UN report: ‘Around 110 children die of diarrhoeal diseases every day’

Polio, cholera spread directly linked to open defecation, lack of toilets, poor personal hygiene: UNICEF RD

ISLAMABAD: Around 110 children under the age of five die every day from diarrheal-related diseases in Pakistan, which is often attributed to poor sanitation.

Pakistan has, however, successfully met the Millennium Development Goal (MDG) for sanitation by halving the proportion of population without sustainable access to basic sanitation from 76 per cent in 1990 to 36 per cent in 2015, according to a UNICEF progress report 2013-15.

The report underlines that 64 per cent of Pakistanis were now using improved sanitation facilities and Pakistan was among the 95 countries in the world to meet the global targets for sanitation.

In an interview with The Express Tribune, UNICEF Regional Director Karin Hulshof shared the success of the Pakistan Approach to Total Sanitation (PATS), which is a government of Pakistan-led approach supported by the UNICEF in promoting the new ‘no open defecation’ mindset in the country.

“In Pakistan, over the last 10 to 15 years, there have been many disasters taking place and to improve the lives of children, we chose six areas. One area is handling sanitation and open defecation and somehow just a couple of years ago, it seemed that the time was right and communities were also demanding for toilets and safe-drinking water,” she said.

Hulshof said that she had learned that over the years in Pakistan, if it was a community people’s-driven demand, it was much more likely that the governments were willing to invest in the needs of the people, referring to PATS which is a community-based programme.

She said that the federal and provincial governments saw the benefit of investing in safe drinking water and also to support the clarity on the importance for people to use toilets. “If we look at the spread of many viruses like polio and cholera, it is directly linked to open defecation, lack of toilet use and lack of hand-washing soap so once the governments and authorities were ready to respond to the demands of the people, it became a movement,” Hulshof said.

She said that even in remote and far-flung villages, there was a sense of aspiration and upward social mobility and dignity for particularly girls and women that they do not need to wait until it is dark to get out and go to relieve themselves but to be able to go at the time they need to go to the toilet.

“A total of 24 million people are still defecating in the open, it is not achieving the MDG that this is all for - the aim is to accelerate now so that as soon as possible, there is no more open defecation and it is possible, if we look at the urban areas including the slums, only 1 per cent goes for open defecation while in rural areas, it is more than 10 per cent,” said Hulshof.

When PATS started, 43 million people were defecating in the open and a global report that came out two weeks ago showed that 25 million people were still practicing open defecation. “So that’s a decline of 18 million individuals and that’s a huge leap forward but we are doing our work and that is not finished yet.”

While taking about millions of people who do not have access to clean drinking water or toilets, Hulshof said that most likely these were the people that were not only deprived of the services, but there were also millions of people who were facing hardship in accessing health services including polio vaccination and routine immunisation.

Hulshof said that while it was ideal to work at community, village and household levels, it was not possible for the government to reach every household. “Toilets are expensive, but what you spend on toilets, you save on the cost to address diarrhoea, cholera, and polio, so it is a direct return on investment.”

Published in The Express Tribune, August 2^nd, 2015.