Rose George – Dirty little secret: the loo that saves lives in Liberia

Diarrhoea kills more children than HIV/Aids, tuberculosis and malaria combined – and its main cause is food and water contaminated with human waste. Liberia’s president is trying to change all that.

• Feb 3, 2012 – Rose George, The Guardian

For the worst country in the world, Liberia looks lush. All along the long road to Fish Town, the sumptuous rainforest on either side is a comfort, a green bath to soothe the dreadful red dust that is constant and the potholes that cause nose-bleeds, head-bumps and nausea even in this well-cushioned Toyota Land Cruiser belonging to WaterAid. We are scrunched into this car for days, because that’s how long it takes to get to Fish Town, only a few hours from Liberia’s capital Monrovia if you’re a crow, but 36 hours otherwise, because the country has only one decent main road.

Not just a flash in the pan: President of Liberia, Ellen Johnson-Sirleaf, is on a mission to educate her people about the link between early mortality and bad sanitation. Photograph: Aubrey Wade for the Guardian

To get there, we must loop north, brushing the border with Guinea, before swooping back down to a town that isn’t much of a town, the joke goes, and doesn’t have much fish. But it’s busy these days because NGO 4x4s such as ours are zooming through on their way to help refugees escaping from Ivory Coast, the latest poor sods in this region to be kicked out of their country by war.

We, though, are not zooming towards refugees but towards something far less newsworthy. It is my sixth visit to Liberia. The first was in 2004, six months into the country’s first peace in 20 years. Liberia had suffered years of stunningly brutal civil wars, orchestrated largely by Charles Taylor, now on trial in the Hague for war crimes (a man who once sued a journalist for saying he had eaten a human heart, and lost); and by other warlords with names such as General Butt Naked, General Peanut Butter and Devil. And this war’s stories were more horrific than most: mass rape; boy soldiers kept going by drugs, looting and raping; parents killed by their own boys; checkpoints made from intestines. Imagine the worst and, if you looked, you’d find it here doubled.

Liberia’s President signs WASH Compact

Liberia‘s President signs WASH Compact

The President of the Republic of Liberia, Madam Ellen Johnson-Sirleaf has finally signed the much talked about Liberia WASH Compact which was developed at the Multi Donor Conference on Water, Sanitation and Hygiene (WASH) held at the S.K.D Spokes Complex in Paynesville, outside Monrovia last year May.

Liberian President, Madam Ellen Johnson-Sirleaf

The Liberia WASH Compact is a product of the Sanitation and Water for All (SWA) Partnership aimed at ensuring that the Liberian population can have adequate access to safe water and improved sanitation facilities.

A release from the WASH Reporters & Editors Network of Liberia quotes the National Water Sanitation and Hygiene Promotion Committee under the leadership of the Public Works Ministry as saying President Johnson-Sirleaf who is WASH Goodwill Ambassador for Africa, signed the Compact last week.

The Liberia WASH Compact outlines the commitment to meet the MDGs challenges through partnership between Government, the Private Sector, Civil Society, Development Partners and the Media.

Liberian President and WASH Ambassador Ellen Johnson Sirleaf awarded Nobel Peace Prize

President Ellen Johnson Sirleaf talking with journalist Rose George in April 2011. Photo: Shout-Africa

Liberian President Ellen Johnson Sirleaf is one of three women who were jointly awarded this year’s Nobel Peace Prize. Mrs Sirleaf became Africa’s first female elected head of state in 2005, following the end of Liberia’s 14-year civil war which left 250,000 people dead. She shares US$ 1.5 million prize money with Liberian Leymah Gbowee and Tawakul Karman of Yemen.

In 2009, Ms Johnson-Sirleaf was appointed as the first Goodwill Ambassador for Water, Sanitation and Hygiene in Africa at the 2nd Africa Water Week that took place in Midrand, South Africa.

National stakeholders in Liberia are currently developing the Liberia Compact, under the framework developed by the Sanitation and Water for All (SWA) initiative. President Johnson-Sirleaf received the draft compact at the end of a Joint Multi-donor Mission on sanitation and water that took place in Liberia from April 27-May 3, 2011.  Ahead of the mission Mrs Johnson-Sirleaf reaffirmed her government’s support to the WASH sector in an interview with journalist Rose George (author of the Big Necessity).

Mrs Sirleaf (72) is standing for re-election next week.

Related web site: Sanitation and Water for All

Source: BBC News, 07 Oct 2011 ; Shout-Africa, 20 Apr 2011 ; WaterAid America, 17 Nov 2009

Rose George: Why there’s a sanitation crisis – and what we can do about it

Rose George, author of the Big Necessity, writes about her visit to a village in Liberia in the Gates Foundation Blog. There she met a local pastor whose 9-month-old daughter Marie, had died in November 2010 from diarrhoea. Despite increasing attention for sanitation from organisations like the Gates Foundation and UNICEF, it is still not enough, she says.

Ask a Liberian how many children they have and they will answer carefully. “Six, living.”

In this village, the creek was everything. It carried away dead bodies in times of war. It brought animal carcasses. Its flow channeled the upstream villages’ excrement, human and animal.

The creek was drinking water, and washing water, and water that brought death. It was the water in which hopeful mothers, who had trekked four hours to the clinic for the free ORS salts, mixed the medicine.

They knew the creek water was dirty, and they still drank it. They had countless visitors tell them about hygiene and disease, and didn’t lack skills to build pits when they built their own houses. Still they used the bush for defecation. Still they tramped fecal particles back into their cooking and living areas, to be ingested and turned into diarrhea.

Sanitation, you see, is not easy.

USAID/Liberia efforts in water supply, sanitation and hygiene

March 25, 2011

Around the world on March 22nd, people recognized World Water Day. The day serves as a reminder of the vital importance of access to clean water and the large numbers of people who live without that access.

Flashback: USAID mission Director, Patricia Rader hands over 350,000 mosquito nets to Deputy Minister of MOH Bernice Dahn.

Nearly 900 million people around the world lack access to an clean water source, and 2.6 billion people lack access to proper sanitation. The dearth of clean water, sanitation, and hygiene is linked to over 2 million deaths every year mainly from diarrhea and diarrhea-related malnutrition.

The impact of water on all aspects of development is undeniable. The health, economic, and social consequences of water deficits in both quantity and quality for all users, as well as for the environment, are enormous and linked to many U.S. foreign assistance priorities in tangible and substantive ways. As a result, forging a water-secure world is an essential step in all of USAID’s development goals.

The people of the United States are dedicated to helping Liberia address water and sanitation challenges. Through USAID programs in the country, we are actively engaged in improving Liberian’s access to clean, safe drinking water and use of water for enhanced hygiene.

USAID’s Rebuilding Basic Health Services (RBHS) program includes activities to prevent water-borne and water-washed diseases by providing adequate quantities of good quality water, access to adequate sanitation, and the promotion of sound hygiene practices in schools and health facilities in rural communities across Liberia.

USAID also has a separate, new multi-year, multi-million dollar water and sanitation program that will seek to improve water supply, sanitation, and hygiene (WASH), as well as the enabling environment for WASH, in target areas within the six counties of Grand Cape Mount, Bomi, Lofa, Nimba, Bong and River Gee in Liberia and the selected communities of Bensonville and Duport Road in Greater Monrovia.

We are also strongly committed to improving the lives of women and girls who are disproportionately impacted by the lack of access to safe drinking water and sanitation.

Sanitation is a critical gap and, in many countries, has lagged behind improving water supplies in terms of investment, political commitment, and progress. This is beginning to change, and USAID supports state-of-the-art approaches to sanitation that focus on behavior change, market development, and facilitating access to sanitation products and services.

In 2009 USAID activities world-wide gave about 6.4 million people access to safe drinking water and 3.4 million people to better sanitation.

In commemoration of World Water Week, USAID reaffirms its commitment to helping Liberians gain access to clean, safe water and vital sanitation and hygiene practices.

Source – Liberian Observer, March 25, 2011

OXFAM – Water, Sanitation and Hygiene Sector in Liberia

Life and Dignity at Risk – The Water, Sanitation and Hygiene Sector in Liberia, 2010.

Read/download (PDF 750KB)

Liberia‘s newly approved water and sanitation policy states that ‘water is life‘ and ‘sanitation is dignity‘. At present, however, the dire state of water, sanitation and hygiene (WASH) services in Liberia constitutes a public health crisis that is killing Liberians and robbing many more of their dignity: three out of four people have no access to safe water, six out of seven are without access to safe sanitation facilities, and altogether unsafe water, sanitation and hygiene practices cause 18 per cent of all deaths in Liberia.

This new paper from the Liberia WASH Consortium argues that these deaths can be prevented, but that Liberia’s government and donors need to rise to some serious challenges. These include speeding up coordination of policies and institutions; increasing the woefully inadequate government and donor financing in order to fill the $94 million financing gap; and dramatically improving aid coordination in the WASH sector. The challenges are serious, but can and must be met in order to halt the scandal of preventable disease and deaths – the denial of life and dignity – that confront millions of people in Liberia through lack of safe water and sanitation.

Key recommendations

• The Government of Liberia should speed up the process of finalising sector policies and improve coordination, improve data collection, increase funding for WASH to between 4 and 5 per cent of its total budget and engage better with civil society.
• Liberia’s donors should dramatically increase funding to meet the $93.5m financing shortfall, greatly improve their own coordination and alignment with the government including by ensuring that the lead donor is effectively driving this process, and support long-term planning by the government which meets both urban and rural needs.
• Liberian civil society should strengthen their engagement in the WASH sector policy and planning processes and provide a means for communities to express their needs, understand their rights and demand services in the water, sanitation and hygiene sector.

Joint Agency Paper: Liberia WASH Consortium

Author: Muyatwa Sitali, WASH Advocacy Coordinator, Liberia

Publication date: 17 June 2010

Liberia – 3 communities achieve Total Sanitation status

Liberia: Three communities meet CLTS compliance

Three communities in Liberia have been declared open defecation free by the coordinating institutions of the Community Led Total Sanitation (CLTS) program. The areas according to Public Works release are Sackie Town, Gbokolleh Town and Frank Town, all in Careysburg District, Montserrado County. The Community Led Total Sanitation (CLTS) approach focuses on igniting a change in hygienic and sanitation behaviors rather than just constructing toilets. The initiation also hopes to see Liberian communities organize themselves in addressing their sanitation needs through collective movement, without subsidies from outside.

CLTS started in Liberia March 30, 2008 and its originated from India by Dr. Kamel Kar, the founder of the organization. The idea was transplanted in Liberia through the instrumentality of UNICEF and the government of Liberia. Since the inception of CLTS in Liberia, about ten (10) communities have been triggered in Todee and Careysburg Districts in Montserrado. CLTS hopes to achieve reduction in water related diseases, community driven in all development initiatives and reduction in environmental pollution.

There are more than fifteen communities in Liberia as a whole trying to obtain ODF status but at present, only three have met the requirements and are going to be certificated during the official launching of the program. The coordinating agencies of CLTS in Liberia are the Ministry of Public Works, Ministry of Health and Social Welfare, UNICEF, SODES and FAAL. 

Meanwhile, strategy developed for the Community Led Total Sanitation program will be launched on Saturday, January 23, 2010 in Gbokolleh Town, Careysburg District, Montserrado County.  CLTS according to strategy developed hopes to declare 2010 as “National Year of Sanitation in Liberia.” The program is expected to caption the theme “from the bush to the toilet house-communities decide for themselves.”

Source – http://www.theliberiantimes.com/article_2010_01_21_5831.shtml

Liberia: No relief as most Monrovians go without toilets

With just one in 25 Liberians having access to a toilet, most [practice open defecation].

Liberia’s 3.5 million people share just 19,690 toilets, according to a government water and sanitation sector assessment from October 2008, and fewer than one in three Liberians have access to safe drinking water, according to the head of Liberia’s Water and Sewer Corporation, Hun-Bu Tulay.

Poor water and sanitation infrastructure contributes to high child deaths from malaria and diarrhoea, which kill 42 percent and 22 percent of Liberian children under age five, respectively, according to the NGO members of the water and sanitation or ‘WASH’ consortium in Liberia.

[...] Congested housing, no requirement that landlords provide working toilets, and virtually no urban planning have combined to create lethal sanitation conditions in the capital, [WASH consortium advocacy manager Muyatwa Sitali] Sitali said.

[...] In the Monrovia neighbourhood of West Point up to 70,000 people share 32 public washrooms which have four functioning toilets among them. “And this is one of the better managed water and sanitation areas in the capital,” Sitali said.

The decrepit infrastructure means toilet-users may have to use up to four gallons of water each time they flush, according to civil servant Florence Nimely, who lives in the city-centre. “At US 25 cents a gallon, for some it is a choice between flushing and affording to buy food at the end of the day,” Nimely said.

[...] “When some of my neighbours defecate they cannot get enough water to flush their toilets, so they sometimes throw the faeces around the place, exposing us all to health hazards,” Monrovia shopkeeper Samuel Tweh told IRIN.

[...] The government needs US$143 million to revitalise the water and sanitation network, according to the latest poverty reduction strategy issued at an April 2008 Liberia donor conference in Bonn, Germany, but as of May 2008 just $57.5 million had been committed.

[...] The Liberian government recently launched its 2008-2011 sanitation management programme, which aims to deliver clean water to half of Monrovia’s residents by 2011, and improve access across all 15 regions.

WASH consortium members Oxfam GB, Concern, Tearfund, Action Contre La Faim, and Solidarité plan to help the government reach its goals, with funding from the UK’s Department for International Development (DFID), the European Union’s humanitarian branch, ECHO, and Irish Aid. UNICEF and the African Development Bank are also providing assistance.

Source: IRIN, 19 Nov 2008