries
The top ten and bottom ten countries are a surprising group. Low levels of coverage are often clustered in certain regions – for example, water access is low in sub-Saharan Africa while sanitation access is low in South and Southeast Asia. In contrast, performance values appear to be spread widely within regions. This suggests that country-specific factors, such as the enabling environment, may be driving performance and regions as a whole are not constrained to perform poorly.

Among countries with top ten values, two are low income, five are lower middle income and three are upper middle income. Among countries with bottom ten values, three are low income, five are lower middle income, and two are upper middle income. Top performing countries are located in all world regions with the most from South Asia (n = 4) and Sub-Saharan Africa (n = 2). Among bottom ten countries, three are from East Asia and the Pacific, and four are from Sub-Saharan Africa. A few countries are under-represented in the JMP data sets that we used, notably highly industrialized countries with very high coverage rates (as data may not be collected) and small island developing nations (as few have nationally representative household surveys).


Among the most populated countries in the world, Pakistan, China, and Nigeria were top performers (ranked 5, 11, and 18 respectively). Russia, the Philippines and India were bottom performers (ranked 72, 83, and 92 respectively).

Trends in performance
Tables 8 and 9 show the trend of components for the top ten and bottom ten countries. Six of the top ten have improving trends over time for all components. Conversely, seven of the bottom ten have an unchanged or deteriorating trend for all components. Tables 6 through 9 show that among most top performing countries, neither water nor sanitation components dominated the overall Index value, suggesting improvements in water and sanitation do not necessarily come at the expense of the other.

http://waterinstitute.unc.edu/wash-performance-index-report/

Riaz Haq said...

#American Diplomat calls #Tamils, an #India ethnic group 'dark', 'dirty' http://www.nydailynews.com/news/world/u-s-diplomat-enrages-members-indian-ethnic-group-calling-dark-dirty-speech-article-1.948348 …

A U.S. diplomat's remarks calling Indian Tamils "dark" and "dirty" has national leaders calling for her to be expelled from the country.

Maureen Chao, an American consul diplomat in India, shocked students at SRM University in southern India Friday when she recounted her first trip to the country in 1989.

"I was on a 24-hour trip from Delhi to Orissa. But, after 72 hours, the train still did not reach the destination...and my skin became dirty and dark like the Tamilians," Chao told students, according to the Hindustan Times.

Chao's comments enraged the Tamil community, an Indian ethnic group, with leaders calling for her to be kicked out of the country.

"This remark which smacks of racism is highly condemnable," said Tamil Nadu Chief Minister Jayalalithaa in a letter to the U.S. consul obtained by The Hindu.

"I would like to request you to impress upon Ms. Maureen Chao that she has to withdraw this remark and also apologize for having made such a comment on the Tamils," Jayalalithaa said.

Other political groups, including the Communist Party of India, called for Chao's withdrawal from the consulate.

"The ministry of foreign affairs should call her in person to express its opposition and expel her immediately from the country," said S. Ramadoss, founder of the PMK political group, to the Times of India.

The U.S. Consulate immediately issued an apology of sorts following the uproar over Chao's comments but did not indicate whether she would remain in her assignment.

"Ms. Chao made an inappropriate comment," read a post on the consulate's website. "Ms. Chao deeply regrets if her unfortunate remarks offended anyone, as that was certainly not her intent."

Chao did not outright say she was sorry for what she said.
`

Riaz Haq said...

#India: inherently unhygienic? #Indian writer touches third rail http://reut.rs/1pa6d7h via @Reuters

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.

Riaz Haq said...

Holding Your Breath in #India #pollution http://nyti.ms/1eCMCxj by Gardiner Harris in New Delhi fir NY Times

We gradually learned that Delhi’s true menace came from its air, water, food and flies. These perils sicken, disable and kill millions in India annually, making for one of the worst public health disasters in the world. Delhi, we discovered, is quietly suffering from a dire pediatric respiratory crisis, with a recent study showing that nearly half of the city’s 4.4 million schoolchildren have irreversible lung damage from the poisonous air.
------------
And children are by no means the only ones harmed. Many adults suffer near-constant headaches, sore throats, coughs and fatigue. Arvind Kejriwal, Delhi’s chief minister, had to leave the city for 10 days in March to cure a chronic cough.

It’s not just the air that inflicts harm. At least 600 million Indians, half the total population, defecate outdoors, and most of the effluent, even from toilets, is dumped untreated into rivers and streams. Still, I never thought this would come home to my family quite as dramatically as it did.

We live in a four-year-old, five-story apartment building that my wife chose because its relatively new windows could help shut out Delhi’s appalling nighttime air. Its cookie-cutter design — by the same developer who built dozens of others in the neighborhood — gave us confidence that things would function, by no means assured for new construction here.

About six months after we moved in, one of our neighbors reported that her tap water suddenly smelled like sewage. Then the smell hit another neighbor and another. It turned out that the developer had dug open channels for sewage that had gradually seeped into each apartment’s buried water tank. When we pulled up the floor tiles on the ground floor, brown sludge seemed to be everywhere.

I was in the shower when this sewage mixture arrived in our apartment. Sounds horrible, but I shrugged and toweled off because that smell is such a frequent presence here.

For much of the year, the Yamuna River would have almost no flow through Delhi if not for raw sewage. Add in the packs of stray dogs, monkeys and cattle even in urban areas, and fresh excretions are nearly ubiquitous. Insects alight on these excretions and then on people or their food, sickening them.


Most piped water here is contaminated. Poor sanitation may be a crucial reason nearly half of India’s children are stunted.

The list of health threats sounds harrowing when considered together, but life goes on and can be quite nice here. Our apartment building eventually installed aboveground water tanks. My children’s school and travel in the region are terrific, and many expats are far more influential here than they would be in their home countries.

Yet one afternoon this spring, someone in our neighborhood burned something toxic, and an astringent cloud spread around our block. My wife was out walking with a friend, and their eyes became teary and their throats began to close. They bolted back inside our apartment where they found Bram gasping again, for the first time in two years. In some places in Delhi, the levels of fine particles that cause the most lung damage, called PM2.5, routinely exceed 1,000 in winter in part because small trash and other fires are so common, according to scientists. In Beijing, PM2.5 levels that exceed 500 make international headlines; here, levels twice that high are largely ignored.

http://www.nytimes.com/2015/05/31/opinion/sunday/holding-your-breath-in-india.html?_r=0

Riaz Haq said...

UNICEF: In spite of #Modi's "Clean India" campaign, #India Lags Behind #Pakistan, #Nepal on Sanitation http://on.wsj.com/1INbqKI via @WSJIndia

Indian Prime Minister Narendra Modi has made sanitation a priority for his country, saying he would rather build toilets than temples and setting a goal for every home in the country to have a place to go to the bathroom by 2019.

But new data show India is lagging behind its neighbors in providing access to adequate sanitation.

“Progress on Sanitation and Drinking Water,” a report published by the United Nations Children’s Fund and the World Health Organization this week, says that advancements in meeting Millennium Development Goals, or MDGs, by 2015 in relation to sanitation have faltered worldwide. The report says 2.4 billion people still don’t have access to improved sanitation.

Mr. Modi launched his Clean India, or Swachh Bharat, campaign last year for good reason. Research shows that the practice of open defecation is linked to a higher risk of stunting in children and the spread of disease. A World Health Organization report said in 2014 that 597 million people in India still relieved themselves outdoors. And the new WHO/Unicef report says that the Southern Asia region has the highest number of people who defecate in the open.

The new data show that despite recent efforts, over the past 25 years, India has been losing the regional race to improve sanitation.

Its neighbors, Nepal, Bangladesh and Pakistan led the way with the greatest percentage-point change in the proportion of the population with access to improved sanitation facilities between 1990 and 2015.

Pakistan’s percentage point change was 40–64% of people have use an improved sanitation facility. In Nepal, a country in which just 4% of people had access to improved sanitation facilities in 1990, access rose by 42 percentage points to 46%. Bangladesh improved its score by 27 percentage points — 61% now have access to improved sanitation facilities.

India meanwhile, had a lower 23 percentage point increase in the same period – bringing the number of people with access to improved sanitation facilities to 40%.

And Sri Lanka is way ahead, with 95% of people having access to improved sanitation.

The report defines an improved sanitation facility as one that hygienically separates excreta from human contact and the target was for 50% or more of those with inadequate water or sanitation in 1990 to have adequate sanitary services in 2015.

Likewise, rates of open defecation have reduced, but India still has the highest percentage of the population defecating in the open–with 44% of people going outside in 2015—down from 75% in 1990, compared with a 13% figure for Pakistan in 2015, 32% for Nepal and only 1% for Bangladesh.

But, the report says: “The 31 per cent reduction in open defecation in India alone represents 394 million people, and significantly influences regional and global estimates.”

Riaz Haq said...

Jharkhand, #India: Girl commits suicide after parents refuse toilet in home

http://www.hindustantimes.com/india-news/girl-kills-self-in-jharkhand-after-parents-refuse-toilet-in-home/article1-1365606.aspx via @htTweets

A class 12 student allegedly committed suicide on Friday in Jharkhand’s Dumka district after her parents turned down her repeated pleas to construct a toilet at home as they wanted to save money for the 17-year-old’s marriage, police said.

Khushbu Kumari, a resident of Dudhani colony in the town, was found hanging from the ceiling of her room by family members, the police added.

The tragedy underlined a growing awareness on hygiene among the younger generation in the state which has country’s highest rate of open defecation.

The 2011 census had said that 92.4% people in Jharkhand’s rural areas do not have toilets.

In recent times, there have been several instances of women refusing to marry into families who don’t have toilets in their homes, which officials attribute to growing public awareness about the health hazards of open defecation.

Dumka police, quoting Khushbu’s family-members, said that she was pressurising her parents for a toilet in her home as she was fed up and ashamed of defecating in open fields.

“Girl’s parents told her that they couldn’t afford a toilet as they were saving money for her marriage,” said investigating officer Manoj Mishra.

Her father Shripati Yadav is a driver.

“For us marriage was more important. She was demanding a toilet and on Friday we had a heated argument. She was stubborn and ended her life,” said a tearful Sanju Devi, Khushbu’s mother.

Police said that the girl ended her life when her parents were not at home.

“It is a tragic incident as girl’s parents were unaware of the importance of toilets,” said Dumka SP Bipul Shukla.

A government official said that under a government scheme, individuals are provided Rs 4,600 for household toilet construction.

“The parents seemed uninformed,” said a senior sanitation officer requesting anonymity.

A study by the Unicef earlier had identified poor sanitation as a major cause for diseases and deaths among children in the state and also showed how open defecation had a strong correlation with malnutrition (55%) and stunting (47%) among children of the state.

Riaz Haq said...

It's no joke. WaterAid says #India has 60.4% people without access to toilet. 36% in #Pakistan #opendefecation https://shar.es/1c08Z4

Noting that the resulting health crisis is a serious matter, the report said that more than 140,000 children younger than five years die each year in India due to diarrhea.
“Nearly 40 per cent of India’s children are stunted; this will affect both their life chances and the future prosperity of India. India also has high rates of maternal and newborn mortality linked to sepsis,” the report said.
The equipment necessary to prevent infection during and after child birth is simple and inexpensive, but requires clean water and soap along with clean surroundings, which are difficult to achieve in an environment contaminated by open defecation and without good hygiene practices such as handwashing with soap by clinic staff and midwives, it said.
Prime Minister Narendra Modi has given the sanitation issue a top political priority, and last year launched Swachh Bharat (Clean India) Mission.
Commenting on Swachh Bharat, which aims to ensure a toilet for every household by 2019 and to educate people about the long-term health and economic benefits of using a a proper sanitation system, the report said that “by simply building the toilets won’t be enough.”
“What will be absolutely crucial is getting local, state and national government to make this a priority, and creating the cultural shift that will ensure that once the toilets are built, they are used by everyone,” it added.

http://www.wateraid.org/what-we-do/our-approach/research-and-publications/view-publication?id=c8e9d0b5-3384-4483-beff-a8efef8f342a

Riaz Haq said...

From WaterAid 2015 Report "It's No Joke: State of the World's Toilets 2015":

India, the world’s second most populous nation, has a well-known problem with sanitation. Cities growing at an incredible pace with unofficial, unserviced slums, combined with cultural preferences for open defecation in fields rather than enclosed spaces, mean India has the World’s Longest Queues for Toilets. If you stretched all 774 million people in India now waiting for household toilets, the queue would stretch from Earth to the moon – and beyond! That queue would take 5,892 years to work through,assuming each person needs about four minutes in the toilet. The resulting health crisis is a serious matter. More than 140,000 children younger than five years die each year in India from diarrhoea. Nearly 40% of India’s children are stunted; this will affect both their life chances and the future prosperity of India. India also has high rates of maternal and newborn mortality linked to sepsis. The equipment necessary to prevent infection during and after childbirth is simple and inexpensive, but requiresclean water and soap, and clean surroundings, which are difficult to achieve in an environment contaminated by open defecation, and without good hygiene practices such as handwashing with soap by clinic staff and midwives. Work is underway in India to end the crisis. Prime Minister Narendra Modi has given the issue high political priority, and in autumn 2014 announced the Swachh Bharat (Clean India) Mission. Swachh Bharat aims to ensure every household has a toiletby 2019 and to educate people about the long-term health and economic benefits of using a toilet. This is an important and long-overdue initiative, and is bringing change to India’s communities. But simply building the toilets won’t be enough. What will be absolutely crucial is getting local, state and national government to make this a priority, and creating the cultural shift that will ensure that once the toilets are built they are used – by everyone.

http://www.wateraid.org/what-we-do/our-approach/research-and-publications/view-publication?id=c8e9d0b5-3384-4483-beff-a8efef8f342a

Riaz Haq said...

V.S. Naipaul understood the culture of open defecation when he said #Indians defecate everywhere http://go.shr.lc/24F1XDl via @riceinstitute

I recently picked up V.S. Naipaul’s book An Area of Darkness, a chronicle of his first trip to India published in 1964. Although some view the book as overly pessimistic and scathing, his portrayal of India’s culture of open defecation is uncannily accurate.
Shankaracharya Hill, overlooking the Dal Lake, is one of the beauty spots of Srinagar. It has to be climbed with care, for large areas of its lower slopes are used as latrines by Indian tourists. If you surprise a group of three women, companionably defecating, they will giggle: the shame is yours, for exposing yourself to such a scene.
In Madras the bus station near the High Court is one of the more popular latrines. The traveller arrives; to pass the time he raises his dhoti, defecates in the gutter. The bus arrives; he boards it; the woman sweeper cleans up after him.

In Goa, you might think of taking an early morning walk along the balustrade avenue that runs beside the Mandovi River. Six feet below, on the water’s edge, and as far as you can see, there is a line, like a wavering tidewrack, of squatters. For the people of Goa, as for those of Imperial Rome, defecating is a social activity; they squat close to one another; they chatter. When they are done they advance, trousers still down, backsides bare, into the water to wash themselves.

Indians defecate everywhere. They defecate, mostly, beside the railway tracks. But they also defecate on the beaches; they defecate on the hills; they defecate on the river banks; they defecate on the streets; they never look for cover.

A handsome young Muslim boy, a student at a laughable institute of education in an Uttar Pradesh weaving town, elegantly dressed in the style of Mr. Nehru, even down to the buttonhole, had another explanation. Indians were a poetic people, he said. He himself always sought the open because he was a poet, a lover of Nature, which was the matter of his Urdu verses; and nothing was as poetic as squatting on a river bank at dawn.
He eloquently describes in these vignettes what we have found 50 years later in the SQUAT and Switching Studies: that defecating in the open is the social norm. It is considered to be a part of the wholesome, rural life, in which one takes a walk outside in nature, socializes with friends, and avoids polluting oneself and one’s home.

Riaz Haq said...

The cultural politics of shit: class, gender and public space in India

Full text HTML
PDF
Free access
DOI:10.1080/13688790.2015.1065714
Assa Doron & Ira Raja
pages 189-207

In this article we seek to interrogate the cultural, political and economic conditions that generate the crisis of sanitation in India, with its severe implications for the poor and the marginalized. The key question we ask is how to interpret and explain the spectre of ‘open defecation’ in India's countryside and its booming urban centres. The discussion is divided into three parts. Part one examines the cultural interpretation of ‘shitting’ as symbolic action underpinned by ideas of purity, pollution and ‘the body politic’. Part two takes the political economic approach to gain further insights into contemporary discourse, performance and cultural politics surrounding toilets and open defecation in India. Part three examines civil society activities, state campaigns and media accounts of open defecation to explore the disruptive potency of everyday toilet activities, and how these interplay with issues of class, caste, and gender. Drawing on interviews and a review of ethnographic work, we seek to interrogate the idiom of modern sanitation, with its emphasis on cleanliness, progress and dreams of technology, as a constitutive idea and an explanatory force in Indian modernity.

http://www.tandfonline.com/doi/full/10.1080/13688790.2015.1065714

Riaz Haq said...

More #Indians have died of dog-bites & rabies than #terror attacks in 20 years. #India #Mumbai #terrorism_deaths

http://www.bbc.com/news/world-asia-india-36035456

In March, the civic authorities in one of India's richest cities made a startling disclosure in the country's top court: dog bites in Mumbai had killed more people in 20 years than the two deadly terror attacks in the city - the 1993 serial blasts and the 26/11 attack in 2008.
According to the municipality's petition in the Supreme Court, 434 people had died from rabies - a fatal viral infection which is almost 100% preventable - transmitted by dogs between 1994 and 2015. (In comparison, the two attacks killed 422 people.) More than 1.3 million people had been bitten by dogs in the city during the same period.
Animal rights groups say the comparison with terror attacks is alarmist hyperbole. But in a country where courts are struggling with a chronic backlog of more than 30 million cases, it is intriguing that the top court has been grappling with the issue of stray - or free roaming dogs - and rabies.
Feral dogs
The reasons are simple: India has some 30 million stray mutts and more than 20,000 people die of rabies every year. Last year, Global Alliance for Rabies Control reported that India accounted for 35% of human rabies deaths, more than any other country.
India dog cull causes controversy and heartache
Why stray dogs are Kashmir's latest threat
How far will India's dog-lovers go to save strays?
Many of these deaths are blamed on the strays. Last month, the top court ordered the government in the southern state of Kerala to pay 40,000 rupees ($600; £415) to a man whose wife died after contracting rabies from a dog bite. (A third of Kerala's one million dogs are strays; and nearly half of the 23,000 people bitten by dogs last year contracted rabies, say officials.) Health officials in Kashmir reported that more than 50,000 locals had been bitten by feral strays between 2008 and 2012, and that a dozen people had died of rabies during the period.