:: Analysis ::

By Shikha Shrestha

Man Bahadur and Dhansari are orphans in Rukum. They both lost their parents to a preventable basic disease: diarrhoea. The story of how eleven-year-old Yam Bahadur Chanara became an orphan is the same. He too lost his parents to this preventable disease. 

When adult poor Nepalis die of diarrhoea due to unsafe water and sanitation, most educated Nepalis in the urban areas do not know what to make of such deaths. On one hand, the disease strikes one as one of those elemental diseases that should been eradicated years ago. On the other hand, 317 Nepalis died from a diarrhoeal outbreak in 12 districts of the mid western part of the country just last August, when 46,000 peoples’ lives were also negatively affected. Jajarkot, which is 400 km northwest of Kathmandu, became the epicentre of the disease as it alone witnessed the death of 143 people. Since disease-related deaths are underreported in Nepal, who knows what the final death figure might have been?

What causes such deaths? Not having safe drinking water and living in surroundings mired in poor sanitation services make it easier for diarrhoea to flourish. The Nepal government estimates that 4.4 million Nepalis do not have access to safe drinking water. This means that the water they drink is muddy or dirty. Similarly, 14 million Nepalis do not have basic sanitation services. This indicates that they do not have hygienic toilet facilities. When you have a situation in which unsafe water and unhygienic sanitation conditions converge, you have a ripe situation for diarrhoea to break out as an epidemic.  True, this sort of deprivation is not limited to Nepal. In fact, WHO and UNICEF estimate that 40 per cent of the world’s population – or 2.5 billion people — does not have access to toilets. WHO further estimates that 28% of under-the-age-five deaths are caused by poor sanitation and unsafe water.

There could be several reasons why Jajarkot became the epicenter for the outbreak last August. But the main reason is this: its sanitation coverage is only 22 percent. Put another way, this means that only two out of 10 people there have proper toilets. And in the absence of toilets, they have to use streams and rivers as their defecation spots, and faecal matters are carried downstream and often become drinking water for others. Comparatively, Jajarkot’s coverage is better than that of Kalikot and Bajura, two districts where the sanitation coverage is below 10 percent.

Proper sanitation saves lives. Not only that, sanitation improves lives. According to a study done by WHO, one dollar invested in sanitation gives a return of nine dollars. Indeed, development experts say that apart from the simple act of sending girls to schools, interventions made in sanitation give the highest development returns – in terms of better health and well-being, which lead poor people on the path to financial security. Yet these truisms have yet to make a dent in the consciousness of our political leaders. Proper sanitation also reduces Acute Respiratory Infections (ARIs), which is a number-one killer of children.

Given the importance of safe water and sanitation, and given also the relative political indifference to better the sanitation coverage, what can one do? The first thing is to campaign together with like-minded organizations and individuals that have worked tirelessly for many years to attract public and political attention to the importance of this issue. Likewise, there is a space for Nepal to be a signatory in Global Framework for Action (GF4A) on Sanitation and Water for all. Nepal’s interest in being a member in GF4A has helped it get selected as one of the pilot countries that would help formulate the framework together with its South Asian partners such as Bangladesh. Nepal’s selection as a pilot country highlights that its sanitation goals are “off-track” so far as the Millennium Development Goals (MDGs) goals are concerned. Being a part of the GF4A helps Nepal signal that it is serious about raising the sanitation coverage, and this in turn, is likely to attract additional donor resources to finalize and implement the Sanitation Master Plan.

Meantime, civil society networks are campaigning together. For instance, networks such as End Water Poverty, Freshwater Action Network and Water Supply and Sanitation Collaborative Council are jointly organizing The World’s Longest Toilet Queue (WLTQ) from 20 to 22 March 2010 with the common call of “Make a Stand for Sanitation and Water”. The primary purpose of this global campaign in Nepal is to show solidarity with 14 million Nepalis who still have to wait in line for their right to use a safe and dignified toilet. The idea is to help influence the government to recognize the act of raising sanitation coverage as an essential and cost-effective development intervention.  

What are the likely outcomes of the WLTQ in Nepal? It will help draw public attention to the fact that so many Nepalis lack access to safe sanitation services. It will highlight how sanitation-induced deaths of poor Nepalis can be prevented. It will make people realize that providing sanitation services is the second most effective development intervention after the education of girls. It’s not necessary that political pressures can only be created through bandhs and strikes. Giving reasons for development interventions and persuading policy-makers to change polices that result in saved lives is an alternative way to bring positive changes in New Nepal.

It is with this idea that the World Longest Toilet Queue campaign in Nepal is being organized in Kathmandu as well as in other rural parts of the country from March 20-22 2010. The message of the campaign is implicit yet obvious: Let there be no orphans in the country whose parents have to die because of preventable diseases that come out of unsafe water and sanitation. Only a consistent propagation and practice of this message will prevent Jajarkot II from happening, and will not make another Man Bahadur, Dhansari and Yam Bahadur Chanara lose their parents to diarrhoea.