‘Law needed to end ill health cycle’

Legislation on sanitation twined with affordable technologies can prevent ‘the cycle of ill health and poverty’ of a country by improving its sanitation and hygiene, says a global health and sanitation analyst.

Yael Velleman, Senior Policy Analyst (Health and Sanitation) of UK charity WaterAid , said on Monday that legislation, affordable technologies and changed behaviour can make a difference in countries that still cannot ensure sanitation for all.

She put stress on investment in the field to reduce illness while talking to bdnews24.com in Kathmandu just a day before the formal launching of the year-long campaign to pressurise South Asian governments to live up to their sanitation promise.

WaterAid says nearly 1 billion of the total over 1.6 billion people do not have access to safe latrines in the region, where respiratory infections and diarrhoea are major under-five killers.

But it says the budgets are poor for improving the standards of sanitation, despite the fact that governments of these countries have made commitments in all high-level meetings to ensure sanitation for all.

“Legislation on sanitation is very important to make sure that standards are being implemented,” Velleman said.

She said in many countries people migrate to cities from rural areas and rent their accommodation. “They don’t own the houses. They don’t own the lands. So they cannot dig a latrine. It’s not really just up to them to improve sanitation standards. The landlords have to comply with those legislations.

“And if you don’t have any legislation you can’t make them (landlords) comply,” she said.

At the same time, she said, the technologies for improving sanitations should be made affordable.

“What we don’t want to happen is penalising poor people who can’t afford it therefore can’t implement. You need both. You need the legislation, you also need affordable technologies and you need the promotion to change behaviours. All these approaches together can really make a difference,” she said.

The campaign launching brought together various organisations, civil society representatives and parliamentarians of Bangladesh, India, Pakistan, Nepal and Sri Lanka to raise a collective voice for sanitation for all.

A citizens’ charter is being developed to be placed at the SAARC Secretariat on Tuesday along with a joint statement issued by the parliamentarians.

WaterAid analyst Velleman said without the government taking the sanitation issue seriously and putting the legislation and infrastructure in place, “you can’t really achieve progress on sanitation.”

The government needs to invest in sanitation-related infrastructure also, she said.

She referred to the Britain’s Public Health Act 1875, which was enacted to get rid of the filthy urban living conditions that caused spread of many diseases such as cholera and typhus.

The law required all new residential construction to include running water and an internal drainage system. It also meant that public health authorities had to have a medical officer and a sanitary inspector to ensure that the laws on food, housing, water and hygiene were being gone by.

As Bangladesh boasts about its significant reduction in maternal and child mortality among the developing nations, Velleman said ‘mortality is only one part of the issue.’

“Once you have good health services, you can reduce mortality. The problem is morbidity. The children are still getting sick.”

As Bangladesh’s 41 percent stunting rate is considered one of the highest in the world, she said it is related to water, sanitation and hygiene.

“They (children) have worm infections. They have diarrhoea. They have all the situations that don’t allow them to absorb the food they eat. Even if you have good food and good health services, but don’t have good sanitation and hygiene, kids are still going to get sick.”

“They might not die. But they won’t grow, they won’t develop their cognitive abilities, they won’t do well at schools. They will be unwell when they will get older. The condition affects their economic progress that impacts their children as well,” she said adding: “It’s the cycle of ill health and poverty that we need to prevent.”

“Bangladesh definitely made a lot of progress to reduce mortality. Now they need to work to reduce illness,” she said calling for investing more on sanitation and making concerted efforts.

“In Bangladesh currently there is a process of finalising a National Nutrition Action Plan and to make this kind of plan successful, it’s not enough that only the Ministry of Health will work alone. It needs Ministry of Water and Sanitation, Ministry of Local Government and others to make sure that all different components are there.”

Briefing media about the launching, Mustafa Talpur, South Asia Regional Advocacy Manager of WaterAid, on Monday said they would call upon the governments to increase budgets for sanitation and to ensure that it reaches those who really need.

Donors’ will be urged to double their investment in South Asia and the civil society organisations working on health and education will be called upon to include sanitation in their agenda for getting maximum results of their programmes.

During the year-long campaign, they will collect signatures for ensuring right to sanitation before a South Asian conference on sanitisation at the end of this year.