Friday, November 18, 2011

India & Pakistan Off-Track, Off-Target on Toilets

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.

The five countries with the largest absolute numbers of people without sanitation – India, China, Indonesia, Nigeria and Pakistan – are all middle income and account for over 1.7 billion people without sanitation.

The report points out that the budgets allocated for water and sanitation improvements in South Asia and Sub-Saharan Africa have been extremely low. Public spending on water and sanitation accounts for 0.45% of gdp in India and only 0.20% of gdp in Pakistan. Some of the shortfall has been made up by official development assistance, particularly for India which has been among the top aid recipients every year since 2000. However, a recent report from the Comptroller and Auditor General in India identified US$2 billion of unspent aid money in 2010. Although detail has not been available beyond a reference to weak planning, the India case study confirms that financial absorption is a problem that has affected the Total Sanitation Campaign in certain states. In Uttar Pradesh, only 63% of the funds released were used in 2005-06, although that improved to 83% in 2006-07. Findings from Chhattisgarh highlight the slow release and use of centrally available funding, with over half of the 16 districts experiencing delays in opting for the second installment. The research shows that the reasons for the low utilization include: states unable to match central government grants, deficiencies in the process of decentralized planning, shortages or short tenure of key staff, delay in the flow of funds, as well as multiple reporting requirements.

Earlier in October this year, India's rural development minister Jairam Ramesh said his nation's rivers have been turned into open sewers by 638 million Indians without access to toilets. He was reacting a UNICEF report that said 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.

WaterAid calls the current hygiene situation a "global crisis" and cites the following statistics:

I. 884 million people in the world do not have access to safe water. This is roughly one in eight of the world's population. (WHO/UNICEF)

II. 2.6 billion people in the world do not have access to adequate sanitation, this is almost two fifths of the world's population. (WHO/UNICEF)

III. 1.4 million children die every year from diarrhoea caused by unclean water and poor sanitation - 4,000 child deaths a day or one child every 20 seconds. This equates to 160 infant school classrooms lost every single day to an entirely preventable public health crisis. (WHO/WaterAid)

Solving this serious problem in developing nations is not going to be easy. It can not be done by simply replicating the western toilet for the vast majority of the poor in South Asia and Sub-Saharan Africa. It will require creative thinking.

One example of creative thinking is Dr. Bindeshwar Pathak of Sulabh International in India. He has developed a simple, low-cost toilet which costs approximately Rs. 700 and could be installed anywhere, including villages without any plumbing. This toilet uses only 1.5 liters of water for flushing as against 10 liters 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.

Another example is Dr. M. Sohail Khan, a professor from Pakistan currently working at UK's Loughborough University, who has received a grant from Gates Foundation. He and his research team are developing a toilet that produces biological charcoal,minerals, and clean water to transform feces into a highly energetic combustible through a process combining hydrothermal carbonization of fecal sludge followed by combustion. The process will be powered by the heat generated during the combustion phase and will recover water and salt from feces and urine.

Gates Foundation is funding research grants under "Reinvent the Toilet Challenge" program to develop a low-cost, no-flush toilet for the masses. In an interview on Public Radio, Dr. Frank Rijsberman of Gates Foundation explained it as follows: "We are asking people to come up with a toilet that does not flush, you know, clean water down an expensive set of pipes to get into a waste water treatment plant where we're spending even more energy and money to get that waste out again. We'd love for people to have what we sometimes call the cell phone of sanitation, an aspirational product that actually recovers resources from waste. There's a lot of energy in human waste. There is nutrients there, and we'd love to find a way to reuse those directly without relying on flushing your waste down the drain with clean drinking water."

I believe that the key to eventually solving the sanitation crisis in the developing world lies in the success of research and development efforts sponsored by organizations like Gates Foundation and Sulabh International.

Related Links:

Haq's Musings

India Leads the World in Open Defecation

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


Anonymous said...

The eminent writer and Congress MP, Mr Shashi Tharoor, on Thursday did some plain talk on India’s global aspirations and said the country was ‘super-poor rather than a superpower’.

Talking to BBC presenter, Ms Anita Anand, on ‘India and China — The New Superpowers,’ Mr Tharoor said he would rather describe the two countries as being on the way of becoming significant powers.

“A superpower is a political, economic and military giant that has global reach,” he said. “The US still holds that position. It can fight a war in East Asia or any other part of the world. But I can’t imagine China or India doing that.”

He added that a large chunk of India’s people did not get three meals a day, had no roof to sleep under and were unable to educate their children. “We still haven’t solved these basic problems,” he said. “So we can’t claim to be a superpower.”

Mr Tharoor, an ace diplomat, added that he would much rather live in a world without superpowers. “In fact, I am penning a book on the theme of a network of countries, a multi-polar world, drawing on the metaphor of the Internet,” he said.

The MP said he felt awful when he heard the Western coinage ‘Chindia’ to refer to the two aspiring superpowers. “Though we are neighbours, we don’t have much in common,” he said. “There is ignorance, indifference and hostility towards India in China.”

There was not much soft diplomacy in terms of people-to-people contact and tourism to create more awareness of each other either, he added.

Pavan said...

Thanks. This has not been covered in the media here. Pavan
PS Are you doing a post on the latest HDR or did I miss it?

Riaz Haq said...

Pavan: "Are you doing a post on the latest HDR or did I miss it?"

I did one about the positive impact of urbanization on human development in Pakistan.

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."

Anonymous said...

At least India does not stand with bowl in hand before America.

Riaz Haq said...

Anon: "At least India does not stand with bowl in hand before America."

Oh really? Did you read the post and digest the table from WaterAid report?

In 2009, India was the biggest recipient with $747 million aid to help build toilets. And it has been among the top recipients of aid since 2001 while Pakistan is not even in the top 10.

India was the fourth largest recipient of aid (ODA) between 1995 to 2008 (US$26.1 billion), according to Global Humanitarian Assistance website.

And foreign aid continues to pour in India as we speak.

Irfan said...

Due to conflict the nation will be hard pressed to achieve MDG unless you're a Zardari chela. recently published this article.

ISLAMABAD, Nov 18: As many as 97, 900 people died annually due to poor water and sanitation in Pakistan, said a report released here on Friday by an international charity.

The report by WaterAid titled: “Off-track, off-target: Why investment in water, sanitation and hygiene is not reaching those who need it most”, was released by the WaterAid`s Country Representative in Pakistan Siddiq Khan on World Toilet Day being observed on November 19 globally.

It said that 48 million Pakistanis defecated in the open and basic toilet was a distant dream for them.

Pakistan had committed under Millennium Development Goal to supply safe water to 93 per cent and adequate sanitation facilities to 64 per cent of the population by year 2015.

Yet, according to the report, only 45 per cent people used improved sanitation facilities in Pakistan. At current rates of progress the water target would be missed by 7 years (2022) and the sanitation target by 13 years (2028).

Rahul said...

Riaz, here you again spinnig the the numbers.

"India was the fourth largest recipient of aid (ODA) between 1995 to 2008 (US$26.1 billion), according to Global Humanitarian Assistance website."

True, but India is considerably larger than Pakistan. The same website has these figures PER CITIZEN:

Humanitarian aid and Total aid
Pakistan. $3.1 & $15.8
India. $0.01 & $1.0
2009 figures

By the way, Pakistan has received $21.4 billion in ODA assistance compared to India's $26.1 billion since 1995 and INDIA HAS SIX TIMES THE POPULATION!


Anonymous said...

some good news...

Anonymous said...

Really.... India is a recipient of aid? Let me far this year, India has GIVEN

1. $2 billion aid to IMF.
2. $500 million credit line to Myanmar
3. $250 million credit line to Nepal

I would like to see how much aid Pakistan has given to other countries.

India is not standing with begging bowl. You are.

Riaz Haq said...

Anon: "Let me far this year, India has GIVEN"

While over 800 million Indians live in abject poverty (World Bank) defecate in the open (UNICEF).

Anon: "India is not standing with begging bowl. You are."

Not true. India stands in line with a much bigger bowl and collects a lot more foreign aid than Pakistan.

As Sashi Tharoor puts it: India is superpoor, not superpower.

Riaz Haq said...

Here's Sashi Tharoor in on failure of parliamentary democracy in India:

THE RECENT political shenanigans in New Delhi, notably the repeated paralysis of Parliament by slogan-shouting members violating (with impunity) every canon of legislative propriety, have confirmed once again what some of us have been arguing for years: that the parliamentary system we borrowed from the British has, in Indian conditions, outlived its utility. Has the time not come to raise anew the case — long consigned to the back burner — for a presidential system in India?

The basic outlines of the argument have been clear for some time: our parliamentary system has created a unique breed of legislator, largely unqualified to legislate, who has sought election only in order to wield (or influence) executive power. It has produced governments obliged to focus more on politics than on policy or performance. It has distorted the voting preferences of an electorate that knows which individuals it wants but not necessarily which policies. It has spawned parties that are shifting alliances of individual interests rather than vehicles of coherent sets of ideas. It has forced governments to concentrate less on governing than on staying in office, and obliged them to cater to the lowest common denominator of their coalitions. It is time for a change.
The parliamentary system devised in Britain — a small island nation with electorates initially of a few thousand voters per MP, and even today less than a lakh per constituency — assumes a number of conditions that simply do not exist in India. It requires the existence of clearly- defined political parties, each with a coherent set of policies and preferences that distinguish it from the next, whereas in India, a party is all too often a label of convenience a politician adopts and discards as frequently as a film star changes costumes. The principal parties, whether “national” or otherwise, are fuzzily vague about their beliefs: every party’s “ideology” is one variant or another of centrist populism, derived to a greater or lesser degree from the Nehruvian socialism of the Congress. We have 44 registered political parties recognised by the Election Commission, and a staggering 903 registered but unrecognised, from the Adarsh Lok Dal to the Womanist Party of India. But with the sole exceptions of the BJP and the communists, the existence of the serious political parties, as entities separate from the “big tent” of the Congress, is a result of electoral arithmetic or regional identities, not political conviction. (And even there, what on earth is the continuing case, after the demise of the Soviet Union and the reinvention of China, for two separate recognised communist parties and a dozen unrecognised ones?)

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.”

bidet spray said...

Sanitation should always be on top of priority when it comes to toilet and bathroom concerns. People should start taking care of their health and focusing on hygiene and health. In every bathroom, they should always use and pay attention to their own health.

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.

Riaz Haq said...

Since the 1990s, Pakistan has reduced its maternal mortality ratio by 50 per cent and infant mortality ratio by 30 per cent. However, it still remains off track with regards to meeting targets of Millennium Development Goals 4 and 5. The majority of under-five deaths are due to birth asphyxia, infections, pneumonia, diarrhoea and severe malnutrition. In terms of under-five mortality, it ranks 26 in the world (UNICEF). Pakistan remains one of only three countries in the world with endemic polio.

Multiple disasters such as earthquakes and floods coupled with armed violence has resulted in much damage and destruction to the social infrastructure including health facilities, especially in the tribal and rural areas of Pakistan. This situation has been further exacerbated by a shortage in nurses, paramedics and skilled birth attendants. Furthermore, there are major disparities between urban and rural areas in terms of access to health services. Routine immunization access and coverage in both urban and rural settings, remains a challenge.

The Pakistan Red Crescent Society operates three basic health units and one mobile health unit in three districts – Quetta, Sibi and Chamman, providing curative and preventive health services with special focus on mothers and children. The teams include male and female doctors, lady health visitors (part of the Government of Pakistan launched programme for family planning and primary care in 1994) and two community mobilizers, linking the communities with the formal health system.

The basic healthcare services package includes appropriate clinical and preventive services with access to free medicines. The priority diseases being treated include diarrhoea, acute respiratory tract infections and malnutrition among children.

In some areas, literacy levels are low and cultural values do not encourage women to make independent decisions. The National Society also provides counselling sessions to tackle cultural beliefs that prevent women from using family planning services as well as health checks and access to contraceptives. There has been a significant increase in uptake of family planning services, growth monitoring and child immunization.

In 2013, the four clinics run by Pakistan Red Crescent Society provided basic healthcare services to more than 70,000 vulnerable people including 27,000 women and 28,000 children. During the same period 15,000 clients accessed family planning services, 4,200 children were screened for growth monitoring and 4,400 children immunized for vaccine preventable diseases.

In another project, the Swiss Red Cross, in collaboration with the Aga Khan University and their local partner Mother and Child Care Trust, is contributing to the pool of lady health visitors by training and expanding midwifery skills and increasing their number at different levels of healthcare, i.e. village, basic health unit and secondary health provider (the thesil [administrative division] headquarters and district hospital) in rural areas of Dadu district, Sindh province.

The mother-in-law of a pregnant woman says, “We are very happy with the services this hospital [tehsil headquarters hospital] has given to us. We are poor, we cannot pay, but still everything is available. We are treated nicely with good behaviour by the staff. I brought my daughter-in-law to deliver here because I have full trust in the staff and that all goes well”.

- See more at:

Riaz Haq said...

"I didn’t like India – the country," she (Dejana Radanovic) wrote on another Instagram Story. "I didn’t like the food, traffic, hygiene (worms in the food, yellow pillows and dirty bed linen in the hotel, not knowing how to use roundabout etc.)

Professional tennis player Dejana Radanovic was accused of being racist after making comments about India following three ITF tournaments in the country.

Radanovic, the world No. 245 in women’s tennis, slammed the "food, traffic and hygiene" of the country on social media.

"I didn’t like India – the country," she wrote on another Instagram Story. "I didn’t like the food, traffic, hygiene (worms in the food, yellow pillows and dirty bed linen in the hotel, not knowing how to use roundabout etc.)

Another post in Munich, Germany read, "Hello civilization. Only those who have experienced something like India for 3 weeks can understand the feeling."

Radanovic, who is from Serbia, addressed the comments that she was racist by saying she was simply commenting about the country itself, not its people.

"I didn’t like India – the country," she wrote on another Instagram Story. "I didn’t like the food, traffic, hygiene (worms in the food, yellow pillows and dirty bed linen in the hotel, not knowing how to use roundabout etc.)

"If you come to my country, Serbia, and you don’t like all those same things, that means you are a racist??? What the hell that has to do with racism?! I have friends all nationalities and colors so don’t go there cause it’s an absolute NONSENSE!"

Radanovic continued with her Stories, saying she enjoyed the people of India.

"95% of the people who go to India from anywhere else in the world cannot adopt [sic] to that kind of life! Of course it’s different when you are born there and used to it! How does not liking mentioned things mean I didn’t like the people? Quite opposite, I liked the people there a lot."