Tag Archives: Pakistan

Pakistan: sanitation crucial to survival for flood victims

Millions remain without proper sanitation in flood-affected Pakistan.

“Sanitation is ‘the invisible problem’ in disaster relief and by highlighting the problem, behaviour change happens,” according to Bill Fellows, the water, sanitation and hygiene (WASH) global cluster coordinator working with United Nations Children’s Fund (UNICEF), the WASH cluster lead agency.

Hygiene is four times as important as clean drinking water for preventing diarrheal disease according to research published in The Lancet medical journal [1]. Whilst in flood devastated Pakistan, access to clean drinking water is on the rise, thanks to the efforts of WASH cluster member agencies, with 2.5 million people receiving clean drinking water every day, the attention to sanitation has become critical in preventing disease outbreaks.

UNICEF, in cooperation with the government, is implementing hygiene education in relief camps through a “no open defecation campaign”. “This is based on a system developed in Bangladesh and helps affected communities take a first step to achieve basic sanitation in disaster affected communities”, said Fellows.

In addition, the hygiene education campaign includes teaching flood survivors to build open pit latrines. As part of the flood relief efforts 2,723 emergency latrines have been built, benefitting 40,000 people.

Female health workers and Pakistan Red Crescent volunteers are also on the frontline of hygiene education, which is one of the most critical components in reducing water-borne disease. To date, these volunteers have helped educate almost 750,000 people on the benefits of good hygiene.

To compliment hygiene education, soap and hygiene kits are needed. UNICEF reports 400,000 hygiene kits are in the pipeline along with three million bars of soap.

“It is crucial in disaster response that flood affected communities receive latrines and soap, as well as hygiene education to prevent illness and disease”, said Manuel Bessler, Head of the Office of Coordination for Humanitarian Affairs (OCHA) in Pakistan.

In addition to water and sanitation flood relief activities, UNICEF and its partners are engaged in an integrated approach to provide humanitarian assistance to millions of flood survivors through health and nutrition, child protection, education and prevention of child trafficking.

[1] The same conclusion can be found in a recent article by Cairncross et al. in the International journal of epidemiology

Read the latest Pakistan Floods WASH-related news on ReliefWeb

Related web site: Global WASH Cluster

Source: ReliefWeb, 14 Sep 2010

Health problems just starting in Pakistan

Aug 30 (Reuters) – As floodwaters recede in Pakistan, experts are warning the real problem — disease, food shortages and malnutrition — might just be starting.

There have been 38,000 reported cases of acute diarrhea and at least one confirmed cholera death, health experts wrote in The Lancet journal.

The U.N. has warned of other imminent waterborne diseases, including typhoid fever, shigellosis and hepatitis A and E, and vector-borne diseases like malaria and dengue fever.

News alerts on WASH Disease Outbreaks – http://washalerts.wordpress.com/

Pakistan – Application of solar collector disinfection (SOCO-DIS).

Water Res. 2009 Dec;43(20):5225-35

Roof-harvested rainwater for potable purposes: application of solar collector disinfection (SOCO-DIS).

Amin MT, Han MY. Department of Environmental Sciences, COMSATS Institute of Information Technology, Abbottabad, 22060, Pakistan. muhammadamin@ciit.net.pk  

The efficiency of solar disinfection (SODIS), recommended by the World Health Organization, has been determined for rainwater disinfection, and potential benefits and limitations discussed. The limitations of SODIS have now been overcome by the use of solar collector disinfection (SOCO-DIS), for potential use of rainwater as a small-scale potable water supply, especially in developing countries. Rainwater samples collected from the underground storage tanks of a rooftop rainwater harvesting (RWH) system were exposed to different conditions of sunlight radiation in 2-L polyethylene terephthalate bottles in a solar collector with rectangular base and reflective open wings. Total and fecal coliforms were used, together with Escherichia coli and heterotrophic plate counts, as basic microbial and indicator organisms of water quality for disinfection efficiency evaluation. In the SOCO-DIS system, disinfection improved by 20-30% compared with the SODIS system, and rainwater was fully disinfected even under moderate weather conditions, due to the effects of concentrated sunlight radiation and the synergistic effects of thermal and optical inactivation. The SOCO-DIS system was optimized based on the collector configuration and the reflective base: an inclined position led to an increased disinfection efficiency of 10-15%. Microbial inactivation increased by 10-20% simply by reducing the initial pH value of the rainwater to 5. High turbidities also affected the SOCO-DIS system; the disinfection efficiency decreased by 10-15%, which indicated that rainwater needed to be filtered before treatment. The problem of microbial regrowth was significantly reduced in the SOCO-DIS system compared with the SODIS system because of residual sunlight effects. Only total coliform regrowth was detected at higher turbidities. The SOCO-DIS system was ineffective only under poor weather conditions, when longer exposure times or other practical means of reducing the pH were required for the treatment of stored rainwater for potable purposes.

USAID Global Development Alliance – Safe Drinking Water Alliance

USAID Global Development Alliance. (2010). Safe Drinking Water Alliance – Experiences in Haiti, Ethiopia, and Pakistan: Lessons for future water treatment programs.

Full-text: http://www.ehproject.org/PDF/ehkm/gda2010.pdf

To address some of the challenges created by lack of access to safe water, in 2004, the United States Agency for International Development’s (USAID) Global Development Alliance (GDA) brought together Johns Hopkins Center for Communication Programs (CCP), Population Services International (PSI), CARE USA, and Procter & Gamble (P&G) to create the Safe Drinking Water Alliance (SDWA). The general goal of the Alliance was to test three marketing models to increase demand for water treatment and to identify the potential of P&G’s PUR in each model as an alternative POU technology. PUR is a household-based water treatment product that combines disinfection with removal of dirt and other pollutants and transforms turbid contaminated water into clear, potable water. The three models tested by the SWDA included:

(1) a commercial marketing model with full cost recovery in Pakistan;
(2) a social marketing model where some promotional costs were subsidized in Haiti; and
(3) an emergency relief model in Ethiopia.

In Pakistan and Haiti a combination of behavior change communication activities and PUR-branded messages and materials were disseminated to increase the demand for water treatment and to introduce PUR. In both countries, CCP led the behavior change campaigns, while in Haiti PSI handled the specific promotion and distribution of PUR. In Pakistan, P&G focused on creating demand for PUR. In Ethiopia, CARE staff working in the Community-Based Therapeutic program were fully in charge of introducing PUR and providing the motivation and information for its use.

In all three contexts SDWA partners also studied barriers and facilitators to sustained water treatment behaviors, as well as reactions to and use of PUR specifically. Findings have clear programmatic relevance, and add to the emerging literature on water treatment behavior and the adoption of new technologies, and particularly provide insights about feasible directions for PUR.

Pakistan: ‘24% of country’s hospital beds occupied by waterborne disease patients’

In Pakistan, 38.5 million people do not have access to safe drinking water and 50.7 million do not have the facility of proper sanitation. These high statistics result in more than 24 percent of Pakistan’s hospital beds being occupied by the people suffering from waterborne diseases. Moreover, diarrhoea is the leading cause of mortality and second leading cause of morbidity among children under five years of age, said experts at a meeting in Karachi.

Addressing the session of the first day of Aga Khan University’s 13th National Health Sciences Research Symposium on ‘Impact of Water and Sanitation on Health: Our Problems and Our Solutions“, Pakistan government Health Director General Dr Rashid Jooma said that the work being done on the water and sanitation sectors in Pakistan is not like that being done in other countries, such as India, worsening the sanitation conditions.

Jooma said that the bad sanitation conditions are not only affecting human health but the environment too. He added that the estimated cost of environmental degradation in Pakistan is Rs 365 billion per year, of which Rs 112 billion [US$ 1.34 billion] is caused by inadequate water supply, sanitation and hygiene conditions.

Talking about the government’s response to these challenges, including legislation and policy, and initiatives for safe drinking water, sanitation and hygiene, he said there are several projects in the pipeline and more is yet to be done.

Senior Architect and Urban Town Planner Arif Hassan underlined the fact that over the last 50 years the government has invested considerable money, including aid, in drinking water and sanitation programmes. However, these projects have not been successful and have increased Pakistan’s foreign debt considerably. Some NGO projects have delivered positive results but unless their methodology becomes a part of the official policy, planning and implementation procedures, they cannot be successful to the extent required for servicing the growing demand for water and sanitation. In the past two years, the government has legislated a sanitation and drinking water policy which, to be successful, will need to relate to ground realities.

[…] Aga Khan Program for Islamic Architecture at MIT Professor Dr James Wescoat said landscape planning has an increasing role to play in helping expand household and neighbourhood water and sanitation solutions to rural and urban areas. “Environmental design has played a vital role in linking water and health, from Mohenjo Daro to Boston,” he said.

Addressing the Symposium via the Internet from India, Dr Bindeshwar Pathak, founder of the Sulabh Sanitary Movement, said low-cost sanitation technology is available and by adopting these technologies, any country can improve the sanitation sector. Sharing his experience of introducing a two-pit pour flush toilet that uses only 1-1.5 litres of water, he said that the technology is flexible and affordable and can be implemented at costs starting from USD 30, depending on the quality.

AKU’s Dr Iqtidar A Khan said that in Pakistan 90 percent of water is used for agriculture and less than 10 percent for drinking and sanitation. He said the water availability has fallen from 5,000 cubic metres per capita in the early 1950s to less than 1,500 cubic metres today. Quoting the words of former United Nations Secretary General Kofi Annan, he said that AIDS, tuberculosis, malaria and other infectious diseases will not be defeated until the battles for safe drinking water, sanitation and basic health care are won.

Source: Amar Guriro, Daily Times, 28 Oct 2009

Pakistan: moving beyond open defecation free sanitation

CLTS-Plan-Booklet

CLTS Picture book. Plan International Pakistan

Pakistan has taken an important step towards improved sanitation through a major sector assessment and setting up of a core group that seeks to move communities beyond open defecation free (ODF) status. The Community Led Total Sanitation (CLTS) approach has already enabled more than 1,500 villages in Pakistan to achieve ODF status and is expected to reach 15,000 villages by June 2011. This will mean that a third of the rural population of Pakistan would be covered.

 

To consolidate this progress and scale up learning, a Core Group was formed in August 2008 to advise the government in policy refinement and implementation of its nation-wide sanitation policy. The Core Group includes senior officials from the key national ministries of Environment and Health, as well as Provincial Planning and Development Departments and international agencies, including WSP.

The group commissioned an assessment of CLTS pilots in nine villages in the country. The evidence gathered revealed that CLTS had the potential to motivate communities to achieve ODF status. However, it did not create demand for “improved sanitation,” which, according to the Joint Monitoring Program, implies use of sanitation facilities “that ensure hygienic separation of human excreta from human contact.

The surveyed communities were found using unimproved and unhygienic latrines without taking any substantial effort to upgrade or replace damaged latrines due to limited knowledge of different latrine options available at the household level.

A countrywide CLTS implementation strategy will be developed based on the recommendations of the review, and is likely to benefit all communities living in rural areas by 2015.

Source: WSP Access, Oct 2009

Reacting to this WSP news item, Prof. Duncan Mara noted in his blog:

‘So now we know what many of us had long suspected: the whole CLTS ‘process’ needs to be upgraded so as to ensure people get at least ‘improved’ sanitation. Actually what people need is ‘good’ sanitation and ‘improved’ does not necessarily mean ‘good’ (after all, ‘improved’ sanitation includes a “pit latrine with slab” − see here − and we’ve all seen hundreds of these that are far from satisfactory).’

Pakistan – Launch of Total Sanitation Campaign

Plan to launch ‘Saaf Suthra Pakistan Programme’

Ministry of Environment along with its partners is working on a comprehensive plan to launch ‘Saaf Suthra (clean) Pakistan Programme’ that envisages total sanitation all across the country to achieve the Millennium Development Goals targets.

Sources at the ministry told APP that allocations would be made for the programme over the next five years to achieve the total sanitation target.

“The ‘Saaf Suthra Pakistan Programme’ will have a phased approach for creating demand through communication and capacity development units in each province,” sources said.

“The programme will also include surveys and mapping for component sharing in selective TMAs and setting up of provincial social mobilisation units to scale up community and school led approaches,” sources added.

Experts at the two-day Pakistan Conference on Sanitation (PACOSAN) a couple of days back had also recommended multiple approaches to focus on the ‘Clean Pakistan Programme’.

It was also proposed during the conference that Rs12.5 billion would be allocated to execute the programme over the next five years, as the environment minister had set a target of total sanitation for all by 2015.

Sources also mentioned that setting up of ‘Rural Sanitation Marts’ in selected tehsils, provision of revolving funds and micro-finance, special consideration for the poorest of the poor, and coverage enhancement of public toilets are other features of the programme.

NGOs would be involved to develop, test, document, and replicate successful models for total sanitation, and solid and liquid waste management, the sources added.

Mentioning the guiding principles of the National Sanitation Action Plan, sources said that open defecation would be unacceptable and there should be an inclusive participatory development.

The total sanitation concept would be adapted with improved sanitation provided to all and focus would be on productive infrastructure only, ensuring that no one is exposed to the risks of unconfined ‘human excreta’ and solid waste. Progress would be accelerated to achieve health benefits and coordinate efforts within a framework of mutual accountability.

Sources also mentioned to improve governance, reward collective outcomes, incentives for producing performance information and support IEC for collective behavioural change.

See also: Call for Total Sanitation in Pakistan by 2015, WSSCC

Source – The News, Pakistan