India is undertaking an ambitious initiative to upgrade its sanitation system nationwide, attempting to give every house and school access to a modern toilet by 2019. Countries around Asia are grappling with the same issue.
In Asia and the Pacific, there are more than 1.7 billion people without access to improved sanitation and 780 million people who still engage in open defecation. This has a profound impact not only on health but also on human dignity.
Women and children are particularly hard hit when they have poor access to modern toilets. About four percent of all maternal deaths are linked to poor hygiene and sanitary conditions, and women who live in households with poor sanitation are more than three times more likely to die than those who live in more sanitary conditions.
The issue can even result in violence toward women. In one case, two women in India were allegedly raped and eventually murdered in Uttar Pradesh state while seeking a discreet place to defecate.
To address the issue, governments in Asia and the Pacific need to invest an estimated $71 billion. International organizations and governments will need to partner with private companies and use innovative financing schemes to raise the money needed to solve the problem on a regional basis.
In addition to financing, the problem requires greater awareness of the issue and initiatives that encourage behavior change. On a broader scale, g governments need to look at new approaches to addressing the issue, along with other public services, according to Changyong Rhee, ADB’s former Chief Economist.
“Access to services such as clean water, sanitation, health care, and schooling is an essential ingredient of personal well-being, economic development, and long-term growth,” he said. “Empowering communities can certainly improve service delivery, but this needs to go hand-in-hand with a change in the way the state does business.”
This will involve state institutions being more responsive to people’s demands for modern services and more focused on delivering what is needed to those who need it most. This includes better use of communications and contracting out some services to private companies and non-government organizations, according to the study Empowerment and Public Service Delivery in Developing Asia and the Pacific, which looked at sanitation as well as other public services.
Some solutions to Asia’s sanitation challenges might be as simple as rethinking the design of the toilet, according to Michael Hoffman, Professor of Environmental Science at the California Institute of Technology and winner of the Reinvent the Toilet Challenge that was set by the Bill and Melinda Gates Foundation.
Though the approaches to the problem are varied, a consistent feature needed for all solutions is the concept that people need to share in the cost of sanitation improvements and to pay for sanitation services, in order to make improvement last over the long term.
Sanitation initiatives around Asia and the Pacific
Countries around Asia and the Pacific are using different strategies and approaches to address the challenges of sanitation and hygiene.
“Countries around Asia and the Pacific are using different strategies and approaches to address the challenges of sanitation and hygiene.”
In Nepal, the government is tackling the water and sanitation challenges in 26 small towns to not only improve community health but also reduce the risk and impact of floods.
In Bangladesh, a program in the city of Dhaka is providing on-site sewage treatment facilities as part of a new approach to finding a long-term solution to waste treatment, while another initiative is helping to create model towns for sanitation that can be replicated nationwide.
In Myanmar, some small communities are building their own latrines with support from the government and international organizations.
In Samoa, the twin issues of sanitation and drainage are being addressed in the city of Apia. Though most people have access to modern toilets in the city, flooding was pouring raw sewage into the streets, making the flood water a health hazard in addition to the other problems it created.
In Kiribati, where remote communities have limited access to fresh water, communities are using innovative septic tank “sludge digesters” to keep sewage away from the water supply and the community. The goal is to reduce infant mortality due to diarrhea by 50 percent by 2021.
Can Asia work together to solve the gargantuan sanitation issues it faces? Vote in the poll and follow the issue on ADB’s Twitter pages for water at @ADBWater and for wastewater at @ADBWastewater.
