Thursday, November 20, 2008

Give your toilet a hug!

If you were inspired to go wash your hands after my Happy Handwashing Day blog, below is text that went out to thousands of Water For People friends and supporters of my musings on World Toilet Day yesterday....

Dear Kate, (I didn't really write this letter to myself-it's part of the email blast....)
The world celebrates the 8th annual World Toilet Day today. While that may seem like a strange thing to highlight for those of us that never think twice about our toilets (unless we have to go and there isn't one around), for the 2.5 billion people in the world who do not have access to such a basic service, this is no laughing matter.

This year is also the International Year of Sanitation. Again, most people may scratch their heads as to why the United Nations decided to designate 2008 as a year devoted to sanitation. Toilets, and what we do on them, doesn't cause many people in developed countries to reflect on their purpose or benefits. But access to improved sanitation has been shown to reduce diarrhea in kids, who are most susceptible, by 22-36%.

Translating percentages into lives, this results in hundreds of thousands of kids living to see their fifth birthday. Last year, a poll conducted by the British Medical Journal showed that sanitation -- not antibiotics, germ theory, or vaccines -- is considered to be the greatest medical advance in the last 150 years because of the associated public health benefits.

But it's not all about health. When I need to go to the bathroom, I look for somewhere private and convenient. Every year, more studies are released showing that from Ghana to Vietnam, these drivers -- privacy, convenience, and even social status -- are why people without sanitation choose to invest in improved sanitation and continue to use the facilities in a hygienic way. The World Health Organization estimates that for each $1 invested into sanitation, the economic return is $7 in costs saved treating illnesses and days of productive work lost.
It's not all about money, either. Girls around the world drop out of school as they get older if schools do not have sanitation facilities. Getting toilets into schools is a proven strategy at retaining young women, thus contributing to social and economic development of society.
Plus, environmentalists promote sanitation as a way to protect the planet. At any given moment, over 200 million tons of untreated wastewater are seeping into groundwater supplies and river-water that many people drink, bathe, and play in.

2.5 billion people lack adequate sanitation
Diarrhea can be reduced by 22-36% with improved sanitation
4,000 children die each day from water-related illnesses

Doing this -- getting sanitation to those who do not have it -- costs money, approximately $10 billion a year until 2015 to meet the Millennium Development Goal for sanitation. $10 billion, the same amount as 1/3 of the global spending on bottled water last year, to protect public health
and improve private dignity around the world.

Hard lessons learned, and millions of dollars spent in the past 30 years from Bangladesh to Panama, show that simply building latrines for "the impoverished" does not automatically translate into sustained use and hygienic management of toilets. Impoverished people are not a homogenous group of people waiting for "development" to happen to them. Rather, individuals have very different wants, needs, and abilities to pay. Promising programs from around the world have taken subsidies that were once used to give latrines away, and are investing that money in the development of a local private sector that meets the real demand of consumers who don't have a place to take care of their needs.

High in the Andes of Peru last week, I listened to Dona Liliana tell me how she has been embarrassed for years when her family from Lima would come visit, and she didn't have a place for them to go to the bathroom. Dona Liliana was a health promoter during the 1960s and 1970s and worked on a program giving away latrines from the Government of Peru. Even with her background in health and latrine promotion, her real desire for a bathroom came from the convenience and social status associated with access to a loo. Eager to improve her situation, she took out a loan from a local credit union to finance the cost of her bathroom. Within the same breath, she told me how she was going to pay off her loan in one year, and how everybody, even the poorest person in her barrio could afford to install their own bathroom IF they wanted to.

So it's going to take money, but it's also going to take thinking outside of the bowl to solve this massive global problem. Traditional approaches aren't making a dent in the number of people who can't simply get up and use a bathroom in their home, flushing away their wastes without a second thought about where they go. We need to be creative in how we "sell" sanitation, how we pay for sanitation, and even how we "celebrate" sanitation.

Happy World Toilet Day!

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