Access to sanitation is a fundamental human right that guarantees bright future and safeguards health and human dignity, especially for women and children.
As we celebrate 30 years of the signing of the Convention on the Rights of the Child (CRC), the most rapidly and widely ratified international human rights treaty in history, Unicef joins the world and the Government of Pakistan to commemorate the World Toilet Day (WTD) on the 19th of November 2019. Pakistan was one of the first countries to ratify the CRC.
This year, WTD’s theme of “Leaving no-one behind” reminds us that access to sanitation should be made universal regardless of race, colour or socioeconomic status. The theme resonates well with Prime Minister Imran Khan’s Clean and Green Pakistan initiative.
The right to sanitation is enshrined in the CRC. According to the Human Rights Watch, lack of access to sanitation can undermine the rights of others, including the right to education, health, decent work, and gender equality.
The Alma-Ata declaration of 1978 recognised safe sanitation as an indispensable element of disease prevention and of primary healthcare programmes. It isolates faeces from the environment thereby breaking the faecal-oral transmission pathways associated with open defecation (OD) that would otherwise lead to significant disease burdens. Availing sanitation facilities leads to time-saving, comfort, increased productivity, greater safety and a higher social status.
According to the Unicef/WHO Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) Report 2017, more than 20 million people defecate in the open in Pakistan. Close to 40 million people use makeshift latrines which lack dignity and protection raising safety issues for children and women. Nearly 200 million people lack access to safely managed sanitation. Effluent from the sanitation systems is discharged into the environment or non-functional centralised sewer systems.
Lack of access to safe sanitation increases the risk of diarrheal diseases, especially for children. These include serious infections such as polio and cholera. According to Val Curtis, the director of the London School of Hygiene and Tropical Medicine, every year more than 750,000 children die of gastrointestinal infections in the world due to lack of toilets.
In Pakistan, 22.5 per cent of infant deaths are due to diarrhoea. According to the 2018 Demographic Health Survey, diarrhoea is more prevalent among children whose households lack basic sanitation. The same survey reported that 37.6 per cent of children in Pakistan are stunted while 23.1 per cent are underweight. All these are associated with a lack of safe sanitation facilities for all in the country.
Women and girls are the hardest hit by this. They usually wait until after dark to defecate making them vulnerable to harassment and assault. Girls also commonly miss out on education if school sanitation including menstruation and hygiene management facilities are inadequate.
The sick and the elderly face special difficulty and a loss of dignity due to the lack of sanitation facilities. This loss of dignity is especially acute for elders, for whom honour and respect are important.
Poor sanitation has an economic cost too. The World Bank estimates that poor sanitation costs Pakistan 3.94 per cent of its GDP, which is about US$ 5.7 billion per annum.
As we commemorate the World Toilet Day this year, I am encouraged by the Government of Pakistan’s efforts in ensuring access to basic sanitation for all through the Clean and Green Pakistan initiative. However, the government and partners need to increase funding for sanitation. The 2017 JMP report estimates that almost 820 latrines need to be constructed per day to achieve an open defecation free Pakistan by 2030.
I would like to reiterate Unicef’s commitment to end open defecation in Pakistan. Unicef and sanitation partners will continue to support the government to implement Pakistan’s Approach to Total Sanitation (PATS) to eliminate open defecation by 2025, the Three Star Approach in schools to ensure availability of sanitation facilities among students and the Water, Sanitation and Hygiene (WASH) in health care facilities to reduce the risk of disease.
Cognizant of Pakistan’s vulnerability to disasters, including earthquakes, floods and droughts, Unicef will continue supporting the government’s disaster management authorities. The efforts will be aimed at assisting communities in preparing and coping with the effects of disasters on WASH facilities while promoting disaster reduction as a key component of programming.
I would like to conclude by calling upon all stakeholders to act within their own means to ensure that everyone has access to sanitation services that provide privacy and dignity by ensuring they are physically accessible, affordable, safe, hygienic, secure, and socially and culturally acceptable.
Published in The Express Tribune, November 19th, 2019.