Let's talk about shit

My previous impromptu blog about World Toilet Day was discussing an entire day dedicated globally to discussing the toilet. In this blog, I am going to do a complete 180 and look at reasons as to why people don’t talk about shit, and how we can get them talking. Below you will see a TEDtalk done by Rose George (figure 1), this video gave me a lot of inspiration for this blog entry and so I thought I would share it with all of you. 

Figure 1

Source: https://www.youtube.com/watch?v=ZmSF9gVz9pg

Why don't we talk about shit more?

We have all heard of the phrase 'sex sells', and it couldn't be truer. Sanitation isn't at the forefront of aid efforts, or governmental decisions; it is something we are embarrassed to talk about, something we believe should be kept private, something which isn't sexy - this needs to change. There is no universal term for shit (see figure 1). People are embarrassed or offended to use certain words making poo difficult to talk about, particularly for those who are in a position of power, whether this is a political position or the head of an NGO (Borel, 2013). There are numerous ways we try to be discreet about having a poo, for example, men in Kenyan communities will say they are 'answering the call of nature' when they need the toilet, and many find the use of the word shit extremely offensive and vulgar, preferring the term haja kubwa (David, 2011), a word which is not used universally. It is not just in the developing world where there is a shyness when it comes to sanitation, in the UK, toilet roll companies such as Andrex are not direct about their product (see figure 2), but instead show a puppy running around with toilet roll (Borel, 2013). This reluctance to talk about shit makes global sanitation issues very difficult to engage with. The Gates Foundation was one of the first organisations to start talking about shit using mediums such as competitions among universities, which has been pivotal in getting people to start talking about shit in academia and among NGOs. With The Gates Foundation as a springboard, this has allowed for numerous new approaches to appear encouraging people to talk about shit and changing their behaviour, in the last decade the approach Community-Led Total Sanitation has become increasingly popular within Sub-Saharan Africa. 

Figure 2 

Source: https://www.youtube.com/watch?v=yx6gZAKWLHk

Community-led total sanitation (CLTS)

CLTS is a method of making sanitation issues important within communities by making them talk and work together to reduce open-defecation (OD) and improve toilet facilities. CLTS comes with many challenges, often people are reluctant to talk about shit due to embarrassment, there are also many cultural taboos that need to be addressed. If cultural taboos are not addressed, regardless of whether latrines are available they will not be used, below I have bullet-pointed a few common taboos and superstitions regarding shit in SSA:

• Pooing over someone else's poo is considered to be bad luck (Zombo, 2010).
• It is a taboo for a father-in-law and his daughter-in-law's poo to mix (Bwire, 2010).
• In Kenya, it is believed a person's poo can be used to bewitch them, this stops people using communal latrines and continue to practice OD due to fear of witchcraft (Bwire, 2010).
• In Ethiopia it is considered a taboo for both men and women to share the same latrine, also the sight of faeces is unacceptable resulting in continuing OD (Chambers and Myers, 2016).

CLTS has a variety of techniques to overcome these embarrassments and taboos. CLTS believe that rather than sitting communities down and lecturing them over the importance of good sanitation and hygiene, the most effective outcomes come from generating disgust through demonstrations. Typical demonstrations include putting a pile of food next to a pile of poo and getting the villagers to watch the flies jump back and forth between the two, people were mostly disgusted by the thought of ingesting someone else’s shit (George, 2012), you have to shock people to change their behaviour (Zombo, 2010). Shocking people is the easy part, getting them to talk shit is difficult. CLTS gets people talking by introducing them to shit through songs, proverbs, stories and laughter (Zombo, 2010). CLTS has found laughter to be the most effective tool, in Sierra Leone CLTS has created a lighthearted song to highlight how easily poo can spread:

"Kaka na kaka, big wan, small wan, na the same foot den get for waka go na chop or water."

(A shit is a shit, big shit or small shit, they all have legs and feet that move them to food and water.)

(Zombo, 2010).

In Sierra Leone alone the CLTS approach has helped 300 villages become OD free (Zombo, 2010). The successes of CLTS are very important, OD and unsafe sanitation facilities can be deadly or cause serious illness amongst communities, and so it is of utmost importance we talk about shit. 

Why is it important to talk about shit?

Every day 4000 children die from diarrhoea, a number that is higher than HIV/AIDS, tuberculosis and measles combined (Borel, 2013), however, it receives far less attention. A single gram of poo can contain upwards of 50 diseases, many of which can be fatal (Borel, 2013). Contracting one of these many diseases can have several negative multiplier effects, such as a lack of productivity in the economy, death, embarrassment, and social isolation; it is estimated that each year $260 billion is lost as a result of inadequate sanitation globally (Borel, 2013). This leads me to next week's blog which will be focusing on water and sanitation related diseases, and the cost they have on many lives. 

World Toilet Day 2017

As some of you may know yesterday (19th November) was World Toilet Day. This will be a quick blog looking at the importance of World Toilet Day, and how it is helping to improve sanitation around the globe.

What is it?

The purpose of World Toilet Day is to raise awareness for the global sanitation crisis. The UN day is helping to work towards meeting the Sustainable Development Goal 'Ensure access to water and sanitation for all by 2030'.

Why is it important?

For many people, especially in the western world, going to the toilet isn't an issue. For many there is a clean toilet within their home, allowing them to safely and cleanly go about their lives. However, for many owning a toilet in one's home is seen as a luxury, something to aspire for. With people defecating in the streets, in the open and in rivers, there is a desperate need to build more toilets. Without safe access to a toilet, or a sanitary way to go to the loo, a number of issues can arise:

• Globally 1.8 billion people drink water contaminated by faeces, which has resulted in large health implications. 
• Around 80% of wastewater in the world flows straight back into the ecosystem without being treated.
• It is believed that improved sanitation facilities could reduce the number of deaths a year by 842,000.
• It is estimated that 10% of the world's population consumes food that has been irrigated by waste water - this creates significant health risks, including diarrhea which kills an estimate 280,000 a year due to poor sanitation. 

By creating World Toilet Day there is a hope to raise awareness about the sanitary crisis, and getting people to start talking about poo!


This year's theme: Waste management.

Every World Toilet Day has a different theme, this year the theme is on Waste management. World Toilet Day has proposed a four-point scheme to effectively manage waste (Figure 1), which they believe will help the world meet the Sustainable Development Goals for water and sanitation:

Figure 1: The 4-step journey of safely treated poo

Source: http://www.worldtoiletday.info/where-does-our-poo-go/ 

This year's theme, wastewater, is very important as it helps highlight the issues that many people face around the world. Billions of people are without effective sanitation systems, which can lead to a large number of issues such as child stunting. This year's World Toilet Day is hoping to improve or put in place these sanitation systems to reduce the amount of poo in the environment, making the world a safer place for all.


To find out more information about World Toilet Day: http://www.worldtoiletday.info/

Millennium Development Goals - part 2

What went wrong?

My previous blog on the MDGs gave a few figures surrounding water and sanitation for Sub-Saharan Africa (SSA), but these figures do not represent the regional difference. Below figure 1 and figure 2 show a breakdown of country populations with access to improved water sources and sanitation sources respectively.

Figure 1 - Percentage of population with improved drinking water source, 1990-2008.

Source: http://www.undp.org/content/undp/en/home/librarypage/mdg/mdg-reports/africa-

collection.html

Figure 2 - Percentage of population with improved sanitation, 1990-2008.

Source: http://www.undp.org/content/undp/en/home/librarypage/mdg/mdg-reports/africa-collection.html

Figure 2 portrays how SSA made very little progress towards achieving the sanitation goal. However, many SSA countries made great improvements in their percentage of the population with access to an improved water source (figure 1). Despite increases in access to improved water sources, water still remains inaccessible to much of the population.

The two figures also show how regional differences need to be highlighted, and SSA should not be generalised. Not all SSA countries missed the targets greatly, for some countries there have been great successes. In 1990, only 43% of Ghana's rural population had access to an improved drinking water source, by 2006 this had almost doubled to 80% of the rural population. Also, 93% of the Senegalese population living in cities had access to improved water in 2006. As you can see it was not all doom and gloom for SSA countries, however, for the many countries who did not meet the targets, there are a variety of potential reasons.

Why did it go wrong?

There is a multitude of reasons as to why SSA did not meet the MDGs for both water and sanitation, below I have addressed the reasons I felt were crucial in SSA being unable to meet the MDGs.

Urban-rural divide.

The MDGs did a great job in reducing urban and rural disparities, however, the difference between the urban and rural is still great across access to both improved water and sanitation sources. In some rural areas of SSA, 40% of the population still relies on surface water, they have very little access to stand posts and water facilities, something which has barely improved over the last fifteen years. Conditions for sanitation in rural areas within SSA is in a far worse condition, as sanitation is deemed not as important as access to safe drinking water, meaning that the rural areas have lagged greatly behind urban areas. With still more than one-third of the population, mostly in rural areas, continuing to defecate in the open, rural SSA has a long way to go to catch up with the urban.

The cost of water. 

Implementing infrastructure and water provisions is a costly business, so much so that spending on the water sector in SSA is currently $3.6 billion a year, which is only one-fourth of what is required. For low-income countries, this high cost for improving water and sanitation sources seems even greater. SSA countries have received donations from many countries and NGOs, which has helped fund capital costs, however, many countries are still faced with maintenance costs, which can be upwards of 2% of GDP, which may not sound like a lot, but when coupled with other issues that require a great deal of spending and weaknesses in budgeting processes, it is a large expenditure for low-income countries.

Inefficiency

The third reason why SSA was unable to meet MDG 7 is due to and the cost of inefficiencies. It was reported that in 2010 approximately $2.7 billion was being wasted as a result of inefficient practice.  One of the greatest inefficiencies faced in SSA is the under-pricing of water services. In order for SSA countries to reach the cost-recovery threshold, they need to price a cubic meter of water at $1.00, however, average water tariffs are around $0.67 per cubic meter, resulting in an annual $1.8 billion loss in revenues. This loss has resulted in a reduction of investment in maintenance and enhancement of sanitation facilities in SSA. It is estimated that if all inefficient practices in SSA's water and sanitation sectors are eliminated, there would still be an annual $7.8 billion (1.2% of GDP) gap in finance.

Were the MDGs too ambitious?

Some believe SSA was set up to fail, the MDGs were made based on 1990s data. SSA had weak initial conditions in 1990, coupled with the unprecedented urbanisation and high population growth, which was far greater than anywhere else in the world, challenged SSA to meet the MDG targets.

Achieving the MDG for water and sanitation in SSA required an additional funding of $16.5 billion annually, which is around 2.6% of Africa's GDP - this level of funding often wasn't achievable for many of the SSA nations. 

In order for every country in the world to have met all 8 MDGs, it would have required an increase in global aid levels by $50 billion per year. Scholars have argued that this was a toxic way of looking at the MDGs, as it placed a heavy focus and reliance on aid, rather than countries being able to achieve the goals on their own accord, and frequently use the view that 'no amount of aid will make Africa grow at 7%' (Clemens and Moss, 2005:2). It is seen that the MDGs were too ambitious for many countries to financially achieve.

Future

SSA failing to meet the MDGs for water and sanitation was not because they failed, or there was a lack of effort, nor was that aid wasted, but perhaps because SSA is missing sustained support, 'development is a marathon, not a sprint' (Clemens and Moss, 2005:4). Perhaps the MDGs were designed not to be precisely met, but maybe a tool to improve conditions in some of the world’s poorest countries, which has happened.

The Sustainable Development Goals (SDGs) are the future in reducing poverty. Having learnt from the success and failures of the MDGs, the SDGs are far more scientific, specific and measurable than the MDGs. The SDGs will be addressed in further detail later on in this blog series.

Millennium Development Goals - part 1

The Millennium Development Goals (MDGs) came to an end in 2015. There was a hope globally that poverty and other issues would be alleviated. Despite the MDG's achieving many of its aims it fell short on water and sanitation, especially in sub-Saharan Africa. As the Millennium Development Goals is a large topic, I will divide my discussion across two blog posts. This week's blog will be focusing on what the MDGs aimed to do with water and sanitation, and why. Next week's blog will focus on what happened. I will then also begin to discuss possible reasons as to why advances in water and sanitation were unsuccessful in Sub-Saharan Africa. 

The United Nations Millennium Development Goals consisted of 8 goals which were designed to be achieved by all countries worldwide. Figure 1 below illustrates the 8 goals. 

Figure 1

Source:

http://un.dk/about-the-un/the-mdgs 

In 2015 the United Nations summarised all that the Millennium Development Goals had achieved in a report. Below I have bullet-pointed a handful of the Millennium Development Goal's greatest successes:

• The number of people living in extreme poverty declined more than half, from 1.9 billion in 1990 to 836 million in 2015.
• Worldwide maternal mortality has fallen by 45% since 1990.
• Gender parity in a majority of countries has been achieved at primary school level. 
• 2.1 billion people worldwide gained access to improved sanitation 
• And finally, 147 countries met the MDG target for the drinking water target, 95 countries met the target for improved sanitation, and 77 countries were able to meet both targets. 

Whilst I could dedicate an entire blog to the Millennium Development Goals, this blog is focusing on water and sanitation in Africa. Therefore, the Millennium Development Goal which is of most use to this blog is MDG 7, 'Ensure Environmental Sustainability'. 

MDG 7, Ensure Environmental Sustainability, was governed by four main targets:

• Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources.
• Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss.
• Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation.
• By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers.

The MDG's recognised the importance of clean and safe water as a vital component of health care, considering it to be one of the most critical instruments in saving lives (Mabugu, 2008). MDG 7 highlighted that water is a fundamental part of human life, a basic human right, this resulted in the MDGs working to increase the number of people with access to an improved water supply and an improved sanitation supply (Mabugu, 2008). This involved creating guidelines on what was suitable water for safe consumption and also resulted in the creation of information networks, which spread knowledge about how people can treat and store water safely and effectively (World Health Organisation, 2013). The Millennium Development Goals helped put water and sanitation on the development agenda (Anand, 2008).

In 1990 the percentage of the population with access to an improved drinking water source was 76%, by 2015 it had increased to 91%, this was above the MDG target, which was reached in 2010 (Figure 2). The MDGs was a great success in ensuring the provision of improved water sources globally, unfortunately, these statistics only represent a worldwide scale, there are still significant geographical differences in results (Anand, 2008). In 1990, 48% of the Sub-Saharan African population had access to improved drinking water sources, and by 2015 this had risen to 68%, falling under the MDG target of 75% for the region (Figure 2). Unfortunately, sanitation globally and in Sub-Saharan Africa has performed worse. 

Figure 2 

Source:  http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf 

In 1990 the percentage of the population with access to an improved sanitation facility was 54%, this later increased to 68% in 2015 (Figure 3). However, there were still 2.4 billion people worldwide without adequate sanitation, meaning the world did not meet the MDG target for sanitation (United Nations, 2015). When looking at statistics for Sub-Saharan Africa the reality becomes bleaker. In 1990 only 24% of Sub-Saharan Africans had access to an improved sanitation source, and by 2015 this had only increased to a measly 30%, well below the 2015 target of 65% (Figure 3). 

Figure 3 

Source:

http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf 

The Millennium Development Goals were supposed to help reduce global poverty, but have been very poor in providing results for water and sanitation in Sub-Saharan Africa. Next week's blog will be looking at what went wrong, and why Sub-Saharan Africa lagged behind so many other regions.