Category Archives: Sanitation and Health

The “Look it up Club” got me hooked: Sanitation Wikipedia needs you, too.

By Diane Kellogg, Chair Sanitation Wikipedia Project

My father always said:  “Your ticket off the chicken farm is your education.” My parents did their part.  They enrolled us in the “Look it up Club” by buying the World Book Encyclopedia, one book at a time—A through Z.   To any question we asked, our parents’ answer was the same:  “You’re a member of the Look it up Club aren’t you? Look it up.”

Education mattered so much that “I have homework” could get you out of gathering eggs after school.  As a result, all five of “the McKinney Kids” got good grades.   Still, I wanted off that chicken farm badly.  More degrees could get you even farther from the chicken farm, right?

I got so far from my practical roots that I actually ended up warning my students against looking it up.  At least not on Wikipedia.  The “pedia” of today couldn’t possibly be as good as the encyclopedia, right?  Anyone and everyone can add “stuff” to Wikipedia, so how could it be any good?

Was I ever wrong. 

You can’t get anything past the Wikipedia Warriors out there on the planet.  Yes, anyone can add things, but there will be an army of eyes on your work.  The article on cholera, for example.  A total of 244 people have the cholera article on their “watchlist.”  Many of those have probably asked Wikipedia to notify them by e-mail when “changes were made to an article you’re watching.”   If you make an assertion without referencing credible sources or insert your own opinion, you will hear from someone.  Wikipedia specializes in facts.  Objective facts.  Wikipedia’s standards keep going up.  It’s the best kind of crowd-sourcing:  the best version of the article is what sticks.

What bothers me is that some of the articles on sanitation are so unreadable:  Out of 100 points possible on the Flesch Readability Score, the page on “diarrhea” gets a 38.  And get this:  2700 people click on that article every day.  Multiply that by 365 days in a year, and you’ve got to wonder.  I wonder if those clickers are finding what they’re looking for.  Mothers in Mali with a sick baby want to know how much time they have to get fluids into that little body. Shouldn’t that diarrhea article be more easy to read and understand?

I’ve done penance in various ways.  I’ve assigned a few Wikpedia articles so students will know I am no longer snooty about the quality of what can be found there.  I’ve edited a few Wikipedia articles where I thought the experts were making concepts more obscure and complex than they needed to be.  (Thankfully, the Wikipedia Warriors said “Thank you: that makes the point more clear.”)  I’ve even asked colleagues to assign their students to do original research on WASH topics to see if they could find more recent information to add to articles.

Now I’m chairing a SuSanA drive to improve WASH content on Wikipedia ahead of World Toilet Day on 19 November 2017.

It’s that readability thing that has me so motivated.  Our goal is to raise the average readability of all WASH articles to 60-70.  The average is now 37.    (You can check the readability of your own writing at this link.)  In the spirit of  practice what you preach, I just did that for my blog:  65.

On World Toilet Day, we will award $500 Honorariums to especially dedicated Sanitation Wikipedia volunteers.  Click  on this page to join the team or email Wikipedia@SuSanA.org to offer a few hours of your time.  We make it fun.

 

 

The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis

The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis. International Journal of Hygiene and Environmental Health
Volume 220, Issue 6, August 2017, Pages 928-949.

Authors: Matthew Freeman, Joshua Garn, Gloria Sclar, et al.

Background – Sanitation aims to sequester human feces and prevent exposure to fecal pathogens. More than 2.4 billion people worldwide lack access to improved sanitation facilities and almost one billion practice open defecation. We undertook systematic reviews and meta-analyses to compile the most recent evidence on the impact of sanitation on diarrhea, soil-transmitted helminth (STH) infections, trachoma, schistosomiasis, and nutritional status assessed using anthropometry.

Methods and findings – We updated previously published reviews by following their search strategy and eligibility criteria. We searched from the previous review’s end date to December 31, 2015. We conducted meta-analyses to estimate pooled measures of effect using random-effects models and conducted subgroup analyses to assess impact of different levels of sanitation services and to explore sources of heterogeneity. We assessed risk of bias and quality of the evidence from intervention studies using the Liverpool Quality Appraisal Tool (LQAT) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively. A total of 171 studies met the review’s inclusion criteria, including 64 studies not included in the previous reviews. Overall, the evidence suggests that sanitation is protective against diarrhea, active trachoma, some STH infections, schistosomiasis, and height-for-age, with no protective effect for other anthropometric outcomes. The evidence was generally of poor quality, heterogeneity was high, and GRADE scores ranged from very low to high.

Conclusions – This review confirms positive impacts of sanitation on aspects of health. Evidence gaps remain and point to the need for research that rigorously describes sanitation implementation and type of sanitation interventions.

 

In Haiti, a Building Fights Cholera

In Haiti, a Building Fights Cholera. New York Times, September 12, 2017.

Next month marks the seventh anniversary of the cholera outbreak that ravaged Haiti. The disease, which can cause death within hours if left untreated, came less than a year after Haiti was rocked by an enormous earthquake that left hundreds of thousands dead and millions injured, displaced and destitute.

Haiti is prone to earthquakes and tropical storms — the island was spared the worst of Hurricane Irma last week — but the cholera outbreak was an anomaly; the disease had never before struck Haiti. It was brought in, it is widely believed, by United Nations peacekeepers from Nepal.

A child with cholera symptoms being examined in the Cholera Treatment Center in Port-au-Prince, Haiti. Credit Dieu Nalio Chery/Associated Press

A child with cholera symptoms being examined in the Cholera Treatment Center in Port-au-Prince, Haiti. Credit Dieu Nalio Chery/Associated Press

One of the world’s most infectious waterborne diseases, cholera spreads quickly and has proved extremely difficult to contain in Haiti. Over 10,000 have died and nearly a million have been stricken to date.

But one organization has managed to nearly eradicate it in a large slum in Port-au-Prince that lacks clean water and sanitation.

One of the game changers that would surprise most people, including global health experts, was actually a building.

It wasn’t just any building, but a very intelligently and beautifully designed one: the Cholera Treatment Center, operated by Les Centres Gheskio, an acronym that stands for the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections.

Read the complete article.

Guardian series on the first 1,000 days

Sept 7 – Surviving without thriving – but all is not lost for the world’s ‘stunted’ children

About 159 million under-fives suffer impaired growth and brain development, but now a study is challenging the view that nothing can be done to help them. Feeding interventions alone are not enough. Environmental factors have to be addressed too.

A quarter of all stunting is linked to chronic diarrhoea in the first two years and almost 90% of cases are the result of a lack of clean water, sanitation and hygiene. Air pollution and the use of biomass fuel play a part. Perhaps better gender parity will prove most significant. If stunting begins in the womb, then clearly maternal health is key: shorter mothers are more likely to have stunted children.

Sept 6 – The first 1,000 days: Jay Rayner explains their impact on a child’s future – video

Good nutrition, healthcare and sanitation are crucial to a child’s early development. Without these, a child’s brain won’t develop properly. They will have a lower IQ and they will grow up shorter than they should, a condition known as stunting. The Observer’s food critic, Jay Rayner, explains how a child’s future is determined by the first years of life.

WSSCC Releases New Global Sanitation Fund Equality and Non-Discrimination Study

How can WASH programmes leave no one behind, as called for in the Sustaionable Development Goals? WSSCC’s new study, Scoping and Diagnosis of the Global Sanitation Fund’s Approach to Equality and Non-Discrimination, helps answer this question.

The study reveals that many people who may be considered disadvantaged have benefited positively from WSSCC’s Global Sanitation Fund (GSF)-supported programmes, particularly in open defecation free verified areas. In addition, a range of positive outcomes and impacts related to empowerment, safety, convenience, ease of use, self-esteem, health, dignity, an improved environment and income generation were reported by people who may be considered disadvantaged.

EQND-Article-Slider
Photo Credit: WSSCC

However, the study finds that GSF has not yet systematically integrated EQND throughout the programme cycle. Across all countries, there are people who have either fallen through the net or whose lives have become more difficult after being unduly pressured, or after taking out loans and selling assets to build toilets. More proactive attention is needed throughout the programme cycle to build on current successes and ensure that people are not left behind or harmed through the actions or omissions of supported programmes.

GSF is in the process of putting the study’s recommendations into practice through revised guidelines, minimum standards, practical tools and other mechanisms.

Download the full study, plus a summarized version with GSF reflections, and annexes

‘It’s a Slow Death’: The World’s Worst Humanitarian Crisis

‘It’s a Slow Death’: The World’s Worst Humanitarian Crisis. New York Times, August 23, 2017.

SANA, Yemen – After two and a half years of war, little is functioning in Yemen.

Repeated bombings have crippled bridges, hospitals and factories. Many doctors and civil servants have gone unpaid for more than a year. map_cholera_top-1050

Malnutrition and poor sanitation have made the Middle Eastern country vulnerable to diseases that most of the world has confined to the history books.

In just three months, cholera has killed nearly 2,000 people and infected more than a half million, one of the world’s largest outbreaks in the past 50 years.

Read the complete article.

Nearly a Billion People Still Defecate Outdoors. Here’s Why

Nearly a Billion People Still Defecate Outdoors. Here’s Why. Nat Geo Magazine, August 2017.

The problem isn’t just a lack of toilets—it’s a lack of toilets that people want to use. The result: millions of deaths and disease-stunted lives.

At 65, Moolchand, bandy-legged and white-haired, has no problem rising for his predawn hunts. In fact he revels in them.

“I hide along the lane with my flashlight,” he says in a low, excited voice, gesturing down the main road of Gaji Khedi village, in India’s Madhya Pradesh state. “And I look for people walking with a lota.”

At a community toilet complex in Safeda Basti, one of Delhi’s many slums, women wait their turn for the single functioning latrine—while covering their noses against the smell of feces left by someone who couldn’t wait. Many people skip the hassle of city-run facilities altogether and do their business in rubble-strewn lots.

At a community toilet complex in Safeda Basti, one of Delhi’s many slums, women wait their turn for the single functioning latrine—while covering their noses against the smell of feces left by someone who couldn’t wait. Many people skip the hassle of city-run facilities altogether and do their business in rubble-strewn lots.

A lota is a water container, traditionally made of brass but these days more often of plastic. Spied outdoors in the early morning, it all but screams that its owner is headed for a field or roadside to move his or her bowels—the water is for rinsing.

“I give chase,” Moolchand continues. “I blow my whistle, and I dump out their lota. Sometimes I take it away and burn it.” Moolchand sees himself as defending a hard-won honor: The district has declared his village “open defecation free.”

“People get angry and shout at me when I stop them,” he says. “But the government has given villagers lots of help to construct a toilet, so there is no excuse.”

Read the complete article.