Some 16,000 volunteers will take to the streets of Juba, the capital of southern Sudan, next month in a United Nations programme to tackle health hazards caused by public dumping of waste in a rapidly growing metropolitan area that has endured repeated fatal outbreaks of cholera, water-borne diseases and malaria.

The project is part of a £20 million United Kingdom-funded project to improve the sustainable use of natural resources in Africa’s largest country, to be carried out by the UN Environment Programme (UNEP) over the next three years. UK Minister of State for International Development Gareth Thomas was visiting Juba to launch the segment that aims to establish long-term waste management capacity in Southern Sudan.

The clean-up, which will be replicated in the nine states of southern Sudan, will be coupled with a sustained awareness-raising campaign to encourage the citizens of Juba to adopt an environmentally friendly attitude towards the disposal of waste in the city.

UNEP’s country-wide programme seeks to help the people of Sudan, a country ravaged by several current and recent conflicts, to achieve sustainable peace, recovery and development by improving the management of natural resources.

The recently established UNEP office in Juba will also provide technical support to the Government to manage its forests and other valuable natural resources in a sustainable manner, and work to build the capacity of Government ministries to tackle environmental issues.

After a peace agreement in 2005 ended two decades of war between the Government in Khartoum, in the north, and southern Sudanese rebels, UNEP conducted a post-conflict environmental assessment, making 85 recommendations and outlining a detailed US$ 120-million action plan over three to five years.

Source: UN News Centre, 16 Oct 2009

05 November 2009

BERKELEY — Researchers at the University of California, Berkeley, have received a five-year, $10.9 million grant from the Bill & Melinda Gates Foundation to evaluate several interventions to combat diarrheal disease in developing countries.

Dr. Jack Colford, professor of epidemiology at UC Berkeley’s School of Public Health, will coordinate the project, working with the International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B) and Innovations for Poverty Action (IPA).

An estimated 2.2 million children under the age of 5 die from diarrheal diseases each year, according to the World Health Organization. Most of these diseases are thought to be preventable with improvements in sanitation, water quality and hygiene.

Due to the high cost of developing and maintaining large infrastructure projects, such as networked water, there is now a movement toward simpler, alternative methods to improve health in rural areas. However, there is almost no evidence that allows direct comparison of the health benefits or cost effectiveness of these simpler interventions, such as improved latrines, household water treatment and hand washing with soap.

The goal of the new project is to determine how sanitation interventions, delivered alone or as part of combined intervention packages, impact child health and well-being. In addition to improved sanitation, the intervention packages will include drinking water improvements and hand washing solutions. The results have the potential to influence how billions of dollars are directed towards long-term improvements in health and economic outcomes for millions of children each year, said Colford.

“Increasingly, foundations, governments, the World Bank and development agencies such as the MCC (Millennium Challenge Corporation) are demanding evidence of effectiveness when awarding development funds,” said Colford. “Right now, it is unknown whether single interventions are as cost effective as combinations of these interventions. This grant will fund the first large-scale, randomized impact evaluation designed to gather rigorous evidence about this question.”

The study will test the impact of these sanitation, water and hygiene interventions using a large-scale, randomized impact evaluation in Bangladesh and Kenya. These two countries are representative of the two regions that account for the majority of the world’s gastrointestinal disease burden: Southeast Asia and sub-Saharan Africa. The researchers expect to enroll a total of 23,000 children in the trials, which will be monitored by several institutional review boards.

Of the $10.9 million, about $7.9 million will be subcontracted out to the two field sites. Dr. Stephen Luby, head of the Programme on Infectious Diseases and Vaccine Sciences with ICDDR,B, and Michael Kremer, Ph.D., a research affiliate with IPA, will lead the trials in Bangladesh and Kenya, respectively. They will be joined by a team of experts from various disciplines, including public health, economics, behavioral change, nutrition, cognitive development and tropical enteropathy.

Source – http://www.berkeley.edu/news/media/releases/2009/11/05_gatesgrant.shtml

SuSanA special seminar: “Organizational co-learning for up scaling sustainable sanitation in Sub-Sahara Africa” at the Africa Water Week (AWW) in Johannesburg South Africa on Sunday, the 8th November 2009

The Sustainable Sanitation Alliance (SuSanA) is a loose network of organizations, NGOs, research institutions and individuals which contribute to the achievement of the MDGs by promoting sanitation systems which take into consideration all aspects of sustainability.

This special seminar convened by SuSanA will focus on Organizational co-learning for up scaling sustainable sanitation in Sub-Sahara Africa. The main aim is to share experiences, trends, challenges and knowledge, as well as formulate five key messages for the 2nd Africa Water Week. Other co-conveners are Water and Research Commission (WRC) South Africa, GTZ and SEI. Furthermore SuSanA will organize an exposition stand at the official AWW area as a joint effort of SuSanA partners (WRC, SEI, GTZ, etc.).

Venue : Gallagher Convention Center, Midrand, Johannesburg, South Africa

Time : 10:00 to 17:00 (+ optional dinner / informal discussions)

More information:

• Registration form
• Current agenda
• Seminar flyer

Contact: Steffen Blume and Elisabeth von Muench, SuSanA Secretariat, www.susana.org, e-mail: steffen.blume [at] gtz.de

World Toilet Day was established on 19 November 2001 by the World Toilet Organization. Celebrated annually, it seeks to increase awareness of the importance of toilet sanitation and each individual’s right to a safe and hygienic sanitary environment.

This year, Unilever’s Domestos will be the inaugural sponsor of World Toilet Day.

To help raise awareness for the 2.5 billion people who don’t have access to sanitation, thousands of people are going to squat for one minute. All over the world, in malls, in offices, on city streets – everywhere you turn, people will be squatting. And we want you to take part! The Big Squat is just one of many World Toilet Day events.

PumpAid’s in the UK has launched GAS, the Give a Sh*t Campaign, which includes the S*it Song, sung by Lark.

On WaterAid’s World Toilet Day web site you can send a postcard to PM Gordon Brown demanding that he talks toilets with world leaders, or play online Turdlywinks.

Follow World Toilet Day on Twitter and Facebook.

WAJIR EAST, 5 November 2009 (IRIN) – The sound of the evening bell at a local boarding high-school in Wajir, in the northeast of Kenya, did not always signal the end of the day’s classes. Instead it marked the end of the evening bathroom break as “bucket toilets” were emptied for the day.

Such stories are commonly told with a mixture of humour and concern in the semi-arid region of Wajir, where most residents have little access to improved sanitation – with serious health implications.

Outside the town, people use water from open dams, which they share with animals. “During the rainy season, run-off water washes animal waste into the dam, contaminating it,” he said.

Wajir residents rely on shallow wells, due to increasing water salinity at depth, which are exposed to contamination during flash floods and from seepage.

The larger Wajir, which borders Somalia, Ethiopia, as well as the Kenyan towns of Mandera, Moyale, Isiolo and Garissa, lies in an area with large aquifers supplied by perennial rivers and dry seasonal river basins – also sources of contamination.

Like most of northern Kenya, Wajir has experienced a prolonged drought and livestock deaths. Animal carcasses litter watering points, posing a further health risk.

Contamination

Wajir South Development Association (WASDA) programme manager, Haretha Bulle, told IRIN of the challenges.

“There are [largely] no flush toilets and no pit latrines,” Bulle told IRIN. A few flush toilets can be found in some hotels and in newer settlements but are rare in households.

According to a UN World Health Organization report, latrine coverage in rural Wajir is about 5 percent and just a little higher in the town.

Because of the high water table, pit latrines are not viable, and residents mainly rely on unhygienic bucket toilets – improvised from plastic jerry cans.

“Waste is collected from the bucket latrines by a tractor, which serves the whole town,” Bulle noted. The town has a population of about 220,000.

“Households are not able to dispose of waste [and] are forced to dispose it anywhere,” she said. “When it rains, the whole town smells. The water gets contaminated more easily and changes colour.”

Refuse pit and open pit dumping is prevalent.

El Nio threat

According to Wajir town resident, Khadijah Ibrahim, ongoing El Nio-related rains will only exacerbate the situation. Her family of eight shares one bucket toilet with three other households – about 24 people in total.

“Sometimes the municipal council comes to empty the bucket after a week or 15 days. By the time the waste collectors come, the bucket toilet is already overflowing,” Ibrahim said.

Her children, the youngest of whom is three, have been trained to wear shoes before going to the toilet to protect themselves, “but they only use soap to wash their hands before they eat”, Ibrahim said.

Eco-toilets

The Arid Lands Development Focus (ALDEF) NGO is piloting eco-toilets, which use heat trapped by solar panels to burn human waste, reducing it to ash.

The toilets do not use water, instead relying on a dehydration/evaporation system. Diyad Hujale, ALDEF programme manager, told IRIN the target was mainly the town centre, which requires about 5,000 toilets.

Hujale recommended that Wajir town’s by-laws should make it compulsory for any upcoming construction to have an eco-toilet facility. The challenge, he said, is “how to get rid of the bucket toilet”.

However, the cost of setting up an eco-san unit, about KSh60,000 (US$800), is prohibitive for private households.

Health education

Past recommendations to improve drainage and sanitation in Wajir have not yielded much, according to Bulle of WASDA. “It is one disaster after the other. When the rains come, we think of the drainage but forget about it when the drought comes.”

At present, village elders in Wajir are being taught how to chlorinate the community wells, according to health officer Njoroge. Health education on the importance of protecting the wells is also being provided.

He said the construction of more toilets is being encouraged in new settlements, where communities are provided with water treatment chemicals.

“Health education is ongoing. Of importance is that there is continued disease surveillance in the district,” he said. The solution lay in “providing clean water to the community and safe disposal of human waste via a sewerage system”.

Source – IRIN News

Lusaka District Commissioner Christah Kalulu is confident [that the city] will have fewer cases of cholera and malaria, and suffer less disaster than it has during rainy seasons over the past decade.

This follows the successful implementation of the District Disaster Reduction (DDR) programme which was launched on August 18, 2009.

By June 2009, 162 deaths occurred countrywide out of 7,587-reported cases of cholera. Lusaka alone had a mortality rate of 30.

The new intervention measures were adopted from the United Nations (UN) lead Programme on Risk Reduction – a global platform on risk reduction currently shared worldwide.

The whole exercise is expected to cost K12.5 billion and so far Lusaka District has raised K5.2 billion from DDR’s own resources since the intervention came as a post budget strategy.

The funds are meant to cover health, water and sanitation, bridges and crossings, garbage collection and drainage clearance.

The Disaster Management and Monitoring Unit (DMMU) which falls under the office of the vice-president, made available temporary water tanks and mobile lavatories in high-risk areas to try and reduce the impact of the disease.

The Lusaka District Commissioner together with the area Members of Parliament and members of the community developed a plan of action [which] will perhaps help answer questions on why [there are] priority [high-risk] areas, like Mandevu and Kanyama.

In 2008, areas like Mandevu experienced floods that left a trail of destruction largely due to the blocked drains and unplanned construction.

The Lusaka District office with the help of prisoners has unblocked drains containing stagnant water, which are not only a potential source of a cholera outbreak but also a breeding ground for mosquitoes that cause malaria.

Mindful of the hazards associated with unblocking drainages, the Lusaka DDR has bought protective clothing, which included overalls, gumboots, and facemasks. The DDR also provides meals for the prisoners.

In areas where there has been erratic water supply or no water at all, the DDR is installing permanent water reticulation stands and sinking bore holes. The Lusaka Water and Sewerage Company (LWSC) has put up 11 permanent water pipes, and is replacing temporary water stands put up in 2008.

Such programmes however cannot succeed without the participation and interest of the community and it is for this reason that Ms Kalulu has embarked on a hygiene promotion crusade. Some of the programmes will include drama with the Muvi Television soap, Banja crew and musicians like Joe Chibangu.

Source: Sam Phirim, Times of Zambia / allAfrica.com, 27 Oct 2009

In early October 2009, at least 29 people died of cholera and hundreds more were being treated for cholera-related symptoms such as acute watery diarrhoea (AWD) in the larger Turkana District in the northwest and in the eastern regions of Garbatulla and Laisamis, say health officials. The regions are not only facing an acute water shortage, due to a prolonged drought, but also have poor latrine coverage.

Cholera has also surfaced in several parts of the Coast in the aftermath of flooding. Coast Provincial Medical Officer Dr Anisa Omar confirmed on 3 November 2009, that 12 people have been admitted at Lamu district hospital after contracting cholera. There were also outbreaks of water-borne diseases in Magarini and Tana Delta district.

Cholera has also killed 11 people in Nairobi. The first case was reported in the sprawling Mukuru kwa Njenga slum. Some 949 people — most of them pregnant women and children under five years — had been treated for cholera and other water-borne diseases like diarrhoea, vomiting and dysentery.

See below two NTVKenya video reports on cholera in Mukuru, which also show the poor sanitary conditions in the slum.

Source: IRIN, 09 Oct 2009 ; Mathias Ringa, Daily Nation / allAfrica.com, 03 Nov 2009 ; Mike Mwaniki, Daily Nation, allAfrica.com, 29 October 2009

Generally, the main perceived advantages of latrine ownership are proximity/easy access and privacy. For the people of Gozakope in the Dangme West District of the Greater Accra Region however, ownership of household latrines means all of these plus massive improvements in their health status.

Raymond Kotoka Lusu, Chairman, Water and sanitation (WATSAN) Committee of Gozakope, has said the introduction of the Community Led Total sanitation (CLTS) approach, which has led to the construction of latrines in various households in the small settlement, has improved health tremendously.

“We used to have diarrhea and stomach problems but now we are growing fat,” Lusu told members of the Ghana WATSAN Journalists Network (GWJN) who took a field trip to the area recently to know at first hand the state of water sanitation and hygiene issues (WASH), as well as, the state of interventions by the Professional Network Association (ProNet) Accra, a partner of WaterAid Ghana.

About a year ago, ProNet Accra introduced CLTS to the Gozakope community located in the Asutwuare Sub-district of the Dangme West District. Hitherto, the community engaged in “free range” defecation. Men, women and children alike defecated in the bush.

A defecation map showed that sometimes the indigenes “did their own thing” close to water bodies and on hills where it was very easy for water to run off into water bodies. Also, they had satellite refuse dumps scattered all around. Though, they experienced health hazards and its attendant problems, they appeared oblivious to the need for alternatives.

Derick Abandoh, ProNet Accra Officer in charge of Hygiene, said the organisation introduced the CLTS approach to the community because it saw evidence of open defecation. Besides, its research proved that there had not been any previous funding of any projects relating to WASH in the community.

Upon entry, ProNet officials took the community through pre-triggering (getting to know the community), triggering (mapping defecation routes), post triggering and the walk of shame (leading the community members to the defecation site and holding discussions at the scene). All of these were supposed to alert the community about the unpleasant outcome of defecating in the open.

The construction of the latrines was undertaken by the community members themselves, using locally available material and local labour. Some of them have estimated the construction cost to be between GH¢70 and GH¢100 [US$ 49-70].

According to the people, the latrines are helping to keep flies away, leading to fewer disease germs being spread from place to place and there is less fecal seepage into water bodies. The result has been that there have been fewer diseases – less diarrhea, less worms, less cholera, and less typhoid fever.

Lamisi J. Dabire, Communication and Campaigns Officer of WaterAid, Ghana, said “All these monies came from their own pockets; it shows their commitment.” She added, “We want to bring the self-help spirit in the community up.”

ProNet has also been working to improve water supply situation in the area [by] putting iron removal plants in some boreholes to make the water safe for use.

Source: Public Agenda / Peace FM Online, 23 Oct 2009

Unicef, Govt launch national hygiene campaign

A national campaign to improve hygiene and sanitation in Tanzania was launched in Dar es Salaam yesterday.

It is the brainchild of the United Nations Children’s Fund (Unicef) and the Ministry of Health and Social Welfare. The national toilet campaign is known as Fyatua choo ushinde (Kiswahili words literally meaning “Click a toilet and win”).

Speaking at the function, the Unicef representative, Dr Abdulai Tinograh, said it is designed to mobilize all Tanzanians to participate in a robust national campaign to improve hygiene and sanitation in the society.

He said Tanzania needs sweeping changes in approaches towards sanitation and significant investments. These would make it achieve the sanitation Millennium Development Goals target of reducing by half the proportion of people living without access to basic sanitation by 2015, he noted.

He said a recent study found out that many schools do not have enough latrines and less than ten per cent of them in eight districts have functioning hand washing facilities.

”We have discovered that 90 per cent of children in these districts and probably in most areas of Tanzania use toilets, but do not have anywhere to wash their hands. Hence, they go back to classrooms with dirty hands which may make them sick,” he said.

Dr Tinograh said because of lack of water in school latrines some schoolgirls decide to leave them since they experience problems, especially during their menstruation periods.

He further said that the severity of the situation is reflected in the fact that between 60 and 80 per cent of all hospital attendances are cases related to poor sanitation, hygiene and inadequate water supply.

With over 1.7 million incidents of diarrhoea occurring annually in Tanzania it is small wonder that it is the fourth leading cause of morbidity and mortality among children after malaria, anaemia and pneumonia, he said.

He noted that while the majority of Tanzanians have access to some type of toilets there is continual need to improve the quality of the facilities and especially promote widely the habit of washing hands using soap to prevent infections and the spread of diseases.

That was why the “Fyatua choo ushinde” was being launched under which there would be prizes presented to winners, he said.

He explained that during the campaign people will be required to send photographs of the kind of toilets available or being used in the community, old toilets, filthy ones and the cleanest or new toilets.

Launching the programme, the permanent secretary in the Ministry of Health and Social Welfare, Ms Blandina Nyoni, said 83 per cent of people living in rural areas and 98 per cent of those in urban areas have toilets but they are not in good conditions.

She said the Government clearly recognizes the importance of hygiene and sanitation. It has therefore set priority targets in the National Strategy for Growth and Poverty Reduction to include 95 per cent of the population with access to basic sanitation by 2010.

Ms Blandina urged Tanzanians to properly use public toilets. She said some people have been misusing public toilets, thereby leading to the spread of sanitation- and hygiene-related diseases.

Source – The Citizen

Rural women in Nepal, especially schoolgirls, are still treated as untouchables during menstruation, resulting in health problems and growing absenteeism.

Social Development Advisor of WaterAid Nepal Om Prasad Gautam says, “Menstrual hygiene is neglected and people do not wish to explore this subject as it is still considered a social taboo.”

Moreover, hygiene is neglected by girls, especially in the rural areas, due to lack of availability and inability to afford sanitary napkins. In a study conducted by WaterAid Nepal in four schools of Nepal, it was observed that the use of sanitary pads is higher among girls in urban schools (50%) in comparison to rural (19%), which clearly mentions that family income affects the use of sanitary napkins.

Schoolgirls also refrain from going to toilets because there is no lock, no water and no disposal facility. They are also seen to avoid going to toilets during menstruation as most schools do not have separate latrines for girls. According to Ministry of Education and Sports (MOES), only 41% of schools in Nepal have latrines with only 26% of schools having separate latrines for girls.

Menstruation is the major contributing factor in absenteeism and poor academic performance among schoolgirls. Girls often remain absent and drop out of schools because of bad sanitation facilities in schools. In WaterAid´s study, some girls ailed by constant worries, though physically present in the school, were seen to be performing poorly.

“Many girls remain absent for 4 days a month during their menstruation cycle,” Anita Pradhan, Documentation Manager of WaterAid Nepal said, adding, “Remaining absent in school for 48 days a year is a huge loss for students.”

According to a survey conducted by Nepal Water for Health (NEWAH) in 7 schools, 94 percent girls went to school but 6 percent remained absent during their menstruation period.

Furthermore, religious and cultural taboos concerning menstruating girls have prevented women from being independent actors. Gautam says he was surprised to find that the girls were asked to not touch water, touch food in the kitchen and not walk through the road near a temple by their mothers.

A girl from Kathmandu shared that her family didn´t celebrate Dashain and Tihar after she looked in a mirror during her menstruation period, as this would bring bad luck.”

Menstrual hygiene has thus a vital aspect of health education and television programs, health officers, teachers and parents can play a very important role in transmitting a message of proper menstrual hygiene. This would save them from many health hazards. Currently, organizations like NEWAH, Lumanti and ENPHO have been working to bring about changes in this sector by spreading awareness on menstruation hygiene.

Related publication: WaterAid (2009). Is menstrual hygiene and management an issue for adolescent school girls?. Kathmandu, Nepal, WaterAid. Full report

Source: Mimansha Joshi, Republica, 29 Oct 2009